AIM: To compare two methods of HPLC-MS/MS and MEIA to monitor the tacrolimus concentrations for organ transplantation patient.METHODS: After developing and validating the HPLC-MS/MS method to determine the concentrations of tacrolimus,the tacrolimus samples were quantitated by two methods of HPLC-MS/MS and MEIA,respectively.Evaluate two methods by statistical analysis of quantitative results.RESULTS: The mean concentration were(4.86?0.46) ng/mL by HPLC-MS/MS and(5.52?0.43) ng/mL by MEIA.The coefficient correlation of two methods was 0.8771,and the two methods have good correlations in statistics.The mean concentration ratio was(90.3?5.3)%.CONCLUSION: The HPLC-MS/MS method is a more precise method for to determining the effective concentration of tacrolimus,which is suitable for daily TDM.

OBJECTIVE To study the in vitro activity of cefepime combined with sulbactam against carbapenem-resistant strains of Acinetobacter spp clinically isolated. METHODS The activity of each drug alone was determined against 24 isolates. Chequerborad synergy testing was then performed against all the isolates. RESULTS The percentage of the FIC index showed 33.3% synergism, 62.5% additive, 4.2% (1/24) indifference, and no antagonism tively. CONCLUSIONS Testing of cefepime and sulbactam combinations revealed synergism and additivity activity against some carbapenem-resistant strains(23/24) of Acinetobacter spp which could be likely to prove beneficial effect for the treatment of infections due to multidrug-resistant strains of Acinetobacter spp.

The paper covered the initial success of Zhejiang province in furthering its development of a basic healthcare system in alignment of social and economic growth. Such progress has been achieved by adhering to the principles of coordinated arrangement,highlighting key points and step-by-step progress. Also presented are the methods and experiences of the province in its reform and perspectives for furthering the ongoing reform.

OBJECTIVE: To investigate the resistance phenotype of acinetobacter baumannii and the expression of ade efflux pump gene. METHODS: Non-repetitive 51 strains of Acinetobacter baumannii were collected in Peking Union Medical Hospital between Feb. 2004 and Feb. 2005. The active efflux system adeB structural gene and sequence were identified by PCR. RESULTS: The tested strains were not susceptible to common broad-spectrum antibiotics. Multidrug resistant Acinetobacter baumannii carried adeB active efflux pump gene. CONCLUSION: The multiple-drug resistance of Acinetobacter baumannii is independent of ?-lactamase. It maybe related to other drug resistance mechanism. The effect of active efflux system is possibly one of the major mechanisms of multidrug resistance of acinetobacter baumannii.

Community Health Committee (CHC), an innovative public participation mechanism of grassroots health service management, established a bottom-up communication channel between the public and government to communicate health related problems and opinions, and set up a grassroots community health services supervision system. The rural residents were endowed with opportunities to take part in grassroots health care decision making and management by CHC. CHC changed the top-down model of traditional health management, improved the grassroots medical services, and increased governance capability of local government We introduced the CHC practice in Zhejiang project counties, exhibited the primary effects and experience of this pilot program, and explored new mechanism and model for rural community residents to participate in grassroots health service management

Microdialysis is an automatic biological sampling technique that is directed into the target tissue. Microdialysis is used to monitor the changes of drug and related substances associated with pathological physiology of tumor in the target tissue at the molecular level. Microdialysis is applied to evaluate the pharmaco-kinetics of drugs in the target tissue of tumor,optimize the combination therapy,explore molecular targeted therapy and study the early diagnosis and prognosis of tumor. Microdialysis provides a new idea and method for the prevention and cure research of tumor.

OBJECTIVE To provide a reference for the improvement of the clinical pharmacy undergraduate internship education in China. METHODS The status of clinical pharmacy undergraduate internship education in China was briefly summarized， and suggestions on its future development based on advanced methods of domestic and abroad were provided. RESULTS & CONCLUSIONS In China， undergraduate students of clinical pharmacy were required to undergo hospital internships for no less than 42 weeks. The internship took place in both pharmacy and clinical departments in hospitals. Students’ performance was usually assessed at the end of the internship. The mainstream teaching patterns included on-site teaching， simulation teaching， case-based discussion teaching， medical and pharmaceutical joint teaching， team-based teaching， academic exchange， and so on. The form of assessment had also shifted from final evaluations to more dynamic formats. The clinical pharmacy undergraduate internship education in China can adopt teaching models such as the layered teaching approach， establish pre-internship assessment or training， and encourage interns to participate in social pharmacy practice and directly interact with patients， etc.， so as to improve the effect of internship.

OBJECTIVE To study the in virto interaction of allicin combined with cefoperazone against clinical isolates of Pseudomonas aeruginosa.METHODS The protocol was designed by checkerboard method and the MICs of allicin combined with cefoperazone against the 17 strains of sensitive and 14 strains of drug-resistant P.aeruginosa were determined by broth dilution method,the FIC index was calculated according to MIC results.The combined effects were confirmed by FIC index.RESULTS The percentage of the FIC index less than 0.5,from 0.5 to 1,from 1 to 2,and more than 2 was 41.2-64.3% 35.7-41.2% 0-17.6%,and 0%,respectively.CONCLUSIONS Synergism and additivity of allicin combined with cefoperazone against P.aeruginosa are their main action,there are little autonomy and no antagonism.Allicin can significantly improve the antibacterial activity of cefoperazone against drug-resistant P.aeruginosa.

Objective To investigate JC virus(JCV) infection in kidney transplant recipients and its influence on graft function and also initially explore JCV infection factors. Methods A total of 49 kidney transplant recipients and 24 health examination persons were enrolled in our study, JCV DNA was measured using nested qualitative polymerase chain reaction assays of urine, while CMV DNA was measured by common qualitative polymerase chain reaction assays of urine. JCV infection factors, such as age, male, immunosuppressive therapy, cytomegalovirus(CMV) infection were analyzed by Binary Logistic Regression, and glomerular filtration rate(GFR) was selected as a index of kidney function and the difference of GFR between JCV-infected and non-infected patients was compared using t test. Results JCV was detected in 42.9% of kidney transplant patients and 4.2% health examination persons. CMV infection and Pred + MMF + CsA triple immunosuppressive regimen were found to be the risk factors of JCV infection. No difference of GFR was observed between JCV infected and non-infected patients (86.470 ± 29.990 and 84.060 ± 33. 729 for each; t =0. 259, P =0.797). Conclusion JCV is frequently detected in kidney transplant recipients. CMV infection and using of Pred + MMF + CsA triple immunosuppressive regimen can significantly increase the risk of JCV infection. While, graft function was not influenced by JCV infection in kidney transplant patients.

Objective To discuss the surgical technique and effectiveness of total knee arthroplasty (TKA) for the valgus knee in adult.Methods Retrospective analysis the clinical data from 2015 January to 2017 May of 38 patients with 40 knees treated in our hospital.Age 46-73(61 ±4.2) years old.The femur-tibia angle (FTA) was 7°-35 ° (11 ° ± 4.3 °),the average range of motion (ROM) was 115 ° ± 10°,the Hospital for Special Surgery (HSS) score was 21-65 (43 ± 8.6).All cases were corrected deformity and improved function by TKA.Results 38 patients were followed up 6 months to 3 years.All patients had no severe pain and dysfunction.The postoperative FTA was 1 °-7°(4 ± 3°),the average ROM was 115° ± 10°,the HSS score was 76 ± 14,showing significant difference compared with preoperative data (P ＜ 0.05).Conclusions The TKA is a conventional therapy for valgus deformed knee in adult.By appropriate approach,precise osteotomy,accurate soft tissue balance,satisfactory joint function and effectiveness can be achieved.