Practice of Standardizing Rational Use of Proton Pump Inhibitors in Neurosurgery Department of Our Hospital by PDCA Cycle Management / 中国药房

OBJECTIVE： To promote rational use of proton pump inhibitors （PPIs） during perioperative period. METHODS： PDCA （Plan， Do， Check， Action） cycle management was used， the irrational use of PPIs of 300 medical records in neurosurgery department of our hospital were collected. The reasons were analyzed， management target was formulated and measures were implemented. The effects of management were evaluated through comparing the rate of irrational drug use and ratio of irrational type of PPIs in 300 medical records of neurosurgery department during perioperative period after management. RESULTS： Through collecting related data to confirm risk factors of stress ulcer， establishing rationality evaluation criteria for perioperative prophylactic use of PPIs， conducting rational drug use training among medical staff， drawing up various management systems and strengthening supervision and management， the rate of irrational use of PPIs was decreased significantly in our hospital； the number of irrational drug use cases decreased from 240 before management to 156 after management， among which the rate of prophylactic drug use without indication decreased from 37.33％ to 29.00％ （P＜0.05）； the irrational dosage rate decreased from 11.33％ to 6.33％ （P＜0.05）； the rate of irrational dosing frequency dropped from 12.67％ to 5.00％ （P＜0.01）. CONCLUSIONS： PDCA cycle management of our hospital can standardize the prophylactic use of PPIs in neurosurgery department during perioperative period and promote rational use of PPIs.

Effects of Emodin against Renal Tubular Epithelial Cell Fibrosis via the Inhibition of Akt/mTOR Signal Pathway / 中国药师

Objective: To investigate the mechanism of emodin ( EM) in the expression of related protein for the fibrosis of the transforming growth factor-β1(TGF-β1)-stimulated human renal tubular epithelial (HK-2) cells. Methods: HK-2 cells were randomly divided into the normal control group, TGF-β1-stimulated model control group and emodin ( TGF-β1 +EM) group. The contents of Collage Ⅰ and fibronectin in the culture supernatant were determined by ELISA. After HK-2 cells were stimulated with TGF-β1 for 24 h, the cells were collected for immunofluorescence, Western blot and RT-PCR analysis. RT-PCR was used to detect PI3K, p-Akt and mTOR. The protein expressions of PI3K, p-Akt and mTOR were detected by Western blot. Immunofluorescence was used to detect PI3K. Results: Compared with those in the model control group, the contents of CollageⅠand fibronectin in the supernatant of emod-in group significantly decreased (P<0. 05), the expression of PI3K protein was inhibited, the expression of downstream p-Akt protein decreased, and the downstream mTOR decreased (P<0. 05), the expression levels of PI3K, p-Akt and mTOR mRNA decreased, the differences were statistically significant (P<0. 05), and the expression of PI3K decreased. Conclusion: Emodin can alleviate fibrosis of HK-2 cells stimulated by TGF-β1 through the classical Akt/mTOR pathway of autophagy.

Analysis on Application Rationality of Proton Pump Inhibitors in 880 Patients Undergoing Operation in Gy-necology Department / 中国药师

Objective:To investigate the use of proton pump inhibitors (PPIs)in gynecological patients in a hospital and analyze the use rationality of PPIs for the prevention of stress ulcer so as to provide reference for the clinical application of PPIs. Methods:To-tally 1000 patients' medical records admitted to the gynecological department for the first time from January 1st to December 31st in 2016 were randomly selected to conduct a retrospective analysis,and the rationality of PPIs was evaluated. Results:The preventive use rate of PPIs was 90.72%(880/970). Among the 880 patients, 28.18%(248/880) of the patients were without indications for the preventive medication,95.68%(842/880) of the patients were with wrong administration time, and 91.46%(578/632) of the pa-tients were with wrong usage and dosage. Conclusion:When PPIs are used for the prevention of SU in gynecological surgery,irrational use such as without indications, unsuitable variety selection and wrong usage and dosage still exists. It is suggested that regulators should strengthen technical and administrative interventions and establish standard for the rational use of PPIs in hospitals so as to avoid the excessive use of PPIs and improve the situation of inappropriate application.

Analysis of the Rationality of Perioperative PPIs in the Prevention of Stress Ulcer in Orthopedic Department of Our Hospital / 中国药房

OBJECTIVE:To analyze the rationality of proton pump inhibitors (PPIs) in the prevention of stress ulcer in perioperative orthopedic patients of our hospitals,and to provide reference for ratioual use of PPIs in clinic.METHODS:The medical records of discharged orthopedic patients were selected during Jan.1st-30th in 2016.Those records were analyzed statistically in respects of the use of PPIs,general information of patients,operation situation,the stressors and risk factors of stress ulcer.The rationality of the use of PPIs was analyzed comprehensively.RESULTS:Among 664 surgical patients,PPIs were used in 210 cases,and H2 receptor antagonist (H2RA) were used in 74 cases,with prophylactic rate of 42.77％.The main types of operation were fracture fixation (74 cases,35.24％),discectomy and discectomy (38 cases,18.11％).Among 210 patients receiving PPIs,all of them used PPIs,among which 68 cases (32.38％) had no medication indications,128 cases (60.95％) were medication timing error,74 cases (35.24％) were administration frequency error and 44 cases (20.95％) were more than 3 d prophylactic drug use.CONCLUSION:When orthopedic patients use PPIs for the prevention of stress ulcer,there are serious irrational phenomena in indications,species selection,usage and dosage,treatment course and so on.Clinicians and regulators should pay great attention to it so as to avoid the excessive application of PPIs.

Influence of Bufalin on the Growth and Proliferation of Human Glioma Cell Line U251 / 中国药师

Objective:To explore the effects of Bufalin on the growth and proliferation of human glioma cells U251. Methods:Methyl thiazolyl tetrazolium(MTT)assay was used to detect the effect of Bufalin on the proliferation of human glioma cells U251. An in-verted microscope was used to observe the changes of cell number,morphology and activity. AnnexinV/ PI was used to measure the in-duction of cell apoptosis caused by Bufalin. Results:Bufalin at different concentrations(0. 001 - 10. 0μmol·L - 1 )inhibited the pro-liferation of U251 cells in a dose and time-dependent manner. Compared with that of the control group,the apoptosis rate of Bufalin group was increased significantly(P < 0. 01). Conclusion:Bufalin can inhibit the growth and proliferation of U251 cells in a dose and time-dependent manner,and induce the apoptosis of U251 cells.

Research Advance in Ionizing Radiation Protection and Repair of Polysaccharide / 中国药师

Ionizing radiation can directly attack biological macromolecules including DNA, protein and lipids. Radiation can also damage cells indirectly by the formation of lots of free radicals through the radiolysis of surrounding water molecules. As the result, ion-izing radiation may make serious injury in human immune system, reproductive system and nervous system. Several synthetic radiopro-tectors have been used in clinic. However, most of them have some undesirable side effects. Hence, natural radioprotectors with high efficiency and low toxicity have been the focus of radioprotection field in recent years. In the paper, the recent research progress in the protection and repair effects of polysaccharides on radiation damage was reviewed.

Analysis of Antibiotics Use and Bacterial Resistant before and after Intervention in Our Hospital / 中国药师

Objective:To analyze the use status of antibiotics and the resistance of clinic isolate bacteria against the commonly used antibiotics before and after the intervention. Methods:Using the information retrieval systems, the consumption of antibiotics in the inpatients during the 1st quarter of 2012(before the intervention) and the same period of 2013(after the intervention) was com-pared. According to the defined daily dose ( DDDs) , the antibiotics were ranked, and the resistance rate against the commonly used antibiotics was analyzed. Results:Compared with the top ten before the intervention, the top ten after the intervention was changed sig-nificantly, however, cephalosporins was still the main species. After the intervention, the overall decline in DDDs was significant, the separation rate and distribution of bacteria remained stable. ESBLs enzyme production rate of Enterobacteriaceae Escherichia coli was re-duced by 7. 61%, and that of Klebsiella pneumoniae was reduced by 1. 34%, and the resistance rate against the commonly used antibi-otics was in an overall downward trend. The resistance rate of Gram-positive staphylococci against the commonly used antibiotics was de-creased, while that of Gram-positive enterococci showed notable difference. Conclusion:The DDDs of antibiotics and bacterial resist-ance rate are in an overall downward trend in our hospital after the intervention;however, there is still exception. Therefore, the clini-cal antimicrobial susceptibility tests should be performed as soon as possible to help the choice of antibiotics.