With the development of clinical pharmacy in hospital,the demand for pharmacy intravenous admixture services (PIVAS) has been gradually increased.By being built inside the pharmacies,PIVAS of this hospital has created a full range of integrated pharmacy service platform.With independent research and development of information management system,innovative design of the modules and equipments based on the concept of internet of things,and integration of artificial and computerized checking,PIVAS of this hospital has formed a system of prevention and control chain,it has been deepening the connotation of clinical pharmacy services,and providing higher quality pharmacy services to clinical drug using.
Objective To investigate the effects of icariin (ICA) on partial vasoactive substances in monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) rat model. Methods Sixty male SD rats were randomly divided into five groups:normal control group,model control group,ICA low-,middle- and high-dose(20,40,80 mg·kg-1·d-1) group,12 rats in each group.Except for normal control group, the rats were injected with MCT (50 mg·kg-1·d-1) to establish PAH model.After 1 week MCT-injection,ICA was given by intragastric administration for 3 weeks according to different groups.Mean pulmonary artery pressure (mPAP) was recorded through catheter connected with Power Lab system.Except for normal control group, the right ventricular hypertrophy index (RVHI) was calculated using formula:right ventricle weight/the weight of left ventricle with septum×100%.The morphology of lung artery was assessed by HE staining.Concentration of angiotensinⅡ(AngⅡ),endothelin (ET),prostaglandine F2α (PGF2α),thromboxane A2(TXA2) and prostacyclin (PGI2) in serum was measured by ELISA kit assay.The protein levels of angiotensin converting enzyme (ACE),cyclooxygenase-2 (COX-2) and thromboxane A2 synthetase (TXAS) were analyzed by Western blotting,expression of ACE,COX-2 and TXAS mRNA was measured by real time RT-PCR. Results Compared with the normal control group,mPAP [(48.5±5.2) mmHg] and RVHI (33.3±3.8)%in model control group were significantly increased (P<0.05),the morphology revealed there was obvious artery remodeling at distal artery,the contents of AngⅡ,PGF2α,TXA2 in serum were elevated,and ACE,COX-2 and TXAS gene expression was up-regulated in rats treated with MCT.ICA (40,80 mg·kg-1·d-1) treatment significantly attenuated mPAP,RVHI and pulmonary artery remodeling (P<0.05),and decreased the contents of serum AngⅡ,ET,PGF2α,TXA2,and PGI2,and inhibited the gene expression of ACE,COX-2 and TXAS. Conclusion ICA decreases the contents of AngII,ET,PGI2,PGF2α and TXA2 in the serum of MCT-induced PAH rats,which may be one of the mechanisms underlying ICA inhibiting PAH.
Objective To explore absorption kinetics of roxatidine acetate hydrochloric (ROX) in intestine of rats. Methods The absorption kinetics and permeability of ROX under different concentrations and different intestinal segments were investigated by double wavelength spectrophotometry via the in situ perfusing method in rats. Results There was no significant difference in Ka of ROX under different concentrations.The absorption rate in rats descended in order of duodenum,jejunum,ileum and colon [(3.87±0.12)×10-2,(2.53±0.18)×10-2,(1.43±0.10)×10-2,(0.91±0.15)×10-2·h-1]. Conclusion The absorption of ROX in intestine complies with the passive transport mechanism and first order kinetics.ROX is well absorbed in the whole intestine.
Objective To explore the effect of 14,15-epoxyeicosatrienoic acids (14,15-EET) on the inflammatory response of BV2 cells under oxygen and glucose depriviation/reoxygenation (OGD/R) conditions. Methods BV2 cells were randomly divided into three groups,blank control group,vehicle control group,and 14,15-EET group.Under treatment of 14,15-EET,the concentration of inflammatory factor in BV2 cell culture media was detected by ELISA at different time points (reoxygenation for 0,3,6,12,24 h) after OGD1h.The viability of BV2 cells was detected by MTT assay at different time points.At the same conditions,using Transwell migration experiment,migration ability of BV2 cells was observed. Results The 14,15-EET group had the lower levels of inflammatory factor secretion,lower viability and weaker ability of migration than the vehicle control group.The above results were most statistically significant at OGD1h/R12h. Conclusion 14,15-EET can inhibit the inflammation of BV2 cells induced by the injury of OGD reperfusion.
Objective To select polyethylenimine polymer with proper molecular weight to enhance the gene expression efficiency of Adenovirus (Ad). Methods Ad was resepcitively complexed with PEI-600,PEI-1 800 and PEI 25 000 by electrostatic adsorption.Afterwards,MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay was used to investigate the cytotoxicity of the complexes with a serial concentration,followed by cell transduction assay to select the best amount of PEI with fixed dose of Ad.In the further,the physicochemical characteristics of the optimized complexes,Zeta potential,and size distribution were studied. Results MTT showed the higher the PEI moderate molecular weight was,the greater the cytotoxity was.PEI-25 000 showed a greater cytotoxicity than that of PEI-600 and PEI-1 800.As compared with PEI-600 and PEI-25 000,PEI-1 800 significanlty promoted expression of Ad gene in A549 cells.PEI turned the Zeta potential of Ad from negative to positive charge. Conclusion In the three kinds of polymer/adenovirus compounds,the cytotoxicity of the compound is positively correlated with the polymer molecular weight and concentration.The greater molecular weight the polymer as well as the higher the concentration are,the higher the cytotoxicity is.
Objective To study the inhibitory effect of curcumin on the proliferation,migration and invasion of non-small cell lung cancer cell A549,and to discuss further if it is closely related to the expression of c-Jun N-terminal kinase (JNK) and relative protein p38. Methods A549 cells were cultured by conventional method,and then treated with different concentration of curcumin (10,20,40,80 μmol·L-1).The proliferation,migration and invasion of A549 cells were measured by real-time cellular analysis (RTCA).The expression levels of JNK,p-JNK,p38 and P-p38 were detected by real-time PCR and Western blotting. Results Curcumin showed an antiproliferation effect against A549 cells with IC50=40 μmol·L-1,and curcumin exhibited obviously inhibitory effect on the migration and invasion of A549 cells.Additionally,compared with control group,curcumin suppressed the expression of JNK and p38 at the gene level,and significantly inhibited the expression of JNK,P-JNK,p38 and p38 (P<0.05) at the protein level. Conclusion These results demonstrated that curcumin can inhibit the proliferation,migration and invasion of A549 cells via reducing the level of JNK,p38 phosphorylation,and blocking JNK signal transduction pathway.
Objective To examine the inhibition effect of zoledronic acid (ZOL) on malignant metastasis of human esophagus squamous cell carcinoma (ESCC) cells and to analyze its molecular mechanisms. Methods EC9706 and EC109 cells were treated with ZOL,and then MTT assay,adhesion and invasion assay were performed to observe the inhibitory effect of As2O3 on proliferation and metastasis of esophagus carcinoma cells.The expression of metastasis-related proteins was detected by Western blotting. Results Exposure to ZOL significantly presented suppressive functions on growth and metastasis of both kinds of cancer cells,in a dose-dependent manner(P<0.05).Additionally,the expression level of occludin was increased after ZOL treatment by suppressing transcriptional factor Slug.Transfection of Slug could reverse anti-metastasis of ZOL. Conclusion ZOL possesses a significant anti-metastasis function on ESCC cells,mainly through repressing Slug to restore occludin expression.
Objective To study effect of bufalin on invasion and metastasis of gastric cancer cells and related mechanism. Methods AGS human gastric cancer cell line was used for in vitro experiments.Cultured cells were treated by negative control group, bufalin group and oxaliplatin group.Cell proliferation was determined by MTT.Invasion and metastasis were observed by Wound-Healing Assay and Transwell Assay.Expression levels of E-cadherin,matrix metalloproteinases (MMP)-2,MMP-9 were detected by Western blotting. Results Bufalin was found to significantly inhibit the proliferation of AGS cells in a dose and time dependent manner.Wound-Healing Assay and Transwell Assay showed that as compared with the blank control group,bufalin inhibited invasion and metastasis of AGS cells (P<0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P>0.05).Western blotting showed the expression of E-cadherin was increased in bufalin group as compared with the blank control group while the expression levels of MMP-9 and MMP-2 were down-regulated (P<0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P>0.05). Conclusion Bufalin has anti-cancer activity on gastric cancer cells,and it has the ability of inhibiting cancer cell invasion and metastasis,and regulating the expression of some related gene.
Objective To discuss the role of therapeutic drug monitoring (TDM) in pharmaceutical care by successful intervention of severe drug-drug interaction in 3 patients with hematological disease treated with voriconazole and rifampin. Methods Three patients with hematological disease were monitored for the plasma concentration of voriconazole before,during,and after the concomitant use of rifampin.The severity of this drug interaction was revealed,risks for developing invasive fungal infection and tuberculosis dissemination after chemotherapy were evaluated based on the TDM results,and alternative regimens were recommended. Results Voriconazole plasma concentration was normal at baseline but significantly depressed after combination with rifampin in all 3 cases.Concomitant use of rifampin leads to a rapid decline in plasma concentration of voriconazole in 2-3 days,and withdraw of this enzyme induction effect takes 8-10 days after discontinuation of rifampin. Conclusion TDM is a helpful tool for providing pharmaceutical care,it helps to objectively visualize the degree of clinically important drug-drug interactions.Clinical evidence together with TDM results suggests high risk for developing invasive fungal infection and tuberculosis dissemination in hematology patients while using this combination therapy.Discontinuation of rifampin was suggested and accepted.For these patients,combination of voriconazole and rifampin should be avoided.
Objective To evaluate the application and efficacy of 6S quality management methods in drug clinical trials of oncology department. Methods By using 6S (Seiri,Seiton,Seiso,Seiketsu,Shitsuke,Safety) quality management methods,quality about mastering level of good clinical practice (GCP) knowledge,sample collection and drug management etc.were controlled,and efficacy after the quality control was evaluated. Results After implemention of 6S quality management,rate of achieving GCP certificate was increased to 77.80%,accuracy rate of sample collection and accuracy rate of medicine preparation were increased to 100.00%,and the rate of relearning study protocol was increased to 100.00%,and subjects’ satisfaction was improved significantly. Conclusion The implementation of 6S quality management methods could effectively enhance the quality of drug clinical trials in oncology department.
Targeted therapeutic drug,having such advantages as targeting,safety,convenience,etc,is increasingly favored by non-small cell lung cancer (NSCLC) patients.At present,there are many kinds of molecular targeted drugs used in clinic,and remarkable efficacy was achieved,and the pain caused by conventional chemotherapy was avoided.At the same time,with the deepening of the understanding of the mechanism of tumor immune,new targeted drugs will also continue to be developed.The emergence of the third generation EGFR-TKI brings new hope for first generation EGFR-TKI resistant patients.Combined use of different immune therapeutic agents,combined application of immunotherapy drugs and cytotoxic chemotherapy drugs and radiotherapy,and the exploration of its predictive biomarkers will become a hot spot in the research of lung cancer.This will undoubtedly bring a new dawn for the treatment of NSCLC.Based on the domestic and foreign research literatures and related materials,this article reviews the latest research progress of various molecular targeted drugs for treatment of NSCLC.
Objective To compare the effect of enteral nutrition liquid with different dietary fiber content on serum protein in patients with stress hyperglycemia. Methods A total of 90 patients with stress hyperglycemia were randomly divided into three groups:enteral nutritional suspension (SP) group (Peptisorb),enteral nutritional suspension (TPF-FOS) group (Jevety) and enteral nutritional suspension (TPF-D) group (Glucerna),each group consisting of 30 patients.In the three groups,prealbumi (PA),serum albumin (ALB),retinol binding protein (RBP),transferrin (TRF) and hemoglobin (Hb) were continuously measured on the 1st,2nd,3rd,4th,5th,6th and 7th day.Data were analyzed by SPSS 15.0.Variances on time and group were analyzed by repeated measures of general linear model. Results The PA,ALB,RBP,TRF and Hb were significantly different among Peptisorb group,Jevety group and Glucerna group (P<0.05).The PA,ALB and Hb which were determined in different time,were not significantly impacted by Peptisorb,Jevety or Glucerna,and not significantly changed with time.The RBP and TRF which were determined at different time,were not impacted by Peptisorb,Jevety or Glucerna,but time×group from RBP and TRF which were determined in different time ,were significantly impacted in Peptisorb group,Jevety group and Glucerna group (P<0.01). Conclusion The content from different dietary fiber significantly affects serum protein in patients with stress hyperglycemia,and TPF-D has the most significant effect on serum protein.
Objective To evaluate the effect of caffeine citrate on oxygen metabolism in brain and intestine in premature infants with neonatal respiratory distress syndrome (NRDS). Methods Preterm infants aged 30-34 weeks with NRDS admitted in Guangzhou Women and Children's Medical Center during May 2015 and April 2016 were enrolled.They were administrated with maintainance dose of caffeine citrate at the 2nd day after birth.The oxygen metabolism in brain and intestine 1 h before,during and after the administration were recorded by near infrared spectroscopy. Results The cerebral oxygen saturation (ScO2) showed a less significant change before,during and after treatment.While a marked increase was seen in intestinal oxygen saturation (SsO2) during and after caffeine citrate administration,as well as the change of SsO2/ScO2 than before.SsO2/ScO2 was dramatical higher in infants with nasal continuous positive airway pressure (nCPAP ) than in those with incubator oxygen supply and mechanical ventilation during and after caffeine citrate treatment than before. Conclusion Caffeine citrate may improve the delivery of oxygen and may increase the oxygenation in local tissues for preterm infants with NRDS,especially for infants with nCPAP.
Objective To assess the effects of different doses of oxycodone hydrochloride on spontaneous breathing and consciousness level of patients,so as to provide theoretical basis for its clinical application.Sixty patients undergoing elective surgery were randomly divided into 3 groups:0.05 mg·kg-1 oxycodone group (group P1),0.1 mg·kg-1 oxycodone group (group P2),0.2 mg·kg-1 oxycodone group (group P3).Changes of respiratory rate (RR),end tidal carbon dioxide partial pressure (PETCO2),saturation of blood oxygen (SpO2) and bispectral index (BIS) were recorded in patients before injection (t0) and 1-15 min after injection (once per min);the Observer's Assessment of Alertness/Sedation Scale (OAA /S) were recorded.At the same time,the adverse reactions were observed after drug injection in each group. Results In 10 min after injection there were no significant differences in the RR,SpO2,PETCO2,BIS and OAA/S in group P1 as compared with those before injection (P>0.05).The patients had no respiratory depression in group P1.In group P2,RR had a significant decrease (P<0.05),BIS had decreased but were greater than 85;there were no significant differences in the SpO2,PETCO2 and OAA/S (P>0.05).The P2 group had 3 cases with respiratory frequency<10 per min,but SpO2 were all greater than 94%.In group P3,There were significant differences in the RR,SpO2,PETCO2,BIS and OAA/S (P<0.05).The P3 group had 12 cases of respiratory frequency <10 per min,at the same time there were 8 patients with SpO2 less than 94%.With the increasing dose,the frequency of respiratory inhibition increased,and there were statistical differences (P<0.05).In 15 min after injection,RR,SpO2,PETCO2,BIS and OAA/S were not significantly different in group P1 and P2 as compared with those before injection (P>0.05).In group P3,RR was significantly different after injection (P<0.05).There were no significant differences in the SpO2,PETCO2,BIS and OAA/S in group P3 after injection (P>0.05).No patients complained with chest wall stiffness,nausea and vomiting,cough and other adverse reactions in group P1 and P2.In group P3,three patients had nausea 5 min after injection,two patients complained of chest skin itching but no skin flushing. Conclusion With the increasing dose,effect of oxycodone hydrochloride on breathing and consciousness level of patients gradually increased.Injection of oxycodone hydrochloride 0.05 mg·kg-1 had no obvious effect on breathing and consciousness.After injection of oxycodone hydrochloride 0.1 and 0.2 mg·kg-1 for 5 to 10 min,respiration inhibition and sedative effect were the most obvious.Fifteen min after injection,the 0.1 mg·kg-1 dose group recovered to the level before,the respiratory rate of the 0.2 mg·kg-1 dose group was still lower than that before the injection.
Objective To development a cooling crystallization process that is suitable for industrial preparation of purified dihydromyricetin. Methods Screen design was used to investigate effects of process parameters such as,temperature,concentration ethanol aqueous,quantity of activated charcoal and adsorption time on yield and purity of dihydromyricetin.Purity was verified by high performance liquid chromatography and thin layer chromatography.The solubility of dihydromyricetin in water at viable temperature and ethanol proportion was also determined by UV spectrophotometry.The solid form was characterized by thermal analysis and powder X-ray diffractometry. Results When temperature was >85 ℃,ethanol concentration <10%,dosage of activated charcoal 0.1%-0.3%,and adsorption time 1-3 min,yield of dihydromyricetin was more than 70%,and the purity greater than 98%.The crystals,prepared by cooling crystallization from water and ethanol aqueous,had the same physical form and crystal habit. Conclusion Cooling crystallization from low concentration of ethanol aqueous gets higher yield and the process is more robust than crystallization from water.
Objective To compare the dissolution curves of metronidazole tablets from 38 national manufactures and original drugs of Britain in four dissolution mediums,and provide the reference for the quality and clinical effect consistency evaluation of metronidazole tablets. Methods Paddle method was adopted at 50 r·min-1 in four dissolution mediums with the volume of 900 mL.The dissolution profiles were determined by ultraviolet spectrophotometry.The cumulative dissolution percentages were calculated and the dissolution curves were drawn.Similarity factor(f2)was used for comparing of the differences between dissolution curves. Results The dissolution profiles of 4 manufactures in pH 1.2 and 9 manufactures in pH 4.5 were similar(f2≥50)to that of original drugs,only 1 and 3 were similar to original drugs in water and pH 6.8,respectively.There are no companies whose dissolution curve were similar to that of original drugs in 4 dissolution mediums. Conclusion Great difference exists between domestic manufactures and pharmaceutical enterprises of origin in dissolution behaviors of metronidazole tablets .In order to ensure the consistency between the metronidazole tablets generics and original drugs of Britain in quality and clinical effect.It is advisable for the relevant companies to improve their product quality by improving the formulation and preparation.
Objective To explore the interaction between warfarin and antiepileptic drugs such as carbamazepine and oxcarbazepine. Methods A 78-year-old woman suffered from warfarin resistance after initial warfarin dosing for several days.Based on her medication review,clinical pharmacist found that the warfarin resistance resulted from co-administered carbamazepine.Her warfarin dosage was increased,and the international normalized ratio(INR) increased to the target range.Another woman had been taking warfarin therapy for long time with a stable maintenance dose.She consulted clinical pharmacist for the influence of co-administered oxcarbazepine on warfarin.The patient was advised to maintain the dose and monitor her INR more closely.Her INR did not fluctuate. Results Carbamazepine induced warfarin metabolism.As a result,the patient needed increased dosage of warfarin to maintain the INR in the therapeutic target range.Oxcarbazepine does not induce liver enzymes,and therefore the INR did not fluctuate. Conclusion Carbamazepine may reduce the efficacy of warfarin.Oxcarbazepine offers a clinical advantage over carbamazepine,especially when co-administration of warfarin is required.
Objective To understand drug use in children with common cold through comments on prescription and drug analysis,and to provide theoretical basis for standardizing medical treatment and promoting rational drug use. Methods A retrospective survey method was applied.Prescriptions of common cold in the department of pediatrics from Oct. to Dec.2015 were reviewed,and Excel 2013 was used for statistical analysis.Rationality of drug use was evaluated based on "hospital prescription review management specification (try out)",instructions and consensus of related experts at home and abroad. Results The utilization rate of antibacterial drugs was 93.4%in children with common cold of our hospital,utilization rate of antiviral drugs was 59.7%,utilization rate of compound cold medicine was 96.4%,and the rate of combined utilization of more than two kinds of compound medicine was 65.7%.Excessive medicine for common cold existed and abuse of cold medicine,antimicrobial and antiviral drug,irational drug combination in this hospital. Conclusion Clinical doctors lack cognition to common cold and cold medicines.Hospital pharmacy department should take effective pharmaceutical interventions to improve the level of rational drug use.
Objective To investigate the entry points for clinical work of intensive care unit (ICU) pharmacists. Methods Through combination with daily work and referring the domestic and foreign literature,the characteristics of ICU medications were discussed to find out the entry point for clinical work of ICU pharmacists. Results ICU patients particularly need individualized pharmaceutical care because of the special pathophysiological characteristics and medicine use. Conclusion ICU pharmacists should provide pharmaceutical care based on Pharmacokinetics/pharmacodynamics knowledge and focus on the drug dosage adjustment,drug interactions and adverse event prevention.
Objective To explore how clinical pharmacists exert their effects in drug therapy. Methods The pharmaceutical practice of clinical pharmacist participating in the treatment of one case of warfarin related nephropathy (WRN) was reported.Early identification of warfarin associated nephropathy and early treatment were necessary and the anticoagulant regimen was optimized.Pharmaceutical education was conducted by clinical pharmacist. Results With guidance by clinical pharmacist,the psychological burden of the patient was reduced,the patient compliance was improved,and the patient understanding of adverse drug reactions was increased. Conclusion Clinical pharmacists involved in clinical treatment practice is conducive to timely detecting and treating patients with adverse drug reactions,and improving the level of drug treatment.