Digoxin is the most frequently prescribed cardiac glucoside in pediatrics.Owing to its pharmacokinetics profile and narrow therapeutic index,some cases such as digoxin intoxication or dose insufficient are not rare.Recent evidence suggests that age,weight,hepatic and renal function,intestinal microbiome,drug interactions and others have influence on the pharmacokinetics of digoxin.So more attentions should be paid to the influencing factors mentioned above when digoxin concentration is monitored except observing intoxication to ensure rational drug use.

Objective To observe the influences of Siwu Decoction on perioperative hidden hemorrhage in senile patients with intertrochanteric fractures, and to supply evidence for Chinese medicine in treating the hidden hemorrhage of senile intertrochanteric fractures patients. Methods By following the inclusion and exclusion standard, 36 patients were admitted into the study. With reference to the medication of Chinese medicine, the patients were divided into treatment group and control group. All of the patients were given conventional anti-infection medicine, symptomatic treatment and dietary guidance. In addition, the treatment group took Siwu Decoction orally, 10 days constituting a period of treatment from the third day after surgery. Before and after treatment, we observed hemoglobin (Hb) level, hematocrit (Hct) and hidden blood loss (intraoperative and postoperative) . Results Hb level was increased and hidden blood loss was decreased in the treatment group ( P<0.05 compared with those before treatment) , but the changes were not obvious in the control group (P>0.05) . The improvement of Hb level and hidden blood loss in the treatment group was superior to that in the control group (P<0.05) . Conclusion Siwu De-coction can increase Hb and Hct levels in senile patients with intertrochanteric fractures, which results into the im-provement of perioperative hidden blood hemorrhage to some extent.

Objective To explore the application of transanal drainage tube in decompression of acute left- sided colorectum obstruction and its nursing. Methods Twenty- one cases of patients, with acute left-sided colorectal obstruction, were enrolled in this study from 2011 and 2014, Results Of the 21 cases, 5 failed to drip, 6 was difficult to drain, 2 having loose stools around the anus, 2 with the tubes out of the anus, and 6 with obstructed tubes during the drainage. Nineteen finally underwent surgery, 16 of which with 1- stage operation, and 13 of the 16 with sufficient lymph node dissection, without stoma leakage. Conclusions Transanal drainage tube plays an important part in acute left- sided colorectal obstruction, and a professional nursing work could help maintain the unobstruction of the tube, which is of much importance in the procedure of the drainage and the decompression of the obstruction.

Objective To establish a method for direct determination of arsenic in water by graphite furnace atomic absorp-tion spectrometry.Methods The contents of arsenic in water samples were directly determined by graphite furnace atomic ab-sorption spectrometry under given conditions of wavelength,ashing and atomization temperature after adding an appropriate amount of nickel sulfate to water samples without enrichment,extraction or transformation of arsenic into hydrogen arsenide of the samples.Results The linear range of the method was0.005-0.200mg /L with a correlation coefficient of0.9996.The re-covery rate,relative standard deviation and detection limit were95.0%-105.0%,4.0%-7.5%and0.005mg /L respectively.Con clu sion Compared with the silver salt method and hydride generation-atomic absorption spectrometry,this method had many advantages such as simplicity of operation,rapidity and suitability for the analysis of batch samples.

The ocean is a huge resource of organisms and about 80% of the world species live in it.Marine organisms synthesize various structurally-unique and pharmacologically-active metabolites which differ from those derived from the land organisms and serve as lead compounds for drug development.More than 15 000 new compounds have been isolated and identified from marine animals,plants and microorganisms since decades ago,and drugs like cephalosporins,ziconotide(Prialt),cytarabine(AraC) and vidarabine(AraA) were developed using these compounds as precursors.

OBJECTIVE: To investigate the status quo and feature of the distribution rationality of licensed pharmacists in different regions in China in recent 2 years.METHODS: Using "per capita licensed pharmacists every ten thousand people" as index to contrast and analyze the distribution of licensed pharmacists.SPSS13.0 statistical analysis software was used to calculate the distribution Tail index(TI) of licensed pharmacists in the east,middle,and west regions of China taking population and GDP as weight.RESULTS: The distribution of licensed pharmacists in the east region in China was more intensive;TI was far greater when using population as weight than using GDP as weight,and all TI decreased in the past 2 years.CONCLUSIONS: The licensed pharmacists should be distributed rationally according to the practical demand on pharmaceutical care,and the government should intensify the education and training of licensed pharmacists in the middle and west regions of China.

OBJECTIVE:To investigate the status quo and the feature of licensed pharmacists in Hubei province to provide experimental reference and policy bases for the concerned governmental department in making decision about management regulations. METHODS: 486 licensed pharmacists who came to attend the continuing education were investigated by questionnaire survey and personal interview regarding their essential information, social approval, and attitude towards their profession etc. RESULTS: The obtained essential information of the licensed pharmacists in Hubei province revealed that the majority of them regarded that they failed to bring their role in into full play in their daily work and their social approval degree was low; as for attitude towards their profession, most of the interviewees responded that the evolvement of policy is the important factor to bring into the role of licensed pharmacists into full play, meanwhile they thought highly of the active role of continuing education. Different type of licensed pharmacists have different needs, to satisfy the diversified needs, a pertinent study is needed. CONCLUSION: The government should establish licensed pharmacists law as soon as possible to identify the legal position of licensed pharmacists and solve their orientation problem so as to bring their role into full play.

OBJECTIVE:To survey the implementation of pharmaceutical care in various levels of medical institutions in Shanghai and introduce the foreign experience in order to find out defect and orientation in the field of pharmaceutical care in China. METHODS:The pharmaceutical care practices of clinical pharmacists in sampled hospitals were surveyed using questionnaire in order to survey the status quo of the implementation of clinical pharmacy projects in various levels of hospitals in Shanghai. The focused projects were evaluated to analyze the advantage and disadvantage of pharmaceutical care provided by clinical pharmacists in various levels of hospitals and orientation of pharmaceutical care in the future. RESULTS:Medical care and pharmaceutical care in China which were different from foreign model of pharmaceutical care with community pharmacy as main model presented multi-level operating model. The scales of pharmacy in China were ranged from community-based health service station to grade A class three hospital according to the rank of hospital. CONCLUSION:The development of pharmaceutical care in China requires clinical pharmaceutical staff overcome the difficulty and strive to make innovation.

Childhood asthma and obesity are significant public health problems all over the world.In the past decades,the prevalence of both diseases has increased considerably.Because both asthma and obesity appear to have their beginnings in early childhood,common exposures that predispose individuals to both conditions may explain how they are associated.These exposures include common genetic predictors,prenatal exposure to specific nutrients and overall maternal nutrition, colonization patterns of the neonatal and infant gut,birth weight and infant weight gain,and sedentary behaviors in early life.

Deletions,insertions,duplications,and complex multi-site variants,now formally termed copy number variations(CNVs),are regions larger than 1 kb that are present with variable copy numbers in comparison with the reference genome.CNVs in humans and other mammals are associated with a series of complex genetic diseases including congenital heart disease.The studies of CNVs have become hot topics.This review mainly discusses the principle of CNVs,the detection techniques and CNVs in the pathogenesis of congenital heart