Objective To investigate the compatible stability of esketamine hydrochloride,sufentanil citrate,butorphanol tartrate,and metoclopramide in 0.9%sodium chloride injection,and to provide a reference for the rational use of medication for postoperative analgesia.Methods The four drugs were compounded by simulating the clinical concentrations of the drugs,and the samples were taken at 0,4,8,12,24 and 48 h under light-shielded and light-exposed conditions at room temperature.The appearance,pH value,relative drug content,and insoluble particles were determined.Results The appearance of esketamine hydrochloride,sufentanil citrate,butorphanol tartrate,and metoclopramide concoction was clear at 48 h.The pH values were in the range of 4.69 to 4.79,and the relative drug content of the four drugs were in the range of 95%to 105%.The number of insoluble particles exceeded the specified range in the Chinese Pharmacopoeia(2020 edition)at 4 h and 8 h.Conclusions Under light-shielded and light-exposed conditions at room temperature,the appearance,pH value and relative drug content of the compounded solution remained stable for 48 h.However,the number of insoluble particles exceeded the specified standard.Therefore,it is not recommended to mix the above 4 drugs with 0.9%sodium chloride injection for use in analgesic pumps.

OBJECTIVE To establish a total quality management system for pharmacy intravenous admixture services （PIVAS）， in order to promote the standardization， accuracy and rationalization of clinical intravenous infusion. METHODS Based on information system in PIVAS， the management system and quality monitoring items of the whole process before， during and after PIVAS infusion preparation were formulated. The quality control and quality improvement were carried out regularly with quality management tools and methods such as PDCA （plan， do， check， process） cycle， quality control circle， and root cause analysis. The main quality control indexes of PIVAS were retrospectively analyzed before （in 2019） and after PDCA cycle management （in 2020 and 2021）. RESULTS The indexes of quality monitoring in the whole process of PIVAS infusion preparation， such as the score of drug quality management， the drug residue qualification rate and the qualified rate of drug content in infusion， were increased from 92 points， 79%， 86.4% in 2019 to 99 points， 92%， 99.8% in 2021， respectively. The indexes of safe and rational drug use， such as the ratio of intravenous irrational medical orders， the rate of drug repercussion， the rate of antibiotics use， and the rate of TCM injection use decreased from 0.98%， 6.1%， 40.55%， 39.70% to 0.23%， 3.2%， 37.18%， 26.00%， respectively. CONCLUSIONS The established total quality management system for PIVAS can improve the quality management level in the infusion preparation process， improve the quality of infusion preparation and promote clinical safe and rational drug use.

Objective To investigate biomechanical differences of two posterior occipitocervical internal fixation techniques for treating basilar invagination with atlantoaxial dislocation (BI-AAD). Methods Intra-articular cage + posterior occipital plate+C2 pedicle screw (Cage+C2PS+OP), and intra-articular cage+C1 lateral mass screw+C2PS (Cage+C1LMS+C2PS) models were established based on occipitocervical CT data of the BI-AAD and clinical operation scheme, and the stability of atlantoaxial joint and stress distribution characteristics of C2 endplate and implanted instruments under different motion states were analyzed. Results Compared with the Cage+C1LMS+C2PS model, the atlantoaxial range of motion ( ROM) under flexion, extension, lateral bending and axial rotation in the Cage+C2PS+OP model were reduced by 5. 26% , 33. 33% , 43. 75% , -5. 56% , and stress peak of screw-rod fixation system were reduced by 47. 81% , 60. 90% , 48. 45% , 39. 14% , respectively. Under two internal fixation modes, stresses of C2 endplate and cage were mainly distributed on the compressive side during the motion, and both the screw-bone interface and the caudal side of screw subjected to large loading. Conclusions Two internal fixation methods could provide similar stability. However, the stress concentration of screw-rod system was more obvious and the possibility of screw loosening and fracture was greater under Cage+ C1LMS+C2PS fixation.

This article reviews the related literature on the reversal of multi-drug resistance in tumors by cepharanthine, and summarizes the reversal effects and mechanisms of multi-drug resistance in different tumors such as leukemia, liver cancer, ovarian cancer, breast cancer, esophageal cancer and colon cancer. Its reversal effect on multi-drug resistance of tumors is the result of a multi-channel, multi-link combination. The main mechanism is to inhibit membrane transporter function, affect enzyme transfer system, inhibit anti-apoptotic pathway activation and anti-apoptotic protein expression.

Thromboxane A2 receptors (TPs) widely distribute in different organ systems and localize both on cell membranes and in intracellular structures.TPs are the members of seven-transmembrane G-protein-coupled receptor (GPCR) super family.Historical-ly, the involvement of TPs in platelet functions has received the greatest attention .TPs have the capacity to activate different signaling cascades which regulate platelet shape change , aggregation and secretion response .Currently , anti-platelet drugs primarily act on re-ceptors and /or signaling molecules in activation pathways .The signaling transduction of TPs in platelet contributes to the investigation of the effects of extracts of traditional Chinese medicine on antiplatelet aggregation and the exploration of the action mechanisms .

OBJECTIVE:To study the stability of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride in-jection in 0.9% Sodium chloride injection. METHODS:At room temperature [(25±1)℃],three injections were poured into infu-sion bag of disposable analgesia pump,and diluted with 0.9% Sodium chloride injection. The changes in precipitation,turbidity, color and pH value of the mixture were observed. The relative percentage of three injections within 72 h were determined by HPLC method. RESULTS:There was no significant change in the pH value and appearance of the mixture. Relative percentage of tramad-ol hydrochloride,fentanyl citrate and ondansetron hydrochloride were all higher than 97% within 72 h. CONCLUSIONS:The mix-ture of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride injection in 0.9% Sodium chloride injection keep stable within 72 h under room temperature.

OBJECTIVE:To systematically review the efficacy and safety of the aerosol inhalation of Yanhuning for injection in adjuvant treatment of children respiratory system infections,and provide evidence-based basis for the administration way of off-label drug use in clinic. METHODS:Retrieved from PubMed,Science direct,EMBase,CHKD,VIP and Wanfang Database, randomized controlled trials(RCT)or quasi-randomized controlled trials(qRCT)about the aerosol inhalation of Yanhuning for in-jection in adjuvant treatment of children respiratory system infections were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 11 RCTs were enrolled,involving 982 patients. Results of Meta-analysis showed,the aerosol inhalation of Yanhuning for injection in adjuvant treatment of children respiratory sys-tem infections can significantly improve the clinical total effective rate [OR=4.47,95%CI(2.80,7.16),P<0.001],shorten breath shortness duration [MD=-2.05,95%CI(-2.86,-1.24),P<0.001],cough duration [MD=-1.73,95%CI(-2.34,-1.13),P<0.001] and pulmonary rales duration [MD=-2.13,95%CI(-3.38,-0.89),P<0.001],reduce the hospitalization days [MD=-2.38, 95%CI(-2.86,-1.89),P<0.001],and not increase the incidence of adverse reactions [OR=0.65,95%CI(0.21,2.00),P=0.45], nor shorten the fever duration[MD=-1.18,95%CI(-2.58,0.22),P=0.10]. CONCLUSIONS:The aerosol inhalation of Yanhun-ing for injection can improve the clinical efficacy in adjuvant treatment of children respiratory system infection,it helps to improve respiratory symptoms in children and does not increase the incidence of adverse reactions.

Objective:To establish a rapid and sensitive method for the determination of carbendazim in honeysuckle flowers by LC-MS/MS. Methods:The sample was extracted by acetic ether. The mass spectrometer was operated in the positive ionization elec-trospray ( ESI) mode using selection ion monitoring ( SIM) . The transition m/z 192→160 was used to quantify carbendazim. Results:The method had a satisfactory linearity within the range of 50-5 000 ng·ml-1 for carbendazim (r=0. 999 4), the limit of detection (LOD) was 2. 0 ng·ml-1, and the mean recovery was 93. 2%. Conclusion:The method of LC-MS/MS is sensitive, simple and ac-curate,which is proved to be suitable for the determination of carbendazim in honeysuckle flowers.

Objective To evaluate the efficacy of aerosol inhalation ofXiyanpingversus ribavirin for the treatment of respiratory tract infections in children.MethodsPubMed, Embase, Cochrane database of Systematic Reviews, CNKI, cqvip and wanfangdata were searched. The randomized controlled trials(RCTs) of aerosol inhalation ofXiyanpingversus ribavirin injections for the treatment of respiratory tract infections in children were incuded. The quality of trials was evaluated and data analyses were performed with the Cochrane Collaboration’s software RevMan 5.0.Results A total of 7 trials were included, involving 857 patients(437 treated withXiyanping, 420 treated with ribavirin). Both of the clinical cure rate(50.11%vs. 40.71%) and clinical effective rate(91.08%vs. 75.95%) in theXiyanping group were significantly higher than those in the ribavirin group, withOR(95%CI) 1.49(1.13 to 1.97) and 3.54(1.87 to 6.71), respectively.Conclusions Aerosol inhalation ofXiyanping superior to aerosol inhalation of ribavirin for the treatment of respiratory tract infections in children. Owing to the poor quality and the small sample size of included trials, more larger good quality CRTs are required to confirm this conclusion.

Objective To compare the feasibility and safety of endoscopy with laparoscopy and without for gastric stromal tumor.Methods A retrospective and comprehensive analysis was made based on the clinical data of endoscopic (53 cases) and laparoscopic (39 cases) resection for gastric stromal tumor (diameter ＜ 3 cm with clear boundary),by comparing the operation time,intraoperative blood loss,indwelling time of postoperative gastric tube,recovery time of bowel functions,postoperative complications,hospitalization time,metastasis,recurrence rate.Results Compared with the laparoscopic group,the endoscopic group required shorter operation time [50(48-58) min VS 70 (50-95) min,U =1575.00,P ＜ 0.01],less intraoperative blood loss [10 (5-15) ml VS 20 (20-30) ml,U =1794.00,P ＜ 0.01],earlier recovery of bowel functions [18 (8-36) h VS 24 (20-40) h,U =1666.00,P ＜ 0.01],hospitalization time,indwelling time of the postoperative gastric tube and postoperative complications showed no statistical difference (P ＞ 0.05).The postoperative follow-up time were (27 + 15) and (24 + 11) months in the endoscopic and laparoscopic group,respectively (t =0.3084,P ＞ 0.05).During the follow-up,no tumor recurrence or distant metastasis was discovered,nor was death of gastric stromal tumor.Conclusion Endoscopy without the assist of laparoscopy for the gastric stromal tumor,whose diameter is less than 3 cm with clear boundary,is safe and less invasive,and leads to quick recovery.