Computer-assisted medication review for asthmatic patients as a basis for intervention Constructing and validating an algorithmic computer instrument in pharmacy practice

OBJECTIVE: To construct and validate a computer instrument that identifies asthma patients receiving--theoretically--suboptimal drug therapy in community pharmacies, by the use of patient medication records. This selection enables the pharmacist to assist these patients in using medicines appropriately. METHODS: According to Dutch asthma guidelines which describe a stepwise approach and in order to define correct profiles for the use at each level of these guidelines, the optimum use of drugs in the different levels in asthma treatment was expressed in defined daily doses (DDDs) per pharmacological drug-group during a period of one year. An algorithmic computer instrument was developed to select patients with medication use deviant from these profiles. By using nine different selection profiles, the computer instrument stratified patients according to the medication records filed in the pharmacy computer. Patient medication records in four community pharmacies were investigated to validate the selection profiles as indicators for theoretically suboptimal drug use by asthma patients. The validation was performed by comparing the professional judgement of participating pharmacists with the selections made by the computer. MAIN OUTCOME MEASURE: Positive predictive value and negative predictive value of the selection made by algorithmic computer instrument. Rate of false-positive results. RESULTS: The computer instrument identified asthma patients using theoretically suboptimal drug therapy with approximately 95% predictive value compared with the professional judgement of the pharmacists. The rate of false-positive results was 5%. CONCLUSION: The results of the algorithmic computer instrument and the professional judgement of the pharmacists are in close agreement. The instrument will be utilised in further research in the IPMP study (Interventions on the principle of Pulmonary Medication Profiles) investigating the role of Dutch community pharmacists in counselling patients who are at risk of suboptimal drug use in the treatment of their asthma.     

基于中药有效成分族的方剂物质基础研究

本文以血管紧张素转化酶（Angiotensin Converting Enzyme，ACE）抑制剂、3-羟基-3-甲基戊二酰辅酶A还原酶（3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase，HMG—CoAR）抑制剂和血管紧张素Ⅱ（AngiotensinⅡ，AngⅡ）、血小板活化因子（Platelet Activating Factor，PAF）受体拮抗剂三维药效团为辨识模型，以三维数据库柔性搜索技术为辨识算法，发现了18首活血化瘀方剂及其所合20味中药可能具有的ACE、AngⅡ、PAF和HMG—CoAR受体活性的物质基础。结果表明，中药有效成分族的研究将为从分子层次上揭示方剂物质基础提供方法学支撑。     

红花掺伪品菊花瓣鉴别

对红花的掺伪品菊花瓣作了性状、显微、理化等方面的鉴别,并将两者作了对比。     

中药有效成分族辨识信息技术研究

中药有效成分族是指作用于同一靶点、具有相同作用机理的中药有效成分之总称。整合信息学、化学、生物学等多学科技术的中药有效成分族辨识信息技术是揭示中药物质基础的方法和技术之一。本文从中药化学成分数据库的构建、中药有效成分族的辨识与验证三个环节探讨了中药有效成分族辨识信息技术的建立及应用。     

近缘种药材垂盆草与佛甲草的比较鉴定

目的:对属于近缘种、外形极似的药材垂盆草与佛甲草进行鉴定比较研究。方法:采用显微鉴定法研究两者茎的横切面及粉末的显微特征;采用薄层色谱比较两者的异同。结果:垂盆草与佛甲草茎横切面组织特征十分相似,但在导管数目、髓部形状及含紫红色物质的细胞数目等有显著差异。对8月份样品而言,前者导管数一般仅有35-58个,髓部多呈三角形;后者则多达75-150个,髓部呈"Y"形。两者的薄层色谱也有较大不同。此外,不同采集期的样品在显微特征上存在某些明显差异。结论:研究结果为两种药材的应用提供了鉴定参考依据,并提示近缘植物药的显微鉴定应注意排除共性。     

RAPD在绞股蓝种类鉴别应用上的条件摸索

目的 为采用随机扩增多态性技术鉴别绞股蓝及其易混品乌蔹莓,进行RAPD条件摸索.方法 运用改进CTAB法提取七叶绞股蓝、五叶绞股蓝、乌蔹莓以及烟草基因组DNA,摸索影响RAPD的条件.结果 用改进CTAB法提取所得的DNA质量较好,均能用于RAPD扩增,并摸索出了最优RAPD扩增条件.结论 改进的CTAB法适合于这4种植物的DNA提取,摸索得到的RAPD扩增条件可用于绞股蓝种类鉴别及与其易混品乌蔹莓的区别.     

Identification of peer effects through social networks using variance restrictions

This paper presents a novel method to identify peer effects through exploiting fluctuations in the variances and covariances of outcomes over a social network. Endogenous and contextual peer effects can be disentangled by contrasting the covariances of the outcomes of peers with the covariances of the outcomes of peers of peers. Correlated effects are incorporated by allowing for unrestricted network level heterogeneity. The method is applied to the Project STAR data to study peer effects in academic attainment of first‐year kindergarten students. Evidence is found of positive peer effects, which are statistically significant and consistent with the existing literature.     

前清蛋白、降钙素原及白细胞计数在诊断小儿重症肺炎中的作用

目的 探讨血清中前清蛋白、降钙素原及白细胞计数在小儿重症肺炎诊断中的指导意义.方法 将本院2015年2月至2016年6月住院的204例肺部感染患儿依据病情严重程度分为重症肺炎组和非重症肺炎组,随机选取本院同期行健康体检儿童50例作为对照组,比较重症肺炎、非重症肺炎患儿与健康儿童PAB、PCT和WBC水平的差异.结果 重症肺炎组患儿PCT和WBC水平均明显高于非重症肺炎组与对照组,PAB水平显著低于非重症肺炎组与对照组,差异均有统计学意义(均P＜0.05);重症肺炎组患儿PCT和WBC阳性率均明显高于非重症肺炎组与对照组,差异均有统计学意义(均P＜0.05);PAB阳性率稍低于非重症肺炎组,但差异无统计学意义(P＞0.05);PCT的Youden指数为0.415,ROC曲线下面积0.821,灵敏度63.5％、特异度76.8％,优于PAB和WBC.结论 PCT可作为小儿重症肺炎诊断的有效指标,并同时参考WBC与PAB水平变化,以便更为周全的鉴别诊断.     

BOPPPS教学模式在《中药鉴定学》课程教学中的应用

BOPPPS教学模式是一种强调学生全方位参与和及时反馈交流的教学设计模式.该文以中药的案例讲解探讨了BOPPPS模式在《中药鉴定学》课程中的具体应用.     

Chemical constituents of Hainan Syzygium myrsinifolium (Hance) Merr. et Perry based on ultra-high performance liquid chromatography-time-of-flight tandem mass spectrometry

Syzygium myrsinifolium (Hance) Merr. et Perry is a unique plant resource on Hainan Island, and there are few reports on its chemical constituents. In the present study, we identified the major chemical constituents in the leaves of Syzygium myrsinifolium (Hance) Merr. et Perry using ultra-high performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MS/MS). The chemical constituents in Syzygium myrsinifolium (Hance) Merr. et Perry were identified rapidly based on the accurate relative molecular mass and combined with literature data and reference substances. A total of 20 compounds, including organic acids, phenolic acids, and flavonoids, were identified. Among these 20 compounds, four organic acids, eight phenolic acids, seven flavonoids, and one coumarin were reported from the leaves of Syzygium myrsinifolium (Hance) Merr. et Perry for the first time. The established method was rapid and accurate, and some chemical constituents in the leaves of Syzygium myrsinifolium (Hance) Merr. et Perry have been identified. This research provided an experimental reference for the study of the constituents and utilization of Syzygium myrsinifolium (Hance) Merr. et Perry.