�����ع���֬�����������Ʊ������������о�

??OBJECTIVE To prepare capsaicin-solid lipid nanoparticles (CAP-SLNs) and study their physical and chemical properties. Then, the CAP-SLNs were modified with chitosan (CTS) and the pharmacokinetics across colon of rats was studied in vivo. METHODS CAP-SLNs were prepared by emulsion-solvent evaporation method. The mean size, encapsulation efficiency and drug loading of the nanoparticles were investigated. RESULTS The average diameter of CAP-SLNs was (118.89??25.0) nm, the encapsulation efficiency was (38.56??2.6)%, and the drug-loading was (6.17??0.21)%. After colon-specific delivery in rats, the AUC_{0-360 min}(243.63??61.46) mg??min??L^-1 and ??_max(1.23??0.18) mg??L^-1 of CTS-CAP-SLNs were 1.81-fold and 1.95-fold higher than CAP. CONCLUSION It is simple and feasible to prepare CAP-SLNs by emulsion-solvent evaporation method. The pharmacokinetic parameters in rats are improved remarkably compared with CAP.     

�����˴ٺ���-��������Ч������ƶѪ����Ӧ��EPO-�²����������

??OBJECTIVE To report a clinical case and review the therapy of renal anemia in children with EPO-?? non-response to provide ideas on optimization of dosing regimens and new ways of clinical practice. METHODS One case of renal anemia was described and analyzed, and relevant literature was accessed and reviewed. RESULTS The level of hemoglobin increased to 100 g??L^-1 and the clinical symptoms were alleviated after transfering to EPO-?? from EPO-??. CONCLUSION For pediatric patients with chronic renal anemia, EPO-?? instead of EPO-?? is effective.     

�����ù��Ĥ΢�����Ʊ�����԰�Ѫ��ϸ������ֳ��������

??OBJECTIVE To construct a novel daunorubicin-loaded microparticles (DNR-MPs)drug delivery system, and study its proliferation inhibiton effect on leukemia cells. METHODS Both DNR-MPs-IDL(DNR microparticles with intracellular drug loading method)and DNR-MPs-EDL (DNR microparticles with extracellular drug loading method)were prepared from HL-60 cells, and the average particle size, Zeta potential and drug loading efficiency of DNR-MPs were measured. The uptake of DNR-MPs by HL-60 cells was analyzed by confocal laser scanning microscopy (CLSM)and flow cytometry (FCM). The inhibition effect of DNR-MPs on the proliferation of HL-60 cells was evaluated by MTT assay. RESULTS There was no significant difference in the average particle size and Zeta potential of the two DNR-MPs. The drug loading efficiency of DNR-MPs-EDL was higher compared with DNR-MPs-IDL. The uptake RESULTS showed that the two DNR-MPs significantly increased the drug uptake compared with free DNR (P<0.05). DNR-MPs-IDL showed a higher drug uptake by the cells than DNR-MPs-EDL did (P<0.05). They also exhibited an enhanced inhibition effect on the proliferation of HL-60 cells compared with DNR (P<0.05). CONCLUSION The different ways of preparation of drug-loaded microparticles can cause varying anti-tumor effect. Microparticles can significantly augment the anti-leukemia efficacy of DNR, indicating a promising drug carrier for the therapy of leukemia.     

���ٰ�����ֱ�����ٴ�·��������ҩ���Ը������������

??OBJECTIVE To investigate drug-induced liver injury(DILI) in clinical pathway on patients with breast cancer and colorectal cancer and to explore whether the prophylactic use of hepatoprotective drugs can be included in the clinical pathway. METHODS Two hundred and five cases from January 2015 to March 2017 were selected. The patients were divided into two groups according to the prophylactic use of hepatoprotective drug. The incidence, time, severity and outcome of DILI, prophylactic use of hepatoprotective drugs were investigated. DILI related risk factors were screened and analyzed by logistic linear regression to discuss the necessity and opportunity of prophylactic use of hepatoprotective drugs. RESULTS Forty-three(20.98%) patients without DILI had prophylactic use of hepatoprotective drugs in 205 cases. The incidence of DILI in the non-prophylactic group was 4.88%. Both two groups hadn't occurred DILI during the first and second cycles of chemotherapy. However, there was a statistically significant difference in the rate of DILI between the prophylactic and non-prophylactic use of hepatoprotective drugs groups in the third cycles of chemotherapy(P<0.05). Multifactor analysis showed that prophylactic use of hepatoprotective drugs was a protective factor for the DILI. CONCLUSION The liver function should be reinforced during the first and second cycles of chemotherapy. The hepatoprotective drugs could be used prophylactically before the next period of chemotherapy if patient with abnormal liver function.     

����Һ�����ü����������뿹���������о��Ŀݲݾ�Ҷ�͹���������

??OBJECTIVE To compare the chemical composition and therapeutic effect between Prunella vulgaris L stem leaf and ear, thus to provide evidence for judging whether the stem leaf of Prunella vulgaris L can substitute the ear as an herbal medicine. METHODS Aqueous extracts of the stem leaf and ear of Prunella vulgaris L from different producing areas were analyzed with HPLC-ESI-MSⁿ. The anti-inflammatory effects were observed by inflammatory models of ear edema induced by dimethylbenzene in mice and hind paw edema induced by carrageenan in rats.Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma level of TNF-?? and antioxidant activities were detected by ABTS method. RESULTS Prunella vulgaris L stem leaf and ear were not significantly different in chemical composition, both of which contained mainly triterpenoids, flavonoids, phenolic acids and other substances. Compared with the model group, Prunella vulgaris L ear significantly reduced the hind paw edema in rats induced by carrageenan from 1 h after oral administration (P<0.05), while the onset time of stem leaf was later than 1 h.Both groups could significantly reduce the ear edema in mice induced by dimethylbenzene(P<0.01). The TNF-?? levels in the Prunella vulgaris L stem leaf and ear groups [(24.16??1.24) and (24.33??2.36 )ng??mL^-1] were lower than that in the model group [(31.34??1.94) ng??mL^-1] (P<0.01).Prunella vulgaris L stem leaf and ear groups showed strong antioxidant activities in the ABTS^??+ scavenging test. CONCLUSION The contents of the main constituents in Prunella vulgaris L stem leaf and ear have significance differences.The RESULTS of animal tests indicate that the aqueous extracts of Prunella vulgaris L stem leaf and ear have significant anti-inflammatory and antioxidant effects.     

���춬����ø͸������-���Ҷ���/��-�����������ҵ�ҩ��ѧ����

??OBJECTIVE To investigate the pharmacokinetics and bioequivalence of hyaluronic acid-graft-poly(ethylene glycol)/??-cyclodextrin nanocapsules loaded with asparaginase(AHAPs) in SD rats. METHODS Rats were randomly divided into two groups. After intravenous injecting AHAPs and free AN, the activity of AN in two groups was assayed at different time points. The pharmacokinetic parameters were calculated by software DAS2.1.1 and the bioequivalence of free AN and AHAPs was judged. RESULTS AUC_{0-48 h} of AHAPs and free AN were (132.26??1.59) and (46.38??1.98) U??h??mL^-1. MRT_{0-48 h} of AHAPs and free AN were (3.64??0.04) and (1.76??5.99) h. The t_max of AHAPs and free AN were (0.75??0) and (0.08??0) h, respectively. The results showed that AUC_{0-48 h}, MRT_{0-48 h} and t_max of AHAPs increased to 2.85, 2.07 and 9.37 times, respectively, as compared with free AN. The 90% confidential intervals of AUC_0-48h, AUC_0-?? and ??_max of tested formulation were 77.0%-78.5%, 77.0%-78.5%, 94.4%-96.0%, respectively. The t_max checked by nonparametric method has significant difference (P<0.05) between AHAPs and free AN. CONCLUSION AHAPs can improve the bioavailability and extend the action time of AN in rats. AHAPs and free AN were not bioequivalent. And AHAPs had better pharmacokinetics properties in rats.     

�츣Ƭ����������ƽ���͵������Ч���о�

??OBJECTIVE To evaluate the pharmacokinetic properties and bioequivalence of two crystal forms of rifampicin. METHODS Drawing the dissolution curves of reference and test medicines in different solutions,and calculated the value of f₂. Twenty-nine healthy male volunteers were randomly administered in a crossover single 300 mg dose of reference and test medicines. Determining the concentration of rifampicin in plasma by HPLC-MS,and analyzed the relative bioavailability and bioequivalence of tablets using SAS program. RESULTS The values of f₂ were more than 50. The pharmacokinetic properties of reference and test tablets were as followsAUC_0→t:(28 476±8 050) vs (28 120±6 916) ng·mL·h^-1,ρ_max:(5 552±1 554) vs (5 911±1 700)ng·mL^-1,t_max:(2.0±1.0) vs (1.8±1.0)h,t_1/2:(2.8±0.5)vs(2.8±0.5)h. 90% CI of AUC and ρ_max of test medicine were 96.2%-106.4% and 98.6%-115.3%,respectively. And there were no significant difference of the t_max of rifampicin between the two medicines(P>0.05). CONCLUSION The results indicate that the two medicines made from rifampicin two crystal forms are bioequivalent completely.     

�����������ص��ܽ�ȡ���͸�Է�������Ԥ���Ƽ��������Ч��

??OBJECTIVE To discuss whether the difference in dissolution profile in vitro may cause different bioavailability in vivo and investigate the effects of the key quality parameters of leflunomide on bioavailability.METHODS Using SANOFI product as the reference preparation and domestic product as the test preparation, the disintegration solution of leflunomide tablets was analyze by Morphologi G3-ID automated measurement to get the paricile size and size distribution of the API; using pH 6.5 FaSSIF solution without adding ox-gall sulfonic acid sodium and lecithin as the dissolution medium, the dissolution and permeation profiles of the reference and test preparations and raw material were compared at 37 ?? with rotate speed of 150 r??min^-1. The influence of quality parameters on the process of API??s release and absorption was investigated, then the difference between the reference and test preparations were compared to preliminarily predict the bioavailability and bioequivalence.RESULTS The particle size Dv(50)of domestic leflunomide tablets was 79.80 ??m, while the particle size Dv(50)of the reference product was 17.60 ??m; the dissolution rate and penetration rate of the test preparation were about 70% of the the reference preparation, the t_max was basically identical,but the ??_max and AUC_0-t were lower than the reference preparation. The bioavailability of the test preparation was about 90% of the reference preparation.CONCLUSION Though the dissolution profile of domestic leflunomide tablets is not identical to the reference preparation, but the two products were predicted to be bioequivalent.     

�����۹���Ƽ��ǽ�(��)��΢������Ⱦ״���������־���Ч������

??OBJECTIVE To analyze the microbial contamination and investigate the bacteriostatic efficacy of compound balloonflowers and ephedrine syrup(??). METHODS The compound balloonflowers and ephedrine syrup(??) was analyzed for the bacteriostatic efficacy, content of bacteriostatic agent and C₁₈ column was adopted with gradient elution. The mobile phase consisted of 0.02 mol??L^-1 ammonium acetate solution and methanol. The detective wavelength was set at 255 nm. The contaminating bacteria detected in the samples were identified by VITEK2 Campact, MALDI-TOF-MS and 16S rRNA sequencing, and homology analysis was conducted for the contaminating bacteria in the samples from the same enterprise. RESULTS The bacteriostatic efficacy of the products of one enterprise did not meet the requirements of Chinese Pharmacopoeia(2015 edition). There were excessive and uneven contamination of microorganisms in the samples. The dosages of bacteriostatic agents in some enterprises did not conform to the standard requirements. CONCLUSION Production enterprises should strictly control the dosages of bacteriostatic agents and the stability of the production process, and strengthen the monitoring of the sterilization effect of the whole production process to improve product quality.     

妇产科专科特色处方前置审核系统的建设与应用

目的 建立适应妇产科专科特色的处方前置审核系统。方法 引进处方前置审核软件,经后台运行收集基于商业知识库规则的审方数据,建立妇产科用药规则维护分级依据,进行规则优化并形成妇产科合理用药知识库,疏通处方前置审核流程并加以实施。结果 通过抽样数据对比发现,药师审方上线后,系统预审问题数及比例、医师提交问题数及比例明显下降、医师主动返回修改问题数及比例相应上升,人员疏忽所致的严重用药错误可被拦截,药师干预处方/医嘱成功率达93.81%。结论 建立妇产科专科特色处方前置审核系统,能有效保证审方准确性,能减少临床医师和审方药师不必要的工作量,有利于处方前置审核工作的推进,进一步保障患者用药的安全性和合理性。     

ŷ���ٴ�ҩѧ��չ�ع˼�����������ϵ����

??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.
     

我院处方点评前后处方合格率的变化及处方质量分析

目的:对我院实行处方点评前后门诊处方进行分析,比较合格率的变化,分析我院不合格处方存在的问题,评价其使用合理性,以提高处方质量,促进合理用药。方法:随机抽取实行处方点评前、实行处方点评期间及实行处方点评后门诊西药处方,按《处方管理办法》和《医院处方点评管理规范(试行)》中规定的项目和方法进行归类、统计分析。结果:实行处方点评前处方合格率83%,实行处方点评后处方合格率96%;不合格处方数较多,占总处方数的10.44%。结论:处方点评大大提高了门诊处方合格率,医院处方在形式上已基本合格,但仍存在不规范处方、不适宜处方和超常处方,需采取相应对策以减少此类问题发生。不合格处方中存在的问题应引起医生的注意,同时临床医生与药师需共同加强药学知识的学习。     

ijԺ�׻��ᰢ�������ٴ�Ӧ�����۷���

??OBJECTIVE To evaluate retrospectively the clinical application of apatinib in a hospital. METHODS The medical records including apatinib were collected during April 2015 to March 2016. Then, the rationality and safety of drug use were evaluated. RESULTS The 84 patients used apatinib during this time, while 15.48% (15 patients) conformed to the approved indications. The major adverse reactions were gastrointestinal disorders, hypertension, skin disorders and myelosuppression. CONCLUSION Irrational use of apatinib such as off-label use, inadequate usage and dosage exists in clinic. Clinicians should pay close attention to the rationality of apatinib, and clinical pharmacists can improve the safety and effectiveness of therapeutic drugs by taking this as the breakthrough point.     

������ʹ����ҩѧ����ʵʩ��Ч������

??OBJECTIVE To improve the control rate of cancer pain and the satisfaction of community patients with cancer pain. METHODS A multidisciplinary team was built,which included community public health workers,clinical pharmacists,community physicians and tracking pharmacists. Pharmaceutical care was provided to patients with cancer pain in the community,and the effects of pharmaceutical care were evaluated. RESULTS The clinical pharmacists provided 52 times of pharmaceutical care to 17 patients,224 cases of medication problems were discovered,and 337 pieces of medication suggestions were made. After receiving pharmaceutical care,the scores of the most severe pain,the mild pain and the average pain in the past 24 h decreased from(9.12??1.34),(5.53??1.46) and (7.24??1.99) to (4.71??1.36),(1.18??0.95) and (2.41??1.18) (P< 0.01), respectively. The percentage of good medication compliance increased from 0% to 64.7% (P< 0.01). The influence of pharmaceutical care on patients included ??helping understand the drugs??, ?? taking medicine on time??, ??reducing adverse drug reaction?? ,??establishing correct concept of medication?? and ??reducing medical costs??,which got scores of (4.35??0.49),(4.53??0.51),(4.00??0.61),(4.29??0.59), and (3.76??0.66),respectively.For ??convenience of pharmaceutical care??,??pharmacist ability??, ??pharmacists?? attitude??,??symptom improvement?? and ??improvement of the quality of life??,the patients gave scores of (4.06??0.66),(4.24??0.44),(4.20??0.40),(4.41??0.71) and (4.29??0.47),respectively. CONCLUSION The problems in the drug treatment in community patients with cancer pain are numerous and complex. Pharmaceutical care can reduce the problems,improve the control rate of cancer pain, and increase the community patients' satisfaction on the management of cancer pain. The patients give positive evaluation to the pharmaceutical care.     

基于Delphi法的黄连药材商品规格感官评价的重现性研究

目的:考察中药材感官经验评价方法的重现性和科学性。方法:以黄连药材为例,采用二次Delphi法评价,检验感官经验评价方法在专家个人及专家群体的一致性和重复性,分析专家的从业时间、从业性质、受教育背景对其评审结果的影响;通过统计分析确定专家评价黄连药材商品规格的主要感官评价指标。结果:本次Delphi法评审专家权威程度系数和专家个人的重现率均较高,分别为0.76和88.3%;专家群体的重现率大于77.4%。其中受教育背景和专家从业性质对其评审结果有重要影响(P<0.05),接受现代教育和工作于学院的专家评审结果其重现性和可靠性均较好。不同从业年龄专家评审结果存在一定差异,但无统计学意义。综合专家结果,就黄连药材而言,外观形状、大小、颜色3个感官指标是专家对其商品规格做出评判的重要影响因素。结论:专家对黄连药材商品规格等级的感官评价经验是客观、可重现的;Delphi法可作为中药材传统感官评价方法客观性及其指标体系规范化研究的有效手段之一。