Objective:To discuss the ways to deal with adverse drug reactions in pharmaceutical care. Methods:A case of drug-induced kidney injury was provided to analyze the effect of clinical pharmacist on adverse drug reactions. Results and Conclusion:Good quality of pharmaceutical care, such as reliable drug information, is valuable in clinical practice.

Aim To investigate effects of berberine (Ber) on the transport of P-gp substrates including cyclosporine A (CsA) and digoxin across Caco-2 and L-MDR cell monolayers. Methods Permeability coefficients and transport rates of digoxin and CsA across Caco-2 and L-MDR1 monolayers were measured in the presence of Ber(50 ?mol?L-1~5 mmol?L-1). Results The inhibition studies for digoxin transport showed a dose-dependent decrease in basal-to-apical direction across Caco-2 and L-MDR1 monolayers in the presence of Ber (50 ?mol?L-1~5 mmol?L-1). Both a dose-dependent decrease in basal-to-apical direction and an increase in apical-to-basal direction were observed for CsA transport across Caco-2 monolayers with different concentrations of Ber. The IC50 values calculated for Ber-induced inhibition of digoxin transport are 1.44 mmol?L-1 in Caco-2 cells and 1.24 mmol?L-1 in L-MDR1 cells, respectively. The IC50 value for Ber-induced inhibition of CsA transport is 607 ?mol?L-1 in Caco-2 cells. Conclusion It was suggested that the inhibition and saturation of P-gp transport activity might be involved in interactions between Ber and CsA.

Background:NLRP3 inflammasome attracts widespread attention in study of inflammatory bowel disease. Faecalibacterium prausnitzii(Fp)is an anti-inflammatory commensal bacterium that has preventive and therapeutic effects on rat colitis. Aims:To explore the underlying mechanism of Fp in treating experimental colitis in rats. Methods:Fifty rats were randomly divided into two groups,10 in control group and 40 in model group. Rats in model group were administered intrarectally with 5% TNBS and dehydrated alcohol to induce experimental colitis. Twenty-four hours afterwards,the model rats were further divided into four groups and administered intragastrically with PBS,culture medium,live Fp and Fp supernatant 1 mL per day,respectively,for 7 days. On day 8,all the rats were sacrificed for evaluation of colonic inflammation. Expressions of the constituents of NLRP3 inflammasome(NLRP3,ASC,and caspase-1)were assessed by Western blotting and real-time PCR;levels of IL-1β and IL-18,the downstream effectors of NLRP3 inflammasome,in colon and plasma were measured by real-time PCR and ELISA,respectively. Results:Weight loss, reduced colon length and colonic inflammatory injury were observed in model rats. These manifestations were ameliorated in live Fp and Fp supernatant groups than those in PBS and culture medium groups. In PBS and culture medium groups, expressions of NLRP3,ASC,and caspase-1 protein and mRNA in colonic tissue were significantly higher than those in control group(P < 0. 05),the colonic and plasma levels of IL-1β were increased(P < 0. 05),and IL-18 levels were decreased(P < 0. 05). In live Fp and Fp supernatant groups,IL-18 level showed a further reduction as compared with PBS and culture medium groups( P < 0. 05),but the increasing trend for other parameters was reduced( P < 0. 05). Conclusions:NLRP3 inflammasome participates in the development of TNBS-induced colitis in rats. Fp might alleviate colonic inflammation by inhibiting NLRP3 inflammasome and its downstream effectors.

BACKGROUND:Previous studies have found that the susceptibility genes of adiponectin gene and calpain 10 gene of type 2 diabetes are closely related with the incidence of diabetes in Chinese renal transplantation patients. So, are other susceptibility genes of type 2 diabetes also associated with posttransplantation diabetes mel itus? OBJECTIVE:To investigate the association between the zinc transporter solute carrier family 30 member 8 (SLC30A8) gene polymorphism and the posttransplantation diabetes mel itus. METHODS:A total of 97 patients with posttransplantation diabetes mel itus and 301 patents without posttransplantation diabetes mel itus (control group) were selected, and then the SLC30A8 gene rs13266634 genotype was detected with real-time PCR method. The association between gene polymorphism and posttransplantation diabetes mel itus was analyzed with Logistic regression test. RESULTS AND CONCLUSION:There were significant differences in al ele frequencies and genotype distributions of rs13266634 between the patients with and without posttransplantation diabetes mel itus (P<0.05). After adjustments of age, sex, body weight and body mass index, the incidence of posttransplantation diabetes mel itus of the CC genotype patients was 2.108 times to that of the TT genotype patients (odds ratio=2.108, 95%confidence interval:1.075-4.131, P=0.044);and the incidence of posttransplantation diabetes mel itus of the CC+CT genotype patients was 1.862 times to that of the TT genotype patients (odds ratio=1.862, 95%confidence interval:1.049-3.306, P=0.034). The results suggest that the C-al ele in rs13266634 of SLC30A8 gene is the independent risk factor of posttransplantation diabetes mel itus.

Objective:To evaluate the effect of continuing intervention on prophylactic application of antibiotics in sterile operation in urology department by clinical pharmacist to provide reference for the clinical prophylactic application of antibiotics. Methods:All cases of discharged patients underwent sterile operation in urology department of our hospital from July 2010 to June 2014 were divided into three groups according to the intervention time and methods: non-intervention group(n=141), stage Ⅰ intervention group(n=139), stage Ⅱ intervention group (n=162) and stage Ⅲ intervention group (n=137). The prophylactic application of antibiotics was statistically analyzed. Results:After the continuing intervention, the prophylactic application rate of antibiotics in the three inter-vention groups was decreased significantly from 100% before the intervention respectively to 34. 5%,18. 5% and 14. 6% after the in-tervention (P<0. 01). The rationality rate of prophylactic application was improved significantly from 36. 9% before the intervention respectively to 58. 3%, 63. 3% and 85. 0% after the intervention (P<0. 01). The course of prophylactic application was decreased significantly from (138.2 ±31.6)h respectively to (89.9 ±48.0)h,(72.8 ±32.5)h and(45.1 ±29.5)h (P<0.01) and the post-operative infection rate was decreased from 2. 8% respectively to 2. 1%,1. 8% and 1. 4%. Conclusion:The pharmaceutical interven-tion is feasible and valid to improve the rational prophylactic use of antibiotics in urological surgery.

OBJECTIVE:To evaluate the efficacy and safety of Fluvastatin vs. Xuezhikang for hyperlipidemia in patients after renal transplantation. METHODS: 56 hyperlipidemia patients after renal transplantation were enrolled: 32 were assigned to receive Fluvastatin (40～80 mg) po qd for 8 weeks and 24 to receive Xuezhikang (0.6 g) po bid for 8 weeks. Total cholesterol (TC),triglyceride (TG),low-density lipoprotein-cholesterol (LDL),high-density lipoprotein-cholesterol (HDL),liver function and renal function in two groups were measured before and after treatment. RESULTS: In Fluvastatin-treated group,the TC decreased from(7.39?1.98)mmol?L-1 to(5.62?0.93)mmol?L-1,LDL reduced from(3.68?1.13)mmol?L-1 to (2.86?0.83)mmol?L-1;in Xuezhikang-treated group,TC decreased from(6.82?1.29)mmol?L-1 to (5.56?1.19) mmol?L-1 and LDL decreased from (3.26?0.73) mmol?L-1 to (2.78?0.80) mmol?L-1,all showing significant differences as compared with before treatment(P 0.05). No obvious adverse effect was noted in either group during treatment. CONCLUSION: Both Fluvastatin and Xuezhikang are safe and effective for hyperlipidemia in patients after renal transplantation.

Objective:To study the effect of cyclosporin A based triple immunosuppressive therapy on the plasma glucose in renal transplant recipients.Method:680 renal transplant recipients treated with cyclosporine A combined with prednisone and mycophenolate mofefil from Jan.1996 to May 2007 were analysed.Result:The morbidities of impaired fast- ing glucose,impaired glucose tolerance and post-transplantation diabetes mellitus (PTDM) were 3.97%,5.15% and 8.09%,respectively.The daily doses and concentrations of CsA and the daily doses of prednisone in the impaired glucose tolerance group and PTDM group were significantly higher than those in the normal plasma glucose group.Conclusion:The daily doses and concentrations of CsA and the daily doses of prednisone were closely related to the impaired glucose toler- ance and PTDM of renal transplant recipients.

Objective:To explore the breakthrough points of pharmaceutical care in the anti-infection treatment by clinical phar-macists. Methods:Using the pharmaceutical care carried out by clinical pharmacists in the treatment of infected patients as the exam-ple, the breakthrough points of pharmaceutical care in the anti-infection treatment by clinical pharmacists were discussed. Results:Clinical pharmacists should be in accordance with the specific clinical conditions to find out such breakthrough points of pharmaceutical care as judging the indications of antibacterial drugs use, assisting in the development of drug therapeutic regimens ( including the choice of species, dosage and solvent, the optimization of PK/PD parameters and the infusion speed) , paying close attention to bacteri-al culture, concerning on drug interactions, monitoring adverse drug reactions and efficacy, providing patient medication education and so on. Conclusion:Clinical pharmacists can participate in anti-infection treatment and carry out individual pharmaceutical care to en-sure the safety and efficacy of drugs.

OBJECTIVE:To investigate the effect of clinical pharmacist intervention on prophylactic application of antibiotics in cardiothoracic surgery. METHODS:Medical records of patients underwent cardiothoracic surgery were collected from our hospi-tal during Mar. to Apr. in 2014 (before intervention) and during Jun. to Jul. in 2014 (after intervention). Those were divided into pre-intervention group(n=115)and post-intervention group(n=119). The prophylactic application effect of antibiotics was com-pared before and after intervention. RESULTS:After intervention,the rates of prophylactic application were decreased significantly from 96.5% to 72.3%;the rationality rate of antibiotics selection was improved significantly from 27.9% to 94.2%;The course of prophylactic medication decreased significantly from(5.4±2.8)days to(2.3±1.8)days;the difference had statistical significance before and after intervention(P<0.01). The postoperative infection rate was decreased from 13.0% to 5.9%,the difference had no statistical significance(P=0.074). The average hospitalization time,average drug costs,and average hospitalization expenses were decreased significantly,the difference had statistical significance(P<0.05 or P<0.01). CONCLUSIONS:Clinical pharmacist inter-vention to prophylactic application of antibiotics in cardiothoracic surgery can control the infection effective and guarantee reason-able and safe use of drugs during perioperative period.

AIM To study the effects of coadministration of berberine chloride(Ber) with cyclosporin (CsA) on liver microsomal cytochrome P450 isoenzyme and multi drug resistance gene in rats. METHODS The activities of liver microsomal erythromycin demethylase(ERD) and aminopyrence N demethylase(ADM) were determined. The levels of mRNA expression of CYP3A1, CYP1A1, CYP2E1, mdr1a and mdr1b were assayed with RT PCR. RESULTS After administration for 6 days, all treatment groups except Ber at 100 mg?kg -1 exhibited inhibitory action on ERD activity in rats. ERD activity markedly decreased in all drug treatment groups after taking drug for 12 days. After administration for 6 days, 45 mg?kg -1 CsA, 100 mg?kg -1 Ber coadministrated with 45 mg?kg -1 CsA and 200 mg?kg -1 Ber plus 45 mg?kg -1 CsA had significant inhibitory effects on ADM activity in rats. All groups except 100 mg?kg -1 Ber and 150 mg?kg -1 ketoconazole had the same effects on ADM activity after treatment for 12 days. Again, after 12 days, all drug treatment groups except 100 mg?kg -1 Ber group was found of remarkable inhibition of the mRNA expression of CYP3A1, CYP2E1, mdr1a and mdr1b. The CYP1A1 gene was not detected in all groups. CONCLUSION The mechanism of Ber to increase CsA concentration is that Ber decreases the expression of CYP3A, mdr1a and mdr1b thereby reduces the metabolism and elimination of CsA by liver.