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1.
China Pharmacy ; (12): 477-484, 2020.
Article in Chinese | WPRIM | ID: wpr-817296

ABSTRACT

OBJECTIVE:To inve stigate the effects of polymorphism of CYP3A4,CYP3A5 and other genes on the increasing of tacrolimus blood concentration by Wuzhi capsules in renal transplantation patients. METHODS :Totally 194 patients in Han nationality underwent renal transplantation and rece ived outpatient follow-up after surgery were selected from the First Affiliated Hospital of Anhui Medical University during Aug. 2015-Nov. 2018,and then divided into single drug group (107 cases)and combination group (87 cases)according to using of Wuzhi capsules or not. Single drug group was given Tacrolimus capsules 0.1-0.15 mg/kg,po,bid+Mycophenolate mofetil capsule s 0.5-0.75 g,bid or Mycophenolate sodium enteric-coated tablets 360-540 mg,bid+Prednisone acetate tablets 10 mg,qd;combination group was additionally given two Wuzhi capsules ,bid,on the basis of single drug group. Two groups were treated at least 7 d. The clinical data (such as patients ’sex and age )were collected ,and enzyme amplification immunoassay was used to detect steady-state valley concentration of tacrolimus ,and calculate valley concentration/daily dose (C/D)value. PCR was adopted to detect patient genotyping of CYP3A5 gene rs 4646457,rs15524 and rs776746 locus,CYP3A4 gene rs 4646437,rs2242480 and rs 35599367 locus,ABCB1 gene rs 1128503 locus,ABCC2 gene rs3740066 locus,NR1I2 gene rs 3814055 locus,POR gene rs 1057868 locus,PPARA gene rs 4253728 locus,IL-3 gene rs 181781 locus, IL-10 gene rs 1800896 locus,CTLA4 gene rs 4553808 locus,CYP2C19 gene rs 4244285 and rs 4986893 locus,respectively. The correlation of each factor and tacrolimus C/D value was analyzed by Kruskal-Wallis test or Spearman rank test. Multivariate linear regression was conducted. RESULTS :In 194 renal transplanation patients ,only wild type at rs 3599367 locus of CYP3A4 gene and rs4253728 locus of PPARA gene were detected ,and each genotype distribution of other genes was consistent with the Hardy-Weinberg equilibrium (P>0.05). Single factor analysis and multiple linear regression analysis showed that the combination of Wuzhi capsules and rs 776746 polymorphism of CYP3A5 gene were related to tacrolimus C/D value(P<0.05). There was statistical significance in tacrolimus C/D values among different genotypes of CYP3A5 gene in single drug group and combnation group(P<0.05). C/D value of GG and AG genotype in single drug group were significantly lower than combination group (P< 0.05),while there was no statistical significance in tacrolimus C/D value of AA genotype between 2 groups (P>0.05). CONCLUSIONS:Combination of Wuzhi capsules or not and polymorphism of CYP3A5 gene rs 776746 locus are associated with blood concentration of tacrolimus in renal transplantation patients in Han nationality. Combined use of Wuzhi capsules can increase blood concentration of tacrolimus in GG and AG genotype ,but have no significant effect on AA genotype.

2.
China Pharmacy ; (12): 417-420, 2019.
Article in Chinese | WPRIM | ID: wpr-816900

ABSTRACT

OBJECTIVE: To design Proton pump inhibitor (PPI) medical order evaluation software, and to promote rational drug use in clinic. METHODS: According to the use of PPI (PPI injection as an example) of inpatients in a Third Grade Class A hospital (hereinafter referred to as "sample hospital"), the evaluation process of medical order evaluation software was designed. On this basis, medical order evaluation software for inpatients was developed in collaboration with computer engineers. Taking the detection rate of irrational drug use and the time consuming per capita as indicators, the effects of software evaluation and manual evaluation were compared. Dispensing medical orders of PPI injection in PIVAS of sample hospital was evaluated with the software pre-evaluation in Feb. 2018. Irrational use of PPI injection (including irrational medication for treatment, prevention and non-indication) in the inpatients was evaluated retrospectively during Jan. 2015-Dec. 2017. RESULTS: The software of PPI audit includes four modules:users and tasks (timing audit), system settings, confirmation of audit results (check the results audited by the software automatically) and reports exporting. Compared with manual evaluation, there was no significant difference in detection rate of irrational drug use in software audit (69.50% vs. 77.00%, P>0.05); the time consuming per capita was shortened significantly (9.25 min vs. 1.50 min, P<0.05). In the application of pre-evaluation, 27 (2.23%) were irrational for treatment, 318 (26.24%) were irrational for prevention and 602 (49.67%) for non-indications. In the application of retrospective review, 4 884 (2.68%) were irrational medication for treatment, 50 399 (27.67%) irrational medication for prevention and 85 106 (46.72%) medication without indications. CONCLUSIONS: The application of PPI medical order evaluation software shortens the time of pharmacist's evaluation, improves the efficiency of evaluation, and promotes the rational use of PPI in clinic.

3.
Article in Chinese | WPRIM | ID: wpr-506608

ABSTRACT

Objective To develop an HPLC method for the determination of mycophenolic acid(MPA), mycophenolic acid glucuronide(MPAG) in plasma.Methods The samples were precipitated with zinc sulphate-methanol solution before injection.Carbamazepine was selected as internal standard,ZORBAX XDB C18 (4.6 mm ×250 mm,5 μm) column was used and the flow rate was 1 mL/min.The mobile phase consisted of methanol-acetonitrile-potassium dihydrogen phosphate buffer solution(gradient elution) .The column temperature was 30℃ and the detective wave length was 254 nm.And then the MPA,MPAG concentration of 32 patients in 7-14 days after renal transplantion were determined.Results The assay was linear within 0.2-50μg/mL for MPA, 2.5-500 μg/mL for MPAG(r>0.999).Absolute recovery rates of MPA,MPAG were more than 80%, the recoveries were between 90%-110%.The intra-day and inter-day RSDs were both lower than 10%.Totally 32 cases of renal transplantion patiens were with mycophenolate mofetil at the dose of 1-1.5 g/d,and MPA in plasma was within the range of 0.32-6.19μg/mL,MPAG in plasma was within the range of 9.52-149.25μg/mL.Conclusion The method is accurate, convenient and rapid, which could be used in the quantitative determination of plasma concentration of MPA,MPAG in renal transplantion patients.

4.
China Pharmacy ; (12): 2348-2351, 2016.
Article in Chinese | WPRIM | ID: wpr-504617

ABSTRACT

OBJECTIVE:To explore the clinical related factors of leucopenia induced by azathioprine in the treatment of inflam-matory bowel disease (IBD). METHODS:Clinical information of 114 IBD patients were collected from our hospital during Jan. 2013-Mar. 2015. Steady concentration of AZA metabolite 6-thioguanine(6-TGNs)in red blood cell was determined by HPLC. The correlation of patient’s gender,age,diseases,AZA daily dose and blood concentration of 6-TGNs with leucopenia induced by AZA were investigated. The optimal critical value of leucopenia could be predicted with ROC curves. RESULTS:Among 114 IBD patients,40 patients suffered from leucopenia(35.1%). There was no statistical significance in the proportion of leucopenia among patients with different age,gender,diseases and AZA daily dose(P>0.05). There was statistical significance in the proportion of leucopenia among patients with different concentrations of 6-TGNs(P291.04 pmol/(8 × 108)RBC. CONCLUSIONS:AZA induced leucopenia may be related to the concentration of 6-TGNs in red blood cell of IBD patients,and high concentration of 6-TGNs is risk factors of leucopenia. Clinicians can provide AZA individual treatment for IBD patient to reduce the occurrence of leucopenia according to routine blood test and the concentra-tion of 6-TGNs.

5.
China Pharmacy ; (12): 694-696, 2016.
Article in Chinese | WPRIM | ID: wpr-501440

ABSTRACT

OBJECTIVE:To explore the role of clinical pharmacists on pharmaceutical care for allergic reaction caused by ox-aliplatin. METHODS:Clinical pharmacists conducted pharmaceutical care for a patient with oxaliplatin-induced allergic reaction, and suggested stopping taking oxaliplatin,giving Dexamethasone injection 5 mg and then slowing down injection speed. RE-SULTS:Physicians adopted the suggestions of clinical pharmacists. Allergic reaction relieved 5 min after giving Dexamethasone in-jection. The patient didn't suffered from this allergic reaction again under tight supervision. CONCLUSIONS:Oxaliplatin is often used for tumor therapy. Medical staff should be familiar with the prevention,diagnosis and treatment of ADR,evaluate oxaliplatin chemotherapy plan in advance and screen high risk allergy factor. The participation of clinical pharmacists in pharmaceutical care contribute to ADR monitoring and promote safe and rational drug use in the clinic.

6.
China Pharmacy ; (12): 4887-4889, 2015.
Article in Chinese | WPRIM | ID: wpr-501192

ABSTRACT

OBJECTIVE:To improve the system of management and maintenance for the purification air-conditioning system in PIVAS,and to further strengthen the management of cleaning environment. METHODS:The cleanness monitoring project of purifi-cation air-conditioning system in PIVAS of our hospital was introduced in terms of temperature and humidity record,pressure differ-ence record,airborne particles detection,settling microbe monitoring report. And the monitoring results were analyzed. RESULTS:The temperature and humidity,pressure difference of clean area in PIVAS of our hospital are both in line with the standard of Phar-macy Intravenous Admixture Quality Management Specification (2010 edition),i.e. temperature at 18-26 ℃,relative humidity of 40%-65%;negative pressure difference between antibiotics,hazardous drug dispensing area and second dressing room are 5-10 Pa. The number of airborne particles (average static particle/m3) at various cleanness degrees in clean area are all in line with the standard of GMP(2010 edition),i.e. maximal allowable number of airborne particles(≥0.5 μm)were 3 520/m3(100 degree);352 000/m3 (10 000 degree);3 520 000/m3 (100 000 degree). The percentage of qualified static settling microbe detection reach 100%in clean area,which is in line with the standard of Settling Microbe Detection Method in Clean Room(Area) of Pharmaceu-tical Industry,i.e. criteria for settling microbe(90 mm)CFU/0.5 h≤1(100 degree);≤3(10 000 degree);≤10(100 000 degree). The percentage of qualified dynamic settling microbe detection is in low level,especially those of dispensing room and secondary dressing room only reaches 80%. CONCLUSIONS:It’s important for effective hospital infection control in PIVAS,the quality im-provement of intravenous injection,the safety guarantee of drug use in patients to further improve standard operation procedure of purification air-conditioning system management and maintenance,and manage and maintain the purification air-conditioning sys-tem completely and scientifically.

7.
Article in Chinese | WPRIM | ID: wpr-432098

ABSTRACT

Objective To evaluate the application value of virtual touch tissue quantification (VTQ)for evaluating small focal liver lesions.Methods Seventy-seven patients with 89 small focal liver lesions,whose largest diameter were less than or equal to 3 cm were evaluated with VTQ.The shcar wave velocity (SWV) of the tumor and background liver parenchyma were calculated,and their results were compared with those of 40 healthy subjects.Statistical analysis was performed on the SWV for the differentiation of normal liver,background liver parenchyma and lesions.The cut-off point for SWV was obtained by using ROC curve analysis which was used to predict malignancy lesions.Results The SWV of malignant lesions was significantly higher than that of benign ones [(2.56-± 0.67) m/s vs (1.70 ± 0.55) m/s,P =0.000].The SWV of metastatic liver carcinoma which came from lung cancer and breast cancer were higher than that of gastrointestinal tract cancer transfers (P =0.000).Based on 1.93 m/s as the cut-off point of SWV value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for diagnosing malignancies were 82.0 %,84.6%,83.15 %,87.23 % and 78.57 % respectively.Conclusions VTQ technique can help the differential diagnosis of small focal liver lesions.

8.
Article in Chinese | WPRIM | ID: wpr-678419

ABSTRACT

AIM To study the antitumor activity of astragalosides(AST) and its mechanism of action. METHODS By using two experimental models of hepatoma(HepA) and Sarcoma 180 in mice, the rate of inhibition of tumor weight AST on the growth of HepA and S180 tumor cells were tested. The growth inhibition of AST on Hela cells was detected by MTT assay. The effect of AST on cell cycle and apoptosis was analyzed by flow cytometry and TUNEL. RESULTS AST inhibited the growth of tumor cells of HepA and S180 in mice. AST inhibited the growth of Hela cell in concentration dependent manner with IC 50 of 80 4 mg?L -1 . Flow cytomety analgsis showed that G 0/G 1 phase rate was increased but S phase rate was decreased. The apoptosis rate of Hela cells treated with AST( 80 and 160 mg?L -1 ) was significantly higher than that of control. CONCLUSION AST can inhibit the growth of tumor cells of HepA and S180 in mice and the growth of HeLa cells in vitro . Causing cell cycle arrest and apoptosis is probably one of the mechanisms of antitumor effect by AST.

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