OBJECTIVE:To analyze the postoperative application of anti-infective agents in patients undergoing stem cell transplantation. METHODS:The application of anti-infective agents in 30 patients undergoing stem cell transplantation in the pretreatment period and after operation in our hospital from 2003 to 2008 were analyzed in respect of etiology inspection,the cost of anti-infective agents,utilization frequency(cases/times),duration of medication,DDDs,DUI,drug combination and its rationality. RESULTS:The infection was found in 26 cases after operation,accounting for 86.67%. Pathogens were found out in 11 cases. The total cost of anti-infective agents was 327 598.23 yuan. The DUI of 7 kinds of top 10 anti-infective agents in terms of DDDs were less than 1 and that of other 3 were more than 1. In terms of drug combination,two-drug consisted of 73.08%(38 cases/times), three-drug 25.00%(13 cases/times)and four-drug 1.92%(1 cases/times). CONCLUSION:The postoperative application of anti-infective agents in patients undergoing stem cell transplantation in our hospital is rational on the whole.

OBJECTIVE:To analyze the drug use in the inpatients undergoing allogenic stem cell transplantation.METHODS:The drug use in 24 inpatients undergoing allogenic stem cell transplantation from 2004 to 2007 were analyzed retrospectively in respect of drug variety and drug cost etc.RESULTS:The average drug cost for the inpatients undergoing stem cell transplantation was(66 418.56?24 381.73)yuan,comprising 61.69% of the total cost of hospitalization.The top 20 drugs in terms of consumption sum were mainly drugs for immune system,drugs affecting hematological and hematopoietic system and anti-tumor drugs etc.The top 20 drugs in terms of DDDs were mainly immunosuppressants,anti-tumor drugs and adjunctive drugs,with DUI ≤1 for the majority of the drugs.CONCLUSION:The drug use in the inpatients undergoing allogenic stem cell transplantation in our hospital was rational on the whole.

Objective To investigate the effectiveness and safety of Xiyanping Injection for the treatment of children with acute suppurative tonsillitis, so as to provide evidence for the prevention and treatment of pediatric acute suppurative tonsillitis with traditional Chinese medicine. Methods Two hundred children with acute suppurative tonsillitis were randomly divided into treatment group and control group, 100 cases in each group. The control group was given routine western medicine treatment, and the treatment group was given Xiyanping Injection based on the treatment for the control group. The treatment lasted for 5 days. The clinical outcomes covered the course of disease, the overall efficacy, adverse reaction, and time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion, as well as the changes of white blood cell count, hyper-sensitivity C reactive protein, alanine aminotransferase, creatinine and creatine kinase levels before and after treatment. Results (1) After treatment, the total effective rate of the treatment group was 97.0% and that of the control group was 87.0%, the difference being significant (P < 0.01). (2) After treatment, time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion as well as hospitalization time of the treatment group was much shorter than that of the control group (P < 0.05 or P < 0.01). (3) After treatment, white blood cell count and hyper-sensitivity C reactive protein level of the two groups were obviously decreased compared with those beforetreatment (P < 0.01) , and the decrease in the treatment group was superior to that in the control group (P <0.01). (4) The inter-group and intra-group comparison of alanine aminotransferase, creatinine and creatine kinase levels before and after treatment showed that the differences were insignificant between the two groups (P > 0.05). No adverse reactions of rash, nausea, vomiting, diarrhea, chest distress, shortness of breath, or drug fever were found in the two groups. Conclusion Xiyanping Injection is effective and safe for the treatment of children with acute suppurative tonsillitis by increasing the total efficiency, reducing the time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion, shortening hospitalization time, and decreasing white blood cell count and hyper-sensitivity C reactive protein level. No obvious hepato-renal function damage occurred during the medication.

OBJECTIVE To study clinical distribution of Serratia and learn the antimicrobial susceptibility to S.marcescens in vitro in order to offer the reference to optimally selecting antibiotic.METHODS It was analyzed that the 222 Serratia strains were distributed in and the was deteted 164 S.marcescens strains were isolated from our hospital from 2001 to 2006.Their VITEK-2 of French Bio-M?rieux Company was adopted to proceed the identification of bacteria and antimicrobial susceptibility test.Data were analyzed by WHONET 5.4.RESULTS Serratia were mainly isolated from sputum,urine,blood,secretion,bile,cerebrospinal fluid,abdominal fluid,et al.Infection of both in-and out-patients could be caused by Serratia and most were in surgery ward.S.marcescens had higher drug resistance rates to piperacillin,cefazolin,cefuroxime,gentamicin and tobramycin which were all above 60%.They were all susceptible to imipenem(minimum inhibitory concentration only 1 ?g/ml) and their susceptible rates to piperacillin/tazobactam,ceftazidime,cefepime,and levofloxacin were all higher than 80%.CONCLUSIONS Serratia are less isolated from clinics,but have much higher antimicrobial resistance to the 1st and 2nd generation cephalosporin and show diversely drug resistance to 3rd cephalosporin,so physicians should pay attention to the infection caused by them.

OBJECTIVE:To investigate blood concentration monitoring data,therapeutic efficacy,toxic reaction and combi-nation of tacrolimus in patients with Allo-HSCT,and to provide reference for clinical application of tacrolimus. METHODS:The blood concentration of tacrolimus in 16 inpatients were monitored with EMIT 3 months after Allo-HSCT. The occurrence of Graft-versus-Host disease(GVHD),ADR and drug combination were analyzed and discussed. RESULTS:A large individual dif-ferences were found in blood concentration of tacrolimus. When blood concentration <8 ng/ml,there seems a greater possibility of GVHD. When >20 ng/ml,the occurrence of diabetes,kidney damage and other side effects seems increased. Tacrolimus had a good effect on treatment and prevention of GVHD,and could have an interaction with other drugs. CONCLUSIONS:Blood concentration monitoring of tacrolimus plays an important role on the prevention and treatment of GVHD,and the decrease of side effects such as diabetes and neurotoxicity. The satisfactory blood concentration is 8-20 ng/ml,when there seems a smaller possibility of GVHD and ADR 3 months after Allo-HSCT.

The medical records of 108 inpatients treated with vancomycin and norvancomycinin were collected and analyzed retrospectively.And 78.7% of all cases were used for therapy and 21.3% for prevention.The pathologic examination submission rate was 88.9% ( n=96 ).The drug utilization index ( DUI) of norvancomycin was 0.95 and vancomycin 0.92.The proportion of combination use was 86.1%and a maximum of 3 antibiotics were used.There were 6.5% cases of doubtful adverse drug reaction.The inpatient uses of vancomycin and norvancomycin are basically rational.Indications should be mastered strictly.Empirical and prophylactic uses should be minimized to prevent and delay drug resistance strain from spreading and prolong effectiveness.Necessary therapeutic drug monitoring is required.

OBJECTIVE:To establish a HPLC method for the determination of oxymatrine(OMT)and matrine(MT)in dog plasma.METHODS:Plasma protein was precipitated with perchloric acid;OMT and MT were extracted with dichloromethane under strong base condition and then plasma levels of OMT and MT were determined by HPLC.RESULTS:The linear ranges of OMT and MT were 0.2～ 15? g? mL-1 and 0.1～ 5? g? mL-1,respectively,and the detection limits of OMT and MT were 20ng? mL-1.The absolute recoveries,relative recoveries,intra-day and inter-day precisions of OMT and MT were all in line with the standards.CONCLUSION:The method is simple,accurate and sensitive yet with little interference,and it is applicable for the determination of OMT and MT in plasma,the studying of the pharmacokinetics,the transformation process and the metabolic pathway of OMT in vivo,furthermore,it serves as guidance for the development of new OMT preparations.

OBJECTIVE To offer the clinical physician the basis of optimal application of antibiotic,we have investigated the variation of antibiotic resistance and the bacterial spectra in the blood culture.METHODS Blood was cultured in BACTEC9120 of BD.The clinical isolates were identified by API and VITEK-2 of Bio-Merieux of France.Antibiotic susceptive test was done by Kirby-Bauer method and the result which was analyzed by WHONET5.3 and SPSS11.5 software was determined by the NCCLS standard of 2005′s edition.RESULTS Organisms were isolated from the blood specimen of 1468 patients,and there were 743 strains of Gram-positive cocci accounted for 50.7%,565 strains of Gram-negative bacilli accounted for 38.5%.Ninety three strains of fungi accounted for 6.3%.We analyzed the drug-susceptive result of Staphylococcus,Escherichia coli,and Klebsiella pneumoniae during five years,and found that all the antibacterial drug lost efficacy in some degree,except that the sensitivity of the staphylococci to vancomycin was 100%.CONCLUSIONS Gram-positive cocci are the main bacteria in blood culture,the species from which are diversified,and the rate of the drug resistance of some bacteria is high.It indicated that doctors should take more blood culture and monitor the bacteria drug resistant for the data of etiology,so that they can utilize antibiotic more reasonably.

OBJECTIVE To learn the profile of Gram-negative bacilli in ICU ward during the eight years and analyze the drug resistant rates in order to provide the basis for empirical treatment of infection.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted Kirby-Bauer method.Data were analyzed by WHONET5.4 software.RESULTS Totally 1492 strains of Gram-negative bacilli were isolated from ICU ward,which included 1146 strains of non-fermentaters,accounted for 76.8% and 346 strains of Enterobacteriaceae,accounted for 23.2%.The first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Escherichia coli by turns.The drug resistant rates were higher and had the tendency of increase by years.CONCLUSIONS Non-fermentaters are the main organisms in ICU ward.The species of bacteria are diversified and the drug resistant rates of them are serious,which should be monitored not only because helping clinical therapy but also discovering the prevalence of drug resistant strains.

OBJECTIVE To learn the epidemiology of respiratory infection in ICU and non-ICU wards,and analyze the difference of drug resistance of Gram-negative bacilli between those two wards in order to provide the basis of empirical therapy for the respiratory infection from the different wards.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted by K-B method.Data were analyzed by WHONET 5.3 software.RESULTS Totally 2184 strains of Gram-negative bacilli were isolated all from the respiratory tract,among which 655 strains were isolated from ICU ward and 1529 strains were from non-ICU ward.In ICU ward,the first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Chryseobacterium meningosepticum,and Stenotrophomonas maltophilia.It showed that non-fermentatives were the main pathogenic bacteria in ICU.In non-ICU ward,the first five bacteria were P.aeruginosa,Klebsiella pneumoniae,A.baumannii,B.cepacia,and S.maltophilia.Drug resistant rate of strain from ICU ward was generally higher than that from non-ICU ward,while levofloxacin in ICU ward showed the better activity than in non-ICU ward.CONCLUSIONS The respiratory infection is one of the hazards in nosocomial infection,drug resistant rate of Gram-negative bacilli from respiratory specimen in ICU is generally higher than that in non-ICU,and the main strains are the mlti-resistant non-fermentatives,which should attract the clinician′s more attention.