Reference materials containing mixed degradation products of amoxicillin and ampicillin were developed after optimization of preparation processes. The target impurities were obtained by controlled stress testing, and each major component was identified with HPLC-MS and compared with single traceable reference standard each. The developed reference materials were applied to system suitability test for verifying HPLC system performed in accordance with set forth in China Pharmacopeia and identification of major impurities in samples based on retention and spectra information, which have advantages over the methods put forth in foreign pharmacopoeias. The development and application of the reference materials offer an effective way for rapid identification of impurities in chromatograms, and provide references for analyzing source of impurities and evaluation of drug quality.
Amoxicillin ; chemistry ; Ampicillin ; chemistry ; China ; Chromatography, High Pressure Liquid ; Drug Contamination ; Mass Spectrometry ; Reference Standards

Behavior Therapy ; Coronary Disease ; prevention & control ; Humans ; Smoking Cessation

Airway Remodeling ; Asthma ; pathology ; physiopathology ; Child ; Humans

Asthma ; diagnosis ; therapy ; China ; Humans ; Practice Guidelines as Topic ; standards

Objective To investigate the clinical efficacy of multidisciplinary integrated treatment and management model in the medical management of elderly patients.Methods 226 elderly patients treated in our hospital from October 2014 to December 2015 were randomly divided into observation group and control group,113 cases in each group.Patients in the control group were treated with traditional medical management model,while patients in the observation group were treated with multidisciplinary integrated treatment and management model.The therapeutic effect,hospital stay,incidence of complications,treatment satisfaction,MMSE score,FCA score and Tinetti score between the two groups were compared.Results The total effective rate (95.58%) in the observation group was significantly higher than that in the control group (79.65%) (χ2=13.21,P=0.000).The mortality rate in the observation group (1.77%) was significantly lower than 7.96% in the control group (χ2=4.68,P=0.004).The satisfaction rate of the observation group (92.04%) was significantly higher than 77.88% of the control group (χ2=8.86,P=0.003).The MMSE score[(25.17±4.43)points],FCA score[(77.35±8.35)points]and Tinetti score[(26.45±4.25)points]of the observation group were significantly higher than those in the control group[(20.13±3.07) points,(65.32±8.88) points and (21.03±3.30) points,t=-2.93,-3.11,-3.18;P=0.025,0.014,0.006].Conclusion Multidisciplinary integrated treatment management model can significantly increase the therapeutic effect,shorter hospital stay,reduce the incidence of complications,improve patients' satisfaction,and improve the quality of life,so it is a new type of efficient and rational therapeutic management model and worthy of clinical promoting.

Objective To study the risk factors for failure of INSURE strategy in very and extremely low birth weight preterm (V/ELBW) infants.Method From January 2005 to December 2014,clinical data of 149 preterm infants (gestational age less than 32 weeks) admitted to neonatal department of Tongji Hospital who received intubation-surfactant-extubation (INSURE) strategy were collected.These infants were assigned into two groups:INSURE failure group and INSURE success group,according to whether a second dose of surfactant or mechanical ventilation was needed within 72 hours after first pulmonary surfactant treatment.The clinical characteristics and outcomes between the two groups were compared.Chi square and t tests were used to define the differences between groups.Logistic regression analysis was used to identify the independent risk factors for INSURE failure.Result Among the 1 149 patients,148 received INSURE treatment,and 113 cases (76.4％) were successfully treated with the INSURE strategy.The infants in the failure group were statistically lower in birth weight,gestation age,antenatal steroids utilization rate,PaO2 and PaO2/FiO2 than those in the success group,while the age of mother,male/female ratio and PaCO2 were higher in the failure group.Logistic regression analysis showed that male (OR =7.440,95％ CI 1.846 ～29.984),BW ＜ 1 000 g (OR =9.180,95％ CI 1.716 ～49.105),PaCO2 ＞48 mmHg (OR =5.996,95％ CI 2.088 ～ 17.213),PaO2/FiO2 ＜205 (OR =3.010,95％ CI 1.033 ～8.774) were independent risk factors for INSURE failure.Conclusion INSURE strategy failure was associated with gender,birth weight,gestation age,antenatal steroids utilization,PaO2,PaCO2 and PaO2/FiO2 of the first blood gas after birth.BW ＜ 1 000 g,PaCO2 ＞ 48 mmHg and PaO2/FiO2 ＜ 205 of the first blood gas after birth were independent risk factors for INSURE strategy failure.

Objective To investigate the treatment of noninvasive ventilator in chronic obstructive pulmonary disease merge chronic type Ⅱ respiratory failure and to analysis its clinical efficacy and safety.Methods According to the random number table,115 cases were randomly divided into two groups,the observation group (n =59)and the control group(n =56).The control group received conventional symptomatic treatment,while the observation group therapy was combined with non -invasive ventilation in the basis of the control group.The changes of HR,RR, PaCO2 ,PaO2 ,Forced expiratory volume in one second 1 (FEV1 ),Forced expiratory volume in one second 1 (Forced expiratory volume in one second 1,FEV1 /FVC)were compared between the two groups before and after treatment 48h.Results Before treatment,there were no significant differences in HR,PaCO2 ,RR,FEV1 ,PaO2 ,FEV1 /FVC (P >0.05).After the treatment,in the control group,HR,RR,PaCO2 ,PaO2 ,FEV1 and FEV1 /FVC were respectively (90.16 ±4.15)beats/min,(23.17 ±1.63)beats/min,(59.68 ±5.85)mmHg,(69.16 ±5.26)mmHg,(2.65 ± 0.25)L and(65.47 ±1.97)%.In the observation group,HR,RR,PaCO2 ,PaO2 ,FEV1 and FEV1 /FVC were respectively (82.93 ±3.76)beats/min,(19.02 ±1.57)beats/min,(50.82 ±6.53)mmHg,(78.06 ±5.48)mmHg,(2.96 ± 0.31)L and (72.38 ±2.15)%.The difference was statistically significant(t =9.800,13.907,7.649,8.877,5.917, 17.942,all P <0.05).No adverse reactions occurred during the treatment.Conclusion The clinical efficacy of non-invasive ventilator in the treatment of COPD associated with chronic type Ⅱ respiratory failure is significant,safe and reliable,which has important research value,and is worthy of further application.