Objective To investigate the clinical application of perioperative human serum albumin(HSA)in cardiac surgery in multiple regions in China,and to evaluate the rationality of its clinical application in conjunction with the clinical guidelines,in order to provide a reference for promoting the rational application of HSA.Methods The medical records of patients who underwent cardiac surgery from April to June 2019 in eight hospitals across the country were retrospectively collected.The statistical information on patients'general information,the dosage,course of treatment,and cost of HSA,and the serum albumin level before and after medication was analyzed to evaluate the use of HSA.Relevant evaluation criteria were established,and the rationality of its medication was evaluated.Results Data from a total of 449 patients were included for analysis,the appropriate rate of medication was 81.1％.The course of medication was mostly＞2-5 days and the total amount of HSA was mostly 50-99 g.The main purpose of medicaiton were improving colloid osmotic pressure,reducing exudation to improve interstitial edema,postoperative volume expansion.Conclusion Clinical attention should be paid to ensure the rational application of HSA in cardiac surgery during the perioperative period and prevent the abuse of blood products.

Objective A case would be discussed on suspected demyelination due to electrolyte disturbance to provide references for clinical pharmacists to carry out pharmaceutical care. Methods A pharmaceutical care case on PCI postoperative acute heart failure and contrast induced nephropathy with suspected demyelization due to electrolyte disturbance was introduced through a combination of analysis on clinical symptoms,renal function,electrolyte,blood glucose level and further discussion on consciousness change reason, diuretic use, electrolyte management, and other related issues. Results Clinical pharmacist should provide more care to patients with abnormal blood sodium and osmotic pressure,pay more attention to the calculation and evaluation of rehydration sodium/filling quantity and speed, accumulate more knowledge of contrast induced nephropathy, and raise their awareness on the identification of high risk population. Conclusion Arrhythmia,heart failure,renal failure,infection can beincentives to one another,and thus doctors and pharmacists must pay more attention to the comprehensive situations.

OBJECTIVE:To explore the effects of short-term application of atorvastatin combined with ezetimibe on efficacy and related indicators of patients with primary nephrotic syndrome with hyperlipidemia. METHODS:Data of 50 patients with prima-ry nephrotic syndrome with hyperlipidemia were retrospectively collected and divided into combination group and control group ac-cording different treatment,25 cases in each group. All patients received low-salt,low-fat ,high-quality protein,giving prednisone 1 mg/(kg·d),po,qd,combined with anticoagulation,diuretic,anti-infection,taking cytotoxic drugs if necessary. Based on it, control group received Atorvastatin calcium tablet 20 mg before going to bed,qd;combination group received Atorvastatin calcium tablet(the same dosage and usage with control group)+Ezetimibe tablet 10 mg,qd. They were treated for 2 weeks. Lipid-lowering efficacy and low-density lipoprotein(LDL-C),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C),24 h uri-nary protein (M-TP),serum albumin,alanine aminotransferase (ALT),aspartate aminotransferase (AST),serum creatinine and blood urea nitrogen before and after treatment in 2 groups were observed and the incidence of adverse reaction was recorded. RE-SULTS:There was no significant differences in the total effective rate of Lipid-lowering in 2 groups(P>0.05). After treatment, LDL-C,TC and HDL-C in 2 groups were significantly lower than before,Alb in combination group and ALT in 2 groups were sig-nificantly higher than before,with statistical significance(P<0.05),while there were no significant difference in 2 groups(P>0.05). And there was no significant difference in the TG,M-TP,AST,serum creatinine and blood urea nitrogen before and after treatment(P>0.05). CONCLUSIONS:Atorvastatin combined with ezetimibe can improve the blood lipid of patients with primary nephrotic syndrome with hyperlipidemia,while showing similar efficacy and safety with atorvastatin alone in a short term.

Objective:To evaluate the curative effect and safety of fasudil hydrochloride injection in the prevention and treatment of aneurysm postoperative cerebral vasospasm by meta-analysis. Methods: The randomized controlled trials were retrieved from PubMed, EMBASE, Cochrane Library, VIP, Wangfang, CNKI and so on. Meta-analysis was conducted using RevMan 5. 0 software. Results:Totally 418 reference studies were screened, from which 11 ones were chosen including 786 patients in all. In the treatment of cerebral vasospasm (CVS), there was no significant difference between the groups (OR=1. 56, 95%CI:0. 95-2. 58, P>0. 05). While in the prevention of CVS, the incidence rate of CVS in fasudil group was significantly lower than that in nimodipine group ( OR=0. 43, 95%CI:0. 23-0. 81, P=0. 008). However, the incidence rate of ADR in fasudile group was higher than that in nimodipine group (OR=0. 43, 95%CI:0. 25-0. 75,P=0. 003). Conclusion:In the prevention of CVS, fasudil may be better than nimodipine, while the incidence of ADR is higher.

OBJECTIVE:To explore the methods of clinical pharmacists providing pharmaceutical care for a patient with N-methyl-D-aspartate receptor(NMDAR)encephalitis complicating with multiple organ infections. METHODS:Taking one clinical case as breakthrough point,the points of pharmaceutical care provided by clinical pharmacists for NMDAR encephalitis complicat-ing with multiple organ infections were analyzed,so as to put forward the suggestions in the field of antibiotics selection,medica-tion approach based on pharmacokinetics,ADR disposal and nutrition support. RESULTS:Clinical pharmacists applied pharmaceuti-cal care to resolve ADR as abnormal liver enzyme timely,and the symptom had been improved gradually. Then the patient was dis-charged from the hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care and screen the possible risk of drug use to avoid the occurrence of severe ADR.

Objective To explore the short-term efficacy and safety of the proton pump inhibitor (PPI) pantoprazole sodium versus rabeprazole sodium for preventing gastrointestinal hemorrhage after percutaneous coronary intervention (PCI) which used aspirin and clopidogrel dual antiplatelet therapy.Methods The clinical data of patients who were hospitalized in the General Hospital of Shenyang Military Command during February to April 2014 and were diagnosed as coronary heart disease (CHD) and received PCI were collected and analyzed retrospectively.The patients were divided into pantoprazole group (an Ⅳ infusion of pantoprazole sodium 40 mg in 0.9％ 100 ml sodium chloride,once daily) and rabeprazole group (oral rabeprazole sodium 10 mg once daily).Three days before PCI,the two groups received dual antiplatelet therapy with clopidogrel and aspirin.The occurrence of gastrointestinal hemorrhage and major cardiovascular events and incidence of adverse reactions within two months after PCI were compared.Results A total of 84 patients were enrolled in this study,each group had 42 cases.Pantoprazole sodium group comprised 23 males and 19 females with an average age of (65 ±8) years; rabeprazole sodium group comprised 22 males and 20 females with an average age of (66 ± 8) years.During follow-up,none of the two groups of patients developed gastrointestinal hemorrhage,no cardiovascular events including myocardial infarction,recurrent angina,stent thrombosis,revascularization occurred.The incidence of gastrointestinal reaction in the pantoprazole sodium group and rabeprazole sodium group were 9.5％ (4/42) and 11.9％ (5/42),respectively.The results of liver function,kidney function and blood routine tests were within normal range in two groups before and after treatment.Before treatment,pantoprazole sodium group serum aspartate aminotransferase [(47 ± 28)U/L] was higher than that of rabeprazole sodium group [(24 ± 13)U/L],the difference was significant (P=0.020).After treatment,pantoprazole sodium group serum aspartate aminotransferase (28 ± 15) U/L was significantly lower than that before treatment (P =0.026).Conclusions In patients underwent PCI and dual antiplatelet therapy,combined treatment with pantoprazole sodium or rabeprazole sodium may be effective in preventing gastrointestinal hemorrhage and do not increase the risk of cardiovascular events within short time.There was no significant difference in efficacy and safety for preventing gastrointestinal hemorrhage in short-term between intravenous pantoprazole sodium and oral rabeprazole sodium.

Objective To explore the short-term efficacy and safety of the proton pump inhibitor (PPI) pantoprazole sodium versus rabeprazole sodium for preventing gastrointestinal hemorrhage after percutaneous coronary intervention (PCI) which used aspirin and clopidogrel dual antiplatelet therapy.Methods The clinical data of patients who were hospitalized in the General Hospital of Shenyang Military Command during February to April 2014 and were diagnosed as coronary heart disease (CHD) and received PCI were collected and analyzed retrospectively.The patients were divided into pantoprazole group (an Ⅳ infusion of pantoprazole sodium 40 mg in 0.9％ 100 ml sodium chloride,once daily) and rabeprazole group (oral rabeprazole sodium 10 mg once daily).Three days before PCI,the two groups received dual antiplatelet therapy with clopidogrel and aspirin.The occurrence of gastrointestinal hemorrhage and major cardiovascular events and incidence of adverse reactions within two months after PCI were compared.Results A total of 84 patients were enrolled in this study,each group had 42 cases.Pantoprazole sodium group comprised 23 males and 19 females with an average age of (65 ±8) years; rabeprazole sodium group comprised 22 males and 20 females with an average age of (66 ± 8) years.During follow-up,none of the two groups of patients developed gastrointestinal hemorrhage,no cardiovascular events including myocardial infarction,recurrent angina,stent thrombosis,revascularization occurred.The incidence of gastrointestinal reaction in the pantoprazole sodium group and rabeprazole sodium group were 9.5％ (4/42) and 11.9％ (5/42),respectively.The results of liver function,kidney function and blood routine tests were within normal range in two groups before and after treatment.Before treatment,pantoprazole sodium group serum aspartate aminotransferase [(47 ± 28)U/L] was higher than that of rabeprazole sodium group [(24 ± 13)U/L],the difference was significant (P=0.020).After treatment,pantoprazole sodium group serum aspartate aminotransferase (28 ± 15) U/L was significantly lower than that before treatment (P =0.026).Conclusions In patients underwent PCI and dual antiplatelet therapy,combined treatment with pantoprazole sodium or rabeprazole sodium may be effective in preventing gastrointestinal hemorrhage and do not increase the risk of cardiovascular events within short time.There was no significant difference in efficacy and safety for preventing gastrointestinal hemorrhage in short-term between intravenous pantoprazole sodium and oral rabeprazole sodium.

Objective To explore the pharmaceutical care plan of clinical pharmacist for elderly patients with coronary heart disease and renal insufficiency. Methods To develop the therapeutic schedule in cooperation with clinicians through clinical rounds, in order to offer specific pharmaceutical care and further develop individualized care plan during patient ' s hospitalization. Results Clinical pharmacists paid close attention to the indicators and adjusted administration time when the adverse reactions such as lower blood pressure, leukopenia, and deterioration of renal function occurred, and finally avoided further potential adverse reactions. Conclusion The incidence of adverse drug reactions were reduced, the safety and efficacy of drugs used were guaranteed, which can promote rational and effective use of drugs in clinic. The overall quality of healthcare was improved with pharmacist involvement.

Object To develop an HPLC method for the determination of plasma level of ferulic acid and study the in vivo pharmacokinetics in rats. Methods The used analytical column was Nucleosil C_ 18 . The mobile phase was methanol-water-acetic acid (35∶65∶0.1). The flow rate was 1.0 mL/min and detection wavelength at 320 nm. Plasma samples were prepared for analysis by addition of internal standard (Tinidazole) followed by extracting with ethyl acetate. Results Linear caliration curve was obtained by plotting concentration vs peak area ratio over the rang 0.25—16.0 mg/L with a correlation coefficient of 0.999 2. The average recovery of ferulic acid was 96.9%—100.6%. The minimum detectable concentration of ferulic acid was 0.2 mg/L. The relative standard deviations for within-day and between-days were less than 3.0% and 5.3%,respectively. The plasma concentration-time curve of ferulic acid in Xinshu Oral Liquid ig given to rats was found to fit a two-compartments model with T_ 1/2? of 12.6 min and T_ 1/2? of 305 min. Conclusion The method is simple,rapid,accurate,and precise, which can be used for the determination of plasma level of ferulic acid and the study of its pharmacokinetics.

OBJECTIVE:To prepare the sterilized medical bone wax and to establish the standard of quality control.METHODS:The bone wax was identified with chemical approach and the quality of bone wax was evaluated by saponification value.RESULTS:The bone wax was appropriate in formula,feasible in preparing technique and satisfactory in therapeutic efficacy with a satisfication rate of 98%.CONCLUSION:There are no obvious differences between the bone wax developed by our hospital and imported bone wax in quality,therefore the prepared bone wax can take the place of imported products.