OBJECTIVE: To introduce the methods of drug purchase management and drug use monitoring in our hospital,and to provide reference for drug management in hospitals.METHODS: Sunshine Project of New Drug Purchase and scientific selection methods for contract drugs were carried out in order to control the quality of drugs and monitor the whole process of new drugs.RESULTS: 82 kinds of new drugs were purchased in our hospital since 2005 and 1 500 kings of drugs were voted by randomly selected experts to apply in the clinic.The consumption sum of drugs in our hospital were controlled within 500 million yuan,and the drug use was basically rational.CONCLUSIONS: Methods for new drugs purchase and use in our hospital can promote rational use of drugs in the clinic.

BACKGROUND:Osteosarcoma combined with pathological fracture was often treated by amputation. With clinical application of neoadjuvant chemotherapy and improvement of technology and material of the prosthesis, the limbs of patients with osteosarcoma combined with pathological fracture were reserved. OBJECTIVE:To evaluate the effect of the application of custom-manufactured artificial total knee prosthesis replacement in limb salvage treatment for patients with osteosarcoma combined with pathological fracture. METHODS:A total of 11 patients with pathological fracture with osteosarcoma located in adjacent knee Joint were enrol ed from June 2002 to September 2012. In accordance with individual condition of the patient, limb salvage treatment was designed for knee prosthesis for a tumor. Fol ow-up results were retrospectively analyzed. There were six males (54.5%) and five females (45.5%) and their age ranged from 11 to 50 years old with an average age of 25.4 years old. Onset regions:seven tumors were located in the distal femur and four tumors were in the proximal tibia. Al patients received neoadjuvant chemotherapy, and limb salvage treatment with custom-manufactured artificial knee prosthesis. The fol ow up was performed for 9 to 105 months. RESULTS AND CONCLUSION:In 11 patients after prosthesis replacement, the regional recurrence rates were 18%, lung metastasis rates were 36%. The five-year survival rate was 58%. Four patients developed lung metastases and died in 9 to 24 months postoperatively. During the last fol ow-up, Enneking score of the affected limbs was 11 to 30 points, averagely 23.3 points, with an excellent and good rate of 82%. Results indicated that combined with neoadjuvanet chemotherapy, the application of custom-manufactured artificial total knee prosthesis replacement in the treatment of osteosarcoma located in adjacent knee joint and pathological fracture achieved an ideal outcomes of the limb salvage treatment in the near future. The lone-term effectiveness was expected to be evaluated.

Objective Toexplore the application value of diffusion tensor imaging (DTI) in evaluating evaluation offunctional changes of the in patients with primary trigeminal neuralgia caused (PTN) by neurovascular compression. Methods 40 unilateral PTN patients and 40 healthy volunteers were enrolled in ourstudy.They allAll patients underwent the general sequences and DTI ,and then to measured the ADC and FA values of the trigeminal nerves. Results (1) Compared with contralateral side (0.408 ± 0.054)and bilateral sides in control group(0.423 ± 0.057), FA value of the ipsilateral side in PTN group(0.330 ± 0.056) was significant lower (P< 0.05)compared with the contralateral side (0.408 ± 0.054) and bilateral sides in control group (0.423 ± 0.057).The ADC value of ipsilateralside (2.052 ± 0.473)× 10-3 mm2/s was significantly higher (P < 0.05) thancompared withthe contralateral side (1.541 ± 0.266) ×10-3 mm2/s and bilateral sides in control group(1.431 ± 0.308) ×10-3 mm2/s. (2) An There's a nnegative correlation was found (r = -0.613,P < 0.001) between the loss of FA and the increase of ADC (r = -0.613,P < 0.001). Conclusion DTI could be used to evaluate the changes of neuratrophy and demyelination ,so it canmight be used of in diagnosis and treatment of PTNin further way.

Objective To evaluate the effect of mouse nerve growth factor on fracture healing.Methods Cochrane library, Pubmed, EMbase, CNKI,VIP,Wanfang Data and CBM were searched for the randomized controlled trials(RCTs)of mouse nerve growth factor on fracture healing from the date of establishment of the databases to May 2014.Three independent rese archers evaluated the included studies using GRADE,according to recommend classification method of GRADE system by three researchers,crtical evaluated and data extracted of the quality of the included studies,which conform to the quality standard of RCT was analyzed by Meta analysis.The extracted data were analyzed by RevMan 5.0 and GRAED proiler.Results A total 5 trials were discovered and all of these were in Chinese.Compared with conventional treatment was improved a lot[MD =-8.74,95%CI( -9.79,-7.68),P<0.0001].However, adverse drug reaction in patients with mouse nerve growth factor were increased[OR =14.66,95%CI(1.89, 113.99),P=0.01].The both outcomes were low quality in the GRADE system.Conclusion Mouse nerve growth factor can improve fracture healing and the side effects will also increase.

OBJECTIVE:To systematically review the related evidence-based guidelines of purulent meningitis in children,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,CBM,Wanfang Data-base,CJFD and VIP,NGC,GIN,TRIP and websites of domestic and international medical associations and industry bodies,the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extrac-tion and quality evaluation. RESULTS:Finally 3 guidelines were enrolled in total,with development time ranging from 2004 to 2012,from USA,Britain and Australia,respectively. All of the recommendations were level B,scope and purpose and clarityshowed the higher scores in AGREEⅡ,more than 70%,and applicability showed generally low scores. Penicillin and cefotaxi-me were recommended in purulent meningitis of neonates,and vancomycin combined with cefotaxime or ceftriaxone were recom-mended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different,and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS:The recommendations of medicines for the treatment of pu-rulent meningitis are basically unanimous,with no regional difference,but there are some differences about dose and the course of treatment. In addition,the classification criteria of the levels of evidence and recommendation are still suboptimal,which needs fur-ther improvement. And guidelines on purulent meningitis should be improved inrigourandapplicabilityin future.

Objective:To determine the content of notoginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules. Meth-ods:The three constituents were determined on a Hypersil ODS-2 C18 column (250 mm × 4. 6 mm, 5 μm) with gradient elution using acetonitrile (A) -aqueous solution (B) (0-8 min, 20%A→20%A, 8-40 min, 20%A→30%A, 40-60 min, 30%A→45%A) at the detection wavelength of 203 nm with a flow rate of 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20μl. Results:The calibration curve showed good linearity within the concentration range of 0. 05-0. 50 mg·ml-1 for notogisenoside R1 , and 0.20-2.00 mg·ml-1 for ginsenoside Rg1 and Rb1(r =0.999 9). The average relative recovery was 98.79%, 98.42% and 98. 89% for each constituent(RSD=0. 85%, 0. 97% and 0. 74%, respectively, n=6). The intra-day RSD was 0. 49%, 0. 20% and 0. 39%, and the inter-day RSD was 0. 75%, 0. 56% and 0. 51%, respectively. The RSDs of stability test and repeatability test were less than 1%. Conclusion:The method is simple with good accuracy and repeatability, which can be used for the determination of no-toginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules.

AIM: To investigate the expression and significance of MAPK-interacting kinase-2 ( Mnk2 ) and eukaryotic initiation factor 4E ( eIF4E) in the patients with resected esophageal squamous cell carcinoma ( ESCC ). METHODS:The protein expression of Mnk2 and eIF4E in ESCC tissues (98 cases) and normal esophageal tissues (20 cases) were assessed by immunohistochemistry (IHC), and their correlations with clinicopathological features were statisti-cally analyzed.RESULTS:The over-expression rate of Mnk2 and eIF4E was 68.4%(67/98) and 61.2%(60/98), re-spectively.The expression of Mnk2 had a positive correlation with eIF4E (P<0.05).Clinicopathologic analysis showed that Mnk2 expression was significantly correlated with T classification ( P<0.05 ) and clinical stage ( P<0.05 ) .CON-CLUSION:The over-expression of Mnk2 was significantly related to the tumor invasive depth , TNM stages and expression of eIF4E in ESCC.Expression of Mnk2 and eIF4E may have a cooperative formation mechanism in the development of ESCC.

OBJECTIVE:To reduce the dispensing errors of similar drugs in hospital outpatient pharmacy,and realize the drug traceability. METHODS:Based on adding drug electronic regulatory code field in drug dictionary background database of hospital information system (HIS), prescription dispensing process in outpatient pharmacy of our hospital was improved. Drug electronic regulatory code was added for scanning code review before secondary review dispensing, and drug terminal traceability was real-ized based on it. Through comparing the dispensing outing error rate before and after 12 months of improvement, ratio of"special abnormal data"related with dispensing error of similar drugs in checking, patients'waiting time and other indicators, the pre-scription dispensing quality of outpatient pharmacy before and after improvement was evaluated. RESULTS:After adding drug elec-tronic regulatory code for scanning code review, the dispensing outing error of similar drugs was decreased from 22 cases to 1 case (accounting for 0.0197‰, 0.0103‰, respectively), number of"special abnormal data"was decreased from 836 to 436 (accounting for 31.5%, 16.8%, respectively), and the average waiting time of patients had no obvious extension(10.85 min, 10.88 min, respectively). It had achieved the traceability inquiry of most outpatient drugs from the pharmacy to the patients. CON-CLUSIONS:The drug electronic regulatory code can reduce the dispensing outing error of similar drugs in outpatient pharmacy, which is conducive to the establishment of drug traceability chain and has improved the quality of pharmaceutical care.

Objective:To explore the clinical application value of MRI in quantitative evaluation of anterior cruciate ligament mucoid degeneration (ACL-MD).Methods:From March to July 2020, 40 patients who were scheduled to undergo arthroscopic treatment were prospectively collected in the First Affiliated Hospital of Kunming Medical University.The anterior cruciate ligament tissue from the lateral edge of the tibial end was taken during the operation. Based on the pathologicalre sults, the patients were divided into the ACL-MD group ( n=19) and the normal group ( n=21). The sagittal plane three-dimensional steady-state rapid precession (3D-FIESTA), T 1 mapping, T 2 mapping, and T 2* mapping were performed before the knee joint surgery, and the scanned images were post-processed and analyzed to measure the T 1, T 2, and T 2* values of the tibial end of the anterior cruciate ligament.The relaxation time of the ACL-MD group and the normal group was compared using independent sample t test. The ROC curve was drawn using each parameter and the areas under the curve (AUC) for the diagnosis of ACL-MD were obtained.DeLong test was used to compare the differences of AUCs. Results:The T 1 [(1 291.9±273.4) ms], T 2 [(54.8±10.6) ms], and T 2* values [(30.6±6.4) ms] of anterior cruciate ligaments in the ACL-MD group were significantly higher than those in the normal group [ (1 087.0±121.0), (44.8±7.1), (20.4±4.8) ms; t=3.011, 3.473, 5.658, all P<0.001]. The AUCs of T 1, T 2, T 2* were 0.747, 0.764, 0.912, sensitivity of 63.2%, 63.2%, 100%, and the specificity of 100%, 95.2%, 76.2% in diagnosing ACL-MD. The AUC of the T 2* value was higher than those of the T 1 and T 2 values, and the differences were statistically significant ( Z=1.734, 2.162, P=0.043, 0.031). Conclusion:T 1, T 2, T 2*values measured by MRI quantitative imaging have high performance in assessing knee joint ACL-MD, and T 2* value has the largest AUC and the highest diagnostic efficiency.

Objective To explore the value of T2-mapping imaging in assessment of lumbar dorsal extensors group (multifidus,longissimus and iliocostalis) function before and after exercises in healthy volunteers.Methods Totally 50 healthy young volunteers underwent T2-mapping imaging before and after exercises.T2 value and cross-section area (CSA) of multifidus,longissimus and iliocostalis were measured at the level of L3 and 14 superior border.Differences of CSA and T2 value were compared between left and right side muscles before and after exercises.The correlation between CSA difference and T2 difference before and after exercises was analyzed.Results At the level of L3 and L4 superior border,CSA and T2 value of bilateral multifidus,longissimus and iliocostalis increased after exercises (all P＜0.05).At the level of L3 superior border,CSA after exercises and CSA difference of left multifidus were higher than those of right side (all P＜0.05).Before exercises,there were statistical differences of T2 values on left and right side of longissimus and iliocostalis at the level of L3 superior border and the longissimus at the level of L4 superior border (all P＜0.05).Positive correlations were found between CSA difference and T2 difference on bilateral iliocostalis at the level of L3 and L4 superior border,as well as on bilateral multifidus at the level of L4 superior border (all P ＜0.05).Conclusion T2-mapping imaging can be used to assess the activity state of lumbar dorsal extensors group before and after exercises.