Objective To evaluate the effects of carpesiumabrotanoides methanol and ethyl acetate extracts on immune function of mice. Methods Totally, 75 mice were randomly divided into five groups(n=15 each group),including low and high dose of carpesiumabrotanoides methanol extracts groups,low and high dose of carpesiumabrotanoides ethyl acetate extract groups and blank control group. They were intragastrically administrated for 10 days.Spleen mass, viscera index,phagocytic function and B lymphocyte hemolytic plaque formation were detected. Results As compared with the blank control group,the spleen mass[(170.6±10.09), (148.6±12.09), (198.6±20.11), (174.8±16.77) mg vs.(117.6±10.89)mg]were significantly higher(P<0.01),and phagocytosis percentage of macrophages [(53.40±3.20)%, (57.40±1.34)%, (56.60±3.97)%, (50.80±3.96)% vs.(35.49±1.64)%]were significantly higher(P<0.01),and the number of hemolytic plaque formation [(498±42.10), (472±20.40), (1368±47.56), (1280±125.98) vs.(361±11.70)]were significantly higher(P<0.01)in the low and high dose of carpesiumabrotanoides methanol extracts groups, low and high dose of carpesiumabrotanoides ethyl acetate extract groups. Conclusion Carpesiumabrotanoides methanol and ethyl acetate extracts can significantly enhance the nonspecific and specific immune function of mice.
Objective To carry out data mining on the new prescriptions of pharyngitis, use traditional Chinese medicine inheritance assistant system and analyze the potential molecular targets and signaling pathways of the prescription by using integrated pharmacology platform. Methods The prescriptions of Chinese herbal medicines were collected through database integration.The association rules and the complex system entropy clustering method were used to determine the frequency and association rules of each drug and to find out the new prescriptions.By integrating the functions of the pharmacology platform and network construction, we obtained the target network and analyzed the molecular mechanism. Results A total of 177 prescriptions were collected to analyze the association between the using frequency of TCM prescriptions and the herbs.Five new prescriptions were Conclusion Combining the traditional Chinese medicine inheritance assistant system and the integrated pharmacology platform, the new prescriptions can be explored from macrocosmic and microscopic perspectives for potential molecular mechanisms, to provide guidance for further research.
Objective To observe the muscular stimulation response of rabbits injected with reduced glutathione for injection from three manufacturers dissolved in 0.9% sodium chloride injection and water for injection, respectively. Methods Three batches of reduced glutathione for injection were dissolved in 0.9% sodium chloride and water for injection at high and low concentrations (0.3, 0.15 g·mL-1). Rabbits femoral quadriceps muscle injection was used to study muscle irritation test with the intra-individual left/right self comparison method. One milliliter test solution was given to each side of rabbit for once administration. The muscle stimulation responses and histopathologic examination on the injection sites were observed 72 hours and 14 days after injection. Results At 72 hours after injection of the test drug dissolved in 0.9% sodium chloride injection, the muscle stimulation responses of test drug 1, 2 and 3 at the high dose were slight, moderate and mild, respectively, and different degrees of hemorrhage, inflammatory cell infiltration, muscle fiber necrosis were observed by histopathological examination. The muscle stimulation responses of test drug 1, 2 and 3 at the low dose were non-irritation, slight and non-irritation, respectively, and there was no obvious anomaly in histopathological examination. When the test drug was dissolved in water for injection, the muscle stimulation responses of all three test drugs at the high dose were severe; massive hemorrhage, lots of inflammatory cell infiltration and muscle fiber extensive necrosis, dissolution, degeneration were observed by histopathological examination. The muscle stimulation responses and pathological changes of all three test drugs at the low dose were moderate. At 14 days after injection, white nodules appeared and desmoplastic changes were observed by histopathological examination on the injection site of the rabbit muscle of test drug 2 at the high dose. Furthermore, the irreversible injury of water as solvent was more serious than that of 0.9% sodium chloride injection. The examination of muscle of test drug 1 and 3 showed no obvious anomaly, indicating that the muscle stimulation responses of test drug 1 and 3 were reversible. Conclusion Reduced glutathione for injection dissolved in 0.9% sodium chloride injection induces slighter muscle stimulation responses than that dissolved in water for injection.
Objective To study the molecular mechanism and active component of Mongolian Prescription ZhuRiheng drop pill in treating coronary heart disease(CHD)based on network pharmacology. Methods Through the literature mining and Chinese medicine database retrieval, the compound of ZhuRiheng drop pill was collected. The oral bioavailability (OB)and drug similarity (DL) of compounds were analyzed and screened by TCMSP. Using the PharmMapper target prediction platform, the potential targets for the compounds were predicted. KEGG pathway enrichment was performed on the compound target of ZhuRiheng drop pill with MAS 3.0. The “compound-target-drug” network model and “compound-target-pathway-disease” network model were established with Cytoscape software, and the network model was analyzed. Results The results of network topology analysis showed that PTPN1, RXRA, PDPK1 and MAPK14 were the main targets of ZhuRiheng drop pill. Sixteen compounds in the preceding 20 compounds ordered by Betweenness and Degree derived from the basic prescription were composed of Fructus choerospondiatis, Nutmeg, Sandalwood, and each of these was 1/3. The average Betweenness values of Fructus choerospondiatis, Nutmeg, Sandalwood were higher than those of other medicinal compounds, among which the average Betweenness of fructus choerospondiatis was the highest. The pathway enrichment results indicated that the biological pathways of ZhuRiheng drop pill associated with the pathogenesis of CHD mainly included focal adhesion, insulin signaling pathway, ErbB signaling pathway, VEGF signaling pathway, Fc epsilon RI signaling pathway, T cell receptor signaling pathway, PPAR signaling pathway, MAPK signaling pathway,etc.ZhuRiheng drop pill and CHD drug have many common targets. Conclusion The mechanism of ZhuRiheng drop pill treating CHD is a synergistic effect by multi-component, multi-target, multi-channel. Fructus choerospondiatis, Nutmeg, Sandalwood are the most important materials.
Objective To establish a rat model of ulcerative colitis by using 2,4,6 three trinitrobenzene sulfonic acid-ethanol composite method and study the therapeutic effect of Gallnut aqueous extract on IL-6/JAK/STAT3 pathway in rats with ulcerative colitis. Methods The expression level of IL-6 and JAK in serum of UC rats was detected by ELISA. The effect of the Gallnut aqueous extract on the reverse transcriptase level of IL-6 and STAT3 in UC rats was detected by RT-PCR. Results Compared with the normal control group, the expression levels of IL-6 and JAK were significantly increased in the model control group (P<0.05). Compared with the model control group, the IL-6 level was significantly decreased in mesalazine group and low- and high-dose of Gallnut aqueous extract group(P<0.05). Compared with the normal control group, the JAK level and IL-6, STAT3 gene expression level were significantly increased in the model group(P<0.01).Compared with the model group, JAK level and IL-6 gene expression were significantly decreased in mesalazine group, and STAT3 gene expression was significantly decreased in the low- and high-dose Gallnut aqueous extract group (P<0.05). Conclusion Gallnut aqueous extract has a certain therapeutic effect on ulcerative colitis rats, and its mechanism is related to the decrease of serum IL-6 and JAK levels and the expression of IL-6 and STAT3 genes in ulcerative tissues of UC rats.
Objective To observe the effect of traditional Mongolian medicine Zhitu Liuwei San on DA and D2 receptor of rats with cisplatin-induced pica. Methods According to the literature, the rat pica model establishment method were reviewed. The Wistar rats were randomly divided into blank control group, model control group, ondansetron antiemetic group, low-, middle- and high-dose Zhitu Liuwei San group. The content of DA, dihydroxy-phenyl acetic acid (DOPAC) in serum, ileum and medulla were determined by ELISA, and the levels of tyrosine hydroxylase (TH) and monoamine oxidase B (MAOB) in ileum and medulla oblongata were measured. The expression of D2 receptor mRNA and protein in ileum and medulla oblongata of pica rats was detected by RT-q PCR and Western blotting. Results ELISA results showed that 72 h after modeling, DOPAC and DA in serum of the rats receiving Zhitu Liuwei San treatment were significantly decreased as compared with model control group (P<0.05, P<0.01); TH in ileum and medulla of the rats significantly decreased and MAOB significantly increased (P<0.05, P<0.01). The results of RT-q PCR and Western blotting showed that compared with the model control group, the expression levels of D2 receptor mRNA and protein in the ileum and medulla of each treatment group of Zhitu Liuwei San were significantly decreased (P<0.05, P<0.01). Conclusion Zhitu Liuwei San significantly inhibits the synthesis of DA and promotes its metabolism, the effect is related to the down-regulation of D2 receptor mRNA and protein expression.
Objective To explore the efficacy of the multimodality analgesic therapy in early stage of herpes zoster, and the effectiveness for preventing the post-herpetic neuralgia. Methods A total of 120 patients diagnosed with herpeszoster whose clinical course was less than 7 days in clinic of Dermatology, Pain Medicine and Neurology of Gezhouba Central Hospital, were recuited in this study. Patients were divided into control group and treatment group,63 patients in control group received conventional treatment for herpes zoster, and 57 patients in treatment group were given multimodality analgesic therapy combined with conventional treatment. The visual analogue scale(VAS) was evaluated before and 4 weeks after treatment, and the efficiency of treatment for two groups was calculated. Patients were followed up through 8 and 12 weeks to explore the incidence and outcome of post-herpetic neuralgia. Results VAS scores of treatment group was statistically significant lower than control group after 4 weeks treatment(P<0.01); The total effective rate for neuralgia in treatment group was higher than control group (93.0% vs 49.2%,P<0.01), and the incidence of post-herpetic neuralgia was lower in treatment group after 8 and 12 weeks treatment (P<0.01). Conclusion Multimodality analgesic therapy can relieve the neuralgia in early stage of herpes zoster, also can develop a favorable long term outcome in post-herpetic neuralgia.
Objective To observe the effects and adverse reactions of three kinds of 5-HT3 receptor antagonists in preventing nausea and vomiting caused by anthracycline combined with cyclophosphamide chemotherapy, and provide reference for clinical rational use of antiemetics. Methods Totally, 129 breast cancer patients receiving anthracycline combined with cyclophosphamide chemotherapy were divided into group A (ondansetron group, n=41 cases), group B (granisetron group, n=55 cases), group C (tropisetron group, n=33 cases), according to the antiemetic regimen used before chemotherapy. Three groups of antiemetic regimens were observed to have adverse reactions such as nausea and vomiting, constipation, fatigue, and abdominal distension within 0 to 5 days after anthracycline combined with cyclophosphamide chemotherapy. Results The effective control rates of nausea and vomiting in the tropoxane group were 81.82%, 87.88%, 63.64%, and 69.70% at 0-24 h and 2-5 d after chemotherapy, respectively, which were better than the other two groups at the same time, but the difference was not statistically significant (P>0.05). The adverse reactions of the three groups were mild, and the incidence of total adverse reactions was not statistically significant (P>0.05). Conclusion The three groups of regimens have the same and better clinical efficacy and safety in the prevention of acute CINV at equivalent dose, but the effect on remission of delayed CINV is not satisfactory. It is recommended to use combination therapy according to the guidelines. 5-HT3 receptor antagonist can be used for long-acting preparation.
Objective To evaluate the effects and safety of continuous and intermittent ultrasound-guided erector spinae plane (ESP) block in postoperative analgesia of laparoscope bilateral inguinal hernia repair. Methods Total of 90 patients undergoing laparoscope bilateral inguinal hernia repair were randomly divided into 3 groups: therapy one group, therapy two group and control group, all groups received general anesthesia. After operation, therapy one group and therapy two group received bilateral ultrasound-guided erector T7 spinae plane block. Catheters were placed by the primary investigator under ultrasound guidance. 20 mL bolus dose of 0.25% bupivacaine was given followed by catheter insertion. Therapy one group was given continuous 2 mL·h-1 0.25% bupivacaine. Therapy two group was given 16 mL bolus dose 0.25% bupivacaine per 8 h. Control group received nothing. the VAS and BCS were observed and recorded after operation(t0) and 2 h after operation (t1) and 4 h after operation (t2) and 6 h after operation (t3) and 8 h after operation (t4) and 16 h after operation (t5) and 24 h after operation (t6). The adverse reaction incidence within 24 h after the surgery were observed and recorded. Results All groups had the surgery successfully done and there were no adverse reactions within 24 h after operation. There were no significantly differences among the three groups in age and weight (P>0.05). There were no significant differences in the VAS between therapy one group and therapy two group in t0 and t1 and t2 and t3 and t4 and t5 and t6 (P>0.05). But the VAS was significantly lower in both therapy groups than in control group (P<0.05). There were no significant difference in BCS between therapy one group and therapy two group in t0 and t1 and t2 and t3 and t4 and t5 and t6 (P>0.05). But the BCS was higher in both therapy groups than in control group (P<0.05). There were no significant difference in the dosage of postoperative analgesic drugs within 24 h between therapy one group and therapy two group. But the dosage of postoperative analgesic drugs were lower in both therapy groups than in control group (P<0.05). Conclusion Ultrasound-guided erector spinae plane block is accurate, the success rate is high, and there is no obvious adverse reaction. Continuous and intermittent 0.25% bupivacaine injection can provide good postoperative analgesia in patients with laparoscope bilateral inguinal hernia repair and reduce the dosage of postoperative analgesic drugs. The clinical use of ultrasound-guided erector spinae plane block is safe and effective.
Objective To investigate the effect and safety of omeprazole/sodium bicarbonate capsule in treatment of active duodenal ulcer. Methods Totally, 238 patients with active duodenal ulcers were randomly divided into the treatment group and the control group with 119 patients in each group.The treatment group was treated with omeprazole/sodium bicarbonate capsule, and the control group treated with omeprazole magnesium enteric tablet.The treatment course was 4 weeks.The stage classification of ulcer under endoscopy and clinical symptoms were compared between the groups before and after the treatment. Results After treatment, the stage of ulcers under endoscopy was significantly improved in both groups, but the proportion of patients in stage S1 or S2, and patients with ulcer area reduction more than 50% had no statistical differences between the treatment group and the control group (86.73% vs.85.59%,and 96.46% vs.97.30%, respectively, P>0.05).The clinical symptoms were significantly improved in both groups.After 4 weeks of treatment, the decline of belching score was significantly greater in the treatment group than in the control group (1.36±0.76 vs.1.09±0.60,P<0.05).The decline of total symptom score was significantly greater in the treatment group than in the control group after 2 and 4weeks (4.54±2.58 vs.3.78±2.12, and 5.33±2.77 vs. 4.53±1.93, respectively, P<0.05).After 4 weeks of treatment, the rate of pain disappearance in the treatment group was higher than that in the control group (96.26% vs.95.19%), but without statistical difference (P>0.05).There were no statistical differences in adverse drug reactions between the two groups. Conclusion Omeprazole/sodium bicarbonate capsule has definite therapeutic effect and good safety in treating active duodenal ulcer.
Objective To establish a method for the content determination of six water-soluble ingredients (chlorogenic acid, cryptochlorogenic acid, glycyrrhizic acid, cinnamaldehyde, paeonol and evodiamine) in Wenjing decoction by HPLC. Methods The Waters Xselect HSS T3 column (4.6 mm×250 mm, 5 μm) was used, with acetoniteile-0.1% formic acid solution as the mobile phase for gradient elution. The temperature of column was 25 ℃ at a flow rate of 0.8 mL·min-1 with full UV wavelength scan. Results Under the above chromatographic conditions, chlorogenic acid, cryptochlorogenic acid, glycyrrhizic acid ammonium salt, cinnamaldehyde, paeonol and evodiamine showed good linear relationship within the ranges of 30.02-150.08,30.07-150.36,68.82-344.08,10.10-50.50,10.21-51.06 and 10.18-50.90 μg·mL-1, respectively. The correlation coefficient was 0.999 9, 0.999 8, 0.999 6, 0.999 9, 0.999 5 and 0.999 5, respectively. Conclusion This method is accurate, simple, stable and reliable, and it could be taken as an effective method for controlling the quality of Wenjing decoction development.
Objective To establish a method for identification of unknown components in human albumin by ultra performance liquid chromatography-electrospray ionization/quadrupole-time-of-flight mass spectrometry(UPLC/ESI-Q-TOF MS)spectrometry. Methods The isocratic elution mode was adopted to separate the protein components of albumin by gel filtration column(Hiprep16/60SepharylS-200HR)using the moblie phase of sodium dihydrogen phosphate-disodium hydrogen phosphate (0.5 mol·L-1 NaH2PO4 200 mL, 0.5 mol·L-1 Na2HPO4 420 mL, isopropyl alcohol 15.5 mL, water 914.5 mL, pH adjusted to 6.98). The unknown components were collected, then desalted, concentrated and digested by trypsin. The peptide was eluted by ACQUITY UPLC BEH130 C18 (2.1×100 mmol·L-1, 1.7 μm) column with mobile phase of water (0.1% formic acid)-acetonitrile with gradient elution mode. Chromatography-mass spectrometry was used to determine the secondary sequences of the peptides and the searching software (PLGS3.0) was used to identify the unknown protein components in albumin. Results A total of 21 proteins were detected in 15 batches of albumin from 5 manufacturers by the established method. Apolipoprotein A-II, Haptoglobin, hempoexin, glycoprotein (Alpha-1B-glycoprotein) and α-2-HS-glycoprotein (Alpha-2HS-glycoprotein) were the common proteins in the products of 5 manufacturers. The number of unknown protein species in human albumin from 5 manufacturers is 7, 10, 10, 12 and 19 respectively. Conclusion This method can be used to examine the unknown proteins in human albumin and to provide guidance for the manufacturing process optimization.
Objective To investigate the effects of quercetin, paeoniflorin and oleanolic acid on the activities of CYP2C9 enzymes in vitro for clinical combination therapy. Methods Tolbutamide served as in vitro probes to evaluate CYP2C9 activity in liver microsome. HPLC method was used to detect themetabolites,hydroxytoluene sulfobutamide production and to evaluate the effects of quercetin, paeoniflorin and oleanolic acid on the activities of CYP2C9 enzymes. Inhibition rate and IC50 of quercetin, paeoniflorin and oleanolic acid were calculated with sulfaphenazole as positive control. Results Among the 3 active constituents tested, oleanolic acid was found to be a moderate inhibitor on CYP2C9 with IC50 of 4.115 μmol·L-1. Quercetin and paeoniflorin was a poor inhibitor for CYP2C9 with IC50 of 15.343 and 49.361 μmol·L-1, respectively. Conclusion Oleanolic acid is a moderate inhibitor of CYP2C9, while quercetin, paeoniflorinweakly suppresses the activity of CYP2C9.
Objective The composition of halogenated butyl rubber stoppers was analyzed. Methods Bythermogravimetric analysis,volatile matter, rubber, carbon black, ash and other information in halogenated rubber stopper were analyzed. Results Through the atlas comparison, plug containing calcium carbonate in the formulation was recognized.TGA method could replace the legal standard of inspection to detect ash content. Conclusion This method can be used to evaluate the consistency of the rubber plug formulation and the stability of the process, thus laying the foundation for choosing drug plug.
Objective To investigate the distribution and drug resistance of pathogens in patients with bloodstream infection from hepatobiliary and pancreatic surgery, and to provide evidence for clinical treatment and infection control. Methods The distribution and drug sensitivity results of positive blood cultures in patients in hepatobiliary and pancreatic surgery from January 2012 to December 2016 were retrospectively analyzed. Whonet 5.6 was used for the statistics of drug resistance. Results Totally, 457 strains were isolated from 4255 of blood cultures of 1850 patients. Aerobic gram negative bacteria were 287 strains (62.8%), aerobic gram positive bacteria were 140 strains (30.6%), fungi were 24 strains (5.3%), and anaerobic bacteria were 6 strains (1.3%). The resistance rate of imipenem, meropenem and tigecycline to Escherichia coli was 0%. The resistance rate of tigecycline, imipenem and amikacin to Klebsiella pneumoniae was 6.5%, 6.5% and 8.1%, respectively. The resistance rate of tigecycline, minocycline and cefoperazone sulbactam to Acinetobacter baumanii was 8.3%, 22.2% and 38.9%, respectively. Gram positive bacteria that are resistant to linezolid, vancomycin, teicoplanin or tigecycline were not found. The incidence rate of MRSA and MRCNS was 92.5% and 91.7%, respectively. Conclusion The proportion of multiple drug resistant bacteria in patients with bloodstream infection from hepatobiliary and pancreatic surgery is high. The combined treatment is needed, and the drug resistance monitoring and infection control measures should be strengthened.
Objective To investigate the pharmacoeconomics of haemocoagulase agkistrodon (HCA) in perioperative period of breast benign tumor treated with mammotome (MMT) system. Methods Totally, 240 patients with breast benign tumor undergoing minimally invasive MMT resection from January to December in 2017 were assigned to group A (HCA 2 U before MMT, 120 cases) and group B (HCA 0U before MMT, 120 cases). The average intraoperative mean blood loss, incidence of intraoperative hematoma, incidence of postoperative hematoma and adverse reactions, average length of hospital stay, drug costs and administration costs were observed and the cost-effectiveness analysis was conducted. Results There were no significant differences between the two groups in the intraoperative mean blood loss and the incidence of intraoperative hematoma, the incidence of postoperative hematoma and treatment effective rate, adverse reactions and average length of hospital stay inpatient drug costs inpatient drug costs (P>0.05), but the average drug costs and administration costs significantly higher in group A than in group B (P<0.01). Group B showed cost-effectiveness advantage. Conclusion Preoperative use of HCA for the treatment of benign breast tumor with MMT minimally invasive resection to prevent bleeding is not obviously efficient, but safe and less economical.
Objective To investigate the effect and security of pegylated liposomal doxorubicin combined with carboplatin in patients with primary advanced or relapsed/metastatic endometrial cancer. Methods Twenty-one patients with advanced or relapsed/metastatic endometrial cancer received pegylated liposomal doxorubicin [30 mg·(m2)-1] + carboplatin (area under curve 5) every 3 weeks for 6 cycles. The response rate,progression-free survival and the toxicity profile were evaluated. Results Two patients had complete responses and 10 patients had partial responses in the 21 patients,for an overall response rate of 57.1%. The median progression-free survival was 9.2 months. The major adverse reactions were haematological toxicity and gastrointestinal reactions. Grade 4 leukopenia was reported in only one patient. Grade 3 leukopenia,anemia,and thrombopenia were observed in 3,1,and 1 of the patients. Grade 1 gastrointestinal reactions occurred in 12 patients,whereas 5 patients experienced grade 2. Other relevant toxicities were stomatitis in 3 patients,palmoplantar erythrodysesthesia in 1 patient,hair loss in 8 patients,and liver toxicity in 1 patient. No renal toxicity and cardiac toxicity were recorded. Conclusion The combination of pegylated liposomal doxorubicin and carboplatin shows good activity and favourable toxicity, and it can serve as a better chemotherapy of patients with advanced or relapsed/metastatic endometrial cancer.
Objective Using Monte Carlo Simulation to estimate and optimize treatment regimens for cephalosporins administration in thoracic surgery so as to provide surgeons with some reference for choosing rational dosing regimens. Methods By using cefazolin and cefuroxime as examples and 100% fT>4MIC (time during which the unbound drug concentration exceeds four-fold the pathogen minimum inhibitory concentration) as the PK/PD target of these drugs for surgical prophylaxis, Monte Carlo Simulation was used to calculate the cumulative fraction of response (CFR) for the specified 100% fT>4MIC target provided by 1, 2, 3 g cefazolin and 0.75, 1.5 g cefuroxime within 6 h post infusion against S.aureus, E.coli, CoNS and S.pneumorüae. A regimen achieving a CFR of ≥90% for the specified 100% fT>4MIC target was considered optimal. Results 2 or 3 g cefazolin against S.aureus within 4 h and against E.coli within 3 h post infusion basically achieved ≥90% CFR; for S.pneumorüae, 1 g of cefazolin also provided excellent CFR within 6 h after administration. However, for all the targeted bacteria even 1.5 g of cefuroxime did not display any ≥90% CFR almost at any time point within 6 h after dose. Conclusion In thoracic surgical procedures we should choose cefazolin as prophylaxis. If duration of an operation is shorter than 3 h a preoperative single-dose of 2 or 3 g cefazolin may be adequate, but if not, an additional dose of 2 g cefazolin at interval of 3 h or 3 g cefazolin at interval of 4 h should be repeated during operation. 1.5 g cefuroxime may be ineffective for thoracic surgical prophylaxis, for this drug we should change the dosing strategy or choose a more sensitive antibiotic.
Objective To explore the treatment strategy of drug-induced pseudoaldosteronism with myocardial injury in order to provide reference for clinical prevention and treatment. Methods Clinical pharmacists summarized the experience of medication adjustment and treatment of a case of pseudoaldosteronism and myocardial injury. Results After definite diagnosis, the hepatoprotective drugs was adjusted, potassium was actively supplemented, and aldosterone receptor antagonist treatment was prescribed for this patient, whose blood pressure, electrolyte, myocardial enzymology and aldosterone levels all returned to normal range. Conclusion By participating in the formulation of drug treatment plans, paying attention to the safety of drug use, and carrying out pharmaceutical monitoring, clinical pharmacists can play an active role in the clinical treatment team.
Objective To analyze the optimal dose of argatroban anticoagulant therapy in continuous renal replacement therapy (CRRT). Methods For 2 patients, clinical pharmacist analyzed the evidence of taking different doses of argatroban in CRRT for high risk of bleeding and hypercoagulation. By analyzing literature about suspicious heparin-induced thrombocytopenia (HIT) patients receiving different doses of argatroban anticoagulant therapy, the clinical efficacy and safety were evaluated. Results Thrombelastography (TEG), coagulation parameters, platelet count and thrombosis or bleeding events were available to assess patient risk of bleeding or thrombosis. The dose of argatroban anticoagulant therapy in CRRT was 0.1-0.6 μg·kg-1·min-1 for patients at high risk of bleeding, according to the literature reports and clinical patients practice. It is recommended to administer a loading dose of 250 μg·kg-1 argatroban, followed by a continuous infusion of 1 μg·kg-1·min-1 in CRRT for patients with hypercoagulable or suspicous HIT, and adjust doses based on coagulation function. Based on current evidence, these two patients had achieved good results in clinical practice. Platelet count and coagulation indicators were improved, and no thrombotic or hemorrhagic complications occurred during Argatroban anticoagulant therapy in CRRT. Conclusion The optimal doses of argatroban anticoagulant therapy in CRRT are different for high risk bleeding, hypercoagulability and HIT patients, and the risk of bleeding and thrombosis should be assessed individually.