Objective:To explore the pharmaceutical care for the elderly cancer patients complicated with bone marrow suppres-sion by clinical pharmacists. Methods:Clinical pharmacists performed the pharmaceutical care through the evaluation of chemothera-py, symptomatic treatment for bone marrow suppression and infection prevention after bone marrow suppression etc. Results:The bone marrow suppression was alleviated without bleeding related with the decrease of platelet and infection. Conclusion:The pharmaceutical care performed by clinical pharmacist can enhance the safety and effectiveness of medication.

OBJCETIVE:To investigate the role of clinical pharmacists in medication reconciliation. METHODS:Totally 200 inpatients admitted or transferred to nephrology department of our hospital during Aug.-Oct. 2015 were selected. Within 48 h after admission,1-year medication history were collected by reviewing electronic medical records,consultation,querying self-prepared drugs and medical history;and then medication reconciliation was conducted by clinical pharmacists. RESULTS:Among drug lists collected by clinical pharmacists,there were 987 kinds of drugs,but only 9.63%(95 kinds) drugs were recorded in the medical records. There were 5 cases of ADR in total,and only 40.00% of them (2 cases) were recorded in the medical records. Among 200 patients,medication reconciliation was needed in 45 cases with reconciliation rate of 22.50%. Among 492 medical orders of 200 patients,medication errors were found in 103 medical orders;the number of medication errors per case was (2.3 ± 1.8), mainly including wrong dose,repeated medication,wrong solvent,drug interactions;the potential risk degree was mainly degree 1 (53 orders,51.46%). Among 103 medication reconciliation orders,main plans were drug withdrawal (78 cases,75.73%), followed by drug change(17 cases,16.50%)and drug supplement(8 cases,7.77%). A total of 90 reconciled medical orders were adopted by physicians,with success rate of 87.38%. CONCLUSIONS:Compared with physicians,clinical pharmacists can obtain more detailed and accurate drug list. It can reduce medication error and guarantee the safety of drug use to maximum extent that clinical pharmacists conduct medication reconciliation.

Objective: To compare the application of Sofren injection in respiratory department before and after the intervention to provide reference for clinical application and pharmacy management.Methods: A retrospective study was conducted on the medical records of inpatients treated with Sofren injection, and then intervene the found problems.Comparative study of Sofren injection in respiratory department before and after the intervention was performed.Results: Among the 584 cases in the retrospective study, those with off-indications were 438 ones (75%), those with inappropriate solvents were 555 ones (95.03%), and those with improper course were 196 ones (33.56%).After the intervention in the clinical practice, the improvement rate of improper solvents was 98.70%, that of off-indications was 29.85%, and that of unsuitable course was 77.71%.Conclusion: Through comparative study on the main problems before the intervention and the effective performance of specific solutions, the application of Sofren injection in respiratory department is greatly improved, which provides reference for the special management of other drugs.

A 72-year-old female patient was admitted to our hospital due to chronic cough, expectoration and dyspnea for 10 years,aggravated with intermittent fever for 1 month. She was diagnosed as acute exacerbation of chronic bronchitis,chronic pulmonary heart disease,cardiac function class IV,bilateral lower extremity venous thrombosis and thrombocytopenia. The application of antico-agulant drugs and coagulant drugs in the patient needed to be well weighed with the methods of the bleeding score system combined with clinical assessment of actual risk of bleeding. The interactions of drugs harmful to the patient should be considered and the prognosis of the patient should also be evaluated with careful clinical thought to reduce the patient's risk.

Objective To investigate the influence of Chaihu Longgu Muli Tang(Chinese Thorowax Root, Bone Fossil of Big Mammals and Oyster Shell Decoction, CLMT) on the mobilization of bone marrow c-kit+stem cells in rats after myocardial infarction(MI). Methods Male SD rats were randomly divided into sham-operation group,model group and CLMT group,and each group was divided again into 3-d sub group,7-d subgroup and 14-d subgroup. The CLMT group was intragastrically given CLMT, and other groups were orally given distilled water. The heart function was reviewed by using echocardiogram, changes of myocardial pathology were reviewed after HE staining,and severity of myocardial fibrosis was observed by after Masson staining. The number of c-kit+positive cells in bone marrow and peripheral blood was detected by using flow cytometry (FCM), and number of c-kit+positive cells in MI border zone was detected by using immunohistochemistry technique. Results The heart function declined gradually along with MI time extension in model group, and difference in heart function had statistical significance compared with sham-operation group at all time points (P <0.05). The heart function trended to stable in CLMT group and was better than that in model group, and difference in LVEF and LVFS had statistical significance compared with model group at time points of 7 d and 14 d(P<0.05). Pathological staining showed that myocardial cells were in alignment without collagen fibers in sham-operation group,necrosis and fibrosis of myocardial cells in model group that aggravated gradually along with MI time extension. The severity of myocardial necrosis and fibrosis was milder in CLMT group than that in model group. The number of c-kit+positive cells in bone marrow and peripheral blood reached peak in model group and CLMT group 7 d after MI, and difference number of c-kit+positive cells had statistical significance compared with sham-operation group,and was higher in CLMT group than that in model group. The difference in number of c-kit+positive cells had statistical significance between 7-d subgroup and 14-d subgroup (P <0.05). The number of c-kit+positive cells in MI border zone was higher in model group than that in sham-operation group,and difference in number of c-kit+positive cells had statistical significance between 7-d subgroup and 14-d subgroup (P<0.05). The number of c-kit+positive cells in MI border zone was higher in CLMT group than that in model group, and difference in number of c-kit+positive cells MI border zone had statistical significance between 7-d subgroup and 14-d subgroup (P<0.05). Conclusion CLMT can improve the mobilization of bone marrow c-kit+stem cells after MI and heart function.

OBJECTIVE: To investigate the effect of chronic emotional stimulation induced by empty bottle stimulation on CXCL12/CXCR4-mediated inflammatory response in rats with acute myocardial infarction (AMI). METHODS: Rat models of anxiety were established by a 21-day stimulation with uncertain empty bottle drinking water, and myocardial infarction was induced by ligating the left anterior descending branch of the coronary artery; compound models were established by performing myocardial infarction operation on the 15th day of anxiety modeling. The rats were randomly divided into 4 groups: shamoperated group (=6), myocardial infarction group (=6), compound model group (with myocardial infarcted and anxiety; = 6), and inhibitor group (compound models treated daily with 1 mg/kg AMD3100 for 6 days; =7). Echocardiography was used to examine the LVEF and LVFS to evaluate the cardiac function of the rats. Elevated maze test and open field test were used to evaluate the behaviors of the rats. The expressions of CXCL12, CXCR4, IL-1β, IL-18 and neutrophil active protease (NE) in the myocardial tissues and blood samples were detected with ELISA and immunohistochemistry. RESULTS: The LVEF and LVFS were lower in the compound model group than in the sham group and myocardial infarction group ( < 0.05), and were higher in inhibitor group than in the compound model group ( < 0.05). LVID; d and LVID; s were lower in the inhibitor group than in the compound model group ( < 0.05). Compared to those in the sham group and myocardial infarction group, the rats in the compound model group more obviously preferred to stay in the closed arm ( < 0.05) in EPM; the rats in the inhibitor group had more times of entering and staying in the open arm than the compound model rats ( < 0.05); the horizontal and vertical movements were less in the compound model rats than in those in the sham group and the myocardial infarction group ( < 0.05) in OFT, and the vertical movement of the rats in inhibitor group was higher than those in the compound model group ( < 0.05). The expression of CXCR4 in the marginal zone of myocardial infarction was significantly higher in the compound model group than in the sham-operated group, myocardial infarction group and inhibitor group ( < 0.05). The expressions of IL-1β, IL-18 and NE in the inhibitor group were significantly lower than those in the compound model group ( < 0.05). Compared with at in the sham-operated group, the number of Nissl bodies in the compound model group decreased significantly ( < 0.01). CONCLUSIONS Chronic emotional stress induced by empty bottle stimulation can lead to dysfunction of the CXCL12/CXCR4 axis, which causes inflammatory cascade after myocardial infarction to worsen myocardial cell necrosis, cardiac function and hippocampal neuronal damage after the infarction.
Animals ; Chemokine CXCL12 ; Coronary Vessels ; Emotions ; Myocardial Infarction ; Myocardium ; Psychological Distress ; Rats ; Receptors, CXCR4 ; Signal Transduction