OBJECTIVE:To provide reference for reducing and avoiding medication errors of high-alert drugs in outpatient de-partment. METHODS:The medication errors of high-alert drugs in outpatient prescriptions were collected from our hospital during 2013-2014,and then analyzed retrospectively in terms of the type and degree of medication error,caused factors of medication er-rors,etc. RESULTS:670 997 prescriptions were checked in two years,and 501 medication errors were found,including 26 medi-cation errors of high-alert medication. There were 7 incorrect route of administration of insulin,1 repeated medication and 1 incor-rect dose of oral hypoglycemic agents,6 repeated administration of opioid drugs and non steroidal anti-inflammatory drugs,2 indi-cation error of paracetamol and codeine phosphate,1 specification and 1 indication error of glucose injection,2 route of administra-tion error of lidocaine,2 administration frequency errors of methotrexate,2 dose error of digoxin and 1 dose error of warfarin;18 doctors'prescribing errors were found by pharmacists'prescription audit,accounting for 69.2%;8 doctors'prescribing errors were not found by pharmacists'prescription audit,accounting for 30.8%. CONCLUSIONS:Medication errors of high-alert drugs occur mainly in the prescription segment,and the main reason is that the electronic prescription system lack of compulsory strategy and policy constraints. Improvement of safety administration of high-alert drugs need to find the error link and adopt targeted medi-cation safety practices.

OBJECTIVE:To provide reference for clinical desicion,drug use and ADR avoidance. METHODS:Clinical pharmacists participated in the consultations and therapy plan about a patient with hiatal hernia complicating with venous catheter- related infections. Clinical pharmacists suggested pulling out peripherally inserted central catheter(PICC)and placing a catheter again. Anti-infective therapy plan had been adjusted:vancomycin 0.5 g/time,ivgtt,q12 h;fluconazole 0.2 g,ivgtt,qd(0.4 g,ivgtt,qd on the first day),cefoperazone/sulbactam 2 g,ivgtt,q8h. Vancomycin and fluconazole were additionally used for anti- infective therapy. RESULTS:Doctors adopted the suggestions of clinical pharmacist,and pulled out PICC;and then the infection of the patient was controlled effectively. Finally,the infection had been cured. CONCLUSIONS:The participation of clinical pharmacists in the consultation contributes to rational drug use,and assists doctors to make the right clinical decisions and avoid adverse drug events.

OBJECTIVE:To systematically evaluate the efficacy and safety of prostaglandin E1 combined with hydration for the prevention of contrast-induced nephropathy(CIN)and provide evidence-based reference for the clinical treatment. METHODS:The PubMed,Medline (Ovid),EMbase (Ovid),Cochrane Library,VIP,CJFD and WanFang database were retrieved to collect the randomized controlled trails(RCT)of prostaglandin E1 combined with hydration for the prevention of CIN. After information collec-tion and methodology quality evaluation,the Meta-analysis was performed using Rev Man 5.3 software. RESULTS:12 RCTs involv-ing 1 732 patients were included. The results of Meta-analysis showed that the incidence of CIN in test group was significantly low-er than control group[RR=0.40,95%CI(0.30,0.53),P<0.001],the incidence of phlebitis was higher than control group [RR=10.18,95%CI(1.37,75.67),P=0.02] and there was no significant difference in the need rate of renal replacement between test group and control group[RR=0.44,95%CI(0.12,1.61),P=0.21]. CONCLUSIONS:Intravenous prostaglandin E1 combined with hydration can effectively reduce the incidence of CIN. Occurance of phlebitis should be paid attention to. Due to the limited quality and sample of included studies,it remains to be further verified by high-quality and large-sample RCT.

Objective To investigate the effects of notoginseng and guiding medicinals mediated notoginseng for improving the renal inter stitial fibrosis in rats with chronic kidney-disease(CKD)by regulating TGF-β signaling pathway.Methods A total of 100 male SD rats were randomly divided into five groups:normal group(NOR,n =20),model group(CKD,n =20),radix notogin-seng group(RN,n =20),radix notoginseng plus platycodi group (RNP) and radix notoginseng plus cinnamon group (RNC,n =20).Except for the NOR group,the CKD rat model in other groups was established by adenine gavage.After modeling,the NOR group and CKD group were given the same volume of normal saline by gavage,while the group RN,RNP and RNC were given corresponding drugs by gavage,for 4 weeks.After 4 weeks,the rats in each group were sacrificed for collecting serum and detecting the renal function(serum Scr,BUN),the renal tissues were taken for conducting HE and Masson staining.Then the renal tissue pathological damage severity was observed.The expressions of FN and LN in kidney tissue were detected by immunohistochemistry and the expressions of TGF-[β,α-SMA were detected by Western blot method.Results Compared with the NOR group,the model group exhibited the renal dysfunction(P＜0.01),renal interstitial severe fibrosis manifestation and increased collagen deposition(P＜0.05),and the expression of kidney tissues α-SMA(P＜0.01),TGF-β(P＜0.01),FN and LN were significantly increased.Compared with the model group,the renal function in various treatment groups was improved,Scr(P＜0.01)and BUN(P＜0.01)were significantly decreased,the renal interstitial fibrosis degree was reduced,collagen desposition was decreased(P＜0.05),renal tissue α-SMA(P＜ 0.05),TGF-β(P＜0.05),FN and LN expression were reduced to some extent,in which the effect of RNC group was stronger than that of the RN group and RNP group.Conclusion Notoginseng and guiding medicinals mediated notoginseng can retard the progression of renal interstitial fibrosis caused by adenine in CKD rat in varying degrees,its mechanism maybe reduce the expression of TGF-β protein.

Objective To explore the value of MR T2 mapping imaging in evaluation of the effection of Zhitong-Jiangu recipes in treatment of cartilage injury in osteoarthritis.Methods The models of osteoarthritis in the knee of New Zealand white rabbits were made with intra-articular injection of papain.Totally 48 New Zealand white rabbits were randomly divided into normal control group,model control group,glucosamine hydrochloride treatment group and Zhitong-Jiangu recipes treatment group.MR T2 mapping was performed on the knee and the content of MMP-1 in articular cartilage was analyzed with immunohistochemistry 4 weeks after treatment.The differences of T2 value and MMP-1 content of articular cartilage among the four groups were compared.The correlation among the different intervention methods,MMP-1 content of articular cartilage and the T2 value of articular cartilage were analyzed.Results T2 value of articular cartilage in the model control group was significantly higher than that in the other three groups (all P＜0.01),and there was no significant difference of T2 value among the other three groups.The MMP-1 content of articular cartilage in glucosamine hydrochloride treatment group and Zhitong-Jiangu recipes treatment group was lower than that in model control group (both P＜0.05),and was higher than that in normal control group (both P＜0.05).There was no significant difference between the two groups.The relationship between MMP-1 content and T2 value of articular cartilage was nonlinear.With the increase of MMP-1 content,T2 value first increased slowly and then increased rapidly (P＜0.05).Conclusion MR T2 mapping imaging is helpful to evaluating the efficacy of Zhitong-Jiangu recipes in treatment of cartilage injury in osteoarthritis in rabbit models.The relationship between MMP-1 content and T2 value of articular cartilage may be nonlinear.

OBJECTIVE: To review targeted muscle reinnervation (TMR) surgery for the construction of intelligent prosthetic human-machine interface, thus providing a new clinical intervention paradigm for the functional reconstruction of residual limbs in amputees. METHODS: Extensively consulted relevant literature domestically and abroad and systematically expounded the surgical requirements of intelligent prosthetics, TMR operation plan, target population, prognosis, as well as the development and future of TMR. RESULTS: TMR facilitates intuitive control of intelligent prostheses in amputees by reconstructing the "brain-spinal cord-peripheral nerve-skeletal muscle" neurotransmission pathway and increasing the surface electromyographic signals required for pattern recognition. TMR surgery for different purposes is suitable for different target populations. CONCLUSION TMR surgery has been certified abroad as a transformative technology for improving prosthetic manipulation, and is expected to become a new clinical paradigm for 2 million amputees in China.
Humans ; Artificial Limbs ; Muscle, Skeletal ; Neurosurgical Procedures ; Plastic Surgery Procedures ; Prosthesis Implantation