OBJECTIVE:To understand the status of the use of national essential medicines,and provides reference for further implementing the national essential medicine system and promoting the priority use of national essential medicines. METHODS:Ac-cording to the statistics analysis of the use of national essential medicines(for example the antihypertensives and oral hypoglycemic agents)in Beijing,Shanghai and Guangzhou areas,the related influential factors about priority use of national essential medicines were explored. RESULTS:The proportions of use amount of national essential medicines in our hospital in 2012-2013 to the total amount of medicines were 21.20% and 18.75%,respectively,with a downtrend;the proportion of antihypertension drugs to total amount was only 14.05%and 13.70%,respectively;compared with the same generic drugs with individual pricing,the GMP prod-ucts of Valsartan capsule,Bisoprilol tablet and Amlodipine tablet had no advantages in DDDs,or even lower. DDDs of individual pricing drugs of Acarbose tablet in medical institutions in Beijing area and tertiary hospitals in Shanghai and Guangzhou area in 2011-2012 were much higher than the generic GMP products with the same generic drugs. CONCLUSIONS:The clinical use of na-tional essential medicines in our hospital and parts of the country still remains to be further improved,the influential factors includ-ed reimbursement mechanism,awareness rate of related knowledge,physicians’habit to drug use and pursuing economic benefits. The propaganda and training should be strengthened,awareness rate of medical staff and publics to national essential medicines, the availability of national essential medicines and national essential medicine system and medicare reimbursement payment policy should be improved,and the priority use of national essential medicines should be promoted by more measures combination use.

OBJECTIVE:To practice over-the-counter service model in the outpatient pharmacy,to improve the phar-macy service quality of pharmaceutical care and to promote rational drug use.METHODS:The background,preparation,procedure and the whole operation courses in establishing the over-the-counter service model in the outpatient dispensary of our hospital were reviewed,summarized and analyzed.RESULTS:The working objectives and principles of the outpatient pharmacy have been established through the over-the-counter service model;pharmacists'position and responsibility,the operation norm,standardized service language,error-sharing system and the solution schemes for disputes have been further improved and consummated;pharmacists'service consciousness and techniques have been improved and their responsibilities have been reinforced.CONCLUSION:The implementation of the over-the-counter service model can facilitate the estab-lishment of excellent service system in the outpatient dispensary,manifest pharmacist'professional value,promote the at-tractive force of pharmaceutical care in hospital.

OBJECTIVE:To systematically evaluate the efficacy and safety of sodium valproate versus diazepam in the treat-ment of status epilepticus in adults,and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from Med-line,EMBase,PubMed,Cochrane Library,CJFD,VIP datebase,CBM and Wanfang database,the randomized controlled trials (RCT) about sodium valproate (test group) versus diazepam (control group) in the treatment of status epilepticus in adults were collected. Meta-analysis was performed by using Rev Man 5.0 statistical software after extracting data and evaluating quality. RE-SULTS:A total of 5 RCTs were included,involving 276 patients. Results of Meta-analysis showed that recurrence rate of epilepsy in 48 h in test group was significantly lower than that of control group [OR=0.39,95%CI(0.16,0.96),P=0.04]. Compared with the control group,the effective rate controlling epilepsy within 2 h[OR=1.76,95%CI(0.88,3.52),P=0.11] and incidence of liver injury[RR=1.19,95%CI(0.38,3.70),P=0.77] were no significant differences. CONCLUSIONS:The efficacy and safety of sodi-um valproate was equivalent to diazepam in the treatment of status epilepticus in adults,however,sodium valproate was superior to diazepam in terms of controlling recurrent effect. Due to methodology limit of included studies,large-scale and high quality RCT are required for further validation of the conclusions.

Objective To study the values of continuous renal replacement therapy (CRRT) for the treatment of multiple organ dysfunction syndrome ( MODS) induced by sepsis. Methods A total of 62 patients with MODS were divided into three groups, namely non-CRRT group, short period CRRT group (24 ~ 48 h) and long period CRRT group( >48 h). Relevant factors including organ function, plasma endothelin-1 (ET-1),sepsis-related organ failure assessment(SOFA)score, average length of survival time and accumulative survival rate were analyzed . Results Compared with non-CRRT group, a statistically significant difference in SOFA score was evident on the 4th day after long period CRRT group and on the 6th day after short period CRRT group. The survival rates of three groups on the third day after treatment were 56. 3% 、 83.3% and 88.9%, respectively (P< 0.05). The survival rates of three groups three weeks after treatment were 53. 1% , 58. 3% and 66.7% , respectively (P>0.05). The average lengths of survival time in three groups were(4.4 ±2.6)days, (9.5 ±6. l)days and (10.3 ±5.4)days, respectively. Compared with non-CRRT group, the average lengths of survival time were longer in the other two groups. The levels of serum ET-1 significantly decreased after CRRT treatment (P<0.05). Conclusions The organ function and survival rate could be improved by CRRT. Average lengths of survival time were significantly prolonged in two CRRT groups(P <0.05). More effective therapeutic results including lower SOFA score and longer average length of survival time were observed when the course of CRRT was extended longer properly.

OBJECTIVE:To improve pharmacists’ consciousness, abilities and skills on pharmaceutical services and to ensure safe and effective use of drugs in patients. METHODS: With the trainning of basic theroy, basic knowledge and basic skills for the priciple to develop technique trainning in view of pharmaceutical technicians in outpatient pharmacy, it were trained or examined by means of traditional exam and operation practice with the results analyzed. RESULTS:In the examinations of drug laws and regulations and pharmacal basic knowledge, 72.8% and 36.4% of pharmacists got excellent level respectively. In the review of prescriptions, and the use of some special drugs, pharmacists masted in sufficiency. CONCLUSIONS: The new open pharmaceutical service mode in the outpatient pharmacy calls for a higher level of expertise and skills for pharmacists, thus the training in fundamental theory, basic knowledge and essential skills are significant in our hospital.

OBJECTIVE:To understand the utilization of antihypertensives in our hospital.METHODS:150medical records of the patients who had received antihypertensives and were discharged in June,2002were collected.The kind,utiliza?tion and combined use of antihypertensives were analysed.RESULTS:The first4places of drugs used in order of number of case were angiotensin converting enzyme inhibitors,?-receptor blocking agents,diuretics and calcium antagonists.The first3places of DDDs of antihypertensives were Betaloc,Benazepril and Fosinopril.DUI≤1.Most patients received a single agent or combination of two or three agents.CONCLUSION:The study shows that complications are frequent and so is the combined use of drugs,and the use of drugs is basically rational.

To cultivate more excellent pharmacists, ensuring patients rational drug use, standardiza-tion training of hospital pharmacists in Beijing has been carried out since 2000, and the wonderful effect has been achieved. The teaching methods mainly include centralized training model, small lectures, practice teaching and self-study. The training teaching content mainly includes prescription audit, drug dispensing and management as well as the pharmaceutical care. In this paper, based on the analysis of the status quo, it is recommended that detailed training formulate, teaching methods and content of the second stage of the training about the training management policy, and the clinicians teaching should be added to the contents of teaching. The thought moral qualities, laws and regula tions, as well as academic and research training should also be added to the teaching content.

OBJECTIVE:To understand features of ADR in our hospital and to promote rational clinical drug use.METHODS:A retrospective method was adopted in which 557 ADR cases collected in our hospital in 2004 were analyzed from aspects of reporters,drug categories,routes of administration,the top 10 ADR-induced drugs and etc.RESULTS:Antibacterial and the traditional Chinese medicine injectable preparation dominated the first place and the second place respectively on the list of ADR report cases;55.83%of the ADR cases was induced by IV drop drugs;Clindamycin injection has the highest incidence rate of ADR;63.91%ADR cases were come from pharmacists.CONCLUSION:Carrying out ADR monitoring work is an important task for medical institutions,the strengthening of ADR monitoring can ensure safe drug use of patients.

Objective: To establish an education program for resident pharmacists to improve clinical problem solving skills with pharmaceutical knowledge.Methods: A case-based education program for resident pharmacists with drug knowledge was established after a questionnaire survey in resident pharmacists and the discussion with clinical teachers.A teaching team was built and the resident pharmacists were divided into several study groups.After a pilot run, the program was operated in pharmacy department.The program was divided into 10 sections by drug indications, and each section was composed of basic drug knowledge lecture and case discussions, which mobilized the study initiative of resident pharmacists.At the half time, resident pharmacists and clinical teachers participated in a midterm survey by a questionnaire.Results: More than 95% resident pharmacists and teachers believed that basic drug knowledge lecture before case discussion was necessary, and compared with previous trainings, the program could further increase study interests of resident pharmacists and improve the clinical problem solving skills.However, 33.3% resident pharmacists and 60% teachers thought the cases were difficult, and 18.5% resident pharmacists and 10% teachers disagreed the cases were close to the actual work.Conclusion: The program is effective in drug knowledge training for resident pharmacists, which can improve pharmaceutical care for patients, while further modifications are still needed to satisfy the demands of resident pharamcists with different working years.

OBJECTIVE:To explore the standardized package of Metformin tablets to meet clinical needs. METHODS:Statis-tics was conducted for the utilization data of Metformin tablets in medical and health institutions from 6 cities of China;question-naires were designed to investigate and analyze the evaluation for the suitability of physicians,pharmacists and patients in the pre-scription,deployment and use links to Metformin tablets with different packaging loaded amount in Beijing and Haikou. RE-SULTS:For 0.5 g/tablet,the daily dose of 1.5 g accounted for the largest proportion (32.23%-69.91%) in 5 cities except for Chengdu. Totally 490 questionnaires about package suitability of Metformin tablets in outpatient department were sent out,includ-ing 478 valid questionnaires with effective rate of 97.5%. Results showed that packaging quantity with 4 weeks was considered as appropriate by physicians,pharmacists and patients in Beijing;however,packaging quantity with 1-2 week(s) was considered as appropriate by physicians,pharmacists and patients in Haikou;300-500 tablets of packaging quantity were preferred to be appropri-ate with the matching degree of automatic dispensing machines in both places. CONCLUSIONS:Considering the results in 2 plac-es,for 0.5 g/tablet,2 weeks is appropriate for the packaging loaded amount in outpatient department,that is 0.5 g×45 tablets/box;and 300-500 tablets/box is appropriate for inpatient pharmacies.