An one-month-old boy was treated with diazoxide capsules purchased by his parents from abroad for congenital hyperinsulinemia. In order to correct his hypoglycemia, the treatment plan was designed as follows: diazoxide capsules with an initial dose of 8.72 mg orally thrice daily [5 mg/(kg·d)] and intravenously high concentration glucose were given at the same time, then the supplement of intravenous glucose was gradually reduced and the dose of diazoxide was gradually increased under close monitoring of blood glucose levels, and finally the intravenous glucose was stopped with the stable blood glucose level (≥3.9 mmol/L). During the first 7 days of treatment, the dose of intravenous glucose and diazoxide were adjusted as planned, the child′s blood glucose was 3.1-5.3 mmol/L, and no hypoglycemia occurred. On the 8th day, the pharmacist found that the child was not awake and the blood glucose was 2.2 mmol/L during patient rounds. After questioning his parents, it was found that the dose of diazoxide was reduced to the initial dose by the parents themselves, leading to an episode of hypoglycemia, which was a medication error caused by the lack of self-supplied drugs management. The pharmacist immediately intervened on his parents′ treatment adherence. The dose of diazoxide was re-adjusted and the child′s blood glucose returned to normal. With the increase of the diazoxide dose, the child developed an adverse reaction of water and sodium retention. The addition of hydrochlorothiazide was recommended by the pharmacists after reviewing previous literatures and the adverse reaction of the child disappeared. Through this case, the clinical management standard of self-supplied drugs for special diseases and the database of safe drug use were established and a multi-disciplinary team for joint services consisting physicians and pharmacists was formed in the hospital under the efforts of clinical pharmacists. The safety management of medication in treatment of hospitalized and discharged children was strengthened and good results have been achieved.

A 4-month and 19-day-old girl with a body weight of 4.4 kg was treated with 5% digoxin oral solution 0.9 ml (0.045 mg) once per 12 hours after repair of ventricular septal and atrial septal defects. Spironolactone, hydrochlorothiazide, and captopril were given at the same time. The blood concentration of digoxin was detected on the 6th day of medication, and the pharmacist found that it was more than 5.0 μg/L, and immediately went to the ward to see the child. The bedside electrocardiograph showed that the baby girl had reduced heart rate (80 beats/min), arrhythmia, third-degree atrioventricular block, complete right bundle-branch block, and ST-T changes. Digoxin poisoning was diagnosed and digoxin was immediately discontinued. Three days later, the blood concentration of digoxin decreased to 1.66 μg/L, and her heart rate and electrocardiograph returned to normal. By reviewing the medication information of the baby, a digoxin poisoning event due to overdose of digoxin and drug interactions was diagnosed. Due to the event, the use of digoxin in hospitalized children in the whole hospital from January 2017 to May 2019 was investigated. Among 323 children, 14 children (4.3%) overdosed with digoxin; 235 children (72.8%) were treated with digoxin for more than 5 days, but the detection rate of blood concentration was only 12.8% (30/235); 67.5% children (240/323) were prescribed drugs that might interact with digoxin or increase the risk in digoxin treatment. Through the analysis of risk factors, improvement measures such as optimizing medical order audit system, increasing the monitoring rate of digoxin blood concentration, and strengthening training were put forward, and an expert consensus in the hospital was reached. After implementation of the improvement measures, a total of 47 children were prescribed digoxin in the whole hospital from January to June, 2020, none of them were given overdose of digoxin, and the monitoring rate of digoxin blood concentration was increased to 40.4% (19/47).

Chengdu Women and Children′s Central Hospital started the construction of a pharmacovigilance system in 2017. In August of that year, 3 venous thrombosis events related to off-label use of heamocogulase agents occurred consecutively within 1 month, which aroused the vigilance of the hospital pharmacovigilance department. And these events were designated as the risk signals of pharmacovigilance. Then the application of heamocogulase agents in the whole hospital was investigated. Intervention measures including formulation of clinical application standard of heamocogulase agents, strengthening of the prescription and medical order management, and strengthening the training of medical staff on the rational use of heamocogulase agents were formulated in connection with the medication risk links, and the pharmacovigilance system of heamocogulase agents was established. From December 2017 to February 2018 after the implementation of the intervention, the consumption of heamocogulase agents decreased by 90.8% (from 6 767 to 624) and the incidences of unreasonable medication indication, irrational course of treatment, and unjustified daily dose decreased significantly, compared with those from June to August 2017 before the intervention. As of the end of 2019, no more heamocogulase agents-related venous thrombotic events have occurred.

A 4-month and 19-day-old girl with a body weight of 4.4 kg was treated with 5% digoxin oral solution 0.9 ml (0.045 mg) once per 12 hours after repair of ventricular septal and atrial septal defects. Spironolactone, hydrochlorothiazide, and captopril were given at the same time. The blood concentration of digoxin was detected on the 6th day of medication, and the pharmacist found that it was more than 5.0 μg/L, and immediately went to the ward to see the child. The bedside electrocardiograph showed that the baby girl had reduced heart rate (80 beats/min), arrhythmia, third-degree atrioventricular block, complete right bundle-branch block, and ST-T changes. Digoxin poisoning was diagnosed and digoxin was immediately discontinued. Three days later, the blood concentration of digoxin decreased to 1.66 μg/L, and her heart rate and electrocardiograph returned to normal. By reviewing the medication information of the baby, a digoxin poisoning event due to overdose of digoxin and drug interactions was diagnosed. Due to the event, the use of digoxin in hospitalized children in the whole hospital from January 2017 to May 2019 was investigated. Among 323 children, 14 children (4.3%) overdosed with digoxin; 235 children (72.8%) were treated with digoxin for more than 5 days, but the detection rate of blood concentration was only 12.8% (30/235); 67.5% children (240/323) were prescribed drugs that might interact with digoxin or increase the risk in digoxin treatment. Through the analysis of risk factors, improvement measures such as optimizing medical order audit system, increasing the monitoring rate of digoxin blood concentration, and strengthening training were put forward, and an expert consensus in the hospital was reached. After implementation of the improvement measures, a total of 47 children were prescribed digoxin in the whole hospital from January to June, 2020, none of them were given overdose of digoxin, and the monitoring rate of digoxin blood concentration was increased to 40.4% (19/47).

Chengdu Women and Children′s Central Hospital started the construction of a pharmacovigilance system in 2017. In August of that year, 3 venous thrombosis events related to off-label use of heamocogulase agents occurred consecutively within 1 month, which aroused the vigilance of the hospital pharmacovigilance department. And these events were designated as the risk signals of pharmacovigilance. Then the application of heamocogulase agents in the whole hospital was investigated. Intervention measures including formulation of clinical application standard of heamocogulase agents, strengthening of the prescription and medical order management, and strengthening the training of medical staff on the rational use of heamocogulase agents were formulated in connection with the medication risk links, and the pharmacovigilance system of heamocogulase agents was established. From December 2017 to February 2018 after the implementation of the intervention, the consumption of heamocogulase agents decreased by 90.8% (from 6 767 to 624) and the incidences of unreasonable medication indication, irrational course of treatment, and unjustified daily dose decreased significantly, compared with those from June to August 2017 before the intervention. As of the end of 2019, no more heamocogulase agents-related venous thrombotic events have occurred.

An one-month-old boy was treated with diazoxide capsules purchased by his parents from abroad for congenital hyperinsulinemia. In order to correct his hypoglycemia, the treatment plan was designed as follows: diazoxide capsules with an initial dose of 8.72 mg orally thrice daily [5 mg/(kg·d)] and intravenously high concentration glucose were given at the same time, then the supplement of intravenous glucose was gradually reduced and the dose of diazoxide was gradually increased under close monitoring of blood glucose levels, and finally the intravenous glucose was stopped with the stable blood glucose level (≥3.9 mmol/L). During the first 7 days of treatment, the dose of intravenous glucose and diazoxide were adjusted as planned, the child′s blood glucose was 3.1-5.3 mmol/L, and no hypoglycemia occurred. On the 8th day, the pharmacist found that the child was not awake and the blood glucose was 2.2 mmol/L during patient rounds. After questioning his parents, it was found that the dose of diazoxide was reduced to the initial dose by the parents themselves, leading to an episode of hypoglycemia, which was a medication error caused by the lack of self-supplied drugs management. The pharmacist immediately intervened on his parents′ treatment adherence. The dose of diazoxide was re-adjusted and the child′s blood glucose returned to normal. With the increase of the diazoxide dose, the child developed an adverse reaction of water and sodium retention. The addition of hydrochlorothiazide was recommended by the pharmacists after reviewing previous literatures and the adverse reaction of the child disappeared. Through this case, the clinical management standard of self-supplied drugs for special diseases and the database of safe drug use were established and a multi-disciplinary team for joint services consisting physicians and pharmacists was formed in the hospital under the efforts of clinical pharmacists. The safety management of medication in treatment of hospitalized and discharged children was strengthened and good results have been achieved.

Objective To study reliability and validity of incontinence impact questionnaire short form (IIQ-7) in the Chinese population. Methods IIQ-7 form was translated into Chinese; 74 patients with urinary incontinence completed the IIQ-7 simplified Chinese version and short-form 12-item health survey (SF-12) questionnaires. The urinary incontinence patient also ran a 1 hour pad test. Then, reliability and validity of those forms were analyzed. Results The Cronbach's alpha of IIQ-7 simplified Chinese version was 0. 824 (P <0. 01). The intra-class correlation coefficient of IIQ-7 simplified Chinese version was 0. 749 (P < 0.01) . IIQ-7 simplified Chinese version scores were negatively correlated with SF-12 scores (Spearman correlation coefficient: - 0. 570, P < 0. 01) , IIQ-7 simplified Chinese version scores were positively correlated with 1 hour pad test (Spearman correlation coefficient: 0.461, P < 0. 01) , IIQ-7 simplified Chinese version scores were also positively correlated with the course of disease (Spearman correlation coefficient: 0. 235 , P < 0. 05) . Factor analysis of IIQ-7 simplified Chinese version showed good construct validity. Conclusions The simplified Chinese version of IIQ-7 has higher reliability and validity in the Chinese population. They are highly recommended for clinical treatment and research.

Objective To explore the role of p38MAPK and TGF?2 in the development of diabetic retinopathy.Methods Fifteen Hamsters were induced into diabetic models by intraperitoneal injection of Streptozotocin(40 mg/kg once a day) for 3 d and 13 Hamsters were successfully established,whose blood glucose was over 13.5 mmol/L.Ten Hamsters as controls were intraperitoneally injected of physical saline of the same volume.At 16th week after induction,the total RNA of retina from all sacrificed Hamsters was collected.The mRNA expressions of p38MAPK,TGF?2 in retina were detected by semi-quantitative RT-PCR and their protein levels by Western blotting.Results The mRNA expressions of p38MAPK,TGF?2 in retina were of high tendency and their protein levels increased.Conclusion p38MAPK signal pathway may involve in the pathogenesis of diabetic retinopathy.

Objective To investigate the combination of compound anisodine and physical therapy in the treatment of amblyopia,and its possible mechanism.Methods Totally 300 outpatients with amblyopia(3 to 14 years old) were randomly and equally divided into treatment group and control group.In the treatment group,subcutaneous injection of compound anisodine(2 ml,once per day) to the superficial temporal artery of eye was given for a course of 14 d and followed by another course after 5 days'interval.Cover treatment was carried out at the same time.The control group was only treated with physical therapy.Vision,central retinal artery peak systolic velocity(PSV) and diastolic resistance index(RI) were measured during the 3 months' follow-up.Results The 3 to 6-year-old efficiency was 75.0%,7 to 9-year-old efficiency was 69.6%,and 10 to 14-year-old efficiency was 61.1% ;The difference of efficiency between therapy group and control group was very significant(P0.05).Conclusion Compound anisodine plus physical therapy for amblyopia at different ages and varying degrees are effective and safe.The mechanism may be due to enhanced retinal blood supply.

Objective To compared the decreasing characteristics of formaldehyde and benzene concentrations in indoor air after decoration. Methods The concentrations of formaldehyde and benzene in indoor air of hotels were determined within one week, one year and more than one year after decoration. Results The concentrations of benzene in indoor air reached the peak(mean: 0.534 mg/m 3) within one week after decoration, and then decreased gradually.The concentrations of formaldehyde were not high within one week after decoration,and then increased gradually, reached the peak (mean: 0.141 mg/m 3) within one year after decoration,then decreased gradually. Conclusion After decoration,the decreasing characteristics of the concentrations of formaldehyde and benzene showed a difference that the concentrations of benzene decreased faster than that of formaldehyde did.