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Objective To explore the starting point of pharmaceutical care by clinical pharmacists for patients after heart valve replacement. Methods Combined with typical cases, the content, focus and effects of pharmaceutical care for patients after heart valve replacement were summarized. Results Clinical pharmacists provided pharmaceutical services such as anticoagulant care and warfarin dosage adjustment, infection monitoring and rational use and care of antibacterial, perioperative airway management, stress ulcer (SU) prevention and pharmaceutical care, and warfarin medication education for patients, which had promoted the rational use of drugs and improved the treatment results of patients. Conclusion Pharmaceutical care by clinical pharmacists could be helpful to improve the safety and efficacy of drug treatment for patients after heart valve replacement. [ABSTRACT FROM AUTHOR]

Objective： To evaluate systematically the therapeutic efficacy of short-term high-dose statins administration before surgery in Asian population with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI） on reducing the incidence of major adverse cardiac events（MACE）. Methods： Published randomized controlled trials（RCTs） were retrieved from PubMed， EMBase and Cochrane Library. Two reviewers independently screened studies according to the exclusion and inclusion criteria and data were extracted. Then，quality evaluation was made by using Cochrane manual 5.1.0. Meta analysis was performed by using Rev Man 5.3 software. Results： A total of 7 RCTs were included，involving 1381 statin-nave Asian patients. Of the 1381 patients，689 patients were given high-dose statins before PCI （the observation group），and 692 patients were given normal or low-dose statins or no drugs before PCI （the control group）.The results of meta analysis showed that the incidence of MACE in the observation group was significantly lower than that in the control group，with statistical significance （P<0.01），and that high dosage of statins before PCI had impact on the incidence of percutaneous myocardial infarction （PMI） in perioperative patients.The incidence of PMI in the observation group was significantly lower than that in the control group，also with statistical significance （P<0.01）. Conclusion：In Asian patients with acute coronary syndrome， high-dose statins administered before PCI could significantly reduce the incidence of MACE and PMI within 30 days after surgery. [ABSTRACT FROM AUTHOR]

Objective To explore the efficacy and safety of dabigatran etexilate in the treatment of elderly patients with non-valvular atrial fibrillation (NVAF), so as to provide reference for clinical treatment and rational drug use. Methods Eighty elderly patients with NVAF in The Seventh People's Hospital of Shanghai from December 2020 to June 2021, aged 65 to 80 years, were enrolled in a self-controlled study. Dabigatran etexilate 110 mg was given orally, twice a day (one in the morning and one in the evening) for 6 months. During the follow-up visit, the coagulation function indexes including APTT, TT, FIB and D-D were observed in patients taking medicine for 1 month and 6 months. Liver function indexes including ALT, AST and TBIL, renal function indicators including UREA and eGFR, and blood routine indexes including HGB and ESR, also were observed in patients taking medicine for 1 month and 6 months. Results Patients were compared at 1 month and 6 months after treatment with dabigatran and before: the difference of coagulation function indexes as APTT and TT was statistically significant (P<0.05);There was no significant difference in liver function index, renal function index and blood routine index (P>0.05); A total of 25 adverse events occurred, and the incidence rate of adverse reactions was 31.25%, there was no adverse events such as serious hemorrhage， life threatening and organ failure hemorrhage occurred．Conclusion Dabigatran has good efficacy and safety in the treatment of the elderly NVAF. [ABSTRACT FROM AUTHOR]

Objective To investigate the application of Lipo-PEG1 injection in our hospital, analyze the rationality of its clinical application and evaluate the role of the administrative intervention in promoting the rational drug use in the hospital. Methods Based on the administrative guidelines announced on July 28, 2016, the data from 1 351 patients who received Lipo-PEG1 injection during July and August were collected and analyzed. Results Lipo-PEG1 injection is widely used in different departments at the hospital. 65.41% cases received this medication as off-label indications. 99.85% cases used this drug with impropriate dosage and indications. 0.39% cases had contraindications. There was no difference before and after the administrative intervention. Conclusion The off-label use of Lipo-PEG1 injection is very common in clinical practice. More clinical attention should be paid to this problem. The results from simple administrative intervention is unsatisfied. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy, safety and drug economics of biapenem, meropenem and imipenem. Methods: The patients with acute biliary tract infection hospitalized in the First Affiliated Hospital of Kangda College of Nanjing Medical University from January 2017 to December 2018 were screened, including 168 patients treated with biapenem, 132 patients treated with meropenem and 216 patients treated with imipenem, and they were randomly and respectively designated as 1-168, 1-132 and 1-216. From the subjects, 100 patients were randomly selected by RANDBETWEEN function of Excel. With 5 days of continuous treatment as the time node, related data concerning clinical manifestations, the results of laboratory images, bacterial culture, and adverse drug reactions (ADRs) of the 3 groups were collected for study. Results: The effective rates and bacterial clearance rates of the 3 groups were: the imipenem group>biapenem group>meropenem group. The effective rates of the imipenem group, the biapenem group and the meropenem group were 88.0%, 79.0% and 74.0%, respectively, and the bacterial clearance rates were 85.7%, 78.3% and 55.6%, respectively, with statistical significance (P<0.05). The rates of ADRs were 6.0%, 4.0% and 8.0%, respectively (P>0. 05). In terms of eco no my, the incremental cost-effectiveness analysis (ICER) value with efficiency as the effect was 18 077.8 yuan, and the ICER value with bacterial clearance as the effect was 21 986.5 yuan. Cbncllision: Of the 3 commonly-used carbapenem antibiotics, biapenem has the exact clinical efficacy with best cost performance. [ABSTRACT FROM AUTHOR]

Objective : To analyze the causes of thrombocytopenia after percutaneous coronary intervention (PCI) in a patient with coronary heart disease. Methods : The causes of thrombocytopenia after PCI were analyzed based on the medical his - tory and medication history. The suspected drugs were assessed according to the evaluation criteria of relevance formulated by National Center for Adverse Drug Reactions (ADRs) Monitoring,and Naranjo ADRs scoring criteria. Results : Through medical history and one by one drug screening,thrombocytopenia was suspected to be induced by antiplatelet drug ticagrelor. The platelet count gradually recovered following abandonment of the drug. Clopidogrel and aspirin were then used to continue dual antiplatelet therapy,and the patient's condition improved and was duly discharged. Conclusion : The thrombocytopenia of the patient might be caused by ticagrelor. [ABSTRACT FROM AUTHOR]

Objective　To investigate the anti-inflammatory role of α7 nicotinic acetylcholine receptor (α7nAChR) under inflammatory stress and its mechanisms. Methods　PNU282987 was used for the activation of α7nAChR and LPS was administrated as inflammatory stressor. Realtime PCR was used for the detection of IL-1β, IL-6, TNF-α, M1 macrophage marker CD68, CD86 and M2 macrophage marker CD206, Arg1. Cell immunofluorescence was used for the detection of M1/M2 ratio and Western blot was applied for the detection of autophagy-related proteins. Results　Under the stimulation of LPS, the mRNA levels of proinflammatory cytokines IL-1β, IL-6 and TNF-α, the proportion of M1 macrophage and autophagy process were increased in BV2 microglial cells. However, the administration of PNU282987 significantly decreased the mRNA levels of IL-1β, IL-6 and TNF-α and the proportion of M1 macrophage while increased the proportion of M2 macrophage and the level of autophagy process. Conclusion　Activating α7nAChR plays an anti-inflammatory role in microglial cells under inflammatory stress due to the regulation of M1/M2 macrophage ratio and increase of autophagy level. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of cetuximab combined with chemotherapy versus chemotherapy alone in the treatment of metastatic colorectal cancer （MCC）. Methods: Literature corresponding to randomized controlled trials of cetuximab combined with chemotherapy versus chemotherapy alone in the treatment of MCC was retrieved from the PubMed, MEDLINE, EMBASE, Cochrane Library, the Wanfang Data-digitalization Journals, the Chinese Science and Technology Journals Database （VIP）, and the Chinese Journal Full-text Database from 2000-01-01 to 2014-06-30. Journals were also searched manually as supplement. The documents retrieved were classified, screened and internalized. Meta-analyses were performed by using RevMan 5.0 software. Results: Five reports involving 3286 patients in total were included in our study. The pooled overall response rate （ORR）, ORR in Kras wild-type population and progression-free survival（PFS）≥12 months rates were 34.79%, 55.49% and 9.84%, respectively in the cetuximab plus chemotherapy group, and were significantly higher than those [24.41%（P=0.006）, 40.77%（P=0.04） and 6.22%（P=0.04）] in the chemotherapy alone group. There were no significant differences in pooled overall survival （OS）≥1, 2 and 3-year rates, PFS≥6-month rate and ORR in the Kras mutation population between the two groups （P>0.05）. There were also no significant differences in the pooled 3-4 level neutropenia rates between the two groups, but the 3-4 level diarrhea rate was 20.13% in the cetuximab plus chemotherapy group, which was higher than that [12.28%（P<0.000 01）] in the chemotherapy alone group. Conclusion: The chemotherapy combined with cetuximab could elevate the ORR, PFS≥12-month rate and 3-4 level diarrhea rate, as compared with chemotherapy alone, but did not increase the OS≥1, 2 and 3-year rates or 3-4 level neutropenia rates. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effect of clinical pharmacists in treatment of renal failure patients with peritonitis caused byperitoneal dialysis. METHODS: Clinical pharmacists participated in treatment of a case of peritonitis caused by peritoneal dialysis，analyzed the rationality of antibacterial drugs application from the perspective of drug selection and administration route. RESULTS： Gram positive coccus was the common pathogenic bacteria of renal failure patients with peritonitis caused by peritoneal dialysis， which can be empirically treated with the first generation of cephalosporin. Based on the drug sensitive tests, vancomycin can be applied alone or combined with other antibacterial drugs when theeffects of the first generation of cephalosporin were poor. The intraperitoneal administration was the best administration route when the bloodstream infection was excluded. CONCLUSIONS： Clinical pharmacists should enrich themselves with knowledge，actively participate into the clinical treatment and give full play to clinical practice to improve the rational drug application. [ABSTRACT FROM AUTHOR]