Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective To analyze clinical characteristics of bloodstream infections caused by coagulase-negative Staphylococci (CNS) and antibiotic resistance of the bacteria,so that to provide basis for the clinical diagnosis and treatment.Methods A retrospective analysis of CNS in blood cultures collected from 108 hospitalized patients in Puai Hospital of Tongji Medical College from January 2016 to December 2017 was performed.The antimicrobial susceptibilities were tested by Kirby-Bauer method and E test method.For measurement variables,normally distributed variables were compared using t test,and non-normal distributed data were compared using Mann-Whitney U test.Categorical variables were compared using x2 test.Results Of the 108 patients,66 were male and 42 were female;the age range was 26 to 98 years and the average was 49 years.According to the criteria for bacteremia,36 of 108 (33.3％) patients with CNS-positive blood cultures were diagnosed with bacteremia and 72 (66.7％) cases were contaminated.CNS bacteremia mainly occurred in the intensive care unit and nephropathy ward.Among them,23 (62.2％) patients were catheter-related blood stream infections,and 11 (29.7 ％) patients were dialysis catheter-related bloodstream infections.Fifteen of 36 (41.7％) strains were isolated within 48 hours of admission.The level of serum procalcitonin (PCT) for bacteremia patients was 2.56 (1.44,7.60) μg/L,and that was 0.13 (0.05,0.23) μg/L in contaminated patients.The difference was statistically significant (Z=8.097,P＜0.05).The white blood cell count of patients with bacteremia was (11.50±4.54) × 109/L,and that was (10.61 ±5.00) × 109/L for contaminated patients.There was no statistical significance (t=0.895,P＞0.05).After antibiotic treatment,26 of 36 bacteremia patients were survived.The PCT levels before antibiotic treatment were 2.05 (1.42,4.32) μg/L,and 0.24 (0.07,0.61) μg/L after antibiotic treatment.Serum PCT was decreased significantly after antibiotic treatment (Z=4.457,P＜0.05).The PCT levels of 10 deaths within 28 days before antibiotic treatment were 4.78 (1.51,19.75) μg/L,whereas 22 (6.40,55.75) μg/L,after antibiotic treatment.The PCT was increased significantly after antibiotic treatment (Z=2.497,P＜0.05).No significant difference was found in PCT between survivors and deaths within 28 days (Z=0.300,P＞0.05).No significant difference was found in white blood cell count between survivors and deaths at 28 days (t=0.771,P＞0.05).There was no statistical difference of the anti-bacterial drug susceptibility between pathogens and contaminants (P＞0.05).All strains were sensitive to vancomycin,teicoplanin and linezolid.Conclusions The incidence of CNS contamination in blood culture is relatively high.It is important to distinguish true bacteraemia from contamination by a review of the clinical and laboratory indicators.PCT is of clinical value to indicate CNS infection and to monitor therapeutic effect.

Objective To explore the diagnostic efficacy of bronchoscopy combined with T-SPOT in tuber-culosis. Methods Totally 248 highly suspected tuberculosis patients were included from February 2015 to April 2016 in our department. According to the different sources of sputum specimens ,they were divided into control group,atomization group and bronchoscope group;Depending on the mode of examination,they were divided into bronchoscopy group,T-SPOT group,bronchoscopy+T-SPOT group.To compare anti-acid smear positive rate,tuber-culosis diagnosis and diagnostic efficacy in each group and safety of bronchoscopy. Results The rate of sputum specimens smear-positive was the highest(37.173%) in bronchoscopy.There were statistically significant of the three groups(P=0.001);The highest diagnostic rate of pulmonary tuberculosis was(92.670%)in Bronchoscopy+T-SPOT group,three groups were statistically significant(P=0.000). The specificity,sensitivity,positive predic-tive value,negative predictive value,positive likelihood ratio and Jorden index were highest in diagnosing tuberculo-sis of bronchoscopy+T-SPOT group ,negative likelihood ratio was lowest. There were Complications of three cases of bleeding,one case of pneumothorax,one case of arrhythmia in bronchoscopy group. Conclusion Bronchoscopy combined with T-SPOT can improve the diagnostic efficacy of tuberculosis ,safe and reliable.

OBJECTIVE:To study the chemical compositions of n-butabol extract from Solanum lyratum. METHODS:Glucan LH-20 column chromatography,silica gel column chromatography and TLC were adopted to separate and purity the chemical com-positions,physicochemical property and spectral evidence to identify their structures. RESULTS:Totally 10 chemical compositions were separated from n-butabol extract,namely apigenin-7-O-β-D-apiofuanosyl(1→2)-β-D-glucose (1),apigenin-7-O-β-D-glucose (2),adenosine(3),3-methoxy-4-hydroxy-5-[(8′S)-3′-methoxy-4′-hydroxyl-phenyl-alcohol]-E-cinnamic-phenylpropyl alcohol-4-O-β-D-glucoside (4),N-(4-amino-butyl)-3-(3-hydroxy-4-methoxy-phenyl)-E-acrylamide (5),N-(4-amino-butyl)-3-(3-hydroxy-4-me-thoxy-phenyl)-Z-acrylamide (6),resveratrol (7),naringenin (8),quercetin (9) and dioscin (10). CONCLUSIONS:Compound 1-8 are first separated from S. lyratum,the study can lay a foundation for quality evaluation of S. Lyratum.

Objective To investigate the level and influencing factors of caregivers′burden among primary caregivers of elderly stroke patients. Methods Totally 298 caregivers of elderly stroke patients were investigated with Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and Simplified Coping Style Questionnaire(SCSQ). The patients were investigated with Modified Barthel Index (MBI). Results The caregivers′burden was in the mild level with a total score of 35.21±11.45. The influencing factors were the number of days of care, daily caring hours, hospital anxiety and depression score, the coping style and the ability of patients to perform ADL. Conclusions The primary caregivers of stroke patients have mild burden. The nurses should be synchronized to assess the health of patients and primary caregivers at the same time, understand the caregivers′burden, and provide specific care advice, in order to reduce the burden of their carer, so as to improve the quality of patients′life.

Aim To investigate the effect of gelsemium alkaloids on chloride channels and cell volume in he-patic carcinoma cells. Methods The time-lapse live cell imaging and whole-cell patch clamp techniques were used respectively to detect the volume changes and currents induced by gelsemium alkaloids in HepG2 cells. Results It was found that the cell volume was decreased by (12. 48 ± 2. 2) % (P<0. 01) when ex-posed to gelsemium alkaloids for 50 min and this phe-nomenon could be inhibited by the chloride channel blocker tamoxifen. It was shown by whole-cell patch clamping that a chloride current could be evoked by extracellular application of gelsemium alkaloids ( 2μmol·L-1 ) . The current was outward-rectified with-out obvious voltage- and time-dependent inactivation. The reversal potential of the current was ( -3. 21 ± 0. 67) mV ,which was close to the equilibrium poten-tial of chloride. The extracellular application of the chloride blockers, tamoxifen and 5-notro-2-(3-phenyl-propylamino)benzoic acid (NPPB), and 47% hyper-tonic solution inhibited the current significantly ( P <0. 01 ) . Conclusion Gelsemium alkaloids could acti-vate chloride channels and induce a volume decrease ( named apoptotic volume decrease, AVD) , and these effect could be inhibited by chloride channel blockers. The results suggest that the chloride channel can be one of the targets of gelsemium alkaloids in their anti-cancer action.

Aim To clarify the effect of Borneol on the chloride channels and cell volume in poorly differentia-ted nasopharyngeal carcinoma CNE-2Z cells.Methods The technique of whole-cell patch clamp was used to detect the chloride currents and analyze the character-istics of the currents in CNE-2Z cells.The volume changes caused by Borneol were measured by the meth-od of time-lapse live cell imaging.Results The chlo-ride currents were induced by extracellular application of Borneol (20 μmol·L -1 )isotonic condition.The currents showed a characteristic of outward rectification and did not show voltage-dependent or time-dependent inactivation.The reversal potential of the currents was close to the CI-equilibrium potential. The currents were inhibited by the chloride channel blocker tamox-ifen.The currents were also inhibited by 47% hyper-tonic solution.Borneol decreased the cell volume by 9.4% in 30 min.Tamoxifen completely inhibited the Borneol-induced cell volume decrease.Conclusion Borneol can activate volume-sensitive chloride channels and induce volume decrease in CNE-2Z cells.Chloride channels play a pivotal role in the process of volume decrease caused by Borneol.

Objective To construct an index system of the performance appraisal to clinic nurses.Methods According to the BSC,KPI and SMART principal,we constructed the primary evaluation indexes.And then two rounds of Delphi consultation were conducted.Results An index system of the performance appraisal to clinic nurses was composed of 5 level-1 indexes,including 22 indexes.Conclusions The index system has high scientific nature and reliability to provide a theoretical basis for the performance appraisal to clinic nurses.

Objective To constmct the training system of specialized nurses in operation room.Methods The Delphi method was used to organize two rounds of consultations by 20 experts from July 1st to Nov.1st 2012.Results In the two rounds of expert consultations,experts' positive coefficients were 95％ and 100％,the authoritative coefficients of experts were 0.86 and 0.89.The evaluation system included 10 first level entries and 38 second-level entries,all entries' importance assignment was more than 4.0,all variable coefficients were less than 0.25.Conclusions The positivity and authority of experts in this study were in high degree,the concentration and harmonization of experts' opinions were relatively high,all entries' weight were relatively high.So the system has high scientific nature and reliability to provide a theoretical basis for specialized nurses in operation room.

OBJECTIVE: To determine the content of zinc in Mongolia patent drug Zhuangxiyin Powder. METHODS: Differential pulse stripping voltammetry was employed for measurement of zinc. RESULTS: The zinc content in three samples of the drug was (493+/-11.95)microg/g, (526+/-13.74)microg/g and (554+/-9.84) microg/g respectively, and the relative standard deviation (RSD) was 2.42%, 2.61% and 1.78% respectively. CONCLUSION: The content of zinc in Zhuangxiyin Powder of daily dosage is higher than the needed daily intake of healthy people.