OBJECTIVE:To provide suggestions for the documentation and management of drug records.METHODS:To analysis the related legal problems of relationships between drug records and medical records,medication records and patient rights,drug records' role as evidence,legal responsibility and risk,countermeasures and recommendations will be presented.RESULTS & CONCLUSIONS:From the legal perspective,the drug record can be used as evidence as medical record and the inappropriate documentation of medication record may lead to legal responsibility.It is important to have a good understanding of the legal meaning of drug records,improve the documentation of drug records and enhance the management of drug records.

OBJECTIVE:To evaluate the value and social effect of the regulation by the indicator of drug proportion. METH-ODS:The scientificity and rationality of pharmaceutical proportion and the regulation activity by the indicator of drug proportion was analyzed by analyzing the connotation and influential factors of drug proportion and the method of comparative study,qualita-tive analysis and quantitative analysis. RESULTS:There was great difference in connotation and value between international drug proportion and domestic one. Indicator of drug proportion had no direct relation to pharmaceuticals consumption control and rational drug use;the value and effect of the regulation activity in a hospital by the indicator of drug proportion were far from complete and required further research. CONCLUSIONS:Health administrative department and policy decisions department should further re-search and objectively evaluate the value and effect of the regulation activity in a hospital by the indicator of drug proportion. Whether the regulation activity in a hospital by the indicator of drug proportion carry out based on scientific verification;if neces-sary,the indicator of drug proportion should be cancelled or adjusted in hospital management and evaluation indicator system.

Objective To detect the correlation of serum myoglobin (Mb) and creatine kinase (CK) levels in multiple trauma patients with outcome and renal failure and compare the prognostic value of the two predictors.Methods Forty-one patients with multiple trauma (ISS ≥ 16 points) were analyzed at days 1,3,7,and 14 posttrauma,for serum Mb and CK concentrations.Moreover,simplified acute physiology score Ⅱ (SAPS Ⅱ),injury severity score (ISS),as well as Glasgow coma score (GCS)at day 1 postrauma,final outcome,and presence or absence of renal failure were recorded.Correlation of serum Mb and CK with ISS,GCS,and SAPS Ⅱ was analyzed.Predictive values of Mb and CK for outcome and development of renal failure after multiple trauma were measured and compared at days 1,3,and 7 posttrauma,according to receiver operating characteristic (ROC) curve.Results Serum Mb concentration revealed a positive correlation with SAPS Ⅱ at each time point and with ISS at days 7 and 14,but a negative correlation with GCS at days 3,7,and 14.Similarly,serum CK concentration presented a positive correlation with SAPS Ⅱ at days 3,7,and 14 and with ISS at days 7 and 14,but a negative correlation with GCS at days 7 and 14.To predict outcome of the multiple trauma patients,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.542,0.900,and 0.981 respectively and for serum CK was 0.232,0.771,and 0.968 respectively.To predict development of renal failure,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.864,0.949,and 0.955 respectively and for serum CK was 0.480,0.889,and 0.939 respectively.Conclusions Serum Mb and CK are both predictive of outcome and development of renal failure following multiple trauma.Whereas in co；rast with CK,serum Mb appears to be a more sensitive marker.

Objective To observe the efficacy and safety of albumin-bound paclitaxel on the patients with advanced malignance in more than the third-lines (including the third-lines).Methods 34 patients with advanced malignance diagnosed by pathological evidence accepted more than the third-lines (including the third-lines) chemotherapy containing albumin-bound paclitaxel after failure of chemotherapy.The efficacy and safety were observed.Results Totally 110 cycles chemotherapy were completed,with a mean of 3.24 cycles in each of the 34 patients.No CR patients,12 cases of PR,9 cases of SD and 13 cases of PD were found.The response rate (RR) was 35.29 ％ (12/34) and the disease control rate (DCR) was 61.76 ％ (21/34).The main toxicity was hematologic toxicity,including neutropenia in 26 cases (76.47 ％),anemia in 14 cases (41.18 ％) and thrombocytopenia in 3 cases (8.82 ％).Other common adverse reactions included alopecia in 27 patients (79.41％) and muscle and joint pain in 15 cases (44.18 ％).Conclusions The albumin-bound paclitaxel is effective and tolerable in patients with advanced malignance in more than the third-lines (include the thirdlines) chemotherapy.

OBJECTIVE: To observe the clinical efficacy of the combination of traditional Chinese medicine and western medicine in treating irritable bowel syndrome (IBS) and the result of intestinal flora regulation. Methods: Sixty IBS patients, 36 males and 24 females, were divided into two groups, with 30 patients in each group. Herbal formula of TongxieYaofang and clostridium butyricum (Cb) were used in the first group for four weeks, while only Cb was used for four weeks in the second group. We observed the changes of coliform group, enterococcus, lactobacillus, bifidobacterium after treatment. RESULTS: The effective rate of the Tongxie Yaofang and Cb treated group was significantly higher than that of the Cb treated group (P < 0.05). The numbers of bifidobacterium and lactobacillus increased, while the numbers of coliform group and enterococcus decreased after the treatment, and the changes of intestinal flora in the integrative medicine treated group were significantly greater than those in the Cb treated group. CONCLUSION: After treatment with the combination of traditional Chinese medicine and western medicine, the intestinal flora can be regulated to equilibrium state.

To study the changes in serum immunosuppressive acidic protein (IAP) and T lymphocytes rDNA transcription activity in peripheral blood of patients with pancreatic cancer before and after operation. The level of IAP and T lymphocytes rDNA transcription activity in peripheral blood of 58 patients with pancreatic cancer were measured before and after opreration by one directional immunodiffusion test and a cell image analysis of Ag NORs, respectively, and the results were compared with that of healthy controls. The level of IAP was higher while T lymphocytes rDNA transcription activity was lower before operation compared with healthy controls( P 0 05). The levels of IAP and T lymphocytes rDNA transcription activity were closely related to tumor invasion, metastasis and clinical stages (TNM). Serial determination of the levels of IAP and T lymphocytes rDNA transcription activity might serve as an important index for evalution of tumor invasion and metatasis, and also prognosis for the patients with pancreatic cancer

Objective To determine the effective target plasma propofol concentration required to prevent the response to fibercolonoscope examination in 50% of patients (EC50) .Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-60 yrs weighing 45-70 kg undergoing fibercolonoscope examination were enrolled in this study. The initial target plasma propofol concentration was set at 5.0 ?g?ml-1 . EC50 was determined by up-and-down sequential experiment. The effect of TCI of propofol was based on the movement on the movement of the body in response to fibercolonoscope examination. If effective the target plasma propofol concentration was set at a lower concentration in the next patient and vice sersa. Each time the target plasma propofol concentration increased/decreased by 0.5 ?g?ml-1. The up-and-down sequences were analyzed by using the Dixon and Massey method to determine the EC50.Results The EC50 of propofol for fibercolonoscope examination was 4.9 ?g?ml-1 [95% confidence interval (CI) 4.5-5.4 ?g?ml-1] . Four patients developed respiratory depression during examination (6.67%). Conclusion The EC50 of propofol for fibercolonoscope examination is 4.9 ?g?ml-1.

Objective To investigate the relationship of the chemical coding enteric nervous system of the mice and expression for neurotransmittor of enteric primary afferent neurons for Nociceptors.Methods Immunocytochemical and morphometric techniques were used to quantify the distribution of IB4-containing neurons in mice enteric nervous system using three mice chiocing every vision 50 neurons undering confocal microscopy IB4 immunolabelling and colocalized with calretinin and lectin B4.Results IB4 being binded to primary afferent neurons of enteric pleuxes happend in small intestin and colon of mice,where it was selective for nociceptive neurons.IB4 revealed large round or oval(Dogiel type II)neurons,type I neurons with prominent laminar dendrites and small neurons of myenteric ganglia.The type II neurons were immunoreactive for calretinin,and some type I neurons were immunoreactive for nitric oxide synthase.Most neurons in the submucosal ganglia bound IB4,and some of these were vasoactive intestinal peptide immunoreactive.Conclusion The results indicate that IB4 labels specific subgroups of enteric neurons in the enteric nervous system of the mice.These include intrinsic primary afferent neurons,but other neurons,including secretomotor neurons,are labeled.The results suggest that IB4 is not a specific label for enteric nociceptive neurons.

Objective:To analyze the effects of rational intervention on prophylactic antibiotics use in typeⅠIncision. Methods:A retrospective investigation method was used. Totally 170 cases with typeⅠIncision undergone in the hospital from April to Decem-ber 2013 were selected as the non-intervention group, and 173 cases with typeⅠIncision undergone in the hospital from April to De-cember 2014 were selected as the intervention group. The prophylactic antibiotics use, medication time, drug selection and duration of drug treatment were analyzed. Results:After intervention, the use rate of antibiotics was decreased from 67. 65% to 26. 59%, the ir-rational rate of use time was decreased from 15. 88% to 4. 63%, the irrational rate of treatment course was decreased from 30. 58% to 8. 09%, and the combination rate was declined from 10. 59% to 5. 20%. Conclusion:The rational prophylactic use of antimicrobial in type Ⅰ incision is improved through the intervention, and further efforts are still needed to improve the reasonable use.