OBJECTIVE:To provide reference for the training of clinical pharmacists in specialized hospitals. METHODS:Based on the characteristics of psychiatric patients,diseases and drugs ,we have discussed from the related links of the trained per-sons,the training targets,the training modes ,the training courses and so on .We have quantified the work of the trained pharma-cists to finish the training period. RESULTS:The cultivation of psychiatric clinical pharmacists take young pharmacists of high com-prehensive quality as the trained persons. They should study in the department of special clinical characteristics,be trained by the teaching team of physicians and pharmacists. After training they can better complete drug cases writing,drug education and other quantitative work. CONCLUSIONS:It shows that the training mode is in accordance with the characteristics of the state psychiatric hospital. This training mode is worth promoting.

OBJECTIVE:To investigate the characteristics of serious ADR in psychiatric hospital,and to provide reference for effective and safe use of drugs in the clinic. METHODS:114 cases of serious ADR in our hospital from 2004 to 2015 were ana-lyzed retrospectively in terms of general information,primary disease,route of administration,dosage form,drug types,organs or systems involved in ADR and clinical manifestations,top 5 ADR-inducing drugs and main clinical manifestations,etc. RESULTS:Of 114 serious ADR cases,the number of female was more than that of male(71/43). Patients aged 21-30 years old took up the greatest proprotion(35 cases,30.70%). The main involved primary disease was schizophrenia(54 cases,47.37%). Oral adminis-tration-induced ADR was most common(103 cases,90.35%). The main involved drugs were antipsychotics,occupying the great-est proportion(75 cases,65.79%). Digestive system involved was the most common(53 cases,42.74%), Olanzapine tablets had the highest incidence of serious ADR (23 cases,18.55%),the main clinical manifestation were both abnormal liver function. There were 8 cases of new serious ADR (7.02%). Most of the ADR can be cured after drug withdrawal or countermeasures,no death case was found. CONCLUSIONS:Psychiatric drugs can induce serious ADR as treat psychiatric disease,among which the in-cidence of ADR induced by Olanzapine tablets is the highest and mainly manifestes digestive system symptoms. It is suggested to strengthen serious ADR monitoring to promote the safe use of drugs.

OBJECTIVE:To analyze the features of risperidone-induced leucocytopenia ADR.METHODS:Twenty-one ADR cases of risperidone-induced leucocytopenia reported by our hospital were collected and analyzed during 2004-2015.The characteris tics of risperidone-induced leucocytopenia were discussed.RESULTS:Among 21 patients,there were 10 male and 11 female.The age was from 15 to 72 years old.Nine cases of patients were 31-40 years old (42.9％).Most of the original disease was schizophre nia.Incubation period of leucocytopenia caused by risperidone was (28.6 ± 21.4) d.Patients had no discomfort complain when leucocytopenia occurred.The lowest white blood cells reported was(3.1 ± 0.5)× 109 L-1.The leucocytopenia were improved after reduc tion,drug withdrawal and symptomatic treatment.CONCLUSIONS:Patients usually have no body discomfort complain when risperidone-induced leucocytopenia appears.Doctors should moniter ADR regularly,identify it earlier and treat carefully.

OBJECTIVE:To investigate the characteristics of central nervous system(CNS)ADR caused by olanzapine,and to provide reference for safe and rational drug use in clinic. METHODS:Thirty cases of CNS ADR caused by olanzapine reported by our hospital to national ADR monitoring center were collected during 2004-2015. General information of patients,drug therapy, ADR,treatment measures and outcomes were analyzed statistically. RESULTS:Among 30 cases of CNS ADR caused by olanzapine, the female was more than male(22/8);the age of patients mainly ranged 21-40 years old(10 cases,33.3%). The original disease was given priority to schizophrenia (18 cases,60.0%). When ADR occurred,average dose of olanzapine was (18.0 ± 7.0) mg/d. The daily dose of 20 mg accounted for the most of ADR(8 cases,26.7%). Main ADR was extrapyramidal syndrome(22 cases, 73.3%). When mostly reduced the drug dose,stopped olanzapine,switched to other antipsychotics,and actively adopted symp-tomatic support treatment,the symptoms were relieved or returned to normal. CONCLUSIONS:The extrapyramidal syndrome take up the majority of CNS ADR caused by olanzapine. ADR is also likely to happen even if the daily dose is small. CNS ADR are more likely to happen in women. At the beginning of the treatment within a month,close attention should be paid to ADR. It is sug-gested to grasp the indications strictly and observe ADR so as to ensure the safety of drug use.

AIM: To observe the levels of triglyceridemia(TG),uricemia(UA),glycemia(GLU),the activity of 3-glyceraldehyde phosphate dehydrogenase(GAPDH) in blood and the gene expression in the liver in the animal model of hypertriglyceridemia,hyperuricemia and hyperglycemia.METHODS: SD rats were randomly divided into three groups,control group,fructose group,fructose and fenofibrate treated group.Rats in control group were fed with standard chow.Rats in fructose group were fed with high fructose diet.Rats in fructose and fenofibrate group were fed with high fructose diet,and treated with fenofibrate 100 mg?kg-1?d-1 by intragastric administration at the same time.Rats in control group and fructose group were given distilled water by intragastric administration.The levels of TG,UA and GLU were detected.Improved method was used to measure the activity of GAPDH.Quanti Gene technology was applied to determine the transcriptional level of GAPDH mRNA.RESULTS: During 7-28 d,the level of TG in fructose group was significantly and persistently high.During 14-28 d,the level of UA was higher.The level of GLU higher than that in control group was only observed at 28th day.The GAPDH activity change in blood and the expression in liver were significantly lower than that in norma1 during 7-28 d.Fenofibrate had the effect on reducing TG only at 7th day and reduced the level of GLU significantly at 28th day.Fenofibrate also increased the GAPDH activity in blood and the expression in liver at 7th day.CONCLUSION: ① The level of TG is significantly and persistently high in the early days by feeding with excessive fructose.The levels of UA and GLU are higher with the time cause of the model development.② The significantly higher level of TG,UA and GLU may be correlated with the reduction of the GAPDH activity in blood and the expression in liver.③ Fenofibrate has the effect of reducing the TG level only in the condition of hypertriglyceridemia,but not in the condition of accompanying hyperuricemia and hyperglycemia.④ The mechanism of reducing the TG level by fenofibrate may be correlated with the increase in GAPDH activity in blood and the expression in liver.

With DQOL (diabetes quality of life) scale, quality of life was evaluated before and after diabetic education in 136 type 2 diabetic patients. The Cronbach′s ? of DQOL scale was from 0.809 to 0.849, suggesting that the DQOL scale did effectively reflect the life quality of type 2 diabetic patients.

Objective To investigate the effect of carvedilol on survival improvement in patients with liver cirrhosis and ascites. Methods A retrospective cohort study was conducted by following up the patients with liver cirrhosis and ascites,the patients were treated in our hospital from March 1st,2010 to March 1st,2011. One hun-dred and fifty eight patients were enrolled and followed up for 5 years to determine the survival status. Patients were divided into the carvedilol group and the propranolol group based on the use of the therapeutic drugs. The baseline , treatment and follow-up data were compared ,and the survival status of patients in two groups were described by the survival curve. The factors influencing the survival of patients with liver cirrhosis ascites were analyzed by the Cox proportional hazards model. Results The age,BMI,HVPG reduction and the prevalence of diabetes in the carve-dilol group were higher than those in the propranolol group ,but upper gastrointestinal variceal re-bleeding rate was lower than that in the propranolol group,with significant differences(P < 0.05,respectively). Kaplan Meier sur-vival function showed that the cumulative survival rate of the carvedilol group was higher than that of the proprano-lol group(P<0.05). Cox regression result showed that hazard ratio of RR=0.714,95％CI(0.565～0.902),P=0.013. Conclusion Carvedilol is a protective factor for patients with liver cirrhosis and ascites ,contributing to im-proving the survival status ,reducing liver cirrhosis related deaths.

OBJECTIVETo analyze the biodistribution of (186)Re-lipiodol (RL) in patients with primary liver cancer (PLC) after hepatic arterial injection in attempt to assess the potential of RL as a radiopharmaceutical for the treatment of PLC.

METHODSRL was synthesized from (186)Rhenium and Lipiodol by a series of physical and chemical procedures. Doses of RL ranged from 1 110 MBq to 2 220 MBq per patient depending on the volume of tumor. Quantitative gamma camera imaging (ECT) and gamma counting of serum and urine were used to obtain data for dosimetry estimation. Serum tumor marker (AFP) level and shrinkage of tumor were used to evaluate the therapeutic efficacy of RL.

RESULTSIn the hepatic tumor, RL was selectively retained and radioactivity was very high throughout this study. The ratio of tumor concentration to the normal liver tissue concentration (T/NT ratio) was 10 - 14 at 48 hours after injection of RL. The main side effects of this therapy were transient fever and anorexia. No unacceptable toxicity was observed. In 100% of the patients, the therapy resulted in a significant decrease of AFP level and reduction of tumor volume.

CONCLUSIONThe biodistribution and imaging results demonstrated RL localized selectively in tumor, and that RL may be a potential internal radiopharmaceutical agent for the treatment of primary liver cancer.

Adult ; Aged ; Carcinoma, Hepatocellular ; drug therapy ; metabolism ; Drug Carriers ; Humans ; Infusions, Intra-Arterial ; Iodized Oil ; administration & dosage ; Liver Neoplasms ; drug therapy ; metabolism ; Male ; Middle Aged ; Radiopharmaceuticals ; adverse effects ; pharmacokinetics ; therapeutic use ; Radiotherapy Dosage ; Rhenium ; adverse effects ; pharmacokinetics ; therapeutic use ; Treatment Outcome

Objective To investigate the intralaboratury and interlabomtory variations of measurements for ALT and AST among four domestic reference laboratories. Methods The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) reference procedures and IFCC procedures without pyridoxal 5-phosphate (PLP) were performed in the reference laboratories. Intralaboratory and interlaboratory CVs were compared with those in 2006 and 2007 IFCC External Quality Assessment Scheme for Reference Laboratories (RELA). Meanwhile, deviations of results for ALT, AST and AST/ALT between two methods were calculated. Results Interlaboratory CVs were generally higher than intralaboratory CVs. Interlaboratory CVs among the 41 laboratories were lower than these in RELA. Results of ALT and AST using method with PLP were higher than those using method without PLP. Difference of AST/ALT ratio between the two methods was significant. Conclusions For reference measurement of the 2 enzymes, interlaboratory CVs of < 3.5 are achievable on frozen serum materials. Measurements on lyophilized materials may have higher CVs. Further studies are needed for the investigation of the differences between results obtained in the absence and presence of PLP.

Objective: To investigate the relationship between hope, mental suffering and quality of life in radiotherapy patients with cervical cancer, to provide the basis for the cancer patient′s psychological intervention. Methods: A cross-sectional study of 120 cases of radiotherapy cervical cancer patients was conducted, using the psychological distress thermometer, Herth Hope Scale, Life Quality Measurement Scale for patients with cervical cancer to evaluate patients′ hope, quality of life and psychological distress. Results: Radiotherapy cervical cancer patients′ psychological distress and hope were negatively correlated (r=-0.385, P <0.01), psychological distress and quality of life were negatively correlated (r=-0.602, P <0.01), hope and quality of life were positive correlation (r=0.711, P <0.01). Patients′ hope played partially mediated effect between psychological distress and quality of life, emotional status, functional status, played fully mediated effect between psychological distress and social family status. The Mediated effect sizes were 35.9%, 36.3%, 55.9% and 100.0%. Conclusions Psychological distress has not only a direct negative effect on the quality of life of cancer patients, but also an indirect negative effect through hope. During the Medical care, we should accurately assess of patient's psychological distress and hope, and take measures to help improve patients' hope and alleviate psychological distress, so as to improve patients′ quality of life.