Objective To investigate the inhibitory effects and mechanism of allicin on the epithelial-mesenchymal transition (EMT) in gastric cancer cells. Methods Human gastric cancer line HGC-27 cell was routinely cultured in RPMI 1640 medium containing 10% fetal bovine serum.The HGC-27 cell was separated into allin (3 μg·L-1) group,IL-6 (50 ng·L-1) group,or allin (3 μg·L-1) combined with IL-6 (50 ng·L-1) group. In addition,the blank control group was set in parallel.By RT-qPCR technology,we detected the expression of E-cadherin,Vimentin and NF-κB P65.Wst-3-2H-tetrazole menosodium salt (CCK-8) experiment,Wound Healing experiment,and cell invasion experiment were used to test the multiplication,removal and aggression ability of HGC-27 cells in each group. Results RT-qPCR showed that E-cadherin mRNA expression was up-regulated,and Vimentin and NF-κB mRNA expression was down-regulated in allicin group when compared with the blank control group. In IL-6 group, E-cadherin mRNA expression was down-regulated,and Vimentin and NF-κB P65 mRNA expression was up-regulated (all P<0.05)compared with blank control group. Compared to the IL-6 group,Allicin combined with IL-6 up-regulated mRNA expression of E-cadherin,and down-regulated the mRNA expression level of Vimentin and NF-κB mRNA (P<0.05). CCK-8 experiment results showed that,the allicin group has a significant inhibitory effect on gastric cancer HGC-27 cells,and the IL-6 group has obvious proliferation advantages when compared with blank control group. Compared with IL-6 group,allicin combined with IL-6 group also has inhibitory effect.The scratch test showed that compared with the blank control group,the migration capacity of gastric cancer cells was significantly weakened after allicin treatment for 12 or 24 hours. Compared with the IL-6 group,the percentage of scratch healing in the allicin combined with IL-6 group was reduced (all P<0.05). Cell invasion experiments showed that,compared with the blank control group,the number of invasions in the allicin group was decreased,the number of IL-6 invasion was increased significantly,and the invasion ability of allicin combined with IL-6 group was significantly weaker than that of IL-6 group (all P<0.05) . Conclusion Allicin can significantly inhibit EMT in the gastric cancer cells, and attenuate their proliferation,migration and invasion,and this process may be related to NF-κB signaling pathway.
Objective To study the effect and mechanism of polysaccharides in Wuzi Yanzong pill on cardiomyocytes injuries induced by hydrogen peroxide (H2O2). Methods Cultured mouse cardiomyocytes were used to establish a model of H2O2-induced cardiomyocyte injury.Cultured cells were randomly divided into five groups:negative control group, induction group,high dose group,middle dose group,and low dose group.In negative control group, normal mouse cardiomyocytes were isolated and purified and cultured;In the induction group,100 μmol·L-1 H2O2 was added into cardiomyocyte culture medium for 2 hours;In the high dose group,Polysaccharide Wuzi Yanzong was added and treated for 24 hours at a concentration of 1×10-4 mol·L-1,and 100 μmol·L-1 H2O2 was added for 2 hours. In the middle dose group,the cardiomyocytes were cultured at the concentration of 5×10-5 mol·L-1 for 24 hours and then reacted with 100 μmol·L-1 H2O2 for 2 hours.In the low dose group,the cardiomyocytes were cultured at the concentration of 1×10-5 mol·L-1 for 24 hours and reacted with 100 μmol·L-1 H2O2 for 2 hours.The protective effect of polysaccharide in Wuzi Yanzong on cardiomyocytes was detected by MTT method.The cell lactate dehydrogenase (LDH) and creatine phosphokinase (CK) were detected by kit.The contents of CK,MDA,CAT,SOD and GSH-Px were detected,the changes of IL-6 and IL-12 were detected by ELISA kit,and the expressions of Bcl-2,Bax and Caspase were detected by Western blot. Results Compared with the negative control group,the absorbance (A value) of cardiomyocytes in the induction group was decreased in MTT cytes,the release of LDH and CK,MDA,IL-6 and IL-12 was increased,and the activities of SOD,GSH-Px and CAT were decreased in the induction group.The difference was statistically significant (P<0.05).Compared with the induction group,the A value,and the activities of SOD,CAT and GSH-Px were increased;the release of IL-6,IL-12,LDH,CK and MDA was decreased;the protein expression of Bcl-2 and Caspase-3 was down-regulated,and Bax was up-regulated in the Wuzi Yanzong polysaccharides groups.The difference was statistically significant (P<0.05). Conclusion Polysaccharides in Wuzi Yanzong can effectively alleviate the peroxidation injury of cardiomyocytes,and reduce or inhibit the lipid peroxidation reaction,thereby alleviating the injury caused by inflammatory factors.It is speculated that the mechanism may be related to down-regulation of Bcl-2 and Caspase protein expression,and up-regulation of Bax protein expression.
Objective To compare the risk of contrast-induced acute kidney injury(CI-AKI)of isotonic and sub-hypertonic contrast media in elderly patients. Methods From July 2007 to July 2018,the medical data of 1 748 elderly patients who used contrast media for enhanced computed tomography (CT),coronary angiography,cardiac interventional therapy and angiography were retrospectively collected.According to the different types of contrast media,they were divided into two groups:290 cases in the isotonic group and 1 458 cases in the sub-hypertonic group.The diagnosis and treatment data of the patients were collected in detail through the electronic medical record system,including age,gender,baseline creatinine before contrast,glomerular filtration rate before contrast and the maximum creatinine value within three days after angiography.The primary outcome was the incidence rate of contrast induced nephropathy,and the secondary outcome was incidence rate of patients whose creatinine elevation >0.5 mg·L-1 and creatinine elevation >1 mg·L-1. Results Compared with the isotonic group,the sub-hypertonic group had lower mean age,lower basal creatinine level,higher basal GFR level,and lower prevalence of CKD and DM (P<0.05). There was no significant difference between the isotonic group and the matching group.In isosmotic group, the incidence rate of CI-AKI, creatinine elevation of >0.5 mg·L-1, and creatinine elevation of >1 mg·L-1 incidence rate were 7.93%,2.07% and 1.03%,respectively.When compared to the sub-hypertonic (7.33%,1.02%,0.55%) and matching group (8.97%,1.38% and 1.38%), there was no statistical difference. Conclusion Compared with sub hypertonic contrast media, isotonic contrast media can not reduce the risk of contrast induced nephropathy in elderly patients.
Objective To summarize the potential inappropriate drug use problems in the prescriptions of elderly patients with chronic diseases,and to conclude the key points in reviewing the prescriptions of elderly with chronic disease. Methods By integrating the judgment standards and catalogues of domestic and international reports,regarding the potential inappropriate drug use of the elderly,and combining with the characteristics of drug use in China,the key points of prescription review for the elderly chronic disease were concluded. Results The key points of prescription review for elderly with chronic disease included: the suitability of drug selection,the suitability of combined medication,and the suitability of medication dosage. Conclusion Due to the special physical status, many basic diseases and complicated medication use,conducting prescription review with these key points could improve the safety and effectiveness of medication for elderly patients with chronic disease.
Objective To evaluate the prevalence of potentially inappropriate medication (PIM) in elderly inpatients who had been lived in the First Affiliated Hospital of Xinjiang Medical University using Beers criteria ( 2019 edition ),and to determine the risk factors related to the prescription of PIM,so as to provide reference for the rational use of drugs in elderly patients. Methods In the retrospective study,the patients aged ≥65 years at department of geriatrics,hypertension,or coronary heart disease from September to December,2019 were included. TheBeers criteria of 2019 edition was used to identify PIM. A logistic regression analysis was used to identify the risk factors of PIM. Results Totally,344 inpatients were enrolled, included,178 females and 166 males. The inpatients were 65-92 (72.85±5.93) years old,the hospital stay length was 3-23 (7.05±2.85) d,the number of diagnoses was 1-26 (8.52±4.36),and the kinds of drug used was 1-39 (8.71±4.60). 124 (36.05%) inpatients had at least one PIM,and the most prevalent PIM occurred in non-steroidal anti-inflammatory drugs,benzodiazepines and combination of potassium-sparing diuretics and RAS inhibitors. Logistic regression analysis showed that PIM was more likely to occur in patients of hypertension department,with 6-10 kinds of diseases,or whose treatment regimen contained 6-10 kinds of drugs. Conclusion The prevalence of PIM in elderly inpatients is high in elderly patients with more than 6 diseases or using more than 6 drugs. Clinical pharmacists should pay more attention to them in order to optimize medication regimens,reduce the PIM,and promote rational drug use in elderly patients.
Objective To analyse the risk factors of basic renal function in elderly patients (≥75 years old) who intended to undergo surgery,to correct the modifiable factors for high-risk patients in time,and to provide a theoretical basis for perioperative precise medication. Methods We retrospectively analyzed the clinical data of elderly inpatients in the department orthopedics,neurosurgery,general surgery and urology of Xuanwu Hospital of Capital Medical University from January 2016 to December 2019. According to “Kidney Disease:Improving Global Outcomes (KDIGO) guidelines”,the medical records of patients were divided into renal injury group (creatinine clearance rate <60 mL·min-1) and normal renal function group (creatinine clearance rate ≥60 mL·min-1). The basic conditions,chronic diseases and long-term medication of the two groups were compared. Binary logistic regression analysis was used to analyze the risk factors affecting basic renal function of elderly surgical patients. Results The medical records of 2 729 patients were collected,and 1 164 cases (42.7%) were in the renal injury group. Multivariate binary regression analysis results showed that female,age,low BMI,hyperuricemia,long-term use of proton pump inhibitors (PPI),angiotensin converting enzyme inhibitors/ Angiotensin receptor blockers(ACEI /ARB)+ non-steroidal anti-inflammatory drugs (NSAID),ACEI/ARB+ furosemide,and the use of ultra-multiple drugs (≥10 species) were independent risk factors for renal function impairment. Conclusion Preoperative pharmaceutical evaluation should be strengthened for elderly patients who intended to undergoing surgery and took excessive use of drugs. Drug treatment regimens should be streamlined actively. For patients with other risk factors of renal injury,the monitoring of renal function should be strengthened during perioperative period. The nephrotoxic drugs mentioned above should be avoided or reduced,so as to protect the renal function of patients.
Objective To evaluate the efficacy and safety of PD-1 inhibitors in the treatment of elderly patients with advanced non-small cell lung cancer. Methods Based on the method of literature retrieval,the academic websites (including Chinese,American and European societies of clinical oncology) and electronic databases (including PubMed,Ovid,Cochrane Database of systematic reviews,Cochrane Central Register of controlled trials,CNKI,Wanfang and VIP) were searched.The relevant guidelines for non-small cell lung cancer and elderly cancer published by the societies and the literatures about PD-1 inhibitors in the treatment of elderly non-small cell lung cancer were included for descriptive analysis. Results Nine articles were finally included in the analysis,including 3 systematic reviews,subgroup analysis of 2 clinical trials,and 1 real-world 2 case reports and 1 cohort study.The guidelines suggest that introducing PD-1 inhibitors will be a standard new approach for most patients with advanced non-small cell lung cancer without actionable oncogenic driver genes.The current guidelines do not recommend administration of PD-1 inhibitors according to the age.Existing studies shown that the safety outcomes of PD-1 inhibitors in elderly patients with non-small cell lung cancer were similar to the overall study population.Elderly patients between 60 and 65 may benefit from PD-1 inhibitor therapy,but the efficacy of immune checkpoint inhibitors is controversial in patients aged 75 years or older. Conclusion At present,pembrolizumab and nivolumab had more evidence when used in elderly patients with non-small cell lung cancer.The limited evidence shows that pembrolizumab is effective and safe for elderly patients with non-small cell lung cancer.There is a lack of evidence of PD-1 inhibitors in the treatment of elderly patients with non-small cell lung cancer,especially the lack of real-world research.
Medication therapy management(MTM)in the United States has played an important role in solving and preventing drug treatment-related problems,improving the quality of drug treatment,and reducing medical costs. This article briefly introduces MTM programs in medical insurance and Medicare Part D,including the beneficiary qualification standards,service providers,service requirements,and related standardized documents,in order to provide reference for MTM service into the medical insurance in China.
Charges for pharmaceutical service not only protect the legitimate rights and interests of pharmacists,but also encourage pharmacists to provide high-quality service for patients.Medication therapy management (MTM) in China is still in its infancy,and the pharmaceutical service billing model is still in the exploratory stage. The United States is the first country to carry out MTM service, establish billing mode,and incorporate MTM service into Medicare Part D of public health insurance. This article mainly introduces the MTM service billing framework and the compensation mechanism for service providers in the United States,in order to provide a reference for China.
Medication therapy management (MTM) services are important means leaded by pharmacists to improve the safety,effectiveness,and benefit of drug use for patients,which have achieved remarkable results in the United States. However,MTM in China is still in its infancy since the standardized process has not been established yet,and the capabilities of pharmacists also need to be improved. This paper introduces the specific process and ability requirements of medication therapy management in United States,in order to provide a reference for China to carry out standardized medication therapy management services.
Medication therapy management (MTM) is a kind of professional pharmaceutical service that includes a series of activities such as medication therapy evaluation,medication therapy consultation,chronic disease management,and medication therapy plan formulation. The concept originated in the United States and the system gradually matured. Compared with China,the United States has formed a relatively complete medication therapy management service system,which has been applied to various pharmaceutical service places. This paper reviews the service methods of medication therapy management and the related content of medication therapy management based on different service places,in order to better understand the current status of medication therapy management in United States and provide reference for the practice of medication therapy management services in China.
Based on the five core elements of medication therapy management (MTM),this paper interprets MTM service process for a patient with chronic obstructive pulmonary disease (COPD) by conducting medication therapy review,intervention and/or referral,personal medication list,medication action plan,documentation and follow-up,in order to make readers have a perceptual understanding of MTM service.
Vonoprazan,as a novel potassium-competitive acid blockers,is non-inferior or superior to traditional proton pump inhibitors (PPIs) in treatment of patients with acid-related diseases (ARDs),which including gastroesophageal reflux disease,peptic ulcer disease, and helicobacter pylori infection.This new drug will provide a new treatment option for patients with ARDs.
Objective To establish a method for the dissolution determination of colchicine tablet,and evaluate the similarity of the dissolution profiles of 23 batches of 5 manufacturers in China. Methods The dissolution was determined by the third method described in China Pharmacopoeia 2015.Three dissolution media consisting of water,pH 4.5 acetate buffer and pH 6.8 phosphate buffer were employed.The dissolution behaviors of colchicine tablet from different manufacturers were detected,and the similarity of the dissolution curves were evaluated by calculating the similarity factor (f2). Results The colchicine tablets had better dissolution in pH 6.8 phosphate buffer. The dissolution behavior of all products from five manufacturers in China was similar with the reference preparations (f2>50). Conclusion This paper establishes a method for determining the dissolution of colchicine tablets based on the release characteristics of multi-media,which can provide reference for the further quality consistency evaluation of colchicine tablets.
Objective To optimize the formulation and process of aspirin-loaded enteric granules by hot melt extrusion technology. Methods Using drug dissolution ratio in hydrogen chloride (HCl,pH=1.2) and buffer (pH=6.8) solution as the evaluation index,the central composite design was applied to optimize the formulation. Results HPMCAS (79.8%),octadecyl alcohol (4.2%) and silica gel (3.0%) were used as enteric material,drug release modifier,and lubricant,respectively.Homogeneous granules were extruded smoothly at 130 ℃; the dissolution ratio of the granules were (9.1±0.56)% at 2 h in HCl (pH=1.2), and (72.42±3.06)% at 45 min in PBS (pH=6.8),respectively. Conclusion Hot melt extrusion technology is suitable and reliable for preparing aspirin enteric granules.
Objective To research the quality status and problems of naphazoline hydrochloride nasal drops. Methods A total of 262 batches of naphazoline hydrochloride nasal drops produced by 10 manufactures were analyzed according to the legal quality standard.At the same time,some exploratory researches are also carried out.The results of legal inspection and exploratory study were statistically analyzed to evaluate the quality of naphazoline hydrochloride nasal drops. Results The legal qualified rate of 262 batches of samples was 95.4%,and 12 batches of samples were unqualified.The results of exploratory study showed that the contents of related substances in 12 batches of samples were high,while the contents of bacteriostatic agents in 54 batches were high. Conclusion The overall quality of naphazoline hydrochloride nasal drops was not optimistic.
Objective To study the optimal formulation and technology of paroxetine hydrochloride orally disintegrating tablets. Methods The types and dosages of disintegrants,fillers,flavor correctants and lubricants were investigated by single factor test with disintegration time as the index.Fuzzy comprehensive evaluation combined with orthogonal test design was used to optimize the dosage of disintegrant PVPP,filler MCC and mannitol with taste (sweetness and sour),texture (gravel sensibility) and disintegration time as the evaluation index. Results The optimal formulation of paroxetine hydrochloride orally disintegrating tablets were PVPP 13%,MCC 32%,mannitol 38%,aspartame 1%,citric acid 2%,magnesium stearate 0.7%. Conclusion The prescription process is reasonable and the quality is stable.
Objective To explore the concentration of phase separation of ritonavir supersaturated solution and to investigate the crystallization process of drugs after phase separation. Methods The ritonavir supersaturated solution was generated by the solvent transfer method.The concentration of phase separation of the supersaturated solution and the existence of the second dispersed phase formed by the phase separation were characterized by polarized light microscopy,ultraviolet extinction,and dynamic light scattering.Further fluorescence spectra (Pyrene as probe) and dynamic light scattering were used to characterize the crystallization process and particle size change of the second dispersed phase. Results It was observed that the second dispersed phase of the supersaturated solution was in the form of nano-droplets,which were formed when the drug solubility was higher than 37 μg·mL-1.The soluble amorphous drug-rich nano-droplets were initially formed.Crystallization began immediately in the absence of excipients. Conclusion The present study comprehensively characterizes the behavior of phase separation to crystallization of drug supersaturated solutions,provides a basis for subsequent research on the effects of excipients and formulation processes on the second dispersed phase in supersaturated systems.
Objective To study the content of liensinine in Plumula nelumbinis from five producing regions and to analyze its major factors by the investigation on the production regions. Methods Investigation and sample collection were conducted in the main producing regions (Jiangxi,Hunan,Hubei,Fujian and Sichuan province) of Plumula nelumbinis,the content of liensinine was determined according to the Chinese Pharmacopoeia 2015 Edition,and the main factors affecting the content were analyzed. Results The qualified rates of the above five provinces were 0,31.0%,100.0%,0 and 0,respectively. Conclusion The producing regions,harvesting period and varieties are the main factors to affect the content of liensinine in Plumula nelumbinis.
Objective To analyze the characteristics of patients with hypertension after renal transplantation and the utilization of antihypertensive drugs in 5 cities in China from 2015 to 2018,so as to provide reference for clinical rational use of drugs. Methods Based on the multi-center prescription data which were randomly selected from the Hospital Prescription Analysis Cooperation Project,the utilization of antihypertensive drugs was analyzed by the drug utilization analysis method recommended by WHO. Results The data of 33 398 patients with hypertension after renal transplantation were extracted from 40 grade III hospitals (excluding military hospitals) in 5 cities.The ratio of male to female was 2.56.The median age was 43 years old.Patients in the middle age (from 41 to 64 year old)group accounted for the highest proportion (50.93%).The patients mainly purchased drugs in the outpatient pharmacy (81.94%).There was no diagnostic record of hypertension in 75.71% of the patients after renal transplant when using antihypertensive drugs.Among all classes of antihypertensive drugs,the number of calcium channel blockers (CCB) [dihydropyridine CCB (dCCB) 31.15%,non-dihydropyridine CCB (ndCCB) 10.54%],angiotensin II receptor blockers (ARB, 24.86%) and β receptor blockers (βBs,21.16%) prescription were the top three.The PDD/ DDD values of these three kinds of drugs were more than 1.The most commonly used single-drug antihypertensive regimen was dCCB,and the most commonly used combination regimen is dCCB+ARB and dCCB+βB. Conclusion The utilization of antihypertensive drugs in these 5 cities is basically reasonable.But it is still necessary to standardize the diagnostic records and adjustment of drug dosage.During the treatment,the patients' ages,complications,medication compliance and economic status should be considered comprehensively,and the individualized treatment principles should be followed.
Objective To investigate the indications of prophylactic use of antibiotics in patients undergoing liver tumor radiofrequency ablation and evaluate the rationality of preventing the use of antibacterial drugs in patients,so as to provide reference for the regulation of clinical work. Methods Retrospective analysis was used to examine 644 cases of radiofrequency ablation of liver tumors from January 2012 to December 2017 in this hospital.According to the special circumstances of the merger,they were divided into the uncombined group and the combined group (age>65 years old,diabetes,multiple tumors,metastatic liver cancer,especially gastrointestinal or biliary anastomosis).Comparative analysis was used of anti-bacterial and non-prophylactic antibiotics in patients with intrahepatic infection. Results In 644 patients with radiofrequency ablation of liver tumors,the infection rate was 2.33%,of which 476 cases were not combined with other cases,the infection rate was 1.05%,and the infection rate of antibiotics was 1.25%. The rate was 1.01%,the difference was not statistically significant. The postoperative infection rate of prophylactic antibiotics combined with metastatic liver cancer(especially those with gastrointestinal or biliary anastomosis) was 5.56%. The postoperative infection rate was 1.01% compared with the difference (P<0.05). The postoperative infection rate of antibiotics for patients with multiple tumors was 8.33%,and patients with anti-infective drugs were not prevented. The postoperative infection rate was 1.25%, the difference between the two groups was statistically significant (P<0.01). Conclusion Radiofrequency ablation of liver tumors does not require antibiotics to prevent intrahepatic infections. For patients with metastatic liver cancer (especially those who have undergone gastrointestinal or biliary anastomosis),patients with multiple tumors should be given antibiotics before surgery to prevent intrahepatic infection.
Objective To establish a method for evaluation of drug use in children and to evaluate the rationality of voriconazole dosage in children by children drug utilization index (cDUI). Methods Retrospective analysis was carried out on the cases of discharged children who were treated with voriconazole from January 2015 to June 2019. The children were grouped according to bady mass,and the cDUI was calculated. Results According to the method of loading dose administration,the cDUI of the oral form and injection form of voriconazole was basically close to 1 in each body mass group (except that the cDUI of the oral form of voriconazole lower than 10 kg group was 1.27,indicating that the dose of this group was relatively large). However,the cDUI of all the body mass groups without load dosage method was generally lower than 0.8 (except that the cDUI of the injection voriconazole of the body mass lower than 10 kg group was 0.94),and the cDUI of the injection voriconazole was even as low as 0.55 in the >40 kg group. Conclusion The dose of voriconazole in the load dose group was basically reasonable,while the dose in the non-load dose group is relatively small. The establishment of cDUI method is an exploratory process. Although there are still some defects in this system and methods,it is still feasible to evaluate the rationality of dosage in children.
Objective To explore the key points of pharmaceutical service in the treatment of pregnant patients with breast cancer or Hodgkin lymphoma. Methods Clinical pharmacist participated in the treatment of two pregnancy patients with cancer by analyzing the patients,reviewing literature,and provided suggestions on chemotherapy and supportive drugs. Results Clinical pharmacists used their professional knowledge to ensure patients chemotherapy safety. Conclusion Clinical pharmacists actively participate in the diagnosis and treatment of pregnant patients with malignant tumor,and provide individualized pharmaceutical services,which is helpful for clinical medication safety.
Objective To analyze and intervene the questions of “off-label use”in pregnant and parturient women for references of rational drug use in the clinic. Methods Formulating the evaluation standard of “off-label use” in our hospital according to the GRADE classification system (developed by the Oxford Center for Evidence-based Medicine),and Micromedex's Thomson classification system.And this standard is used to evaluate the problem of “off-label use” in actual work. Results The off label use of ritodrine hydrochloride tablets and phloroglucinol for injection should be prohibited in pregnant and parturient women, and tetrabutaline sulfate injection can be used in special situation. Conclusion For pregnant and parturient women, “off-label use” should be careful.It should only be used under the support of authoritative clinical data evidence.
Objective To explore the approaches of pharmaceutical care in lipid-lowering therapy for patients with coronary heart disease. Methods Clinical pharmacists participated in a case of patient with coronary heart disease and provided information of pharmacology,pharmacokinetics,pharmacodynamics and adverse drug reactions of lipid-lowering drugs,including statin,cholesterol absorption inhibitor and evolocumab. Meanwhile,clinical pharmacists performed pharmaceutical care,medication guidance and follow-up for the patient. Results After adjustment of lipid-lowering regimen,the indicators of the patient were significantly improved without drug adverse action. Conclusion Comprehensive pharmaceutical care provided by clinical pharmacists are important to improve the safety,efficacy and compliance of lipid-lowering therapy for patients with coronary heart disease.
Objective To investigate risk factors associated with liposomal amphotericin B-related acute kidney injury and record the incidence. Methods A retrospective study was performed to collect data in adult patients receiving liposomal amphotericin B(AmBisome) from January 2016 to December 2018,basic information and related medications were recorded for univariate and multivariate stepwise logistic regression analysis. Results A total of 272 patients receiving AmBisome,24 patients had AKI with an incidence of 8.8%.According to univariate analysis,factors associated with acute kidney injury were female gender,concomitant use of cyclosporin,hematopoietic stem cell trans-plantation and cumulative dose of AmBisome≥450 mg (P<0.1).Multivariate analysis identified two independent factors including female gender and cumulative dose of AmBisome≥450 mg(P<0.05). The creatinine value of 13 patients with AKI decreased after one week of drug withdrawal (P<0.05). Conclusion AKI induced by AmBisome is a common complication inpatient, and the risk assessment of AKI to female patients and patients treated with AmBisome whose cumulative dose ≥450 mg should be strengthened during the treatment. The value of creatinine should be closely monitored during the administration,especially around the 2 weeks. In addition,the AKI induced by AmBisome in the most patients was reversible.
This article analyzed the role of the American pharmaceutical industry association in the quality assurance of doctors of pharmacy (Pharm.D.) training. It mainly sorted out the ways of the American pharmacy industry through leading professional certification,instructing talent training,and organizing qualification examinations to fully participate in the doctoral education of pharmacy.On this basis,we put forward institutional recommendations for establishing a professional certification system for master degree of pharmacy in our country,encouraging industry associations to participate in pharmacy personnel training,organizing professional certification,and achieving the linkage of professional degree education and practicing qualifications.This system framework provided useful theoretical and practical references to improve quality assurance system of pharmacy professional degree in China and to realize a high-quality development in pharmacy education.