OBJECTIVE:To investigate the condition and characteristics of drug-induced liver injury (DILI) of anti-infective agents and provide reference for the prevention and treatment of anti-infective agents related DILI. METHODS:Based on retrospective analysis,a total of 572 DILI reports of anti-infective agents were collected from PLA ADR monitoring center during 2009 to 2013, and then analyzed statistically in terms of patient’s age and gender,main diagonosis,categories of DILI-inducing drugs,type,route of administration,occurrence time,lab indicator,DILI types and clinical manifestations,the application of liver protective drugs,out-comes,etc. RESULTS:Among 572 DILI cases,there were 412 cases(72.03%)of male patients and 160 cases(27.97%)of female patients,and average age of the patients was(44.54±23.75)years old. ADRs were related to 57 kinds of anti-infective agents in 6 cat-egories. Rifampin was the most frequent in suspected drugs,followed by isoniazid,moxifloxacin,fluconazole,azithromycin,cefurox-ime, cefoperazone/sulbactam, levofloxacin, cefoxitin and voriconazole. Intravenous infusion was the main administration route (74.48%). The occurrence time of ADRs was mainly within two weeks (86.19%). Hepatocellular damage (93.33%) was the main type in 360 cases of ADR for evaluation of liver injury types. The majority of cases(82.17%)were cured or improved after drug with-drawal and symptomatic treatment. CONCLUSIONS:Cephalosporin,fluoroquinolones,antituberculosis and antifungal drugs might be the common agents which caused liver injury. Hepatocellular damage is the most frequent type. Most of patients have a favourable prognosis. Clinical medical staffs should strengthen the awareness of DILI caused by anti-infective agents and ehance the prevetion of it.

Objective To explore the influence and it′s mechanism of workplace mindfulness on thriving at work of nursing staffs. Methods A cross-section survey was conducted to collect data with an online method, the multiple line hierarchical regression analysis method was performed to test the relations between variables. Results The mean workplace mindfulness score of nursewas 4.74±0.63, the mean thriving score was 3.07 ± 0.71. Workplace mindfulness had a significantly positive prediction on thriving at work (β=0.344, P<0.01) of nurses. Conclusions Workplace mindfulness could affect nurses′thriving at work, which is beneficial to improve the growth and vitality of nursing staffs, which in turn to enhance them to abundant and vigorous life.

A simple and quick method is described for the determination of ferulic acid, senkyunolide I, senkyunolide H, senkyunolide A and ligustilide in rhizomes of Ligusticum chuanxiong. The 5 active ingredients in the sample was extracted using 40% ethanol and analyzed by reversed-phase high performance liquid chromatography (HPLC). Chromatography separation was performed using Agilent 1100 series HPLC system with a Symmetry C18 column and gradient elution with a mixture of three solvents : solvent A, acetonitrile, solvent B, methanol and solvent C, 1% aqueous acetic acid, 0 min to 5 min A: B: C 20: 40: 40, 5 min to 30 min A: B: C 60 to 100 : 0 : 40 to 0. The effluent was monitored using a VWD detector set at 321 nm (0-4.3 min) and 275 nm (4.31-30 min). The flow rate was set at 1 mL x min(-1) and the injection volume was 10 microL. The column temperature was maintained at 35 degrees C. The calibration curve was linear (r > or = 0.99) over the tested ranges. The average recovery was 94.44%-103.1% (n = 6). The method has been successfully applied to the analysis in different harvest periods of L. chuanxiong samples. In this paper, single-factor randomized block design to study the 5 components content of L. chuanxiong on ten collecting stages. For the L. chuanxiong collected from April 15th to May 30rd, the content of 5 ingredients increased primarily, and then decreased. Determine the appropriate harvest time has important significance to the promotion of the quality of L. chuanxiong.
4-Butyrolactone ; analogs & derivatives ; analysis ; Acetic Acid ; chemistry ; Acetonitriles ; chemistry ; Benzofurans ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coumaric Acids ; analysis ; Ligusticum ; chemistry ; Methanol ; chemistry ; Solvents ; chemistry ; Time Factors

OBJECTIVEStudy the actual dosage of clinical prescription in pediatrics of traditional Chinese medicine (TCM), and offer the consummate data for formulating the dosage standard of Chinese cut crude drug.

METHODWe made use of the methods of stratified sampling and random sampling to investigate 38 736 broth prescriptions of pediatrics of TCM in 21 various hospitals, 18 provinces, and constructed the database, then applied Weka KDD software to analyze.

RESULTWe identified the frequency and clinical dosage intervals of 300 drugs, and the practical dosage of 155 drugs. Most of drug's dosage centralized the four intervals: (3-6], (6-9], (9-12], (12-15], and the concrete dosage were 6, 9, 10, 12, 15 g, etc.

CONCLUSIONThe dosages in the pharmacopoeia are not coincided with the practical dosages in pediatrics, and demand to revise. This paper will offer the consummate data for formulating the new dosage standard.

Adolescent ; Child ; Child, Preschool ; Dosage Forms ; Humans ; Medicine, Chinese Traditional ; methods ; Pediatrics ; methods ; Prescriptions

OBJECTIVEStudy the actual dosage of clinical prescription in surgery of traditional Chinese medicine (TCM), and offer the consummate data for formulating the dosage standard of Chinese cut crude drug.

METHODWe made use of the methods of stratified sampling and random sampling to investigate 84,759 broth prescriptions of surgery of TCM in 21 various hospitals, 18 provinces, and constructed the database, then applied Weka KDD software to analyze.

RESULTWe identified the frequency and clinical dosage intervals of 300 drugs, and the practical dosage of 155 drugs which dose has difference between in the actuality and in the pharmacopoeia. Most of drug's dosage centralized the four intervals: (3-6], (9-12], (12-15], (18-21], and the concrete dosage were 3, 6, 10, 12, 15, 20 g, etc.

CONCLUSIONThe dosages in the pharmacopoeia are not coincided with the practical dosages in surgery, and demand to revise. This paper will offer the consummate data for formulating the new dosage standard.

Dosage Forms ; standards ; Drugs, Chinese Herbal ; administration & dosage ; General Surgery ; Medicine, Chinese Traditional ; methods

OBJECTIVEStudy the actual dosage of clinical prescription in gynecology of traditional Chinese medicine (TCM), and offer the consummate data for formulating the dosage standard of Chinese cut crude drug.

METHODWe made use of the methods of stratified sampling and random sampling to investigate 41,226 broth prescriptions of gynecology of TCM in 21 various hospitals, 18 provinces, and constructed the database, then applied Weka KDD software to analyze.

RESULTWe identified the frequency and clinical dosage intervals of 300 drugs, and the practical dosage of 155 drugs which dose has difference between in the actuality and in the pharmacopoeia. Most of drugs dosage centralized the three intervals: (3-6], (9-12], (12-15], and the concrete dosage were 9, 10, 12, 15 g, etc.

CONCLUSIONThe dosages in the pharmacopoeia are not coincided with the practical dosages in gynecology, and demand to revise. This paper will offer the consummate data for formulating the new dosage standard.

Drug Administration Schedule ; Female ; Gynecology ; methods ; Humans ; Medicine, Chinese Traditional ; methods

OBJECTIVEStudy the actual dosage of clinical prescription in medical department of traditional Chinese medicine (TCM), and offer the consummate data for formulating the dosage standard of Chinese cut crude drug.

METHODWe made use of the methods of stratified sampling and random sampling to investigate 269 882 broth prescriptions of Medical Department of TCM in 21 various hospitals, 18 provinces, and constructed the database, then applied Weka KDD software to analyze.

RESULTWe identified the frequency and clinical dosage intervals of 300 drugs, and the practical dosage of 155 drugs which dose has difference between in the actuality and in the pharmacopoeia. Most of drug's dosage centralized the four intervals: (3-6], (9-12], (12-15], (18-21], and the concrete dosage were 3, 6, 10, 12, 15, 20 g, etc.

CONCLUSIONThe dosages in the pharmacopoeia are not coincided with the practical dosages in internal medicine, and demand to revise. This paper will offer the consummate data for formulating the new dosage standard.

Drug Administration Schedule ; Drug Prescriptions ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Medicine, Chinese Traditional ; methods

Objective To build a multi‐level hierarchical structure model of the influencing factors for hierarchical medical system ,to identify the role relationship between all the factors and transmission pathways ,and to recommend on developing China′s hierarchical medical system . Methods Thirty influencing factors were identified in a screening based on literature review for the hierarchical medical system .On such basis ,16 influencing factors were identified by three health policy experts ,which affect operations of the current system .Interpretative structural modeling was called into play in the end to analyze the hierarchy relationship between various influencing factors and the conduction loops .Results There exist among the 16 factors a 3‐level hierarchical structureand two conduction loops .The factor directly limiting the hierarchical medical system is two‐way referral,and most internal core drivers arehuman resources development and governance mechanism.By means of self‐growth and external constraints ,they exert their influence on the operation of hierarchical medical system .Conclusions There are interactive hierarchical effects among the factors ,merging into three node elements of functional role,inter‐entity relationshipand patient participation.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion: The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.
Anemia, Hemolytic, Autoimmune ; Antibodies, Monoclonal, Murine-Derived ; Humans ; Retrospective Studies ; Rituximab ; Splenectomy

OBJECTIVETo analysis the clinic and genotype in two Chinese patients with Dyskeratosis congenita (DC).

METHODSThe two patients were characterized by mucocutaneous abnormalities (abnormal nails, lacey reticular pigmentation, and oral leukoplakia), bone marrow failure. They were diagnosed with DC. DC genes were amplified by polymerase chain reaction (PCR), including DKC1, TERT, TERC, TINF2, NOP10, NHP2, then DNA sequencing was performed for abnormal exons.

RESULTSAn abnormal peak was found in exon 6 of TINF2 gene of the two patients. DNA sequencing showed a 845G→A transition in TINF2 gene in the two patients.

CONCLUSIONWe should think about DC if the young patients with mucocutaneous abnormalities and marrow failure. TINF2 c.845G→A(R282H) does exist in the two patients. It is reported in China for the first time.

Base Sequence ; Child, Preschool ; DNA Mutational Analysis ; Dyskeratosis Congenita ; diagnosis ; genetics ; Exons ; Female ; Humans ; Infant ; Male ; Telomere-Binding Proteins ; genetics