ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Objective:To explore the protective effect of labor analgesia on pelvic floor muscle function of primipara after vaginal delivery.Methods:A total of 140 cases of primipara with vaginal delivery admitted to the Affiliated Hospital of Jining Medical College from March to August 2022 were selected retrospectively, and they were divided into control group (routine delivery) and observation group (painless delivery) according to the intention of delivery, each group with 70 cases. Labor pain, pelvic floor muscle function score and pelvic floor muscle status at 6 weeks postpartum, Female Sexual Function Scale (FSFI) score at 3 months postpartum and reported postpartum symptoms were compared between the two groups.Results:The scores of Visual Analogue Scale (VAS) at immediately after gastric antral empting, after drinking carbohydrates (5, 30, 60, 120 min) and at full opening of uterine orifice in the observation group were lower than those in control group, there were statistical differences ( P<0.05). At 6 weeks postpartum, the maximum muscle voltage of pelvic floor muscle and the average muscle voltage of continuous contraction of pelvic floor muscle for 60 s in the observation group were higher than those in control group: (20.97 ± 2.64) μV vs. (17.31 ± 2.48) μV, (17.33 ± 3.01) μV vs. (13.42 ± 2.77) μV; the mobility of bladder neck and the hiatus area of levator anal muscle in resting state in the observation group were lower than those in the control group: (27.15 ± 3.55) mm vs. (31.05 ± 4.75) mm, (9.97 ± 2.12)cm 2 vs. (11.57 ± 2.84) cm 2, there were statistical differences ( P<0.05). At 6 weeks postpartum, the scores of static pre-stage, static post-stage, type Ⅰ muscle fiber, type Ⅱ muscle fiber and total scores in the observation group were higher than those in the control group: (67.21 ± 12.54) scores vs. (54.17 ± 10.84) scores, (69.12 ± 14.11) scores vs. (56.47 ± 11.24) scores, (63.54 ± 11.45) scores vs. (50.97 ± 10.74) scores, (57.15 ± 8.15) scores vs. (49.76 ± 6.44) scores, (64.25 ± 12.14) scores vs. (57.84 ± 20.57) scores, there were statistical differences ( P<0.05). At 6 weeks postpartum, the scores of FSFI in the observation group were higher than those in the control group ( P<0.05). The rate of urine leakage, fever and mattress sweat reported in the observation group were lower than those in the control group: 22.86%(16/70) vs. 40.00%(28/70), 15.71%(11/70) vs. 30.00%(21/70), 30.00%(21/70) vs. 47.14%(33/70), there were statistical differences ( χ2 = 4.77, 4.05, 4.34, P<0.05). Conclusions:Labor analgesia can effectively shorten labor process, relieve labor pain and protect pelvic floor muscle function during vaginal labor in primipara.

OBJECTIVE To investigate and analyze the operational costs and current charging policies of pharmacy intravenous admixture service （PIVAS） in China， and provide a reference for promoting high-quality and sustainable development of PIVAS. METHODS Questionnaires were distributed in 30 provinces， autonomous regions， and municipalities across the country through the “Wenjuanxing” platform from May 6th to July 1st， 2022. The operational costs， charging status and suggestions of PIVAS were investigated and analyzed. RESULTS A total of 761 PIVAS participated in the survey nationwide， including 666 tertiary medical institutions， 93 secondary medical institutions， and 2 primary medical institutions. Approximately 60.58% of PIVAS had implemented a charging system that allowed charges. Among them， most PIVAS required inspection and evaluation before charging. The annual operating cost of PIVAS in China was approximately 2 098 100 yuan， with the integrated operating cost comprising 89.36% of the total， while the dispensing cost accounted for only 10.64%. Human costs emerged as the highest annual consumption （74.20%）， followed by decoration and facility maintenance costs （4.77%） and equipment acquisition costs （3.44%）. Regarding charges for different drugs nationwide， common drugs had an average charge standard of 4.39 yuan per bag while antibacterial drugs averaged 5.01 yuan per bag； hazardous drugs had an average charge of 23.17 yuan per bag， whereas parenteral nutrition solutions averaged 38.75 yuan per bag. However， the recommended average charges of the four drugs mentioned above were 6.71， 9.63， 38.35 and 44.03 yuan per bag， respectively. CONCLUSIONS At present， there is no unified inspection and evaluation standard and charging standard in China. Moreover， the current charging standard is lower than the recommended standard. It is necessary to combine operational costs and develop more reasonable and fair charging standards.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Objective To study the epidemiological characteristics of norovirus (NV) and rotavirus (RV) in children with diarrhea. Methods In this study, fecal specimens of 2 135 children with diarrhea admitted to our hospital from January 2019 to December 2019 were collected. The infection of NV and RV virus was detected by immunochromatography and ELISA, respectively. The epidemiological characteristics of RV virus. Results The total positive detection rate of 1 388 children was 65.01% (1 388/2 135), and the positive detection rate of RV virus was 34.52% (651/2 135), which was higher than 30.49% (737/2 135) of NV virus (χ²=7.895, P<0.05); there is no difference in the positive detection rate of NV virus among children of different genders (P>0.05), the positive detection rate of RV in males is 61.74%, higher than that of females 38.26% (χ²=25.318 , P<0.001); the age of children infected with NV and RV viruses are within 2 years old, and the cumulative positive detection rates are 64.21% (418/651) and 60.92% (449/737), which is higher than other ages (χ²=35.791, P<0.001); the high incidence season of NV virus is mainly winter, and the cumulative positive detection rate from October to December is 81.26% (529/651), higher than other seasons (χ²=173.426 , P<0.001), the high incidence season of RV virus is mainly spring and winter, the cumulative positive detection rate from November to March of the next year is 87.11% (642/737), higher than other seasons (χ²=252.628, P<0.001). Conclusion Spring and winter are the seasons of high incidence of viral diarrhea in children. Close monitoring of children under 2 years of age should be strengthened to prevent viral diarrhea early.

Objective:To explore the therapeutic effect and safety of oral ibuprofen (INN)on patent ductus arterio-sus (PDA)in neonates.Methods:A total of 160 neonates,who hospitalized in our hospital and were diagnosed as PDA by color echocardiography from Feb 2011 to Dec 2013,were enrolled.According to number table method, they were randomly and equally divided into high dose group (received INN 10mg/kg on the first day,then 5mg/kg on the second and third day)and low dose group (received INN 5mg/kg for 3d).PDA closure was observed,com-pared and analyzed between two groups after INN therapy.Results:After INN therapy,PDA closed in 57 cases (71.3%)in high dose group,it was significantly higher than that of low dose group (48.8%,39/80),P <0.01;there were no significant difference in incidence rates of adverse reactions between two groups (P >0.05 all).Con-clusion:High-dose ibuprofen possesses better therapeutic effect on patent ductus arteriosus in neonates;its adverse reactions are few;which can avoid postoperative pain in partial children.

BACKGROUND: It is recently found that some kinds of antibiotics can aggravate the obstruction of neuromuscular junction(NM J) transmission,exacerbate myasthenia gravis (MG). Hitherto, there are few reports about the effect of antibiotics on transitive function on animal models. Along with the appearance of new antibiotics, the effects of the antibiotics on NMJ transitive function need to be further observed.OBJECTIVE: To investigate the effect of aminoglycoside antibiotics, fluoroquinolone antibiotics and cephalosporin antibiotics on the transitive function of NMJ in MG, and to provide an experimental basis for using those antibiotics securely in clinic and for selecting those antibiotics to treat MG properly.DESIGN: Randomized controlled study based on experimental animals.SETTING: Department of nosocomial infection, neurology and pharmacy in a university hospital.MATERIALS: The experiment was conducted at the Neurological Institute of Tongji Medical College, Huazhong University of Science and Technology from March 2002 to January 2003. Totally 150 healthy female C57BL/6mice, 6 - 8 weeks old, weighting 18 - 20 g, were divided randomly into 4groups: normal group( n = 10), MG group( n = 10), saline group( n = 10)and antibiotics group( n = 120) . Mice in antibiotics group were divided randomly again into gentamicin group, etimicin group, ciprofloxacin group,fleroxacin group, cefuroxime group and cephradine group, with 20 mice in each group.INTERVENTIONS: C57BL/6 mice were immunized with the acetylcholine receptor(AChR) protein in complete Fruend' s adjuvant(CFA) to establish experimental autoimmune myasthenia gravis(EAMG) . Mice in saline group were injected normal saline and mice in antibiotics group were injected antibiotics(10 mg/kg), lasted 14 days. Mice in MG group were without any treatments. On the 7th day after the last immunization and the 14th day after the antibiotics treatments, MG scores was evaluated, repetitive nerve stimulation(RNS) and the levels of acetylcholine receptor antibody(AChRab)were tested at the same time.RESULTS; The mean symptom scores on the 14th day after the antibiotics treatment with gentamicin, etimicin, ciprofloxacin and fleroxacin were higher than that in MG group, and there was no significant difference in the mean symptom scores among cefuroxime group, cephradine group and MG group. The decrement percent of RNS in gentamicin group [ (21.22 ± 4.63)% ], etimicin group[ (19.08 ±4. 25)% ], ciprofloxacin group[ (22.25 ±4.95)% ] and fleroxacin group[ (21.71 ±4.99)% ] were higher than that in MG group[(15.75 ±2.22)% ], but no difference was found in the attenuation rate among cefuroxime group[(15.25 ±2. 87)% ],cephradine group[ ( 15.25 ± 3.30)% ] and MG group. The levels of AChRab in gentamicin, etimicin, ciprofloxacin and fleroxacin groups were also higher than that in MG group, but no difference was found among cefuroxime group, cephradine group and MG group.CONCLUSOIN: Aminoglycoside and fluoroquinolone antibiotics can aggravate the obstruction of NMJ transmission, and cephalosporin antibiotics have no obvious effect on the obstruction of NMJ transmission function in MG.