Documenting the provision of pharmaceutical care

There is a growing importance and need for the documentation of the clinical work done by the pharmacist in providing pharmaceutical care. The data provided by documentation of care are critical to the effective and efficient transition from a product-based profession to a patient-care, service-based profession, especially during a period of great scrutiny of resource utilization in the hospital industry. Intervention documentation can serve both to document the provision of pharmaceutical care to individual patients and to provide critical information to managers to justify and expand the level of service provided.     

蒙药忠论-5胶囊总生物碱测定及其体外溶出度研究

目的 考察蒙药忠伦-5胶囊中总生物碱含量及其体外溶出情况。方法 以苦参碱为对照品，利用酸性染料比色法测定总生物碱；以水为介质，用转篮法考察其体外溶出度。结果 含量测定方法精密度为RSD＝1．89％，平均回收率为100．89％，RSD＝3．49％。；苦参总生物碱相对累积溶出度与溶出时间相关显著(P＜0．01)，T50＝24min，Td＝31min，m＝1．32。结论 用上法测定总生物碱含量及体外溶出度，对评估忠伦-5胶囊质量有实用价值。     

A prospective trial of short‐fractionation radiotherapy for the palliation of liver metastases

The purpose of this study was to prospectively examine the effectiveness and tolerability of a simple radiotherapy technique for the palliation of symptomatic liver metastases. Twenty‐eight patients with symptomatic liver metastases were enrolled from seven centres, and received targeted (partial or whole) liver irradiation consisting of 10 Gy in two fractions over 2 days. Symptoms at baseline were hepatic pain (27 patients), abdominal distension (19), night sweats (12), nausea (18) and vomiting (eight). Twenty‐two patients (76%) had failed previous treatment with chemotherapy, hormonal therapy and/or high‐dose steroids. Symptoms and potential toxicities were prospectively assessed at the time of treatment, then 2, 6 and 10 weeks later. Individual symptom response rates were 53?66% at 2 weeks. Partial or complete global symptomatic responses were noted in 15 patients (54%) overall. The treatment was well tolerated with two patients (7%) experiencing grade 3 toxicity (one vomiting and one diarrhoea); however, four patients reported temporary worsening of pain shortly after treatment. This simple and well‐tolerated treatment achieves useful palliation.     

Aberrant crypt focus promotion and glucose intolerance: correlation in the rat across diets differing in fat, n-3 fatty acids and energy

McKeown-Eyssen (Cancer Epidemiol. Biomarkers Prevent., 3, 687-695, 1994) and Giovannucci (Cancer Causes Control, 6, 164-179, 1995), noting the striking similarity in lifestyle risk factors for colorectal cancer and insulin resistance, proposed that the hyperinsulinemia, glycemia and hypertriglyceridemia associated with insulin resistance promotes colon cancer. To compare the effect of diet on colon cancer promotion and insulin resistance in the F344 rat, we assessed the effect of fat, n-3 fatty acids and energy in pairwise comparisons on average size of aberrant crypt foci (ACF) and on glucose intolerance in the same animals in a single experiment. Diets high in fat and energy increased and diets with increased n-3 fatty acids and calorie restriction decreased both ACF growth and glucose intolerance compared with control diets. The measures of promotion of colon cancer and insulin resistance were strongly correlated (n = 98, r = 0.67, P < 0.001). In addition, both were highly correlated with daily energy intake (r = 0.62 and 0.66) and were also correlated with basal (post-prandial) insulin, glucose and triglycerides (r = 0.31-0.53, P < 0.01). We concluded that ACF growth and glucose intolerance are correlated for a wide range of diets and that increased circulating energy (glucose and triglycerides) may lead to both colon cancer promotion and insulin resistance.      

多非替利衍生物CPU 228(V03)对大鼠心室肌细胞钙瞬变的调节

目的在β-受体激动情况下,研究多非替利衍生物CPU 228对电刺激触发心肌细胞的胞浆Ca2+浓度([Ca2+]i)变化及钙瞬变动力学参数的影响.方法游离单个大鼠心室肌细胞,Fluo-3/AM负载,电刺激诱发心室肌细胞钙瞬变,定量测定心室肌细胞内Ca2+浓度变化,异丙肾上腺素(isoproterenol, ISO)100nmol·L-1激动β-受体,观察CPU 228 1 μmol·L-1对钙瞬变动力学参数、[Ca2+]i及钙负荷水平的影响.结果CPU 228 1 μmol·L-1对大鼠心室肌细胞[Ca2+]i的影响不明显(P>0.05);ISO 100 nmol·L-1显著升高大鼠心室肌细胞[Ca2+]i和细胞内钙负荷水平,缩短钙瞬变时程,并且增加钙瞬变的消除速率.CPU 228 1 μmol·L-1显著抑制ISO的上述作用.结论在β-受体激动情况下,CPU 228可以降低心肌细胞[Ca2+]i,使ISO改变的钙瞬变动力学参数恢复到正常水平.     

乌贼墨对小鼠脾细胞和巨噬细胞NO生成及 IFN-γ分泌水平的影响

目的：探讨乌贼墨对脾细胞和巨噬细胞NO生成及IFN-γ分泌的影响。方法：用Griess法和ELISA法分别检测了经乌贼墨灌胃处理后小鼠脾细胞和腹腔巨噬细胞培养上清中NO和IFN-γ的水平的变化。结果：乌贼墨灌胃处理小鼠后的第4、6天脾细胞及腹腔巨噬细胞(Mφ)可产生较高水平的NO；脾细胞可产生较高水平的IFN-γ，并且小鼠脾细胞NO的产生水平与IFN-γ产生水平呈正相关(r=0．98)；用LPS和L-NMMA(NO抑制剂)分别同乌贼墨灌胃第6d小鼠的脾细胞一起培养，结果显示LPS可协同IFN-γ促NO水平升高。L-NMMA可抑制小鼠脾细胞的NO生成。结论：乌贼墨可促进巨噬细胞NO生成；脾细胞NO的产生与IFN-γ分泌水平呈正相关。     

食品级番茄红素对小鼠的免疫调节功能

目的研究番茄红素对免疫系统的调节作用。方法实验小鼠随机分成3组：对照组、低剂量组（10mg／kg）、高剂量组（20mg／kg）。低剂量组、高剂量组分别用色拉油稀释的番茄红素灌胃，对照组用色拉油灌胃。30天后检测小鼠的脾淋巴细胞增殖程度、NK细胞的杀伤活性、迟发性变态反应的程度、巨噬细胞吞噬功能。结果与对照组比较，高剂量组能显著增强脾淋巴细胞的增殖能力，提高自然杀伤细胞的活性和巨噬细胞吞噬功能，增强小鼠的足跖肿胀度（P〈0．05）。除增殖反应外，低剂量组其他指标与对照组比较，差异均无显著性。结论番茄红素具有增强小鼠免疫调节的功能。     

Intravesical oxybutynin: practicalities of clinical use.

Oral anticholinergic therapy, used for the treatment of detrusor overactivity (DO), is limited by systemic side-effects and because of failure to respond. Alternative routes of administration include the intravesical route. We reviewed 11 women who were treated with intravesical oxybutynin (IVO). All had idiopathic DO, their symptoms having been unsuccessfully controlled on oral agents. Seven patients had symptomatic improvement. Six out of the eight patients that completed their voiding diaries showed a reduction in voiding frequency. Five patients found the procedure too inconvenient. Seven patients suffered chemical irritation. One patient complained of voiding difficulties. No patient reported systemic side-effects. The mean duration of treatment was 4-5 weeks; two patients continue to use IVO. IVO can be used successfully in the treatment of DO, but its use is limited due to the inconvenience related to catheterisation. With the advent of Botox and oxybutynin patches, IVO probably has a limited role.