1. Review of development about european clinical pharmacy and analysis of quality assessment system
Chinese Pharmaceutical Journal 2015;50(9):824-828
OBJECTIVE: To review the development of clinical pharmacy in Europe, analyze the quality assessment system and provide a reference for China. METHODS: By reviewing the literature of European hospital pharmacy or clinical pharmacy services from 1960 to 2013, sum up the development process of clinical pharmacy in Europe and analysis existing quality assessment system. RESULTS: European clinical pharmacy development can be divided into four parts; initial stage ("clinical pharmacy" introduced to hospital), exploring stage ("ward pharmacy service" mode), developing stage ("patient-centered" work system) and mature stage (improving "clinical pharmacists" evaluation system) ; It has formed quality assessment system of pharmacy service structure, process and outcome, but has not yet established a comprehensive system of evaluation criteria. CONCLUSION: Through analyzing and comparing the development progress and quality assessment system of European clinical pharmacy, it is useful to determine a clear direction of Chinese hospital pharmacy and to promote the establishment and improvement of Chinese quality evaluation system.
2.Strong Expression of Recombinant Human Morphogenetic Protein-4 in Escherichia coli and its Bioassay in vivo
Si-Hong GAO ; Ju WANG ; Que-Wei DONG ; Kan LIU ; Xue-Ting LIU ; An HONG ; Qiu-Ling XIE ; Fen-Yong SUN ;
China Biotechnology 2006;0(03):-
Objective:To produce rhBMP-4 with bioactivity in E.coli. Methods: The full-length human BMP-4 gene was mutated by PCR without changes in amino acid sequence, then the synthesized gene was cloned into plasmid pET-3c, transducted into BL21(DE)plysS, and induced by adding IPTG to a final concentration of 1.0 mmol/L. The protein product was purified using ion-exchange chromatography method and then renaturated, bioactivity was checked by C2C12 differentiation in vitro and mouse ectopic bone formation in vivo. Results: A 438 bp gene fragment encoding mature peptide of hBMP-4 was cloned , the protein product was mostly in the form of inclusion body, after renaturation, the engineering protein shows better bioactivity. Conclusion:The mutant strategy can enhance the expression of bioactive rhBMP-4 in E.coli expression system.
3.Influence of genetic polymorphisms in drug metabolism enzymes and transporters on pharmacokinetics of different fluvastatin formulations
Qian XIANG ; Jun-Yu XU ; Ling-Yue MA ; Nan ZHAO ; Xiao-Dan ZHANG ; Qiu-Fen XIE ; Zhuo ZHANG ; Xia ZHAO ; Yi-Min CUI
Chinese Journal of Pharmacology and Toxicology 2018;32(4):317-317
OBJECTIVE The purpose of the present study was to investigate the impact of fluvas-tatin formulation on the pharmacokinetics-genetic polymorphis relationship. METHODS We compared the difference between the pharmacokinetics of fluvastatin as an extended-release (ER) 80 mg tablet and an immediate-release(IR)40 mg capsule in terms of drug metabolism enzyme and transporter ge-netic polymorphisms. In this open-label, randomized, two-period, two-treatment, crossover study, ef-fects of BCRP, SLCO1B1, MDR1, CYP2C9, and CYP3A5 polymorphisms on the pharmacokinetics of fluvastatin were analyzed in 24 healthy individuals.Each treatment duration was 7 days with a washout period of 7 days between the crossover.Serum concentration of fluvastatin was evaluated using high-performance liquid chromatography-tandem mass spectrometry. RESULTS The SLCO1B1 T521C genotype had no statistically significant effect on IR 40 mg capsule of fluvastatinafter single or repeated doses.However,for the ER 80 mg tablet,the SLCO1B1 T521C genotype correlated with the AUC0-24of repeat doses (P=0.01). The CYP2C9*3 genotype correlated with the AUC0- 24after the first dose IR 40 mg capsule (P<0.05); however, the difference between CYP2C9*1/*1 and CYP2C9*1/*3 was not statistically significant after repeated doses. CONCLUSION The effect of SLCO1B1 T521C on fluvas-tatin exposure was observed and was more profound in ER and repeated dose administration than in IR and single dose administration.We recommend that formulation should be incorporated into future pharmacogenomics studies and clinical implication guidelines.
4.Pharmaceutical care of a elderly patient with atrial fibrillation undergoing warfarin-induced digestive tract hemorrhage
Zi-Ning WANG ; Qiu-Fen XIE ; Qian XIANG ; Yi-Min CUI
The Chinese Journal of Clinical Pharmacology 2017;33(23):2439-2440,2460
Objective To provide a reasonable anticoagulant treatment plan for an artrial fibrillation patient.Methods Clinical pharmacists participated in one case of senior patient who under warfarin treatment with digestive tract hemorrhage,and provided personal anticoagulant treatment plan by analyzing the reasons of labile international normalized ratio (INR) and bleeding and using anticoagulant gene test result.Result and conclusion The patient was discharged from hospital.By combination of disease,drug combination,genotype factors,the effectiveness and safety of treatment were improved.
5.Pharmaceutical care on anti-TB drugs combined with anti-platelet drug in the treatment of non-ST segment elevation acute myocardial infarction and pulmonary tuberculosis
Liang-Fang ZHOU ; Qian XIANG ; Yun-Xia HE ; Qiu-Fen XIE ; Zi-Ning WANG ; Yi-Min CUI
The Chinese Journal of Clinical Pharmacology 2018;34(7):878-880
Objective To explore the method of pharmaceutical care for patients with non-ST segment elevation acute myocardial infarction and pulmonary tuberculosis by clinical pharmacist.Methods Clinical pharmacist participated in an acute non-ST segment elevation myocardial infarction patients with pulmonary tuberculosis,analyzing the treatment options for patients,assessing the efficacy of anti-platelet drugs,discussing gene polymorphisms and the interactions efficacy between anti-TB drugs and anti-platelet drugs.Results and conclusion Analyzing the function and characteristics of each drug,managing of drug interactions,providing individual treatment strategies for patientssare the key points for clinical pharmacists participating in clinical work.
6.Research status of laboratory tests for patients with direct oral anticoagulants
Zhe WANG ; Qiu-Fen XIE ; Qian XIANG ; Yi-Min CUI
The Chinese Journal of Clinical Pharmacology 2018;34(10):1253-1256
In recent years,the use of direct oral anticoagulants (DOACs) have been gradually accumulated in clinical practice.In specific cases,the DOACs blood concentration of patients are needed to be clearly defined in order to assist in further diagnosis and treatment.Therefore,through the study of literature retrieval of DOACs laboratory test at home and abroad,we intended to explore detection method of four kinds of DOACs (dabigatran,rivaroxaban,apixaban and edoxaban).Meanwhile we also discussed the use of DOACs detection and its effect on coagulation function detection in emergency or during the perioperative period.Finally,the results turned out that patients with dabigatran can detect the blood concentration by activated partial thromboplastin time,diluted thrombin time and ecarin clotting time.Factor Xa activity assay can be used for patients taking direct a factor Xa inhibitor,and high sensitivity of prothrombin time detection are especially suitable for rivaroxaban patients.
7.Case analysis of one co-infected atrial fibrillation patient′s adjustment of warfarin dose with the guidance of genotype
Qiu-Fen XIE ; Qian XIANG ; Ying ZHOU ; Yi-Min CUI
The Chinese Journal of Clinical Pharmacology 2014;(7):639-641
Objective To provide patients with reasonable individua-lized warfarin anticoagulation therapies according to the genotype testing.Methods Through clinical pharmacists′participation in anticoagulant therapy of an elderly female , who was admitted into hospital for aggrava-tion of heart failure due to atrial fibrillation and pulmonary infection , the reason for the elevated international normalized ratio ( INR ) was ana-lyzed , and the dose of warfarin was adjusted according to genotype results ( CYP2 C9*1/*1 and VKORC1 -1639 GA ).Before discharging her , pharmacist educated the patient so as to enhance self -anticoagulant therapy management.Results and Conclusion The patient's condition was improved.Her INR was 1.46 and in an upward trend before the day of her discharge.Guidance of genotypic testing combined with patients′concomitant diseases , medications, diet et al, could reduce time of INR to reach the target range and also improve the effectiveness and safety of anticoagulant therapy.
8.Study on the prevalence rate of chronic obstructive pulmonary disease in northern part of Guangdong province.
Xiao-ping WANG ; Yu-min ZHOU ; Xiang-yi ZENG ; Sheng-ming LIU ; Rong QIU ; Jun-fen XIE ; Jin-ping ZHENG ; Jia-chun LÜ ; Nan-shan ZHONG ; Pi-xin RAN
Chinese Journal of Epidemiology 2005;26(3):211-213
OBJECTIVETo investigate the prevalence of chronic obstructive pulmonary disease (COPD) and its risk factors in population over 40 years old in northern part of Guangdong province.
METHODSUsing uniform scheme, procedures and questionnaire, a cluster-randomized-sampling survey for the population aged over 40 years in a rural area of Shaoguan in the northern part of Guangdong province was performed. Spirometry was performed for every participant, followed by a bronchodilatation test when bronchial obstruction was present.
RESULTSThere were 1468 cases with complete data from 1498 people aged >or= 40 years including 640 males, 828 females with an average age of 54.3 years old. The total prevalence of COPD was 12.0%. The prevalence of COPD in males was significantly higher than that in females (18.3% vs. 7.1%, P < 0.01). Only 80.7% of the patients with COPD presented one or more symptoms as cough, phlegm, or dyspnoea. Underdiagnosis of COPD would be quite serious. Only 26.1% of the cases was previously diagnosed to have chronic bronchitis, emphysema, or COPD. Smoking was an important risk factor to COPD and 78.4% of the patients with COPD were smokers. However, relation of biomass and COPD called for further investigation.
CONCLUSIONPrevalence of COPD was much higher than expected in the northern part of Guangdong while smoking was an most important risk factor of COPD. Lung function test seemed to be of great importance to COPD diagnosis, especially in the earlier period of COPD.
Adult ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; epidemiology ; Risk Factors ; Sex Factors ; Smoking ; adverse effects ; Surveys and Questionnaires
9.Rare thalassemia mutations among southern Chinese population.
Fen LIN ; Liye YANG ; Min LIN ; Xiangbian ZHENG ; Min LU ; Meilan QIU ; Liejun LI ; Longxu XIE
Chinese Journal of Medical Genetics 2017;34(6):792-796
OBJECTIVETo detect rare types of thalassemia mutations among southern Chinese population.
METHODSPeripheral blood samples from 327 patients from various regions of southern China were collected. The patients were suspected as rare-type thalassemia for their inconsistency between hematological phenotypes and results of routine mutation screening. The samples were further analyzed with GAP-PCR and DNA sequencing.
RESULTSOne hundred and eight cases were diagnosed as rare types of thalassemia. Among whom 10 rare α-globin gene mutations including --THAI, HKα, αααanti3.7, αααanti4.2, -α2.8, -α27.6, CD74 GAC>CAC (Hb Q-Thailand), CD30 (-GAG), CD31 AGG>AAG and CD118 (+TCA), and 12 rare β-globin gene mutations including CD37 TGG>TAG, CD39 CAG>TAG/CD39 CAG>TAG, β II-2 (-T), -90(C>T), -31(A>C), -88(C>T), CD7(-A), CD138(+T), CD89-93 (--AGTGAGCTGCACTG), CD54-58 (-TATGGGCAACCCT), Chinese G γ +(A γδβ)0 and Vietnamese HPFH (HPFH-6) were identified. -88(C>T) (HBB: c.-138C>T) and CD39 CAG>TAG (HBB: c.118C>T) were discovered for the first time in Chinese population. CD7(-A) (HBB: c.23delA) and CD138(+T) (HBB: c.416_417insT) were new types of β-globin gene mutations.
CONCLUSIONThe present study have enriched the mutation spectrum of thalassemia in southern China, which has provided necessary information for its diagnosis.
Humans ; Mutation ; Thalassemia ; genetics ; alpha-Globins ; genetics ; beta-Globins ; genetics
10.Difference distribution of glycoprotein Ⅱb/Ⅲa receptor exon polymorphisms between Chinese cardiovascular patients and healthy population
Zhuo ZHANG ; Qian XIANG ; Yan-Jun GONG ; Kun HU ; Qiu-Fen XIE ; Zi-Ning WANG ; Yi-Min CUI
The Chinese Journal of Clinical Pharmacology 2018;34(19):2245-2247,2251
Objective To investigate the differences in distribution of Glycoprotein (GP)Ⅱb/Ⅲa receptor exon polymorphisms between Chi-nese cardiovascular patients and healthy population .Methods Based on our previous study of healthy volunteers , this study used the method of Sequenom Mass ARRAY?to detect the exon mutation sites of ITGI2B and ITGB3 which encoding GPⅡb/Ⅲa receptor and analyzed the differences in distribution between the two populations .Results Eighteen sites were detected.Three variants in the ITGA2B locus and fifteen variants in the ITGB3 locus were identified.The linkage relationships between single nucleotide polymorphisms (SNPs) in cardiovascular patients and healthy population were similar. The genotypes of ITGB3 rs112188890 (P<0.001), rs11871447 ( P <0.001 ), rs4634 ( P <0.05 ), and rs70940817 ( P<0.001 ) were significantly different between cardiovas-cular patients and healthy population.Conclusion There are multiple polymorphic sites in the exons of ITGI2B and ITGB3 in Chinese population.