ObjectiveTo explore the effects of vascular endothelial growth factor A （VEGFA） rs2010963 and rs3025039 polymorphisms on chemotherapy toxicities and clinical prognosis in children with brain tumors. MethodsA total of 104 pediatric patients with brain tumors receiving standardized chemotherapy were enrolled. Matrix-assisted laser desorption/ionization time of flight mass spectrometry was used for VEGFA rs2010963 and rs3025039 genotyping. The χ² test was applied to analyze the association between genotypes and chemotherapy‑related toxicities. Cox regression was used to evaluate the correlations of clinicopathological characteristics and genotypes with the progression‑free survival （PFS）. In addition， bioinformatic analyses were conducted to investigate the regulatory factors potentially affected by the two SNP loci. ResultsThe VEGFA expression in brain tumors （5.17±1.81） was significantly higher than that in normal tissues （4.33±1.56， P<0.001）. Patients with high VEGFA expression had significantly worse overall survival than patients with low VEGFA expression （P<0.001）. Among the 104 children with brain tumors included， the rs2010963 CC， CG， and GG genotypes accounted for 14.42%， 55.77%， and 29.81%， respectively. The frequencies of C and G alleles were 42.31% and 57.69%， respectively. The rs3025039 CC， CT， and TT genotypes accounted for 70.19%， 25.96%， and 3.85%， respectively. The frequencies of C and T alleles were 83.17% and 16.83%， respectively. The children with the rs3025039 CC genotype had significantly higher incidences of thrombocytopenia （46.58%） and gastrointestinal toxicity （56.16%） than CT genotype carriers （22.22% and 33.33%， respectively， P<0.05）， and significantly lower incidences of coagulation disorders （4.11%） than TT genotype carriers （50.00%， P<0.05）.The incidence of hyperlipidemia （2.74%） was significantly lower than that in the CT genotype carriers （14.82%， P<0.05）. The tumor type and the rs2010963 genotype were significantly associated with PFS （P<0.05） in univariable and multivariable Cox regression analysis. Bioinformatic analysis indicated that the rs2010963 and rs3025039 polymorphisms regulated VEGFA expression by affecting the binding of transcription factors and miRNAs to their target gene sequences， respectively. ConclusionThe VEGFA rs3025039 CC genotype is a risk factor for thrombocytopenia and gastrointestinal toxicity， and a protective factor for coagulation disorders and hyperlipidemia. The rs2010963 CG genotype is a protective factor for brain tumor progression.

OBJECTIVE： To design Proton pump inhibitor （PPI） medical order evaluation software， and to promote rational drug use in clinic. METHODS： According to the use of PPI （PPI injection as an example） of inpatients in a Third Grade Class A hospital （hereinafter referred to as "sample hospital"）， the evaluation process of medical order evaluation software was designed. On this basis， medical order evaluation software for inpatients was developed in collaboration with computer engineers. Taking the detection rate of irrational drug use and the time consuming per capita as indicators， the effects of software evaluation and manual evaluation were compared. Dispensing medical orders of PPI injection in PIVAS of sample hospital was evaluated with the software pre-evaluation in Feb. 2018. Irrational use of PPI injection （including irrational medication for treatment， prevention and non-indication） in the inpatients was evaluated retrospectively during Jan. 2015-Dec. 2017. RESULTS： The software of PPI audit includes four modules：users and tasks （timing audit）， system settings， confirmation of audit results （check the results audited by the software automatically） and reports exporting. Compared with manual evaluation， there was no significant difference in detection rate of irrational drug use in software audit （69.50％ vs. 77.00％， P＞0.05）； the time consuming per capita was shortened significantly （9.25 min vs. 1.50 min， P＜0.05）. In the application of pre-evaluation， 27 （2.23％） were irrational for treatment， 318 （26.24％） were irrational for prevention and 602 （49.67％） for non-indications. In the application of retrospective review， 4 884 （2.68％） were irrational medication for treatment， 50 399 （27.67％） irrational medication for prevention and 85 106 （46.72％） medication without indications. CONCLUSIONS： The application of PPI medical order evaluation software shortens the time of pharmacist's evaluation， improves the efficiency of evaluation， and promotes the rational use of PPI in clinic.

Objective To investigate the usage of intravenous infusion and the antibiotic intravenous infusion in different hospitals nationwide ,and to evaluate the influence of the hospital bed number ,hospital area and hospital grade on the clinical application of intravenous infusion .Methods Intravenous infusion volume ,rate and other related indexes were analyzed based on the inpatient information obtained from the regional medical big data net for 156 hospitals .Results 1323852 inpatients were included in this study .93 .13％ of those patients received intravenous infusion therapy .The average daily infusion volume was 782 .67 ml per bed .The average infusion time was 7 .39 days per patient .44 .78％ of inpatients received intravenous antibi-otic treatment .The average daily antibiotic infusion volume was 92 .48 ml per bed .Conclusion Generally ,the inpatient per-centage of intravenous infusion was getting higher in China .The greater infusion volume in larger hospitals suggested that the patient′s condition is relatively more serious in the larger hospital .The higher grade hospitals used smaller antibiotic infusion rate and volume ,indicating the antibiotic use in high grade hospitals is relatively more standardized .

OBJECTIVE:To provide evidence for rational use and clinical monitoring of Alprostadil lipid-micro injection (Li-po-PGE1). METHODS:Adult inpatients receiving Lipo-PGE1 from hospital information system(HIS)of 159 hospitals were select-ed as research subject. Based on frequency statistics,population,clinical diagnosis,and average daily dose of Lipo-PGE1 were all studied. RESULTS:A total of 71687 adult inpatients were included,and the male was more than female,mostly aged 61-75. The hospitalization duration was 8-14 d(45.01%),most of patients were recovered(68.20%). Lipo-PGE1 was wildly used in the clin-ic,and was used for 871 kinds of clinical diseases in total;top 3 diseases were cerebral infarction(9.06%),non-insulin dependent diabetes mellitus (8.65%) and chronic ischemic heart disease (8.08%). The average daily dose of different diseases and different hospitals were significantly different,mostly≤12.5μg. CONCLUSIONS:As adjuvant drug,medical institutions and related super-vision departments should formulate reasonable monitoring index and strengthen medication guidance and evaluation of Lipo-PGE1.

OBJECTIVE:To investigate the differences of antibacterial agent products directory between China and America, and to provide reference for the relevant departments. METHODS:Using domestic and imported drug data released by China Food and Drug Administration(CFDA)and national drug code(NDC)issued by America Food and Drug Administration(FDA),anti-bacterial drugs of China and America were analyzed comparatively in respects of types,specification,the number of products, child-size dosage form,concentration ratio of manufacturers. RESULTS & CONCLUSIONS:In CFDA’s and FDA’s directory of antibacterial drugs,the number of type,specification and product were 191 and 84,460 and 1 392,23 824 and 3 139,respective-ly. The number of child-size dosage form were 51 and 26. The number of products in enterprises with the top 10 product number ac-counted for 6.29% and 33.67%. In China,the type and specification of antibacterial drugs are abundant but low. It is recommend that antibacterial drugs’approval should be examined and supervised strictly. At the same time,products already marketed should be reselected and revaluated,and price or market mechanism should be adopted to promote the survival of the fittest of antibacterial drugs.

Objective To evaluate the implementation of hospital pharmacy distribution for inpatient pharmacy services , with impact on understanding investigation for ward nurse awareness of the drug storage management ,and to optimize ward base drug administration .Methods By improving the drug delivery service process in a hospital ward ,the statistical base vari-ety and number of the base drugs were counted two years in 2012 and in 2014 respectively ;with a questionnaire analysis in ward nurses on base drug awareness and drug management situation .Results After the drug distribution process optimization , time that nurses receive medicines from pharmacies decreased from 90 min to 20 min;base ward drugs from 2012 of 16 catego-ries ,237 varieties ,down to 2014 of 13 categories ,209 species .Questionnaire survey results showed that the ward nurse awareness of drug administration should be improved further .Conclusion By optimizing the drug distribution process ,reduced storage ward medicines can increase the time nurses for patients and services as well as reduce the risk faced by the ward base drug administration .