OBJECTIVE:To explore the role of clinical evidence-based pharmacy in anticoagulant treatment strategies during continuous renal replacement therapy (CRRT). METHODS:Taking a thrombocytopenia patient of anticoagulant treatment during CRRT for instance,clinical pharmacists analyzed the evidence of taken argatroban anticoagulant therapy during CRRT for high risk blooding and thrombocytopenia patients based on evidence-based pharmacy combined with clinical data,monitored the efficacy and safety and evaluated the treatment process. RESULTS:Totally five literature about anticoagulant treatment strategies during CRRT for high risk blooding and thrombocytopenia patients were obtained,including one systematic review,one RCT and three cohort studies. Based on the above evidences,good results were achieved in the clinical practice of this patient,no thrombotic or hemor-rhagic complications occurred in this patient,platelet count and coagulation indicators of patients also improved. CONCLUSIONS:Evidence-based pharmacy plays an important role in anticoagulant treatment strategies during CRRT.

Objective:To explore the role of clinical pharmacists participating in analgesic pharmaceutical care. Methods:Through participating in the analgesic treatment of a patient with left upper lung adenocarcinoma complicated with bone metastases,clinical pharmacists analyzed the rationalization of analgesic drug use in the cancer patient and the contents of pharmaceutical care. Results:Clinical pharmacists timely discovered and solved the problems and provided reasonable advice for clinics during the whole pharmaceutical care process of the cancer patient. Conclusion:Analgesic pharmaceutical care carried out by clinical pharmacists is beneficial to promoting the individualization and standardization of pain treatment,which plays an important role in the rational drug use,reduce adverse drug reactions and so on.

OBJECTIVE:To establish a RP-HPLC method for the determination of capsaicin in Capsicum annuum. METHODS:The determination was performed on Zorbax Eclipse XDB-C18(150 mm?4.6 mm,5 ?m) column with column temperature set at 40 ℃.The mobile phase consisted of acetonitrile and 0.1% phosphate acid solution (45∶55,pH=2.6) with flow rate at 1.0 mL?min-1 and detective wavelength set at 281 nm.RESULTS:The calibration curve of capsaicin was linear over the concentration range of 30～70 mg?L-1(r=0.999 9).The average recovery for capsaicin was 101.33 %(RSD=1.57%,n=9).CONCLUSION:The method is simple,rapid and accurate,and suitable for the determination of capsaicin in Capsicum annuum.

ObjectiveTo investigate the effects of two health education models on the psychology and nutrition of patients waiting for cadaveric renal transplantation.Methods A total of 125 patients waiting for cadaveric renal transplantations were involved in our study.They were diagnosed with chronic renal failure in our hospital during September 1, 2009 to August 30, 2010.The patients were randomly divided into control group (n = 62) and observational group(n = 63).Patients in the control group received traditional health education with routine preoperative education during hospitalization.In the observational group, full-time nurses assessed the nutrition status of each patient and monitored the data. The observational patients were followed up and were given dietary guidance and knowledge of transplantation.Various kinds of education formats were adopted in observational group to provide communication opportunities between patients and surgeons in charge as well as patients who underwent transplantation.Psychological testings of patients in both groups were tested by self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after the health education.Triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC) and biochemistry index were also tested.Psychological and nutritional status of patients in the two groups was compared.ResultsThere were no significant differences in scores of the SAS, SDS, TSF, Hb, and albumin (Alb) between the two groups (all P＞0.05) before health education.After health education, SAS and SDS in observational group were lower than those in the control group (40.02 ±9.05 vs 47.05 ± 10.32,42.70 ± 10.01 vs 50.83 ± 10.12; both P＜0.01).Both TSF and Hb were elevated after education (P ＜ 0.001 or 0.05).Alb was significantly elevated in the observational group [(35.67 ±6.19)g/L vs (37.48 ±5.09)g/L, P ＜0.01].ConclusionComprehensive and various health education methods can significantly alleviate mental stress and improve nutrition of the patients waiting for kidney transplantation, which is helpful for patients facing disease positively and having a better quality of

Objective To investigate the effects of penehyclidine hydrochloride on blood-brain barrier in a rat model of cardiopulmonary bypass ( CPB) . Methods Sixty adult male SD rats, aged 4-6 months, weighing 320- 370 g, were randomly divided into 5 groups ( n = 12 each) : sham operation group (group S), CPB group, and low-, median- and high-dose penehyclidine hydrochloride groups (groups LP, MP and HP). The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg, intubated and mechanically ventilated. The femoral and jugular arteries and jugular vein were cannulated. CPB was performed for 60 min. Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in groups LP, MP and HP respectively, while the equal volume of normal saline was added in group CPB. Evans blue was injected via femoral vein at 1 h before the animals were sacrificed. Six rats in each group were sacrificed, their brains immediately removed and the hippocampi isolated for determination of Evans blue content. The other rats were sacrificed and the hippocampi isolated to determine the water content and observe the ultrastructure of blood-brain barrier. Results Compared with group S, the Evans blue content and water content were significantly increased in the other groups ( P ＜ 0.05) . Compared with groups CPB and LP, the Evans blue content and water content were significantly decreased in groups MP and HP ( P ＜ 0.05) . The Evans blue content was significantly lower in group HP than in group MP ( P ＜ 0.05). The CPB-induced changes were significantly attenuated in groups MP and HP compared with groups CPB and LP. Conclusion Penehyclidine hydrochloride can protect blood-brain barrier against the CPB-induced injury and the effect is related to the dose.

Objective To investigate the effect of penehyclidine hydrochloride on brain injury induced by cardiopulmonary bypass (CPB) in rats. Methods Thirty adult male SD rats were randomly divided into 5 groups ( n = 6 each): sham operation group (group S), CPB group, and low, median and high dose penehyclidine hydrochloride groups (group PL, PM , PH). Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in group PL, PM and PH respectively, while the equal volume of normal saline was added instead in group S. Blood samples were obtained at 2 h after termination of CPB to determine the plasma concentrations of neuron specific enolase (NSE) and S-100β protein. The brain tissues were taken to observe the ultrastructure of hippocampal neurons with electron microscope. Results The concentrations of NSE and S-100β protein were significantly higher in the other groups than in group S, while lower in group PM and PH than in group CPB and PL( P＜ 0.05). The S-100β protein concentration was significantly lower in group PH than in group PM( P ＜ 0.05). The damage to hippocampal neurons was significantly attenuated in group PM and Ps. Conclusion Penehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced brain injury in a dose-dependent manner in rats.

Objective Analyze the amino acids and acylcarnitines in the blood of patients first diagnosed with uremia using tandem mass spectrometry in order to provide a basis for clinical diagnosis and treatment. Methods 30 patients with uremia were selected as the research objects,while 15 cases of healthy person were served as the control. The values of 11 kinds of amino acids and 2 kinds of acylcarnitines in the two groups were detected using tandem mass spectrometry,and the data were analyzed and compared. Results The levels of alanine(Ala)and tyrosine(Tyr)in uremia group were significantly lower than those in control group(P < 0.05),while the levels of citrulline(Cit),glycine(Gly)and proline(Pro)were significantly higher in uremia group than in control group (P < 0.05). The differences were mainly in non-essential amino acids between the two groups. The levels of free carnitines and total carnitines in uremia group were significantly higher than those in normal group(P < 0.05). Conclusion For the patients first diagnosed with uremia(not treated with replacement therapy),the disturbance of amino acid metabolism mainly in non-essential amino acids were found in their blood,and the carnitine levels were higher than normal levels. The results could provide the basis for clinical nutrition therapy for patients with uremia.

Objective To prepare and screen out monoclonal antibodies against the receptor bind-ing domain (RBD) of Middle East respiratory syndrome coronavirus ( MERS-CoV) spike ( S) protein in mice. Methods The RBD of MERS-CoV S protein expressed in the insect-baculovirus system was purified and then used to immunize the female BALB/ c mice. The spleen cells collected from the mice were fused with myeloma Sp2 / 0 cells. The positive hybridoma cells were obtained by using limited dilution method. Enzyme-linked immunosorbent assay ( ELISA), Western blot assay and neutralization test based on the MERS-CoV pseudovirus were performed for further screening and identification. Results Twelve strains of hybridoma cells that produced the monoclonal antibodies against RBD of MERS-CoV S protein were screened out. All of the 12 monoclonal antibodies (McAbs) could have specific reaction with the RBD of MERS-CoV S protein as indicated by the results of ELISA. Of the 12 McAbs, two were identified as the immunoglobulin M (IgM) isotype and the rest were IgG1 isotype by using double antibodies sandwich ELISA. Four McAbs including 1F1, 2E4, 3C3 and 3E6 were identified as having neutralizing activity by the neutralization test based on MERS-CoV pseudovirus. Results of the Western blot assay showed that the four McAbs (1F1, 2E4, 3C3 and 3E6) could have specific reaction with the RBD of MERS-CoV S protein, but no cross-reac-tion with that of SARS-CoV S protein. Conclusion Twelve mouse-derived McAbs against the RBD of MERS-CoV S protein were obtained. The prepared hybridoma cells showed the characteristics of high speci-ficity and stability in antibody secretion. Four out of the 12 McAbs were proved to have neutralizing activity.

OBJECTIVE: To explore the influence of psychological factor on asthma, the protective and therapeutic effects of Shugan Lifei Recipe on rats with asthma under stress and the mechanisms. METHODS: Allergy and stress-induced asthma models were established in rats by giving ovalbumin and restraining stress. Radioimmunoassay, enzyme linked immunosorbent assay, in situ hybridization and immunohistochemical method were used to detect plasma corticosterone, IL-4, IFN-gamma, expression of glucocorticoid receptor (GR) mRNA in hippocampus and adrenocorticotropic hormone corticoliberin (CRH) positive neuron in hypothalamus. Optical and electron microscopes were used to observe the morphological changes of pulmonary hilar and hippocampal tissues. RESULTS: Shugan Lifei Recipe (SGLFR) could reduce plasma corticosterone, decrease CRH positive neurons in paraventricular nucleus of hypothalamus, up-regulate the expression of GR mRNA in hippocampus and reduce the injury of hippocampal neuron. SGLFR had certain inhibitive effect on hyperfunction of hypothalamo-pituitary-adrenal cortex (HPA) axis in rats with asthma under stress and could also relieve the pathological changes of the pulmonary hilar tissue. The level of plasma IFN-gamma was increased while the level of plasma IL-4 was decreased in SGLFR-treated group. CONCLUSION: The mechanism of SGLFR in treating the rats with asthma under stress is probably to regulate the hyperfunction of HPA axis and the disorder of immuo-system.

Objective To investigate the real situation of the burden of the caregivers who take care of patients with spinal cord injury.Methods Using phenomenological research methods of qualitative study,information of 15 family caregivers of patients with spinal cord injury were collected through semi-structured interviews in Jiangxi province,and data were analyzed with Colaizzi 7-step analysis method.Results Four themes were summarized:weak social support system,heavy economic burden,insufficient care ability,mental and physical exhaustion; mental and physical exhaustion concluded three sub-themes:burnout,lifestyle changes,sad/helplessness.Conclusions Care burden of caregivers of patients with spinal cord injury includes four aspects:social,physical,psychological,and less caring capacity.Care workers should be concerned about the health status of the caregivers,give targeted care intervention,so that caregivers can be adapted to the caregivers' role,maintain and promote a high level of health of the patients and their families.