OBJECTIVE:To provide reference for clinical pharmacists on how to provide better pharmaceutical service for clinic. METHODS: The basic qualities, working place, service mode, cooperation mode etc of the clinical pharmacists were summarized and analyzed and exemplified. RESULTS & CONCLUSIONS: Clinical pharmacists should have a certain basic qualities, and they should improve their insight into problems step by step, deepen their cooperation with doctors, and provide comprehensive pharmaceutical service for patients.

Cytochrome P450 is one of the important drug metabolization enzymes in humans. This paper reviews drug relevant CYP, the relationship of CYP and drug interaction, and effects of Chinese medicine on CYP. The aim is to answer and predict the clinical drug interaction and the adverse drug reactions. Moreover, suitable drug can be selected to evaluate the action of CYP, and it can offer the scientific assurance for clinical individual therapy.

OBJECTIVE:To systematically review the efficacy of fluconazole in the treatment of candida infections in different parts,and provide evidence-based reference. METHODS:Cochrane library,Medline,EMBase,PubMed,CBM,CJFD,VIP data-base and Wanfang database were retrieved to collect the randomized controlled trial(RCT)of fluconazole(test group)vs. other an-tifungal agents(control group)in the treatment of candida infections in different parts. After information collection and quality eval-uation,the Meta-analysis was performed by Rev Man 5.1 software. RESULTS:There were totally 6 literatures included,involving 1 966 patients. Meta-analysis results showed that the effectiveness in test group was lower than control group in the treatment of can-didemia [OR=0.48,95%CI(0.29,0.77),P=0.003];compared with control group,there were no significant differences in the effec-tiveness in the treatment of esophagus candidemia [OR=1.15,95%CI(0.74,1.78),P=0.52]. CONCLUSIONS:The efficacy of flu-conazole in the treatment of candidemia is no better than anidulafungin and equivalent with amphotericin B;the efficacy of flucon-azole in the treatment of esophageal candidiasis is equivalent with itraconazole,voriconazole,anidulafungin and micafungin. Due to the limit of included studies,it remains to be further verified by high-quality,large-sample and long follow-up RCTs.

Objective To explore the effect of failure mode and effect analysis (FMEA) method in strengthening the management of critical value of blood specimens in hospital. Methods According to the procedures of FMEA, critical values management team were established, drew flow chart of generating test specimens and crisis value, explored the potential failure mode and failure cause, analyzed the severity, possibility and critical value, and formulate and implement countermeasures according to the research outcome. Results The crisis value of the failure mode fell from 1 320 to 151 after the implementation of FMEA, and rate of decline was 88.56%; number of unqualified blood samples decreased from 510 cases to 78 cases, and the difference is statistically significant (χ2=407.27, P<0.05);critical value processing defects decreased from 85 cases (a total of 236 cases) to 3 cases (a total of 229 cases), and the difference was statistically significant (χ2=91.26, P<0.05). Conclusions FMEA method is helpful to improve the accuracy and precision of critical value management of clinical blood samples, so as to ensure the safety of patients in hospitals.

OBJECTIVE:To evaluate the safety of acyclovir in the treatment of liver-transplanted children with EB-viremia. METHODS:Retrospectively analysis was conducted for the general information of 10 liver-transplanted children with EB-viremia, preoperative donor and recipient EBV infection and treatment,tacrolimus dose and plasma concentration before and after interven-tion,platelets,serum creatinine and white blood cell levels before and after treatment,and the recurrence were followed-up. RE-SULTS:Biliary atresia was the primary disease for all the children,EB virus polymerase chain reaction(EBV-PCR)was positive, and there was no routine testing for donor HBV infection;6 cases reduced the tacrolimus dose,4 remained unchanged,and 9 cas-es of plasma concentrations reduced after intervention,9 were negative and 2 recoveried. There were no significant differences in the platelets,serum creatinine and white blood cells before and after treatment(P>0.05). CONCLUSIONS:Acyclovir can be used in the treatment of liver-transplanted children with EB-viremia,with good safety.

OBJECTIVE:To explore the new mode and new method for the teaching work mode of clinical pharmacists in phar-maceutical ward rounds. METHODS:Medicine comprehensive ward rounds mode centered by teachers and independent pharmaceu-tical rounds interrogation mode centered by clinical pharmacist trainees were respectively tried by clinical pharmacists to guide clini-cal pharmaceutical cares. Three-level mode of medical rounds was used for reference. Teaching rounds by trainees,teaching staff and teachers were tried to train the learning and practice ability of different levels of trainees. RESULTS & CONCLUSIONS:Ac-cording to the different forms of exploration of teaching work mode in pharmaceutical ward rounds,trainees,teaching staff and teachers has practiced and improved in the pharmacy professional practice skills. Pharmaceutical ward rounds are the important parts of work,and different teaching modes are significant for the advanced quality of trainees.

Objective:To investigate the clinical pharmaceutical care methods and promote rational drug use. Methods:The diag-nosis and treatment process of one patient with chronic obstructive pulmonary disease were used as the examples, the pharmacists par-ticipated in selecting drugs, adjusting dosage and making individual regimen to carry out the pharmaceutical care in the whole treatment process, including observing curative effect, monitoring adverse reactions, implementing patient education,nutritional support, immu-notherapy and the effect evaluation. Results:Clinical pharmacists together with clinicians developed the treatment regimens for the pa-tient with the full implementation of pharmaceutical care, the effect was promising, and the patient recovered and discharged from hos-pital. Conclusion:Clinical pharmacists should implement pharmaceutical care for patients with chronic obstructive pulmonary disease in the whole treatment process, which can reduce drug adverse reactions and interactions effectively, and play an important role in ra-tional and safe drug use.

Objective To identify dosimetric predictors for the development of gastrointestinal toxicity in patients with pancreatic adenocarcinoma treated with TOMO radiotherapy .Methods From January 2014 to Janu-ary 2015 ,we analysed the medical records of 68 pancreatic cancer patients who received helical tomotherapy from Air Force General Hospital .The stomach and duodenum were contoured separately to determine their dose volume histogram(DVH)parameters.Chi-square test was employed to analyze the count data .Spearman correlation anal-ysis was used to analyze the relationship between occurrence of gastrointestinal toxicity and clinical and physical factors.Logistic regression models was performed to identify risk factors associated with gastrointestinal toxicity . Results The median follow-up was 9 months(4~16 months).18 patients experienced grade II acute gastroin-testinal toxicity ,1 patient experienced grade Ⅲ acute gastrointestinal toxicity , whereas 17 patients experienced grade II late gastrointestinal toxicity ,1 patient experienced grade Ⅲlate gastrointestinal toxicity .On UVA,the vol-ume,Dmean,D1,D3,D5,D10,V5 to V40,and V5′to V45′of duodenum were significantly associated with GradeⅡor higher gastrointestinal toxicity ( P <0.05 ) .The MVA, V45′of duodenum was independent predictor for gradeⅡor higher gastrointestinal toxicity(P<0.05).The ROC analysis also showed that V45′of 0.5cm3 was the optimal threshold to predict for gastrointestinal toxicity for the entire cohort .Conclusion V45′of duodenum is of greater importance in the judgment of occurrence of hypofractioned radiation -induced gastrointestinal toxici-ty.

OBJECTIVE:To investigate ADR induced by dasatinib,and to provide reference for clinical rational drug use. METHODS:By means of literature metrology method,dasatinib-induced ADR cases domestically and internationally reported were analyzed. RSEULTS:A total of 63 ADR cases were induced by dasatinib,and the age of patients were mainly 41-60 years old. The most cases(25.4%)occurred within 1 month of medication. The patients mainly were from Asian countries and regions(53.9%). Organs/systems involved in dasatinib induced ADRs were mainly respiratory system(40.1%),digestive system(17.5%)and hema-tologic system(11.7%). Main clinical manifestations were pleural effusion(23 cases),pulmonary artery hypertension(15 cases), expiratory dyspnea(8 cases),diarrhea(8 cases),etc. CONCLUSIONS:Daring the use of dasatinib,great importance should be attached to ADR monitoring and prevention so as to avoid serious ADR.

AIM: To explore the immunomodulatory effect of paecilomyces cicadidae polysaccharides (PCPS).METHODS: Subcutaneous injection with 50, l00, 200 mg/kg of PCPS were given in the back of the rats everyday for l5 days. The number of white blood cells (WBC) was counted. The activities of acid phosphatase (ACP) and lactase dehydrogenase (LDH)in liver, kidney, spleen and thymus were detected by automatic biochemistry analyzer. The ability of devouring neutral red and activity of ACP, LDH, arginase in alveolar macrophages were also detected. The body weight of the rat everyday during experiment and weight of the spleen and thymus after the rats were killed were measured and wet weight index was calculated.RESULTS: The wet weight index of spleen and thymus, the activity of ACP, LDH, arginase and ability of devouring neutral red in alveolar macrophages in the test group treated with PCPS were significantly higher than those in control group. CONCLUSION: PCPS shows a significant immunomodulatory effect with the increasing counts of WBC and activation of alveolar macrophages in a dose-dependent manner.