In the face of escalating problems with pathogen control, the development of proper formulations of existing antibiotics is as important as the development of novel antibiotics. Daptomycin is a lipopeptide antibiotic with potent activity against Gram-positive bacteria. Currently, only injectable solution of daptomycin has been approved for clinical use. In the present study, the formulation of PEGylated liposomal daptomycin (PLD) was prepared and optimized, and its efficacy against methicillin-resistant Staphylococcus aureus (MRSA252) strains was investigated. The obtained PLD had a mean vesicle diameter of (111.5 +/- 15.4) nm and a mean percent drug loading of (5.81 +/- 0.19) % with high storage stability. Potent activity of PLD against MRSA was demonstrated in vitro with a more sustained effect than that of conventional liposomal daptomycin and daptomycin solution. In addition, intravenous administration of a single dose (equal to human use) of PLD significantly increased the survival of mice in a MRSA252 systemic infection model compared with other formulations. Drug distribution in the lung was significantly enhanced following administration of PLD, and no measurable tissue lesions or pathological changes were detected during PLD treatment. Taken together, PEGylated liposomes loaded with daptomycin may represent a promising approach to reduce MRSA252 infections, especially those involving bloodstream dissemination, such as hematogenous pulmonary infection.

Objective:To study the effect of quality control circle(QCC)on the reasonable ratio of clinical prescriptions. Methods:The dispensed prescriptions in orthopedic emergency department were reviewed in our hospital,and the reasons of unreasonable prescriptions were analyzed. According to the QCC technique,the activities were implemented,the standardized work process was made out and the results were studied. Results:After the six-month QCC activities,the unreasonable ratio of emergency orthopedics prescriptions was reduced from 70% to 21% ,and the target yield rate was 140% and the improvement rate was 70% . Conclusion:The QCC has obvious effect on the improvement of reasonable ratio of emergency orthopedics prescriptions.

OBJECTIVE：To explore high-alert drug management mode of our hospital ，and to provide reference for the management and utilization of this category in medical institutions. METHODS ：According to High-alert Drug Catalog （2019 edition）issued by Hospital Pharmacy Committee of Chinese Pharmaceutical Association ，the high-alert drug catalog of our hospital and their risk points were formulated. Relevant training and assessment were conducted for physicians ，pharmacists and nurses throughout the hospital. Using qualification rate of high-alert drug management and utilization as index ，the effectiveness of high-alert drug management and utilization were compared before and after optimization. RESULTS ：In our hospital ，the risk of high-alert drugs was controlled by establishing inspection and supervision group ，pharmacist education ，information management ， prescription review and individualized administration ，medication guidance ，prescription review and medication error reporting and other measures and with continuous optimization. Compared with before optimization ，qulification rate of high-alert drug management and utilization increased from 37.3％ to 80.1％ in clinical departments （P＜0.01），and that increased from 59.2％ to 85.0％ in pharmacy department （P＜0.01）. There were still some problems ，such as the inconsistency of high-alert drugs accounts and materials ，the failure to report all medication errors in time ，the imperfect establishment of prescription review software rules ， the insufficient medication guidance ，and the lack of individual medication varieties. CONCLUSIONS ：By optimizing the management of high-alert drugs ，the management and utlization of this category is improved effectively in clinical departments and pharmacy departments of our hospital.

OBJECTIVE：To prov ide reference for mobilizing the work enthusiasm of clinical pharmacists ，and further promoting the strategic objectives of performance appraisal in three-level public hospitals （“National examination ”for short ）. METHODS：A department performance appraisal team was established ，and a key performance indicator system consisting of 4 first-level indicators and 9 second-level indicators was constructed by using literature retrieval and expert consultation. The performance distribution method of double assessment of performance score and performance score was established ，and a performance publicity and feedback performance mechanism was formed. Relevant data were collected to compare the core work indicators of clinical pharmacists ，use intensity of antibiotics ，compliance rate of essential drugs in our hospital from Apr. to Dec. 2019（before implementation ）and Apr. to Dec. 2020（after implementation ）. RESULTS ：After the implementation of performance appraisal scheme ，the total number of medication recommendations of clinical pharmacists increased from 1 192 to 5 226，with an increase of 338.42％；the number of medication suggestions received increased from 846 to 4 855，with an increase of 473.88％； and the rate of drug suggestions received increased from 70.97％ to 92.90％；the number of pharmaceutical consultation increased from 195 to 1 284，with an increase of 558.46％；the number of drug counseling increased from 1 203 to 2 719，increasing by 126.02％. Form Apr. to Dec. 2020，the number of patient safety medication evaluation forms reached 660. The antibiotics use density（AUD）in clinical departments of 13 clinical pharmacists were decreased to different extent after the implementation of performance appraisal scheme ，the decine rate was 92.31％（12/13），and the compliance rate was 69.23％（9/13）；utilization rate of essential medicine among outpatients of 11 clinical pharmacists ’clinical departments had achieved positive growth ，and those among inpatients of 2 clinical pharmacists ’clinical departments had achieved positive growth. CONCLUSIONS ：The performance appraisal system of clinical pharm acists formulated by our hospital links the “National examination ”index with the performance ， appraisal of clinical pharmacists ，which can provide ideas for No.2018sxzx57，No.2020jyxm2328，No.2020jyxm2307） the performance appraisal of three-level public hospitals and help to promote the high-quality and sustainable development of hospital pharmaceutical care.