Objective To investigate the particle size of traditional Chinese medicine （TCM） ointments in various hospitals. Methods The powders of 7 varieties of externally-applied TCM ointments from Longhua Hospital, Shanghai University of Traditional Chinese Medicine （our hospital） were subjected to comminution processes. Each variety was separately processed by a universal grinder, a hammer mill, and a jet mill, yielding a total of 21 samples. The particle sizes of these 21 samples from our hospital, along with 6 samples obtained from 6 other hospitals, were measured by employing a Bettersize2 laser particle size analyzer and microscopic examination. Results The volume-based average particle size of 21 samples from our hospital ranged from 3.34 to 52.53 μm, while that of 6 samples from other hospitals ranged from 38.59 to 118.50 μm. Notably, the particle size of samples processed by jet milling could be reduced by 12% to 86% compared with those processed by universal mechanical crushing. Microscopic observation revealed that particles larger than 180 μm were detected in 17 samples from our hospital and all 6 samples from other hospitals. Conclusion Compared with universal grinder sample and hammer grinder, jet mill could reduce the average particle size of powder. However, the increasement in pulverization time and loss of pulverization were substantial. Furthermore, in accordance with the particle size requirements for ointments specified in the current Pharmacopoeia of the People's Republic of China (2020 Edition), particle size testing of TCM ointments remains challenging. Therefore, further data accumulation should be imperative to establish particle size standards for TCM ointments.

Objective To investigate the mechanism of Qizhenziyin mixture in the treatment of hypogonadism by using the network pharmacology approach. Methods The active components of Qizhenziyin mixture were obtained by searching TCMSP ，TCMID and HIT databases.The related targets of candidate compounds were obtained by searching STITCH databases. The potential targets of Qizhenziyin mixture in the treatment of hypogonadism were obtained by mapping the disease genes of hypogonadism with Genecards and DisGeNet databases. The protein interaction platform database (STRING) was used to construct the interaction relationship between action targets. The target protein interaction （PPI） network was constructed by introducing Cytoscape software. The mechanism of Qizhenziyin mixture in the treatment of hypogonadism was explained through the enrichment analysis of GO, KEGG and molecular docking technology. Results A total of 148 drug-disease chemical compounds, 96 drug-disease intersection targets, 1085 disease targets were obtained；the components for treating diseases are: quercetin，kaempferol, luteolin, etc; enrichment analysis of GO revealed 1792 biological processes （BP）, 31 cellular components (CC) and 79 molecular functions (MF)；the results of KEGG pathway enrichment analysis indicated such as FOXO signaling pathway, prostate cancer, AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, etc.The results of molecular docking showed that kaempferol and LEP had the best and stable binding energy. Conclusion The active components of Qizhenziyin mixture may play a role of the treatment of hypogonadism by improving insulin resistance and the expression of testosterone synthetase of Leydig cells.

Objective To establish a gas chromatography for simultaneous determination of camphor residue and borneolum content in Qingchang Suppository. Methods Gas chromatograph method was used. The chromatographic column was Agilent capillary column(30 m×0.25 mm×0.25 µm). The column temperature was 140 ℃. The sample injection temperature was 250 ℃. The FID detector temperature was 250 ℃. Results Camphor，borneol and isoborneol content showed good linear in the extent of 0.0299~1.497(r=1.000), 0.0205~1.025(r=1.000), 0.0097~0.4830 µg (r=1.000). RSDs of precision，stability and repeatability test results were less than 2%. The recovery was 99.7%, 101.0%, 102.5%. Conclusion This method is simple and quick with accurate result, which could be used for the content determination of Borneol in Qingchang Suppository.

A 78-year-old male patient with peritoneal dialysis received Juhong Tanke (橘红痰咳液) solution 10 ml thrice daily and 4 Jinqiaomai tablets (金荞麦片) thrice daily orally because of cough at night for 3 weeks(conventional abdominal dialysis maintenance treatment was given according to the original schedule). On day 5 of treatments, the peritoneal exudate was turbid. Laboratory tests showed white blood cell count (WBC) 1.1×10 9/L, neutrophils 0.65, hemoglobin (Hb) 105 g/L, platelet count (PLT) 90×10 9/L, high sensitivity C-reactive protein 26.9 mg/L, and procalcitonin 10.89 mg/L; the examination for exudate showed WBC 13 131×10 6/L and neutrophils 0.96. Acute diffuse peritonitis was diagnosed. Meropenem, moxifloxacin, norvancomycin, vancomycin, and linezolid were given successively along with the peritoneal dialysis, the infection was still not well controlled, and then the anti-infective drugs were changed to an IV infusion of tigecycline 50 mg twice daily. On day 9 of tigecycline treatment, the patient had sudden cold sweats and palpitations with fatigue, dizziness, and hunger. The peripheral blood glucose level was 2.0 mmol/L. An intravenous injection of 50% glucose was given and the blood glucose increased to 5.8 mmol/L. The patient had no history of diabetes mellitus, it was considered that hypoglycemia was related to tigecycline. Then tigecycline was discontinued and replaced by oral rifampicin 0.45 g thrice daily and an IV infusion of vancomycin 500 mg dissolved in 0.9% sodium chloride injection 100 ml once every 12 hours. Three days after tigecycline withdrawal, the patient′s blood glucose level was 3.0 mmol/L at dawn. Intravenous and oral glucose supplementation treatments were continued, and 19 days later, the patient′s fasting blood glucose level was 4.8-6.3 mmol/L.

A 78-year-old male patient with peritoneal dialysis received Juhong Tanke (橘红痰咳液) solution 10 ml thrice daily and 4 Jinqiaomai tablets (金荞麦片) thrice daily orally because of cough at night for 3 weeks(conventional abdominal dialysis maintenance treatment was given according to the original schedule). On day 5 of treatments, the peritoneal exudate was turbid. Laboratory tests showed white blood cell count (WBC) 1.1×10 9/L, neutrophils 0.65, hemoglobin (Hb) 105 g/L, platelet count (PLT) 90×10 9/L, high sensitivity C-reactive protein 26.9 mg/L, and procalcitonin 10.89 mg/L; the examination for exudate showed WBC 13 131×10 6/L and neutrophils 0.96. Acute diffuse peritonitis was diagnosed. Meropenem, moxifloxacin, norvancomycin, vancomycin, and linezolid were given successively along with the peritoneal dialysis, the infection was still not well controlled, and then the anti-infective drugs were changed to an IV infusion of tigecycline 50 mg twice daily. On day 9 of tigecycline treatment, the patient had sudden cold sweats and palpitations with fatigue, dizziness, and hunger. The peripheral blood glucose level was 2.0 mmol/L. An intravenous injection of 50% glucose was given and the blood glucose increased to 5.8 mmol/L. The patient had no history of diabetes mellitus, it was considered that hypoglycemia was related to tigecycline. Then tigecycline was discontinued and replaced by oral rifampicin 0.45 g thrice daily and an IV infusion of vancomycin 500 mg dissolved in 0.9% sodium chloride injection 100 ml once every 12 hours. Three days after tigecycline withdrawal, the patient′s blood glucose level was 3.0 mmol/L at dawn. Intravenous and oral glucose supplementation treatments were continued, and 19 days later, the patient′s fasting blood glucose level was 4.8-6.3 mmol/L.

Adaptation, Physiological ; Adenosine Monophosphate ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Administration, Intranasal ; Alanine ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Animals ; Betacoronavirus ; genetics ; physiology ; Chlorocebus aethiops ; Coronavirus Infections ; drug therapy ; virology ; Disease Models, Animal ; Female ; Host Specificity ; genetics ; Lung ; pathology ; virology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mutation, Missense ; Nasal Mucosa ; virology ; Pandemics ; Pneumonia, Viral ; drug therapy ; virology ; RNA, Viral ; administration & dosage ; genetics ; Turbinates ; virology ; Vero Cells ; Viral Load ; Virus Replication

Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection.Methods The culprit medication for drug eruption was identified by reviewing the patient′s liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments.Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway.Results The rash was poorly controlled after clinical pharmacist′s initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral).The clinical pharmacist further suggested dexamethasone intravenous drip.The patient recovered well with the combination therapy of antihistamines and glucocorticoid.Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient′s disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

Objective To improve the rational use of angiotensin-converting enzyme inhibitors (ACEI).Methods Clinical pharmacists reviewed ACEI use for the patients admitted into coronary heart disease care unit (CCU) during May 2012 to May 2013 to analyze the rational use of ACEI according to the expert consensus standards, guidelines and drug instructions of ACEI without any interventions.Clinical pharmacists intervened the irrational use of ACEI based on the same standard from June 2013 to May 2015.Results By comparing the data before and after intervention, it was found that the percentage of ACEI use increased from 80.1％ to 98.9％.The percentage of initial ACEI overdose was dropped from 21.4％ to 0.9％, and the percentage of under dose was decreased from 4.7％ to 0.5％, which was statistically significant.Conclusion Clinical pharmacists can play a leading role in promoting the rational use of ACEI.

OBJECTIVE:To investigate the consumption of drugs after the inplementation of total cost prospective payment sys-tem(PPS),and to provide reference for hospital drug cost control. METHODS:The data of prescriptions collected from 9 hospital during 2007-2014 were divided into group A,B and C according to PPS,and then summarized statistically in respects of increase rate of total consumption sum,consumption sum ratio of major category;the drug cost per time of outpatient department,emergen-cy department and inpatient department were calculated as well as consumption sum ratio of self-paid drugs;the dosage per time of drugs in blood pressure and diabetes prescription were also calculated. RESULTS:The total consumption sum of drug increased slowly after the implementation of total cost PPS;the consumption sum ratio of major category kept stable,while that of anti-infec-tive agent decreased;the emergency drug cost per time achieved a negative growth,and outpatient and inpatient drug cost per time increased slightly. The proportion of self-paid drugs was relatively stable. The dosage per time of drugs in hypertension and diabetes prescriptions was stable,too. CONCLUSIONS:Total cost PPS is useful in controlling the rapid growth of drug costs,and promote the reasonable drug use. The consumption sum of self-paid drugs are well controlled. The increase of drug cost per time in outpa-tient and inpatient should arouse the attention of the relevant departments. In addition,it has no effect on drug dosage for the pa-tients with hypertension and diabetes.

Objective The aim of the study is to evaluate clinical efficacy and safety of azatreonam or ceftazidime on treatment of lower respiratory tract infection .Methods Four English databases (MEDLINE、EMBASE、Pubmed、Cochrane li‐brary) and three Chinese databases (CNKI、VIP、WANFANG) were searched .Meta‐analysis was performed using Review Manager 5 .2 .Results The Meta‐analysis revealed azatreonam was superior to ceftazidime in total efficiency (RR=1 .15 ,95%CI is 1 .09‐1 .21) .No significant differences are seen between azatreonam and ceftazidime (RR=1 .03 ,95% CI is 0 .98‐1 .09) on the bacterial eradication rates or the incidence of adverse reactions (RR=0 .66 ,95% CI is 0 .39‐1 .12) .Conclusion Azatreonam is more effective than ceftazidime on the treatment of lower respiratory tract infection in the clinical practice .