2016 Vol. 34, No. 5
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2016, 34(5): 385-388,402.
doi: 10.3969/j.issn.1006-0111.2016.05.001
Abstract:
Human cytochrome P450 (CYP) 3A, which is widely involved in the various drug metabolism, is most abundant in liver and intestine. The activity of CYP3A enzyme may be induced or inhibited in the process of drug metabolisms, and affect the metabolism of other CYP3A substrates and modulators vice versa. At present, in vitro probe drugs and in vivo biomarkers are both available to evaluate the activity of CYP3A enzyme. The former requires oral probe drugs, the latter does not need for those drugs and just allows laboratory technicians to detect endogenous substrates, such as 4β-hydroxycholesterol and 6β-hydroxycortisol. As reported, studies on CYP3A help to explain the inter-individually variability in drug metabolism, to indicate dose adjustments in combination regimens when drug interactions exist, to predict drug efficacy and toxicity reaction for providing theoretical guidance for individualized medication, and to reduce market risk of new drugs for the potential drug interactions. We summarized these two kinds of endogenous biomarkers and their clinical application in this review.
Human cytochrome P450 (CYP) 3A, which is widely involved in the various drug metabolism, is most abundant in liver and intestine. The activity of CYP3A enzyme may be induced or inhibited in the process of drug metabolisms, and affect the metabolism of other CYP3A substrates and modulators vice versa. At present, in vitro probe drugs and in vivo biomarkers are both available to evaluate the activity of CYP3A enzyme. The former requires oral probe drugs, the latter does not need for those drugs and just allows laboratory technicians to detect endogenous substrates, such as 4β-hydroxycholesterol and 6β-hydroxycortisol. As reported, studies on CYP3A help to explain the inter-individually variability in drug metabolism, to indicate dose adjustments in combination regimens when drug interactions exist, to predict drug efficacy and toxicity reaction for providing theoretical guidance for individualized medication, and to reduce market risk of new drugs for the potential drug interactions. We summarized these two kinds of endogenous biomarkers and their clinical application in this review.
2016, 34(5): 389-392,398.
doi: 10.3969/j.issn.1006-0111.2016.05.002
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Clopidogrel is commonly used as an anti-platelet aggregation drug in the clinical treatment, which is often used in combination with traditional Chinese medicine. Strengthening the study on the interaction mechanism of Chinese herbal medicine and its active components with clopidogrel, to improve the effect of anti-platelet aggregation and the therapeutic effect of clopidogrel resistance. The research progress on the interaction of Chinese herbal medicine and its active components with clopidogrel were summarized in domestic and foreign literatures. Cytochrome P450, liver carboxylesterase, P glycoprotein is a major part of the interaction of traditional Chinese medicine and its active ingredient of clopidogrel. Some active components in Chinese medicine have synergistic effect of clopidogrel on platelet aggregation.
Clopidogrel is commonly used as an anti-platelet aggregation drug in the clinical treatment, which is often used in combination with traditional Chinese medicine. Strengthening the study on the interaction mechanism of Chinese herbal medicine and its active components with clopidogrel, to improve the effect of anti-platelet aggregation and the therapeutic effect of clopidogrel resistance. The research progress on the interaction of Chinese herbal medicine and its active components with clopidogrel were summarized in domestic and foreign literatures. Cytochrome P450, liver carboxylesterase, P glycoprotein is a major part of the interaction of traditional Chinese medicine and its active ingredient of clopidogrel. Some active components in Chinese medicine have synergistic effect of clopidogrel on platelet aggregation.
2016, 34(5): 393-395,473.
doi: 10.3969/j.issn.1006-0111.2016.05.003
Abstract:
Seaweed polysaccharides are not only a direct inhibitory effect on tumor cells, but also an indirect therapeutic effected by enhancing immune function or inhibiting tumor cell metastasis. Seaweed polysaccharides could inhibit the growth of tumor cells due to reducing tumor chemotherapy drug resistance and inhibiting free radical generation, accelerating free radical scavenging. Moreover, seaweed polysaccharides have a synergistic effect with chemotherapy drugs to reduce their side effects and protest patients from radiotherapy-induced immune cell damage. Therefore, seaweed polysaccharide could be used as adjuvant therapeutic agents. the antitumor activity and mechanism of seaweed polysaccharides were summarized, covering 28 articles published in the years from 2004 to 2015.
Seaweed polysaccharides are not only a direct inhibitory effect on tumor cells, but also an indirect therapeutic effected by enhancing immune function or inhibiting tumor cell metastasis. Seaweed polysaccharides could inhibit the growth of tumor cells due to reducing tumor chemotherapy drug resistance and inhibiting free radical generation, accelerating free radical scavenging. Moreover, seaweed polysaccharides have a synergistic effect with chemotherapy drugs to reduce their side effects and protest patients from radiotherapy-induced immune cell damage. Therefore, seaweed polysaccharide could be used as adjuvant therapeutic agents. the antitumor activity and mechanism of seaweed polysaccharides were summarized, covering 28 articles published in the years from 2004 to 2015.
2016, 34(5): 396-398.
doi: 10.3969/j.issn.1006-0111.2016.05.004
Abstract:
Chinese medicinal materials, as main treatment measures, are commonly used in clinic practice of Chinese traditional medicine with long history, and a significant proportion of Chinese medicinal material resources are from wild resource. Unreasonable exploitation and utilization of wild resources of Chinese medicinal material that happened in recent years make it a great challenge to sustainable development. This paper discussed on issues of Chinese medicinal material resources development and strategies of endanger species protection.
Chinese medicinal materials, as main treatment measures, are commonly used in clinic practice of Chinese traditional medicine with long history, and a significant proportion of Chinese medicinal material resources are from wild resource. Unreasonable exploitation and utilization of wild resources of Chinese medicinal material that happened in recent years make it a great challenge to sustainable development. This paper discussed on issues of Chinese medicinal material resources development and strategies of endanger species protection.
2016, 34(5): 399-402.
doi: 10.3969/j.issn.1006-0111.2016.05.005
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Objective To investigate the effect against exercise-indused fatigue in mice by aqueous extract of Ludisia discolor and its mechanism. Methods Male mice were randomly divided into five groups including low, middle, high dose groups [aqueous extract of Ludisia discolor at dose of 1.22, 2.44, 4.88 g/(kg·d) respectively], positive control group [aqueous extract of Rhodiola, at dose of 2.34 g/(kg·d)] and control group (distilled water). After intragastric administration for seven days, mice were measured for loading swimming time, and were tested 90 minutes after loading swimming for blood urea nitrogen, blood lactic acid and hepatic glycogen levels. Results The blood urea nitrogen was significantly decreased (P<0.05) in aqueous extract of Ludisia discolor groups, and hepatic glycogen was significantly increased (P<0.05) in a dose-dependent manner. The blood lactic acid was significantly decreased in high dose group, and weight loading swimming time was prolonged (P<0.05). The effects of Ludisia discolor is similar compared to Rhodiola. Conclusion The aqueous extract of Ludisia discolor has anti-fatigue action in mice. The mechanism might be related with the increased glycogen reserves, increased glucose aerobic decomposition, as well as reduced anaerobic glucolysis and reduced protein breakdown.
Objective To investigate the effect against exercise-indused fatigue in mice by aqueous extract of Ludisia discolor and its mechanism. Methods Male mice were randomly divided into five groups including low, middle, high dose groups [aqueous extract of Ludisia discolor at dose of 1.22, 2.44, 4.88 g/(kg·d) respectively], positive control group [aqueous extract of Rhodiola, at dose of 2.34 g/(kg·d)] and control group (distilled water). After intragastric administration for seven days, mice were measured for loading swimming time, and were tested 90 minutes after loading swimming for blood urea nitrogen, blood lactic acid and hepatic glycogen levels. Results The blood urea nitrogen was significantly decreased (P<0.05) in aqueous extract of Ludisia discolor groups, and hepatic glycogen was significantly increased (P<0.05) in a dose-dependent manner. The blood lactic acid was significantly decreased in high dose group, and weight loading swimming time was prolonged (P<0.05). The effects of Ludisia discolor is similar compared to Rhodiola. Conclusion The aqueous extract of Ludisia discolor has anti-fatigue action in mice. The mechanism might be related with the increased glycogen reserves, increased glucose aerobic decomposition, as well as reduced anaerobic glucolysis and reduced protein breakdown.
2016, 34(5): 403-407,415.
doi: 10.3969/j.issn.1006-0111.2016.05.006
Abstract:
Objective Experimental study on effects of Yangxinshi tablets in the prevention and treatment of chronic ischemic heart failure and acute myocardial ischemia reperfusion injury in order to provide a theoretical basis for its clinical application. Method Rat model of chronic ischemic heart failure and acute ischemia reperfusion mouse model of myocardial infarction were constructed through coronary artery ligation. Those animals were randomized to sham operation group, model group, positive drug group, high Yangxinshi tablet dose group, middle Yangxinshi tablet dose group, low Yangxinshi tablet dose group. Rat electrocardiogram, ultrasound, ACE, ACD, TNF-a, mouse myocardial infarction area, CK, LDH, SOD and related factors were recorded during pre-dosing and post-dosing after modeling. Morphological changes were observed with cardiac pathological section. Results The biochemical indicators in model group were significantly different from sham operation group with statistical significance (P<0.001). Compared to the model group, positive drug group and high Yangxinshi tablet dose group exhibited biochemical differences with statistical significance (P<0.001, P<0.01, P<0.05), significant myocardial infarction area reduction (P<0.01, P<0.05), improvement in myocardial cells and reduction in the cell infiltration. Conclusion Yangxinshi tablets have preventive and therapeutic effects on chronic ischemic heart failure and acute ischemia reperfusion injury.
Objective Experimental study on effects of Yangxinshi tablets in the prevention and treatment of chronic ischemic heart failure and acute myocardial ischemia reperfusion injury in order to provide a theoretical basis for its clinical application. Method Rat model of chronic ischemic heart failure and acute ischemia reperfusion mouse model of myocardial infarction were constructed through coronary artery ligation. Those animals were randomized to sham operation group, model group, positive drug group, high Yangxinshi tablet dose group, middle Yangxinshi tablet dose group, low Yangxinshi tablet dose group. Rat electrocardiogram, ultrasound, ACE, ACD, TNF-a, mouse myocardial infarction area, CK, LDH, SOD and related factors were recorded during pre-dosing and post-dosing after modeling. Morphological changes were observed with cardiac pathological section. Results The biochemical indicators in model group were significantly different from sham operation group with statistical significance (P<0.001). Compared to the model group, positive drug group and high Yangxinshi tablet dose group exhibited biochemical differences with statistical significance (P<0.001, P<0.01, P<0.05), significant myocardial infarction area reduction (P<0.01, P<0.05), improvement in myocardial cells and reduction in the cell infiltration. Conclusion Yangxinshi tablets have preventive and therapeutic effects on chronic ischemic heart failure and acute ischemia reperfusion injury.
2016, 34(5): 408-411.
doi: 10.3969/j.issn.1006-0111.2016.05.007
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Objective To discuss the signficance using nutrtional risk screening (NRS) to evaluate nutritional status in patients with severe stroke. In the meantime compare the clinical application value between enteral and parenteral nutritional support therapies. Methods A retrospective survey was adopted to analyze the nutritional status in 267 patients with severe stroke. Their nutritional statuses were evaluated by NRS 2002 nutrtional risk screening. Patients were divided into three groups, including enteral nutrition (EN) group, parenteral nutrition (PN) group and EN+PN group based on the type of their nutritional support. By comparing changes of indicators before and after of adiministration of nutritional support, the clinical efficacy and adverse reactions for each group were evaluated. Results In EN group and EN+PN group total protein and albumin level were significantly increased after 10 days nutritional support (P<0.05). Small changes in patients' liver and kidney function indices in EN group. The incidence of co-infection was 16.67% in EN group, which was lowest among three groups. Conclusion Enteral nutrition support could not only improve the nutritional status of patients with severe stroke, but also could reduce the incidence of infections and gastrointestinal complications. It significantly improves the prognosis of patients.
Objective To discuss the signficance using nutrtional risk screening (NRS) to evaluate nutritional status in patients with severe stroke. In the meantime compare the clinical application value between enteral and parenteral nutritional support therapies. Methods A retrospective survey was adopted to analyze the nutritional status in 267 patients with severe stroke. Their nutritional statuses were evaluated by NRS 2002 nutrtional risk screening. Patients were divided into three groups, including enteral nutrition (EN) group, parenteral nutrition (PN) group and EN+PN group based on the type of their nutritional support. By comparing changes of indicators before and after of adiministration of nutritional support, the clinical efficacy and adverse reactions for each group were evaluated. Results In EN group and EN+PN group total protein and albumin level were significantly increased after 10 days nutritional support (P<0.05). Small changes in patients' liver and kidney function indices in EN group. The incidence of co-infection was 16.67% in EN group, which was lowest among three groups. Conclusion Enteral nutrition support could not only improve the nutritional status of patients with severe stroke, but also could reduce the incidence of infections and gastrointestinal complications. It significantly improves the prognosis of patients.
2016, 34(5): 412-415.
doi: 10.3969/j.issn.1006-0111.2016.05.008
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Objective To evaluate effects of dexmedetomidine on onset, duration of supraclavicular brachial plexus block induced by levobupivacaine and postoperative analgesia with ultrasound guide. Methods Eighty patients undergoing elective surgeries of distal arm and forearm with class Ⅰ~Ⅱ ASA were enrolled, and the patients were randomly divided into two groups, one was control group (group C) patients with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 1 ml normal saline, the other was dexmedetomidine group patients (group D) with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 100 μg dexmedetomidine. The supraclavicular brachial plexus block was guided with ultrasound. Observation indicators include: sensory and motor onset blocks, duration of sensory and motor blocks, time to first rescue analgesia and hemodynamic parameters. Results The differences of sensory block onset between group C and D were not significant. Compared to group C, motor block onset of group D was significantly shorter (P<0.01), sensory block duration and motor block duration were longer (P<0.001), time to first rescue analgesia after the surgeries was longer (P<0.001). Mean arterial pressure and mean heart rate of group D were significantly lower than those of group C, respectively (P<0.02). Conclusions Dexmedetomidine can significantly prolong the duration of block and postoperative analgesia of supraclavicular brachial plexus block induced by levobupivacaine.
Objective To evaluate effects of dexmedetomidine on onset, duration of supraclavicular brachial plexus block induced by levobupivacaine and postoperative analgesia with ultrasound guide. Methods Eighty patients undergoing elective surgeries of distal arm and forearm with class Ⅰ~Ⅱ ASA were enrolled, and the patients were randomly divided into two groups, one was control group (group C) patients with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 1 ml normal saline, the other was dexmedetomidine group patients (group D) with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 100 μg dexmedetomidine. The supraclavicular brachial plexus block was guided with ultrasound. Observation indicators include: sensory and motor onset blocks, duration of sensory and motor blocks, time to first rescue analgesia and hemodynamic parameters. Results The differences of sensory block onset between group C and D were not significant. Compared to group C, motor block onset of group D was significantly shorter (P<0.01), sensory block duration and motor block duration were longer (P<0.001), time to first rescue analgesia after the surgeries was longer (P<0.001). Mean arterial pressure and mean heart rate of group D were significantly lower than those of group C, respectively (P<0.02). Conclusions Dexmedetomidine can significantly prolong the duration of block and postoperative analgesia of supraclavicular brachial plexus block induced by levobupivacaine.
2016, 34(5): 416-420,449.
doi: 10.3969/j.issn.1006-0111.2016.05.009
Abstract:
Objective To obtain iridoid glycosides with relatively high purity by the optimization of the preparation process of iridoid glycosides from Lamioplomisrotata. Methods Used methanol-water mobile phase with gradient run to set up an HPLC method and achieved the best separation of each composition. Recorded and calculated statistics for its three-dimensional absorption spectrum combined with UV visible wavelength scanning to analyze the characteristics of the impurities, which have affected the purity of previous preparations of iridoid glycosides from Lamioplomisrotata. To optimize the process, a macroporous adsorptive resin chromatographic column and a polyamide chromatographic column were used on the basis of characteristics of the impurities. A real time UV visible wavelength scan was applied to monitor the effluent components of each column to remove the impurities. Merged the ethanol elution which had the characteristic absorption at 235 nm and smaller absorptions at other wavelengths. The target solutions were cryodesiccated. Compared the differences of the iridoid glycoside compositions at equal concentrations before and after the experiment by HPLC. Results The contents of iridoid glycosides from Lamioplomisrotata before and after the purification process were 69.06% and 90.60% respectively. The yield was 16.70% (use the quality of the water extract as a reference).The transfer rate of iridoid glycosides was 74.72% (relative to the quality of water extract of total iridoid glycosides). Compared with the previous preparation technology, the content was increased to 21.54%. Conclusion The optimization process was simple and practicable with high efficiency, which made a significant improvement in the purity of the iridoid glycosides from Lamioplomisrotata.
Objective To obtain iridoid glycosides with relatively high purity by the optimization of the preparation process of iridoid glycosides from Lamioplomisrotata. Methods Used methanol-water mobile phase with gradient run to set up an HPLC method and achieved the best separation of each composition. Recorded and calculated statistics for its three-dimensional absorption spectrum combined with UV visible wavelength scanning to analyze the characteristics of the impurities, which have affected the purity of previous preparations of iridoid glycosides from Lamioplomisrotata. To optimize the process, a macroporous adsorptive resin chromatographic column and a polyamide chromatographic column were used on the basis of characteristics of the impurities. A real time UV visible wavelength scan was applied to monitor the effluent components of each column to remove the impurities. Merged the ethanol elution which had the characteristic absorption at 235 nm and smaller absorptions at other wavelengths. The target solutions were cryodesiccated. Compared the differences of the iridoid glycoside compositions at equal concentrations before and after the experiment by HPLC. Results The contents of iridoid glycosides from Lamioplomisrotata before and after the purification process were 69.06% and 90.60% respectively. The yield was 16.70% (use the quality of the water extract as a reference).The transfer rate of iridoid glycosides was 74.72% (relative to the quality of water extract of total iridoid glycosides). Compared with the previous preparation technology, the content was increased to 21.54%. Conclusion The optimization process was simple and practicable with high efficiency, which made a significant improvement in the purity of the iridoid glycosides from Lamioplomisrotata.
2016, 34(5): 421-423,446.
doi: 10.3969/j.issn.1006-0111.2016.05.010
Abstract:
Objective To clarify the necessity of therapeutic drug monitoring (TDM) of voriconazole, and give relevant clinical tips, by comparing the plasma concentration of different clinical specialties before and after adjustment of dose. Methods This is a retrospective study of voriconazole TDM data. It involves 435 cases voriconazole plasma trough concentration measurement results of 154 inpatients to make a preliminary assessment. Results 4.3% plasma concentration were higher than 5.5 μg/ml, 26.5% plasma concentration were less than 1.0 μg/ml in renal transplantation department; while 52.3% plasma concentration were higher than 5.5 μg/ml, no less than 1.0 μg/ml in infectious disease department. Conclusions Therapeutic drug monitoring is necessary for rational use of voriconazole. The majority of plasma concentrations in renal transplantation patients were <1.0 μg/ml, lower than recommended treatment concentration range; while most infectious disease patients have > 5.5 μg/ml, higher than recommended treatment concentration range. Clinical pharmacists can be more closely involved in the clinical use of voriconazole based on the results of the therapeutic drug monitoring.
Objective To clarify the necessity of therapeutic drug monitoring (TDM) of voriconazole, and give relevant clinical tips, by comparing the plasma concentration of different clinical specialties before and after adjustment of dose. Methods This is a retrospective study of voriconazole TDM data. It involves 435 cases voriconazole plasma trough concentration measurement results of 154 inpatients to make a preliminary assessment. Results 4.3% plasma concentration were higher than 5.5 μg/ml, 26.5% plasma concentration were less than 1.0 μg/ml in renal transplantation department; while 52.3% plasma concentration were higher than 5.5 μg/ml, no less than 1.0 μg/ml in infectious disease department. Conclusions Therapeutic drug monitoring is necessary for rational use of voriconazole. The majority of plasma concentrations in renal transplantation patients were <1.0 μg/ml, lower than recommended treatment concentration range; while most infectious disease patients have > 5.5 μg/ml, higher than recommended treatment concentration range. Clinical pharmacists can be more closely involved in the clinical use of voriconazole based on the results of the therapeutic drug monitoring.
2016, 34(5): 424-427.
doi: 10.3969/j.issn.1006-0111.2016.05.011
Abstract:
Objective To establish the quality control standards for Compound caulis Polygoni multiflori mixture. Methods Caulis polygoni multiflori, cortex alibiziae and schisand chinensis were identified by TLC, total flavonoids were determined by UV. Results Caulis polygoni multiflori,cortex alibiziae and schisand chinensis could be detected by TLC. A better linear relationship between concentration and absorbance in the range of 9.12~27.36 μg/ml. The linear regression equation was A=0.034 55 C-0.110 34 (r=0.999 2), The average recovery of emodin was 101.0%(RSD=1.58%). Conclusion The method is simple, quick, accurate and sensitive, which could be used as a quantitative analysis method for this preparation.
Objective To establish the quality control standards for Compound caulis Polygoni multiflori mixture. Methods Caulis polygoni multiflori, cortex alibiziae and schisand chinensis were identified by TLC, total flavonoids were determined by UV. Results Caulis polygoni multiflori,cortex alibiziae and schisand chinensis could be detected by TLC. A better linear relationship between concentration and absorbance in the range of 9.12~27.36 μg/ml. The linear regression equation was A=0.034 55 C-0.110 34 (r=0.999 2), The average recovery of emodin was 101.0%(RSD=1.58%). Conclusion The method is simple, quick, accurate and sensitive, which could be used as a quantitative analysis method for this preparation.
2016, 34(5): 428-430,440.
doi: 10.3969/j.issn.1006-0111.2016.05.012
Abstract:
Objective To develop a HPLC-fluorescence method to determine levofloxacin concentration in plasma for studying bioequivalence of levofloxacin hydrochloride tablet in Chinese healthy volunteers. Methods A single-dose of 0.2 g test or reference preparation was given to 24 healthy volunteers in a randomized crossover study. The concentrations of levofloxacin at different time points were determined by HPLC with fluorescence detection. The pharmacokinetic parameters were calculated using DAS 2.0 software program. Results The main pharmacokinetic parameters of the test and reference preparation,t 1/2、tmax、ρmax、AUC0-36 and AUC0-inf, were respectively (6.71±0.95) h and (6.60±1.00) h,(0.85±0.30) h and (0.79±0.28) h,(2 815.48±513.04) ng/ml and (3 185.59±674.29) ng/ml,(17 157.61±1 949.07) ng·h/ml and (17 425.06±2 447.80) ng·h/ml,(18 324.52±2 019.41) ng·h/ml and (18 540.41±2 523.08) ng·h/ml. The statistical analysis showed that the main pharmacokinetic parameters between test and reference preparations were no significant differences. The 90% confidence interval of test and reference preparations AUC0-36、AUC0-inf and ρmax were 95.2%~102.5%、96.1%~102.2% and 82.8%~94.9%. Conclusion The test and reference preparations were bioequivalent.
Objective To develop a HPLC-fluorescence method to determine levofloxacin concentration in plasma for studying bioequivalence of levofloxacin hydrochloride tablet in Chinese healthy volunteers. Methods A single-dose of 0.2 g test or reference preparation was given to 24 healthy volunteers in a randomized crossover study. The concentrations of levofloxacin at different time points were determined by HPLC with fluorescence detection. The pharmacokinetic parameters were calculated using DAS 2.0 software program. Results The main pharmacokinetic parameters of the test and reference preparation,t 1/2、tmax、ρmax、AUC0-36 and AUC0-inf, were respectively (6.71±0.95) h and (6.60±1.00) h,(0.85±0.30) h and (0.79±0.28) h,(2 815.48±513.04) ng/ml and (3 185.59±674.29) ng/ml,(17 157.61±1 949.07) ng·h/ml and (17 425.06±2 447.80) ng·h/ml,(18 324.52±2 019.41) ng·h/ml and (18 540.41±2 523.08) ng·h/ml. The statistical analysis showed that the main pharmacokinetic parameters between test and reference preparations were no significant differences. The 90% confidence interval of test and reference preparations AUC0-36、AUC0-inf and ρmax were 95.2%~102.5%、96.1%~102.2% and 82.8%~94.9%. Conclusion The test and reference preparations were bioequivalent.
2016, 34(5): 431-436,454.
doi: 10.3969/j.issn.1006-0111.2016.05.013
Abstract:
Objective To study the chemical constituents from the Stichopus variegatus. Method The compounds were isolated and purified by silica gel column chromatography, Sephadex LH-20 gel filtration and recrystallization. The structures of these compounds were identified through chemical reactions and spectral analyses, such as IR,1H,13C NMR,MS. Results Three compounds were identified as 3-O-[3-O-methyl-β-D-glucopyranosyl(1→3)-β-D-xylopyranosyl(1→3)-β-D-glucopyranosyl(1→2)-β-D-xylopyranosyl]-holosta-7,24-diene-3β,23S-diol, named as variegatuside C; 3-O-{3-O-methyl-β-D-glucopy-ranosyl(1→3)-β-D-xylopyranosyl(1→4)-β-D-glucopyranosyl(1→2)[β-D-glucopyranosyl(1→4)]-β-D-xylopyranosyl-holosta-8-ene-3β,23S-diol, named as variegatuside D; 3-O-{3-O-methyl-β-D-glucopyranosyl(1→3)-β-D-xylopyranosyl(1→4)-β-D-glucopyranosyl(1→2)[3-O-methyl-β-D-glucopyranosyl(1→3)-β-D-glucopyranosyl(1→4)]-β-D-xylopyranosyl｝-holosta-9-ene-3β,23S-diol, named as variegatuside E. Conclusion All three compounds are new compounds.
Objective To study the chemical constituents from the Stichopus variegatus. Method The compounds were isolated and purified by silica gel column chromatography, Sephadex LH-20 gel filtration and recrystallization. The structures of these compounds were identified through chemical reactions and spectral analyses, such as IR,1H,13C NMR,MS. Results Three compounds were identified as 3-O-[3-O-methyl-β-D-glucopyranosyl(1→3)-β-D-xylopyranosyl(1→3)-β-D-glucopyranosyl(1→2)-β-D-xylopyranosyl]-holosta-7,24-diene-3β,23S-diol, named as variegatuside C; 3-O-{3-O-methyl-β-D-glucopy-ranosyl(1→3)-β-D-xylopyranosyl(1→4)-β-D-glucopyranosyl(1→2)[β-D-glucopyranosyl(1→4)]-β-D-xylopyranosyl-holosta-8-ene-3β,23S-diol, named as variegatuside D; 3-O-{3-O-methyl-β-D-glucopyranosyl(1→3)-β-D-xylopyranosyl(1→4)-β-D-glucopyranosyl(1→2)[3-O-methyl-β-D-glucopyranosyl(1→3)-β-D-glucopyranosyl(1→4)]-β-D-xylopyranosyl｝-holosta-9-ene-3β,23S-diol, named as variegatuside E. Conclusion All three compounds are new compounds.
2016, 34(5): 437-440.
doi: 10.3969/j.issn.1006-0111.2016.05.014
Abstract:
Objective To analyze the outputof hotliteratures on pharmacology & toxicology in the world. Methods Essential Science Indicators Database were retrievedandthe national distribution, published journals and hot research topics of hot literatures were analyzed. Results There were 76 papers in ESI on pharmacology & toxicology,which were publishedin 22 countries or regions, involved 5 hot research topics. Conclusion The influence of hot literatures on pharmacology & toxicology from China was behind European and American countries. Chinese journals should focus on the hot research on pharmacological & toxicology and improve the influence and scope of journals.
Objective To analyze the outputof hotliteratures on pharmacology & toxicology in the world. Methods Essential Science Indicators Database were retrievedandthe national distribution, published journals and hot research topics of hot literatures were analyzed. Results There were 76 papers in ESI on pharmacology & toxicology,which were publishedin 22 countries or regions, involved 5 hot research topics. Conclusion The influence of hot literatures on pharmacology & toxicology from China was behind European and American countries. Chinese journals should focus on the hot research on pharmacological & toxicology and improve the influence and scope of journals.
2016, 34(5): 441-442.
doi: 10.3969/j.issn.1006-0111.2016.05.015
Abstract:
Objective To develop a HPLC method for psoralenand angelicin content assay in Zhuanggu granules. Methods Agilent Zorbax C18 column(4.6 mm×250 mm, 5 μm) was used with methanol and water(45:55) as mobile phase. The detection wavelength was set at 245 nm. The flow rate was 1.0 ml/min and column temperature at 25 ℃. The injection volume was 10 μl.Psoralenand angelicin were extracted with 70% ethanol under water bath. Results The linearity was obtained over 3.75~40 μg/mlfor psoralenand angelicin. The RSDs were less than 2%. The average recovery was between 94% and 105%. Conclusion This simple and accurate HPLC method was suitable for the quality control of Zhuanggu granules.
Objective To develop a HPLC method for psoralenand angelicin content assay in Zhuanggu granules. Methods Agilent Zorbax C18 column(4.6 mm×250 mm, 5 μm) was used with methanol and water(45:55) as mobile phase. The detection wavelength was set at 245 nm. The flow rate was 1.0 ml/min and column temperature at 25 ℃. The injection volume was 10 μl.Psoralenand angelicin were extracted with 70% ethanol under water bath. Results The linearity was obtained over 3.75~40 μg/mlfor psoralenand angelicin. The RSDs were less than 2%. The average recovery was between 94% and 105%. Conclusion This simple and accurate HPLC method was suitable for the quality control of Zhuanggu granules.
2016, 34(5): 443-446.
doi: 10.3969/j.issn.1006-0111.2016.05.016
Abstract:
Objective To establish a high performance liquid chromatography method for the determination of matrine in Lefu oral liquid. Methods The HPLC method was performed on a Diamonsil Platisil NH2 column (4.6 mm×250 mm, 5 μm) with the mobile phase of acetonitrile-isopropyl alcohol-3% phosphoric acid solution (84:4:12). The flow rate was 1.2 ml/min. The sample injection volume was 5 μl. The detective wavelength was 205 nm. Results The calibration curve of matrine showed good linear response ranged from 54.50 to 872.00 μg/ml with r=0.999 1. The average recovery of spiked samples for matrine was 99.82% while the relative standard deviation for repetitions was 1.12%. Conclusion The method was simple, reliable and repeatable, which could be used for the quantitative determination of matrine of Lefu oral liquid.
Objective To establish a high performance liquid chromatography method for the determination of matrine in Lefu oral liquid. Methods The HPLC method was performed on a Diamonsil Platisil NH2 column (4.6 mm×250 mm, 5 μm) with the mobile phase of acetonitrile-isopropyl alcohol-3% phosphoric acid solution (84:4:12). The flow rate was 1.2 ml/min. The sample injection volume was 5 μl. The detective wavelength was 205 nm. Results The calibration curve of matrine showed good linear response ranged from 54.50 to 872.00 μg/ml with r=0.999 1. The average recovery of spiked samples for matrine was 99.82% while the relative standard deviation for repetitions was 1.12%. Conclusion The method was simple, reliable and repeatable, which could be used for the quantitative determination of matrine of Lefu oral liquid.
2016, 34(5): 447-449.
doi: 10.3969/j.issn.1006-0111.2016.05.017
Abstract:
Objective To establish an HPLC quantitative method for the content determination of baicalin in Kangdeling capsule. Methods The chromatography column was Agilent Tc-C18-WR (4.6 mm×250 mm,5 μm),and the column temperature was 30 ℃.The mobile phase consisted of acetonitrile and 0.5‰ phosphoric acid (26:74).The flow rate was 1.0 ml/min, and the detection wavelength was 265 nm. Results The retention time of baicalin was about 16 min. The calibration equation was Y=22 114.67 X-112 836.7(r=0998 8)with good linearity in the range of 5.410-108.2 μg/ml for baicalin. The average recovery was 98.78% while RSD were 0.74%. Conclusion This method is simple, time-saving and accurate which could be used to routine analysis of baicalin in Kangdeling capsule.
Objective To establish an HPLC quantitative method for the content determination of baicalin in Kangdeling capsule. Methods The chromatography column was Agilent Tc-C18-WR (4.6 mm×250 mm,5 μm),and the column temperature was 30 ℃.The mobile phase consisted of acetonitrile and 0.5‰ phosphoric acid (26:74).The flow rate was 1.0 ml/min, and the detection wavelength was 265 nm. Results The retention time of baicalin was about 16 min. The calibration equation was Y=22 114.67 X-112 836.7(r=0998 8)with good linearity in the range of 5.410-108.2 μg/ml for baicalin. The average recovery was 98.78% while RSD were 0.74%. Conclusion This method is simple, time-saving and accurate which could be used to routine analysis of baicalin in Kangdeling capsule.
2016, 34(5): 450-454.
doi: 10.3969/j.issn.1006-0111.2016.05.018
Abstract:
Objective To establish a quality control standard for Qingre Baidu granules. Methods Isatidis Radix, Fructus Forsythiae,Herba Violae, and Glycyrrhizae were identified by TLC, and the concentration of chlorogenic acid was determined by HPLC. This method was employed on an Agilent ZORBAX SB-C18 column (4.6 mm×250 mm, 5 μm) at 30℃ with a mobile phase of acetonitrile (A) and 0.2% formic acid (B) using the gradient elution program shown as follows: 0-12 min, 11%-12% A run at the flow rate of 1.0 ml/min. The injection volume was 20 μl and the detection wavelength was 327 nm. Results Characteristic spots could be detected by TLC and the specificity of the method was satisfactory. As for chlorogenic acid, the equation of linear regression of chlorogenic acid was Y=60.239 4X+9.096 3 (r=0.999 9) with the linear range of 6.19-396.00 μg/ml. The average recovery was 99.66% (RSD=2.82%). Conclusion The established method is simple, reliable, reproducible, and can be used for the quantitative determination and quality control of Qingre Baidu granules.
Objective To establish a quality control standard for Qingre Baidu granules. Methods Isatidis Radix, Fructus Forsythiae,Herba Violae, and Glycyrrhizae were identified by TLC, and the concentration of chlorogenic acid was determined by HPLC. This method was employed on an Agilent ZORBAX SB-C18 column (4.6 mm×250 mm, 5 μm) at 30℃ with a mobile phase of acetonitrile (A) and 0.2% formic acid (B) using the gradient elution program shown as follows: 0-12 min, 11%-12% A run at the flow rate of 1.0 ml/min. The injection volume was 20 μl and the detection wavelength was 327 nm. Results Characteristic spots could be detected by TLC and the specificity of the method was satisfactory. As for chlorogenic acid, the equation of linear regression of chlorogenic acid was Y=60.239 4X+9.096 3 (r=0.999 9) with the linear range of 6.19-396.00 μg/ml. The average recovery was 99.66% (RSD=2.82%). Conclusion The established method is simple, reliable, reproducible, and can be used for the quantitative determination and quality control of Qingre Baidu granules.
2016, 34(5): 455-458.
doi: 10.3969/j.issn.1006-0111.2016.05.019
Abstract:
Objective To optimize the cream base of benzhydramine hydroehloride. Methods Five nonionic surfactants as an emulsifier were used to prepare benzhydramine hydroehloride creams. The five sorts of cream were evaluated from the appearance,preliminary stability, accelerated test stability and room temperature stability. Results Benzhydramine hydroehloride cream could be prepared using five nonionic surfactants. On appearance of smoothness, gloss and spread, formula E was best but formula A was worst, while formulas B and D were close and worse than formula E only. In the stability tests, all of creams had no obvious change after the centrifugal experiment and the low temperature experiment. In the high temperature experiment, the formula E was stable, formulas A, B and D showed a little appearance change, and the formula C became layered bleeding. In room temperature, the formula C became bleeding after five days, which happened to the formula A after one month, and formula B after two months. The formulas D and E had no obvious change until six months in room temperature. Conclusion The formulas D and E were stable, which had clinical application value.
Objective To optimize the cream base of benzhydramine hydroehloride. Methods Five nonionic surfactants as an emulsifier were used to prepare benzhydramine hydroehloride creams. The five sorts of cream were evaluated from the appearance,preliminary stability, accelerated test stability and room temperature stability. Results Benzhydramine hydroehloride cream could be prepared using five nonionic surfactants. On appearance of smoothness, gloss and spread, formula E was best but formula A was worst, while formulas B and D were close and worse than formula E only. In the stability tests, all of creams had no obvious change after the centrifugal experiment and the low temperature experiment. In the high temperature experiment, the formula E was stable, formulas A, B and D showed a little appearance change, and the formula C became layered bleeding. In room temperature, the formula C became bleeding after five days, which happened to the formula A after one month, and formula B after two months. The formulas D and E had no obvious change until six months in room temperature. Conclusion The formulas D and E were stable, which had clinical application value.
2016, 34(5): 459-462.
doi: 10.3969/j.issn.1006-0111.2016.05.020
Abstract:
Objective To summarize the clinical experience of bortezomib-based treatment for Waldenström macroglobulinemia and evaluate the therapeutic efficacy and safety. Methods The clinical data were collected for 15 patients with Waldenström macroglobulinemia receiving bortezomib-based treatment from December 2008 to October 2015.Three therapeutic regimens included BD (bortezomib and dexamethasone) in one case, RBD (bortezomib, rituximab and dexamethasone) in three cases and BCD (bortezomib, dexamethasone and cyclophosphamide) in eleven cases.Responses, adverse reactions and survival analysis were evaluated respectively. Results The overall response rate and major response rate were 93.3% and 80% including CR 1 case, VGPR 2 cases, PR 9 cases and MR 2 cases. The common adverse events included gastrointestinal (53.3%), leukopenia (20%), infection (20%) and peripheral neuropathy (26.7%). After a median follow-up of 21 (3-85) months, the median PFS (progression-free survival) time was 21 (3-36) months and 1 year PFS rate was 83.3%. Survival analysis showed that two prognostic risk factors related to PFS were high-risk group based on international prognostic scoring system for WM(IPSSWM)(P=0.015) and the low response to treatment (P=0.024). Conclusion Bortezomib-based therapeutic regimensexhibited significant efficacyfor patients with WM. IPSSWM and the responses to treatment can be usedto monitor the disease progression and evaluate the therapeutic result.
Objective To summarize the clinical experience of bortezomib-based treatment for Waldenström macroglobulinemia and evaluate the therapeutic efficacy and safety. Methods The clinical data were collected for 15 patients with Waldenström macroglobulinemia receiving bortezomib-based treatment from December 2008 to October 2015.Three therapeutic regimens included BD (bortezomib and dexamethasone) in one case, RBD (bortezomib, rituximab and dexamethasone) in three cases and BCD (bortezomib, dexamethasone and cyclophosphamide) in eleven cases.Responses, adverse reactions and survival analysis were evaluated respectively. Results The overall response rate and major response rate were 93.3% and 80% including CR 1 case, VGPR 2 cases, PR 9 cases and MR 2 cases. The common adverse events included gastrointestinal (53.3%), leukopenia (20%), infection (20%) and peripheral neuropathy (26.7%). After a median follow-up of 21 (3-85) months, the median PFS (progression-free survival) time was 21 (3-36) months and 1 year PFS rate was 83.3%. Survival analysis showed that two prognostic risk factors related to PFS were high-risk group based on international prognostic scoring system for WM(IPSSWM)(P=0.015) and the low response to treatment (P=0.024). Conclusion Bortezomib-based therapeutic regimensexhibited significant efficacyfor patients with WM. IPSSWM and the responses to treatment can be usedto monitor the disease progression and evaluate the therapeutic result.
2016, 34(5): 463-465.
doi: 10.3969/j.issn.1006-0111.2016.05.021
Abstract:
Objective To evaluate the suppressive effect of dezocine, lidocaine and ephedrine on fentanyl-induced cough. Methods A total of 120 patients ASA I-II, scheduled for elective surgery under general anesthesia, were randomly allocated into four groups (n=30, each group). Group Ⅰ,Ⅱ,Ⅲ, Ⅳ were given saline (2 ml), dezocine (0.1 mg/kg), lidocaine(1 mg/kg) or ephedrine(5 mg), respectively. One minute later all patients were injected with 4 μg/kg of fentanyl, after another one minute, all patients were given midazolam(0.1 mg/kg)+ propofol(2 mg/kg,0.4 ml/s)+cisatracurium (0.2 mg/kg). The incidence rate and severity of cough were recorded and hemodynamic parameters were also observed. Results The incidence rate of cough was 50%, 16.7%, 13.3% and 20% for group Ⅰ,Ⅱ,Ⅲ and Ⅳ, respectively. Comparing to group I, the incidence rate of cough was significantly lower (P<0.05) in other groups, but among the three experimental groups there was no significant difference in cough incidence rate and intensity. The hemodynamic changed of each group before and after the induction was consistent. Conclusion A priming dose of dezocine(0.1 mg/kg), lidocaine (1 mg/kg) or ephedrine (5 mg) could effectively reduce the Fentanyl-induced cough response.
Objective To evaluate the suppressive effect of dezocine, lidocaine and ephedrine on fentanyl-induced cough. Methods A total of 120 patients ASA I-II, scheduled for elective surgery under general anesthesia, were randomly allocated into four groups (n=30, each group). Group Ⅰ,Ⅱ,Ⅲ, Ⅳ were given saline (2 ml), dezocine (0.1 mg/kg), lidocaine(1 mg/kg) or ephedrine(5 mg), respectively. One minute later all patients were injected with 4 μg/kg of fentanyl, after another one minute, all patients were given midazolam(0.1 mg/kg)+ propofol(2 mg/kg,0.4 ml/s)+cisatracurium (0.2 mg/kg). The incidence rate and severity of cough were recorded and hemodynamic parameters were also observed. Results The incidence rate of cough was 50%, 16.7%, 13.3% and 20% for group Ⅰ,Ⅱ,Ⅲ and Ⅳ, respectively. Comparing to group I, the incidence rate of cough was significantly lower (P<0.05) in other groups, but among the three experimental groups there was no significant difference in cough incidence rate and intensity. The hemodynamic changed of each group before and after the induction was consistent. Conclusion A priming dose of dezocine(0.1 mg/kg), lidocaine (1 mg/kg) or ephedrine (5 mg) could effectively reduce the Fentanyl-induced cough response.
2016, 34(5): 466-468,477.
doi: 10.3969/j.issn.1006-0111.2016.05.022
Abstract:
Objective To evaluate opioids utilization of cancer ached inpatients in the integrative traditional Chinese and western medicine hospital and provide suggestion for the rational utilization of opioids. Method DDDs,DUI,the distribution of cancer pain,pain scores of the discharged patients and the utility of opioids were evaluated and analyzed by retrieving the medical records from January in 2013 to December in 2014. Results 292 medical records were selected and analyzed.Among them,89 patients' pain score≥3.The top opioids of DDDs were sufentanil citrate injection and fentanyl derivatives,which is the main medication in treating the cancer pain patients.And the irrationaluseof fentanyl transdermal system was a common phenomenon among different departments. Conclusion Theutilization of opioids was basically rational,but there still had some deficiencies. The intervention and management of narcotic drugs should be strengthened and deepened.
Objective To evaluate opioids utilization of cancer ached inpatients in the integrative traditional Chinese and western medicine hospital and provide suggestion for the rational utilization of opioids. Method DDDs,DUI,the distribution of cancer pain,pain scores of the discharged patients and the utility of opioids were evaluated and analyzed by retrieving the medical records from January in 2013 to December in 2014. Results 292 medical records were selected and analyzed.Among them,89 patients' pain score≥3.The top opioids of DDDs were sufentanil citrate injection and fentanyl derivatives,which is the main medication in treating the cancer pain patients.And the irrationaluseof fentanyl transdermal system was a common phenomenon among different departments. Conclusion Theutilization of opioids was basically rational,but there still had some deficiencies. The intervention and management of narcotic drugs should be strengthened and deepened.
2016, 34(5): 469-473.
doi: 10.3969/j.issn.1006-0111.2016.05.023
Abstract:
Objective To formulate the clinical application specification of antibiotics, make a deference index of antibacterial drugs in chest department according to the investigation about the antibiotics' utility situation in chest department in 2014 and provide a theoretic foundation for the clinical doctor to promote the clinical rational drug use. Methods The antibiotics' application information of 300 cases inpatients in the chest department of a hospital in 2014 were researched and analyzed through retrospection, regarding with the relevant regulations and related clinical practice guidelines, the clinical application specification of antibiotics was formulated and the analysis,calculation, statistics to the actual and theoretical value of the rate and intensity of antibiotics' application, the application rate of the prophylactic antibiotics of type I incision on the inpatients in the chest department had been done. The differentiation index of them were establish. Results The rates of the actual antibiotics' application and the prophylactic antibiotics of type I incision respectively were 72.7% and 92.6%, while the intensity of antibiotics' application was 61.2 DDDs/(100 persons·d). The deference indexes of them were developed 69.3%, 63.0% and 49.3 DDDs/(100 persons·d). Conclusions There're still much irrational places in the use of antibiotics in chest department of the hospital. It's essential to strengthen supervision in order to promote the rational use of antibiotics in clinical practice.
Objective To formulate the clinical application specification of antibiotics, make a deference index of antibacterial drugs in chest department according to the investigation about the antibiotics' utility situation in chest department in 2014 and provide a theoretic foundation for the clinical doctor to promote the clinical rational drug use. Methods The antibiotics' application information of 300 cases inpatients in the chest department of a hospital in 2014 were researched and analyzed through retrospection, regarding with the relevant regulations and related clinical practice guidelines, the clinical application specification of antibiotics was formulated and the analysis,calculation, statistics to the actual and theoretical value of the rate and intensity of antibiotics' application, the application rate of the prophylactic antibiotics of type I incision on the inpatients in the chest department had been done. The differentiation index of them were establish. Results The rates of the actual antibiotics' application and the prophylactic antibiotics of type I incision respectively were 72.7% and 92.6%, while the intensity of antibiotics' application was 61.2 DDDs/(100 persons·d). The deference indexes of them were developed 69.3%, 63.0% and 49.3 DDDs/(100 persons·d). Conclusions There're still much irrational places in the use of antibiotics in chest department of the hospital. It's essential to strengthen supervision in order to promote the rational use of antibiotics in clinical practice.
2016, 34(5): 474-477.
doi: 10.3969/j.issn.1006-0111.2016.05.024
Abstract:
Objective To investigate the effect of clinical pharmacists in the analgesic therapysoas to improve the rational use of analgesic drugs. Methods Clinical pharmacists participated in the formulation of drug therapy plan for the patient of cancer pain with renal insufficiency in respects of drug selection, dosage and adverse reaction monitoring. Results Physicians accepted suggestions from clinical pharmacists.The first day, the morphine hydrochloride tablets were used for rapid titration. The next day doxycodone were used, adding the morphine hydrochloride tablets when required. After the pain was controlled stability, the transdermal fentanyl was used to alleviate the damage of kidney. Conclusion The clinical pharmacist could assist clinicians to adjust the therapeutic regimen of the cancer patients with severe pain and improve the level of clinical drug treatment.
Objective To investigate the effect of clinical pharmacists in the analgesic therapysoas to improve the rational use of analgesic drugs. Methods Clinical pharmacists participated in the formulation of drug therapy plan for the patient of cancer pain with renal insufficiency in respects of drug selection, dosage and adverse reaction monitoring. Results Physicians accepted suggestions from clinical pharmacists.The first day, the morphine hydrochloride tablets were used for rapid titration. The next day doxycodone were used, adding the morphine hydrochloride tablets when required. After the pain was controlled stability, the transdermal fentanyl was used to alleviate the damage of kidney. Conclusion The clinical pharmacist could assist clinicians to adjust the therapeutic regimen of the cancer patients with severe pain and improve the level of clinical drug treatment.
2016, 34(5): 478-480.
doi: 10.3969/j.issn.1006-0111.2016.05.025
Abstract:
Objective To enhance oral tablets ward pharmacy inventory efficiency and improve the comprehensive quality of the pharmacist by QCC activities. Method Main factors to extend the ward pharmacy tablet counting time were analyzed through collecting the previous ward pharmacy tablet count time and account matching rate. According to the main problems, the strategies were found out to be implemented, identify and evaluate the implementation result. Result In view of the oral medicine ward pharmacy inventory of the reasons for the low efficiency, following measures should be taken: reducing oral drug dispensing station varieties, finishing cargo, strengthening personnel training, changing inventory counting method and optimization of inventory materials and re-enacted drugs location code and so on. Ward pharmacy tablet counting time reduce from 6.5 hours to 3 hours (reducing by 53.85%). Conclusion The QCC activities could significantly improve the oral medicine ward pharmacy inventory efficiency and comprehensive quality of pharmacists.
Objective To enhance oral tablets ward pharmacy inventory efficiency and improve the comprehensive quality of the pharmacist by QCC activities. Method Main factors to extend the ward pharmacy tablet counting time were analyzed through collecting the previous ward pharmacy tablet count time and account matching rate. According to the main problems, the strategies were found out to be implemented, identify and evaluate the implementation result. Result In view of the oral medicine ward pharmacy inventory of the reasons for the low efficiency, following measures should be taken: reducing oral drug dispensing station varieties, finishing cargo, strengthening personnel training, changing inventory counting method and optimization of inventory materials and re-enacted drugs location code and so on. Ward pharmacy tablet counting time reduce from 6.5 hours to 3 hours (reducing by 53.85%). Conclusion The QCC activities could significantly improve the oral medicine ward pharmacy inventory efficiency and comprehensive quality of pharmacists.
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