100MIC.The endotoxin could be released more and more with the time.CONCLUSION:It is reasonable to choose antibiotics to refer to the characteristics of the endotoxin release by germs.

Management of hospital water supply facilities is key to its logistics management.This paper cited the domestic water supply facilities management as an example, and summed up practical experiences in both JCI certification and review along with the hospital′s fine management of water facilities.On such basis, it described such aspects as the establishment of management system, operation standards and work flow, implementation of preventive maintenance, renovation, emergency protection, inspection supervision, file management and staff training.These efforts provide reference for how to establish the fine management mode of water supply facilities.

OBJECTIVE: To study the hospital infections caused by ESBLs-producing Escherichia coli and Kalispell.METHODS: Bacterial drug resistance of 460 stains of ESBLs-producing Escherichia coli and Kalispell pneumonia and the application of antibiotics in our hospital in 2005 were analyzed retrospectively.RESULTS: The infections caused by ESBLs-producing Escherichia coli and Kalispell pneumonia were more often found in department of respiratory diseases,ICU and neurosurgery patients,which were treated empirically predominantly with levofloxacin,followed by cefoperazone/sulbactam,but were treated mostly by carbapenems,levofloxacin,cefoperazone/sulbactam after the drug susceptibility test results were obtained.The drug combination was characterized predominantly by combined use of two kinds,at most 6 kinds in combination.CONCLUSION: In most of the cases the medication for infections caused by ESBLs-producing Escherichia coli and Kalispell pneumonia is effective and reasonable.However,in a few cases the application of antibiotics is irrational and nonstandard,which should be given fully attention.

OBJECTIVE:To explore the suitable clinical service mode for pharmacists in China.METHODS:A questionnaire was designed and a random sample of 170 people were selected from 2 hospitalized patients,doctors,nurses and pharmacists,the results were analyzed using statistical method.RESULTS:There was a general lack of knowledge about clinical pharmaceutical service,higher demands on participation of pharmacists in clinical work were made,and present situation was less than satisfied.CONCLUSION:Clinical service mode of patients first and rational drug use foremost should be established,Chinese pharmacists should improve their knowledge construction and clinical service capability.

OBJECTIVE:To study the potential of three kinds of Chinese medicines in combination with Ceftriaxone in inducing endotoxin release from Klebsiella for references of combined use of Chinese medicines and western medicines in the treatment of severe infections.METHODS:The amount of endotoxin released from Klebsiella after being treated in vitro by Ceftriaxone(high,medium and low concentrations)alone or in combination with 3 antibacterial Chinese medicines for 4 hours was compared.RESULTS:The amount of endotoxin released by Klebsiella in low concentration of Ceftriaxone either alone or in combination with Chinese medicines were the maximum but minimum in high concentration Ceftriaxone group.The amount of endotoxin released in low concentration group was larger than in blank group(without antibacterial treatment),and that released amount in Shuanghuanglian plus Ceftriaxone group was less than in Ceftriaxone alone group.CONCLUSION:Low concentration of Ceftriaxone can induce Klebsiella to release endotoxin,while Shuanghuanglian can reduce Ceftriaxone-induced release of endotoxin.

Objective To study the relationship among iron metabolism indicators in the patients with hepatitis B and to analyze their clinical significance.Methods Serum ferritin,iron and hepcidin were detected in 96 cases of hepatitis B and 58 negative control subjects.The above indicators detected results and their relationship were analyzed.Results Compared with the control group,ser-um ferritin and serum iron concentration in the hepatitis B group were increased,he difference was statistically significant (P <0.05);serum ferritin and serum iron concentration in the hepatitis B group demonstrated the positive correlation (P <0.05);serum ferritin in the patients with hepatitis B was negatively correlated with hepcidin (P =0.018).Conclusion The patient with hepatitis B often have the iron metabolism abnormality,and the iron metabolism indicators is expected to be an assessment indicator of treat-ment and prognosis in the patients with hepatitis B.

Immunomagnetic separation (IMS) was coupled with fluorescent microspheres lateral flow assay (FM-LFA) for rapid detection of S.choleraesuis in this study.The target bacteria were firstly enriched from sample by immunomagnetic beads (IMBs),then eluted by heat treatment and detected by fluorescent microspheres lateral flow test strip.The IMBs was labeled with 30 μg/mg antibody,and the capture efficiency was greater than 90％ against 102-106 CFU/mL of S.choleraesuis with great specificity.The immunofluorescent microspheres were prepared by coupling 300 μg of 11 D8-D4 monoclonal antibody with 1 mg of fluorescent microspheres at pH 6.Monoclonal antibody 5F11-B11 (2.0 mg/mL) and donkey anti-mouse IgG (1.0 mg/mL) were sprayed on nitrocellulose membrane as test line and control line,respectively.The FM-LFA based on IMS was used to detect S.choleraesuis in PBS and milk.The limits of detection in PBS buffer and milk were 1.5×105 CFU/mL and 7.6×105 CFU/mL respectively,which were 10 and 200 times lower than that of traditional fluorescent microspheres lateral flow assay,respectively.The results showed that the method,which could enrich S.choleraesuis in milk effectively,could avoid matrix interference and improve the detection sensitivity,thus had a good application prospect.

OBJECTIVE:To explore the ways and methods for pharmacists to participate in community pharmaceutical care, and to provide reference for guaranteeing safe use of drugs in the elderly. METHODS:Questionnaire survey about medication situa-tions and pharmaceutical care demands was conducted among the elderly randomly selected from some communities of Guangzhou Yuexiu District and Liwan District. The investigation data was analyzed statistically. RESULTS:Totally 300 questionnaires were sent out,and 283 were recycled with effective recovery rate of 94.33%. Among respondents,64.66% geriatric people had a high school education or above and 87.99% elderly people enjoyed medical insurance for urban residents;the major health problems of the elderly were chronic diseases like hypertension,osteoporosis,hyperlipidemia,diabetes. 55.48% interviewees preferred to pur-chasing drugs from governmental hospitals and 40.28% interviewees used to purchase drugs from community hospitals;in terms of understanding of drug information,72.08% interviewees tended to consult doctors about drug use but only 12.72% intervieweestended to consult hospital pharmacists about drug use. Interviewees often took various kinds of drugs,there were 72.44%interview-ees taking drugs according to the doctor's advice. 44.88%interviewees accustomed to storing drugs at discretion. 68.20%interview-ees deemed that the responsibilities of the pharmacists were drug dispensing,but only 28.27% interviewees thought that pharma-cists could provide medication guidance and consultation;in terms of community pharmaceutical care,interviewee had much great-er demands to daily care and rational drug use of lectures. CONCLUSION:Geriatric people take many different drugs to treat their diseases in those communities,there are many problems that are not conducive to safe drug use. Those reflected urgent need for community pharmaceutical care,and then higher requirements are put forward for the professional quality of pharmacists.

OBJECTIVE:To provide reference for the establishment of work mode of automatic dispensing system in large-scale integrated pharmacy. METHODS:Introducing the establishment and optimization situation of the automatic pharmacy dispensing system in the outpatient pharmacy of our hospital,changes of related deployment indexes before and after optimization were compared,and the main measures for improving the work efficiency of automatic dispensing system were explored. RE-SULTS:Based on setting and regularly adjusting stored drug varieties,numbers of occupied tracks and unbundled drug factors,de-signing deployment operation mode that the system automatically dispensing preparations to immediate-dispensing and pre-dispens-ing windows,establishing operational specifications and management refinement,the outpatient pharmacy had established automat-ic dispensing system with prescription deployment number more than 12000 pieces/d and optimized work mode. Compared with be-fore optimization,host,auxiliary and smart cabinet varieties were increased in the case of the same number of total staff,immedi-ate-dispensing windows were increased and pre-dispensing windows were decreased. Proportion of full-automatically-dispensed pre-scriptions was increased (up from 41.18% to 48.32%) in the case of total prescription increasing in peak hours,and numbers of hourly prescription deployment were increased in both immediate-dispensing and pre-dispensing windows. Average time to wait for medicine of patients was shortened(down from 5.63 min to 5.18 min),supplemental medicine error and inner errors rate of deploy-ment (down from 0.48% to 0.44%) were decreased (P<0.05). CONCLUSIONS:The established automatic dispensing system mode can meet the needs of prescription deployment in large-scale integrated outpatient pharmacy,and improve the work efficiency by continually optimization.

OBJECTIVE: To standardize and simplify the drug receving and preparing model. METHODS: Reasonable pharamcy inventory parameters were set up based on our experience; second order drug storeroom dynamic inventory system was designed and applied, and the indexes of drug storeroom inventory and workload of the new and the old models were reported and analyzed. RESULTS: The new warning system provided an optimal inventory, and in which the incidences of overstock or stock shortage, the frequency of daily drug receving, drug kinds and the time used with checking stock and filling receipt were all significantly less than in the traditional model. CONCLUSION: Due to the second order drug storeroom dynamic inventory warning system, the drug receiving was more scientific, the drug stock amount was reduced and the drug receiving time was saved, and the mangament level of hospital drug storeroom inventory was enhanced.