OBJECTIVE:To provide reference for further standardizing and perfecting the management of drug unpacking in outpatient pharmacy.METHODS:A total of 6 primary and secondary health institutions (4 community health service centers and 2 secondary hospitals) were selected from 2 districts in Shanghai to conduct a questionnaire survey on the use of their drugs and drug unpacking in outpatient pharmacy.The survey data was analyzed statistically.RESULTS:Totally 6 institution questionnaires and 6 pharmaceutical staff questionnaires were sent out,all were received with recovery of 100％.In 2015,the average number of essential medicines in community health service centers and secondary hospitals were 496.50,542.00,respectively,and the average number of varieties sold were 530.75,1 052.00.In outpatient pharmacy of surveyed community health service center,the number of unpacked drugs was 10-21 which were essential drugs and class A medical insurance drugs,and the consumption sum of unpacked drug ranged 5.56-16.70 ten thousand yuan.In outpatient pharmacy of 2 two secondary hospitals,the number of unpacked drugs were 17 and 23,respectively,most of which were essential drugs and class A medical insurance drugs,and the consumption sum of unpacked drug ranged 13.19 to 158.06 ten thousand yuan.The proportion of unpacked drugs was less than 5％ of the total number of varieties sold,and the proportion of consumption sum of unpacked drugs was less than 1％ of total consumption sum.Estazolam tablets and Alprazolam tablets took up the top 5 in the list of consumption sum of unpacking drugs in 2 types of intervi ewed instiutions.All the surveyed institutions were not equipped with drug dispensing machine in the outpatient pharmacy,still depended on manually unpacking.There were four institutions to regularly arrange the unpacking,unpacking frequency was usually 1 to 3 times a week,supplemented by the need to arrange unpacking,and another two to implement a daily unpacking.There were 5 institutions to develop a drug unpacking mechanism in the institutions,but the relevant system was not perfect.CONCLUSIONS:The enthusiasm of pharmaceutical saff in primary and secondary health institutions in Shanghai to carry out or engage in unpacking work need to be improved,the instructions for unpacked drugs are not available on request,and the way to unpack drugs still needs to explore.

This work was supported by Science and Technology Program of Health and Family Planning Commission of Jiangxi Province (No.20161106) Abstract Objective: To investigate the prognostic value of subventricular zone (SVZ) invasion in glioma patients. Methods: The clini-cal data of 175 patients with glioma diagnosed based on pathology in Jiangxi Province Cancer hospital between January 2010 and July 2015 were analyzed retrospectively. There were 59 cases of World Health Organization (WHO) gradeⅡ, 59 cases of WHO gradeⅢ, and 57 cases of WHO gradeⅣat the first diagnosis. There were 75 cases of SVZ invasion (SVZ+) and 100 cases of SVZ non-invasion (SVZ-) according to preoperative magnetic resonance imaging. The survival outcomes of both cohorts were compared using the Log-rank test. The correlation between the recurrence pattern and SVZ involvement was analyzed using Chi-square tests. Results: The me-dian follow-up time was 63 months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 42.2% and 37.5%, respectively. These were 20.9% and 15.3% in the SVZ+group, compared with 57.1% and 44.1% in the SVZ-group, respectively (P<0.001 and P<0.001, respectively). The SVZ+group had fewer cases of total resection, larger lesions (maximum diameter greater than 5.0 cm), and more cases of gradeⅣ(P<0.001, P<0.001, and P=0.018, respectively). There were 89 cases of recurrence. The total recur-rence rate was 62.7% in the SVZ+group, compared with 42.0% in the SVZ-group (P=0.007); the distant recurrence rates were 21.3% and 7.0% (P=0.004), respectively. Conclusions: SVZ invasion is a poor prognostic factor for OS and PFS in gliomas, which is positively correlated with a low total resection rate, large lesions, and gradeⅣlesions, and increases the probability of total recurrence and dis-tant recurrence.

Objective:To assess the prognostic factors of World Health Organization(WHO)grade Ⅱ gliomas.Methods:A total of 146 patients diagnosed with WHO grade Ⅱ gliomas were treated at Jiangxi Province Tumor Hospital between June 1997 and April 2015,in-cluding 90 gross total resections(GTRs)and 56 partial resections.According to the 2007 WHO grading system of gliomas,there were 96 astrocytomas,30 oligodendrogliomas,and 20 oligoastrocytomas.Results:The median follow-up time was 88 months.Five-year overall survival(OS)and progression-free survival(PFS)rates were 75.7% and 60.0%,respectively,and 10-year OS and PFS rates were 57.4% and 37.8%,respectively.Univariate analysis of OS revealed statistically significant differences in age,sex,subventricular zone (SVZ) invasion, peritumoral edema, residual tumor volume, preoperative tumor size and numbers, and the extent of resection (P<0.05). Compared with astrocytoma patients, oligodendroglioma patients had better OS and PFS (P=0.040 and 0.049, respectively). Among those factors,sex,SVZ invasion,residual tumor volume,preoperative tumor numbers,and the extent of resection were like-wise significant for PFS (P<0.05). Multivariate analysis revealed that the extent of resection, SVZ invasion, and peritumoral edema were independent prognostic factors for OS(P<0.05)and the extent of resection and tumor numbers were independent prognostic fac-tors for PFS(P<0.05).Sixty patients developed recurrences,including 53 tumor bed failures and 7 intracranial disseminations.Conclu-sions:The extent of resection,SVZ invasion and peritumoral edema may be independent prognostic factors for OS in low-grade glio-mas.Postoperative radiotherapy would improve PFS for patients who underwent GTRs.The major pattern of failure was tumor bed re-currence.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.