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OBJECTIVE：To investigate the consistency and difference of f luorescence immunochromatographic and liquid chromatography-tandem mass spectrometry （LC-MS/MS）and enzyme multiplied immunoassay technique （EMIT）in the blood concentration monitoring of mycophenolic acid. METHODS ：Fluorescence immunochromatography ，LC-MS/MS and EMIT were used to detect the blood concentration of mycophenolic acid in 61 blood samples of children treated with mycophenolate mofetil ester orally at different time points. Kolmogorov-Smirnov method ，Wilcoxon pairing test ，Passing-Bablok regression ，Cusum method，Spearman correlation analysis ，Bland-Altman scatter diagram were adopted for statistical analysis. RESULTS ：Blood concentrations of mycophenolic acid ，which were determined by fluorescence immunochromatography ，LC-MS/MS and EMIT ， showed non-normal distribution. Passing-Bablok regression analysis showed that regression equation of fluorescence immunochromatography and LC-MS/MS ，fluorescence immunochromatographic method and EMIT were CFI=0.928 3CLC-MS/MS+0.961 7 and CFI＝0.880 7CEMIT－0.488 2（FI means fluorescence immunochromatographic ）. Spearman correlation analysis showed that the correlation coefficients between fluorescence immunochromatography and LC-MS/MS ，fluorescence immunochromatography and EMIT were 0.968 and 0.929， respectively （P＜0.000 1）. Bland Altman scatter plot analysis showed that 3.28％ of the 358341451@qq.com difference between fluorescence immunochromatography and LC-MS/MS was outside the consistency limit （±1.96SD）， and 1.64％ of the difference between fluorescence immuno- chromatography and EMIT was outside the consistency limit （± 1.96SD）. Wilcoxon pairing test showed that the results of fluorescence immunochromatography were higher than those of LC-MS/MS （Z＝3.76，P＝0.000 2）and lower than those of EMIT （Z＝－5.96，P＜0.000 1）. CONCLUSIONS ：Fluorescence immunochromatography shows good consistency and correlation with LC-MS/MS and EMIT ；the blood concentrations of mycophenolic acid detected by fluorescence immunochromatography were higher than those by LC-MS/MS and lower than those by EMIT . It can be used for bedside rapid detection. When using the test results of different methods for clinical medication ，the differences of test methods need to be considered.
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OBJECTIVE:To provide reference for clinical pharmacists participating in pharmaceutical consultation for children with urinary tract infection,and to improve rational drug use in clinic. METHODS:The information of 40 children with urinary tract infection consulted by clinical pharmacists were collected retrospectively from Jan. 2016 to Jan. 2017. The detection of pathogenic bacteria in urine culture,drug resistance of Gram-positive bacteria and Gram-negative bacteria to commonly used antibiotics,clinical pharmacist consultation,outcome,the utilization of antibiotics before and after consultation were analyzed. RESULTS:Among 40 children,urine culture of 37 children was positive,and 58 strains were detected. Gram-positive bacteria were mainly Enterococcus faecium and Enterococcus faecalis;resistance rates of E. faecium to penicillin,ampicillin,amoxicillin/clavulanate potassium were 100%;resistance rate of E. faecalis to high-concentration of gentamicin and tetracycline was higher than 50%. Both were completely sensitive to linezolid,vancomycin,teicoplanin, quinupristin/dalfopristin and tigecycline. Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae;resistance rates of them to penicillin,piperacillin were 100%;all of them showed low resistance to amikacin(21.43% to E. coli,20.00% to K. pneumoniae). The main reason for the consultation was the selection of antibiotics for drug-resistant bacteria infection;the following reason was the selection of antibiotics for mixed bacterial infection. The consultation advices of clinical pharmacists were mostly addition or replacement of antibiotics,followed by continuing the current treatment. Totally 37 cases were recovered from the hospital after receiving 40 times of consultation and adjusting medical orders. Before consultation,antibiotics with high utilization rate were piperacillin/tazobactam(11 cases)and roxavidospora(9 cases). After consultation,antibiotics with high utilization rate were vancomycin(8 cases)and amikacin(7 cases). CONCLUSIONS:Clinical pharmacists participate in pharmaceutical consultation of urinary tract infection in children,provide suggestions and adjust therapy plan from aspect of pharmacy to promote rational use of antibiotics and therapy efficacy.
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OBJECTIVE:To explore the role of clinical pharmacists participating in anti-infective treatment for a child with complex infection. METHODS:Clinical pharmacists participated in treatment process of one child with pulmonary infection and brain abscess after a near-drowning incident,assisted physicians to adjust antibiotics therapy plan,and put several suggestions as the adjustment of anti-gram-positive and anti-gram-negtive bacterium drugs,the dosage adjustment of vancomycin,vancomycin-induced ADR and disposal,the selection of anti-Pasteurella pneumotropica drugs,the enhancement of anti-fungal infection therapy,accord-ing to pathogen characteristics,treatment effect and ADR. RESULTS:Physicians partly adopted the advice of clinical pharmacists, the child’s pulmonary and brain infection were controlled effectively and ADR disappeared after 5 times of adjusting anti-infective the rapy plan. CONCLUSIONS:Clinical pharmacists participate in the treatment process of one child with complex infection,and assist physicians to formulate safe and effective anti-infective plan according to the results of etiological examination;dispose ADR timely and carry out efficacy evaluation of antibiotics and pharmaceutical care,that can give positive effects on patient treatment.
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Objective To observe safety of intravitreal injection of mouse nerve growth factor and its distribution in retina in rabbits .Methods The behavioral observation ,slit lamp examination ,fundus examination ,eye B ultrasonic and histopathological ex‐amination were carried out on 1 ,7 and 30 d after intravitreal injection 30 μg/100 μL mNGF to determine the safety in eye .The dis‐tribution and peak time in retina were investigated at 15 ,30 min ,1 ,3 ,6 ,8 ,12 ,24 ,48 h after intravitreal injection 125 I‐NGF 30 μg/100 μL .Results No abnormal changes were found in their cornea ,lens ,vitreous body and retina after mNGF intravitreal injection . And the each layer of retinal cells layout were regular according to the result of morphological observation on 30 days after treat‐ment .The peak concentration of mNGF in retina and the highest in whole eye was (118 .32 ± 18 .74)% ID/g and the peak time was at 3 hour after injection .Conclusion It is safe for intravitreal injection of mNGF and mNGF could gather in retina quickly after in‐travitreal injection .
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Objective To establish a novel atherosclerosis model by inflammation in rats and investigate the anti-atherosclerotic effect of Rb1.Methods Healthy male SD rats were randomly divided into three groups, namely the control group, model group (using zymosan A to induce inflammation) and Rb1-treated group (12 rats in each group).The rats were administered liquid paraffin (i.p.), zymosan A (20 mg/kg, i.p., once every 4 days) or zymosan A and Rb1 (40 mg/kg, i.p., once daily), respectively.All animals were fed a high-fat diet for 10 weeks.At scheduled time points, pathological changes in the aorta were observed using Sudan IV staining and transmission electron microscopy.White blood cell count was used to assess the inflammation.The expression of NFκB, TNFα, IL6 was evaluated by real time PCR, im-munohistochemistry and ELISA, respectively.Results Typical atherosclerotic changes such as fatty streaks, plaque, foam cells in the rats following zymosan A induction were alleviated by Rb1 treatment.In the Rb1-treated group, there was a markedly decreased expression of NFκB, TNFα, and IL6.Conclusion The model of atherosclerosis can be established by inflammation based on high-fat diet in rats.Rb1 inhibits atherosclerosis through anti-inflammatory effect.
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Objective To investigate the changes of the cytokines on the aortas of atherosclerosis (AS) rats. Methods Zymosan-liquid medical paraffin suspension (contain Zymosan 20 mg/kg) was injected intra- peritoneally once a week for 10 times and given intraperitoneal injections of ovalbumin, 2.5 mg/kg, once a week for 7 times after initial subcutaneous sensitization. All animals were fed cholesterol-rich diet to induce AS. Electron microscopy was used to observe the foam cells, and RayBio Rat Cytokine Antibody Array 1.1 was employed to detect the cytokines in the aorta wall. Results Electron microscopy showed all models had monocytes migration from lumen to subendothelium in the aorta and formed to foam cell for phagocytosis lipid, indicating typical characteristic of AS in the rats. Most pro-inflammatory cytokines were increased except Fractalkine and IL-6, but anti-inflammatory cytokines were all slightly decreased. Conclusion Inflammation and immune can induce the formation of foam cells. The balance of pro-inflammatory cytokines and anti-inflammatory cytokines is broken is the important reasons of atherogenesis。