OBJECTIVE: To evaluate the use of Xingnaojing Injection in medical insurance inpatients in Beijing city so as to provide reference for rational drug use and medical insurance billing.METHODS: Inpatient cases using Xingnaojing Injection in 5 Beijing hospitals of different levels were randomly sampled from the 2004 Beijing Medical Insurance Database,and analyzed in terms of indication, dosage, treatment course and ADR.RESULTS: A total of 676 cases were sampled with more than 25 kinds of indications,and among the top 10 indications, 18.0% were inconsistent with the instruction,and 17.5% were in lack of evidence support such as randomized controlled trials.Individual dose of Xingnaojing Injection was(27.9?9.0)mL, which was higher than the usual dose described by the instructions and clinical trials.The mean treatment course of Xingnaojing Injeciton was 14.6 days,with 20.9% exceeding 20 days.Drugs used in combination with Xingnaojing Injection included anti - thrombosis agents( 13.3% ) and traditional Chinese medicines with the action of promoting blood circulation and removing blood stasis (12.7%) .CONCLUSION: The use of Xingnaojing injection in medical insurance patients was not consistant with the instruction or evidence supported by clinical trials.

Objective: To compare the pharmacokinetic c haracteristics of amphoterici n B liposomes injection (LAmB) with market amphotericin B injection (MAmB) in ra bbits by intravenous administration. Methods: LAmB and MAmB wer e intravenously ad ministrated to rabbits at a single dosage of 1 mg*kg －1. The AmB concent rations i n plasma samples were determined by HPLC, and the pharmacokinetic parameters wer e calculated by means of 3P97, and ANOVA were done by means of the Excel softwar e. Results: The concentration- time data of LAmB and MAmB after intravenous administration were best fitted acc ording to three compartment-model with a weight of 1/C and 1 respectively . After a singl e intravenous administra tion, C max　of LAmB and MAmB were 8.4±2.1 and 2.4±0.6 mg*L －1, AUC were 22.5±6.8 and 9.0±1.9 mg*h*L －1, CL were 0.050±0 .024 and 0.114 ±0.022 L*h －1, V c were 0.13±0.04 and 0.46±0.18 L , respectively. Comparing with MAmB, all rabbits showed high plasma levels, large area under the curve values and low cl earance, small apparent volume of distribution of LAmB. Conclusion: There were several striking differences between the pharmacokinetics properties of LAmB and MAmB in jection in rabbits. All changes of the pharmacokinetics properties will be advan tageous to reduce toxicity and improve therapeutic effect.

OBJECTIVE:To promote rational use of Xingnaojing (XNJ) injection in medical insurance patients.METHODS:Clinical trials on indications of XNJ were searched systematically,and clinical evidence that XNJ was applied for different indications were collected and classified.A questionnaire survey was carried out in 20 medical institutions to find out the doctors' attitude and prescribing practice relating to indications,application indications,usage and dosage,timing of application and drug combination of XNJ.The results of above 2 kinds of studies were provided to a group of experts to reach consensus about guideline of XNJ.RESULTS:Guidelines of XNJ,which contained the application indications,timing of medication,dosage,treatment course and drug combination,were developed.The strength and degree of evidence were labeled for each items of recommendation.CONCLUSION:For drugs with low-quality clinical evidence,guideline should be developed according to experts' consensus which is based on evidence-based medicine.

Objective To demonstrate the possibility when discriminating between severe and nonsevere tricuspid regurgitation by E-wave velocity in tricuspid flow.Methods The peak velocity of the tricuspid inflow E-wave was measured in 107 patients,who were divided into mild group(n =39),moderate group(n =42)and severe group(n =26)according to the degree of tricuspid regurgitation(TR).Results Peak E-wave velocity of mild group,moderate group and severe group was (48.6 ±13.8)cm/s,(47.4 ±11.7)cm/s,and (78.3 ±26.1)cm/s, respectively.Mean E-wave velocity of mild group and moderate group were similar,which were lower than that of severe group (P <0.01).A peak E-wave velocity of over 62 cm/s had a sensitivity of 71% and specificity of 92% for the detection of severe TR.Conclusion Increased peak tricuspid E-wave velocity is associated with severe TR and thus can be used as a simple measure of TR grade.

Objective To investigate the effects of ulinastatin pretreatment on oxidative stress response and hepatocyte growth factor (HGF) after hepatectomy in rats.Methods One hundred and twelve pathogen-free male Sprague-Dawley rats,aged 3 months,weighing 230-280 g,were randomly divided into 2 groups (n=56 each): group hepatectomy (group H) and group ulinastatin pretreatment (group U).Left and median lobe resection was performed and then liver ischemia was induced by blood flow occlusion of right and caudate lobes for 30 min,followed by perfusion in both groups.Ulinastatin 50 000 U/kg was injected intravenously at 5 min before occlusion in group U.Eight rats in each group were chosen and the blood samples were taken from the inferior vena cava for measurement of serum ALT and AST activities and HGF concentration before ischemia and at 1,6,12,24and 48 h of reperfusion.Then the right lobe were removed for determination of apoptosis,SOD and myeloperoxidase (MPO) activities,MDA content,expression of proliferating cell nuclear antigen (PCNA) and liver regeneration.Apoptotic index was calculated.Another 8 rats in each group were chosen and the 7 day survival rate was recorded.Results Compared with group H,the levels of ALT,AST,MPO aud MDA and apoptotic index were significantly decreased,and the levels of HGF and SOD,PCNA expression and liver regeneration were significantly increased at different time points in group U (P ＜ 0.05).There was no significant difference in 7 day survival rate between group H and group U (P＞ 0.05).Conclusion Ulinastatin pretreatment can strengthen liver regeneration after hepatectomy in rats,the underlying mechanism may be related to inhibition of oxidative stress response and increase in HGF production.

Objective To explore the application value of comparative imaging combined with multimedia teaching in the five-year undergraduate intemship teaching of nuclear medicine.Metbods 70 undergraduates internship in the nuclear medicine department of our hospital from June 2017 to February 2018 were divided into the control group and experimental group,35 in each group.The control group adopted traditional teaching method,and the experimental group adopted comparative imaging combined with multimedia teaching for internship teaching.The theoretical test scores,the evaluation of the self-perception of the teaching process and the teaching feedback of the two groups were compared.Results The theoretical test scores of the experimental group students were significantly higher than those of the control group,including the noun explanation [(26.60 ± 0.51) vs.(22.20 ± 0.58)],the short-answer question [(26.80 ± 0.37) vs.(22.40 ± 0.60)],the essay question [(36.00 ± 0.71) vs.(27.40 ± 1.03)] and total score [(92.40 ± 0.93) vs.(71.80 ± 0.37)].The satisfactions with the evaluation of the self-perception in the teaching process and the teaching feedback in the experimental group were also much better than those of the control group.Conclusion The application of comparative imaging combined with multimedia teaching in the practice teaching for undergraduate students in nuclear medicine could effectively improve the clinical practice teaching quality and actively promote the development of the teaching of nuclear medicine.

OBJECTIVE：To prepare the liposomes carrier materials lecithin.METHODS:The lecithin was extracted and prepared from fresh yolks.The purity,the content,the percentage of oxidation and the quality standard were studied.RESULTS:The lecithin we prepared was chromatographically homogeneous phospholipid,with no indication of any other components.The content of lecithin was more than 98%,the percentage of oxidation was very low,and the results of studies on the quality standard were fit for the USP.CONCLUSION:The results showed that,the lecithin we prepared could be used as the liposomes carrier materials.

The pharmacy department of medical institutions assumes important responsibilities in the emergency response work.The standard of pharmacy administration in emergencies is formulated based on the principles of scientificity,versatility,instructiveness,and operability,through sorting out problems,collecting opinions and expert argumentation.This standard has 49 standards of 9 key elements from three aspects:emergency mechanism,emergency support,and emergency services.This article aims to introduce the construction method and formulation process of the pharmacy administration in emergency standards,and analyzes the content,to guide for improving emergency response ability of the medical institutions'pharmacy department in emergency events.

AIM:To comprehensively evaluate the efficacy and safety of rituximab(RTX),tocilizumab(TCZ),and teprotumumab(TMB)in the treatment of thyroid-associated ophthalmopathy(TAO).METHODS:A systematic search was conducted in PubMed,Embase and Cochrane Library databases for systematic reviews/meta-analyses on TAO treat-ment,with the search time limited to January 2024.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 state-ment,Assessment of Multiple Systematic Reviews(AMSTAR)2 tool,and Grading of Recommenda-tions,Assessment,Development,and Evaluation(GRADE)were used to assess the reporting quality,methodological quality,and evidence quality of the included studies.RESULTS:The current systematic reviews on the three monoclonal antibodies in TAO treatment exhibited deficiencies in reporting quali-ty,methodological quality,and evidence quality.Di-rect comparative evidence between the three monoclonal antibodies is still lacking.Based on indi-rect comparative evidence,TCZ appears to be the most promising treatment option,followed by TMB and RTX.In terms of efficacy,TCZ and TMB signifi-cantly reduced the Clinical Activity Score(CAS),pro-ptosis,and improved quality of life.TCZ also signifi-cantly reduced the incidence of diplopia.RTX signif-icantly reduced disease response,while RTX and TCZ both significantly improved disease inactiva-tion rates.RTX showed no significant difference in diplopia,lid fissure changes,NOSPECS score and quality of life.The conclusions regarding safety are inconsistent,with TCZ and TMB potentially increas-ing the incidence of adverse events,while RTX showed no significant difference in safety com-pared to glucocorticoids or placebo.CONCLUSION:This study provides evidence-based insights for the selection of three monoclonal antibodies in the treatment of TAO.While TCZ may have advantages in efficacy,considering the limitations of existing evidence,more high-quality studies are needed to further verify and compare the efficacy and safety of different monoclonal antibodies in TAO treat-ment.