Objective To evaluate the efficacy of medroxyprogesterone acetate(MA)plus metformin as the primary fertility-sparing treatment for atypical endometrial hyperplasia(AEH)and early-stage grade 1 endometrial adenocarcinom...Objective To evaluate the efficacy of medroxyprogesterone acetate(MA)plus metformin as the primary fertility-sparing treatment for atypical endometrial hyperplasia(AEH)and early-stage grade 1 endometrial adenocarcinoma(G1 EAC)and the recurrence rate after treatment.Methods Sixty patients(aged 20-42 years)with AEH and/or grade 1 EAC limited to the endometrium were enrolled prospectively and randomized into two groups(n=30)to receive oral MA treatment at the daily dose of 160 mg(control)or MA plus oral metformin(850 mg,twice a day)for at least 6 months.The treatment could extend to 12 months until a complete response(CR)was achieved,and follow-up hysteroscopy and curettage were performed every 3 months.For all the patients who achieved CR,endometrial expressions of IGFBP-rP1,p-Akt and p-AMPK were detected immunohistochemically.Results A total of 58 patients completed the treatment.After 9 months of treatment,23(76.7%)patients in the combined treatment group and 20(71.4%)in the control group achieved CR;two patients in the control group achieved CR after converting to the combined treatment.The recurrence rate did not differ significantly between the control group and combined treatment group(30.0%vs 22.7%,P>0.05).Ten(35.7%)patients in the control group experienced significant weight gain of 5.7±6.1 kg,while none of the patients receiving the combined treatment exhibited significant body weight changes.Compared with the control group,the patients receiving the combined treatment showed enhanced endometrial expressions of IGFBP-rP1 and p-AMPK with lowered p-Akt expression.Conclusion Metformin combined with MA may provide an effective option for fertility-sparing treatment of AEH and grade 1 stage IA EAC,and the clinical benefits of metformin for controlling MA-induced weight gain and promoting endometrial expressions of IGFBP-rP1 and p-AMPK while inhibiting p-Akt expression warrants further study.展开更多
Zero addition of drugs is an important aspect of medication reformation in the whole country, which is the end of the era of medicine. The role of pharmacists is changing from being medication dispensers to outcome-or...Zero addition of drugs is an important aspect of medication reformation in the whole country, which is the end of the era of medicine. The role of pharmacists is changing from being medication dispensers to outcome-oriented and patient-focused care providers. However, it is still unclear how to play the role of pharmacists and carry out the related work in the new situation. Here, literature for relevant evidence was searched and summarized. Analysis results showed that there was a significant gap between pharmacy practice in China and developed countries. Evidence has supported pharmacists in their emerging role as care providers, that is available to improve the efficacy and quality of pharmaceutical care and ensure the safety of medicines for patients, but still more efforts are needed to promote new attitude toward more professional career, such as paying attention to the examination of outpatient prescription and medical orders, deeply clinical practice and individualized treatment, self-enhancement and public awareness of pharmacists. Collectively, the safety of patients can be ensured only by improving profession of pharmacists and showing the value of pharmacists. In doing so, pharmacy can develop rapidly, and pharmaceutical care with rational drug use can be realized.展开更多
Objective： To explore the short and long-term efficacy of combining electroacupuncture（EA） and Qibei mixture in the treatment of irritable bowel syndrome（IBSD）.Methods： Six hundred and forty-four patients with c...Objective： To explore the short and long-term efficacy of combining electroacupuncture（EA） and Qibei mixture in the treatment of irritable bowel syndrome（IBSD）.Methods： Six hundred and forty-four patients with confirmed IBSD from the Department of Gastroenterology, the First Affiliated Hospital of Xinxiang Medical University in China, recruited from July 2012 to June 2016, were randomly divided into four groups, the EA group, Qibei mixture group, combination group and medication group with 161 patients in each group. The patients in the EA group were treated with EA at zúsānlǐ（足三里ST36）. Gān shù（肝俞BL18）, Pǐshù（脾俞BL20）. Tàichōng（太冲LR36） and Qízhōngsìbiān（脐中四边）once daily for 4 weeks, while the patients in the Qibei mixture group were treated with 50 mL of Qibei mixture twice daily, the combination group with the above-mentioned EA and Qibei mixture, and the medication group with 1 tablet compound diphenoxylate twice, 3 g montmorillonite powder three times and 25 mg amitriptyline twice daily. The defecation frequencies, stool properties, accompanying symptom score, life quality score and adverse reactions were recorded pre-treatment,at the end of treatment and 6 weeks post-treatment for the four groups.Results： Compared with pre-treatment, the defecation frequencies, stool property score and accompanying symptom score were all decreased significantly at the end of treatment in each group（all P〈0.01）,while the scores of nine dimensions of quality of life were all increased significantly（all P〈0.01）. The above-mentioned indices were better in the combination group than in the other groups（all P〈0.05）.Compared with the end of treatment, no significant recurrences of the above-mentioned indices had occurred in the combination group or the EA group at 6 weeks post-treatment（both P〉0.05）, but these indices all recurred significantly in the group given Qibei mixture and the medication group（P〈0.05）.The short-and long-term total effective rates in the combination group both showed significant differences from those in the other groups（P〈0.05, P〈0.01）. No serious adverse reactions occurred in the four groups.Conclusion： EA and Qibei mixture can decrease defecation frequencies, improve stool properties, and alleviate accompanying symptoms to increase life quality, but the therapeutic effect of combination therapy is greater, with better reliability and long-term efficacy.展开更多
As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry ou...As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry out the comprehensive prevention and control of chronic diseases,strengthen the health guidance and comprehensive intervention of common and chronic diseases of the elderly,and strengthen the health management of elderly patients.Collaborative drug therapy management(CDTM)is a drug treatment management mode that emerged in pharmaceutical services under the situation of new medical reform,aiming to expand the role of pharmacists in the medical team and improve the quality of hospital medical service.Although CDTM has shown some favorable effects in managing chronic diseases in the elderly population,the popularization of CDTM in China is limited by the differences in supporting facilities,management mode,and pharmacist’s abilities in hospitals.By exploring the CDTM mode for elderly patients with chronic diseases,we provided a reference for further promoting the CDTM services and laid a good foundation for displaying pharmacist value and the realization of real pharmaceutical care.展开更多
文摘Objective To evaluate the efficacy of medroxyprogesterone acetate(MA)plus metformin as the primary fertility-sparing treatment for atypical endometrial hyperplasia(AEH)and early-stage grade 1 endometrial adenocarcinoma(G1 EAC)and the recurrence rate after treatment.Methods Sixty patients(aged 20-42 years)with AEH and/or grade 1 EAC limited to the endometrium were enrolled prospectively and randomized into two groups(n=30)to receive oral MA treatment at the daily dose of 160 mg(control)or MA plus oral metformin(850 mg,twice a day)for at least 6 months.The treatment could extend to 12 months until a complete response(CR)was achieved,and follow-up hysteroscopy and curettage were performed every 3 months.For all the patients who achieved CR,endometrial expressions of IGFBP-rP1,p-Akt and p-AMPK were detected immunohistochemically.Results A total of 58 patients completed the treatment.After 9 months of treatment,23(76.7%)patients in the combined treatment group and 20(71.4%)in the control group achieved CR;two patients in the control group achieved CR after converting to the combined treatment.The recurrence rate did not differ significantly between the control group and combined treatment group(30.0%vs 22.7%,P>0.05).Ten(35.7%)patients in the control group experienced significant weight gain of 5.7±6.1 kg,while none of the patients receiving the combined treatment exhibited significant body weight changes.Compared with the control group,the patients receiving the combined treatment showed enhanced endometrial expressions of IGFBP-rP1 and p-AMPK with lowered p-Akt expression.Conclusion Metformin combined with MA may provide an effective option for fertility-sparing treatment of AEH and grade 1 stage IA EAC,and the clinical benefits of metformin for controlling MA-induced weight gain and promoting endometrial expressions of IGFBP-rP1 and p-AMPK while inhibiting p-Akt expression warrants further study.
文摘Zero addition of drugs is an important aspect of medication reformation in the whole country, which is the end of the era of medicine. The role of pharmacists is changing from being medication dispensers to outcome-oriented and patient-focused care providers. However, it is still unclear how to play the role of pharmacists and carry out the related work in the new situation. Here, literature for relevant evidence was searched and summarized. Analysis results showed that there was a significant gap between pharmacy practice in China and developed countries. Evidence has supported pharmacists in their emerging role as care providers, that is available to improve the efficacy and quality of pharmaceutical care and ensure the safety of medicines for patients, but still more efforts are needed to promote new attitude toward more professional career, such as paying attention to the examination of outpatient prescription and medical orders, deeply clinical practice and individualized treatment, self-enhancement and public awareness of pharmacists. Collectively, the safety of patients can be ensured only by improving profession of pharmacists and showing the value of pharmacists. In doing so, pharmacy can develop rapidly, and pharmaceutical care with rational drug use can be realized.
文摘Objective： To explore the short and long-term efficacy of combining electroacupuncture（EA） and Qibei mixture in the treatment of irritable bowel syndrome（IBSD）.Methods： Six hundred and forty-four patients with confirmed IBSD from the Department of Gastroenterology, the First Affiliated Hospital of Xinxiang Medical University in China, recruited from July 2012 to June 2016, were randomly divided into four groups, the EA group, Qibei mixture group, combination group and medication group with 161 patients in each group. The patients in the EA group were treated with EA at zúsānlǐ（足三里ST36）. Gān shù（肝俞BL18）, Pǐshù（脾俞BL20）. Tàichōng（太冲LR36） and Qízhōngsìbiān（脐中四边）once daily for 4 weeks, while the patients in the Qibei mixture group were treated with 50 mL of Qibei mixture twice daily, the combination group with the above-mentioned EA and Qibei mixture, and the medication group with 1 tablet compound diphenoxylate twice, 3 g montmorillonite powder three times and 25 mg amitriptyline twice daily. The defecation frequencies, stool properties, accompanying symptom score, life quality score and adverse reactions were recorded pre-treatment,at the end of treatment and 6 weeks post-treatment for the four groups.Results： Compared with pre-treatment, the defecation frequencies, stool property score and accompanying symptom score were all decreased significantly at the end of treatment in each group（all P〈0.01）,while the scores of nine dimensions of quality of life were all increased significantly（all P〈0.01）. The above-mentioned indices were better in the combination group than in the other groups（all P〈0.05）.Compared with the end of treatment, no significant recurrences of the above-mentioned indices had occurred in the combination group or the EA group at 6 weeks post-treatment（both P〉0.05）, but these indices all recurred significantly in the group given Qibei mixture and the medication group（P〈0.05）.The short-and long-term total effective rates in the combination group both showed significant differences from those in the other groups（P〈0.05, P〈0.01）. No serious adverse reactions occurred in the four groups.Conclusion： EA and Qibei mixture can decrease defecation frequencies, improve stool properties, and alleviate accompanying symptoms to increase life quality, but the therapeutic effect of combination therapy is greater, with better reliability and long-term efficacy.
文摘As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry out the comprehensive prevention and control of chronic diseases,strengthen the health guidance and comprehensive intervention of common and chronic diseases of the elderly,and strengthen the health management of elderly patients.Collaborative drug therapy management(CDTM)is a drug treatment management mode that emerged in pharmaceutical services under the situation of new medical reform,aiming to expand the role of pharmacists in the medical team and improve the quality of hospital medical service.Although CDTM has shown some favorable effects in managing chronic diseases in the elderly population,the popularization of CDTM in China is limited by the differences in supporting facilities,management mode,and pharmacist’s abilities in hospitals.By exploring the CDTM mode for elderly patients with chronic diseases,we provided a reference for further promoting the CDTM services and laid a good foundation for displaying pharmacist value and the realization of real pharmaceutical care.
