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.

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 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 .

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:To analyze the intervention effect of a successfully created platform“intelligent interactive software for drug monitoring warning” on the decrease of medication errors and adverse drug events,and the increase of the drug treatment level. Meth-ods:The intensive care unit ( ICU) of our hospital was selected as the experiment group, and the ICU of the other two hospitals was used as the contrast group. During the first 18 months, both groups were without intervention. During the latter 18 months, the plat-form was used in the experiment group, and the clinical pharmacists employed alerts of the system in the practice of interaction with doctors to correct the medication errors. No intervention was performed in the contrast group. In addition, all adverse drug events in both groups were surveyed. Results:During the first period, 50 preventable adverse drug events were discovered with the incidence of 6. 8% in the experimental group. During the second period, the correct rate of the alerts was 97. 7%. Through the effective interven-tion,the alerts and their percentage in the prescriptions were from the maximum of 68 and 1. 1% to the minimum of 6 and 0. 1%. To-tally 17 preventable adverse drug events were found with the incidence of 2. 4% after the intervention. The decline was significant, 848 991 yuan of hospitalization expenses was saved, and 294 days of the length of stay were shortened. There was no change in the contrast group, and there was no change in unpreventable adverse drug events in the two groups before and after the intervention. Conclusion:The intelligent interactive software for drug monitoring warning can examine many sorts of medication errors,and decline the inci-dence rate of preventable adverse drug events in ICU. However, it needs to continuously improve the intelligence. Clinical pharmacists need to master the relevant conditions of patients to detect the irrational drug use based on the clinical practice for each patient.

Objective To observe the effect of leukocytapheresis(LCAP)on the coagulation,fibrinolysis system and lung injury in the endotoxemia dog and explore the mechanism in the endotoxin-induced lung injury dog. Methods Endotoxemia-induced model in dogs was established by administration of lipopolysaccharide(LPS,2 mg/kg).Separation of the leucocytes wag performed with the automated continuous flow blood cell separators.A total of 30 male mongrel dogs were randomly divided into LPS group(group L,only injected with LPS,with no LCAP),sham LCAP group(group S,received sham LCAP at 12-14 hours after administration of LPS)and LCAP treatment group(group T,received LCAP at 12-14 hours after administration of LPS),10 dogs per group.The dynamic changes of the activated protein C(APC),soluble thrombomodulin and plagminogen activator inhibitor-1 in the serum were measured at 0 hour before LPS administration,at 2,6,12,14,16,24 and 36 hours after administration of LPS.Results Through LCAP,there found the following four results:(1) the APC level in the serum of the group T wag(50.805±4.422)μg/ml and(40.480±2.993)μg/ml at 14 hours and 16 hours respectively,which were significantly higher than(45.881±4.024)μml and(35.935±4.057)μg/ml in the group L(P<0.05).(2)The expressions of soluble thrombomadulin in the group T was (9.688±O.914)μml and(10.492±O.865)μg/ml at 14 hours and 16 hours respectively,which was statistically lower than(11.005±0.854)μg/ml and(12.04±0.954)ug/ml in the group L(P<0.05).(3)Thelevel of plagminogen activatorinhibitor-1 in the group T was lower than that in the group the group T Wag statistically lower than that in the group L(ALI/ARDS occurred in 2 and 7 dogs of the groups T and L respectively within 36 hours after infusion of LPS.P<0.05). Conclusions At the decrease the incidence of acute lung injury partly due to its role in improving the function of coagulation and fibrinolysis.