OBJECTIVE:To discuss the existence and possibility of development of hospital preparations in new situation in China.METHODS:To describe the basis and problems for existence and development of hospital preparations in new situation in China.RESULTS:There are necessity of existence and possibility of development of hospital preparations,however,the hospital preparation should be regulated in construction of assortment,decreased in quantity and reduced in scale.CONCLUSI_ON:As long as the development strategy for hospital preparations,controlling scale,ensuring quality,creating unique features and developing new drugs,is persisted,the prospect of hospital preparation will certainly be bright.

OBJECTIVE:To arouse great attention in the circle of medicine to the presupposition of canceling drug price addition in hospitals.METHODS:The causes,effects and drawbacks of drug price addition in hospital were introduced;The aim,possibility and feasibility of canceling drug price addition were pondered over;The possible ways for the compensation for revenue losses in hospital due to the canceling of drug price addition were proposed;The possible changes in drug prices and hospital pharmacy after the canceling of drug price addition were predicted and the corresponding developmental strategy on hospital pharmacy were put forward.RESUTLS&CONCLUSION:It is possible and feasible to cancel hospital drug price addition,which will bring about significant influences(both positive and negative)on drug prices and hospital pharmacy once being put into practice,to which great attention should be paid.

The effects of Panax notoginseng saponins (PNS) and verapamil(Ver)on hemo-dynamics of internal carotid artery and superior mesenteric artery were determined and compared in anesthetized Sprague ~ Dawley strain rats. PNS 30-150 mg ? kg-1 iv was shown to reduce the mean blood pressure, internal carotid arterial resistance and superior mesenteric arterial resistance by 11 % ~19%, 14%~27%,23%~ 39%respectively. Meanwhile, the mesenteric ar-terial blood flow increased.by 16%~51%. Ver showed similar reflects as PNS. The results indicated that the vasodilation effects of PNS and Ver are vascular selective, that is PNS and Ver are more potent in dilating the mesenteric artery than the internal carotid artery.

Objective To investigate the related factors of postoperative pulmonary complications with abdominal operation. Methods 193 cases after abdominal operation were reviewed. The age, smoking history, surgery duration, surgical site, pulmonary function, artery blood gas analysis, and the incidence of post-operative pulmonary complications were analyzed. Results Pulmonary complications were found in 29 cases. The age was higher and surgery duration was longer in patients with pulmonary complications than those without pulmonary complications (P<0.05). The patients with abnormal forced expiratory volume in the first second (FEV1)%, FEV1/ forced vital capacity (FVC)%, maximum ventilatory volume (MVV)% and smoking history before operation were in higher risk for post-operative pulmonary complications (P<0.05). There was significant difference in artery blood gas analysis between the 2 groups (P<0.05). Conclusion The age,smoking history, surgery duration and pulmonary dysfunction may be the risk factors of pulmonary complications after abdominal operation,while it is important to monitor the blood gas analysis.

Objective To explore the safety and effectiveness of using low molecular weight heparin (LMWH) in place of warfarin for anticoagulation in patients with a previous cardiac valve replacement. Methods We reviewed 70 patients hospitalized from Jan 2002 to Apr 2009 undergoing abdominal surgery who have had a previous cardiac valve replacement and had been on warfarin anticoagulation therapy. LMWH began to replace warfarin for anticoagulation 3 clay before the surgery in 33 cases, while the other 37 patients simply ceased to use any anticoagulant since 3 days before the surgery. Postoperative bleeding and embolism risk were compared between these two groups. Results There were 2 patients suffering from postoperative bleeding in the operative field in LMWH group, while there was no postoperative bleeding in patients on anticoagulant suspension group (χ~2=0.641, P>0.05). There was no valve embolism occurred in these two groups. Conclusions It is a safe way to stop using warfarin with LMWH taking the task for perioperative anticoagulation in patients with a history of cardiac valve replacement 3 days before an elective abdominal surgery. This protocol decreases the risk rate of valve embolism not at the expense of increasing postoperative bleeding.

Objective To discuss the influential factors of postoperative pulmonary complications in elder patients accepted abdominal operation. Methods The clinical data of 95 cases accepted abdominal operation were analyzed retrospectively,and all the patients aged over 60. These patients were divided into two groups based on whether they had pulmonary complications or not. Seven relative factors including the age,sex,smoking history,surgery duration ,operation place,pulmonary function,anesthesia were analyzed and the relationship between these factors and the incidence of postoperative pulmonary complications were explored,too. Results Among the 95 patients,19 cases had pulmonary complications. The surgery duration in patients with pulmonary complications ((3.4 ± 1.1)h)were significantly higher than in those without pulmonary complications ((2. 6 ± 0. 9)h)(P ＜0.05). We also found significant differences in the comparison of FEV1%(59.2 ±9.5),FEV1/FVC(61.3 ±7.7)% ,MVV%(59.3 ±8.6)% in the group with pulmonary complications,with FEV1%(79.7 ± 11.5)%、FEV1/FVC(73.2 ±8. 3)% 、MVV%(74. 2 ±6. 4)% in the group without pulmonary complications. The epigastric operation and general anesthesia before operation were risk factors for post-operative pulmonary comphcations(P ＜0. 05). Conclusions Surgery duration,operation place,pulmonary dysfunction and anesthesia may be the risk factors of pulmonary complications after abdominal operation.

【Objective】To determine the content and dissolution of two imported levothyroxine sodium tablets.【Method】The content of levothyroxine sodium was assayed on a Hypersil BDS C18 column with a mobile phase consisting of methanol-0.85% phosphoric acid (60∶40) at a flow rate of 1.5 mL/min and detected at 225 nm.The study on dissolution was conducted according to the method Ⅱ of dissolution apparatus in USP(23).【Results】The average content of two formulations was 107.74% and 99.72%,respectively.The value of T50,Td and m of two tablets differed significantly (P<0.01).【Conclusion】There was a significant dissolution difference between two levothyroxine sodium tablets.

Objective To investigate the characteristics of laparoscopic cholecystectomy(LC) in the elderly. Methods A retrospective analysis was made on clinical data of 118 elderly patients treated with LC in this hospital between January 2000 and January 2005. Results The LC was successfully completed in 116 patients,while conversions to open surgery were required in 2 patients due to low level of insertion of the cystic duct(1 patient) and common bile duct injury(1 patient).The operation time was(30~120 min)(mean,50 min).The postoperative recovery was uneventful in all the patients.The length of hospital stay after operation was 3~7 d(mean,4.5 d).The patient with common bile duct injury was followed for 2 years and 6 months.Transient onsets of abdominal pain and fever were noted and cured with antibiotics for 2~5 days.No biliary tract stenosis or bile duct calculus was seen.Follow-up observations in the remaining 117 patients for 6~12 months(mean,10.5 months) revealed no abdominal pain,fever,or jaundice. Conclusions Laparoscopic cholecystectomy is acceptable and safe for elderly patients.Proper peri-operative management and careful surgical performance are essential to the success of surgery.

Objective To analyze the safety and efficacy of laparoscopic radical resection of colorectal cancer for elderly patients over 70 years old. Methods From January 2014 to January 2017,a retrospective analysis of the patients with radical surgery for colorectal cancer in Department of General Surgery,Beijing Anzhen Hospital,Capital Medical University was performed. According to the patient′s age, the patients were divided into ≥70 years old group (68 cases) and＜70 years old group (84 cases). The preoperative clinical data of the two groups were analyzed. The surgeons strictly followed the standard lymph node cleaning and the principle of no tumor for colorectal cancer radical operation. The surgical conditions, pathology,short-term efficacy and the follow-up conditions of the two groups were compared. Statistical analysis was performed using SPSS 20. 0. The normal distribution of the data was expressed as Mean±SD,and the t-test was used for comparison between the group. The count data was compared using the χ2 test or the Fisher exact probability method. Results The operation was successfully completed in both groups. In the group of≥70 years old,2 cases were converted to open due to extensive adhesion of the abdominal cavity,no perioperative death. Compared with the＜70 years old group,≥70 years old group had more hypertension and coronary heart disease, respectively ( 38. 2%( 26/68 ) vs. 14. 3%( 12/84 )), and the difference was statistically significant ( P＜0. 05 ) . There was no significant difference in intraoperative blood loss and operation time between the two groups (P＞0. 05) . There was statistically significant difference in incidence of postoperative cardiovascular events between the groups (26. 4%(18/68) vs. 7. 14%(6/84)χ2＝ 6. 428, P＝0. 010) . However,there were no significant differences between the two groups in implications,rate of death and the time stayed in hospital. (P＞0. 05). Conclusion Laparoscopic radical resection for colorectal cancer patients over 70 years old is safe and feasible with strict indications and attention to perioperative management.