OBJECTIVE:To promote physicians and pharmacists obtain thorough knowledge about drug fever and its main features,clinical manifestation and identification evidence so as to improve the level of diagnosis and treatment. METHODS:The step and process of clinical pharmacists involving in medical consultation and intervention for drug fever were introduced and related knowledge of drug fever was interpreted term-by-term. RESULTS:Drug fever was common in the process of medical diagnosis and treatment. Once occurrence time of drug fever,feature of thermal variation and accompanying body reaction were observed, the relevant diagnosis can be conducted. CONCLUSION:Clinical pharmacists involving in ward around and medical consultation contribute to medical diagnosis,treatment and patient using drug safely,effectively,economically and rationally.

OBJECTIVE:To develop a method for concentration determination of voriconazole in human plasma and apply it in the clinic. METHODS:UPLC-MS/MS method was adopted. Using ketoconazole as internal standard,the determination was per-formed on Shim-pack VP-ODS column with mobile phase consisted of water(containing 1‰ formic acid and 2 mmol/L ammonium acetate)-acetonitrile(gradient elution)at flow rate of 0.3 ml/min and column temperature of 40℃.The electrospray ion source,pos-itive ionizing pattern and multiple reaction monitoring were used;the mass transition ion-pairs of voriconazole and internal standard were m/z 351.2→282.2 and m/z 532.1→490.2. RESULTS:The linear range of voriconazole were 1-10 000 ng/ml (r=0.999 5,n=5),and the limit of quantitation was 1 ng/ml;RSDs of inter-day and intra-day were all lower than 10%;method recovery was higher than 90%(RSD<8%),and extraction recovery was higher than 70%(RSD<8%). The plasma concentrations of voriconazole in 10 patients with invasive fungal infection determined by this method were 507.33-7 011.24 ng/ml,and those of 3 patients were outside the recommended treatment concentration range. CONCLUSIONS:The established method is fast,accurate and sensitive,and can be applied for the therapeutic drug monitoring of voriconazole.

Objective To analysis the major problems and the causes in the process of centralized purchasing of national essen -tial drugs, and to give some effective solutions according to the price problems for ensuring the quality and regular supply of national es -sential drugs , decrease patients burden effectively and safeguard the medication safety of patients .Methods The implementation of cen-tralized purchasing of national essential drugs was investigated , the problems which were major and outstanding were analyzed to find out the internal causes and the effective solutions were given .Results The progression of centralized purchasing of national essential drugs was successfully in general .The implementation of the principle of winning of the bidding with the lowest bid price lead to excessive low price, which caused some problems such as lower quality or bad supplied of some national essential drugs .Conclusion The price policy of centralized purchasing of national essential drugs should not be instituted based on the lower price , more winning of biddings .It needed more scientific and overall perspective thoughts .It maybe solve the problems mentioned above by winning of the bidding with the lowest bid price in the interval average price , appropriately loosing the control of difference rate with the results of decreasing the drug price , avoiding cut-throat competition, ensuring the quality and supply of drugs , lightening the patients′burden, releasing the problem of high cost of getting medical treatment .

Objective:To explore the application effect of evidence-based clinical practice of enhanced recovery after surgery multiple discrepancies theory (ERAS-MDT) in perioperative nursing of patients with hepatectomy.Methods:From January to December 2018, 62 patients with hepatectomy who received perioperative care of ERAS-MDT in the Department of Hepatobiliary and Pancreatic Surgery of Ningbo First Hospital of Zhejiang Province were selected as the control group. We reviewed the implementation effect, searched the clinical practice guidelines, systematic reviews and evidence summary related to ERAS-MDT, carried out field investigation and expert consultation, summarized the obstacle factors, formulated countermeasures, and built a standardized operation mode of ERAS-MDT. From January to December 2019, a total of 66 patients with hepatectomy who received standardized ERAS-MDT perioperative nursing were selected as the observation group. The first exhaust time, defecation time, first ambulation time, first oral feeding time, hospitalization time, nutritional status and pain score were compared between the two groups.Results:The first exhaust time, defecation time, first ambulation time, first oral feeding time, hospitalization time of the observation group were earlier than those of the control group, and the differences were statistically significant ( P<0.05) . The albumin level of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The pain scores of the observation group on the operation day was lower than those of the control group, and the difference between the two groups was statistically significant ( P<0.05) . Conclusions:A standardized management model of ERSA-MDT based on evidence-based clinical practice exhibits positive effect on the perioperative recovery of hepatectomy patients, which can further improve the clinical outcome of patients.