Objective:To evaluate the utilization of oral hypoglycemic drugs in 34 hospitals of Nanjing to provide clinical reference for the drug rational use. Methods: According to the sales data of oral hypoglycemic drugs in 34 hospitals of Nanjing from 2011 to 2013,the utilization of oral hypoglycemic drugs was analyzed retrospectively in respect of consumption sum,DDDs and defined daily cost ( DDC) by daily dose limit analysis method. Results: The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose,glimepiride and metformin. In terms of DDDs,glimepiride, metformin and gliclazide ranked the top 3. The consumption sum and DDDs of oral hypoglycemic drugs were increased year by year in Nanjing. The ratio of serial number of consumption sum and DDDs was from 0. 3 to 2. 0. Conclusion: The demanded quantity of oral hypoglycemic drugs is increased year by year from 2011 to 2013. The application conforms to the safe, effective and economic principle. The drugs should be chosen according to the drug characteristics in order to improve the abnormal glucose metabolism and prevent and treat the complications.

Objective To evaluate the effect of trimetazidine(TMZ) and metoprolol combining the other regular medicine on the stable angina peetoris patients with type 2 diabetes mellitus. Methods 78 patients with type2 diabetes mellitus and the patients with no less than two months stable and revoked-angina pectoris by effort were colleeted. They were divided into two groups. In one group,20mg of TMZ was used three times a day. In the other group,25mg metoprolol was used and two times a day. The two groups all combined with the regular medicine,bamyl, caleiume-antagonist and long-efficency nitrate and rutine antilipemic, antidiabefie agents for ten weeks and analyzed the statistical difference of two groups. Meanwhile some parameter were observed including the heart rate,blood pressure, blood glucose, TG, TC, HDL-C and LDL-C during the treatment. Results In two groups, cardiac pectoris frequency and lasting-time and the used-nitroglycerin decreased significantly, while the time of next angina outcome and left ventrieular ejection fraction(EF% ) increased significantly. The therapy hasen't great differene(P>0.05) in two groups. But in TMZ group, HR, bllod pressure, blood glucose and blood fat haven't great difference(P > 0.05) before ad after thereapy. In metoprolol group the difference is significant(P < 0.05, P < 0.01) and twogroups have great difference(P < 0.05). Conclusion The results suggest that the TMZ is effect and safe on the sta-ble angina peetoris patients with type 2 diabetes mellitus.

Objective:To evaluate the utilization of antifungal drugs in Nanjing area, and provide clinical reference for the rational use of antifungal drugs. Methods:According to the sales data of antifungal drugs in 34 hospitals in Nanjing area from 2013 to 2015, the utilization of antifungal drugs was analyzed in respects of consumption sum, DDDs and DDC. Results:The consumption sum and use of antifungal drugs increased year by year. The maximum amount of consumption sum growth rate was 41. 13%. Triazole drugs oc-cupied the top of consumption sum during the past three years, and the sales amount accounted for more than 60% of all. In term of consumption sum, voriconazole, fluconazole, itraconazole and caspofungin ranked top 4 of antifungal drugs. Clotrimazole topical prepa-rations and oral itraconazole ranked top 2 of DDDs, and caspofungin, micafungin and voriconazole ranked top 3 of DDC. Conclusion:The clinical application of antifungal drugs continues to increase during 2013 and 2015. Invasive fungal infection is a lethal factor at high risk. Choosing reasonable, effective, safe and economic of antifungal drugs is the first principle in clinical treatment.

Ulcerative colitis (UC) is a subtype of inflammatory bowel disease. Its pathogenesis is not clear and the pathogenesis is complex. Moreover, it is recurrent and its healing is delayed. It is a kind of refractory disease. Its incidence and recurrence rate showed a trend of increasing year by year in our country at present. At the present stage, the main treatment focuses on glucocorticoids, aminosalicylic acid, immunosuppressor and biological agent. Although biological agent can greatly improve the efficacy, there are many problems in clinical treatment for a small amount of refractory patients. The comprehensive intervention combined with non-drug treatment should be performed, so as to achieve the curative effect. Fecal microbiota transplantation (FMT) has attracted people′s attention in recent years. It displays a certain therapeutic effect on the treatment of UC in the active stage, especially refractory recurrent UC. Therefore, the domestic and overseas FMT treatment are summarized in the paper.

OBJECTIVE:To establish a rapid,sensitive,accurate and stable method for the determination of voriconazole in human plasma in order to monitor clinical use of voriconazole. METHODS:HPLC-UV detection method was applied using carba-mazepine as internal standard. Plasma samples were treated with acetonitrile protein precipitation. The determination was performed on Phecda C18 column with 20 mmol/L monopotassium phosphate buffer solution (pH 6.0)-acetonitrile (50∶50,V/V) as mobile phase at flow rate of 1 ml/min. The column temperature was 40℃ and detection wavelength was 255 nm. The injection volume was 50 μl. RESULTS:The retention time of voriconazole and internal standard were 8.34 and 6.24 min. The linear range of voricon-azole in plasma were 0.10-20.00 μg/ml(r=0.999 5). The lowest limit of quantitation was 0.05 μg/ml. Intra-day and inter-day RSD were below 1.57% and 1.45%,respectively. The extraction recovery of low,medium and high concentrations were between 81.40%to 128.29%. CONCLUSIONS:The method is simple and accurate for therapeutic drug monitoring(TDM)of voriconazole.

OBJECTIVE:To systematically review the efficacy,safety and economy of acarbose versus metformin in the treat-ment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed, Medline,CJFD,Wanfang database,VIP database,randomized controlled trails (RCT) about acarbose (test group) versus metfor-min(control group)in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 statis-tics software,and the decision tree model was used to do the cost-effectiveness analysis by using TreeAge Pro 2011.1.0.12.1 soft-ware. RESULTS:A total of 8 RCT,involving 418 patients. Results of Meta-analysis showed 2 h postprandial blood glucose (2 h PG)in test group [MD=-2.21,95%CI(-2.92,-1.51),P<0.001] was lower than that of control group,there was no signifi-cant diffcrencc in the glycated hemoglobin levels[MD=0.02,95%CI(-0.38,0.34),P=0.91],fasting blood glucose level[MD=0.05,95%CI(0.91,1.01),P=0.92] and incidence of adverse reactions [OR=1.84,95%CI(0.80,4.24),P=0.92] between 2 groups. Results of decision tree analysis showed the cost-effectiveness ratio in test group and control group was 847.15 and 272.53,respec-tively;and incremental cost-effectiveness ratio was 13 776. CONCLUSIONS:Acarbose shows an obvious advantage on decreasing the 2 h PG of type 2 diabetes,however,pharmacoeconomics shows metformin has higher economic effects. Due to the limit of methodological quality,large-scale and high quality RCT are required for further validation of the conclusions.

Objective To explore the effects of compound lidocaine cream applied to postoperative wound and nasal packing on postoperative sinus pain after endoscopic sinus surgery . Methods From April 2015 to June 2016, 100 cases of endoscopic sinus surgery were carried out in our hospital under general anesthesia .The patients were randomly divided into two groups , with 50 cases in each group .The group A was given compound lidocaine cream 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing;the group B was given saline 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing . The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at the time of extubation (T0), 1 h after extubation (T1), 4 h after extubation (T2), 10 h after extubation (T3), and 12 h after extubation (T4), respectively.The visual analogue scale (VAS) of pain after extubation was recorded . Results The HR, SBP and DBP at T0, T1, T2 and T3 in the group A were significantly lower than those in the group B (P<0.05).The HR and SBP were not significantly different at T4 between the two groups (P>0.05), while the DBP was significantly lower in the group A than that in the group B (t=-2.562, P=0.012).The VAS scores were significantly lower in the group A than those in the group B at T 0, T1, T2 and T3 (P=0.000).No statistical difference was seen in VAS scores at T4 between the two groups (t=-1.199, P=0.233). Conclusions Application of compound lidocaine cream on nasal endoscopic wound and intranasal packing can effectively relieve the pain after endoscopic sinus surgery .The method has good analgesic effects and is worthy of popularization and application .

Objective To study medicine storage scale model for disaster relief.Methods The medicine storage scale for disaster relief was dynamically simulated by using DAMANO programming language of System Dynamics (SD) and was calculated with discrete algorithm using FORTRAN programming language.Results The established model could be used for dynamic tracing of the inventory of the warehouse.Conclusion Medicine storage scale for disaster relief can be determined through the model established by dynamic simulation or discrete calculation.

Objective To observe the expression of estrogen receptors (ERαand ERβ) on gastric cancer cells and evaluate the effect of Tamoxifen(TAM) on the cell proliferation and expression of serine proteinase inhibitor 9(PI9) of gastric cancer cells . Methods PI9 positive expression(MNK45 ,SGC7901)and negative expression (BGC823)of gastric cancer cell lines were from pre‐liminary screened ,the expression of ERα and ERβ detected by immunofluorescence chemical method ,the cell proliferation and ex‐pression of PI9 were tested by CCK8 assay and reverse transcription‐PCR after intervention of TAM .Results ERαprotein expres‐sion was noted in MNK45 and SGC7901 ,ERβwas noted in BGC823 ,but the expression of ERαand ERβwere not appear to be obvi‐ous after the intervention of TAM .Tamoxifen could obviously inhibited cell proliferation of MNK45 and SGC7901 at concentration of 0 .1-100 .0 μmol/L ,the differences were statistically significant compared with negative control group (P<0 .05) ,but showed no dose‐dependent to the proliferation of BGC823 and MNK28 .After treating with TAM ,the expression of PI9 mRNA of SGC7901 (0 .402± 0 .020) and MNK45(0 .359 ± 0 .048) were obviously lower than that in the negatwe control group(P< 0 .05). Conclusion Tamoxifen could significantly inhibit the proliferation of PI9 positive expression than PI9 negative expression of gastric cancer cell lines ,and showed obviously dose‐dependent ,its role in inhibiting proliferation might closely related to immune tolerance improved by PI9 .

OBJECTIVE:To determine the concentration of pseudoephedrine hydrochloride in human plasma by LC/MS. METHODS:The separation of sample was performed on Zorbax Eclipse XDB C18 with diphenhydramine used as the internal standard.The mobile phase was a mixture of methanol-water(10mmol?L-1 NH4Ac plus 0.1% acetic acid)(55∶45) with a flow rate of 0.2mL?min-1.The column temperature was set at 30℃.The atmospheric pressure chemical ionization-mass spectrometry(APCI-MS) were adopted with pseudoephedrine m/z =166.1 and diphenhydramine m/z =242.3.RESULTS:The linear concentration range for pseudoephedrine was 3.2～408.96ng?mL-1(r=0.999 0) with lowest detection limit at 3.2ng?mL-1.The average recovery was 98.21% with both the intra-day RSD and the inter-day RSD at less than 13%.The stability of pseudoephedrine was stable.CONCLUSION:The method is of high sensibility and accuracy,and it can be used for blood concentration monitoring pharmacokinetic study of pseudoephedrine.