OBJECTIVE:To analyze the clinical characteristics of cefepime-induced neurotoxicity and to provide reference for rational use of cefepime.METHODS:Medical records of cefepime-induced neurotoxicity were collected from medical literatures from 1997 to 2009.Age and gender of 46 patients,primary diseases,drug usage,onset time of ADR,clinical symptom and prognosis were analyzed.RESULTS:Of 46 patients,25 cases were male and 21 female.Their average age was (59.56?18.84) years old (unknown age of 1 case).38 cases received cefepime alone and 8 cases cefepime combined with other drugs.All patients were administered by intravenous infusion.Of 46 patients,32 patients suffered from chronic renal failure,among which 10 patients received overdosage of medicine (unknown dosage of 1 case).Clinical symptoms of cefepime-induced neurotoxicity were encephalopathy,myoclonus and epilepsy.The occurrence time of neurotoxicity was (4.39?2.18)d (unknown occurrence time of 2 cases).The symptoms of 36 cases were relieved and cured after drug withdrawal and treatment with mean cure duration of (2.67?2.64)d.CONCLUSION:Great importance should be attached to the antibacterial effects of cefepime and cefepime-induced neurotoxicity.

OBJECTIVE: To discuss the characteristics and regular pattern of the adverse drug reactions(ADR) in our hospital.METHODS: A total of 314 ADR case reports collected by ADR monitoring center in our hospital during 2007 were analyzed statistically.RESULTS: 13 categories(178 kinds) of drugs and 338 cases were involved in the total 314 ADR case reports,mainly anti-infective agents(128 cases,38 kinds) and Chinese drugs preparation(51 cases,20 kinds).The ADR were manifested chiefly as lesions of skin and its appendants(134 cases) followed by gastro-intestinal lesion(56 cases).The patients showed a favorable turn and the death occurred in only 1 case.CONCLUSION: More attention should be paid to the monitoring of rational drug use to avoid or reduce the incidence of ADR.

Objective To investigate the effects of minimally invasive intracranial hematoma clearance on the perihematomal glutamate(Glu) level,permeability of blood-brain barrier(BBB) and brain edema.Methods Thirty rabbits with body weight of 2.80-3.40 kg were used to established the model of spontaneous intracerebral hemorrhage(ICH) and randomly divided into the minimally invasive group(MI) and control group(MC) after the model was prepared successfully.The MI group underwent minimally invasive procedures for removing intracranial hematoma by stereotactic instrument within 6 h after establishing the ICH model.The brain tissue was extracted on postoperative 1,3,7 d,and the perihematomal brain tissues were taken to detect the Glu level,BBB permeability and water content of brain tissue,which were compared with those in the control group.Results The Glu level,BBB permeability and brain water content on 1,3,7 d in the MI group were lower than those in the MC group,and the differences were statistically significant(P＜0.05).Conclusion The minimally invasive surgery for removing intracranial hematoma is helpful to reduce perihematoma Glu level,BBB permeability and brain water content.

ObjectiveTo establish the specific chromatogram and thin layer chromatography（TLC） of Qingxin Lianziyin（QXLZY） benchmark samples， in order to clarify the key quality attributes and provide a reference for the quality evaluation of QXLZY. MethodHigh performance liquid chromatography（HPLC） specific chromatogram of QXLZY benchmark samples was developed by using a YMC Hydrosphere C₁₈ column（4.6 mm×250 mm， 5 μm） with the mobile phase of acetonitrile（A）-0.2% formic acid aqueous solution（B） for gradient elution（0-10 min， 5%-20%A； 10-20 min， 20%A； 20-25 min， 20%-24%A； 25-40 min， 24%-30%A； 40-55 min， 30%-50%A； 55-65 min， 50%-100%A； 65-75 min， 100%A； 75-75.1 min， 100%-5%A； 75.1-90 min， 5%A）， and the detection wavelength was 360 nm. Ultra-high performance liquid chromatography-linear ion trap/orbitrap mass spectrometry（UHPLC-LTQ-Orbitrap MS） with electrospray ionization（ESI） was used to identify the components of QXLZY benchmark samples by accurate relative molecular weight and multilevel MS fragment ion information， the detection conditions were positive and negative ion modes and data dependency scanning mode. TLC identification methods for Ophiopogonis Radix， Lycii Cortex， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma in QXLZY were established. ResultA total of 15 characteristic peaks were identified from Glycyrrhizae Radix et Rhizoma， Plantaginis Semen and Scutellariae Radix， and the relative standard deviations of the retention times of 15 characteristic peaks in 15 batches of QXLZY benchmark samples were≤3% with peak 8（baicalin） as the reference peak. A total of 100 compounds， including flavonoids， organic acids， saponins， amino acids and others， were identified in the benchmark samples by UHPLC-LTQ-Orbitrap MS. The established TLC had good separation and was suitable for the identification of Ophiopogonis Radix， Lycii Cortex， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma in QXLZY. ConclusionThe material basis of QXLZY benchmark samples is basically determined by MS designation and source attribution. The established specific chromatogram and TLC of QXLZY are simple， stable and reproducible， which can provide a reference for the development and quality control of QXLZY.