OBJECTIVE:To study the general pattern and characteristics of the adverse drug reactions (ADR) induced by mannitol.METHODS:The literature related to the ADR induced by mannitol reported during 1999～2008 retrieved from CNKI was analyzed statistically.RESULTS:A total of 135 mannitol-induced ADR cases were collected,of which,males showed higher proportion than females,and the ADRs chiefly manifested as acute renal failure(30 cases,22.22%),followed by allergic reactions(17 cases,12.59%) and shock(17 cases,12.59%).CONCLUSION:Clinicians should tighten monitoring on the use of mannitol to reduce the occurrence of mannitol-induced ADR.

OBJECTIVE:To evaluate the efficacy and safety of Wenxin granules for congestive heart failure (CHF).METHODS:Literatures about random controlled trails of Wenxin granules for CHF were retrieved from PubMed,EMbase,Cochrane,CBMdisc,CNKI while other relative research papers were searched by hands.Included studies were evaluated by methodological quality assessment and analyzed using RevMan5.0.0 software.RESULTS: Eight randomized controlled trials of Wenxin granules were included.The results of Meta-analysis showed the obvious effective rate and effective rate of improvement of heart function in patients with CHF or CHF complicated by ventricular arrhythmia (VA) in study group were better than in control group.The differences between study group and control group had no statistical significance.The obvious effective rate of improvement of VA and the levels of NSVT,PVBs and LVEF in patients with CHF complicated by VA in study group were superior to control group.The differences between study group and control group had statistical significance(P

OBJECTIVE: To review the efficacy and safety of ambroxol for lung protection in perioperative period. METHODS: Random controlled trails (RCTs), systematic review (SR), and meta-analysis of ambroxol for lung protection in perioperative period were searched in Cochrane, PubMed, Embase, ISI, CBMdisc, CNKI, VIP and Wangfang dababase; the methodology quality of every RCT was evaluated, then meta-analysis was performed by software of RevMan5.0.0. RESULTS: Twelve RCTs of ambroxol for lung protection in perioperative period were included. According to the meta-analysis results, the ambroxol group was better than the control group in pulmonary complications [RR 0.55,95% CI(0.40, 0.74), P=0.0001], The cough and expectoration degree in the ambroxol group was better than the control group [RR 1.25, 95% CI (1.09, 1.44), P=0.001]. The ambroxol group was also better than the control group in sputum volume [RR 1.24,95% CI(1.12, 1.38), P < 0.00001]. ADR had no significant difference between the ambroxol and control groups. CONCLUSION: Using ambroxol for lung protection in perioperative period can improve post-operativer-espiratory system symptoms and reduce pulmonary complications. Ambroxol has a satisfactory lung protective effect in the preoperative period. Copyright 2012 by the Chinese Pharmaceutical Association.

OBJECTIVE: To review the efficacy and safety of ambroxol for treatment of bronchiofitis. METHODS: Random controlled trials (RCTs), systematic review (SR), and meta-analysis of ambroxol for treatment of bronchiofitis were searched in Cochrane, PubMed, Embase, ISI, CBMdisc, CNKI, VIP and Wangfang database; the methodology quality of every RCT was evaluated, then meta-analysis was performed by software of RevMan5.0.0. RESULTS: Twenty-nine RCTs were included. According to the meta-analysis results, the effective rate in ambroxol group was better than the control group [RR 1.25,95% CI (1.20, 1.30), P < 0.00001]. The time of hospital stay was obviously shorter than the control group [RR-1.38,95% CI(-1.67, -1.08), P < 0.00001]. The recovery of respiratory system symptoms in ambroxol group was earlier than that in the control group (P < 0.01). ADR had no significant difference between the ambroxol and control groups. CONCLUSION: Ambroxol can improve the respiratory system symptoms of bronchiofitis and reduce the time of hospital stay. Ambroxol has remarkable and predictable effect. Copyright 2012 by the Chinese Pharmaceutical Association.

Objective To evaluate the intervention effectiveness of collaboration among physicians, nurses and pharmacists for elderly people. Methods Randomized controlled trails ( RCT) of collaboration among physicians,nurses and pharmacists for elderly people were gathered from MEDLINE,EMbase,CENTRAL,CNKI,VIP and Wanfang. The retrieved studies were screened according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analyses with The Cochrane Collaboration ' s Revman 5. 3. 0 software. Results Four randomized controlled trials of collaboration among physicians,nurses and pharmacists for elderly people were included. The results of meta-analyses showed that the hospitalization rate, emergency admission rate, mortality and potentially inappropriate medication use were not significantly better in the collaboration group than in the standard of care group [RR=1.02,95%CI (0.93,1.11),P=0.69;RR=0.97,95%CI (0.89,1.05),P=0.42;RR=1.03,95%CI (0.87,1.21),P=0.75;and RR=1.09,95%CI (0.84,1.41),P=0.51,respectively]. There were no statistically significant differences between the collaboration group and the standard of care group. Conclusion Collaboration among physicians, nurses and pharmacists is not therapeutically effective for elderly people. But its long-term efficacy still needs to be confirmed by performing more high quality,large sample RCTs with long term follow-up.

OBJECTIVE:To build the off-label drug use control system,and to realize automatic prompt for off-label drug use by system when physicians prescribed drugs. METHODS:The module and flow chart of off-label drug use control system were de-signed based on B/S structure. The drugs of the prescriptions were verified one by one in terms of drug indication,drug dosage, age and gender of patient,route of administration,etc. The system prompted automatically off-label drug use when drug use didn’t agree with preset value;at the same time,the management effect of the system was evaluated by taken the amount of attention about antibiotics medical orders as an example. RESULTS:At present,265 kinds of drugs were involved in the system designed by our hospital. Since the system was applied,the system had prompted more than 50 thousand items of off-label drug use prescrip-tions/medical orders,accounting for 0.3% of total. Among the types of off-label drug use,the most number of medical orders were over single dose(745 items),followed by extra-indication(706 items)and over daily dose(671 items). Within 3 months after sys-tem used,the attention numbers of antibiotics medical orders of over daily dose decreased month by month. CONCLUSIONS:Es-tablished off-label drug use control system of our hospital has a stable running and convenient manipulation,and contains powerful practicability. It can monitor off-label drug use of some drugs.

OBJECTIVE:To systematically review the efficacy and safety of exenatide in the weight loss of obesity and over-weight,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,Med-line,EMBase,CJFD,VIP and Wanfang Database,randomized controlled trails (RCT) about exenatide versus placebo or other medicines in the treatment of obesity or overweight were collected. Meta-analysis was performed by using Rev Man 5.3.0 software after data extract and quality evaluation. RESULTS:A total of 25 RCTs were enrolled,involving 5 307 patients. Results of Meta-anal-ysis showed body mass in exenatide groups was significantly lower than placebo group[SMD=-2.06,95%CI(-2.97,-1.15),P<0.001],insulin group [SMD=-3.51,95%CI(-4.52,-2.51),P<0.001],glyburide group [SMD=-3.70,95%CI(-4.28,-3.12),P<0.001],rosiglitazone group [SMD=-1.25,95%CI(-1.71,-0.80),P<0.001] and sitagliptin group[SMD=-0.71,95%CI(-0.93,-0.48),P<0.001],and there was no significant difference with metformin group and tasilutai group. Incidence of ad-verse reactions in exenatide group was significantly higher than insulin group[RR=1.22,95%CI(1.06,1.41),P=0.006] and lower than tasilutai group [RR=0.95,95%CI(0.91,0.99),P=0.02],and there was no significant difference with placebo group and met-formin group. CONCLUSIONS:Exenatide can effectively reduce the body mass of obesity and overweight,however,digestive sys-tem shows more adverse reactions. Due to the limit of methodological quality,more high-quality,large-scale and long-term fol-low-up RCTs are needed for further verification for the conclusion.

Objective To investigate the effect of penehyclidine (PHCD) on Toll-like receptor 4 (TLR4)mRNA and Toll-like receptor 2 (TLR2) mRNA expression in the lung tissue in rats with acute lung injury induced by lipopolysaccharide (LPS) .Methods Sixty healthy SD rats of both sexes weighing 200-220 g were randomly divided into 5 groups ( n = 12 each) :control group (group C) , LPS group and P1-3 groups. Acute lung injury was induced by intraperitoneal (IP) LPS 8 mg/kg in LPS and P1-3 groups. PHCD 0.3, 1.0 and 3.0 mg/kg were given IP after LPS administration in P1-3 groups. The animals were anesthetized at 6 h after IP LPS. Blood samples were collected for determination of serum TNF-α and IL-6 concentrations ( by ELISA) and then sacrificed, the lungs were immediately removed for determination of TLR4 mRNA and TLR2 mRNA expression (by RT-PCR), and microscopic examination. Results LPS significantly increased TLR4 mRNA and TLR2 mRNA expression in the lung tissue and serum TNF-α and IL-6 concentrations. PHCD 1.0 or 3.0 mg/kg significantly inhibited LPS-induced increase in TLR4 mRNA and TLR2 mRNA expression in the lung tissue and serum TNF-α and ILr6 concentrations.The lung histopathologic damage was significantly ameliorated in P2 and P3 groups as compared with group LPS.Conclusion PHCD can protect the lungs against LPS-induced acute lung injury through inhibiting TLR4 mRNA and TLR2 mRNA expression in the lung tissue and reducing the inflammatory response.

Objective To study the disease pathogenesis of systemic lupus erythematosus patients with thrombocytopenia ,and discuss reticulated platelets (RP) in SLE merger thrombocytopenia disease of diagnosis and treatment in the clinical application val-ue .Methods 55 patients diagnosed with SLE patients and 50 cases of healthy check-up ,low platelet count patients of SLE patients treated before and after the inspection by Sysmex XE-5000 automatic blood cell analyzer immature platelet fraction (IPF) and other peripheral blood cell parameters .Results Group of patients with SLE and normal controls of IPF test results respectively was (5 .30 ± 3 .75)% ,(2 .74 ± 1 .05)% ,both comparative difference was statistically significant (P<0 .05);SLE associated with throm-bocytopeniagroupofIPF[(10.14±3.66)% ],platelets(PLT)[(67.2±13.5)×109/L],meanplateletvolume(MPV)[(12.64± 0 .92)fL] ,platelet distribution width(PDW)[(18 .24 ± 1 .70)fL] compared with normal control group and SLE did not reduce plate-let group ,differences had statistical significance(P<0 .05);SLE associated with thrombocytopenia in patients with IPF respectively before and after treatment was (9 .76 ± 1 .82)% and (5 .86 ± 0 .96)% ,both comparative difference was statistically significant (P<0 . 05) .Conclusion The main cause of SLE patients with thrombocytopenia may be associated with peripheral blood platelet destruc-tion ,IPF′s result can reflect the bone marrow platelet production ,Help in the auxiliary diagnosis of disease and prognosis judg-ment .

Objective To investigate the function of triggering receptor expresses on myeloid cells receptor-1 (TREM-1) in lymphocyte differentiation and regulation of Aspergillus infected immunosuppressed rats.Methods Cyclophosphamide (CTX) was intraperitoneally injected and Fumigatus spore suspension was inhaled by percutaneous tracheostomy to establish the immunosuppressive invasive pulmonary aspergillosis (IPA) rat model.After 24 h, 48 h, 72 h and 96 h inoculation, rats were sacrificed.Lung tissue specimens, bronchoalveolar lavage fluid (BALF) , and plasma samples were collected.Plasma and BALF sTREM-1, plasma T cell-specific transcription factor (T-box expressed in T cells, T-bet) and eomesodermin(Eomes) were detected by ELISA.Biopsy specimens of lung tissue were used for periodic acid-schiff (PAS) staining and culture.Results The mortality rate of immunosuppressed rats after Aspergillus inhalation for 96 h was as high as 54.4％.Biopsy of lung tissue suggested acute inflammatory cell infiltration, interstitial lung congestion, alveolar structural damage, and visible Aspergillus hyphae in alveoli.Compared with normal control group[(110.50 ± 7.70)ng/L], plasma sTREM-1 in study groups were significantly increased [IPA : (146.77 ± 10.41) ng/L;CXT + IPA at 24 h : (226.00 ± 11.88) ng/L;CTX + IPA at 48 h : (200.77 ± 10.63) ng/L;P ＜ 0.05], so were T-bet levels [IPA : (561.17 ± 7.23) μg/L;CXT + IPA at 24 h : (647.00 ± 33.03) μg/L;CTX + IPA at 48 h : (619.23 ± 87.44) μg/L;control group : (340.03 ± 26.32) μg/L;respectively, P ＜0.05].However, plasma Eomes levels in IPA group, CTX + IPA at 24 h and 48 h were significantly lower compared with that in normal controls [IPA : (7.96 ± 0.65) ng/L;CXT + IPA at 24 h : (3.97 ± 0.35) ng/L;CTX + IPA at 48 h : (4.00 ± 0.74) ng/L;control group : (8.38 ± 0.51) ng/L;respectively,P ＜0.001].Compared with those in CTX + IPA vaccination after 24 h and 48 h, plasma sTREM-1 [(106.67 ±7.64)ng/L;(133.27 ± 32.79) ng/L] and T-bet [(299.64±63.07)μg/L;(398.02 ± 109.22) μg/L] in CTX + IPA at 72 h and 96 h inoculation were significantly lower (P ＜ 0.001).While Eomes [(8.38 ± 0.54) ng/L;(8.40 ± 0.70) ng/L] raised significantly higher (P ＜ 0.001).Compared with the control group, sTREM-1 levels in BALF of IPA + CTX 24 h, 48 h, 72 h, and 96 h groups were consistently high (P ＜ 0.05).Pearson correlation analysis showed that sTREM-1 and T-bet had a significant positive correlation (r =0.91, P ＜ 0.001), yet Eomes was negatively correlated with them (r =-0.788, P ＜ 0.001).Conclusions sTREM-1 in rat plasma and BALF appears highly expressed in immune compromised Aspergillus infected rat model.Plasma sTREM-1 is closely correlated with T-bet and Eomes levels, which suggests that TREM-1 may be involved in lymphocytic regulation and differentiation during fungal infection.