Objective:To evaluate the utilization of oral hypoglycemic drugs in 34 hospitals of Nanjing to provide clinical reference for the drug rational use. Methods: According to the sales data of oral hypoglycemic drugs in 34 hospitals of Nanjing from 2011 to 2013,the utilization of oral hypoglycemic drugs was analyzed retrospectively in respect of consumption sum,DDDs and defined daily cost ( DDC) by daily dose limit analysis method. Results: The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose,glimepiride and metformin. In terms of DDDs,glimepiride, metformin and gliclazide ranked the top 3. The consumption sum and DDDs of oral hypoglycemic drugs were increased year by year in Nanjing. The ratio of serial number of consumption sum and DDDs was from 0. 3 to 2. 0. Conclusion: The demanded quantity of oral hypoglycemic drugs is increased year by year from 2011 to 2013. The application conforms to the safe, effective and economic principle. The drugs should be chosen according to the drug characteristics in order to improve the abnormal glucose metabolism and prevent and treat the complications.

Objective To evaluate the effect of trimetazidine(TMZ) and metoprolol combining the other regular medicine on the stable angina peetoris patients with type 2 diabetes mellitus. Methods 78 patients with type2 diabetes mellitus and the patients with no less than two months stable and revoked-angina pectoris by effort were colleeted. They were divided into two groups. In one group,20mg of TMZ was used three times a day. In the other group,25mg metoprolol was used and two times a day. The two groups all combined with the regular medicine,bamyl, caleiume-antagonist and long-efficency nitrate and rutine antilipemic, antidiabefie agents for ten weeks and analyzed the statistical difference of two groups. Meanwhile some parameter were observed including the heart rate,blood pressure, blood glucose, TG, TC, HDL-C and LDL-C during the treatment. Results In two groups, cardiac pectoris frequency and lasting-time and the used-nitroglycerin decreased significantly, while the time of next angina outcome and left ventrieular ejection fraction(EF% ) increased significantly. The therapy hasen't great differene(P>0.05) in two groups. But in TMZ group, HR, bllod pressure, blood glucose and blood fat haven't great difference(P > 0.05) before ad after thereapy. In metoprolol group the difference is significant(P < 0.05, P < 0.01) and twogroups have great difference(P < 0.05). Conclusion The results suggest that the TMZ is effect and safe on the sta-ble angina peetoris patients with type 2 diabetes mellitus.

Objective To define the variety and action mechanism of endogenous health resources as well as their economic features, utilization results and influence and to put forward suggestions for giving priority to their development in policy making. Methods Materials from on the spot investigations and materials already available were used to conduct a positive economic study by means of combining document summaries with descriptive studies and analyses. Results Static, exogenous and endogenous health resources were defined, the contribution rate of progress in science and technology in 23 hospitals was determined to be 35.5%, senior human resources were found to be scarce, and the competitiveness of hospitals at the central hospital level was discovered to be weak. Conclusion Effective utilization and optimum distribution of endogenous health resources constitute the key to the realization of the structural readjustment of the health industry and the attainment of sustainable economic growth and development.

Objective To study medicine storage scale model for disaster relief.Methods The medicine storage scale for disaster relief was dynamically simulated by using DAMANO programming language of System Dynamics (SD) and was calculated with discrete algorithm using FORTRAN programming language.Results The established model could be used for dynamic tracing of the inventory of the warehouse.Conclusion Medicine storage scale for disaster relief can be determined through the model established by dynamic simulation or discrete calculation.

OBJECTIVE:To establish a rapid,sensitive,accurate and stable method for the determination of voriconazole in human plasma in order to monitor clinical use of voriconazole. METHODS:HPLC-UV detection method was applied using carba-mazepine as internal standard. Plasma samples were treated with acetonitrile protein precipitation. The determination was performed on Phecda C18 column with 20 mmol/L monopotassium phosphate buffer solution (pH 6.0)-acetonitrile (50∶50,V/V) as mobile phase at flow rate of 1 ml/min. The column temperature was 40℃ and detection wavelength was 255 nm. The injection volume was 50 μl. RESULTS:The retention time of voriconazole and internal standard were 8.34 and 6.24 min. The linear range of voricon-azole in plasma were 0.10-20.00 μg/ml(r=0.999 5). The lowest limit of quantitation was 0.05 μg/ml. Intra-day and inter-day RSD were below 1.57% and 1.45%,respectively. The extraction recovery of low,medium and high concentrations were between 81.40%to 128.29%. CONCLUSIONS:The method is simple and accurate for therapeutic drug monitoring(TDM)of voriconazole.

Ulcerative colitis (UC) is a subtype of inflammatory bowel disease. Its pathogenesis is not clear and the pathogenesis is complex. Moreover, it is recurrent and its healing is delayed. It is a kind of refractory disease. Its incidence and recurrence rate showed a trend of increasing year by year in our country at present. At the present stage, the main treatment focuses on glucocorticoids, aminosalicylic acid, immunosuppressor and biological agent. Although biological agent can greatly improve the efficacy, there are many problems in clinical treatment for a small amount of refractory patients. The comprehensive intervention combined with non-drug treatment should be performed, so as to achieve the curative effect. Fecal microbiota transplantation (FMT) has attracted people′s attention in recent years. It displays a certain therapeutic effect on the treatment of UC in the active stage, especially refractory recurrent UC. Therefore, the domestic and overseas FMT treatment are summarized in the paper.

The paper presents a definition of a hospitals overall competitiveness and expounds its action mechanism, viz. the government plays a guiding role in competition, which constitutes the means via which the subjects of competition seek survival and development, the key basis for a hospital in working out its strategies, and the driving force for a hospitals development. Then it analyzes the features of and the factors affecting a hospitals overall competitiveness and sets forth the evaluation procedure, viz. establishing an evaluation index system, determining and normalizing the standard value for evaluating each index, giving each index a corresponding weight according to its importance and conducting comprehensive evaluation. Next the paper discusses ways of predicting a hospitals overall competitiveness. The steps include: making clear that the purpose of the prediction is to enhance the competitiveness of the hospital in the future, screening the data, selecting the method of prediction, setting up a mathematical prediction model, conducting prediction with the model and evaluating and modifying the evaluation results.

OBJECTIVE:To determine the concentration of pseudoephedrine hydrochloride in human plasma by LC/MS. METHODS:The separation of sample was performed on Zorbax Eclipse XDB C18 with diphenhydramine used as the internal standard.The mobile phase was a mixture of methanol-water(10mmol?L-1 NH4Ac plus 0.1% acetic acid)(55∶45) with a flow rate of 0.2mL?min-1.The column temperature was set at 30℃.The atmospheric pressure chemical ionization-mass spectrometry(APCI-MS) were adopted with pseudoephedrine m/z =166.1 and diphenhydramine m/z =242.3.RESULTS:The linear concentration range for pseudoephedrine was 3.2～408.96ng?mL-1(r=0.999 0) with lowest detection limit at 3.2ng?mL-1.The average recovery was 98.21% with both the intra-day RSD and the inter-day RSD at less than 13%.The stability of pseudoephedrine was stable.CONCLUSION:The method is of high sensibility and accuracy,and it can be used for blood concentration monitoring pharmacokinetic study of pseudoephedrine.

Objective To observe the expression of estrogen receptors (ERαand ERβ) on gastric cancer cells and evaluate the effect of Tamoxifen(TAM) on the cell proliferation and expression of serine proteinase inhibitor 9(PI9) of gastric cancer cells . Methods PI9 positive expression(MNK45 ,SGC7901)and negative expression (BGC823)of gastric cancer cell lines were from pre‐liminary screened ,the expression of ERα and ERβ detected by immunofluorescence chemical method ,the cell proliferation and ex‐pression of PI9 were tested by CCK8 assay and reverse transcription‐PCR after intervention of TAM .Results ERαprotein expres‐sion was noted in MNK45 and SGC7901 ,ERβwas noted in BGC823 ,but the expression of ERαand ERβwere not appear to be obvi‐ous after the intervention of TAM .Tamoxifen could obviously inhibited cell proliferation of MNK45 and SGC7901 at concentration of 0 .1-100 .0 μmol/L ,the differences were statistically significant compared with negative control group (P<0 .05) ,but showed no dose‐dependent to the proliferation of BGC823 and MNK28 .After treating with TAM ,the expression of PI9 mRNA of SGC7901 (0 .402± 0 .020) and MNK45(0 .359 ± 0 .048) were obviously lower than that in the negatwe control group(P< 0 .05). Conclusion Tamoxifen could significantly inhibit the proliferation of PI9 positive expression than PI9 negative expression of gastric cancer cell lines ,and showed obviously dose‐dependent ,its role in inhibiting proliferation might closely related to immune tolerance improved by PI9 .

OBJECTIVE:To systematically review the efficacy,safety and economy of acarbose versus metformin in the treat-ment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed, Medline,CJFD,Wanfang database,VIP database,randomized controlled trails (RCT) about acarbose (test group) versus metfor-min(control group)in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 statis-tics software,and the decision tree model was used to do the cost-effectiveness analysis by using TreeAge Pro 2011.1.0.12.1 soft-ware. RESULTS:A total of 8 RCT,involving 418 patients. Results of Meta-analysis showed 2 h postprandial blood glucose (2 h PG)in test group [MD=-2.21,95%CI(-2.92,-1.51),P<0.001] was lower than that of control group,there was no signifi-cant diffcrencc in the glycated hemoglobin levels[MD=0.02,95%CI(-0.38,0.34),P=0.91],fasting blood glucose level[MD=0.05,95%CI(0.91,1.01),P=0.92] and incidence of adverse reactions [OR=1.84,95%CI(0.80,4.24),P=0.92] between 2 groups. Results of decision tree analysis showed the cost-effectiveness ratio in test group and control group was 847.15 and 272.53,respec-tively;and incremental cost-effectiveness ratio was 13 776. CONCLUSIONS:Acarbose shows an obvious advantage on decreasing the 2 h PG of type 2 diabetes,however,pharmacoeconomics shows metformin has higher economic effects. Due to the limit of methodological quality,large-scale and high quality RCT are required for further validation of the conclusions.