Objective To analyze antimicrobial use in the different grades of hospitals within 3 years after the car-rying out of rectification activities of antimicrobial use,and provide basis for making continuous improvement pro-gram of antimicrobial management.Methods Retrospective analysis was performed,outpatient and emergency pre-scriptions and medical records of discharged patients (100 were type Ⅰ incision surgery)were selected from 5 tertia-ry hospitals and 5 secondary hospitals within 3 months,antimicrobial use and management were investigated. Results 200 outpatient prescriptions,100 emergency prescriptions,and 200 medical records of discharged patients were selected from each hospital.In tertiary and secondary hospitals,antimicrobial usage rate in outpatient prescrip-tions was 17.40% and 18.00% respectively,emergency prescriptions was 31 .60% and 40.10% respectively;a-mong inpatients,antimicrobial usage density(AUD)was (28.13±8.04)and (49.67±11 .63)respectively,and anti-microbial usage rate was 41 .30% and 56.20% respectively;pathogenic detection rate of antimicrobial therapeutic cases was 45.70% and 22.70% respectively,therapeutic cases with limit level of antimicrobials was 61 .50% and 27.40% respectively;antimicrobial usage rate in type I incision surgery was 20.00% and 40.40% respectively;The rational rate of antimicrobial types was 94.60% and 59.20% respectively,rational rate of opportunity of antimicro-bial use was 95.20% and 48.20% respectively;combination rate was 8.80% and 36.60% respectively,and rational rate of treatment course was 84.00% and 52.80% respectively.Conclusion In tertiary hospitals,antimicrobial use after 3 years rectification of antimicrobial use conform to the antimicrobial management requirement of Ministry of Health,the overall quality index is better than secondary hospitals,management of antimicrobial in secondary hos-pitals use should be improved.

OBJECTIVE: To look for the breakthrough for the implementation of national essential drugs system in China. METHODS: Based on relevant literatures, the disadvantage of establishment of National Essential Drug System and its main reason were considered. RESULTS: Five disadvantages of establishment of National Essential Drugs System were as follows: early starting, slow process and some links against essential drug system; clear direction of national drug policy without significant effectiveness; Essential Drugs List didn’t occupy high dominant position. National Essential Drugs System lacked of legal status and liability subject. CONCLUSION: National Essential Drug System should be escalated from policy of government to national policy, and legislation of National Essential Drug System should be strengthened. Government at all levels is liability subject to implement National Essential Drugs System and perform classification management system of essential drug.

OBJECTIVE:To establish the quality standard of Paris pubescens. METHODS:Qualitative identification of medici-nal material was conducted from original plant morphology,properties and microscopic characteristics (cross section,powder). The contents of parissaponinⅠ,Ⅱ,Ⅵ,Ⅶwere determined by HPLC. The determination was performed on Agilent C18 column with mobile phase consisted of acetonitrile-water(gradient elution)at the flow rate of 0.9 mL/min. The detection wavelength was set at 203 nm,and column temperature was 25 ℃. The sample size was 5 μL. The content of total saponins in P. pubescens was deter-mined by UV spectrophotometry. RESULTS:The rhizome of P. pubescens was nodular flat cylindrical in shape,slightly curved,ti-ny odor,bitter in taste. The large vessels were found in transverse xylem;phloem cells were small;powder had a large number of starch grains,mostly single grain. The linear ranges of parissaponin Ⅰ,Ⅱ,Ⅵ,Ⅶ and total saponins were 0.64-12.8,0.46-9.2, 0.26-5.2,0.23-4.6,20.5-143.5 μg(r were 0.9999、0.9999、0.9999、0.9999、0.9997),respectively. RSDs of precision,stability and reproducibility tests were all lower than 3.0%.The recoveries were 96.38%-105.24%(RSD=3.01%,n=6),97.24%-102.57%(RSD=2.50%,n=6),97.19%-101.74%(RSD=1.52%,n=6),93.72%-104.00%(RSD=3.53%,n=6),98.11%-104.50%(RSD=2.57%,n=6). CONCLUSIONS:Established standard can be used for quality evaluation of P. pubescens.

Objective To understand antimicrobial resistance and homology of carbapenem-resistant Klebsiella pneumoniae (CRKP)from an intensive care unit (ICU).Methods 11 CRKP isolates from patients and environment of an ICU in a hospital were performed antimicrobial susceptibility testing,the homology of CRKP was analyzed by randomly amplified polymorphic DNA (RAPD)method.Results Of 11 CRKP isolates,8 were from patients,and 3 from environment,the main specimen was sputum(n =6,54.55%).Antimicrobial susceptibility testing results re-vealed that 10 (90.91%)CRKP isolates were resistant to ciprofloxacin;11 isolates were susceptible to compound sulfame-thoxazole,intermediate to imipenem,and resistant to other antimicrobial agents(100%).All 11 CRKP isolates had 3 bands,and were divided into two types:(typeⅠ,n=10;type Ⅱ,n=1).Conclusion Antimicrobial resistance of Kleb-siella pneumoniae in ICU is serious,CRKP isolated from ICU patients and environment are of the same clone. Cleaning,disinfection,and monitoring of ICU environment should be strengthened,which is helpful for reducing, timely warning of multidrug-resistant organisms,and reducing healthcare-associated infection.

Objective ToestimatetheprevalenceofPanton-Valentineleukocidin (PVL)genes and antimicrobial resistance in methicillin-sensitive Staphylococcus aureus (MSSA)isolateds from outpatients with skin and soft-tissue infections (SSTIs)in Wuhan city. Methods A total of 182 MSSA isolates were collected from outpatients with SSTIs in 5 different hospitals in Wuhan city between 2011 and 2013. The Kirby-Bauer′s disk diffusion method was used to evaluate antimicrobial susceptibility of the MSSA isolates, and multiplex PCR was performed to detect mecA and PVL genes in these isolates. Results Of the 182 MSSA isolates, 65 (35.71%)carried PVL genes. The positive rate of PVL genes was significantly different among patients with different diseases (χ2 = 49.76, P = 0.00), and relatively higher in patients with furuncles/carbuncles(7/7), folliculitis(3/3), abscesses(55.53%, 30/57)or impetigo(2/4). The age of patients with PVL-positive MSSA infection was significantly younger than that with PVL-negative MSSA infection (35.40 ± 19.31 years vs. 43.21 ± 20.75 years,t = 2.50, P = 0.01). Among 65 PVL-positive MSSA isolates, the rate of resistance to clindamycin was highest (87.69%), followed by that to penicillin(53.85%)and erythromycin(41.54%). The frequency of resistance to clindamycin was highest in 117 PVL-negative MSSA isolates, followed by that to penicillin (20.51%)and ampicillin (12.82%). Furthermore, there was a significant increase in the rate of resistance to penicillin(χ2 = 21.19), ampicillin(χ2 = 97.97), doxycycline(χ2 =11.61), ciprofloxacin(χ 2 = 8.07), erythromycin(χ 2 = 25.04)and gentamicin(χ 2 = 10.86)in PVL-positive MSSA isolates compared with PVL-negative MSSA isolates (all P < 0.05). Conclusions MSSA isolates from outpatients with SSTIs in Wuhan city are resistant to most β-lactam antibiotics. Flucloxacillin, compound sulfamethoxazole tablets or doxycycline is recommended for empirical treatment of PVL-positive MSSA infections.

Objective To explore the status of depression in patients with advanced schistosomiasis and its influencing fac-tors,so as to provide the evidence for improving psychological interventions. Methods A total of 206 patients with advanced schistosomiasis were investigated with the self-designed general information questionnaire,the Self-Rating Depression Scale,and WHOQOL-BREF Form. Results Among the 206 cases,the incidence of depression was 69.4%,and depression was negatively related to the quality of life(P = 0.000). The multiple logistic regression analysis showed that the times of hospitalization(β=0.442,P=0.007)was a risk factor for depression,while the high education levels(β=-0.583,P=0.011)and the history of por-tal hypertension operation(β=-0.917,P=0.000)were the protective factors. Conclusion The incidence of depression in ad-vanced schistosomiasis patients is high,and it is influenced by various factors. Therefore,we should take corresponding interven-tions to reduce its occurrence.

Objective:To study the pharmacokinetics and tissue distribution characteristics of curcumin in turmeric capsules in rats.Methods:SD rats were given the capsules at the dose of 5 g· kg-1 , and plasma, liver, kidney, stomach and small intestine were withdrawn.Curcumin was determined by HPLC .Results:The results showed that the linear range of curcumin was 0.1-10μg· ml-1 .The metabolic results in vivo showed that t1/2 was (25.13 ±5.63) h, tmax was 0.50 h, Cmax was (0.44 ±0.01)μg· ml-1 , and AUC0-t was (2.11 ±0.04)μg· ml-1 · h.Meanwhile, curcumin could be detected out in gastrointestinal tract , liver and the other or-gans.Conclusion:Turmeric capsules can make curcumin rapidly absorbed and effectively distributed in various tissues of rats .The re-sults provide evidence for the clinical medication .