Objective:To discuss the regularity of adverse drug reactions induced by statin.Method:82 cases from published articles were retrieved from 1998 to 2008.According to the given standard,the data were statistically analyzed. Result:77 articles carried 82 case reports concerning statins inducing ADRs in the period of 10 years.52 cases were caused by simvastatin.ADRs of statins could involve multiple organs and systems,mainly myopathys.Severe reaction could result in renal failure and even death.Conclusion:A rational use of statins should be strengthened in the clinical practice and strict monitoring in order to prevent and reduce the occurrence of serious adverse drug reactions.

Objective To summarize the clinical application of parenteral nutrition (PN) in Fuwai Hospital. Methods The clinical applications of PN in 132 critically ill patients undergoing cardiac surgery in our hospital were retrospectively investigated and analyzed. Results The application of PN in Fuwai hospital was basically appropriate and standardized. Energy supply in PN formulation was reasonably low, but still met the energy needs of patients in the fasting period. The nutritional composition and energy/nitrogen ratio in the formulation were basically rational. However, problems including the lack of double energy in partial formulation, low proportion of glucose-supplied energy due to low glucose-lipid ratio, and insufficient supply of insulin still existed. One (0.76%)patient was discharged according to his own decision; 22 ( 16.67% ) patients died, which were not directly associated with PN; and the other 109 (82.58%) patients were cured and discharged. Conclusion Application of PN for critically ill patients undergoing cardiac surgery must strictly follow the operation indications and rationally select nutritional components and proportions to ensure its safety and effectiveness.

Small cell carcinoma of cervix (SCCC) is a rare and high malignant neuroendocrine tumor.Because of its strong invasion,metastasis in early stage and easy recurrence,the prognosis is poor.Its diagnosis is based on pathomorphology,and immune-histochemistry biomarkers can improve its diagnosis.Combined therapy is recommended.Postoperative platinum/etoposide (PE),vincristine/adriamycin/cyclophosphamide (VAC) or taxel/carboplatin(TP) chemotherapy can improve the prognosis.

Objective:To analyze infection-related factors for Coronary artery bypass grafting(CABG).Method: The cases undergoing operations with CABG from January to June in 2006 were 614.The records of the two sets of statistical indicators were kept and the data were analyzed to find the infection-related factors.Result:There were three factors related to infection:the measure of anaesthesia,the time of hospitalization before surgical operations and the duration of prophylac- tic antibiotics treatment.Diabetes mellitus was not a risk factor in our study.Conclusion:In view of patients'health condi- tion,prophylactic antibiotics can be used to prevent infection in surgical operations.Shortening the time of hospitalization before surgical operations and adopting off-pump coronary artery bypass grafting can decrease the infection.CABG is as safe for diabetic patients as for non-diabetic patients.

Objective To explore the interaction between warfarin and antiepileptic drugs such as carbamazepine and oxcarbazepine.Methods A 78-year-old woman suffered from warfarin resistance after initial warfarin dosing for several days.Based on her medication review,clinical pharmacist found that the warfarin resistance resulted from co-administered carbamazepine.Her warfarin dosage was increased,and the international normalized ratio (INR) increased to the target range.Another woman had been taking warfarin therapy for long time with a stable maintenance dose.She consulted clinical pharmacist for the influence of co-administered oxcarbazepine on warfarin.The patient was advised to maintain the dose and monitor her INR more closely.Her INR did not fluctuate.Results Carbamazepine induced warfarin metabolism.As a result,the patient needed increased dosage of warfarin to maintain the INR in the therapeutic target range.Oxcarbazepine does not induce liver enzymes,and therefore the INR did not fluctuate.Conclusion Carbamazepine may reduce the efficacy of warfarin.Oxcarbazepine offers a clinical advantage over carbamazepine,especially when co-administration of warfarin is required.

Abstract: Objective　To determine the rate of nasal carriage Staphylococcus aureus among healthcare workers in Department of Infectious Diseases department of the First Affiliated Hospital of Xi'an Jiaotong University Hospital, and to perform characterization on isolated strains. Methods　A cross-sectional study was performed on 86 healthcare workers from February 2022 to June. Nasal swabs were collected from the healthcare workers, and S. aureus were identified after incubation. Antibiotic susceptibility, including chlorhexidine and mupirocin, was assessed by disk diffusion and minimal inhibitory concentration method. The PCR technique was used to detect the biocide resistance genes (qacAB, smr, lmrS mepA, and sepA), virulence genes (pvl, fnbA/fnbB, sea, seb, sec, sed, tst, eta, etb) and mecA gene. SCCmec typing and multilocus sequence typing was performed. For mupirocin-resistant strains, PCR amplification and sequencing were used to identify whether the strains had ileS gene mutations or carried resistant genes (mupA and mupB). Results　S. aureus was isolated from 37 of the 86 healthcare workers (43.02%) , including 13 methicillin-resistant Staphylococcus aureus (MRSA) strains. The strains showed low resistance rates to levofloxacin (2.70%, 1/37), chloramphenicol (8.11%, 3/37), tetracycline (8.11%, 3/37), gentamicin (10.81%, 4/37), and ciprofloxacin (10.81%, 4/37). A total of 17 strains were identified as multidrug-resistant strains. Four SCCmec types were identified in MRSA strains, with the type II being the most frequent (53.85%, 7/13), followed by type IV (30.77%, 4/13). ST59 (46.15%, 6/13) was the most frequent among MRSA strains, while ST5 (41.67%, 10/24) was the most frequent among methicillin-susceptible S. aureus (MSSA) strains. sea was the most frequent virulence gene (56.76%, 21/37). sepA and mepA were detected in all 37 isolates. One Staphylococcus aureus strain was not sensitive to chlorhexidine, two strains had the missense mutation V588F (G1762T) and showed low level resistance to mupirocin, and one strain carrying mupA gene was highly resistant to mupirocin. Conclusion　The nasal colonization rate of Staphylococcus aureus among healthcare worker in the investigated hospital was high, indicating a risk for nosocomial infections. Strengthened monitoring and decolonization treatment should be carried out to reduce these risks.

Objective To discuss the clinicopathologic characteristics and risk factors for lung metastasis of early-stage cervical cancer after radical hysterectomy. Methods The complete clinicopathologic data of patients with lung metastasis of cervical cancer after radical surgery from January 2008 to December 2013 admitted in Zhejiang Cancer Hospital were retrospectively analyzed by univariate and multivariate analysis. Results (1)There were 38 cases of early cervical cancer suffered from lung metastasis after radical hysterectomy during the period. The median age at diagnosis of cervical cancer was 46 years, the average lung metastasis time was 13 months after operation, 50.0%(19/38) cases occurred in the first year. Thirty-one cases were squamous cell carcinoma and 7 cases were non-squamous cell carcinoma.(2)Univariate analysis showed that age,clinical stage, manner of tumor growth, tumor grade, perineuronal invasion, para-aortic lymph node metastasis were not significant effect on postoperative lung metastasis(all P>0.05). But tumor size, histologic types, depth of stromal invasion, uterine body infiltration, lympho-vascular space invasion,pelvic lymph node metastasis, positive margin and abnormal tumor markers were significantly correlated with postoperative lung metastasis(all P<0.05). Multivariate analysis showed that only tumor size, histologic types and pelvic lymph node metastasis were independent risk factors for lung metastasis of cervical cancer(P<0.05). Conclusions Patients of early-stage cervical cancer with lung metastasis mostly occurs within 1 year after radical hysterectomy. Local large tumor lesions (tumor size>4 cm), non-squamous cell carcinoma and pelvic lymph node metastasis were more likely to have lung metastasis.

OBJECTIVE: To establish bacterial endotoxin test for cardioplegic solution (compound jiagaimei solution).METHODS: Semi-quantitative analysis stated in volume Ⅱ of Chinese Pharmacopoiea (2005 edition) was used to detect 3 batches of compound jiagaimei solution with tachypleus amebocyte lysate (TAL).RESULTS: The interference factors of bacterial endotoxin test could be overcome through 6-fold dilution of cardioplegic solution.The content of bacterial endotoxin in 3 batches of samples were 0.36,0.36 and 0.255 EU?mL-1,respectively.They were all lower than the limitation of bacteria endotoxin of 1.5 EU?mL-1.CONCLUSION: It is feasible to detect bacterial endotoxin of compound jiagaimei solution using semi-quantitative analysis.

OBJECTIVE:To change the drug management mode in wards,promote drug use for patients timely and rationally. METHODS:Automated dispensing cabinet(ADC)was used to manage the drugs in some wards in our hospital,and introduce its use practice from aspects of drug management mode,pharmacists'management to ADC,related measures when using ADC manag-ing ward drugs,effect evaluation after using ADC(using species of base drugs,average time of dispensing temporary medical or-ders,drug returning times in 5 wards before and after using ADC as indexes),etc. RESULTS:Drug management method was es-tablished in ADC by screening drugs into the cabinet and developing process of taking drugs out. And pharmacists had achieved drug management in wards by establishing drug lists,conducting replenishment and inventory management,developing emergency plan,enhancing supervision and inspection,etc. Compared with before using ADC,average species of base drugs in the 5 wards increased from 65.8 to 157.2;average time of dispensing temporary medical orders dropped from 24.5 min to 5.8 min;and average drug returning times in 3 months decreased from about 200 times to about 20 times(P<0.05 or P<0.01). CONCLUSIONS:Us-ing ADC in wards for drug management has not only improved use convenience of drugs in wards,working efficiency of nurses as well as pharmaceutical care quality of pharmacists,but also has changed drug management mode and promoted rational drug use of patients.

OBJECTIVE:To improve the drug storehouse management model,and provide reference for hospital management reform. METHODS:Management operation of external drug storehouse management model in our hospital in 3 months was intro-duced from aspects of number of personnel,delivery timeliness as well as accuracy rate of entering and going-out storage,etc. Ef-fective and feasible solutions for developing external drug storehouse management and guaranteeing clinical drug supply were sum-marized. RESULTS:Through ensuring drug category,management level of external drug storehouse,job responsibility of related staff in hospital and pharmaceutical business companies,information platform and distribution management,external drug store-house work in our hospital was basically completed. Compared with before,it had effectively reduced the investment of human and material resources,management staff was decreased from 4 persons to 3 persons;and purchased drugs could be completely deliv-ered within the specified time. CONCLUSIONS:Under the circumstances of hospital management facing constant reform,the man-agement model of external drug storehouse can be considered to reduce management cost of hospital and expand the scale of company.