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Yigongsan， derived from QIAN Yi’s Key to Therapeutics of Children’s Diseases in the Song Dynasty， is a classic pediatric prescription that is included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） released by the National Administration of Traditional Chinese Medicine in 2022. This paper verifies and analyzes the historical origin， composition， dosage， processing， decoction method and efficacy of Yigongsan by systematically combing ancient books and modern documents. As a result， Yigongsan is composed of five herbs： Panax ginseng， Poria cocos， Atractylodes macrocephala， Citrus reticulata and Glycyrrhiza uralensis， of which P. cocos should be peeled， A. macrocephala is fried with soil， G. uralensis is roasted with honey while P. ginseng and C. reticulata are raw products. According to the dosage of ancient and modern times， each medicinal herb must be ground into fine powder， 1.6 g for each， added with 300 mL of water， 5 pieces of Zingiber officinale， and 2 Ziziphus jujuba， decocted together to 210 mL， and taken before meals. In ancient books， Yigongsan is used to treat vomiting， diarrhea， spleen and stomach deficiency， chest and abdominal distension， and lack of appetite， etc. Modern research showed that Yigongsan could also be used in the diseases of immune system， respiratory system， blood system， etc.， involving infantile anorexia， asthma， anemia， tumors and so on.
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OBJECTIVE To compare the general status of training programs for geriatric clinical pharmacists in China and the United States， and provide a reference for further optimizing training programs of geriatric clinical pharmacists in China. METHODS Retrieved from the American Society of Health-System Pharmacists （ASHP） website and the Chinese Hospital Association website， the detailed information and data on training outline， institution type/scale， enrollment number， training contents， project application conditions and graduation assessments for clinical pharmacists in geriatric field were collected and statistical analysis was performed using Excel software. RESULTS & CONCLUSIONS As of January 12， 2024， ASHP provided 24 geriatric clinical pharmacist training programs and 25 positions available for application in the postgraduate year two training， which provided compensation. The training base involved hospitals and pharmaceutical colleges， with varying scales. Applicants needed to obtain a doctor of pharmacy and complete postgraduate year one training. ASHP had designed detailed training objectives for the four essential skills of basic patient care， advanced patient care， leadership and management skills， and knowledge education and teaching dissemination. Each training base could appropriately add optional skills such as academic skills， long-term care skills and other skills according to its characteristics， developed a student rotation plan， and conducted assessments and evaluations at multiple time points during the training process. There were 5 training programs for geriatric clinical pharmacists in China， with 15 positions， which didn’t provide compensation； training bases were all third-grade class A hospitals with relatively large scale. The applicant needed to obtain a bachelor’s degree or above， and different years of work were required based on their major and degree level. The Pharmaceutical Specialized Committee of the China Hospital Association had established a detailed training outline， proposing specific training objectives on theoretical knowledge， practical skills， scientific research thinking， etc. The training base organized assessments and evaluations at the time of enrollment， completion of specified content training， and graduation. According to the experience of the US， it is recommended to provide differentiated knowledge and skills training for students at different levels， flexibly arrange rotating departments， require students to work independently and deeply participate in clinical teaching and research work， conduct multiple and various forms of assessments， and adjust learning plans in a 13264273306@126.com timely manner to comprehensively enhance their abilities.
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The classic formula Zhulingtang, derived from the medical work Treatise on Cold Damage (《伤寒论》) compiled by ZHANG Zhongjing, a medical sage in the Eastern Han Dynasty, has been included in the Catalogue of Ancient Classic Formulas (First Batch) published by the National Administration of Traditional Chinese Medicine in 2018. Using the method of textual research, this study systematically reviewed ancient and modern literature to conduct a historical and textual analysis of Zhulingtang, including its origin, composition, dosage, processing, decoction methods, efficacy, and applications. A total of 733 pieces of relevant information related to Zhulingtang were collected, involving 206 ancient Chinese medical texts, with 52 of them providing detailed records of the composition, dosage, processing, and efficacy of Zhulingtang. The results of the analysis showed that Zhulingtang was composed of Polyporus, Poria, Alismatis Rhizoma, Asini Corii Colla, and Talcum. Polyporus and Poria should be used without their peels, Asini Corii Colla should be stir-fried with clam powder, and Talcum should be ground into powder or soaked in water. Based on the conversion of ancient and modern dosages, Polyporus, Poria, Alismatis Rhizoma, and Talcum, 15.63 g for each one, were decocted with 800 mL of water to 400 mL. Then the drug residue was removed, and 15.63 g of Asini Corii Colla was added to the drug juice for melting by heating. The decoction should be taken warm, 140 mL each time, three times a day. Zhulingtang has the effects of promoting diuresis, nourishing yin, and clearing heat, and it is mainly used to treat water-heat combination syndrome, characterized by symptoms such as difficult urination, fever, and thirst. Modern research indicates that Zhulingtang is commonly used to treat diseases such as cirrhotic ascites, chronic glomerulonephritis, nephrotic syndrome, diarrhea, and urinary tract infections. This study provides key information about the famous formula Zhulingtang, which can serve as a reference for further development and research on its application.
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OBJECTIVE：To est ablish the working mode of the first pharmaceutical ward rounds of clinical pharmacists in our hospital，in order to provide a useful reference for establishing a national standardized pharmaceutical ward rounds model. METHODS：By sharing the clinical cases of the first pharmaceutical ward rounds ，the work content and process of the first pharmaceutical ward rounds in our hospital were introduced. RESULTS & CONCLUSIONS ：The clinical pharmacist ’s first pharmaceutical ward round in our hospital mainly includes self introduction of clinical pharmacists ，diagnosis of patients ’condition under the guidance of doctors ，collection and evaluation of patients ’previous medication information （including previous medication varieties ，usage methods ，efficacy and safety evaluation ），assistance for doctors in formulating initial treatment plan ， carrying out initial medication and diet education ，and intensive communication and cooperation with nurses. The development of first pharmaceutical ward rounds promotes the rational use of drugs in clinic ，elevates the hospitalization satisfaction of patients and improves the professional quality of clinical pharmacists.
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OBJECTIVE：To summari ze clinical application and existing problems of artificial auditing and information-based medical order auditing modes so as to provide reference for improving rational medication. METHODS ：Collecting data by literature search ，using “Prescription auditing ”“Medical order auditing ”“Prescription pre-auditing ”“Medication error ” “Medication-related problems ”“Medication safety ”“Alert fatigue ”“Medication review ”“Decision support medication review ” “Real-time medication review ”“Real-time prescription surveillance ”“Clinical alarms decision support systems ”“Clinical pharmacy information systems ”“Medication errors ”“Medication related problem ”as keywords ，the related literatures from Jan. 2000 to Nov. 2019 were retrieved from CNKI ，Wanfang database ，PubMed，Embase，Web of Science and other databases. The clinical application and existing problems of 2 medical order auditing modes were analyzed and summarized. RESULTS & CONCLUSIONS：The artificial auditing mode can reduce medication-related problems （such as poor drug treatment effect ， untreated symptoms or indications ，potential adverse drug events ，unnecessary drug treatment ，etc.），improve life quality of patients，but can not decrease the mortality and the length of hospitalization stay ；there are some problems ，such as many pharmacists needed for medical order auditing ，insufficient auditing time ，different auditing standards ，auditing time lagging. The information-based medical order auditing mode can reduce medication-related problems ，save auditing time ，reduce the incidence of medication errors ，reduce unreasonable medical orders ，and improve audit efficiency. Compared with the artificial auditing mode ，it has certain advantages ，but there are problems such as alarm fatigue. At present ，the domestic medical order auditing mode is dominated by artificial audit mode ；the information-based medical order auditing mode is still in the initial stage ，and the most attention is paid to its influence on the qualified rate of prescription ，while the research on the incidence of adverse events and other clinical effects is less. Later ，the 2 midical order can be D181100000218002）； improve to provide a reference for medical order auditing of 2019 hospital pharmacy personnel.
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A teaching case library of clinical pharmacy was constructed to improve case teaching for pharmacy residents. Through establishment of draft requirement and organizing a group of authors consti-tuted by preceptors of pharmacy residents, the teaching cases were written, the contents and forms of which were assessed by teaching demonstration, interactively examined and revised by fellow teachers, audited and screened by senior pharmacists , and thus a case library was collaborated , processed and established . Finally, a case library was formed, which included 11 systems, such as endocrine, cardiovascular and neu-rological systems, and 32 cases of drug treatment for common diseases in each system. The construction ofcase library has enhanced the teaching consciousness and skills of resident pharmacists' teaching team. This case library will become an important resource for teaching and scientific research in the future.
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OBJECTIVE:To provide reference for exploring the way to improve the ability of pharmaceutical care in primary pharmaceutical staff. METHODS:Questionnaire survey was conducted among pharmaceutical staff(including head of pharmacy department),director/vice-director of hospital in charge of pharmacy,medical staff and patients from primary medical institutions in 9 provinces(regions,cities). The results of investigation were analyzed statistically. RESULTS:A total of 77 primary medical institutions involved in the survey. Totally of 2 273 questionnaires were sent out,and 2 248 effective questionnaires were collected with effective recovery rate of 98.9%. Among effective questionnaires,278 questionnaires were filled out by pharmaceutical staff (68 by head of pharmacy department),48 by director/vice-director of hospital in charge of pharmacy,771 by medical staff and 1 151 by patients. Results of survey showed that only 140 pharmaceutical staff had obtained pharmacy practice qualification,accounting for 50.4%. The surveyed primary medical institutions provided limited pharmaceutical care projects,and the projects with high proportion were medication explanation(85.7%)and medication consultation(84.4%). The establishment of Health Service Record Card in elderly patients(19.5%),the development of chronic disease management(23.4%)and the development of chronic disease related pharmaceutical knowledge publicity at the primary level(37.7%)took up low proportion relatively. Overall satisfaction of surveyed medical staff to pharmaceutical care of pharmaceutical staff was general(77.2%). Surveyed patients greatly satisfied with the attitude of pharmaceutical staff(85.5%)but overall satisfaction of them to professional knowledge of pharmaceutical staff(78.2%)was general. Surveyed pharmaceutical staff training needs in descending order were medication explanation(74.5%),medication counseling(71.9%)and providing pharmaceutical information(64.0%). However,the projects which had low proportion of training needs included chronic disease management(22.3%)and lifestyle guidance (27.0%),etc. The more favorite training forms in descending order were further study in medical institution at higher level(65.4%),expert lectures(60.1%)and training in the training base (57.9%). CONCLUSIONS:The primary medical institutions provided limited pharmaceutical care. It is necessary to further explore and standardize pharmaceutical care criteria. The overall satisfaction of medical staff and patients on pharmaceutical care of pharmaceutical staff is not high in primary institutions,and it needs to be further improved. The related pharmacy training for primary pharmaceutical staff still needs to be strengthened,and can be conducted according to the favorite form of training so as to improve the ability of pharmaceutical care.
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Objective:To systematically review the efficacy and safety of acid-suppressive therapy including proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) and compare with those of placebo or blank control in the postoperative patients with stress ulcer bleeding (SUB) to provide evidence-based reference for clinical practice.Methods:The Cochrane library,Medline,Embase,CBM,CNKI,VIP,Wan Fang Data,clinicaltrials.gov,ISRCTN Register and WHO ICTRP were searched.Only randomized controlled trials (RCTs) of acid-suppressive therapy compared with placebo or blank control for postoperative stress ulcer bleeding were selected with bleeding rate,mortality,adverse drug reactions,gastric juice pH and length of stay as the indices.After the quality evaluation and data extraction,Meta-analysis was performed by using Stata12.0 statistics software.The results were expressed as relative risk(RR) and its corresponding 95% confidence interval(CI).Funnel plot and Eggers test were used to determine the publication bias;and then Grade approach was applied to assess the confidence in the evidence for each outcome.Results:Totally 15 trials enrolling 971 patients were selected,and acid-suppressive therapy was more effective than placebo or blank control in reducing the risk of stress ulcer bleeding,overt upper gastrointestinal bleeding and clinical important bleeding(RR 0.29,95% CI:0.19-0.45;RR 0.25,95%CI:0.10-0.64;RR 0.36,95%CI:0.17-0.77)(moderate),however,there was no statistical significance in the incidence of occult bleeding,mortality and adverse drug reactions (RR 0.79,95%CI:0.41-1.50;RR 0.49,95%CI:0.17-1.38;RR 0.78,95%CI:0.33-1.85,very low confidence).The subgroup analysis of drug classification,operation types and administration juncture showed that the incidence of SUB using PPI (RR=0.27) was lower than that using H2RA (RR=0.33);that of heart surgery (RR=0.20) was lower than that of general surgery (RR=0.31) and neurosurgery(RR=0.37);that of postoperative administration (RR=0.26) was lower than that of preoperative administration (RR=0.23).Conclusion:Acid-suppressive drugs seem to be more effective than placebo or blank control in reducing the risk of bleeding without significant increase of the risk of mortality or adverse drug reactions.The robustness of the conclusion is limited because of the low quality of the trial methodology,incomplete outcome indicators and lack of safety indices for pneumonia and clostridium diffcile-associated infection.Trials with high-quality and larger sample size are still needed to verify its clinical effects.
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Objective: To establish an education program for resident pharmacists to improve clinical problem solving skills with pharmaceutical knowledge.Methods: A case-based education program for resident pharmacists with drug knowledge was established after a questionnaire survey in resident pharmacists and the discussion with clinical teachers.A teaching team was built and the resident pharmacists were divided into several study groups.After a pilot run, the program was operated in pharmacy department.The program was divided into 10 sections by drug indications, and each section was composed of basic drug knowledge lecture and case discussions, which mobilized the study initiative of resident pharmacists.At the half time, resident pharmacists and clinical teachers participated in a midterm survey by a questionnaire.Results: More than 95% resident pharmacists and teachers believed that basic drug knowledge lecture before case discussion was necessary, and compared with previous trainings, the program could further increase study interests of resident pharmacists and improve the clinical problem solving skills.However, 33.3% resident pharmacists and 60% teachers thought the cases were difficult, and 18.5% resident pharmacists and 10% teachers disagreed the cases were close to the actual work.Conclusion: The program is effective in drug knowledge training for resident pharmacists, which can improve pharmaceutical care for patients, while further modifications are still needed to satisfy the demands of resident pharamcists with different working years.
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Objective To investigate the clinical status about the utility of compound amino acid (15) and dipeptides (2) in-jection, and to promote the rational drug use in our hospital .Methods Data from 127 patients who used compound amino acid (15) and dipeptides(2) injection in surgical wards were collected in July 2012.The data about the drug usage method , duration, administra-ted timing, drug combination and the differences in all departments was analyzed .Results Existing problems:62.2% patients used compound amino acid (15) and dipeptides (2) injection by peripheral intravenous infusion , 6.3% patients used more than 14 days and 7.1%patients infused singly.Conclusion Compound amino acid(15) and dipeptides(2) injection had problems of off-label drug use in surgical ward , which need to be improved .
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OBJECTIVE:To explore the components and style of the intervention performed by clinical pharmacists to facilitate communication between pharmacists and physicians. METHODS: The data about clinical pharmacists' medication intervention and the follow-up results on ICU physicians in general surgery department during Nov. in 2007 were collected for statistical analysis with regard to the components and style of the intervention. RESULTS: The components of clinical pharmacists' medication intervention included dosage and administration (36.1%),whether the drug use was in line with indications (27.8%),assessment on adverse drug reactions (22.2%). The style of intervention included timely intervention and delayed intervention,and 50%～66.7% of the timely intervention and 90.1%～100% of the delayed intervention were accepted by physicians. CONCLUSION: The intervention of clinical pharmacists should be based on sound evidence and reasons,meanwhile,an appropriate style should be adopted in communicating with physicians so as to improve its accepting rate by physicians.
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OBJECTIVE:To investigate the effects and the mechanisms of cornel iridoid glycoside(CIG)on antiapoptosis in cellular model of alzheimer disease(AD)induced by the protein phosphatase inhibitor okadaic acid(OA).METHODS:The human neuroblastoma cell line SK-N-SH cells were preincubated with CIG for 24 h,and then incubated with OA 10 nmol for 6 h.The changes of apoptotic cells were observed by TUNEL method.Western blotting was used to determine the expression of apoptosis-regulating factors Bcl-2,Bcl-2 related X protein(Bax)and Caspase-3.RESULTS:The normal SK-N-SH cells spread well and no apoptotic cells appeared.In OA-treated model group,the number of apoptotic cells increased significantly,the expressions of Bax and Caspase-3 increased significantly,but Bcl-2 expression decreased significantly.In CIG(100 and 200 ?g?mL-1)-treated group,the number of apoptotic cells decreased significantly as compared with OA-treated model group,and the expressions of Bax and Caspase-3 decreased significantly whereas Bcl-2 expression increased significantly.CONCLUSION:CIG can inhibit the apoptosis of nerve cells through affecting apoptosis-regulating factors,suggesting its potential as a therapy for AD.
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Aim To investigate the effects of ginsenoside(GS) on phosphorylation of tau protein,microtubule,cellular apoptosis and its related factors in cellular model of Alzheimer disease(AD) induced by the protein phosphatase 1 and 2A inhibitor okadaic acid(OA).Methods The human neuroblastoma cell line SK-N-SH cells were cultured with GS for 24 h,the culture medium was changed,and then incubated with OA 10 nmol?L-1 for 6 h.The changes of cell morphology were observed by inverted microscope.The laser confocal microscopy was used to observe the microtubule changes.Western blot was applied to determine the expression of phosphorylation of tau protein,and apoptosis-regulating factors Bcl-2,Bax and Caspase-3.The changes of apoptotic cells were observed by TUNEL method.Results The normal SK-N-SH cells spread well.OA-treated cells showed that the cell axons and the microtubules were broken and decreased under the inverted microscope and laser confocal microscope.Preincubation of GS demonstrated the significantly protective effects against the morphologic damage induced by OA.In OA-treated group,the phosphorylation of tau protein at Ser-199/202 and Ser-404 sites was higher than that in normal group,and the non-phosphorylation of tau protein at the same sites was lower;Incubation of GS at the dose of 50 mg?L-1 and 100 mg?L-1 with the cells decreased the phosphorylation of tau protein Ser-199/202 and Ser-404 sites.GS group at the dose of 50 mg?L-1 and 100 mg?L-1 decreased the expression of at non-phosphorylation of tau protein at the Ser202 site.The apoptotic cells were not found in normal group.The number of apoptotic cells were obviously increased.the expression of Bax and caspase-3 significantly enhanced,and Bcl-2 expression decreased in the OA-treated model group.GS significantly decreased the apoptotic cell number of nerve cells,inhibited the expression of Bax and caspase-3.Conclusion GS can protect the nerve cells from pathological change induced by OA.Maybe because it can inhibit the hyperphosphorylation of tau protein and protect the nerve cells from apoptosis,thus GS may have potential to treat Alzheimer disease.
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OBJECTIVE: To study the how's for pharmacists at inpatient pharmacy to provide pharmaceutical care for improved safe and effective use of drugs. METHODS: Pharmacists at inpatient pharmacy can provide pharmaceutical care as per specific clinical needs, and start from such details as preparing the booklet of commonly-used chemotherapy drugs, offering face-to-face advises on drug use for diabetics, and helping nurses to manage the medicine cabinets. RESULTS & CONCLUSION: Pharmacists at inpatient pharmacy should provide the right pharmaceutical care that can meet actual clinical needs.