Objective:To explore the role of clinical pharmacists in the development of individualized drug treatment regimens for the osteosarcoma children with irregular body weight .Methods:Clinical pharmacists involved in the calculation of body weight surface area increased to that of adult for one case of osteosarcoma child during the chemotherapy , comparatively analyzed the suitable calcula-tion formula of surface area for the children in our country and helped clinicians make accurate dose of chemotherapy drugs .Mean-while, according to the pathological and physiological characteristics of the child , clinical pharmacist also provided advice on adjuvant drug use such as antiemetic regimen etc .Results:Physicians adopted the suggestions of clinical pharmacists and the chemotherapy was successfully completed .Overdose adverse reactions were avoided without the use of foreign general calculation formula of body surface area for the overweight child , and inadequate dose was also avoided for the conservative treatment , which could lower the risk of re-duced potential anticancer efficacy .Conclusion:Clinical pharmacists can help doctors perform safer and more effective drug treatment program and reduce adverse drug reactions in the treatment of special patients through participation in the development of individualized medication for cancer children to obtain maximum profit .

OBJECTIVE:To systematically review the relationship of clinical efficacy between XPD Lys751Gln (A/C),XPD Asp312Asn(G/A)and platinum-based chemotherapy in patients with advanced non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Cochrane Library, EMBase, Medline, CJFD,VIP database and WanFang database,studies about the effects of XPD Lys751Gln and XPD Asp312Asn polymorphism on ef-fectiveness,clinical outcomes and adverse drug reaction of platinum-based chemotherapy in advanced NSCLC patients were collect-ed,and Meta-analysis was performed by using Rev Man 5.3 software. RESULTS:Totally 30 studies were included,involving 5 028 patients. Genetic testing showed that XPD Lys751Gln divided into mutant gene (Lys/Gln + Gln/ Gln) and wild-type gene (Lys/Lys),while XPD Asp312Asn divided into mutant gene (Asp/Asn + Asn/Asn) and wild-type gene (Asp/Asp). Results of Me-ta-analysis showed,the progression-free survival (PFS) of Lys/Gln+Gln/Gln patients with platinum in XPD Lys751Gln polymor-phism was obviously lower than Lys/Lys patients [OR=-1.12,95%CI(-1.73,-0.50),P<0.001],while there was no significant difference in the chemotherapy effectiveness and total survival period. The effective rate of Asp/Asn+Asn/Asn patients for platinum in XPD Asp312Asn polymorphism was lower than Asp/Asp patients [OR=0.80,95%CI(0.68,0.96),P=0.02],while there was no significant difference in the total survival period and PFS. Meanwhile,the incidence of Ⅲ-Ⅳ level gastrointestinal adverse reac-tions of Lys/Gln+Gln/Gln with platinum in XPD Lys751Gln polymorphism was higher than Lys/Lys patients [OR=0.43,95%CI (0.20,0.94),P=0.03],and there was no significant difference in Ⅲ-Ⅳ level blood system adverse reactions. CONCLUSIONS:XPD Lys751Gln polymorphism may be associated with PFS and Ⅲ-Ⅳ level gastrointestinal adverse reactions for advanced NSCLC patients with platinum-based chemotherapy,while XPD Asp312Asn polymorphism may have effect on platinum-based chemotherapy,both of them may be as estimate the chemotherapy effect and prognosis detection index of platinum-based chemo-therapy.

Objective To investigate the drug resistance and genotype of methicillin-resistant Staphylococcus (MRS), and to study the epidemiology of drug resistance in Staphylococcus. Methods Drug susceptibility tests were performed for 138 Staphylococcus strains clinically isolated, and mecA gene was detected with PCR. For mecA positive strains, Staphylococcal cassette chromosome mec (SCCmec) gene was detected by two multiplex PCR assays. Results Seven (10.8%) out of 65 Staphylococcus aureus strains were methicillin-resistant Staphylococcus aureus (MRSA) strains, and 44 (60.3%) out of 73 coagulase negative Staphylococcus strains were methicillin-resistant coagulase negative Staphylococcus (MRCNS)strains. There was statistical significance on the difference of isolation rates (x2 = 37. 05, P ＜0.01). No vancomycin or nitrofurantoin resistant strain was found. There were 52 (52/138, 37.7%) mecA positive strains, including 16 SCCmec type Ⅰ strains, 1 type Ⅱ strain, 13 type Ⅲ strains, 9 type Ⅳ strains and 4 type Ⅴ strains. Conclusions Drug resistance in MRS is increasingly serious. MRCNS strains are more popular than MRSA in clinic, and SCCmec Ⅰ and Ⅲ may account for most infections.

Objective To investigate the prevalence of nosocomial infections in Tianjin Children's Hospital and to provide database for monitoring and control of nosocomial infection.Methods The medical records of 6101 children admitted in the first half of 2005 and the laboratory results of isolated bacteria from clinical samples in 2005 were retrospectively investigated.Results The total nosocomial infection rate was 3.47%(212/6101),in which the surgical nosocomial infection rate was 2.66%(32/1204)and 2.95%(180/6101)infections were caused by non-surgical incisions.Respiratory tract was the most frequent infection site(119/212,56.1%).Several opportunistic pathogens were responsible for the major nosocomial infections,they were Escherichia coli,Coagulase negative staphylococcus,Enterococcus,Klebsiella pneumonia,Staphylococcus aureus and Pseudolnonas aeruginosa.Conclusion The pathogenic isolates for the infections show high resistance to most antibiotics.Monitor and control of the incidence of nosocomial infections and resistance to antibiotics should be enforced.

Objective To share the content and the entry point of the clinical pharmacist participating in the oncology emergency drug treatment. Methods Five typical cases of oncologic emergency occurred in patients with advanced cancer. Clinical pharmacists participated in the drug treatment of circulatory system of emergency,nervous system emergency,metabolic system emergency,blood system emergency and multi-drug resistant bacteria infection.Clinical pharmacists provided suggestions for clinical medication and a whole-course pharmaceutical care by using pharmaceutical knowledge and reviewing relevant information material. Results The work of pharmacists get clinical recognition by assisting clinicians to solve the critical emergencies of cancer patients and improving the effect of drug treatment. Conclusion Clinical pharmacists can be gradually integrated into the medical team and play a critical role as clinical pharmacists in terms of drug treatment.