Multicenter retrospective investigation and analysis of the rationality of the application of human albumin in cardiac surgery during the perioperative period / 药物流行病学杂志

Objective To investigate the clinical application of perioperative human serum albumin(HSA)in cardiac surgery in multiple regions in China,and to evaluate the rationality of its clinical application in conjunction with the clinical guidelines,in order to provide a reference for promoting the rational application of HSA.Methods The medical records of patients who underwent cardiac surgery from April to June 2019 in eight hospitals across the country were retrospectively collected.The statistical information on patients'general information,the dosage,course of treatment,and cost of HSA,and the serum albumin level before and after medication was analyzed to evaluate the use of HSA.Relevant evaluation criteria were established,and the rationality of its medication was evaluated.Results Data from a total of 449 patients were included for analysis,the appropriate rate of medication was 81.1％.The course of medication was mostly＞2-5 days and the total amount of HSA was mostly 50-99 g.The main purpose of medicaiton were improving colloid osmotic pressure,reducing exudation to improve interstitial edema,postoperative volume expansion.Conclusion Clinical attention should be paid to ensure the rational application of HSA in cardiac surgery during the perioperative period and prevent the abuse of blood products.

Medication Analysis of Electrolyte Disturbance with Suspected Deteriorated Demyelination Post PCI / 医药导报

Objective A case would be discussed on suspected demyelination due to electrolyte disturbance to provide references for clinical pharmacists to carry out pharmaceutical care. Methods A pharmaceutical care case on PCI postoperative acute heart failure and contrast induced nephropathy with suspected demyelization due to electrolyte disturbance was introduced through a combination of analysis on clinical symptoms,renal function,electrolyte,blood glucose level and further discussion on consciousness change reason, diuretic use, electrolyte management, and other related issues. Results Clinical pharmacist should provide more care to patients with abnormal blood sodium and osmotic pressure,pay more attention to the calculation and evaluation of rehydration sodium/filling quantity and speed, accumulate more knowledge of contrast induced nephropathy, and raise their awareness on the identification of high risk population. Conclusion Arrhythmia,heart failure,renal failure,infection can beincentives to one another,and thus doctors and pharmacists must pay more attention to the comprehensive situations.

Effect of Short-term Application of Atorvastatin Combined with Ezetimibe on Lipid-lowering Efficacy and Related Indicators of Patients with Nephrotic Syndrome with Hyperlipidemia / 中国药房

OBJECTIVE:To explore the effects of short-term application of atorvastatin combined with ezetimibe on efficacy and related indicators of patients with primary nephrotic syndrome with hyperlipidemia. METHODS:Data of 50 patients with prima-ry nephrotic syndrome with hyperlipidemia were retrospectively collected and divided into combination group and control group ac-cording different treatment,25 cases in each group. All patients received low-salt,low-fat ,high-quality protein,giving prednisone 1 mg/(kg·d),po,qd,combined with anticoagulation,diuretic,anti-infection,taking cytotoxic drugs if necessary. Based on it, control group received Atorvastatin calcium tablet 20 mg before going to bed,qd;combination group received Atorvastatin calcium tablet(the same dosage and usage with control group)+Ezetimibe tablet 10 mg,qd. They were treated for 2 weeks. Lipid-lowering efficacy and low-density lipoprotein(LDL-C),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C),24 h uri-nary protein (M-TP),serum albumin,alanine aminotransferase (ALT),aspartate aminotransferase (AST),serum creatinine and blood urea nitrogen before and after treatment in 2 groups were observed and the incidence of adverse reaction was recorded. RE-SULTS:There was no significant differences in the total effective rate of Lipid-lowering in 2 groups(P>0.05). After treatment, LDL-C,TC and HDL-C in 2 groups were significantly lower than before,Alb in combination group and ALT in 2 groups were sig-nificantly higher than before,with statistical significance(P0.05). And there was no significant difference in the TG,M-TP,AST,serum creatinine and blood urea nitrogen before and after treatment(P>0.05). CONCLUSIONS:Atorvastatin combined with ezetimibe can improve the blood lipid of patients with primary nephrotic syndrome with hyperlipidemia,while showing similar efficacy and safety with atorvastatin alone in a short term.

Meta-analysis of Fasudil Hydrochloride Injection in the Treatment of Aneurysm Postoperative Cerebral Vasospasm / 中国药师

Objective:To evaluate the curative effect and safety of fasudil hydrochloride injection in the prevention and treatment of aneurysm postoperative cerebral vasospasm by meta-analysis. Methods: The randomized controlled trials were retrieved from PubMed, EMBASE, Cochrane Library, VIP, Wangfang, CNKI and so on. Meta-analysis was conducted using RevMan 5. 0 software. Results:Totally 418 reference studies were screened, from which 11 ones were chosen including 786 patients in all. In the treatment of cerebral vasospasm (CVS), there was no significant difference between the groups (OR=1. 56, 95%CI:0. 95-2. 58, P>0. 05). While in the prevention of CVS, the incidence rate of CVS in fasudil group was significantly lower than that in nimodipine group ( OR=0. 43, 95%CI:0. 23-0. 81, P=0. 008). However, the incidence rate of ADR in fasudile group was higher than that in nimodipine group (OR=0. 43, 95%CI:0. 25-0. 75,P=0. 003). Conclusion:In the prevention of CVS, fasudil may be better than nimodipine, while the incidence of ADR is higher.

Pharmaceutical Care for a Patient with Anti-N-methyl-D Aspartate Receptor Encephalitis Complicating with Multiple Organ Infections / 中国药房

OBJECTIVE:To explore the methods of clinical pharmacists providing pharmaceutical care for a patient with N-methyl-D-aspartate receptor(NMDAR)encephalitis complicating with multiple organ infections. METHODS:Taking one clinical case as breakthrough point,the points of pharmaceutical care provided by clinical pharmacists for NMDAR encephalitis complicat-ing with multiple organ infections were analyzed,so as to put forward the suggestions in the field of antibiotics selection,medica-tion approach based on pharmacokinetics,ADR disposal and nutrition support. RESULTS:Clinical pharmacists applied pharmaceuti-cal care to resolve ADR as abnormal liver enzyme timely,and the symptom had been improved gradually. Then the patient was dis-charged from the hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care and screen the possible risk of drug use to avoid the occurrence of severe ADR.

Pharmaceutical Care on Patients with Coronary Heart Disease and Renal Insufficiency / 医药导报

Objective To explore the pharmaceutical care plan of clinical pharmacist for elderly patients with coronary heart disease and renal insufficiency. Methods To develop the therapeutic schedule in cooperation with clinicians through clinical rounds, in order to offer specific pharmaceutical care and further develop individualized care plan during patient ' s hospitalization. Results Clinical pharmacists paid close attention to the indicators and adjusted administration time when the adverse reactions such as lower blood pressure, leukopenia, and deterioration of renal function occurred, and finally avoided further potential adverse reactions. Conclusion The incidence of adverse drug reactions were reduced, the safety and efficacy of drugs used were guaranteed, which can promote rational and effective use of drugs in clinic. The overall quality of healthcare was improved with pharmacist involvement.

Determination of plasma level of ferulic acid in Xinshu Oral Liquid by HPLC and its in vivo pharmacokinetics in rats / 中草药

Object To develop an HPLC method for the determination of plasma level of ferulic acid and study the in vivo pharmacokinetics in rats. Methods The used analytical column was Nucleosil C_ 18 . The mobile phase was methanol-water-acetic acid (35∶65∶0.1). The flow rate was 1.0 mL/min and detection wavelength at 320 nm. Plasma samples were prepared for analysis by addition of internal standard (Tinidazole) followed by extracting with ethyl acetate. Results Linear caliration curve was obtained by plotting concentration vs peak area ratio over the rang 0.25—16.0 mg/L with a correlation coefficient of 0.999 2. The average recovery of ferulic acid was 96.9%—100.6%. The minimum detectable concentration of ferulic acid was 0.2 mg/L. The relative standard deviations for within-day and between-days were less than 3.0% and 5.3%,respectively. The plasma concentration-time curve of ferulic acid in Xinshu Oral Liquid ig given to rats was found to fit a two-compartments model with T_ 1/2? of 12.6 min and T_ 1/2? of 305 min. Conclusion The method is simple,rapid,accurate,and precise, which can be used for the determination of plasma level of ferulic acid and the study of its pharmacokinetics.

Preparation and Clinical Observation of Sterilized Medical Bone Wax / 中国药房

OBJECTIVE:To prepare the sterilized medical bone wax and to establish the standard of quality control.METHODS:The bone wax was identified with chemical approach and the quality of bone wax was evaluated by saponification value.RESULTS:The bone wax was appropriate in formula,feasible in preparing technique and satisfactory in therapeutic efficacy with a satisfication rate of 98%.CONCLUSION:There are no obvious differences between the bone wax developed by our hospital and imported bone wax in quality,therefore the prepared bone wax can take the place of imported products.

Evaluation on Biological Compatibility and Hemostatic Effect of Sterilized Medical Bone Wax on Bone Wound / 中国药房

OBJECTIVE:To evaluate the biological compatibility and clinical therapeutic effect of the medical sterilized bone wax.METHODS:Embedding test and pathological test as well as hemolytic test were performed by using rabbits as test animal.12531case-times were investigated in respect to the therapeutic effect,prognosis and satisfactory rate.RESULTS:The embedded bone wax was coated by connective tissue and has not been absorbed without surrounding inflammation,edema or necrosis.The bone wax could not be absorbed after stanching bleeding of the bone broken surface.No hemolytic phenomena were observed.The wound healing obtained a satisfactory rate of99.1%.CONCLUSION:The sterilized medical bone wax has good biological compatibility and is safe and effective to stanch bleeding.It is convenient to use due to its singer dose sterilized packaging.