OBJECTIVE: To investigate the situation and future trend of use of drugs in this hospital after medical re- form.METHODS:Using the principle of sequencing analysis of DUD system of drug,we analysed the data of drug consumption in our hospital during the period 1999-2000.RESULTS: The policy of medical reform has affected the component ratio of drugs used, the consumption of peroral drugs being increased.The incidence of cardiovascular diseases was high in this re- gion.CONCLUSION:Most of the drugs used after medical reform were those assigned in medical insurance,which will improve the rationality and effectiveness of medication.

Aflibercept is a soluble fusion protein which combines ligand-binding elements taken from the extracellular components of vascular endothelial growth factor (VEGF) receptor-1 and receptor-2 fused to the Fc portion of IgG,and it is a novel antiVEGF drug,which can reduce vascular permeability and inhibit neoangiogenesis by binding VEGF tightly.A large number of phase Ⅲ clinical trials have demonstrated the satisfactory outcomes of aflibercept in the management of neovascular age-related macular degeneration,macular edema secondary to retinal vein occlusion or macular edema and other retinal vascular diseases.Moreover,intravitreal injection of afiibercept can improve the visual acuity and attenuate the fundus lesion,which provides a new drug option for physicians.The review will summarize the chemical properties of aflibercept and its application,safety and efficacy of aflibercept for the treatment of retinal vascular diseases.

Objective To study the impact of sucrose analgesia on pain response and salivary cortisol levels in preterm infants.Method Preterm infants admitted to our hospital between January 2014 and October 2016 with gestational age ＜ 34 weeks,birth weight ＜ 2 000 grams,and length of hospital stay ≥ 14 days were prospectively assigned into two groups.The intervention group received 0.3 ～ 0.5 ml of 12％ sucrose solution two minutes before each painful procedure,while the control group received none.At time of discharge and at 8 months of corrected age (CA),pain response was measured,saliva samples were collected and salivary cortisol levels were assayed using Enzyme Immunoassay Kit before and after pain stimulus.Result A total of 82 infants were included in our study,42 in the intervention group,and 40 in the control group.There were no statistically significant differences between two groups in pain response at discharge and 8 months of CA.At time of discharge and at 8 months of CA,infants in intervention group had higher salivary cortisol levels than in control group at time of discharge and 8 months of CA after pain stimulus [6.8 (5.6,11.7) ng/ml vs.5.4 (2.6,10.8) ng/ml,5.0 (3.3,5.6) ng/ml vs.4.8 (3.0,5.5) ng/ml] after log transformation,two groups were statistically significant (P ＜ 0.05).However,before the pain stimulus,no differences were found between two groups.Multiple stepwise regressions analysis showed that salivary cortisol level post pain stimulus was negatively related to the total number of pain stimulus,and positively related to sucrose analgesia at discharge and 8 months of CA.Conclusion Sucrose analgesia may mitigate the negative effect of repeated pain stimulus on cortisol regulation in preterm infants,however,may have no influence on pain response of them.

Objective To investigate the effect of remote medical information platform on efficiency of chest pain diagnosis and treatment and on clinical decision analyses in chest pain center.Methods A total of 537 chest pain patients who met the inclusion and exclusion criteria were consecutively enrolled and divided into two groups.The group without the chest pain platform(before setting up the platform)was 251 cases,and the group with chest pain platform(after setting up the platform)was 286 cases.The constituent ratio of acute coronary syndrome (ACS),the numbers of cases of both emergency thrombolysis and emergency percutaneous coronary intervention(PCI),the mean transfer treatment time,the first time medical contact to balloon catheter technique(FMC-to-B) and the door-to-balloon(D-to-B) time were compared between the two groups.The important multivariate factors affecting the D-to-B time were analyzed.Results The group with versus without chest pain platform showed the statistically significant improvements in the parameters as follows:(1)getting long range treatment (249 cases or 87.1％ vs.92 cases or 36.7 ％,x2 =146.56,P ＜0.05),(2) receiving thrombolysis(64 cases or 22.4％ vs.15 cases or 6.0％,x2 =28.61,P＜0.05),(3)average transfer treatment time(TTT) (176.3 ± 86.1 min vs.360.7 ± 107.4 min,t =11.53,P ＜0.05),(4)FMC-to-B(203.8±65.9 min vs.583.4±125.1 min,t =8.41,P＜0.05)and (5)D-to-B time(86.5±30.6 min vs.148.2 ± 41.7 min,t =4.49,P ＜ 0.05).Especially,patients after setting up the chest pain platform reached the standard of D-to-B time less than 90 min.According to whether reaching the standard of D-to-B time or not,clinical decision-making model analysis showed that the average Gini coefficient achieving the millennium development goal(MDG) was highest in the hospital referral,followed by the average transfer treatment time and emergency thrombolysis.Conclusions Reducing average transfer treatment time,improving the efficiency of hospital referral,and refining the remote terminal information platform for chest pain diagnosis and treatment are important for chest pain center by analyzing clinical data of chest pain patients.