OBJECTIVE: To analyze utilization of antibiotics for special use in medical institution in order to provide reference of reducing incidence of ADR and avoiding rapid occurrence of bacterium. METHODS: The utilization of antibiotics for special use in our province from Jan. 2005 to Jun. 2008 was analyzed with DDD and DDDs as index. RESULTS&CONCLUSION: The changes of DDDs, cost order and proportion of antibiotics for special use were different from each other. The ratio of order of cost to order of DDDs of antibiotics for special use was between 0.33～5.00 and 72.22% of antibiotics for special use were widely used in different grades of medical institutions. Therefore, it is necessary to strictly control the introduction and utilization which meet requirement. Drug resistance rate of some antimicrobials for special use is up to 100%. So the relevant measure should be taken such as withdrawal of antibotics, monitor of drug resistance and establishment of warning system. Considering a certain degree of abuse, strict measure should be adopted in the primary medical institutions.

OBJECTIVE: To provide reference for the formulation of national centralized drug purchase policy. METHODS: Five stages of drug purchase were reviewed to analyze target of centralized drug purchase policy, purchase mode, suitable range of centralized purchase and its ways and rules, etc. Problems about centralized drug purchase were summarized, and trend of standardizing national drug centralized purchase was put forward. RESULTS & CONCLUSION: Centralized drug purchase should be further standardized and improved.

OBJECTIVE:To promote effective supervision of key monitoring drugs by provincial pharmaceutical quality control center,and to improve rational drug use. METHODS:The effects of No.2 district of Sichuan province pharmaceutical quality con-trol center on 3 categories of key monitoring drugs guidance and supervision,through urging medical institution in the area to estab-lish key monitoring drugs supervision system,formulating prescription review guideline for 3 categories of key monitoring drugs [TCM injection,adjunctive drug,proton pump inhibitors (PPIs)],developing baseline data survey,inspecting the application of key monitoring drug in medical instaurations on the spot and other measures,were introduced. Through collecting the reports of re-gional quality control center to the provincial quality control center,supervision system of medical institutions were analyzed statisti-cally. Key monitoring drugs of medical institutions in the area were analyzed statistically in respects of rational utilization ratio,uti-lization quantity,utilization amount,etc.,so as to evaluate supervision effects. RESULTS:Up to Apr. 2016,92.26%medical insti-tutions had been aware of the relevant requirements of the documents;84.25% had established the hospital supervision system. 3 categories of key monitoring drugs prescription(orders)comment guideline had been developed in Mar. 2016. 18 third-grade class-A general medical institutions were randomly selected;among 3 categories,irrational utilization ratio of TCM injection decreased by 12.35%(35.41% vs. 47.76%);that of adjunctive drugs decreased by 9.64%(20.95% vs. 30.59%);that of PPIs decreased by 7.44%(40.49% vs. 47.93%) in May 2016,compare to Jan. 2016. Average consumption sum of them decreased by 12.07%, 13.30%,9.49%,respectively in Apr. 2016,compared to Jan. 2016. 55.02% medical institutions had started to collect the baseline data. CONCLUSIONS:The provincial pharmaceutical quality control center has played an important role on establishing a supervi-sion system,it can promote the effective supervision by guiding and supervising the medical institutions evaluating the supervision of medical institutions and pointing out the problems.

OBJECTIVE:To explore effective pharmaceutical administration measures for the rational adjunctive drugs. METH-ODS:The effective pharmaceutical administration of adjunctive drugs in medical institutions of Sichuan province was introduced, including establishing key monitoring management system of adjunctive drugs (establishing and implementing prescription review system,rational drug use training,strict supervision and examination) and playing promotion effect of provincial pharmaceutical quality management control center on medical institutions,etc. The effects of pharmaceutical administration in 18 third-grade class-A medical institutions were evaluated through statistically analyzing rational utilization ratio,drug ratio,consumption sum of ad-junctive drugs. RESULTS:Up to May 2016,key monitoring management system of hospital adjunctive drugs had been established and improved in medical institutions over Sichuan province. The rational utilization ratio of adjunctive drugs in 18 medical institu-tions increased from 69.41% in Jan. 2016 to 79.05% in May 2016;drug ratio decreased from 29.22% to 27.93%. The monthly consumption sum of adjunctive drugs decreased from 22 970 000 yuan in Apr. 2015 to 17 380 000 yuan in Apr. 2016(decreasing by 20.49%). CONCLUSIONS:Medical institutions of Sichuan province conduct effective pharmaceutical administration of adjunc-tive drugs through establishing the key monitoring management system for medical institutions and playing the role of the provincial pharmaceutical quality management control center for the supervision.

Differentiating syndrome factor and forming syndrome type according to symptoms and signs are the rules and processes of syndrome differentiation in traditional Chinese medicine (TCM). TCM syndrome differentiation is a nonlinear complex giant system. In order to solve the key problem of determination of diagnosing weight value for syndrome factor differentiation, a new algorithm of double levels of frequency and weight based on the analysis of frequency statistics was applied, and the accurate syndrome differentiation parameters were acquired. Therefore, based on the nonlinear and multivariate analysis, a new algorithm of calculating diagnostics for syndrome factor differentiation was established.

Compared to traditional paper & pencil test,computer-based test has obvious advantages in improving reliability and validity of test.With the increasing popularity of computer-basedtest,making ICO examinations(International Basic Science and Clinical Sciences Assessment for Ophthalmologists) computerized can be realized in our country for the reason that we own hardware and software required by computerized exam,including standardized examination room,professional test personnel,examinee with computer skills,etc.Currently,we can rely on available resources to carry out pilots in the areas meeting the condition of computer-based test,take the form of paper and pencil and computer at the same time,and then promote the process of computer-based ICO examinations.

The concept of syndrome in traditional Chinese medicine (TCM) is a nonlinear, open and complicated huge system. Syndrome differentiation in TCM belongs to cognitive and noetic science. To establish a new syndrome differentiation system based on the key elements of the syndrome is necessary for TCM practitioners to promote differentiation ability and reach consensus on differentiation method. With combination of experience and computation models, the Bayesian network was used in the study of the relationship between the key elements of syndrome and the symptoms, and the relationship among different key elements, in which the computing diagnosis result was identical to the result from an experienced TCM doctor. The study showed that Bayesian network is a good method to deal with the information of symptoms and signs for syndrome differentiation, but it is also not to reflect comprehensively the thinking ability of TCM doctors in doing syndrome differentiation.

Objective To compare the clinical efficacy of different doses of ultrafine extracted granule preparation (EGP) and traditional herbal decoction (THD) of Li Zhong Tang in treatment of epigastric pain. Methods Sixty cases of epigastric pain patients in accordance with the diagnostic criteria of deficiency and cold pattern of spleen and stomach in TCM were randomly divided into THD group, 1/3 dose group and 1/5 dose group, and were given THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP, respectively. The clinical efficacy of the three groups after one course of medication was comparatively analyzed. Results There were no significant differences in age, course of disease, symptom score before treatment, epigastric pain efficacy and syndrome curative effect among the three groups, the differences had no statistical significance (P>0.05). The severity, frequency and duration of epigastric pain were all reduced in the three groups, with significant differences between before and after treatment (P<0.05). Conclusion There are no significant differences in the clinical efficacy on epigastric pain among THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP. In addition, the effect of 1/3 dose group is very close to the THD group.

Objective To study the effect of laparoscopic cholecystectomy endoscopic sphincterotomy combined with Oddi lithotomy (EST) treatment of gallbladder stone on common bile duct stones. Methods A retrospective analysis between May 2003 and June 2009 ,the combined treatment of LC and EST in 78 patients with common bile duct stones was retrospectivelly analyzed. First, bile duct stones were removed by EST, then laparoscopic cholecystectomy was performed within 5 days. Results EST was performed successfully in 76 cases (97%), failure in 2 cases, 1 case abdominal choledochojejunostomy due to the end of bile duct stenosis; one cases of common bile duct stone diameter of 1.6 cm, firm, failure of mechanical lithotripsy received common bile duct ploration T-tube drainage 76 cases of laparoscopic operation is successful, without obvious bleeding, bile leakage and other severe complications. Conclusions The advantages of EST + LC for the gallbladder stones and common bile duct stones with less trauma, faster recovery, fewer complications, and no T-tube drainage, etc; this is a safe and effective treatment.

Objective To explore the application of evaluation of measurement uncertainty in routine coagulation assays based on the data of internal quality control (IQC) and results of external quality assessment (EQA) .Methods Data of clinical coagulation assays of clinical laboratory of Xiangyang city hospital were collected ,Which came from six months of IQC and 3 times of EQA of ministry of health clinical laboratory center from 2012 to 2013 .The combined and expanded uncertainties of 3 measurements(PT , APTT and Fbg) were evaluated according to CNAS top-downapproach .Results When PT were in 12 .72 s and 21 .04 s ,its ex-panded uncertainty were 1 .06 s and 1 .96 s ,and APTT in 36 .6 s and 50 .6 s were 2 .59 s and 5 .30 s ,and Fbg in 3 .32 g/L was 0 .30 g/L .Conclusion Evaluation of measurement uncertainty by using internal quality control data and EQA results for routine coagula-tion detection index is economical and practical and acceptable way ,with good clinical practice .