Objectives To analyze the labeling of drug items for patients with renal insufficiency in our hospital so as to provide reference for rational use of drugs. Methods The drug instructions used in No.1 Hospital of Jilin University in 2017 were collected. According to the classification of pharmacology, the instructions of the top 9 drugs system were selected. The annotation of drug items for patients with renal insufficiency in these pharmaceutical instructions was analyzed. Results A total of 812 drug instructions were included, in which 72.17% did not mark drug instruction for renal insufficiency patients. According to the administration system, the highest unlabeled rate were digestive system drugs; according to the method of administration, the highest unlabeled rate was external preparation of drugs, accounting for 83.33%; according to production enterprises, the highest unlabeled rate were domestic drugs, accounting for 75.55%. There were only 23.40% of the tagging items having guidance of medication, and some with a certain degree of confusion in the annotation. Conclusion The unlabelling situation of drug instructions for renal insufficiency patients is very serious. It should arouse the attention of pharmaceutical manufacturers and the pharmaceutical supervisory department is suggested to strengthen the supervision of drug instructions and regulate the contents of drug labeling in drug instructions, so as to guide the rational use of drugs in clinical practice.
Objective To analyze the clinical efficacy of valve-in-valve transcatheter mitral valve replacement in the treatment of degenerated bioprosthetic mitral valves. Methods The clinical data of patients who underwent transcatheter mitral valve replacement due to degenerated bioprosthetic mitral valves at the First Affiliated Hospital of Zhengzhou University from 2020 to 2023 were retrospectively analyzed, including baseline characteristics, surgical data, perioperative complications, and hemodynamic changes during the early postoperative and follow-up periods. Results A total of 31 patients were enrolled, including 7 males and 24 females with an average age of (66.57±9.32) years, and the average replacement time of surgical biological valves was (9.92±3.71) years. There were 7 cases transfemoral vene-atrial septal approach and 24 cases transapical approach. All patients showed significant improvement in cardiac function after operation, and the patients with New York Heart Association (NYHA) grade Ⅲ or Ⅳ and moderate and severe tricuspid valve regurgitation decreased. The peak flow velocity of mitral valve and the average transvalvular pressure gradient were decreased by echocardiography, and left ventricular ejection fraction had no significant change. One patient died of recurrent stroke on the 5th day after surgery, while the rest of the patients were discharged without complications such as cardiac death, all-cause death or outflow tract obstruction. During the median follow-up time of 12 months, no adverse events occurred and hemodynamics were stable. Conclusion The valve-in-valve transcatheter mitral valve replacement is safe and feasible for the treatment of patients with degenerated bioprosthetic mitral valves, demonstrating good hemodynamics and satisfactory short-term clinical outcomes.