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 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.

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.

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.

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.

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.

Objective To evaluate the short-term and long-term therapeutic efficacies of LU’s heat-producing needling (Shao Shan Huo) in treating cervical spondylotic radiculopathy (CSR). MethodTwo hundred patients with CSR were randomized into a treatment group and a control group, 100 in each group. The treatment group was intervened by using heat-producing needling method, while the control group was by regular acupuncture technique with even reinforcing-reducing manipulations. For both groups, the treatment was given once a day, 10 sessions as a treatment course. The Pain Rating Index (PRI), Present Pain Intensity (PPI), and Visual Analogue Scale (VAS) were adopted for observation before intervention and after two treatment courses. The clinical efficacies were compared between the two groups.Result Right after the intervention and in the 3-month follow-up, the VAS, PPI, and PRI scores were significantly different from that before intervention in both groups (P<0.01). There were significant differences in comparing the VAS, PPI, and PRI scores between the two groups after intervention and in the 3-month follow-up (P<0.01). The VAS, PPI, and PRI scores in the treatment group right after intervention were markedly different from that in the 3-month follow-up (P<0.01). The total effective rate was 98.0% in the treatment group versus 79.0% in the control group, and the difference was statistically significant (P<0.01).Conclusion LU’s heat-producing needling is an effective way in treating CSR, as it can significantly reduce pain intensity, and improve other symptoms and body signs.

Objective To investigate the clinicopathological and immunophenotype features of hemangiosarcoma.Methods The clinical,pathologic features of 5 cases of hemangiosarcoma,admitted in our hospital during 2006-2014,were retrospectively analyzed.Results Tumors were located in the spleen (n =3),liver(n =1),scalp(n =1),tumor metastasis to the lung or marrow was found in 4 cases.Preoperative misdiagnosis as lymphoma,cavernous haemangiomas or parasite cyst was suggested by ultrasonography or CT,and final diagnosis was established by typical pathological pictures.CD34,CD31,FⅧ and Vim were positive in tumor cells while CK,EMA were negative.The survival time of the patients receiving resection only was 2 days,4 months and 13 months.The survival time of the patients receiving operation plus chemotherapy was 6 months or 48 months.Conclusions Hemangiosarcoma is a rare and aggressive malignant tumor of soft tissue which has poor prognosis.The additional survival benefits provided by chemotherapy remains unproven.

Objective To investigate the characteristics and risk factors of the cerebral artery atherosclerotic stenosis in patients aged 90 years and older. Methods A total of 92 patients,aged 90 years or older,admitted to our hospital from July 2009 to July 2014 were respec-tively enrolled in this study. All participants underwent CTA to assess the presence and severity of atherosclerotic stenosis with intracranial and extracranial cerebral artery. The association between atherosclerotic stenosis and related risk factors were analyzed. Results The preva-lence of cerebral artery atherosclerotic stenosis was high in the cohort. The frequency of stenosis with intracranial artery was higher than the frequency with extracranial artery (86. 2% vs 44. 8%). The most common positions of cerebral artery atherosclerotic stenosis were the middle cerebral artery (43. 1%),the posterior cerebral artery (43. 1%),and extracranial vertebral artery (32. 8%). The mean age,body mass in-dex,systolic and diastolic blood pressure,and fasting blood glucose of stenosis group are significantly different from the non-stenosis group in single factor analysis (P<0. 05). Multivariate Logistic regression analysis showed body mass index was the independent risk factor of cere-bral artery atherosclerotic stenosis(β=1. 326,OR=3. 765,P<0. 05). Conclusion The prevalence of cerebral artery atherosclerotic steno-sis was high in the patients aged 90 years and older. Body mass index was the independent risk factor. The weight control should be pay atten-tion to prevent cerebral artery atherosclerotic stenosis and stroke.