OBJECTIVE:To enhance the level of rational use of drug in hospitals.METHODS:The rational use of drug software system-Prescription Automatic Screening System(PASS)was installed and operated at doctor workstation,clinic pharmaceutical workstation and inpatient pharmacy including the intravenous drugs distribution center,where also nested with the patients'information consulting system;the function of information confirmation about the quantity and kinds of drugs was developed as well so as to share data in the PASS and hospital information system,and construct a computer network sys?tem of rational use of drug in the clinic,also be used in the clinic.RESULTS:The network of rational use of drug provided an effective means for instructing and monitoring use of drug in the clinic.CONCLUSION:Developing digital computer means for the pharmacy services in the clinic is practicable and effective.

OBJECTIVE:To evaluate the cost and effectiveness of three pharmacotherapeutic schemes for hemorrhage of upper digestive tract caused by liver cirrhosis.METHODS:132 patients with hemorrhage of upper digestive tract were treated by different drugs:octreotide(49),somatostatin(42),pituitrin(41).Evaluation was carried out with pharmacoeconomic cost-ef_fectiveness analysis.RESULTS:The hemostatic rates of octreotide,somatostatin and pituitrin for rupture of esophageal varicosis were 88.89%,80% and 46.15%;for peptic ulcer bleeding associated with liver cirrhosis 88.89%,87.50% and 50.00% and for hemorrhage from acute gastric mucosa erosion combined with liver cirrhosis 100.00%,94.44% and 68.18%,respectively.The costs of octreotide,somatostatin and pituitrin schemes were RMB 2 242.8,3 294 and 996.2 yuans,respectively.CONCLU_SION:According to the evaluation with pharmacoeconomic cost-effectiveness analysis,the therapeutic scheme of pituitrin seems to be the best one for treating hemorrhage of upper digestive tract resulting from liver cirrhosis.

OBJECTIVE: To probe into the standardized management of dispensing in the pharmacy METHODS: To introduce the idea of standardization in dispensing, to establish and implement SOP(standard operating procedure), to carry out networking management, to setup the modern facility, and to introduce the new open and divisional mode for dispensing drugs and to put dispensing and supply of drugs in over - inclusive standardized management .RESULTS: The standardized management of dispensing and supply of drugs was achieved on the whole and the aim of precise dispensing and scientific management was fulfilled. CONCLUSION: The establishment and implementation of SOP, the networking management of drugs and mord-ernization of facility are the basis of standardization of dispensing of drugs.

Objective: To establish the identificational method of Compound Biejiaruangan Tablets. Methods: The microscopic identification and TLC were used. Results: Carapax Trionycis, Radix Paeoniae Rubra, Radix Notoginseng, Placenta Hominis, and Cordyceps in Compound Biejiaruangan Tablets can be distinguished by microscopic identification and Cordyceps, Fructus Forsythiae and Radix Notoginseng can be identified by TLC, respectively. Conclusion: This method is simple, rapid and with a good reappearance, and available for quality control of the preparation.

Breast cancer stem cells (CSCs) are the main causes leading to the failure of treatment of breast cancer and play important roles in the progression of breast cancer and drug resistance, which are closely related to the therapeutic resistance of radiotherapy and chemotherapy, and endocrine therapy.The metastatic potential and therapeutic resistance of CSCs are associated with epithelial mesenchymal transition and Hedgehog, Wnt, interleukin-6/signal transduction and tanscriptional activation factor 3, transforming growth factor-β and other signaling pathways.While some of the targeted drugs targeting these signaling pathways are undergoing clinical transformation, which is expected to provide new approach for the clinical treatment of breast cancer.

OBJECTIVE　To study the pharmacokinetics of omeprazole (OME) in 8 patients with liver cirrhosis.METHODS　The plasma concentrations of OME were determined by HPLC,and the pharmacokinetic parameters were computed by using 3P97 program.RESULTS　The plasma concentration versus time curve following intravenous 40 mg OME in patients with liver cirrhosis was coincident with two-compartment model.The elimination half-life was (3.34±0.38) h,which was longer than the value of the healthy volunteers and CLs was lower than the value of the healthy volunteers.CONCLUSION　The dosage of OME may be given in the half of the routine dosage or adjusted conditionally when using for the patients with liver cirrhosis.

Objective To verify the clinical effect of Qinghuang powder in chronic myelogenous leukemia(CML). Methods 86 CML patients treated with Qinghuang powder, in which 28 cases also partially received herbal medicine (activating blood circulation to dissipate blood stasis). Results 62 cases had complete remission (72.1%), 14 cases partial remission (16.3 %), advance 8 cases(9.3 %), inefficiency 2 cases (2.3 %), and the total efficiency was 97.7 %. The symptom were improved after a week when patients had taken medicines. 44 cases have hepatomegalia, among them 39 cases have diminished or became normal compared to untreated. 70 cases have splenoparectasis, among them 60 cases became normal, 9 cases diminished, and 1 case had no change after treatment. It took 15.5 days in average when spleen began to diminish, and took 62.9 days to become smallest. The WBC began to decrease at 10.4 day and took 54.8 days in average became normal. The major side effect was digestive tract symptom, followed by skin pigmentation and skin excessive cornification. It could be avoided by low dosage. Conclusion Qinghuang powder could not only induce CML to CR, but also improve the clinical symptom of CML and eliminate the infiltration of leukemia cells. It has little influence to Hb and Plt.

OBJECTIVETo evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL).

METHODSThe clinical data were analyzed in 4 cases of urosepsis caused by ESWL during the period from January, 2008 to October 2011.

RESULTSTwo of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture revealed the presence of E. coli in 2 cases, Klebsiella pneumoniae in 1 case and Pseudomonas putida combined E. coli in 1 case. All the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and anti-inflammatory therapy. The vital signs of the patients became stable after 5-11 days (mean 6.75 days). Three patients underwent ureteroscopic lithotripsy, and 1 patient had emergency ureteral stent indwelling. All the 4 patients were cured and discharged.

CONCLUSIONESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for which early nonsurgical interventions should be administered immediately after the diagnosis is established.

Adult ; Female ; Humans ; Lithotripsy ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Sepsis ; etiology ; therapy ; Ureteral Calculi ; therapy ; Urinary Tract Infections ; etiology ; therapy

OBJEVTIVETo analyze the complications of extracorporeal shock wave lithotripsy (ESWL) for treatment of lower urinary tract stones and identify the factors contributing to the complications.

METHODSWe retrospectively analyzed the postoperative complications of ESWL in 83 patients with lower urinary tract stones and their association with the patients' age, height, body weight, body mass index (BMI), stone features, shock wave times, and shock wave energy.

RESULTSOf the 83 cases treated with ESWL, 72.3% (60 cases) showed gross hematuria, 27.7% (23 cases) complained of pain, and 25.3% (21 cases) had both pain and gross hematuria. None of the patients reported vomiting, skin rash, flatulence, gastrointestinal bleeding or other complications. Patients with postoperative gross hematuria, pain, and both had significantly greater stone length, stone width and more shock body times than those without these complications (P<0.01 or P<0.05). Patients with gross hematuria had significantly lower height than those without complications (P<0.05).

CONCLUSIONThe common complications of ESWL for lower urinary tract stones include hematuria and pain. The patient's height, stone length, stone width and shock times are important factors contributing to these postoperative complications.

Abdominal Pain ; etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Hematuria ; etiology ; Humans ; Lithotripsy ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Urinary Bladder Calculi ; therapy ; Young Adult

Objective:To explore the clinical effect and application value of simultaneous modulated accelerated radiotherapy (SMART) in the suspicious positive lymph nodes of head and neck.Methods:From January 2017 to February 2019, 60 patients with suspected positive lymph nodes in the head and neck in the Hanzhong Central Hospital of Shaanxi Province were divided into experimental group and control group according to different treatment plans, and 30 patients in each group were included. In the experimental group, 63.36 to 66.66 Gy patients were treated with SMART, while in the control group, 54.12 to 60.06 Gy patients were treated with conventional neck prophylactic radiation. In order to evaluate the feasibility of the method, the change of the short diameter of the largest cross section of the suspicious positive lymph nodes in the two groups were observed, and the adverse reactions in the treatment of the two groups were analyzed.Results:There was no significant difference between the two groups before treatment ( P>0.05). After treatment, the size of short diameter of lymph nodes in the two groups was smaller than that before treatment. The maximum short diameter of the largest cross section of lymph nodes in the experimental group was smaller than that before treatment: (0.43 ± 0.07) cm vs. (0.72 ± 0.10) cm, and the difference was statistically significant ( P<0.05). In the control group, the maximum short diameter of the largest cross section of lymph node decreased after treatment, and the difference was not statistically significant ( P>0.05). After treatment, the reduction of the short diameter in the experimental group was more obvious than that in the control group. The maximum short diameter of the largest cross section between the two groups: (0.43±0.07) cm vs. (0.66±0.08)cm was statistically significant ( t = 11.523, P<0.05). Before treatment, hemoglobin (HGB) levels of the two groups were in the normal physiological range, and there was no significant difference between the two groups ( P>0.05); the white blood cell (WBC) levels of the two groups at different time after treatment were compared: in the first week (7.83 ± 2.53) × 10 9/L vs. (8.26 ± 3.16) × 10 9/L, in the third week (7.14 ± 3.65) × 10 9/L vs. (7.08 ± 2.53) × 10 9/L, in the fifth week (5.47 ± 2.81) × 10 9/L vs. (6.41 ± 2.57) × 10 9/L, and in the seventh week (4.36 ± 2.59) × 10 9/L vs. (4.98 ± 1.64) × 10 9/L, and there were statistical differences ( P<0.05), which indicated that the WBC index levels of the two groups were gradually decreased during the treatment, and the decreased degree of the experimental group was higher than that of the control group. The levels of HGB and PLT were maintained in the normal physiological range before and after treatment, and there was no significant difference between the two groups ( P>0.05). The main complications in the treatment of the experimental group were xerostomia and stomatitis. The adverse reactions in the control group were pain in the target area of radiotherapy. There was no significant difference between the two groups ( P>0.05). Conclusions:The application of IMRT is an effective method for the treatment of occult lymph node metastasis, and it is also a therapeutic diagnostic method, which can provide evidence for the study of the law of lymph node metastasis in the head and neck. The safety and tissue tolerance of IMRT in the treatment of suspicious positive lymph nodes in the head and neck are good, which can be used for the suspicious lymph nodes in the head and neck. The treatment of positive lymph nodes and the evaluation of patients′ prognosis provide an effective way of clinical treatment.