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.

Objective To study the shift handover experience of ICU clinical nurses. Method About 19 ICU nurses were enrolled in the investigation using semi-structured interviews and the results were analyzed with phenomenological analysis. Result Their shift handover experience were summarized into 6 themes, that is high recognition on the importance of shift handover, lack of standardized processes, incomplete contents of shift handover, frequent interruption, forgotten information and repeated information. Conclusions Shift handover is an important part of ICU nursing function but there are many problems in the practical operation. The nurse managers need to standard the handover process, stipulate handover contents and enhance the training on shift handover with specialist examination and positive results for the purpose of improving the quality of the shift handover.

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 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 investigate the mechanism of cross allergy reaction during the application of β-lactam antibiotics, and to provide reference for rational drug use in clinic. METHODS:Based on study experience of author in UIC and its affiliated hospital during advanced study,according to the experience of drug use safety management in patients allergic to β-lactam antibiot-ics from Rush University Medical Center,the mechanism of cross allergy reaction during the application of β-lactam antibiotics was summarized,and the disposal procedure for patients allergic to β-lactam antibiotics in the Affiliated Hospital of UIC was intro-duced. RESULTS:The principal reason for cross allergy reaction induced by β-lactam antibiotics were same or similar side chains between drugs. Cross allergy reaction occurred when IgE recognized these side chains. The disposal procedure for patients allergic to β-lactam antibiotics in the Affiliated Hospital of UIC included that the indication of β-lactam use was evaluated;standard penicil-lin skin testing according to evaluation results,anti-infection treatment by Grade challenge β-lactam antibiotics and course and rap-id drug tolerance induction. CONCLUSIONS:The disposal method for patients allergic to β-lactam antibiotics in the Affiliated Hos-pital of UIC can provide new thought for domestic clinical pharmacists in rational drug use among the patiens with reported aller-gies to special group as pregnant women,children.

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 investigate the effects of cardiopulmonary bypass (CPB) on the expression of tight junction protein occludin in rat lung tissues.Methods Twenty adult male Sprague-Dawley rats were randomly divided into 2 groups (n=10 each): sham operation group (group S) and CPBgroup.The rats underwent 1 h of CPB and were observed 2 h later in group CPB.The lung water content,neutrophil percentage and protein concentration in bronchoalveolar lavage fluid (BALF) were measured.The expression of occludin in lung tissues was detected by immunohistochemistry and Western-blot analysis.The ultrastructure of alveolar epithelial barrier was observed with transmission electron microscope.Results Compared with group S,the lung water content,protein concentration in BALF and neutrophil percentage were significantly increased (P ＜ 0.05),the expression of occludin in lung tissues was significantly down-regulated (P ＜ 0.05) and the damage to alveolar epithelial barrier was aggravated in group CPB.Conclusion The expression of occludin in lung tissues is down-regulated and the damage to alveolar epithelial barrier is induced after CPB,which may be one of the important factors in acute lung injury induced by CPB.

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.