OBJECTIVE:To investigate the role of clinical pharmacists in the medical treatment. METHODS:Medical treatments in which clinical pharmacists assisted doctors from Mar. 2008 to Mar. 2009 in the digestive department of our hospital were introduced. RESULTS&CONCLUSION:Clinical pharmacists can help doctors to choose suitable drugs according to drug property. Clinical pharmacist can combine their pharmacy knowledge with clinics to promote the rational use of drug.

Objective To study the accuracy of plasma matrix metalloproteinase-9 (MMP-9) predicting hemorrhagic transformation (HT) in ischemic stroke. Methods The studies on plasma MMP-9 predicting HT in ischemic stroke were included, in which diagnostic criteria, methods, and subjects were clearly described, regardless of language of publication and type of studies. MEDLINE (Apr, 1966 to 2006), EMBase (Apt, 1966 to 2006), CNKI (Feb, 1977 to 2006), and wanfangshuju (1989 to 2005) were searched and the references lists of eligible studies were manually searched. Two reviewers independently evaluated the quality of studies and extracted data. The data were analyzed using the Revman 4. 2 or SPSS 11.0. Results Five trials including 497 patients fulfilled the inclusion criteria, 109 of the 497 patients developed HT. The heterogeneity among studies was great (xspecialty 89. 9% (95% CI: 86. 4%-93.5%), sensitivity 86. 5% (95% CI: 77. 3%-96. 8%). Conclusions The values of plasma MMP-9 may be an independent predictor of hemorrhagic transformation. The number of patients in the included studies is not large enough, and the results need to be confirmed in further studies.

OBJECTIVE:To investigate the features of adverse drug reactions(ADR) occurred in the infusion room of our hospital so as to improve rational clinical drug use.METHODS:A total of 225 ADR cases reported by the infusion room of our hospital from Jan.1,2007 to Dec.31,2008 were analyzed retrospectively and statistically.RESULTS:Of the total 225 ADR cases reported,109 cases(48.44%) were children aged below 10;115 cases(51.11%) occurred within 10～30 min;ADR were induced by 29 kinds of medicines,with cephalosporin and penicillins showing the highest proportions(43.56% and 23.56%,respectively);143 cases(63.6%) manifested more often as lesions of skin and its appendage followed by ADR of digestive system(40 cases/17.8%).CONCLUSION:ADR monitoring plays an important role in medical institution.Tightening ADR monitoring in the infusion room contributes to patients' medication safety.

Objective To investigate the effect of lacosamide on expression of Nav1 .8 in dorsal root ganglia (DRG) in a rat model of chronic neuropathic pain.Methods Thirty-six female specific-pathogen-free (SPF)SD rats were randomly assigned into 3 groups ( n = 12 each): sham operation group (group S), model group (group M) and lacosamide group (group L) . Chronic neuropathic pain was produced by insertion of a small stainless steel rod (4.00 mm in length and 0.63 mm in diameter) into the L, intervertebral foramen in the rat, producing a chronic steady compression of the DRG in M and L groups. The mechanical threshold was measured 2 days before operation and on the 2, 4, 6, 7, 8, 9 and 10 days after operation (T0-7 ) . Intraperitoneal lacosamide 20mg/kg (in normal saline 0.5 ml) was injected at T4-7, twice a day in S and L groups. In group M, normal saline 0.5 ml was injected at T4-7 twice a day and the mechanical threshold was measured after the last administration everyday . The L, DRG on the operated side was removed after measurement of pain threshold to detect the expression of Na, 1.8 mRNA and protein by RT-PCR and immuno-histochemistry respectively. Results Compared with group S, the mechanical pain threshold was significantly decreased at T1-7 and the expression of Navl .8 mRNA and protein was up-regulated in M and L groups ( P < 0.05) . Compared with group M, the mechanical pain threshold was significantly increased at T4-7 and the expression of Nav 1.8 mRNA and protein was down-regulated in group L ( P < 0.05) . Conclusion The mechanism by which lacosamide reduces chronic neuropathic pain is related to the down-regulation of the expression of Nav 1.8 in rat DRG.

Objective To detect the expressions of decoy receptor 3 (DcR3) in pancreatic cancer tissues and to analyze the significance of DcR3 in the diagnosis, treatment and prognosis of patients with pancreatic cancer.Methods The expressions of DcR3 in pancreatic cancer tissues (n =100), paracancer tissues (n =15) and normal tissues (n =15) were detected with immunohistochemical method (Envision method).Results The positive rate of DcR3 in pancreatic cancer tissues was significantly higher than that in adjacent-tumor pancreatic cancer tissues (86.0％ vs.46.6％, P ＜ 0.05).The positive rate of DcR3 in adjacent-tumor pancreatic cancer tissues was significantly higher than that in normal tissues (46.6％ vs.13.3％, P ＜ 0.05).In clinical stage Ⅲ, the positive rate of DcR3 was significantly higher than that in stage Ⅱ and stage Ⅰ (100％ vs.87.0％, P＜0.05;100％ vs.62.5％, P＜0.05).There were significant differences among the three groups (P ＜ 0.05).With lymph node metastasis, the DcR3 positive rate was significantly higher than that in the group without lymph node metastasis (93.4％ vs.79.6％, P ＜ 0.05).In poorly differentiated pancreatic cancer, the positive rate of DcR3 was significantly higher than that in the highly differentiated group (100％ vs.64.0％, P ＜0.05), the positive rate of DcR3 was significantly higher in the moderately differentiated group than that in the highly differentiated group (88.6％ vs.64.0％, P ＜ 0.05) , There were significant differences among the three groups (P ＜ 0.05).There was no significant difference in the positive rate of DcR3 between the different age groups or the different gender groups (P ＞ 0.05).Conclusions The expression levels of DcR3 in patients with pancreatic cancer gradually increased from normal tissues to paracancer tissues, to pancreas tissues.The expression level of DcR3 protein was closely related to clinical stage, degree of tissue differentiation and presence of lymph node metastasis, but not associated with age, sex, and tumor diameter size.

Objective To sum up effective measures to prevent complications of peripherally inserted central catheter (PICC) by applying evidence-based nursing in patients after PICC insertion.Methods From January 2011 to January 2013,1490 patients inserted with PICC in Hunan Provincial Tumor Hospital were selected by convenience sampling,whom were divided into control group (n =758) and observation group (n =732) with random number table.The control group received routine care,while the observation group received evidence-based nursing.Nursing program for the observation group was formed based on literature regarding the causes of and solutions for phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage of insertion sites.Results The incidences of postoperative phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage at insertion sites in the observation group were significantly lower than those in the control group (3.14％ vs.8.97％,P=0.023;4.23％ vs.11.74％,P=0.021;3.96％ vs.8.44％,P=0.001;4.92％vs.12.66％,P =0.011).Conclusions The application of evidence-based nursing in patients with PICC insertion could effectively reduce the complication,and improve the quality of clinical nursing care.

This paper introduced the definition of case management, the application of case management model in China and abroad, analyzed the necessity of the implementation of colostomy case management in the field of patients with colostomy, and then discussed the challenges and solving strategies in the delivery of colostomy case management in China in order to provide a theoretical basis for the establishment and promotion of colostomy case management model.

Objective To study the releasing properties and mechanism in vitro of the active ingredients of the gastric floating sustained-release tablet containning Zuojin Pellet extraction(ZJ-GFST).Methods The release rates of berberine,palmatine,evodiamine,and rutaecarpine from ZJ-GFST in vitro within 8 h were measured by using rotating basket method in Chinese Pharmacopeia.The cumulative curve of drug release data was fitted to zero order,first-order and Higuchi equation to ascertain the kinetic modeling of drug release.Release mechanism was ascertained using Peppas equation.Results The similar factors of the cumulative release curve of all the four ingredients mutually compared were more than 80%,indicating that the release of the four ingredients were similar.The cumulative release rate of all the four ingredients fitted Higuchi equation.The value of slopes of Peppas models of all the four ingredients were more than 0.45,indicating that drug released by concurrent action of diffusion and matrix erode(non-fickian diffusion).Conclusion The releasing properties in vitro of the active ingredients of ZJ-GFST is consistent.

AIM: To select optimum purification of Qingluotongbi decoction (Caulis Sinomenii etc.). METHODS: Qingluotongbi decoction was refined respectively by ceramic membrane microfiltration, ultrafiltration, alcohol sedimentation, high speed centrifugalization, flocculation and macroporous resin absorption. Their refining effect was compared according to indexes of color, clarity, loss rate of sinomenine, removal ratio of impurity. RESULTS: All kinds of purification made decoction light and clear. Removal ratio of impurity by macroporous resin absorption was the highest and reached 80% or more. Removal ratio of impurity by ceramic membrane microfiltration was 21.17% , less than that by alcohol sedimentation or ultrafiltration, but more than that by flocculation and centrifugalization. Loss rate of sinomenine by AB 8 type macroporous resin absorption was the lowest and reached 6.39% , and that by ceramic membrane microfiltration was 15.31% , less than that by ultrafiltration, alcohol sedimentation, centrifugalization and flocculation. The chromatogram of decoction disposed by macroporous resin was different from that of decoction unsettled, but that disposed by ceramic membrane was similar to that of decoction unsettled. CONCLUSION: The technique of ceramic membrane microfiltration is optimum purification of Qingluotongbi decoction with the virtues of moderate removal ratio of impurity, small amount lose rate of sinomenine and simple process.

AIM: To preparate brucine liposome. METHODS: Brucine liposomes were preparated by a combination of ammonium sulfate transmembrane gradients method and extrusion through microfiltration membranes.The methods were evaluated by particle morphology,the size range,and encapsulation efficiency. RESULTS: The optimal preparating process parameters of brucine nanometer liposome were lecithin-to-cholesterin ratio of 100∶15,the volume of 0.1 mol/L of water solution of ammonium sulfate being 66.7 times as large as lecithin,the volume of brucine being 0.0167 times than lecithin,the temperature and the time of incubating being 40 ℃ and 20 min,respectively.The encapsulation efficiency of this method was over 90%. CONCLUSION: Preparation of brucine liposomes by a combination of ammonium sulfate transmembrane gradients method and extrusion through microfiltration membranes is feasible.