OBJECTIVE To compare the predictive accuracy and clinical applicability of four vancomycin individualized dosing tools （SmartDose， ClinCalc， Gulou， Pharmado） and provide a basis for rational clinical medication use. METHODS A retrospective cohort study was conducted， enrolling 479 adult patients who received vancomycin therapy and underwent steady-state trough concentration monitoring in Zhongshan Hospital， Fudan University （Xiamen Branch） from January 1， 2022， to June 30， 2024. The predictive accuracy of each tool was evaluated using indicators， such as mean error （ME）, mean absolute error （MAE）， mean percentage error （MPE）， mean absolute percentage error （MAPE）， the proportion of patients with an absolute percentage error （APE） of less than 30%， the 95% limits of agreement， and the overall relative percentage difference between predicted and measured values. Using indicators such as accessibility， patient management， and recommendation of multiple treatment options， the clinical panxso@163.com applicability of the tools for all patients was evaluated； using the discrepancy in accuracy between the predicted and actual measured blood drug concentrations as an indicator， the clinical applicability was assessed for patients in different renal function subgroups （hyperfunction， normal， mild impairment， moderate impairment， and severe impairment）. RESULTS In terms of accuracy， SmartDose demonstrated the best overall performance with an MAPE of 46.40% and a proportion of APE ＜30% （46.56%）. Bland-Altman analysis indicated that SmartDose had the smallest overall relative percentage difference （－7.25%）， although the 95% limits of agreement were broad for all tools， with differences between the upper and lower limits exceeding 200%. In terms of applicability， all four dosing tools were freely accessible and demonstrated good availability； SmartDose and Pharmado provided the most comprehensive solutions， offering features such as patient management， multiple regimen recommendations， and drug concentration-time curve plotting. Stratified analysis based on renal function revealed that Pharmado showed optimal prediction for hyperfiltration patients （mean difference： 0.11 mg/L）. SmartDose and ClinCalc showed relatively better performance in normal and mild renal impaiment （mean difference： 0.37， 0.51 mg/L and －1.13， －1.33 mg/L，respectively）. SmartDose performed best in moderate renal impairment （mean difference： －2.60 mg/L）. Pharmado and Gulou had smaller prediction biases in severe renal impairment （mean differences： 1.52 mg/L and －0.23 mg/L， respectively）. CONCLUSIONS The four individualized dosing tools demonstrated limited accuracy in the initial prediction of vancomycin concentrations. Among them， SmartDose demonstrates the highest overall prediction accuracy and possesses comprehensive clinical management features. It is recommended that Pharmado be preferred for patients with renal hyperfiltration； SmartDose or ClinCalc can be used for patients with normal or mildly impaired renal function； SmartDose is recommended for patients with moderately impaired renal function； Pharmado or Gulou may be considered for patients with severely impaired renal function.

Off-label use means that the intended use of the drug is not included in the instructions approved by the National Medical Products Administration,including unapproved indication,dosage,the course of treatment,route of administration,or population.The formulation of Pharmaceutical Supply Services-Key Medications Management-Off-label Uses is based on relevant laws,regulations,normative documents,guidelines,literatures,and expert opinions,and follows the principles of scientificity,versatility,instructiveness,and operability.This standard regulates and standardizes the institutional and organizational construction,process management,and the whole process of quality management and evaluation improvement of off-label uses,which is the basis for medical institutions to carry out off-label uses management.This article introduced the formulation process of the off-label uses standard and analyzed the key contents of the standard,which would help medical institutions to better comply with and meet the requirements of this standard in the practice of off-label use management.

Drugs under special management include narcotic drugs,psychotropic drugs,toxic drugs for medical use,radiopharmaceuticals,and pharmaceutical precursor chemicals.Supervising and guiding the clinical use of drugs under special management is one of the important responsibilities of the Pharmaceutical Management and Drug Therapy Committee(Group)of medical institutions.The standard for drugs under special management is led by the Pharmaceutical Professional Committee of the China Hospital Association,which standardizes 16 key elements of organizational management,process management,and quality control management drugs under special management in medical institutions.It can guide the standardized implementation of Pharmaceuticals under special control work in various levels and types of medical institutions.This article elaborates on the methods and contents of formulating standards for Pharmaceuticals under special management,to provide reference and inspiration for medical institutions to carry out special drug drug management and daily related work.

The management of clinical application of antimicrobial drugs is an important part of the pharmaceutical management and pharmacy services in medical institutions.Based on national policies and regulations,this standard focuses on the whole life cycle of antimicrobial drugs in medical institutions.It is developed based on the principles of scientific validity,universality,guidance and operability,formed by sorting out problems,collecting opinions,expert argumentation and deliberation.It is the first group standard to standardize the clinical application management of antimicrobial drugs.This paper introduces and analyzes the team composition,problem sorting and compilation process,and various elements of the standard in the process of formulating the standard,and provide a reference for the majority of peers who use it.

Antineoplastic drugs refer to the drugs that act at the cellular and molecular levels to inhibit tumor growth or eliminate tumors through pathways such as cell killing,immune regulation,and endocrine regulation.Antineoplastic drugs generally including chemotherapeutic drugs,molecular targeted therapeutic drugs,immunotherapeutic drugs,and endocrine therapeutic drugs.The management and rational application of antineoplastic drugs in medical institutions are related to the safety of patient treatment.The standard for management of antineoplastic drugs use in clinical is compiled by the Pharmaceutical Affairs Committee of China Hospital Association,which specification requirements 18 key elements in the organizational management and system,medication management,drug monitoring and evaluation of antineoplastic drug management in healthcare institutions.This standard is applicable to all levels and types of healthcare institutions carrying out oncology diagnosis and treatment.This paper describes the methodology and basic content of the standard,hoping to providing a reference for medical institutions to carry out relevant work.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

OBJECTIVE: To investigate the antibiotic use in Shanghai Second and Third Class Hospitals. METHODS: The use of antibiotics in outpatients and inpatients in 10 third class hospitals and 13 second class hospitals were analyzed statistically in respect of consumption sum, order of varieties. RESULTS: The proportion of antibiotic use in Shanghai second and third class hospitals showed a different degree of decrease. However, in terms of the number of prescriptions and consumption sum, the proportions of antibiotics used in outpatient department were significantly higher in second class hospitals than in third class hospitals. The proportion of antibiotic use in inpatients (both non-surgery and surgery ones) were still on the high side, most had a postoperative antibiotic using coure of 3 to 7 days. CONCLUSION: The proportion and duration of antibiotic use should be strictly under control to ensure safe, effective and economical use of antibiotics.

Objective:To establish the method of determination of the contents of Danshensu and Protocatechuic aldehyde in Huoxue Mixture simultaneously by RP HPLC.Methods:The determination was carried out with Inertsil ODS column. The mobile phase consisted of methanol 0.5% HAc (22∶78) and UV detection wavelength was 280nm. Results:The average recovery of standard addition were 96.7%, RSD =1.12% ( n =5) for Denshensu, and 97.0 %, RSD =1.53% ( n =5) for Protocatechuic aldehyde, There was a good linear relationship between the absorption area value and the concentration in the range of 1.25～10?g for Deshensu and 0.25?g～2.0?g for Protocatechuic aldehyde.Conclusion: The method is simple, acurate, reproducible and can be used for content determination of Huoxue Mixture.

Objective:To establish the determination of the contents of ferulic acid and paecniflorin in Huoxue Mixture Radix Salviae Miltiorrmizae, Radix Angelicae sinensis, Radix Paeoniae Rubra cortex Moutan, Radix Astragali and caulis Spatholobi simultaneously by HPLC.Methods:The determination was carried out with ZORBAX *ODS column. Chromatographic condition of ferulic acid: the mobile phase consisted of methanol 1%HAc (42∶58) and UV detection wavelength was at 313nm. Chromatographic condition of paecniflorin: the mobile phase consisted of methanol water (25∶75) and UV detection wavelength was 230nm.Results:There was a good linear relationship between the absorption peak area and the concentration in the rang of 0.125～1.0?g for ferulic acid and 0.25～2.0?g for paecniflorin, respectively.Conclusion:The method is simple, acurate, reproducible and can be applied for content determination of Huoxue Mixture.

OBJECTIVE:To determinate the plasma concentration of ropivacaine in rabbits by HPLC,and study the secu?rity of ropivacaine in rabbits.METHODS:Nine rabbits were injected with ropivacaine drop by drop with a speed of1mg/(kg?min)until the rabbits died.RESULTS:The mean plasma concentration of ropivacaine in rabbits was224.54?107.45mg/L when the rabbits died.CONCLUSION:Ropivacaine has high security in rabbits.