OBJECTIVE:To provide a reference for reducing adverse events due to off-label use of drugs and promoting ratio-nal use of intravenous drugs in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. METHODS:The pre-scriptions of intravenous drugs in 42 wards of our hospital from Jul. 2013 to Jun. 2014 were reviewed,and then off-label use of drugs were analyzed,where statistics was made mainly to drug overdose,the use of drugs at the concentration beyond the standards (including concentrations too high and too low) and associated conditions. RESULTS:There were 622 irrational prescriptions,in-cluding 60 concerning off-label use of drugs,accounting for 9.6% of irrational prescriptions,in which 40 were involved with the concentration which was too high,accounting for the highest percentage(66.7% of prescriptions related to off-label use of drugs), 17 were related to drug overdose(28.3% thereof),and 3 were in relation to the concentration which was too low(5.0% thereof). CONCLUSIONS:Pharmacy intravenous admixture service may,through the communication between the pharmacist and the doc-tor,refuse to make up the above-mentioned prescription which was found to be irrational(including that involving in off-label use of drugs)or make up such prescription after it is modified according to the requirements as specified in the label to reduce the occur-rence of off-label use of drugs so as to promote rational drug use.

The classification of diagnosis and treatment is based on the classification of disease, and medical institutions at different levels bear different diseases to achieve the first contact care in primary hospitals and two-way referral.As one of the common chronic diseases, diabetes is a serious threat to human health.The classification of diagnosis and treatment model is beneficial to controlling blood sugar and promoting the integrated management of chronic diseases.Clinical pharmacists as medical and pharmaceutical professionals can provide pharmacy services to promote rational drug use in the diagnosis and treatment of diabetes.The article summarized the current methods for the classification of diagnosis and treatment model (diabetes mellitus) and the participation ways of clinical pharmacists in the model in order to provide new ideas for the comprehensive management of diabetes mellitus.

Objective To study the differences between renal clear cell renal cell carcinoma (CCRCC)and angiomyolipoma (AML)with minimal fat,whose size were both smaller than 3cm and the lesions center were both located outside the renal contour. Methods 6 cases of CCRCC and 18 cases of AML with minimal fat were analyzed retrospectively.All the lesions were confirmed pathologically.The morphological characteristics,plain and enhanced CT values were obtained for compare.Results The lesion length diameter,morphology,the early excretory phase CT value and the pattern of enhancement were not significant different between the two groups (P>0.05).There was significant difference in the focal cystic and necrotic between CCRCC group and AML group (P<0.05).Plain scan density,enhanced uniformity,pseudo capsule sign,plain CT values,medullary junction CT value and the pattern of enhancement from medullary junction phase were statistically different between those two groups (P< 0.001).Conclusion The focal cystic and necrotic,plain scan density, enhanced uniformity,pseudo capsule signs,plain CT values,the cortex and medullary junction CT value and the enhanced amplitude were very important role in differential diagnosis of CCRCC and AML with minimal fat.

Objective　To study hydroquinone(HQ) induced mitochondrial oxidative injury in mice bone marrow cells in the presence of Cu 2+. Methods　In the presence of 1 μmol/L Cu 2+,bone marrow cells isolated from mice were treated with 0,10,20 and 40 μmol/L HQ for 30 min for the dose-effect study,or treated with the combination of 1 μmol/L Cu2+ and 20 μmol/L HQ for 0,30,60 and 120 min for time -course study.Cell death rate(CDR),reactive oxygen species(ROS),mitochondrial e nzyme activity(MEA) and mitochondrial membrane potential(MMP) were observed. Results　In the presence of 1 μmol/L Cu2+,the lowest dosage of HQ (10 μmol/L) and the shoytest exposure time(30 min,20 μmol/ L) caused increase of CDR(115% and 117% of control respectively) and ROS generat ion(374% and 541% of control respectively) as well as de crease of MEA(54% and 30% of control respectively) and MMP(67% and 71% of contro l respectively) in dose- and time-dependent manner(ROS:r=0.941,0.981;CDR: r=0.866,0.866;MEA:r=-0.842,-0.902,respectively).All data were statistica lly different when compared with the control(P<0.05).In addition,ROS appeare d to have a close relationship with CDR(r=0.943),MEA(r=-0.977) and M MP(r=-0.902). Conclusion　In the presence of 1 μmol/L Cu2+,H Q could definitely cause mitochondrial oxidative injury in mice bone marrow cell s.Mitochondrial oxidative injury induced by ROS generation might be one of impor tant pathways leading to cytotoxicity of HQ.

Objective　To study hydroquinone(HQ) induced mitochondrial oxidative injury in mice bone marrow cells in the presence of Cu 2+. Methods　In the presence of 1 μmol/L Cu 2+,bone marrow cells isolated from mice were treated with 0,10,20 and 40 μmol/L HQ for 30 min for the dose-effect study,or treated with the combination of 1 μmol/L Cu2+ and 20 μmol/L HQ for 0,30,60 and 120 min for time -course study.Cell death rate(CDR),reactive oxygen species(ROS),mitochondrial e nzyme activity(MEA) and mitochondrial membrane potential(MMP) were observed. Results　In the presence of 1 μmol/L Cu2+,the lowest dosage of HQ (10 μmol/L) and the shoytest exposure time(30 min,20 μmol/ L) caused increase of CDR(115% and 117% of control respectively) and ROS generat ion(374% and 541% of control respectively) as well as de crease of MEA(54% and 30% of control respectively) and MMP(67% and 71% of contro l respectively) in dose- and time-dependent manner(ROS:r=0.941,0.981;CDR: r=0.866,0.866;MEA:r=-0.842,-0.902,respectively).All data were statistica lly different when compared with the control(P<0.05).In addition,ROS appeare d to have a close relationship with CDR(r=0.943),MEA(r=-0.977) and M MP(r=-0.902). Conclusion　In the presence of 1 μmol/L Cu2+,H Q could definitely cause mitochondrial oxidative injury in mice bone marrow cell s.Mitochondrial oxidative injury induced by ROS generation might be one of impor tant pathways leading to cytotoxicity of HQ.

Objective To explore the clinical features and perioperative treatment effects of colorectal cancer in elderly patients.Methods Retrospective analysis of clinical data especially focusing on perioperative treatment from 104 elderly patients with coloreetal cancer were performed.Results A total of 99 patients (95.2%) were cured or improved at discharge.Perioperative pulmonary infection occurred in 13 cases (12.5%), of whom 6 cases (5.8%) suffered from respiratory failure.Lower extremity deep venous thrombosis occurred in 3 cases (2.9%), incision infection in 6 cases (5.8%), wound dehiscence in 2 cases (1.9%), intestinal fistula in 1 case (1.0%) and gastroparesis in 1 case (1.0%).About 5 cases (4.8%) died from multiple organ failure.Conclusions Old age is not a contraindication in surgical treatment for colorectal cancer.Paying attention to accurate and timely treatment in perioperative peroid can reduce postoperative complications and improve patients' quality of life.

Objective: To study the dosages of capsules commonly used in children to provide reference for the addition of capsule specification for children.Methods: According to the application situation of capsule dosages commonly used for the inpatients in one children's hospital from January 1, 2013 to September 1, 2016, and combined with the usage rates of various drugs with different dosages, the addition of the minimum dosage of capsules was proposed.Results: Totally 10 species of commonly used capsules were selected from the children's hospital, and among them, 4 ones met the requirements of clinics, and the other 8 ones needed the specification addition, including clostridium butyricum capsules (210 mg) and polysaccharide ferric complex capsules (25 mg).Conclusion: The existing capsule specification can not fully meet the clinical requirements in the children's hospital.Therefore, appropriate dosage adjustments are still needed.

Objective: To establish the standardized management mode for emergent medicines of inpatient area based on JCI. Methods:The expiry verification data of emergent medicines in hospital wards were collected from 2013 to 2015. The number and the amount of emergent medicines expired in the last three months in each calendar month during the three years were analyzed, the exist-ing problems in the management mode were found out and gradually optimized using PDCA cycle. Results:From 2013 to 2015, the re-placement amount of emergent medicines expired in the next month was 3497. 37 yuan. The number of emergent medicines expired in current month was 62. A total of 420 times of emergent medicines didn' t meet the requires of expiry verification from 2013 to 2015. After the check-in form redesign for emergent medicines and the standardization of replacement process, the number of expired medi-cines in the rescue carts was reduced, and the validity and quantity of drugs in all the rescue vehicles could be clearly shown in the new form. Conclusion:The standardization of emergent medicine management model can guarantee the safety of emergent medicines used in patients.

0.05) but a statistically significant negative correlation was noted between serum cholesterol and zinc (r= -0.9986, P

Objective To evaluate and analyze the drug-drug interactions(DDI)of different antidiabetic drugs.Methods DDI database Lexi-InteractionTMwas used to evaluate DDI for 28 commonly used antidiabetic medications(including insulin and 27 non-insulin preparations).Results 882 DDIs were identified for 28 drugs.Category C was the top rated DDI(69.8%). Category C,D,X were accounted for 91.2% of the total DDI.28 medication combinations belonged to category X,which should be avoided to use together.Sulfonylureas had the most DDI,followed by metformin.Alpha-glucosidase inhibitors had least DDI.Conclusion Hypoglycemic drugs with less DDI,such as α-glycosidase inhibitors,glucagon-likepeptide1(GLP-1)an-alogs and sodium-dependent glucose transporters 2 inhibitor(SGLT2i)should be considered with high priority for patients tak-ing multiple antidiabetic medications,elderly patients and patients with liver-kidney dysfunction.