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.

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.

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 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 investigate the influence of VEGF expression on the apoptosis of pancreas subjected to ischemia/reperfu-sion injury. Methods Thirty male SD rats were randomly divided into three groups (rt = 10). Group A was served as sham-operation group. Groups B were subjected to 30 min of ischemia by clamping of celiac artery and superior mesenterie artery then releasing for 6 hours to produce ischemia/reperfusion injury model. Groups C were treated with VEGF antisense oligodeexynueleotide after isehemia. Rats were sacrificed, the pancreas was obtained to detect the VEGF expression by immunohistochemical method, and apoptosis was determined by TUNEL staining. Results Apoptosis appeared and VEGF expression up regulated in pancreas after Isehemia/reperfusion injury. Comparison between Groups C and Groups B showed a significant down regulation of VEGF expression (P <0. 05) and a notable increase of apoptotic index (P < 0. 05). Conclusion VEGF expression suppresses apeptosis of pancreas during the course of ischemia/reperfusion injury and may play an important role in protection of pancreas against the ischemia/repeffusion injury.

Objective To estimate and optimize the dosage regimen of vancomycin and linezolid for treatment in different Gram-positive cocci infections. Methods The pharmacokinetic data of vancomycin and linezolid were collected, and the pharmacodynamics in vitro of these drugs for staphylococcus epidermidis, staphylococcus aureus, enterococcus faecalis and enterococcus faecium were analysed. The cumulative response fraction (CFR) was evaluated in different dosage regimens of two drugs against four types of bacteria. Results The regimen of 3 500 mg/d vancomycin was recommended for patients with staphylococcus epidermidis infection. The regimen of 2 500 mg/d vancomycin was recommended for patients with staphylococcus aureus infection. The regimens of 3 000 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecalis infection. The regimens of 2 500 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecium infection. Conclusion In application of vancomycin and linezolid for treatment of Gram-positive cocci infections, different dosage regimens should be used in different types of infections.

Objective:To modify Ganodermalucidum polysaccharides(GLP) with sulfate and observe the protective effect of Ganodermalucidum polysaccharide sulfate (GLPS) on the cerebral ischemia reperfusion injury in the rats,and to investigate its mechanism.Methods:GLP was modified by sulfation to obtain GLPS.A total of 100 SD rats were randomly divided into sham operation group, model group, GLP group (40 mg·kg-1·d-1), GLPS group (40 mg·kg-1·d-1) and nimodipine group (1 mg·kg-1·d-1).The cerebral ischemia reperfusion models were established by middle cerebral artery occlusion method in the rats.The neurologic deficit score and the content of water in brain tissue of the rats with cerebral ischemia reperfusion injury were detected and the activities of superoxide dismutase(SOD) and the levels of malondialdehyde (MDA) were detected.The levels of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB),tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) and interleukin-6 (IL-6) in the brain tissue homogenate were detected by ELISA.Western blotting method was used to detect the protein expression levels of HSP70 and p-Akt in the brain tissue of the rats.Results:Compared with model group, the neurological function scores of the rats in GLP group and GLPS group were decreased(P<0.01),the water contents in brain tissue were decreased(P<0.05), the SOD activities were increased and the MDA levels were decreased(P<0.05), and the levels of NF-κB, TNF-α, IL-1 and IL-6 were decreased(P<0.05);the effect in GLPS group was significantly better than that in GLP group(P<0.05).The results of Western blotting method showed that the p-Akt protein expression levels in the brain tissue of the rats in GLP and GLPS groups were increased compared with model group (P<0.05);compared with model group, the HSP-70 protein expression level in the brain tissue of the rats in GLPS group was increased(P<0.01),but the effect in GLP group was not obvious.Conclusion:Sulfation can significantly improve the protective effect of GLP on the cerebral ischemia reperfusion injury in the rats and its mechanism may be related to regulating the HSP70/PI3K/Akt signaling pathway and inhibiting the inflammatory reaction damage to the nerve cells of reperfusion.