Valproic acid is a first-line broad-spectrum antiepileptic drug, however, the pharmacokinetics of valproic acid are affected by many factors, such as heredity, drug combination and so on. So, how to realize the individualized dosing regimen of valproic acid has received much attention. Population pharmacokinetics combines classical pharmacokinetic principles and population statistical models to quantitatively evaluate the influence factor of drug concentration in the patient population. Thus, it can optimize characterization of the differences among individuals. This article reviews the researches about valproic acid in recent years, and summarizes the effect of the factors on the metabolism of valproic acid, such as drug combination and gene polymorphism. Additionally, focus on the latest research progress of individual administration of valproic acid under the guidance of population pharmacokinetics.
Objective To understand the current application status of global trigger tool (GTT) in China and abroad, and to provide reference for application and improvement of GTT in medical institutes in China. Methods The databases of Pubmed and CNKI were searched, and the relevant literatures were reviewed and collected, and the application of GTT for measuring adverse events (AE) were analyzed and evaluated. Results Fifty-eight valid articles from 15 countries were included.The studies involve several aspects of GTT applications.Articles about GTT used for measuring the incidence of AE accounted for 62.07%, the researches on the object category of AE accounted for 36.21%, those evaluating the effectiveness of GTT as an AE measurement tool accounted for 27.59%, those about improvement and exploration of GTT application performance accounted for 23.41%, and those about comparison between GTT and other AE detection methods accounted for 15.52%.In 18.97% of the studies, the number of reviewers and criteria were accordant with the GTT White Paper, but 32.76% of the studies did not clearly describe the reviewers and criteria.The most common method for reporting the AE rate was the proportion of patients with AE.The research object includes 11 categories: common hospital patients, children, patients in intensive care unit (ICU), etc.; AE ratio of common hospital patients was 3.4% to 43.3%, the preventable proportion was between 32.2% and 72.4%.The most common types of AE were drug related adverse events, infection/hospital acquired infections, surgery-related complications, abnormal blood potassium, pressure ulcer and so on.Evaluation performed in the United States, Republic of Korea, Spain, China and other countries and regions’ showed GTT had higher efficiency and other advantages as compared with the other AE detection methods including voluntary reporting system, HMPS, QPSIQ DLCR.The exploration of GTT performance improvement involves many factors influencing the detection effectiveness such as different reviewers, review experience, sampling method, sample size, trigger etc. Conclusion GTT has been applied to AE detection of hospital patients in various countries, and it has shown some advantages.GTT is an effective tool for AE measuring, which could be widely used in AE monitoring of hospitalized patients in medical institutions of China.
Objective To study the absorption characteristics of promethazine hydrochloride in different parts of rat intestine, provide evidence for the development of new preparation. Methods Rat single-pass intestinal perfusion model was established. By using high performance liquid chromatography (HPLC), 25, 50, 100 μg·mL-1 promethazine hydrochloride concentration changing in different parts of the intestine was detected. Through the relevant calculation, the absorption rate constant (Ka), and the apparent absorption coefficient (Papp) were obtained. Results With the concentration increase of promethazine hydrochloride in duodenal and ileal segments, the Ka and Papp increased significantly in the same part. Ka was (28.00±0.02)×10-2min-1 and Papp was (9.64±0.22) in the jejunum were the highest when the promethazine hydrochloride concentration was 50 μg·mL-1. As the concentration increased in colon, there were no significant changes in Ka and Papp. Conclusion Promethazine hydrochloride is absorbed in various intestinal segments, most obviously in duodenum and ileum, the absorption order is duodenum>ileum>jejunum>colon. Promethazine hydrochloride is absorbed most in the small intestine, in line with the intestinal absorption characteristics.
Objective To observe the effects of orexin-1 receptor inhibitor on proliferation and estrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Methods BMSCs were isolated and cultured from Sprague-Dawley rats, and orexin-1 receptor inhibitor was prepared to different concentration of solutions: 10-2, 10-3, 10-4, 10-5 and 10-6 mol·L-1. Then, the cells at passage 3 were cultured in orexin-1 receptor inhibitor solutions. The cell growth, alkaline phosphatase activity and osteocalcin secretion were measured by MTT, PNPP and ELISA, respectively. The mRNA expression levels of Runx2 and COL1A1 were detected by real-time quantitative PCR. Results The best concentration of orexin-1 receptor inhibitor for the proliferation of BMSCs was 1×10-4 mol·L-1. Orexin-1 receptor inhibitor promoted the proliferation at concentration of 10-6, 10-5, 10-4 mol·L-1 in 3, 5 and 7 days. Orexin-1 receptor inhibitor at concentration of 10-6, 10-5 and 10-4 mol·L-1 for 5 days significantly stimulated ALP activity. Orexin-1 receptor inhibitor significantly up-regulated Runx2 and COL1A1 mRNA expression at concentration of 10-6, 10-5, 10-4 mol·L-1 for 5 days (P<0.05). Conclusion Orexin-1 receptor inhibitor can promote BMSCs proliferation and stimulated ALP activity and osteocalcin secretion.
Objective To observe the influence of jatrorrhizine on the Akt/AMPK/eNOS signaling pathways and potential protective function in blood vessel of diabetes rats. Methods Male Wistar rats (n=60) were randomly divided into normal control group, model control group, low-and high dose jatrorrhizine groups. Except normal control group, the other rats were given intraperitoneal injection of STZ after induced insulin resistance, to made type Ⅱ diabetes model. CMC-Na solution (5%) was given to normal control and model control group, and the jatrorrhizine resolved in the same solution was administered to low (50 mg·kg-1) and high dose (100 mg·kg-1) jatrorrhizine groups for 8 weeks. Their body weight, blood glucose, and serum insulin levels were measured at the end of the treatment, IL-1β, TNF-α level in serum were measured by ELISA, and the eNOS, Akt/AMPK protein expression levels in the blood vessel were measured by Western blotting. Results Compared with normal control group, the weight of model control group was lossed, blood glucose was increased(P<0.01). Compared with model control group, high-dose jatrorrhizine significantly increased body weight, alleviated blood glucose and decreased serum insulin (P<0.01). Serum inflammatory factor like IL-1β was (92.3±4.3) pg·mL-1 in normal control group, (152.4±20.0) pg·mL-1 in model control group, (120.96±33.0) pg·mL-1 and (95.05±7.7) pg·mL-1 in low- and high- dose jatrorrhizine groups, respectively. TNF-α was (10.50±0.82) pg·mL-1 in model control group, (7.48±0.36) pg·mL-1 in normal control group, (8.82±0.42) and (7.11±0.33) pg·mL-1 in low- and high- dose jatrorrhizine groups, respectively. As compared with control group, eNOS and Akt/AMPK expression in blood vessel was significantly reduced (P<0.05) in model control group, and those were significantly increased in high- dose jatrorrhizine group as compared with model control group (P<0.05 or P<0.01). Conclusion Jatrorrhizine may exert protective effect on diabetes mellitus rats through regulating Akt/AMPK/eNOS signaling pathway in blood vessel.
Objective To develop a new botox-like polypeptide with anti-wrinkle and anti-aging functions, which will be used in the field of cosmetics and dermatology. Methods A series of new peptide compounds were synthesized via modifying the structure of SYN-AKE by peptide synthesis technology. Simulating muscle contraction by using co-culture model of human muscle cells and mouse embryonic spinal cord neurons to test the effects. Results Six new synthetic peptides were selected. The results showed that the muscle contraction frequency was lowered by adding C19H30N5O4 compound than adding SYN-AKE in 1 min(P<0.05). Conclusion C19H30N5O4 is expected to become a new cosmetic peptide raw material and dermatology drug in the field of anti-wrinkle and anti-aging.
Objective To evaluate the anti-platelet aggregation effect of ergosterol in vitro and explore the preliminary mechanism. Methods The anti-platelet aggregation activity of ergosterol was assessed in vitro on rabbit platelet aggregation. Different inducers, ADP (4 μmol·L-1), collagen (4 μg·mL-1), arachidonic acid (AA, 1 mmol·L-1) and thrombin (0.5 U·mL-1), and blockers (ozagrel, dipyridamole, clopidogrel and aspirin) were applied to observe the potential targets of ergosterol, platelet aggregation induced by ADP (0, 1, 2, 4, 6 μmol·L-1) or fibrinogen (0, 1, 2, 4, 6, 10 mg·mL-1). Results Ergosterol exhibited an obvious anti-platelet aggregation effect in vitro with IC50 values on different inducers (ADP, collagen, AA and thrombin) of (19.3±0.8), (23.4±1.2), (26.7±0.7), (32.9±1.5) μmol·L-1, respectively. Conclusion Ergosterol can significantly inhibit aggregation and activation of platelet. It provides experimental basis for full exploration of ergosterol and development of novel anti-platelet aggregation drugs.
Objective To explore the correlation between Y-box binding protein-1 (YB-1) and P-glycoprotein (P-gp) in drug-resistant hepatocellular carcinoma (HCC) Bel-7402/ADM cells, and speculate the related mechanism of drug resistance. Methods Bel-7402/ADM cells were developed by concentration gradient escalation and intermittent administration of large dose. The levels of YB-1 mRNA and MDR1 mRNA were detected by means of RT-PCR.Western blotting was used to detect the protein expression of YB-1 and P-gp in the Bel-7402 cells and doxorubicin resistant Bel-7402 (Bel-7402/ADM) cells. Bel-7402/ADM cells were transfected with small interfering RNA (siRNA) targeting human YB-1. Expression levels of YB-1 and MDR1 mRNA and protein were detected by means of RT-PCR and Western blotting. Results IC50 values of ADM on hepatoma carcinoma cells Bel-7402 and Bel-7402/ADM were (2.23±0.07) and (7.02±0.03) μmol·L-1. The mRNA expression levels of MDR1 and YB-1 were all significantly higher in Bel-7402/ADM cells than in Bel-7402 (P<0.01). The mRNA expression levels of MDR1 and YB-1 in Bel-7402/ADM cells transfected with YB-1 siRNA were reduced significantly (P<0.01). The protein levels of YB-1 and MDR1 in Bel-7402/ADM cells transfected with YB-1 siRNA were reduced significantly (P<0.05). Conclusion These results suggest that the high expression level of YB-1 is probably correlated with multidrug resistance in HCC Bel-7402/ADM cells.
Objective To elucidate activity of baicalin against human cytomegalovirus (HCMV) in vitro, and explore its effect on apoptosis of human embryo lung fibroblasts (HEL) infected with HCMV. Methods CCK-8 kit was used to determine the maximum tolerated dose (MTC) of HEL cell to baicalin while the anti-HCMV median efficacious concentration (EC50) of baicalin was determined by standard plaque reduction method. After treatment with baicalin of different concentrations for 24, 48, 72 and 96 h, cell apoptosis and pro-caspase-3 expression was detected by flow cytometry and Western blotting, respectively. Results The MTC of baicalin was 20.6 μg·mL-1; The EC50 of anti-HCMV of baicalin was 16.13 μg·mL-1; The apoptosis rate increased gradually in the groups with low and high multiplicity HCMV infection at early time, showing significant dose-dependent manner. While the ratio of apoptotic cells was going to decrease in high multiplicity infection group 96 h after the infection. The expression of pro-caspase-3 was significantly higher in high-dose baicalin treatment group than in the infection control group (P<0.05). Conclusion Baicalin has a direct anti-HCMV effect in vitro. One of the mechanisms might be related with it inhibiting cell apoptosis and antagonizing activation of pro-caspase-3.
Objective To explore the preventive effect and mechanism of tea polyphenols on morphine-induced constipation. Methods Female Kunming mice were randomly divided into 4 groups (10 mice per group), including blank control group, model control group, tea polyphenols group and tea polyphenols + morphine group. Tea polyphenols group and tea polyphenols + morphine group were pretreated with 100 mg·kg-1 of tea polyphenols for 4 days, meanwhile blank control group and model control group were preteated with 0.1 mL·kg-1 of 0.5% CMC-Na for 4 days. On the fourth day model control group and tea polyphenols + morphine group were intraperitoneal injected 20 mg kg-1 morphine, otherwise blank control group and tea polyphenols group were injected with 0.1 mL·kg-1 of 0.9% sodium chloride solution. Then mice were given 0.2 mL of 5% ink solution by intragastric administration 15 min later. The latency to paw licking was detected in hot plate test to evaluate the effect of tea polyphenols on morphine analgesia. The levele of motilin (MLT), substance P (SP) and somatostatin (SS) in intestinal tissue were determined by enzyme-linked immunosorbent assay (ELISA) among groups. Results Compared with the blank control group, the length of propelling ink and the propelling rate of ink were significantly lower in the model control group (P<0.01), meanwhile tea polyphenols group were much higher(P<0.05). Compared with model control group, the length of propelling ink and the propelling rate of ink were significantly higher in tea polyphenols + morphine group mice (P<0.05). The first paw licking time of control group and tea polyphenols group were (8.64 + 2.72)s and (9.11 + 2.13) s, and the time of model control group and tea polyphenols + morphine group were (18.79±3.58)s and (20.10±3.72) s. The contents of MLT and SP were reduced in model control group (P<0.05), but significantly increased in tea polyphenols group (P<0.05) compared with blank control group. Compared with the model control group, MLT and SP had an obviously increase in tea polyphenols + morphine group (P<0.05). Compared with blank control group, the content of SS was increased in model control group, but decreased markedly in tea polyphenols group and tea polyphenols + morphine group (P<0.05). Conclusion Tea polyphenols can prevent the morphine-induced constipation without decreasing the analgesic effect of morphine, which is related to the regulation of the content of MLT, SP and SS.
The high incidence of schizophrenia causes a greater burden on society and family.In the past of half century, with the widespread use of schizophrenic drugs,the prognosis of clinical schizophrenia has been substantially improved after following the principles of early, effective and maintenance therapy.In this overview,the clinical characteristics at different stages of disease progression with the recent advances in drug therapy of schizophrenia was combined,to introduce clinical selection of schizophrenic drugs.
Depression is a common mood disorder, with a high incidence and prevalence, while the overall diagnosis and treatment rate are low.Even if patients attained the initial clinical cure, there is still a high risk of depression recurrence, of which a great part may turn into self-mutilation or even suicide.Taking antidepressants as the most preferred treatment of moderate and major depression is recommended by almost all clinical treatment guidelines at home and abroad currently.At the same time, the concept of depression treatment is changing gradually from the initial single-mode drug therapy for symptom control to a comprehensive, individualized, quantitative treatment model.Promising psychological treatment, physical therapy and other alternative and complementary treatments are developing quickly.
Insomnia is the most common type of sleep disorder in the clinic.Long-term insomnia seriously affects people's work and life, and the incidence of insomnia is increasing year by year.In order to provide reference for the clinic, this paper summarizes the current advances in the treatment of insomnia, including pharmacotherapy and non-pharmacotherapy.Non-pharmacotherapy includes cognitive behavioral therapy and physical therapy.Pharmacotherapy includes benzodiazepine receptor agonists, including benzodiazepine and non-benzodiazepine hypnotics, melatonin and melatonin receptor agonists, antidepressant drugs with sedative effects, antipsychotic drugs, antihistamines that have central inhibitory effects, Chinese medicine.
Alzheimer's disease (AD) is the most common type of dementia.Currently, there is a lack of drugs that could effectively slow and halt the progression of AD.The present review describes the advancements in the treatment of AD, mainly including drugs for symptomatic control, drugs that control the behavioral and psychological symptoms of dementia, and some other drugs for AD and the non-pharmaceutical treatments.It is hoped that early diagnosis, early intervention and comprehensive therapy could relieve the symptoms and slow the progression of AD.
Objective To investigate the effects of specific TrkB receptor agonist 7,8-dihydroxyflavone (7,8-DHF) on spatial cognitive function and synaptic structure in schizophrenia rat model. Methods SD infant rats were divided into normal control group and model group according to the random number table method on the 6th day after birth. During the postnatal day 7 to 11, rats in the normal control group received subcutaneous injection of 0.9% sodium chloride solution (1 mL·kg-1) twice daily, and the rats in the model group were injected with dizocilpine (0.1 mg·kg-1). Beginning on the postnatal day 60, model rats were randomly divided into 7,8-DHF group and model control group, which were given intraperitoneal injection of 7,8-DHF (5 mg·kg-1) and DMSO once daily for 14 consecutive days, respectively. The rats of normal control group were given equal volume injections of DMSO. Morris water maze task, Golgi staining and Western blotting were adopted to examine spatial cognitive function, hippocampal dendritic spine density, protein expression and activity, respectively. Results The result in the open field test showed that the total travelled distance within 5 min was (12.20±1.62) m in the normal control group, (11.73±1.36) m in the model control group and (12.94±1.09) m in the 7,8-DHF group. The escape latency and travelled distance in the model control group were significantly higher than those in the normal control group (P<0.05), and the escape latency and travelled distance in rats of 7,8-DHF group were significantly shortened as compared with those in the model control group (P<0.05). There was no significant difference in the swimming speed among the three groups (P>0.05). The hippocampal dendritic spine density was (14.2±2.3)/10 μm in the normal control group, (8.0±1.9)/10 μm in the model control group, and (13.5±1.7)/10 μm in the 7,8-DHF group, the differences between the three groups were significant (all P<0.05); the phosphorylation level of GluR1 protein was (100.0±5.0) in the normal control group, (47.9±10.8) in the model control group, and (97.5±9.3) in the 7,8-DHF group, and the differences among the three groups were significant (all P<0.05). Conclusion 7,8-DHF treatment could improve the spatial cognitive function in rat model of schizophrenia and the mechanisms might be related with the increases of hippocampal dendritic spine density and phosphorylated levels of GluR1.
Objective To observe the effect of risperidone on serum brain derived neurotrophic factor (BDNF) in first-episode schizophrenic patients. Methods In the treatment group, 90 first-episode schizophrenics were treated with risperidone for 16 weeks, and the dose of risperidone was (3.79±0.88) mg·d-1. Serum BDNF levels were measured before treatment, at 2, 8, and 16 weeks after treatment. The severity of schizophrenia symptoms was assessed by the positive and negative symptom scale (PANSS) before and after sixteen weeks of treatment. Serum BDNF concentrations were measured in 90 healthy controls. Results BDNF in the control group was (22.867±6.051) ng·mL-1. The serum BDNF levels before treatment and at the end of week 2, 8, 16 after the treatment in the treatment group were (14.256±4.096), (13.078±3.462), (18.001±5.753), (21.089±6.692) ng·mL-1, and the serum BDNF level was significantly lower in the treatment group than that in the control group (P<0.01). After the treatment, the level of BDNF in the treatment group decreased at first and then increased, compared with that before treatment, the difference was significantly (P<0.05 or P<0.01). The level of BDNF in the treatment group at the end of week 16 was not significantly different from that of the control group (P>0.05). After treatment, the total score of PANSS scale and its subscales decreased, the difference was significantly (P<0.01). At the end of week 16, the PANSS subscale reduction rate was positively correlated to the serum BDNF concentration change (r=0.499, P=0.001). The change rate of serum BDNF concentration at the end of week 16 was not correlated with the dose of risperidone (r=0.103, P=0.335). Conclusion BDNF is abnormal in the first episode of schizophrenia, which can be improved by risperidone treatment.
Objective To investigate the method for preparing oridonin-single-walled carbon nanotubes (ORI-SWCNTs) nanocomposite and study its adsorption kinetics. Methods ORI-SWCNTs nanocomposite was prepared by using the method of solution mixing. The synthesized ORI-SWCNTs nanocomposite was characterized by using Laser particle size analyzer, Fourier transform infrared, DSC analysis, powder X-ray diffraction and electron microscopy techniques. Results The encapsulation efficiency and loading capacity of ORI in SWCNTs-COOH nanocarrier was estimated to be about (70.23±2.1) % and (27.29±1.2) %, respectively. The Zeta potential was (-34.29±1.2) mV, partical size was about (458±18) nm. The absorption of ORI on SWCNTs-COOH could be explained by pseudo-second-order model. Conclusion The established preparation process of ORI-SWCNTs nanocomposite by solution mixing is feasible, with higher loading efficiency and encapsulate efficiency..
Objective To establish an innovative methods for the identification of nimodipine polymorphs. Methods Nimodipine of two crystal forms were prepared by rapid solvent removal and identified by powder X-ray diffraction,infrared spectroscopy and Raman spectroscopy.The dissolution study of the powder samples were carried out in six different mediums. Results Powder X-ray diffraction patterns of crystal form A and B could be used for the identification of crystal forms of nimodipine.Crystal form B has characteristic diffraction peaks at 2θ=5° and 2θ=13° in the pattern,while crystal form A has characteristic diffraction peaks at 2θ=27° distinguishing two crystal forms effectively.Raman spectrum could be used to identify the crystal forms.Compared with Raman spectra of crystal form B, there exists characteristic scattering peak at 500 cm-1 in crystal form A.According to the position and intensity of the peaks of crystal form A and B, it could distinguish two crystal types effectively.The results of dissolution tests showed that the solubility of crystal form A is better than crystal form B. Conclusion Various analysis techniques in different principle were used in the research, such as Powder X-ray diffraction, Infrared spectroscopy and Raman Spectroscopy etc.Crystal forms were confirmed in several aspects according to the properties of different crystal form, and the solubility of crystal form A is better than crystal form B.
Objective To establish a HPLC method for determination of 18β-isomer in magnesium isoglycyrrhizinate. Methods The determination was performed by Agilent Extend-C18 column (4.6 mm×250 mm, 5 μm). Mobile phase consisted of 0.1 mol·L-1 potassium dihydrogen phosphate buffer solution (adjusted to pH 7.0 with potassium hydroxide)-acetonitrile (80:20) at the flow rate of 1.0 mL·min-1. The column temperature was 30 ℃, and the detection wavelength was set at 250 nm. Results The resolution of magnesium isoglycyrrhizinate and 18β-isomer was greater than 2.0. The linear range of them was 0.41-2.46 μg·mL-1 (r=0.999 8), the detection limit was 0.21 ng, and the average recovery were 100.2%,99.1%,110.2%,RSD were 0.9%,0.1%,0.2%(n=3). Conclusion The method is simple and accurate, and can be used for determination of 18β-isomer in magnesium isoglycyrrhizinate.
Objective To prepare quercetin (QT)-loaded polylactic-co-glycolic acid-D-α-tocopheryl polyethylene glycol 1000 succinate (PLGA-TPGS) nanoparticles (QPTN) and QT-loaded polylactic-co-glycolic acid (PLGA) nanoparticles (QPN) by using QT as model drug and PLGA-TPGS or PLGA as carrier materials, and to investigate the quality of the two nanoparticles. Methods QPTN and QPN were prepared by using the ultrasonic emulsification-solvent evaporation method, and their surface morphology,size and surface charge were detected by using a transmission electron microscope (TEM) and a Nano ZS90 light scattering and laser Doppler anemometry, respectively. Drug loading (DL), entrapment efficiency (EE) and in vitro drug release of QT in the two nanoparticles were determined by using a reverse phase-high performance liquid chromatography (RP-HPLC) on Hypersil C18 column (4.6 mm×250 mm, 5 μm) with methanol and 0.03% phosphoric acid (3:2) as mobile phase, and the detective wavelength was 370 nm. Results TEM images exhibited that two nanoparticles were all spherical and regular. The average sizes of QPTN and QPN were (155.4±2.7) nm and (363.8±3.2) nm, while DL and EE of QPTN were approximately (21.6±2.8)%, (93.7±2.9)% (n=6), and DL and EE of QPN were approximately (15.0±1.5)%, (64.6±1.6)% (n=6), respectively. Both of nanoparticles exhibited sustained release, and the cumulative QT release of QPTN and QPN reached (85.8±2.8)% and (68.6±1.4)% (n=6) at day 30, respectively, with a significant difference between them (P<0.05). Conclusion QPTN gets smaller size, higher DL and EE, and exhibits sustained release, and the in vitro cumulative QT release is faster and more complete than QPN relatively.
Objective To compare and explore the efficacy of regional citrate anticoagulation therapy and regional heparin anticoagulation therapy in continuous renal replacement therapy (CRRT) of acute kidney injury (AKI) patients with risk of bleeding by an retrospective study. Methods A total of 96 AKI patients with risk of bleeding were collected retrospectively and treated with CRRT. All the patients were divided into two groups: regional citrate group (n=50) and regional heparin group (n=46). APTT, level of Ca2+, pH value, levels of HC
Objective To evaluate whether individualized dosage regimen based on therapeutic drug monitoring (TDM) is beneficial for improving the rate of pharmacokinetics/pharmacodynamics (PK/PD) reaching the standard and anti-infection efficacy. Methods Totally, 36 cases in the intensive care unit (ICU) of Nanjing Drum Tower Hospital using meropenem during January 2015 to December 2015 were collected, and divided into intervention group and control group. Results On the fourth day of administration, meropenem concentration in intervention group was significantly higher than that of the control group (22.5 μg·mL-1 and 17.5 μg·mL-1, respectively, P=0.007).With minimal inhibitory concentration (Cmin) >8 μg·mL-1 serving as target, the rate of reaching the standard was both 22.2% on day 2, 100.0% and 72.2% on day 4 in intervention group and control group, respectively (P=0.015). With minimal inhibitory concentration (Cmin) >32 μg·mL-1 serving as target, the rate of reaching the standard was both 0 on day 2, 38.9% and 5.5% on day 4 in intervention group and control group, respectively (P=0.015). The clinical curative rate of the intervention group and control group was 83.3% and 72.2%, respectively (P=0.437), and the failure rate was 16.7% and 27.8%, respectively.Bacteria clearance rate was 88.9% and 55.5% in the intervention group and control group, respectively(P<0.05). Conclusion Individualized dosage regimen based on TDM in ICU patients is beneficial to improving the rate of PK/PD reaching the standard and anti-infection efficacy.
Objective To improve the quality of pharmaceutical care in specialized children's hospital, provide convenient on-line medical consultation to parents, create the professional brand of whole-ranged pharmaceutical care by clinical pharmacist. Methods The First WeChat platform named "drugs consultation of Shanghai Children's Hospital" was inaugurated in Shanghai. Parents of children could search WeChat code or scan the QR code to join in WeChat friends, and asked questions online. Clinical pharmacists took turns on duty to answer questions online every day. Results During June 2014 to January 2016, number of WeChat friends was more than 8 000, total number of medication consultation was 13 315, average number of daily effective medication consultation was 26 (the peak was more than 60), 20 original medical articles of popular science were released, 100 other medical articles of popular science were reposted. Peak date of consulting was Tuesday, trough date of consulting was Saturday. Peak time of consulting was 9:00-10:00, while trough time of consulting was 4:00-5:00. For consultation, top ten diseases or symptoms was cough, fever, runny nose, sore throat, coughing phlegm, diarrhea, infection, pneumonia, skin eczema, adverse drug reactions; Top ten drugs was ibuprofen suspension or suspension drops, ambroxol hydrochloride and clenbuterol hydrochloride oral solution, paracetemol, pseudoephedrine hyrochleride, dextromethorphan hyorobromode and chlorpheniramine maleate suspension, pediatric pseudoephedrine hydrochloride and dextromethorphan hydrobromide drops, azithromycin tablets or suspension, vitamin, combined bacillus subtilis and enterococcus faecium granules with multivitamines, live, ambroxol hydrochloride oral solution, montmorillonite powder, loratadine tablets or syrup. Conclusion New mode of internet+pharmaceutical care is recognized by public and official. Clinical pharmacist can ensure the safety of pharmacy in children inside and outside of hospital effectively through WeChat real-time online interaction with parents. Professional brand of full process pharmaceutical care has been made by clinical pharmacists successfully.