OBJECTIVE: To assess the efficacy and safety of different therapeutic regimens for Acinetobacter baumannii infection. METHODS: PUBMED (1995 to 2011), Cochrane Central Register of Controlled Trails (Issue 7, 2011), CNKI (1979 to 2011), and VIP (1989 to 2011) were searched for randomized controlled trial, quasi-randomized controlled trial, prospective and retrospective cohort study. A meta-analysis was performed with Cochrane Collaboration's RevMan 5.0 software. RESULTS: Eight literatures involving 544 patients with Acinetobacter baumannii infection were identified. Five studies used ampicillin/sulbactam. The analysis showed that there was statistically significant difference in the success rate between ampicillin/sulbactam and other drugs with OR of 1.69 and 95% CI of 1.03 to 2.75 and in mortality with OR of 0.51 and 95% CI of 0.29 to 0.89.As for improvement, bacteriologic success, treatment failure and adverse events, there was no statistically significant difference. There was one study involving cefoperazone/sulbactam and four studies on colistin. As far as bacteriologic success, clinical success and adverse events were concerned, there was no statistically significant difference. However, patients receiving colistin treatment had higher mortality with OR of 1.76 and 95% CI of 1.09 to 2.86. CONCLUSION: Ampicillin/sulbactam has better effect against Acinetobacter baumannii. It can improve the symptoms and clinical signs and dose not have significant adverse effect.

Background: The risk of opportunistic infection in ulcerative colitis (UC) is significantly higher than that in healthy subjects, and has adverse impact on clinical outcome. Aims: To analyze the prevalence of opportunistic intestinal infection in UC patients and explore the risk factors of UC complicated with opportunistic infection. Methods: Clinical data of patients with UC hospitalized in Peking University Third Hospital from January 2012 to December 2020 were collected retrospectively. Information on demography, clinical characteristics, laboratory, endoscopic and pathological findings, as well as the medication histories were recorded; the factors associated with opportunistic intestinal infection were analyzed using univariate and multivariate analyses. Results: A total of 275 UC patients were included, with an opportunistic intestinal infection rate of 26.2%; among which, rates of cytomegalovirus (CMV), Epstein ‑ Barr virus (EBV), fungi, Clostridium difficile, amoeba, and multiple infection were 13.5%, 14.5%, 5.1%, 1.5%, 1.1%, and 9.1%, respectively. Multivariate Logistic analysis demonstrated that severe disease activity (OR=6.517, 95% CI: 1.487‑28.552, P=0.013) and albumin <30 g/L (OR=3.895, 95% CI: 1.590 ‑ 9.544, P=0.003) were independent risk factors for CMV infection. The independent risk factors for EBV infection included severe disease activity (OR=11.260, 95% CI: 2.249‑56.382, P=0.003), albumin <30 g/L (OR=2.548, 95% CI: 1.096‑5.927, P=0.030) and C‑reactive protein (CRP) elevation (OR=1.046, 95% CI: 1.007‑1.086, P=0.019). While for intestinal fungal infection, the risk in patients with chronic relapsing type UC was lower (OR=0.278, 95% CI: 0.087‑0.886, P=0.030). Intestinal multiple infection was mainly composed of viral infection, and the independent risk factors were similar to those of CMV and EBV infection. Conclusions: Most of the opportunistic intestinal infection in UC patients is viral infection. Disease activity, inflammatory response and reduced albumin are risk factors for intestinal viral infection in UC patients, while the risk of fungal infection is only related to clinical subtyping.

The incidence of inflammatory bowel disease (IBD) is increasing year by year, yet lacking specific treatment, which seriously affects patients' health and quality of life. The pathogenesis of IBD has not been fully clarified, the psycho-neuro-endocrine-immune regulation through gut-brain axis may play an important role in the pathogenesis of IBD. Studies have shown that IBD patient has an increased risk of depression. More than 20% of IBD patients have depression, the incidence is about 2-4 times that of general population. Antidepressant therapy has good efficacy in some IBD patients. The possible mechanism includes affecting the gut-brain axis, inhibiting inflammation, improving mood, etc. However, there are few relevant studies, and the value of antidepressant therapy in the treatment of IBD needs to be further confirmed by large-sample randomized controlled studies. This article reviewed the application of antidepressant therapy in IBD.

OBJECTIVE: To evaluate the efficacy and safety of rivaroxaban in the treatment of deep venous thrombosis(DVT). METHODS: PubMed, Embase, Cochrane Library, Web of Science, Clinical Trials, CNKI, CBM and WANFANG database were systematically searched. All databases had been searched from up to August 2016. All randomized controlled trials (RCTs) of rivaroxaban therapy in patients with deep venous thrombosis were selected. Meta-analysis was carried out by using RevMan 5.3 software. The incidence of recurrent DVT, recurrent VTE, DVT, pulmonary embolism(PE), major bleeding, clinical relevant non-major bleeding(CRNMB) and all-cause mortality after the treatment were compared and the results were presented with risk ratio (RR) with 95% confidence interval (CI). RESULTS: Total 5 RCTs of 4 737 cases were included in this study, including 1 605 cases accepted rivaroxaban (treatment group), other of 3 132 cases accepted other drugs (control group). The results of Meta-analysis were as follows the incidence of recurrent DVT in the rivaroxaban group was lower than that in the unfractionated heparin/low molecular heparin+ vitamin K antagonists (UFH/LMWH+VKA) group (P=0.002). There was no significant difference in the incidence of pulmonary embolism, venous thromboembolism, major bleeding, CRNMB and all-cause mortality between the treatment and control group (P>0.05). CONCLUSION: In the treatment of DVT, rivaroxban shows better efficacy than that of traditional anticoagulant therapy (UFH/LMWH+VKA) and it will not increase the risk of adverse events such as bleeding and death.

OBJECTIVE: To establish the criteria in repeated usage of traditional Chinese patent medicines. METHODS: Fifteen experts were invited to take a two-rounded questionnaire survey. Experts' positive coefficients, authority coefficient, reliability, concentration degree and coordination degree towards experts' opinions were calculated by SPSS23.0 after integrating the opinions. The criteria were modified based on the prespecified principles. RESULTS: In this two-rounded survey, experts' positive coefficients were 100.00% and 93.33%, averaging authority coefficient was 0.91, reliability of two rounds were 0.87 and 0.82. Coordination degree increased from 0.36 (P<0.01) to 0.46 (P<0.01). Three first level index and eighteen second level index were included in this cirteria. CONCLUSION: With well response, authority, reliability and coordination, this study could define preliminary evaluation criteria of repeated traditional Chinese patent medicines.

OBJECTIVE: To evaluate the quality of now available clinical guidelines and consensus statements on type 2 diabetes. Based on this assessment, the comparison of guidelines and consensuses is made to give some suggestions on the methods of making these documents. METHODS: PubMed, Embase, CNKI, Wanfang, SinoMed and guideline websites were systematically searched. Literatures were screened according to defined criteria for including. AGREE II was used to instrument assess the quality of the guidelines and consensuses. RESULTS: The result showed that the quality of included guidelines is various, but the overall quality of guidelines is still higher than consensuses. Guidelines got high scores in scope and purpose domain and clarity of presentation domain, but low scores in rigor of development domain and applicability domain. Consensus statements got low scores in all 6 domains. CONCLUSION: The main reason for the difference is consensuses have poor methodology. Rapid advice guidelines were suggested as an alternative for consensus statements.

OBJECTIVE: To systematically evaluate the economics of saxagliptin for treatment of type 2 diabetes mellitus. METHODS: PubMed, Embase, Cochrane Library, NHS EED, CNKI, Wanfang and CBM were systematically searched. Literatures were screened according to pre-defined inclusion criteria. The quality of included studies were evaluated by CHEERS statement and the economic results were systematically analyzed. RESULTS: Eight cost-effectiveness analyses were included, one of which was conducted in China. Patients among the studies all had blood glucose non-adeguately controlled by monotherapy. When added on to metformin, saxagliptin was cost-effective compared with sulfonylureas (glipizide and glimepiride) and thiazolidinediones (pioglitazone and rosiglitazone). When added on to metformin or sulfonylureas, saxagliptin was cost-effective compared with NPH insulin. CONCLUSION: Saxagliptin represents a cost-effective option in treatment of type 2 diabetes mellitus patients with non-adequately controlled blood glucose after monotherapy.

OBJECTIVE: To review the established tele-pharmacy service system,service pattern and standard based on modern telecommunications and information technologies and provide references for exploration and implementation of tele-pharmacy in China to deliver pharmaceutical care to patients at a distance. METHODS: Literatures about tele-pharmacy practice in domestic and at abroad were retrieved. The development,service pattern,advantages and disadvantages and related application studies of tele-pharmacy were summarized and analyzed. RESULTS: Tele-pharmacy is used to deal with how to obtain equivalent pharmaceutical care as traditional service pattern to underserved populations in the status of lacking pharmacists and poor access to pharmaceutical care. More and more countries have approved and conducted this pattern,and the impact and patient satisfaction have been confirmed. But limitations such as laws and technologies still exist. CONCLUSION: Tele-pharmacy service could play an important role in balancing pharmacist resources and promoting rational drug use.

OBJECTIVE: To describe the continuous improvement process of the quality system of phase I labs by using (plan-do-check-action) PDCA method. METHODS: Considering the particular characteristics of phase I labs, PDCA cycle was applied to the quality management system as well as the research programs. RESULTS: As a quality management tool, PDCA method holds the same goal as ISO 17025 system, that is, to improve the management system of phase I labs. CONCLUSION: PDCA method is very useful in helping phase I labs achieve the quality goals, which, as a result, can ensure the accuracy and reliability of the research results.

In recent years, the appearance of tumor cell chemoresistance has brought new challenges to the treatment and prognosis of bladder cancer. Therefore, it is more and more urgent to study the chemoresistance mechanisms of bladder cancer. The current studies show that the chemoresistance mechanisms of bladder cancer mainly include drug efflux, epithelialmesenchemal transformation (EMT), cell autophagy, microRNA regulation and genetic epigenetic modification, which involves a variety of cell signal transduction pathways. Moreover, the different mechanisms of chemoresistance maybe have connections with each other by the same signaling pathways, thus forming a complex regulatory network. This paper reviews the latest progress in the study of chemoresistance mechanisms of bladder cancer, in order to provide new ideas for the targeted treatment of bladder cancer.