OBJECTIVE To provide reference for improving the pre-prescription review system and reducing the occurrence of medication error by analyzing the drug-related problems （DRPs） in the pre-prescription review orders of pediatric outpatient clinics using the Pharmaceutical Care Network Europe （PCNE） classification system. METHODS The data of pre-prescription review orders were retrospectively collected from outpatient department of Shanghai Children’s Medical Center， Shanghai Jiao Tong University School of Medicine from July 2022 to June 2023； DRPs in the pre-prescription review orders were classified and summarized by using the PCNE classification system （version 9.1）， and then analyzed in terms of types and causes of issues， and the acceptance of interventions. RESULTS A total of 66 017 DRPs orders were included， involving 41 165 patients. The proportion of DRPs orders in children aged ≤5 years old was the highest （58.25%）， followed by children aged 6-12 years old （33.52%）； the department with the highest proportion of DRPs was internal medicine of pediatrics department （71.41%）； the department with the highest incidence of DRPs was thoracic surgery department （9.73%）； top three drug categories of DRPs orders were systemic anti- infective drugs （25.26%）， Chinese patent medicines （24.74%） and respiratory drugs （22.38%）. Referring to PCNE classification system， the types of DRPs mainly focused on treatment safety （64.86%）； the reasons of DRPs orders mainly focused on dose selection （82.09%）， of which 41.26% were due to excessive drug dosage； 92.13% of interventions could be accepted and fully executed by doctors. CONCLUSIONS DRPs orders identified by the pre-prescription review system can be effectively analyzed by using PCNE classification system. Pharmacists should focus on medication use in children aged ≤5 years old， update and develop personalized prescription review rules timely， and meet the rational needs of clinical medication for children.

Objective:To analyze the dosage distribution and the frequency of each dosage of high-risk tablets in the hospitalized patients in a children's hospital,and study whether the existing specifications of high-risk tablets meet the pediatrics clinical needs. Methods:All the prescriptions including high risk tablets were analyzed from 2014 to 2016 in Shanghai children's medical center. The frequency of every dosage of every drug was analyzed,and the current specifications were judged according to the frequency. New specifications were proposed when the existing specifications did not match the clinical needs. The new frequency of the proposed speci-fications was re-accounted for all the three-year prescriptions in order to evaluate whether the proposed new specifications met the clini-cal needs. Results:Among the five kinds of high-risk oral tablets,methotrexate tablets and vitamin A acid tablets were in accordance with the actual clinical requirements. Mercaptopurine tablets should add two specifications including 12.5 mg and 17 mg,and warfarin sodium tablets should add one specification(1.25 mg). Hydroxyurea tablets(250 mg) and warfarin sodium tablets(1 mg) were rec-ommended used in the children's hospital. Conclusion:The existing specifications of high-risk oral tablets can't fully meet the clini-cal needs,therefore,specifications still needs to be adjusted.

BACKGROUND:LL37, the only antimicrobial peptide of the cathelicidin family identified from the human, not only promotes the proliferation of endothelial cel s, but also plays an important role in angiogenesis and re-epithelialization.
OBJECTIVE:To construct a recombinant adenovirus overexpressing human antimicrobial peptide LL37 gene, and to detect the expression and secretion of LL37 after transfected into the canine vaginal epithelial cells.
METHODS:The cDNA encoding LL37 was amplified by PCR. Recombinant adenovirus expression plasmid encoding LL37 and green fluorescent protein (EGFP) was constructed, and identified using restriction endonuclease technology and DNA sequencing method. Adenovirus particles were generated by cotransfecting the 293-packaging cel line. The adenovirus were col ected, amplified and concentrated, and viral titers were determined by end-point dilution assay by applying serial dilutions of the purified viruses to 293 cel s. Primary cultured canine vaginal epithelial cel s were transfected by the recombinant adenovirus. The transfection efficacy was observed by fluorescence microscope, and the cultured supernatant was col ected to determine the expression of LL37 by ELISA method at 1, 2, 3, 5 and 7 days after transfection.
RESULTS AND CONCLUSION:The adenovirus vector GV314-LL37 with the titer of 3×109 pfu/mL was successful y constructed and identified by DNA sequencing methods. Canine vaginal epithelial cel s were successful y isolated and cultured and grew stably. After transfection, vaginal epithelial cel s could express the EGFP and LL37 efficiently in a time-dependent manner detected by fluorescence microscope and ELISA method. The transfection efficacy of EGFP reached to 89%at 72 hours. The level of LL37 in the cel culture supernatant in the transfection group was significantly higher than that in the control group, the highest expression of LL37 was found at 3 days that lasting for 7 days. In conclusion, the recombinant adenovirus overexpressing human antimicrobial peptide LL37 gene is successful y constructed, which can express and secrete LL37 after transfected into canine vaginal epithelial cel s, providing a foundation for constructing the tissue-engineered vagina possessing anti-infection and neovascularization.

Objective We investigated urinary incontinence (UI) among patients of the Gynecological Department of Renmin Hospital of Wuhan University,to observe characteristics of women with UI in our province,and to analyze preliminary factors affecting their treatment.Methods We evaluated 15 300 patients treated for UI from August 2009 to April 2011,using site information and questionnaires.We also compared them to 66 825 other gynecology outpatients at our hospital over the same period.Results We found that the incidence of UI tended to increase with age,and was associated with body mass index,parturition,and surgery history.But 54.63％ (8358/15 300) of them refused surgical treatment.Of these 8358 patients,29.78％ (2489/8358) because of economic factors,25.83％ (2159/8358) because of mental stress,and 24.30％ (2031/8358) because of lack of faith in the efficacy of surgical treatment,20.09％ (1679/8358) did so because of knowing little of the disease.Conclusions UI is inconvenient to patients,and seriously affects their physical and mental health. Many patients refuse surgical treatment.Medical staff should attempt to educate patients better with regard to treatment,and to offer them help to improve the quality of their lives.

Forty nine patients with vesicovaginal fistula underwent transvaginal repair by the use of Foley catheter in our hospital.The clinical data were retrospectively analyzed.The success rate of primary operation was 98% (2/49), the mean operation time was (85±8)min, the mean postoperative hospital stay was( 13±2) d, the rate of postoperative urine leakage was 2%(1/49), the mean bladder capacity was (378±53)ml.Transvaginal repair of vesicovaginal fistula by the use of Foley catheter is an effective surgical modality with satisfactory results.

This study investigated the anti-HSV-2 effect of alumen through in vitro and in vivo experiments.Viable cell counting was employed to assess the toxicity of alumen on Vero cells.The inhibition rate of HSV-2 was defined as the cytopathic effect (CPE) of the cells infected with the virus.Alumen suppositories of different concentrations were vaginally applied to the guinea pigs which were then infected with HSV-2 via a vaginal route.The clinical symptoms were observed and the local virus titer calculated.The results showed that alumen had an in vitro anti-HSV-2 effect by means of antiviral duplication,direct killing of the virus,and antiviral adsorption.Alumen suppositories of different concentrations could reduce or completely inhibit HSV-2 infection in guinea pigs.It was concluded that alumen had an in vitro anti-HSV-2 effect through multiple approaches and it could suppress in vivo vaginal HSV-2 infection of guinea pig to some extent.

This study investigated the anti-HSV-2 effect of alumen through in vitro and in vivo experiments. Viable cell counting was employed to assess the toxicity of alumen on Vero cells. The inhibition rate of HSV-2 was defined as the cytopathic effect (CPE) of the cells infected with the virus. Alumen suppositories of different concentrations were vaginally applied to the guinea pigs which were then infected with HSV-2 via a vaginal route. The clinical symptoms were observed and the local virus titer calculated. The results showed that alumen had an in vitro anti-HSV-2 effect by means of antiviral duplication, direct killing of the virus, and antiviral adsorption. Alumen suppositories of different concentrations could reduce or completely inhibit HSV-2 infection in guinea pigs. It was concluded that alumen had an in vitro anti-HSV-2 effect through multiple approaches and it could suppress in vivo vaginal HSV-2 infection of guinea pig to some extent.

Objective To explore the perfect operation method for patients with vaginal vault prolapse.Methods Twenty six patients with vaginal vault prolapse who underwent transvaginal mesh repair by Prolift from January 2008 to June 2010 were analyzed retrospectively.Results The interval time between the first operation and this morbidity of ten patients who had underwent total hysterectomy for none FPFD ( ie:hysteromyoma et al) was ( 115.2 ±51.67) months,but the interval of sixteen patients who had underwent traditional repair operation (ie:transvaginal hysteromyoma and/or colporrhaphia anterior-posterior) for FPFD was (24.38 ± 13.43) months,which was markedly shorter ( t =6.75,P ＜0.01).The interval time between the first operation and the 2nd operation of the ten patients was ( 142.8 ±59.04) months,but that of the sixteen patients was (62.13 ± 44.51 ) months,which was significantly shorter ( t =3.97,P ＜0.01 ).Their age and POP-Q staging had no difference ( P ＞0.05).All operations were successfully performed by one gynecologist.The average operation time was ( 60.96 ± 7.88 ) minutes,the average blood loss was ( 119.23 ±27.53) ml,and there was no concomitant injury.All patients were followed up of 3 ～24 months.No vaginal erosion and prolapse recurrence happened,and the cure rate was 100％.Conclusions The Prolift system appeared to be a relatively safe and effective alternative to conventional surgeries for the treatment of vaginal vault prolapse.However,long-term follow-up still need to be performed.

The clinical data of 42 patients with pelvic organ prolapse, who underwent laparoscopic sacral colpopexy using prolene meshes were retrospectively reviewed. During the operation prolene meshes were placed in the rectovaginal septum and vesicovaginal septum ,and the uterus was preserved in all cases.The mean operation time was (92 ± 12)min and the mean blood loss during the operation was (98 ± 11 )ml.Postoperatively, both prolapse and symptoms were significantly improved ( P ＜0. 01 ) according to the pelvic organ prolapse quantification (POP-Q) system. The operation is an effective and minimally invasive new technique which offers a chance for patients with pelvic organ prolaps who desire to preserve uterus.

Objective:To explore the effect and mechanism of Xinfuning( recombinant human α-2b interferon capsule for vaginal foams) on the clearance of human papilloma virus (HPV). Methods: The patients with HPV infection were divided into experimental group (Xinfuning group) and control group (Shurunshuan group, a common recombinant human interferon α-2b in suppository form) .The HPV negative conversion rate was compared between the two groups after action on vaginal posterior fomix. The content of cytokines IL-4, IL-10, IFN-γ, TNF-a in the cervical region before or after the application was detected by ELISA. Results:The negative conversion rate in the experimental group was higher than that in the control group ( P<0.05). The content of IL-4, IL-10 was decreased and the cont ent of IFN-γ,TNF-α was increased apparently( P < 0.05). Conclusions: Interferon has the effect on clearance of HPV infection by regulating Th1/Th2 balanced state to boost immunization and the unique preparation of Xinfuning can strengthen such function.