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Article in Chinese | WPRIM | ID: wpr-828098


OBJECTIVE@#To investigate the role of pharmacist-led anticoagulation monitoring service for warfarin anticoagulation therapy in patients during hospitalization.@*METHODS@#We retrospectively analyzed the data of 421 patients receiving warfarin anticoagulation therapy during hospitalization between April, 2016 and December, 2017. Of these patients, 316 received daily pharmacist-led anticoagulation monitoring service including checking the patients' International Normalized Ratio (INR) and other pertinent laboratory test results and reviewing medication changes and the patients' clinical status (monitoring group); the other 105 patients receiving warfarin anticoagulation therapy without pharmaceutical care served as the control group. The data including compliance rate of anticoagulant indicators, incidence and rate of prompt management of INR alert, thrombosis and bleeding events during hospitalization were analyzed among these patients.@*RESULTS@#Compared with the control patients, the patients in the monitoring group showed a significantly higher percentage time within target INR range [(73.20±9.46)% (46.32±17.11)%, < 0.001] and a higher qualified rate of INR before discharge (98.42% 60.95%, < 0.001) as well as a higher proper INR-monitoring frequency (97.15% 66.67%, < 0.001). The patients in the monitoring group showed a significantly lower incidence of INR alert than the control patients (8.23% 20.00%, < 0.001) with also a much higher rate of prompt management (96.15% 33.33%). The two groups had similar incidences of clinical events except that the control group reported a higher incidence of minor bleeding episodes (9.52% 2.53%, =0.005).@*CONCLUSIONS@#Pharmacist-led anticoagulation monitoring service can significantly improve the effectiveness and safety of warfarin anticoagulation therapy for patients during hospitalization.

Anticoagulants , Drug Monitoring , Hospitalization , Humans , Pharmacists , Retrospective Studies , Warfarin
Article in Chinese | WPRIM | ID: wpr-755072


Objective To evaluate the validity and reliability of the Chinese version of Xerostomia Questionnaire ( XQ-C) in nasopharyngeal carcinoma patients treated with radiotherapy. Methods XQ-C was translated according to the International Quality of Life Assessment project approach. Patients with nasopharyngeal carcinoma in different radiotherapy stages were enrolled in this study and assessed by using the XQ-C. The validity and reliability of the questionnaire results were evaluated. The content validity was assessed by experts grading method. The construct validity was assessed by exploratory factor analysis. The discriminant validity was determined by non-parametric method. The reliability was evaluated by Cronbach′s α and split-half reliability to assess the internal consistency. Results A total of 212 questionnaires were completely filled out. Content validity showed that the item content validity index ( I-CVI) ≥0.80, Scale-CVI/Ave=0.97, and P value of Kendall′s W test was 0.701. Exploratory factor analysis revealed that XQ-C was a unidimensional scale. The scale scores of patients at different stages of radiotherapy significantly differed, suggesting that the discriminant validity was good. Cronbach′s α of the scale was 0.951 and Guttman′s semi-reliability coefficient was 0.940. Conclusion The XQ-C is valid and reliable, which can be widely applied in the clinical diagnosis, treatment and research of xerostomia in Chinese nasopharyngeal carcinoma patients after radiotherapy.

China Occupational Medicine ; (6): 198-202, 2019.
Article in Chinese | WPRIM | ID: wpr-881778


OBJECTIVE: To investigate the levels of cortisol and inflammatory factors and their influencing factors in patients with occupational noise-induced hearing loss(ONID). METHODS: A total of 106 ONID patients were selected as the ONID group, and 50 healthy participants without noise exposure were selected as the control group by judge sampling method. The levels of salivary cortisol in the two groups were detected by enzyme-linked immunosorbent assay.The serum levels of cortisol, tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) and C-reactive protein(CRP) in the peripheral blood were detected by electrochemiluminescence assay. Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus in ONID patients. RESULTS: The level of salivary cortisol in the morning and in the nighttime, and cortisol, TNF-α, IL-6 in the serum were higher in the ONID group compared with that in the control group(P<0.05). There was no significant difference in the serum level of CRP between these two groups(P>0.05). Spearman correlation analysis results showed that the level of cortisol in the saliva and in the serum was not correlated with TNF-α and IL-6(P>0.05). Analysis of multiple linear regression showed that the levels of serum cortisol and salivary cortisol in the morning in the ONID patients were positively correlated with noise exposure level(P<0.05). The level of TNF-α in the serum was positively correlated with tinnitus score(P<0.05). CONCLUSION: Hyperactivity of hypothalamus-pituitary-adrenal axis and inflammation activation may exist in patients with ONID. The cortisol can be used as a biomarker for the effect of noise-stress.

China Occupational Medicine ; (6): 342-346, 2018.
Article in Chinese | WPRIM | ID: wpr-881705


OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.

Article in Chinese | WPRIM | ID: wpr-667483


Objective To identify the effect of renal impairment on the pharmacokinetics of mycophenolate mofetil in Chinese adult renal recipients during the early post-transplant period.Methods Thirty Chinese renal allograft recipients treated with mycophenolate mofetil in combination with tacrolimus and corticosteroids were divided into three groups based on their renal functions.Group Ⅰ had preserved renal function (eGFR≥90 mL/min/1.73 m2,n =9);Group Ⅱ had moderate renal insufficiency (30≤eGFR<90 mL/min/1.73 m2,n =12) and Group Ⅲ had severe renal impairment (eGFR <30 mL/min/1.73 m2,n =9).mycophenolic acid (MPA) exposure and MPA glucuronide (MPAG) exposure were determined by high performance liquid chromatography (HPLC)at first month after transplantation.MPA-AUC0-12h and MPAG-AUC0-12h were calculated by the linear trapezoidal rule.Results Mean MPA-AUC0-12h values were similar between group Ⅰ and group Ⅱ(37.8 ± 15.6 vs.54.5 ± 27.0μg·h·ml-1,P>0.05).MPA-AUC0-12h values were significantly higher in group Ⅲ than in group Ⅰ (75.7-±29.5 vs.37.8-± 15.6μg·h·ml-1,P<0.05).The severe renal insufficiency group showed a significantly increased AUC0-12h for MPAG (1899.1 ± 987.1 μg·h· ml-1vs.859.9 ± 261.4 vs.692.6 ± 384.8,P<0.05).There was no significant difference in MPAGAUC0-12h between group Ⅱ and Group Ⅰ (P =0.532).Conclusion In adult renal recipients during the early post-transplant period,total MPA exposure was significantly increased because of severe renal insufficiency with oliguria or anuria.Adjusting MMF dose according to renal function may help to prevent side effects and improve efficacy.

Article in Chinese | WPRIM | ID: wpr-597856


Objective To establish a high-performance liquid chromatography method for simultaneous determination of mycophenolic acid(MPA) and its 7-O-glucuronide metabolite (MPAG) in human plasma and to study pharmacokinetics of MPA in Chinese renal transplant recipients after administration of mycophenolate mofetil( MMF). Methods Plasma protein was precipitated with metlianol: 5% ZnSO4 ( 70∶30, V∶ V), using naproxen as internal MPA and MPAG after 1.5g/d administration of MMF in 6 early-stage renal transplant recipients were as follows :Tmax was(1.08±0.74)h and(2.58±1.24)h,Cmax was(21.33±8.61)mg/L and(106.98±31.91)mg/L,AUCO-t was (58.73 ±16.26)mg ? L-1 ? h-1 and(833.32±215.03)mg ? L-1 ? h-1,respectively.Conclusion This method was accurate, sensitive and specific and it was successfully applied in therapeutic drug monitoring (TDM) of mycophenolate mofetil in early-stage renal transplant recipients.