Objective To investigate the distribution and antibiotic resistance of pathogenic bacteria in PICU and to provide evidence for use of antibiotics rationally.Methods All the basic clinical features and pathogenic bacteria isolated from patients in PICU of our hospital from October 2009 to September 2012 were analyzed retrospectively.Results A total of 672 pathogenic bacterial strains were isolated (positive rate 16.7％ 672/4 020),75.1％ and 24.9％ were gram negative bacteria and gram positive bacteria,respectively.Pseudomonas aeruginosa was the most common bacteria isolated in gram negative bacteria,followed by Klebsiella pneumonia and Escherichia coli in this order.And Staphylococcus was the main strain in gram positive bacteria.Positive specimens were mainly from lower respiratory tract and bloodstream infection.Most Staphylococcus were resistant to penicillin,oxacillin and erythromycin but susceptible to vancomycin,teicoplanin and linezolid.Gram negative bacteria were resistant to ampicillin,ampicillin-sulbactam,piperacillin and cephalosporin,but susceptible to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,ciprofloxacin and amikacin.Conclusion Gram negative bacteria is the prevalent strains in PICU of our hospital,Pseudomonas aeruginosa,Klebsiella pneumonia and Escherichia coli are common bacterium isolated.Most isolates are highly drug-resistant.Analysis of pathogenic bacteria and drug-resistance surveillance are of vital importance to guide treatments for critically ill children and reduce drug-resistant bacterial strains.

OBJECTIVE: It is found that there are differences in quality of drugs on the market. In order to get safe, effective and rational drug use, we suggest that the evaluation of drugs be mandatory. METHODS: The drugs have been evaluated from angles of clinic effectiveness, bioequivalence, pharmacoeconomics and pharmaceutics. RESULTS: Different evaluating ways showed different characteristies. CONCLUSION: The quality control by pharmaceutical methods is one of the easiest and the most economic ways to do.

Objective To systematically observe the damage of pancreas and changes of serum amy-lase and lipase in septic rat at different time points after the septic rat model being established. Methods Fifty-four male rats were randomly divided into sham group,sepsis group and normal control group. In the sepsis group,rats were given cecal ligation and puncture so as to produce a model of the rat′s intestinal septic shock. In sham group,after opening the abdominal cavity of the rats,only the cecum was pulled out of the abdominal cavity,then the abdominal cavity was satisfied and stitched. The arterial blood and pancreatic tis-sues of the rats in both sepsis and sham groups were collected for detection of serum amylase and lipase and observation of damage of pancreas by light and electron microscopy at 3 h,6 h,12 h,24 h after the model be-ing established. Results The levels of serum amylase of sepsis group showed a rising trend over time,and peaked at 24 h(2 779. 83 U/L), which showed no difference among 4 time points. There was no significant difference of serum amylase among 3 groups at each time point except for 12 h value. The levels of serum li-pase in both sepsis and sham group were higher than that in normal control group at 3 h(P<0. 05),while de-creased to the level of normal control group at 24 h. By light microscope,pathological changes of pancreas in the sham groups were that lobule was slightly widened; mild interstitial edema,vasodilation and a little in-flammatory cell infiltration were occasionally found;most of the lobular structure was complete. In the sepsis group,pancreatic pathological changes aggravated with time prolonged. Pancreatic lobules gap widened,inter-stitial were infiltrated by the inflammatory cell,flocculus brim structure was fuzzy,focal necrosis was found occasionally,islet structure was complete at 3 h. Pancreatic lobule was significantly wider,more inflammatory cell infiltrated,necrosis enlarged at 6 h,and pancreatic lobule was obvious edema,more inflammatory cell in-filtration and focal necrosis were found at 12 h. Vascular of pancreatic lobule was dilatation and congestion, pancreatic lobule and islet edge blurred,more lobular necrosis at 24 h. The modified Schmidt scoring of sham group and sepsis group at 3 h,6 h,12 h,24 h were 2. 0,3. 6,3. 4,3. 6 and 4. 6,6. 0,6. 8,7. 6,respectively. By transmission electron microscope,the ultrastructure of pancreatic cell in sham group was normal,mitochondri-al and lysosomal swelling were found occasionally. When in the sepsis group,the nucleus was normal,some mitochondria was swelling and cracking, lysosomes was swelling at 3 h, nucleus was complete, a part of swelling mitochondria and lysosomes appeared vacuolated necrosis at 6 h,and karyopyknosis and chromatin condensation were found,more mitochondria and lysosomes were swelling necrosis and vacuolar degenerated, rough endoplasmic reticulum was swelling at 12 h,cell karyopyknosis and chromatin condensation were obvi-ous,a large number of mitochondria and lysosome, endoplasmic reticulum were swelling, dilatation and vacuolar necrosis at 24 h. The modified Schmidt scoring showed no significant correlation with the levels of serum amylase and lipase in sepsis group(r=0. 472,P=0. 199;r=0. 260,P=0. 499). Conclusion The pancreas was damaged in the septic rat. The pathological changes of pancreas were obvious at 6 h after sepsis onset. The characteristics of the pancreas ultrastructure change includes the changes of the mitochondria and lysosome in the early period,clear vacuoles necrosis of mitochondria and lysosome,and destruction of nucleus and the endoplasmic reticulum. There is no significant correlation between pancreatic pathological changes and serum amylase as well as lipase,serum amylase and lipase can′t indicate the extent of pancreas damage in sepsis.

OBJECTIVE:To compare the physical chemistry properties of copying(A) and original(B) aluminium phosphate gel METHODS:We examined the character,antacid activity,isolating capacity against H+ ions and viscosity in different pH values of two products RESULTS:Product A was not better than product B in the Character,antacid activity,isolating capacity against H+ ions and viscosity;The antacid activity of two preparations not influenced obviously by the food with low concentration;Two preparations all had difference physical chemistry properties in batches CONCLUSION:Product B was better than A in comparison of the physical chemistry properties

OBJECTIVE:To provide references for drug administrator in coping with the challenge of drug shortage and the promotion of rational drug use. METHODS: With American Society of Hospital Pharmacists Guidelines on Managing Drug Shortages as references,the feasible management strategies for drug shortage in China were put forward based on the reality of our country and our experience in the practice of drug shortage management. RESULTS & CONCLUSIONS: It is advisable to draw experiences from U.S. Food and Drug Administration to tackle the problem of the shortage of essential drugs through the co-efforts of Ministry of Public Health,State Food and Drug Administration and Stage Development and Reform Committee and develop contingency planning strategy in health care organization to deal with the shortages of certain drugs and reduce potential clinical safety hazard induced by drug shortages.

OBJECTIVE:To evaluate the quality of anticoagulant therapy in patients who took warfarin and provide data sup-porting for strengthening the management of these patients. METHODS:A retrospective analysis of related clinical data of 214 pa-tients who meet the inclusion criteria was performed. RESULTS:The average time for patients took warfarin was (321.64 ± 189.50)d,average times for tested INR was(12.01±7.03)times in clinic;when anticoagulant therapy,INR<2.0 accounted for 51.96%,2.0≤INR≤3.0 accounted for 39.13%,and INR>3.0 accounted for 8.91%;patients with target INR≤2.0 accounted for 45.33%,target INR=2.5 accounted for 38.32%,and target INR≥3.0 accounted for 0.93%;the average TTR was (50.80 ± 22.32)%;and there was no statistical significance in the TTR of different ages and diseases(P>0.05). CONCLUSIONS:The anti-coagulant therapy in some patients who took warfarin shows poor quality,it needs strengthening the quality management to make it safe and effective.

Objective To study the changes of cytokines in children with hand-foot and mouth disease.Methods Sixty-two cases of hand-foot-mouth disease admitted to our hospital from March 2011 to December 2011 were included in this study.Thirty-seven cases were male and 25 cases were female,the youngest one was four month old,and the oldest one was eleven month and 4 years old,the average age was (1.56 ± 0.98) years old.Sixty-two children with hand-foot-mouth disease were devided into ordinary group (n =20),severe group (n =20),critically ill group (n =22).Twenty healthy children served as control group.The plasma levels of pro-inflammatory cytokines [tumor necrosis factor(TNF)-α,interleukin(IL)-1β、IL-6] and anti-inflammatory cytokines (IL-1 0、IL-13、IL-4) were detected.Results The pro-inflammatory and anti-inflammatory cytokines of patients with hand-foot and mouth disease were increased compared with control group.The levels of TNF-α in severe and critically ill groups were (201.45 ± 133.42) ng/L,(220.37 ± 117.54)ng/L respectively,which significantly increased compared with ordinary group [(118.12 ±11205) ng/L] (P ＜0.05).The levels of IL-1β and IL-6 in critically ill cases were (651.77 ±538.45) ng/L and (88.02 ±50.76) ng/L respectively,which significantly increased compared with severe cases [(551.75 ± 252.75) ng/L,(59.25 ± 28.80) ng/L] and ordinary cases [(270.18 ± 249.79) ng/L,(55.76 ± 28.68) ng/L] (P ＜ 0.05).The level of IL-10 was (137.53 ± 72.07) ng/L in ordinary cases,which increased significantly compared with the severe and critically ill cases[(57.07 ±55.02) ng/L,(73.37 ±56.01) ng/L] (P ＜0.05).The levels of IL-13 were (507.53 ±210.86) ng/L and (489.67 ± 168.99) ng/L in severe and critically ill cases respectively,which significantly increased compared with ordinary cases [(387.16± 157.43) ng/L] (P ＜0.05).The levels of IL-4 showed no significant differences among the ordinary,severe and critically ill groups(P ＞ 0.05).Conclusion The pro-and anti-inflammatory cytokines were involved in inflammatory response simultaneously in patients with hand-foot and mouth disease.The increases of TNF-α,IL-1β and IL-6 are consistent with severity of the disease,while factor IL-10,IL-13 are decreased as the severity of the disease.The increase of the pro-inflammatory cytokines and decrease of the anti-inflammatory cytokines are the important sign of the exacerbation.

Objective To explore the mediating role of coping modes between illness perception and posttraumatic growth among patients with breast cancer. Methods Totally 300 patients with breast cancer were investigated with the posttraumatic growth inventory, brief illness perception questionnaire and medical coping modes questionnaire. Results The total score of illness perception was 40. 77 ± 6. 85. The scores of confrontation coping style,avoidance coping style and resignation coping style were 19.42±3.51, 17.78±2.79,8.64±3.35. The total score of posttraumatic growth was 57.38±10.48. Illness perception was negatively correlated with posttraumatic growth ( r=-0.743) ,confrontation( r=-0.568) and avoidance ( r=-0.621),positively related with resignation( r=0.727).Posttraumatic growth was positively correlated with confrontation and avoidance ( r=0.729, r=0.657) ,but negatively correlated with resignation( r=-0.757) (P<0.01) . Coping modes had a partial mediating effect on the relationship between illness perception and postt?raumatic growth. The total mediation effect value was 0.428,and the mediation effect was 57.60%,while con?frontation and resignation mediation effect value were -0. 191 and -0. 207, and the mediation effect were 25.70% and 27. 86%. But there was no statistical significance in avoidance mediation ( effect value was-0.030 and the mediation effect was 4.04%) . Conclusion Confrontation and resignation coping modes play a role multiple mediation effects between illness perception and posttraumatic growth.

Objective: To establish the quality standard for Tiaolitongbao I capsules.Methods: The components including Astragalus , Atractylodes, Finger citron and Radix aucklandiae were identified by TLC.Emodin, the effective component of Polygonum cuspidatum , was determined by HPLC.Results: The characteristic spots in TLC were clear without any interference.The linear range of emodin was 4.25-68.00 μg·ml-1 (r =0.999 9).The average recovery was 95.22% ,and RSD was 1.47% (n =6).Conclusion: The methods used for the identification and quantification are sensitive, simple and accurate, which can be used for the quality control of Tiaolitongbao I capsules.

Objective:To summarize the drug repercussion data in outpatient pharmacy and analyze the reasons to provide sugges-tions for the improvement. Methods: The information was collected from the hospital information system ( HIS) during January 1, 2013 and December 31, 2015, including drug name, category, quantity, amount, reasons for drug repercussion and the other statisti-cal data. Results:During the three years, the number of prescription drugs, amount of money and varieties of drug repercussion were increased. The most common reasons for drug repercussion were the other reasons, withdrawn by doctors and the request of patients. The sum of drug repercussion was positively correlated with the drug price and the amount of drug repercussion. Conclusion:The op-tion simplicity for drug repercussion in HIS is the main reason for drug repercussion bythe other reasons. The occurrence of drug re-percussion should be intervened by such methods as gradually improving the HIS, establishing intervention measures, enhancing the professional quality of pharmacists and so on.