OBJECTIVE:To develop a method for the determination of midazolam in child plasma.METHODS:Plasma level of midazolam in twenty two ICU children with mechanical ventilation was detected by solid-phase extraction-HPLC after treatment with midazolam for 24h.The separation was performed on Zorbax Eclipse XDB C18 column with acetonitrile — 7.56mmol? L-1 ammonium sulfate(gradient elution) as mobile phase.The flow rate was 1.0mL? min-1,the column temperature was 25℃ and the wavelength of UV detector was 254nm.RESULTS:The calibration curves for midazolam had a good linearity over the range of 0.05～ 25.00mg? L-1(r=0.999 8).The average recovery for midazolam was 99.29%.Both the intra-day RSD and inter-day RSD were less than 4%.The limits of quantitation for midazolam was 0.01mg? L-1.CONCLUS-ION:The method is sensitive,accurate,simple and rapid,and applicable for clinical blood drug level monitoring of midazolam.

OBJECTIVE: To establish a HPLC method for the determination of plasma level of cefuroxime in experimental dogs. METHODS: 1. 0mL plasma samples were taken from experimental dogs at different time after intravenous injection of cefuroxime sodium 50mg? kg-1. Following pretreatment, the samples were subjected to determination on XDB-C18 chromatographic column. The mobile phase consisted of CH3CN-1‰ ( NH4) 2SO4 ( 12∶ 88) with a flow rate of 1. 0mL? min-1. The detection wavelength was 273nm and the column temperature was 25℃ . The quantification was performed by external standard method. RESULTS: Good linear relationship was achieved when the detection concentration of cefuroxime was within the range of 0. 5～ 250? g? ml-1( r=0. 999 5) . The average recovery of cefuroxime was 97. 76～ 116. 00% ( RSD

OBJECTIVE To investigate the distribution of pathogenic bacteria and clinic antibiotics usage in children′s hospital and provide basis for reasonable use of antibiotics. METHODS K-B disk agar diffusion method was adopted to detect drug susceptibility in vitro.Chi-square test was used to analyze the data. RESULTS Among all the pathogenic bacteria the proportion of Gram-negative bacteria was 67.1%,the first five predominant species were Escherichia coli,Klebsiella pneumonii,Enterobacter cloacae,Pseudomonas aeruginosa and Acinetobacter calcoaceticus/baumannii,accounted for 21%,16%,6.3%,6.0% and 6.0%,respectively.Piperacillin,cefuroxime and cefotaxime showed resemble curves of time-antimicrobial resistance. CONCLUSIONS Gram-negative bacteria are the main pathogens in children′s hospital.Resistance rates of most bacteria against the second and the third generation cephalosporins have increased markedly.Obvious mutiple-antimicrobial resistance exists among antibiotics with resemble structures and antimicrobial mechanisms.The trend of change in antibiotics′ resistance is parallel with that of the drug′s quantity used.Rotative principles may be applied to the usage of antibiotics.

OBJECTIVE:To study the pathogenic organism of sepsis in children with tumor and its drug sensitivity for references of clinical medication.METHODS:The drug sensitivity of hemoculture samples of children with neoplastic hema-tologic disorder was detected by paper disk method.RESULTS:Of the total109pathogenic bacteria isolated from hemoculture samples,60(55.0%)were gram-positive(G + )bacteria,47(43.1%)were gram-negative(G - )bacteria and2(1.8%)were fungi.Vancomycin,teicoplanin and aminoglycosides were more sensitive to G + bacteria,while carbopenems and cefoperazone/sulbactam were more sensitive to G - bacteria.CONCLUSIONS:In treating sepsis in children with tumor,the choice of drugs should be based on the drug sensitivity test,the possibility of G + and G - bacteria infections should be considered in empiric treatment and the possibility of mycotic infection should also be considered after long-term administration of antibacterials.

OBJECTIVE:To explore the role of clinical pharmacists in the treatment of critical patients at perinatal stage. METHODS:During the treatment process of 4 critical patients at perinatal stage,according to the patients'special pathophysiolog-ic status (such as urea cycle disorder,dyslipidemia,severe infection,can not recover circulating blood volume rapidly,etc.), weighing the order of priority,based on relevant guidelines and literatures,clinical pharmacists provided individual medication ad-vices in respects of drug selection,medication timing,treatment course,drug combination and dosage adjustment,such as using cefuroxime,reduced glutathione,ursodesoxycholic acid,etc.,stopping drugs timely or adjusting antibiotics therapy plan. They al-so provided pharmaceutical care as lab index determination and ADR monitoring. RESULTS:Physicians adopted clinical pharma-cists'advices,and then 4 critical patients were all recovered. CONCLUSIONS:During the treatment course of critical patients at perinatal stage,clinical pharmacists should select safe and effective drugs as much as possible and adjust therapy plan in time ac-cording to clinical symptoms. When the security runs counter to effectiveness,clinical pharmacists should fully weigh the advantag-es and disadvantages and guarantee the maximum safety of pregnant or delivery women and fetuses.

Objective To evaluate the efficacy and safety of platinum-based chemotherapy in elderly patients with advanced non-small cell lung cancer(NSCLC). Methods Clinical data of forty-one elderly patients (≥70 years) with advanced NSCLC who were treated by platinum-based chemotherapy were analyzed retrospectively. Results Among the 41 patients, 18 (43.9%) patientswere treated with vinorelbine, 9 (22.0%) patients with gemcitabine, 7 (17.1%) patients with paclitaxel and docetaxel respectively. The overall response rate was 19.5%. The median time to progression (MTTP) was 5.8 months, and 1-year survival rate was 65.8% with a median survival time (MST) of 14.2 months. No significant statistical differences were found among the four regimens. The major side effect was bone marrow suppression. Three patients withdrew chemotherapy after one cycle due to grade Ⅲ-Ⅳ myelosuppression. There was no death associated with chemotherapy. Conclusions The platinum-based combined chemotherapy is effective and well-tolerated in elderly patients with advanced NSCLC.

The fall risk was evaluated with Modified Falls Efficacy Scale (Chinese version) in 426 elderly hypertensive patients (hypertensive group) and 436 elderly people without hypertension (control group) from rural communities in Zhejiang Quzhou areas.The fall risk scores were compared between hypertensive group and control group ; and also between patients with history of falls and those without falls.The results showed that the average score was 8.62 ± 2.15 in hypertensive group and 9.35 ± 1.35 in control group (P ＜ 0.01).The average score was 6.94 ± 1.85 in hypertensive patients with history of falls (n =112) and 9.22 ± 1.42 in without history of falls (n =314) (P ＜0.01).Our study suggests that there is a higher fall risk in elderly hypertensive patients than in elderly people without hypertension; and fall risk assessment with Modified Falls Efficacy Scale (Chinese version) can be used for prediction of fall for the elderly people in rural community.

Objective To investigate the relationship between changes of cholinergic system and memory ability impairment in rats long-term exposed to hypoxia-hypercapnia.Methods Forty-eight SD rats were randomly divided into control group,2 weeks hypoxia-hypercapnia group and 4 weeks hypoxiahypercapnia group.The chronic hypoxia-hypercapnia rat model was set up.The memory ability was assessed by eight-arm radial maze.Morphological changes were observed by the HE staining and Nissl staining.Acetylcholine(ACh) content,choline acetyl-transferase (ChAT) activity and acetyl-cholinesterase (AChE) activity in the hippocampus were detected by spectrophotometry,while expression of α7 neuronal nicotinic acetylcholine receptor (α7 nAChR) protein by Western blot.Results Memory ability,especially the working memory was impaired in rats exposed to chronic hypoxia-hypercapnia.And the memory ability decreased more markedly in four weeks group.Compared with those of normoxic rats,the levels of ACh and the activities of AChE and ChAT in the hippocampus of the two weeks group were significantly decreased (ACh:(58.9 ±2.7) vs (47.4 ±3.2) μg/mg (protein) ; AChE:(0.326 ±0.019) vs (0.247 ±0.020) U/mg (protein) ; ChAT:(127.1 ±8.6) vs (90.4 ±6.9) U/g (tissue wet weight),t =7.674,8.139,9.408,all P ＜ 0.05).Compared with the two weeks group,those changes were more obvious in the four weeks group rats (ACh:(47.4 ±3.2) vs (32.5 ±3.2) μg/mg (protein); AChE:(0.247 ±0.020),(0.170±0.019) U/mg (protein); ChAT:(90.4 ±6.9),(55.6 ±6.0) U/g (tissue wet weight),t =9.279,8.036,10.781,all P ＜ 0.05).Compared with the normoxic rats,the expressions of α7 nAChR protein were significantly decreased in two weeks group rats (t =4.481,P ＜ 0.05).Moreover,the expressions of α7 nAChR protein were significantly decreased in four weeks group rats comparing with the two weeks group (t =4.965,P ＜ 0.05).Conclusions An impairment of rat' s memory ability may be induced by hypoxia-hypercapnia,and the injury degree is correlated with the exposure time.Cholinergic system dysfunctions may contribute to the memory function defects in chronic hypoxia-hypercapnia rats.

OBJECTIVE:To establish evaluation system and quality management of dispensing department in hospital and provide basis for comprehensive and correct assessment of pharmacy dispensing work.METHODS:Based on the platform of human resource management,the flow and job responsibility of drug dispensing were adjusted."Drug dispensing work quality management specification and performance evaluation system" was established and put into practice.RESULTS:Drug dispensing quality management had criteria and principles to go by.The level of management staff were improved dramatically.58.3% of department administrators were younger than 40 years old,who were recruited and went on duty after passing examination.CONCLUSION:"Drug dispensing work quality management specification and performance evaluation system" is the comprehensive requirement of effectively ensuring the quality of drug dispending work and safety of drug utilization and reflects the standard and scientific management of drug dispensing.

OBJECTIVE:To provide reference information for the adoptation of fast drug dispensing model in hospital pharmacy of China.METHODS:The procedure of fast drug dispensing system(FDDS)was analysed and compared with tradi?tional dispensing system in advantages and disadvantages.RESULTS:FDDS could raise the speed,accuracy of drug dispensing and improve the quality of pharmaceutical service.CONCLUSION:FDDS is suitable for drug dispensing in large-scale hospi?tals.