OBJECTIVE:To introduce the function and operation of "Intelligentized prescription-monitoring system on the dosage and medication frequency of antibiotics" in order to reduce adverse drug events and increase therapeutic efficacy. METHODS: The monitoring system was evaluated and analyzed from aspects of the tools used for the research and development,software and hardware platforms,functional modules,characteristics,technical difficulties,and effectiveness of the monitoring system. Meanwhile,599 prescriptions sampled randomly were examined online. RESULTS: For the total 599 prescriptions,50 warnings appeared in the system,and which had been confirmed to be correct by experts. CONCLUSIONS: The discrepancy between the dosage and (or) medication frequency and the drug package inserts can be detected with the use of monitoring system,which thus meets our expected goal.

OBJECTIVE:To reduce the incidence of the preventable adverse drug events by using information technology. METHODS:The intelligent prescription screening system was developed and the hospital information system-based link between "contraindications" and diagnosis of patients,their laboratory results and creatinine clearances were realized. RESULTS:Of the total 5 546 prescriptions selected randomly within one day,46 laboratory results-related,28 diagnosis-related and 32 creatinine clearance-related contraindications were detected by the system. CONCLUSION:This link mode is practical in that those prescriptions that violating the contraindications can be found out by the system; however,the clinical effect of the intelligent prescription screening system remains to be proved.

Aim To develop a sensitive, rapid and ac-curate LC-MSn method for determination of midazolam/1′-hydroxymidazolam and their pharmacokinetic char-acteristics in rat brain. Methods SD rats received in-travenous injection of midazolam ( 5 mg · kg-1 ) via femoral vein, a probe drug of cytochrome P450 3A. The microdialysis ( MD ) samples in situ brain were collected every 8 mins at 2. 0μl·min-1 in 2. 4 hours. Analytes in brain dialysate were quantified by the pro-posed LC-MSn method. Gradient elution was performed on an Agilent Eclipse Plus-C18 column ( 2 . 1 × 50 mm, 3. 5 μm). The mobile phase consisted of 2 mmol ·L-1 ammonium acetate and acetonitrile. The analyte was detected using electrospray ionization ( ESI ) in multiple reaction monitoring ( MRM) modes. The reac-tion selected ions were 326 . 1/291 . 1 m/z for midazo-lam, 342. 1/324. 1 m/z for 1′-hydroxymidazolam and 285. 1/154. 0 m/z for diazepam as internal standard. Result The linear ranges of midazolam and 1′-hydroxymidazolam were 0 . 78~100 and 0 . 195 ~12 . 5μg·L-1 respectively. The lower limit of quantification was 0 . 2 μg · L-1 . The RSD of intra- and inter-batch precisions was less than 7 %. The RSD of accuracy was from -1 . 34 to -8 %. Conclusion This sensi-tive and rapid LC-MSn method is suitable for determi-nation of midazolam/1′-hydroxymidazolam in rat brain dialysate. MD combined with LC-MSn method may give assistance to deep and further studies of drug metabo-lism and CYP3A enzyme in brain.

Objective:To understand the use of antibiotics in our hospital to provide clinical drug reference. Method:The hospital outpatient and emergency prescriptions in 2007 were randomly selected and according to clinical pharmacology knowledge and literature material,sorting of the antibiotics use frequency and category was carried out,and the statistics and rationality about the antibiotics prescriptions were classified and analyzed.Result:According to the use frequency(DDDs),the top 3 kinds were ornidazole,levofloxacuin and azithromycin.Cephalosorins,quinolones and macrolides were most frequently used in clinic.In the total 10,800 prescriptions audited,3842 antibiotic prescriptions and 409 irrational prescriptions were used respectively in the drug solvent which presented problems in the dosage regimen,pharmacological effects and rational drug use.Conclusion:The use of antibiotics in the hospital was basically reasonable,but there were still some problems and the need to further improve the prescription audit would be helpful for the rational use of antibiotics.

OBJECTIVE: To promote rational use of non-antimicrobials based on Intelligent Monitoring System for Dosage and Frequency of Drugs.METHODS: Base on the information system of hospital,dosage and frequency of drugs were collected from Intelligent Monitoring System for Dosage and Frequency of Drugs and connected with patients’ ages,weights,body surface areas and renal functions.1 315 hospitalized prescriptions of non-antimicrobials were randomly collected from our hospital one day.RESULTS: There were 200 warnings of overdosage each time and moderate frequency,91 warnings of overdosage each time and inadequate frequency,43 warnings of moderate dosage each time and inadequate frequency,41 warnings of moderate dosage each time and excessive frequency,15 warnings of inadequate dosage each time and moderate or inadequate frequency for drugs that needn’t be adjusted according to age and renal functions.There were 11 warnings of overdosage and excessive frequency for drugs that should be adjusted according to patients’ age and renal function.CONCLUSION: This kind of connection is practical,when prescriptions of non-antimicrobials which violate the rules of dose and (or) frequency are identified by system.But the significance of Intelligent Monitoring System for Dosage and Frequency of Drugs should be proved by practice.

Alzheimer disease (AD) is a significant threat on health in elderly people.Many traditional Chinese herbs and their prescriptions show fairly good effect in treatment of AD.We review the results on treatment of AD from three aspects of AD' s pathogenesis, in which the natural herbs were mainly used, and present the way to the problem to be solved.

Parkinson's disease is a kind of familiar diseases troubling old people in China.It's recognized internationally that DBS is the best method to control Parkinson's disease.This paper designs a kind of DBS without internal electrical source,which can greatly decrease the treatment cost for Parkinson's disease.The structure,circuit philosophy and experiments on rats are also mentioned.

Objective To investigate the clinical results in the treatment of developmental dysplasia of the hip (DDH) with one stage open reduction and Salter or Dega osteotomy for “walking age”children .Methods We retrospectively reviewed 16 patients(16 hips)with unilateral hip dislocation who had undergone one‐stage open reduction and Salter or Dega innominate osteotomy in the the“walking age”children .the results were evaluated clinically by McKay′s classification and radiologically by the modified Severin′s classification .Early signs of osteonecrosis were identified by neck widening ,epiphysis fragmentation ,and presence of a metaphyseal growth disturbance line in the first year after the operation .Results After a follow‐up of one year on average ,good clinical and ra‐diographic results were noted in 87 .5% and 81 .25% of the patients ,respectively .Osteonecrosis occurred in 3 hips(18 .75% ) .Con‐clusion One‐stage open reduction and Salter or Dega osteotomy is an effective treatment for developmental dysplasia of the hip in walking age .

Objective To explore the relationship between the genetic polymorphism and serum concentration of mannan binding lectin (MBL)and the clinical manifestation of the hand-foot-mouth disease (HFMD) children infection by human enterovirus 71 (HEV71).Methods One hundred and thirty-eight children diagnosed as HFMD infected by HEV71 (including 80 mild cases and 58 severe cases) and 40 healthy,symptom-free children were investigated.The concentrations of serum MBL were measured in 40 healthy controls,80 mild HFMD cases and 56 severe HFMD cases at both acute and convalescent phases by a sandwich enzyme immunoassay with a human MBL ELISA kit.And the genomic DNA of all cases were extracted from blood according to standard phenol-chloroform procedure.Six SNPs in the MBL gene(-550G/C,-221G/C and +4C/T of the promoter,CGT52TGT,GGC54GAC,and GGA57GAA of the exon 1) were analyzed by a sequencing-based typing method.Results The MBL serum level of the severe HFMD circulatory respiratory failure group in acute phase was significantly increased compared with severe HFMD encephalitis group,the mild cases and the control,but in the convalescence phase it significantly decreased compared with them.The frequencis of type B/B mutation (+230 of the exon 1),type P/P mutation (+4C/T of the promoter),and type H/H mutation (-550G/C of the promoter) were a significant difference among mild group,severe group and the control(P=0.006,0.043,0.028,respectively).The frequencies of LYPB/LYPB genotype and HYPA/HYPA genotype were a significant difference among mild group,severe groupand the control (P=0.028,0.014,respectively).Conclusion Low MBL protein level as a result genetic polymorphism seems to be correlative with clinical manifestation of HFMD disease.The MBL gene mutation and low MBI.protein level may be used as one of the evaluation method of HFMD severeity.

Objective:To analyze the intervention effect of a successfully created platform“intelligent interactive software for drug monitoring warning” on the decrease of medication errors and adverse drug events,and the increase of the drug treatment level. Meth-ods:The intensive care unit ( ICU) of our hospital was selected as the experiment group, and the ICU of the other two hospitals was used as the contrast group. During the first 18 months, both groups were without intervention. During the latter 18 months, the plat-form was used in the experiment group, and the clinical pharmacists employed alerts of the system in the practice of interaction with doctors to correct the medication errors. No intervention was performed in the contrast group. In addition, all adverse drug events in both groups were surveyed. Results:During the first period, 50 preventable adverse drug events were discovered with the incidence of 6. 8% in the experimental group. During the second period, the correct rate of the alerts was 97. 7%. Through the effective interven-tion,the alerts and their percentage in the prescriptions were from the maximum of 68 and 1. 1% to the minimum of 6 and 0. 1%. To-tally 17 preventable adverse drug events were found with the incidence of 2. 4% after the intervention. The decline was significant, 848 991 yuan of hospitalization expenses was saved, and 294 days of the length of stay were shortened. There was no change in the contrast group, and there was no change in unpreventable adverse drug events in the two groups before and after the intervention. Conclusion:The intelligent interactive software for drug monitoring warning can examine many sorts of medication errors,and decline the inci-dence rate of preventable adverse drug events in ICU. However, it needs to continuously improve the intelligence. Clinical pharmacists need to master the relevant conditions of patients to detect the irrational drug use based on the clinical practice for each patient.