Objective To evaluate the cost-effectiveness of two chemotherapy regimens in NSCLC for the purpose of lower cost,higher quality medical care.Methods 56 patients with advanced NSCLC were divided into two groups from our hospital,group PP(pemtrexal+cisplatin,n=30)and group GP(gemcitabine+cisplatin,n=26),and analyzed by pharmaco-economic cost-effectiveness method,and retrospective analysis was also applied.Results Effective rates of two regimens were 46.67%,42.31%,no significant difference.But there was significant difference in the incidence rate of ADR between the two groups.The cost of chemotherapy regiments were 31 985.48 and 27 683.15 yuan.The average length of stay was 10.94 and 13·91 days.Compared to group GP,for each unit of efficacy,the cost in group PP were increased 986.77 yuan.Conclusion From the analysis of cost-effectiveness,group PP had higher chemotherapy costs,but better safety than group GP.

OBJECTIVE:To provide reference for reducing the clinical return of finished infusions. METHODS:Interventions for clinical return of PIVAS finished infusions in our hospital were introduced,the return situation of finished infusions before(dur-ing 2013-2014)and after(during 2015-2016)intervention was compared,and intervention effects were evaluated. RESULTS:Our hospital intervened it by rationally selecting and using syringes,strengthening visible particle check of finished infusion before dis-tribution;optimizing the order of drug configuration,reasonably arranging the drug infusion sequence;strengthening the clean-up in work area before drug infusion,correctly using disinfectant;strictly implementing intravenous infusion associative operation, playing the role of pharmacists;cultivating good work habits,and strengthening teamwork,etc. Compared with before interven-tion,the return numbers of finished infusion were decreased by 41.2%,and reported loss amount reduced by 45.7%. The return caused by visibility particles,finished infusion oxidation discoloration after too long storage time,finished infusion leakage,contin-uous infusion of drugs compatibility,heterodyne error,improper drug configuration method in packaging to the ward,improper use of disinfectant before infusion decreased by 25.3%,46.9%,39.4%,77.8%,73.9%,75.0%,100%,respectively. CONCLU-SIONS:Intervening the return of finished infusion can reduce the return numbers and drug waste.

Objective To analyze the relationship between pyrazinamide plasma concentration and liver injury in patients with tuberculosis and explore the early prediction method of drug-induced liver injury (DILI) in initial treatment in patients with tuberculosis.Methods Data of tuberculosis patients (all the patients were initially treated, no other complications, and underlying disease) receiving 2HREZ/4HR treatment regimen [isoniazid, rifampicin, ethambutol, and pyrazinamide were given at the first 2 months of treatment, isoniazid and rifampicin were given at the later 4 months of treatment] in Nanjing Chest Hospital, Medical School of Southeast University from January to December 2016 were collected.According to the pyrazinamide concentration in serum on the 6th day of treatment, patients were divided into 3 groups, the <20 mg/L group, 20-40 mg/L group, and >40 mg/L group.The incidences of DILI in the 3 groups were compared.Results A total of 45 patients in accordance with the criteria were collected, including 33 males and 17 females with age from 18 to 50 years and an average age of (34±10) years.Among them, 36 patients had pulmonary tuberculous, 9 patients had tuberculous pleurisy, and 5 patients had tuberculosis meningitis.The pyrazinamide concentrations in serum were 16-51 mg/L and the average concentration was (35±9) mg/L.There were 4 patients in the <20 mg/L group, 28 patients in the 20-40 mg/L group, and 13 patients in the >40 mg/L group.Of the 45 patients, 11 patients developed DILI and the incidence was 24.4%.The pyrazinamide plasma concentrations in the 11 patients with DILI were 26 mg/L to 51 mg/L, 4 patients′ concentrations were 40 mg/L and 7 patients′ concentrations were >40 mg/L.The incidences of DILI in the <20 mg/L, 20-40 mg/L, and >40 mg/L groups were 0/4, 14.2 %(4/28), and 53.85% (7/13), respectively.The difference between the 20-40 mg/L and the >40 mg/L groups was statistically significant (X2=7.708, P=0.008).Conclusions The DILI incidence in initial treatment of tuberculosis patients increased with increase of pyrazinamide plasma concentration.Early therapeutic drug monitoring for pyrazinamide could predict the occurrence of DILI and was beneficial for reducing or avoiding the effect of DILL for tuberculosis treatment.

Objective To analyze the relationship between pyrazinamide plasma concentration and liver injury in patients with tuberculosis and explore the early prediction method of drug-induced liver injury (DILI) in initial treatment in patients with tuberculosis.Methods Data of tuberculosis patients (all the patients were initially treated, no other complications, and underlying disease) receiving 2HREZ/4HR treatment regimen [isoniazid, rifampicin, ethambutol, and pyrazinamide were given at the first 2 months of treatment, isoniazid and rifampicin were given at the later 4 months of treatment] in Nanjing Chest Hospital, Medical School of Southeast University from January to December 2016 were collected.According to the pyrazinamide concentration in serum on the 6th day of treatment, patients were divided into 3 groups, the <20 mg/L group, 20-40 mg/L group, and >40 mg/L group.The incidences of DILI in the 3 groups were compared.Results A total of 45 patients in accordance with the criteria were collected, including 33 males and 17 females with age from 18 to 50 years and an average age of (34±10) years.Among them, 36 patients had pulmonary tuberculous, 9 patients had tuberculous pleurisy, and 5 patients had tuberculosis meningitis.The pyrazinamide concentrations in serum were 16-51 mg/L and the average concentration was (35±9) mg/L.There were 4 patients in the <20 mg/L group, 28 patients in the 20-40 mg/L group, and 13 patients in the >40 mg/L group.Of the 45 patients, 11 patients developed DILI and the incidence was 24.4%.The pyrazinamide plasma concentrations in the 11 patients with DILI were 26 mg/L to 51 mg/L, 4 patients′ concentrations were 40 mg/L and 7 patients′ concentrations were >40 mg/L.The incidences of DILI in the <20 mg/L, 20-40 mg/L, and >40 mg/L groups were 0/4, 14.2 %(4/28), and 53.85% (7/13), respectively.The difference between the 20-40 mg/L and the >40 mg/L groups was statistically significant (X2=7.708, P=0.008).Conclusions The DILI incidence in initial treatment of tuberculosis patients increased with increase of pyrazinamide plasma concentration.Early therapeutic drug monitoring for pyrazinamide could predict the occurrence of DILI and was beneficial for reducing or avoiding the effect of DILL for tuberculosis treatment.

Objective: To summarize the experience of clinical pharmacy of traditional Chinese medicine in a special hospital. Methods: Combining the work of clinical pharmacists in the hospital, the service content of clinical pharmacy of traditional Chinese medicine in the special hospital was described and the improvement methods were explored. Results:The pharmaceutical care of clini-cal pharmacy of traditional Chinese medicine could improve safe and rational use of drugs. Conclusion: Pharmacists should enhance the study of pharmacy and traditional Chinese medicine to improve the pharmaceutical care of clinical pharmacy of traditional Chinese medicine.