Characteristics of drug-related problems and pharmacists' interventions in a geriatric unit in China.

Background Data is lacking on the characteristics of drug-related problems in Chinese elderly inpatients and the impacts of clinical pharmacy activities in the geriatric ward in China. Objective To describe the nature of drug-related problems in elderly inpatients based on the Pharmaceutical Care Network Europe classification, and identify the correlates of the drug-related problems. Setting Geriatric ward of a tertiary hospital in Beijing, China. Method Pharmacists reviewed medication orders over a 12-month period with drug-related problems and interventions documented. Drug-related problems were categorized respectively according to the Pharmaceutical Care Network Europe classification. A multivariate logistic regression analysis was carried out to determine factors associated with drug-related problems. Main outcome measure The causes, interventions proposed and risk factors of potential drug-related problems. Results A total of 335 interventions associated with possible drug-related problems for 184 older patients were recorded. The incidence of patients experiencing at least one drug-related problem was 34.5%. Drug therapy problems were most commonly classified within the treatment effectiveness domain. Drug selection accounted for most cause of possible drug-related problems. The most common intervention was starting a drug and the acceptance rate was 91.9%. The factors associated with drug-related problems were the number of prescribed medications, Charlson Comorbidity Index and length of stay (P < 0.05). Conclusion Drug-related problems are common in elderly inpatients. Clinical pharmacy service is necessary to the optimization of drug therapy in older inpatients.

Trimetazidine combined with berberine on endothelial function of patients with coronary heart disease combined with primary hypertension.

Effects of trimetazidine combined with berberine on endothelial function of patients with coronary heart disease combined with primary hypertension (CCP) were investigated. A total of 68 patients with CCP were selected from July 2014 to August 2016 to serve as observation group. At the same time, 68 healthy people were also selected to serve as control group (physiological saline). Expression of endothelial nitric oxide synthase (eNOS) mRNA in the blood samples of the observation and control groups before and after treatment was determined by RT-PCR. Levels of NO in the plasma of the observation and control groups before and after treatment were measured by nitric acid reductase method. Brachial artery flow-mediated vasodilation (FMD) of observation and control groups was detected by brachial artery ultrasonography before and after treatment. Before treatment, expression level of eNOS mRNA in blood of the observation group was significantly lower than that of the control group (P<0.05). After treatment, expression level of eNOS mRNA was significantly increased (P<0.05). Plasma NO content 41.06±3.63 mol/l in blood of the observation group was significantly lower than that of the control group 53.28±3.09 mol/l (P<0.05). After treatment with trimetazidine and berberine, level of NO 50.75±2.75 mol/l was significantly increased compared with the level before treatment (P<0.05). FMD value (5.03±0.95) was significantly lower in observation group than that in control group (16.04±1.63) (P<0.05). After treatment with trimetazidine and berberine, FMD value (14.02±2.39) was significantly increased compared with the level before treatment (P<0.05). The results suggested that the combination of trimetazidine and berberine can increase the content of NO in blood and promote endothelium-dependent dilation function of brachial arteries, which is helpful in the treatment of CCP.

Risk Factors for Venous Thromboembolism in Hospitalized Patients in the Chinese Population.

Venous thromboembolism (VTE) refers to the formation of a blood clot inside veins and has a high risk of inducing medical accidents. An effective risk assessment model will help screen high risk populations and prevent the occurrence of VTE. In this study, 287 VTE cases were collected and analyzed for risk factors in a Chinese population. The risks of VTE were evaluated using the Caprini and Padua models. Our results indicated that the Caprini model was more effective in evaluating VTE risk among hospitalized patients than the Padua model. As well, the Caprini model was more relevant in VTE risk assessment among surgery patients compared with internal medicine patients, while the Padua model showed no significant differences. In our studies, the most frequent risk factors included obesity, medical patients currently at bed rest, and severe lung disease. Our studies provide clinical support on selecting the suitable risk assessment model of VTE in the Chinese population.

Application of MRI in indirect temporomandibular joint injury without condylar fracture.

OBJECTIVE: To discuss the application of MRI in indirect temporomandibular joint injury without condylar fracture. METHODS: MRI examination on temporomandibular joint was conducted in 28 patients with indirect injury to temporomandibular joint without condylar fracture. The scanning sequence included T(1)WI, PDWI on oblique sagittal section at both open and closed mouth positions, and T(1)WI, T(2)WI on oblique coronal section. The MRI appearance was analyzed by 2 senior radiologists. RESULTS: Among the 56 temporomandibular joints of 28 patients, 35 joints exhibited pathological changes on MRI, in which there were 9 bone injuries, 21 articular disc dislocation, 24 intracapsular hematocele and hydrops. CONCLUSIONS: MRI can clearly reveal bone injury, articular disc dislocation as well as articular capsule abnormality in the indirect injury of temporomandibular joint without condylar fracture. It is highly advocated in clinical use.