ObjectiveTo compare the effect and side effects of citalopram and fluoxetine in the treatment of depression.Methods46 cases meet the diagnostic criteria of CCMD-3 in patients with depression were randomly divided into citalopram group and fluoxetine group,treatment for 6 weeks,with Hamilton Depression Rating Scale (HAMD) and Emergent Symptom Scale(TESS) assessed the efficacy and adverse reactions.Results The efficiercy in citalopram group was 75.4％,74.8％ for the fluoxetine group,the difference between the two groups was not significant ( P＞0.05).Affter 2weeks treatment HAMD score between the two groups was significantly different (P ＜ 0.05),TESS score in Citalopram group was lower than the fluoxetine group,the differences were significant ( P ＜ 0.05 ).ConclusionCitalopram and fluoxetine have good antidepressant effects.Citalopram has the advanteges of early onset,cess adverse reactions.

Objective To comparie effect of risperidone and clozapine on the treatment of schizophrenia and adverse reactions. Methods 40 cases were randomly divided into two groups of patients with schizophrenia, risperi-done and clozapine group 20 cases, pre-treatment and treatment in the first weekend 2,4,6 Symptom Rating Scale (PANSS) and the reaction volume Table (TESS) were used to assess the efficacy and adverse reactions. Results Comparison of reduction rate PANSS, there was no significant difference(P > 0. 05), compared with clozapine group, risperidone group had less adverse reactions. Conclusion Risperidone and clozapine group had considerable effect in the treatment of schizophrenia, but risperidone had fewer adverse reactions.

OBJECTIVE:To investigate the situation and developing trend of the use of narcotics METHODS:The data of narcotics used in our hospital in 2000～2002 were collected from HIS System and analyzed RESULTS:The sum of money of narcotics was increasing year by year,especially for morphine preparation;The use of Durogesic and MS Contin for the pain control of cancer occupied the first and second places in frequency,but the amount of use of pethidine injection was constantly high CONCLUSION:Irrational drug-use for the pain control of cancer still existed

[Objective] The study was conducted to investigate the effect of micronized fenofibrate on acute insulin response in the subjects with impaired glucose metabolism and hypertriglyceridemia. [Methods] Fifty-three subjects were randomly (2:1 ratio) allocated to fenofibrate group (n=36, including IFG 3 cases, IGT 19 cases, IFG/IGT 6 cases, T2DM 8 cases) or control group (n = 17, including IFG 1 case, IGT 9 cases, IFG/IGT 4 cases, T2DM 3 cases) without any intervention for 3 months. Fasting blood samples were collected for measuring fasting plasma glucose (FPG), free fatty acids (FFA), and lipid profile. IVGTTs were carried out with measurement of plasma insulin before and after treatment. Acute insulin response (AIR), the maximum insulin concentrations (C_(INS,MAX)) to fasting insulin (FINS) ratio (C_(INS,MAX)/FINS) and values of the maximum insulin concentrations increment (△C_(INS)) during IVGTT were calculated as indexes of first-phase insulin secretion. HOMA insulin resistance index (HOMA IR) was used for assessing insulin resistance. [Results] After 3-month treatment, the lipid profile was evidently improved in fenofibrate group. Levels of trigiyceridemia (TG), low-density lipoprotein cholesterol and FFA were significantly reduced and high-density lipoprotein cholesterol increased significantly. Waist circumference was also significantly declined. No change of above indicators was found in control group. In fenofibrate group, C_(INS,MAX)/FINS and △C_(INS) were significantly increased (median 8.4 pmol/L vs. 5.3 pmol/L, 808±473 pmol/L vs. 660±472 pmol/L, both P<0.0001), along with great improvement of AIR (5 585±3 441 pmol·L~(-1)·min~(-1) vs. 4 444±3 642 pmol·L~(-1)·min~(-1), P<0.0001). The level of FINS and HOMA IR was also markedly reduced (108±65 pmol/L vs. 166±115 pmol/L, P = 0.002; 3.8±2.3 vs. 6.0±4.2, P = 0.001). In contrast, there were modest declining in acute insulin response (AIR: 4 313～1 943 pmol·L~(-1)·min~(-1) vs. 5 362±2 861 pmol·L~(-1).min~(-1); C_(INS,MAX)/FINS: median 4.6 vs. 7.0, P= 0.01; △C_(INS): 641±286 pmol/L, vs. 720±321 pmol/L, P= 0.003 9) and increasing HOMA IR (7.8±4.2 vs. 5.6±3.2, P<0.000 1) in control group after 3-month follow-up. The improvement of AIR was correlated with the decreasing of plasma FFA and TG (r=0.41, 0.36, P = 0.002, 0.014), but no correlation with the changing of FPG and HOMA IR. [Conclusions] These results indicated that sbort-term lipid-lowering treatment with fenofibrate evidently improved acute insulin response and alleviated insulin resistance in subjects with impaired glucose metabolism and hypertriglyceridemia. Moreover, the improvement of insulin secretion capacity may be mainly due to the relieving of iipotoxity resulting from finofibrate.

Thirty six patients with hypertriglyceridemia and impaired glucose regulation or newly diagnosed type 2 diabetes, whose fasting plasma glucose was ≤8.0 mmol/L, were treated by fenofibrate for 3 months. Lipid profile, insulin during intravenous glucose tolerance test and oral glucose tolerance test ( including glucose) were measured before and after treatment After treatment, lipid profile was significantly improved. Insulinogenic index (△I30/△G30) and acute insulin response were significantly increased (98. 9vs. 129. 2, 3558.9 vs. 4783. 3 pmol · L - 1 · min - 1, respectively, P ＜ 0. 05 ). Fasting insulin and insulin resistant index in homeostasis model assessment ( HOMA IR) decreased ( 128. 6 vs. 84. 8 pmol/L, 4. 8 vs.3.0, respectively, P ＜0. 05 ). The improvement of insulin secretory function was more significant in patients with higher triglyceride (TG ＞ 3. 3 mmol/L). These results indicate that short-term lipid-lowering treatment with fenofibrate can improve β-cell function and insulin resistance. Patients with higher triglyceride are likely to achieve more benefit from lipid-lowering treatment.

AIM: There has been accumulating evidence demonstrating that activators for peroxisome proliferator-activated receptor ? (PPAR?) have antiinflammatory, antiatherogenic, and vasodilatory actions. We investigated the effect of PPAR? activator, fenofibrate, on trombin-induced endothelin-1 (ET-1) expression in cultured vascular endothelial cells. METHODS: Bovine aortic endothelial cells (BAECs) were treated with the PPAR? activator, fenofibrate. The ET-1 concentrations were evaluated by radioimmunoassay. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the ET-1 mRNA expression. RESULTS: Thrombin(10U/L) induced ET-1 release in BAECs [(22.4?4.7) nmol/g protein vs control (13.2?1.6) nmol/g protein, P

Objective To analyze and compare the therapeutic drug monitoring (TDM) and regularity of tacrolimus in deceased donor liver transplantation (DDLT) and living-donor partial liver transplantation (LDLT) the therapeutic drug monitoring (TDM) and regularity of tacrolimus.Method The clinical data of 68 patients undergoing liver transplantation from January 2010 to October 2011 were analyzed retrospectively.Thirty cases underwent LDLT as group A,and the remaining 37 underwent DDLT as group B.Result The time to reach therapeutic window was shorter in group A(3.9 ± 0.7 days) than in group B (6.5 ± 1.0 days,P＜0.01).The tacrolimus dosage in group A was significantly less than that in group B during the first 28 days post-transplantation.However,the tacrolimus dosage approached gradually and tended to be consistent after 28 days.On the postoperative day 7,14,21 and 28,the Tacrolimus dosage in group A was 72.37％,79.31％,90.11％ and 95.45％ of that in group B respectively.Concentration-dose ratio in group B was in a steady state (80-90 g/L).Concentration-dose ratio in group A was decreased with time,culminating at 28th day and close to that in group B.Correlation analysis revealed that graft recipient weight ratio(GRWR) had a significantly positive correlation with the tacrolimus dosage on the first 7 days (r =0.557) and a significantly negative correlation with the tacrolimus concentration/dose ratio (r =-0.578).Conclusion The early tacrolimus dosages in patients subject to LDLT were correlated significantly with the GRWR.The early tacrolimus dosages in patients undergoing LDLT were about 70％ of those in patients undergoing LDLT.However,with the regeneration of the liver,they tended to be consistent after 28 days.

Objective To evaluate the impacts of the essential medicine system in Jiangsu Province on rational drug use in community health service centers.Methods 7667 outpatient prescriptions from 6 community health service centers in Nantong were selected by cluster sampling from January 2009 to December 2011,the part of SDUIs(Selected Drug Use Indicators)developed by WHO and the self-design indicators were employed to analyze rational use of drugs.Results After implementation of the essential medicine system,the average types of drugs per prescription decreased from 3.02 to 2.74,the rate of antibiotic drugs usage dropped from 61.43％ to 51.2％,the rate of one antibiotic usage reduced from 33.94％to 28.58％,and two types from 20.43％to 15.8％,all with significant differences(P＜0.001).The average expenses in single prescription arose from RMB 69.70 to 87.28,the rate of essential medicine usage increased from 81.22％to 85.60％,the injection utilization decreased from 31.14％ to 14.13％,while TCM utilization ascended from 16.17％to 21.8％,all with significant differences(P＜0.001).Condusion The essential medicine systems has positive impacts on rational drug use,but the expenses of per prescription are higher,and irrational antibiotic drugs are still a serious problem.

OBJECTIVE:To discuss rational use of injection in order to provide reference for rational use of injection in the clinic. METHODS:Drug use was analyzed in respect of route of administration,selection of solvent,compatibility of drugs, speed of intravenous administration,the concentration of mixture,etc. RESULTS&CONCLUSION:There are some mistakes in the application of injections,but some faults and adverse drug reactions (ADRs) can be warned early. By strengthening pharmaceutical monitoring,related faults and ADRs can be reduced to the minimum.

AIM: We hypothesized that PPAR? ligands stimulate endothelial-derived nitric oxide(NO) release to protect the vascular wall.Thus,the purpose of this study is to investigate the effects of ciglitazone(Cig) and fenofibrate(Fen) on angiotensin Ⅱ(AngⅡ)-induced decrease in endothelial NO synthase(eNOS) expression and NO production in human umbilical vein endothelial cells(HUVECs).METHODS: HUVECs were preincubated for 24 h with Cig(10~(-7), 10~(-6),10~(-5),10~(-4) mol/L) or Fen(10~(-5) and 10~(-4) mol/L),then incubated for 12 h with 10~(-7) mol/L AngⅡ.Total RNA was extracted,and the expression of mRNA and protein of eNOS was assessed by RT-PCR and Western blotting.NO production was measured by Griees method.RESULTS: In the presence of 10~(-7) mol/L AngⅡ for 12 h,NO production in cultured HUVECs was decreased(P