0.05).Conclusion:There was likely no association between the polymorphism at the serotonin transporter gene and autism. The serotonin transporter gene polymorphism might not play a causal role in the development of autism.

OBJECTIVE:To explore hospital pharmacists service mode and the subject construction of hospital pharmacy. ME-THODS:Through reviewing the transformation process of hospital pharmacy and pharmacist's duty,the present structure,con-tent,working model and achievements of pharmacy in our hospital were introduced based onlarge pharmacyof taking clinical pharmacy as core,paying attention to personnel training,technical innovation,physican,pharmacist and nurse cooperation,multi-ple discipline integration,etc.;the direction of hospital pharmacy was explored. RESULTS:Many adjustments were made to facili-tate the smooth and orderly development of hospital pharmacy under the new situation,as that establish the rational drug use and quality safety system,drug supply and operation management system working mode;that the development strategy of pharmacy was identified asfocusing on the rational drug use,combining the management functionandproviding professional pharmaceuti-cal care for the clinic and patients,providing professional technical support for the hospital decision and medical management;that the construction of clinical pharmacy specialty/key discipline and drug clinical trial technology platform in accordance with the international standard and so on were lined in the project of pharmacy;that quality control circle was cited,pharmaceutical supervi-sion and pharmaceutical care were expanded to the public and the fine;that a fine,professional pharmacist team was cultured. CONCLUSIONS:The construction of future hospital pharmacy needs the concept oflarge pharmacywith multi-disciplinary inte-gration to develop towards standardization,refinement,specialization and modernization.

OBJECTIVE:To provide reference for the rational drug use of traditional TCM injection. METHODS:Medical re-cords of 792 patients receiving TCM injection were collected from Qingdao Municipal Hospital in the first quarter of 2014(before intervention)and 836 patients collected from the first quarter of 2015(after intervention),and then analyzed comparatively in re-spects of patient’s gender information,rationality of TCM injection,irrational drug use,ADR. RESULTS:After intervention,the use of TCM injection in the hospital became standard gradually,and rational rate increased from 42.42% to 69.98%. Irrational drug use as super-indication medication,overdose,inadequate solvent amount decreased;the ratio of TCM injection prescription cost per capita decreased from 16.64% to 12.59%;the incidence of ADR decreased from 6.94% to 2.51%,with statistical signifi-cance(P<0.05). Except that the amount of Andrographolide for injection,Xuesaitong for injection,Zhengqing fengtongning injec-tion,Reduning injection increased,those of other TCM injection decreased. CONCLUSIONS:Pharmaceutical intervention mea-sures of clinical pharmacists are effective and feasible,and promote rational and standard use of TCM injection.

Objective: To analyze characteristics of serious adverse drug reaction from Qingdao and provide reference for clinical applications. Methods: 1 130 reports collected by Qingdao Center for ADR Monitoring in 2016 were analyzed using retrospective study method. Results: The antibiotics, traditional Chinese medicine injection and antitumor drug caused the higher proportion of serious adverse drug reaction.Injection was the main way for administration, which induced 73.45% of serious adverse drug reaction.65.00% cases with allergic shock occurred within 10min.Levofloxacin lactate injection caused the highest proportion of serious adverse drug reaction, Danhong injection caused the highest proportion of allergic shock reaction, Reduning injection caused the highest proportion of serious adverse drug reaction in children. Conclusion Safety monitoring for antibiotics, traditional Chinese medicine injection and antitumor drug should be further strengthened, including children adverse reactions.

AIM: To verify the bioequivalence between sustained released tablet of nepopam and normal one. METHODS: 18 volunteers were randomly devided into two groups. Double periodical crossed design was used, and poly dose of nefopam was administered to 18 volunteers following single dose after one week interval. The concentration of nefopam hydrochloride in serum was determinated by HPLC, and the related parameters came out through 3p97 programme. RESULTS: In the single dose test the drug concentration of sustained released tablet maitained 2040 mg?L -1 for 10 h ,c max was ( 45.8 ?15.7) mg?L -1 ,t peak was ( 3.4 ? 0.8) h , and the corresponding parameters of normal tablet were over 20 mg?L -1 for 7.5 h ,( 72.7 ?26.0) mg?L -1 ,and ( 1.6 ? 0.6) h . The AUC was ( 363.4 ? 107.1 ) and ( 374.8 ?125.7) mg?h?L -1 respectively, and F was ( 1.02 ? 0.25 ). In the poly dose test the c max of sustained released and normal one was ( 31.50 ? 12.65 ) and ( 33.68 ?10.51) mg?L -1 ,c min was ( 13.4 ? 4.4 ) and ( 10.9 ?5.4) mg?L -1 , t peak was ( 2.6 ? 0.6 ) and ( 1.22 ? 0.46) h , and FI was ( 0.77 ? 0.26 ) and ( 1.04 ? 0.18 ) respectively. CONCLUSION: The sustained released tablet is credible and the two types of tablet are equieffective in AUC.

Alterations of the lactoferrin gene are associated with an increased incidence of tumor,however,the exact mechanisms involved in the anti-tumor activity of lactoferrin are still unclear.Several studies suggest that lactoferrin can affect the initiation and development of tumors via different mechanisms such as damaging cell membranes,inducing apoptosis,blocking cell cycle,regulating cellular immune response and inhibiting angiogenesis in different cancer cell lines.Further study about the mechanism can provide new ideas for clinical prevention and treatment of tumors.

OBJECTIVE To compare the efficacy and safety of levetiracetam versus valproic acid in the treatment of pediatric epilepsy， and to provide evidence-based reference. METHODS The databases including CNKI， VIP， China Biomedical Literature Database， Wanfang data， PubMed， Embase and Cochrane Library were searched for the RCTs about levetiracetam （trial group） and valproic acid （control group） were collected from the inception to October 1st， 2021. After literature screening and data extraction， the quality of included literature was evaluated using the bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0 and RevMan 5.3 software were used for meta-analysis， sensitivity analysis and bias risk analysis. RESULTS A total of 33 RCTs were included， involving 3 116 patients in total. The results of the meta-analysis showed that the effective rate of trial group was significantly higher than control group [RR＝1.06， 95%CI （1.02， 1.11）， P＝0.003]. The subgroup analysis according to different courses of treatment showed that there was no statistical significance in the effective rate between 2 groups after 1 and 3 months of treatment （P＞0.05）； after 6 months of treatment， the effective rate of trial group was significantly higher than that of control group （P＜0.05）. The incidence of adverse drug reaction in trial group was significantly lower than control group [RR＝0.50， 95%CI （0.41， 0.61）， P＜0.000 01]； among specific adverse drug reactions， the incidence of nausea and vomiting in trial group was significantly lower than control group （P＜0.05）； but there was no statistical significance in the incidence of rash， drowsiness， abnormal mood， loss of appetite， dizziness or headache （P＞0.05）. Results of sensitivity analysis showed that study results were stable and reliable. Results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS The short-term efficacy （1， 3 months） of LEV is similar to that of VPA in the treatment of pediatric epilepsy， but long-term efficacy （6 months） of LEV is better than that of VPA； moreover， LEV shows better safety in digestive system.

OBJECTIVE： To analyze the characteristics and regularity of new/severe pediatric ADR in Shandong province， and to promote the safe use of drugs in children. METHODS： A retrospective analysis of new/severe pediatric ADR in the Shandong Provincial ADR database 2016-2017 was conducted in respects of children’s gender and age， primary disease， ADR history， family ADR history， dosage form， route of administration， drug type， systems/organs involved in ADR， clinical manifestations， off-label drug use， drug combination， occurrence time， effects of ADR on primary disease， outcome， etc. RESULTS： A total of 44 742 pediatric ADR cases were collected from Shandong province ADR database from 2016 to 2017， including 27 060 male， 17 664 female and 18 gender unknown. 530 cases were diagnosed as new/severe pediatric ADR， including 334 male and 196 female with ratio of male to female 1.70 ∶ 1. New/severe ADR reports of children aged 1-3 took up the highest proportion （158 cases， 29.81％）. Primary diseases were mainly respiratory disease （190 cases， 25.85％）； there were 10 children with ADR history （1.89％）， 2 with family ADR history （0.38％）. Dosage forms were mainly injection （358 cases， 67.55％）. Route of administration were mainly intravenous drip （431 cases， 81.32％）. The drugs that caused ADR included 20 categories and 162 species， mainly including drug for regulating hydroelectric acid-base balance （148 cases caused by 8 kinds of drugs， 27.92％）， antibiotics （89 cases caused by 33 kinds of drugs， 16.79％）， traditional Chinese medicine and its extract （80 cases caused by 24 kinds of drugs， 15.09％）. The systems/organs involved in ADR were mainly systemic injury （201 cases， 37.92％， main clinical manifestations included chills and fever， etc.）， followed by skin and its appendants （99 cases， 18.68％， mainly clinical manifestations included rash and itching， etc.）， respiratory system （76 cases， 14.43％， main clinical manifestations included dyspnea and cough， etc.）. Off-label drug use were found in 41 cases （7.74％）， including the safety of drug use was not clear in drug instructions （20 cases， 3.77％）； no drug testing was carried out and no reliable references were available （13 cases， 2.45％）， that medicine was prohibited was stated in drug instructions （2 cases， 0.38％）. 106 cases （20.00％） had drug combination， including combined use of two drugs， three drugs and four drugs （62， 36， 8 cases）. ADR occurred mainly within 0-5 min （140 cases， 26.42％）. Among 530 children， ADR had no obvious effect on the outcome of the disease in 457 cases （86.23％）； ADR caused longer course of disease in 57 cases （10.75％）. 278 cases （52.45％） were cured and 243 cases （45.85％） were recovered. CONCLUSIONS： It is necessary to strengthen the monitoring of drug use in children， formulate national standards and relevant laws and regulations for children’s rational drug use， improve the awareness of medical staff to children’s ADR， strengthen the education and publicity of the knowledge about safe drug use in children， and to promote rational drug use.

OBJECTIVE：To systematically evaluate the safety of meropenem for neonatal infection ，and to provide evidence-based reference for safe use of it in the neonatal population. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library，ISI Web of Science ，International Health Technology Assessment Network Website ，China Journal Full-text Database ， Wanfang Database ，CBM，Chinese Sci-tech Periodical Full-text Database ，randomized controlled trials （RCTs）about meropenem or meropenem combined other drugs （trial group ）versus the similar drugs that could replace meropenem （control group ）for neonatal infection were collected during the inception to May 1st，2021. After literature screening and data extraction ，the quality of included literatures were evaluated with Cochrane systematically evaluator manual 5.1.0. Meta-analysis was conducted with RevMan 5.3 software. RESULTS ：A total of 25 RCTs were included ，involving 2 090 children. Results of Meta-analysis showed that the incidence of overall ADR in trial group was significantly lower than control group [RR ＝0.53，95％CI（0.44，0.65），P＜0.000 01]. Results of subgroup analysis showed that the incidence of overall ADR in trial group was significantly lower than control group receiving ceftazidime [RR ＝0.55，95％CI（0.41，0.74），P＜0.000 1]，tigecycline [RR ＝0.37，95％CI（0.23，0.59），P＜0.000 1]， ceftriaxone [RR ＝0.53，95％CI（0.35，0.80），P＝0.003]. The incidence of overall ADR in trial group with neonatal purulent meningitis [RR ＝0.63，95％CI（0.44，0.92），P＝0.02]，severe neonatal multidrug-resistant bacterial infection [RR ＝0.37，95％CI（0.25， 0.55），P＜0.000 01]，neonatal severe bacterial infection [RR ＝ 0.67，95％CI（0.48，0.94），P＝0.02] were significantly lower than control group. The incidence of specific ADR such as mail： rash，gastrointestinal reaction ，hemoglobin reduction in trialgroup were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of specific ADR between 2 groups，such as elevated transaminase ，secondary fungal infection and renal injury （P＞0.05）. Results of bias analysis showed that when the incidence of overall ADR was used as index ，there was a certain degree of publication bias in this study ，when the incidence of specific ADR was used as index ，there was less possibility of publication bias in this study. CONCLUSIONS：Meropenem is safe in the treatment of neonatal infection ，especially in the treatment of neonatal purulent meningitis，severe neonatal multidrug-resistant bacterial infection and neonatal severe bacterial infection ，it is superior to ceftazidime，tigecycline，ceftriaxone and other antibacterial drugs in safety.

Case management includes the development of nursing plans, drug management, changing the living environment, participation in team interventions and follow-up by telephone contact, which can reduce the frequency of patients′ attendance and save the medical resources. This article summarizes the roles of community nurse in case management for frequent attenders to provide reference for case management in the community health care in China.