Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To explore the effect of rehabilitation nursing guided by precision nursing theory on the health belief and self-management behavior of patients with myocardial infarction after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 184 patients with myocardial infarction who received PCI treatment at Queshan County People's Hospital from January 2020 to January 2021 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, with 92 cases in each group. The control group was given routine postoperative nursing, while the observation group was given rehabilitation nursing guided by precise nursing. Health Belief Scale and Self-management Scale were used to evaluate the effect of intervention.Results:Repeated measures analysis of variance showed that total scores of health beliefs and self-management behavior of patients in two groups existed time, the interaction effect between groups, time and between groups ( P<0.05) . Conclusions:Rehabilitation nursing guided by precision nursing theory can improve the health belief level and self-management behavior of patients with myocardial infarction after PCI.

Objective:To investigate the clinical characteristics of pregnant women with leukemia, the condition of leukemia and the influence of clinical treatment on maternal and infant outcomes, and to explore the best clinical management method of leukemia in pregnancy.Methods:Among 79 890 pregnant and lying-in women in Qilu Hospital of Shandong University from January 2004 to December 2015, 22 cases (0.028%) were with leukemia, including 5 cases of leukemia diagnosed before pregnancy [all acute myeloid leukemia (AML)] and 17 cases of leukemia diagnosed for the first time after pregnancy [9 cases of AML, 5 cases of chronic myeloid leukemia (CML), 2 cases of acute lymphoblastic leukemia (ALL), and 1 case of chronic lymphocytic leukemia (CLL)]. According to the gestational weeks of admission and confirmed gestational weeks of leukemia, the 22 patients were divided into early-stage group (initial gestational week < 14 weeks, 5 cases), mid-stage group (newly diagnosed gestational week ≥ 14 weeks and < 28 weeks, 11 cases), and late-stage group (newly diagnosed gestational week ≥ 28 weeks, 6 cases, including 2 cases with previous diagnosis of leukemia). The final pregnancy outcomes included abortion, induced labor, premature delivery, full-term delivery and maternal and infant death. The effects of clinical treatment and obstetric treatment of leukemia on the final maternal and infant outcomes, follow-up to understand the progress of primary disease and fertility of pregnant women, and the impact of leukemia and pregnancy treatment on long-term health status of infants were analyzed.Results:Among 22 patients with leukemia in pregnancy, 14 cases (63.6%) (5 cases in early-stage group and 9 cases in mid-stage group) choosed to give up pregnancy, including 4 cases of early pregnancy abortion and 10 cases of mid pregnancy induced abortion; 12 cases of 14 cases were induced abortion or induced labor after leukemia remission induced by advanced chemotherapy. The remaining 8 patients (2 cases in mid-stage group and 6 cases in late-stage group) continued pregnancy and gave birth to live infants, of which 3 cases received chemotherapy before delivery.Conclusions:Gestational leukemia is a high-risk obstetric case, but it is still expected to achieve good pregnancy outcome under good management and treatment. On the basis of following the principles of leukemia treatment, according to the gestational weeks and patients' wishes, the individualized clinical management plan is formulated, and the accurate chemotherapy timing is conducive to the prognosis of mother and infant.

Objective: To improve the economic and technical indicator’s evaluation system and the essential medicines’ centralized bidding procurement practice in China. Methods:By using the literature analysis, comparative analysis and field survey, we collected and analyzed the implementation plans and regulations for the essential medicines’ centralized bidding procurement in 30 provinces. Results: The quality level classification lacks in preci-sion. The economic and technical indicator’s concentration grade is low, the score and content in each indicator un-reasonably fluctuates in different provinces and these indicators are of low efficiency in bond with their structures for the drug quality evaluation. The quality level indicator lacks in the distinction degree and the government’s unreason-able interference exists in competition. Conclusions and suggestions: The quality levels’ indicator type and number should be simplified. The economic and technical indicators’ function, content, score, weight value and the structure should be normatively and scientifically set to improve the efficiency during the drug quality evaluation and the gov-ernment should strive to play their role in the market.

Promoting equity and access to medicine is important to guarantee health equity. The international communities commonly guarantee equity and access to medicine through free pharmaceutical policy. In most coun-tries, free pharmaceutical policy covers patients who cannot afford, children under 5, pregnant women and elderly people. The free medicines include essential medicines, medicines for chronic and infectious diseases, vaccines, etc. Financing of free medicines comes from health insurance, direct government investment and international aid, and the medicine delivery mainly depends on the public medical institutions. Free pharmaceutical policy in China mainly refers to medicines for infectious diseases and vaccines, and the coverage is narrow. This paper argues that since China has been becoming one of the middle income countries, the amount of free medicines should be in-creased, especially for chronic diseases, such as diabetes, hypertension, etc. The equity and access to medicine in China should be further promoted by providing all essential medicines for free.

Objective:The paper aims to provide recommendations for improving the essential medicines’ cen-tralized bidding procurement and quantity-based pricing policy. Methods: Based on the documents and literature on essential medicines’ centralized bidding procurement, we analyzed the factors which have a great impact on implemen-tation of the quantity-based pricing in essential medicines’ centralized procurement using the text research, semi-structured interview questionnaire and on-phone interviews. Results:The quantity-based pricing needs to define a ge-neric name and specific dosage form of drugs in the essential medicines’ centralized procurement. Its implementation was mainly influenced by the following factors:the procurement area accessibility, the pharmaceuticals category, dis-ease and drug alternative procurement methods and cycle, the payment and settlement time, and irregularities in the procurement process. Suggestions:During this implementation, we also need to clearly predict the quantity and pro-curement method, set up a proper policy environment for a quantity-based pricing, cancel the price linkage mecha-nism, strictly put into practice the payment deadline, employ a unique billing method and strengthen the information construction for the provincial centralized procurement platform. Some medicines’ quantity-based pricing should be carried out in the chosen pilots for laying a good foundation for its promotion.

Objective:To improve the centralized bidding procurement practice of essential medicine in China. Methods:By using literature review, comparative analysis and field investigation, implementation plans and regula-tions of the centralized bidding procurement of essential medicines in 30 provinces were collected and analyzed. Re-sults:There are differences in the operating organization, scope of implementation, purchasing cycle, bidding pro-curement mode, judgment criteria and other aspects among provinces. Conclusion: The progress of the implementa-tion of the centralized bidding procurement practice of essential medicine under the request of Document No. 56 of the State Council differed greatly among the provinces. The government should adhere to the centralized bidding procure-ment practice of essential medicine, give full play to the advantages of group purchasing, explore approaches of medi-cal insurance institutions participating in the centralized bidding procurement practice, and perfect the assessment of drug quality to assure the quality of essential medicine.

Objective To decrease radiation induced toxicities especially mucostis in patients with locally advanced nasopharyngeal carcinoma( NPC ) who underwent concurrent radiochemotherapy, the maximum tolerated dose and dose limited toxicities of capecitabine combination with cisplatin were observed. Methods From Aug 2006 to Oct 2007, 24 patients with intensity modulated radiotherapy(IMRT) and concurrent chemotherapy with capecitabine and cisplatin for nasopharyngeal carcinoma(stages Ⅲ-Ⅳ) were enrolled in this study. There were four dose-level groups of Capecitabine[625-1250 mg/(m2 ·d) , d1-14]and fixed cisplatin dose[20 mg/(m ·d) ,d1-5) ]MRI and CT scan were used for evaluation of tumor shrinkage. Treatment related toxicities were evaluated according to the common toxicity criteria( NCI-CTC Version 3.0). Results The acute side-effects include Grade 3 or Grade 4 mucosal toxicity(lasting for at least 5 d) and Grade 3 or Grade 4 non-mucosal toxicity were evaluated. Group 625 mg/m2 and Group 825 mg/m2 had none, Group 1000 mg/m2 had 6 patients and Group 1250 mg/m2 had 3 patients for mucosal toxicity, which were the main dose-limited toxicity and relevant to the dose of capecitabine apparently( P < 0. 05 ). There was also a trend of increase by the dose level of capecitabine for other toxicities. The median follow-up time for all patients was 28. 5 months. The locoregional recurrence occurred in 2 patients and distant metastasis in 2 patients. Two-year overall survival rate and locoregional control rate were 100% and 91.7%, respectively.Complete response and partialresponse were found on MRI or CT scan in patients of 29. 2% at the end of treatment and 83. 3% after three months, respectively. Conclusions The combination regimen of capecitabine and cisplatin is safe and effective according to the preliminary result. Toxicities related to radiochemotherapy for NPC were significantly associated with the dose level of chemotherapy.

Objective: To investigate the reversal effects of pulsed magnetic fields(PMF) on the drug resistant cell line K562/ADR in vitro and their mechanism.Methods: MTT assay was used to determine the IC50 of ADR on K562/S and K562/ ADR cell lines,the detriment of PMF on the K562/ADR cell line and the reversal effects of the drug resistance after treatment with different frequencies of PMF.Flow cytometry(FCM) was applied to the assessment of concentration of intracellular ADR.Results: The drug-resistance multiple of the K562/ADR cell line was 29.36.PMF did not affect the growth of the K562/ADR cell line.Different frequencies of PMF produced different effects on the IC50 of the K562/ADR cell line.In the same condition,70Hz PMF produced the most significant effect and increasea the concentration of intracellular ADR.Conclusion: PMF can reverse the multidrug resistance of K562/ADR by enhancing the drug concentration in K562/ADR cells,and its frequency is correlated with its reversal effect:low fregucncy produces better effect.

OBJECTIVETo investigate the effect of second messengers protein kinase C (PKC) and inositol (1,4,5)-trisphosphate (IP(3)) during hypoxic-ischemic brain injury in neonatal rats.

METHODSThe protein concentration was determined by Lowry's method. PKC activity was measured by the incorporation of [gamma-32P] into a specific substrate peptide in the cytosol and particulate fraction, respectively. IP(3) was determined by the radioreceptor binding assay.

RESULTSCompared with the control, PKC activities in the particulate fractions in both the cerebral cortex and hippocampus decreased, while increased in the cytosol in cerebral cortex and remained within the normal range in the cytosol in the hippocampus at 0, 4, 12, 24, 48, 72 h, 7, and 14 d after hypoxic-ischemia for 20 min. All these changes restored to normal levels at 21 d post hypoxic-ischemia. Similarly, a decrease in IP(3) in the cerebral cortex and hippocampus and an increase in IP(3) in the thalamus after hypoxic-ischemia were noted, respectively. Changes in cytosolic PKC activity were not related to those of IP(3), as evaluated statistically.

CONCLUSIONHypoxia-ischemia induces disturbance of the second messengers IP(3) and PKC, which may play important roles in the pathogenesis of hypoxic-ischemic brain injury.

Animals ; Animals, Newborn ; Brain Ischemia ; etiology ; metabolism ; Female ; Hypoxia, Brain ; etiology ; metabolism ; Inositol 1,4,5-Trisphosphate ; physiology ; Male ; Protein Kinase C ; physiology ; Rats ; Rats, Wistar