OBJECTIVE:To investigate the application and feasibility of the PDCA cycle management method in pharmacy management of three-level general hospital re-accreditation in our hospital and promote continuous improvement of hospital pharma-cy management. METHODS:Referring to 2011 edition of Detailed Rules for Three-level General Hospital Accreditation,the work of hospital pharmacy management was checked and continually improved based on the PDCA cycle management method. RE-SULTS:After the application of PDCA,prescription error rate in outpatient pharmacy dropped from 0.0314% to 0.0192%;the number of dispense error in center pharmacy decreased by 60.2% and the accuracy rate of drug stock increased from 87.14% to 97.32%;the number of dispensing errors in pharmacy intravenous admixture service reduced from 5.6 bags/week to 1.8 bags/week, and the error rate reduced by 67.86%;the proportions of irrational prescriptions of glucocorticoid drugs dropped from 19.26% to 4.23%. CONCLUSIONS:The application of PDCA cycle management method in pharmacy management of three-level general hos-pital reaccreditation and the establishment of relevant system can obviously improve the work of pharmacy management continuously.

95%). Patients with overweight/obesity were more likely to have absent myocardial perfusion (MBG 0/1 grade 44.6%、64.3% and 30.6%,MBG 2/3 grade 55.4%、35.7% and 69.4% respectively, P=0.027), and absence of STR (STR

Objective To analyze the rented factors leading to successful treatment of ectopic pregnancy by conservative therapy and to explore importance of this therapy. Methods 152 patients with ectopic pregnancy performed with conservative treatment were randomly recruited into a methotrexate plus Chinese medicine group, a 5-fluorouracil plus Chinese medicine group and a exclusive Chinese medicine group. The curative rate and side effect were observed in groups, and the relation between the treatment condition and the curative rate was analyzed. Results There was no difference in curative rate among groups, while the side effect in the exclusive Chinese medicine group was lower than other groups. It showed high curative rate in patients with two or more conditions of having mass less than 3 cm, the level of bloodβ-hCG less than 1000 IU/L, and the depth of posterior fomix effusion less than 1 cm. Conclusion Among the treatments of ectopic pregnancy, Chinese medicine has fewer side effects. Fully evaluation on the treatment condition can improve the curative rate.

Fibrosis is a pathological process characterized by tissue scars and can occur in many organs of the human body. Organ fibrosis is manifested by increased fibrous connective tissue and reduced parenchymal cells in organ tissues, which can lead to destruction of organ structures and reduced function, which seriously endangers human health. Current strategies for treating organ fibrosis include: blocking the transforming growth factor-β1 (TGF-β1)/Smad signaling pathway, anti-inflammatory, regulating the sphingosine kinase 1/sphingosine-1-phosphate (SK1/S1P) signaling pathway, antagonizing vasoactive peptide receptors, enzyme inhibitors, kinase inhibitors, inhibitors of cellular signaling pathway, regulation of metabolic pathways, and mesenchymal stem cell therapy. In the review, the treatment strategies for organ fibrosis and the latest developments in the research of anti-organ fibrosis drugs are summarized to provide a reference for the development of anti-organ fibrosis drugs.

Objective To investigate the effect of dexmedetomidine on the stress responses during wakeup test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.Methods Thirty-six ASA physical status Ⅰ or Ⅱ patients,undergoing cerebral functional area operation requiring wake-up test,aged 18-60 yr,weighing 50-70kg,were randomly divided into control group (group C) or dexmedetomidine group (group D) with 18 cases in each group.Dexmedetomidine 0.8 μg/kg was infused over 10 min before induction of anesthesia followed by infusion at 0.4 μg·kg-1 · h-1 in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with target-controlled infusion of propofol and remifentanil and iv injection of cisatracurium.At 30 min prior to wake-up test,target-controlled infusion of propofol and application of mulscle relaxants were stopped,the target plasma concentration of remifentanil was decreased to 1 ng/ml,and in group D the infusion rate of dexmedetomidine was decreased to 0.1 μg·kg 1· h-1.Anesthesia time and consumption of anesthetics before wake-up test,wake-up time,and development of complications and intraoperative awareness during wake-up test were recorded.At 30 min prior to wake-up test (T1),immediately after wake-up (T2),at 5 min after wake-up (T3),and at 10 min after the anesthetic depth was deepened (T4),HR,mean arterial pressure and BIS value were recorded and blood samples were taken for determination of plasma concentrations of epinephrine (E) and norepinephrine (NE).Results Compared with group C,the consumption of propofol and remifentanil was significantly reduced before wake-up,the incidence of hypertension was decreased during wake-up test,and HR and plasma E and NE concentrations were decreased at each time point (P ＜ 0.05),and no significant difference in mean arterial pressure and BIS value was found in group D (P ＞ 0.05).Tachycardia,restlessness,bucking and awareness were not observed during wake-up test in group D.Conclusion Dexmedetomidine can inhibit the stress responses during wake-up test and raise the quality of wake-up test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.

AIM: To investigate the activation dynamics and the intracellular localization of p38 protein kinase in Raw264.7 cells after lipopolysaccharide (LPS) stimulation.METHODS: Protein kinase assay and immunogold electron microscope technique were used to check the activation dynamics and distribution of p38 MAPK in Raw264.7 cells before and after LPS stimulation. RESULTS: The kinase assay results showed that a marked increase in p38 activity was detected 15 min after LPS treatment, and reached maximal activity 30 min post stimulation, then dropped down and got closed to the pre-stimulated level 2 h later. The optimal LPS concentration for treatment was 100 ?g/L. The immunogold electron microscope data showed that p38 spread evenly in every part of the cytosol of the non-stimulated and EGF stimulated Raw264.7 cells, such as endoplasmic reticulum, mitochondria, lysosome, while the golden granules intensity in the cytosol area decreased and in the nuclear area increased significantly after LPS stimulation.CONCLUSION: p38 MAPK moves to the nuclei of Raw264.7 cells on account of stimulation by LPS.

Objective To elucidate the role of P38 signaling pathway on heat-induced apoptosis in monocytic cell line Raw264.7.Methods Raw cells were transfected with constitutively active mutant MKK6b(E)and dominant negative mutant P38(AF),or the empty cloning vector pcDNA3 and apoptosis was detected by flow cytometric analysis.Results The ectopic expression of P38 mutant was confirmed by immunostaining with the antibody against the Flag-epitope tag.Expression of MKK6b(E)led to a marked increase in P38 kinase activity in transfected cells and induced a 4-fold increase in the number of apoptotic cells as compared to that in cultures of control transfected cells.Meanwhile the expression of MKK6b(E)increased the apoptotic rate of Raw cells induced by heat.In contrast,the dominant-negative mutant P38(AF)inhibited Raw cells apoptosis induced by heat.Conclusion The activation of the MKK6-P38 MAP kinase signaling pathway is required for heat-induced apoptosis in Raw264.7 cells.

Beta-Elemene is an antitumor drug which is isolated from the traditional Chinese medicinal herb Curcumae Phaeocaulis Rhizoma, it is the main component of elemene which is extracted from the plant and delivered via blood circulation after intravenous injection. The antitumor effect of beta-elemene in vitro and in vivo was definite, and beta-elemene could improve the patient immunity and no sever side effect, drug resistance or bone marrow suppression were found during the clinical studies. And human serum albumin (HSA) is a primary extracellular protein which has a high concentration distribution in blood plasma and has many characteristic physiological functions. Therefore, the binding of beta-elemene to protein may be very important for absorption, distribution, metabolism and elimination. Therefore, the study on the interaction of beta-elemene with drug-carrying protein is very important. In this work, molecular binding of beta-elemene to human serum albumin (HSA) was investigated by using spectrofluorometer. the binding constants suggested that a strong interaction and the formation of a complex between beta-elemene and HSA. This clearly implies that beta-elemene can be stored and removed by the proteins in the body. Furthermore, the fluorescence quenching results showed that the HSA fluorescence was quenched by beta-elemene through static quenching mechanism. Thermodynamic parameters showed that hydrophobic interactions play a role in the binding of beta-elemene to HSA. The negative deltaH(0) and positive deltaS(0) in case of beta-elemene therefore showed that electrostatic attraction play a role in the binding of beta-elemene to HSA.
Drugs, Chinese Herbal ; chemistry ; Humans ; Kinetics ; Protein Binding ; Serum Albumin ; chemistry ; Sesquiterpenes ; chemistry ; Spectrometry, Fluorescence ; Thermodynamics

Objective To explore the effects of Atorvastatin and Simvastatin on serum levels of lipid,high sensitive C-reactive protein (hs CRP)and ventricular remodeling in patients with acute coronary syndromes(ACS).Methods In this prospective study,96 patients with acute coronary syndrome were admitted in our hospital from December 2014 to September 2016.In the prospectively study,they were randomized into Atorvastatin group(Atorvastatin 20 mg daily,n =48) and Simvastatin group(Simvastatin 40 mg daily,n=48),and serum levels of hs CRP,lipids and changes in myocardial function were detected and compared between two groups before and after treatment.Results The serum levels of hs-CRP and lipids were significantly lower in Atorvastatin group than in Simvastatin group at 8 weeks after treatment(P＜0.05).At the end of the treatment,the levels of left ventricular reject fraction and left ventricular end-diastolic volume index were improved (all P ＜ 0.05) in two groups,but significantly higher in Atorvastatin group [(44.8 ± 6.3) ％ and (62.7 ± 10.4)] than in Simvastatin group [(48.9 ± 6.9) ％ and (67.9 ± 10.5) respectively,all P ＜ 0.05).Conclusions Simvastatin and Atorvastatin can effectively promote the decrease in levels of blood lipids and inflammatory reaction,and help to improve the myocardial function in patients with acute coronary syndrome,but Atorvastatin effects are more significant.