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OBJECTIVE To establish a method for simultaneous determination of two third-generation anti-epileptic medicines such as lacosamide and perampanel in human plasma and apply this method in clinical practice. METHODS Using clozapine as internal standard， the concentrations of lacosamide and perampanel of plasma samples in 10 epileptic patients were determined by LC-MS/MS after protein precipitation with acetonitrile and dilution with acetonitrile-water （20∶80，V/V）， and the plasma minimum concentrations were obtained by dilution of multiple. The determination was performed on Welch Ultimate XB-C18 column， with mobile phase A consisted of 10 mmol/L ammonium formate and mobile phase B consisted of methanol-acetonitrile-isopropanol （0.2% formic acid） mixed solution （7∶1.5∶1.5， V/V/V） for gradient elution at the flow rate of 0.4 mL/min. The column temperature was set at 40 ℃ ， and the sample size was 5 μL. The electrospray ion source and multi-reaction monitoring mode were used for positive iron scanning. The ion pair used for quantitative analysis of lacosamide， perampanel and internal standard were m/z 251.2→ 144.1， m/z 350.2→219.2 and m/z 327.2→270.0， respectively. RESULTS The linear ranges of lacosamide and perampanel were 0.001 25-0.125 μg/mL（r＞0.99）， 0.037 5-3.75 ng/mL （r＞0.99）； the limits of quantification were 0.001 25 μg/mL and 0.037 5 ng/mL， respectively. The precision and accuracy within and between batches， extraction recovery rate， matrix effect， and stability all met relevant requirements. The minimum concentrations of lacosamide in No. 1-5 patients were 5.3-12.2 μg/mL， and the minimum concentrations of perampanel in No.6-10 patients were 208-510 ng/mL， respectively. CONCLUSIONS The established method is simple， rapid and suitable for the therapeutic drug monitoring of lacosamide and perampanel.
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OBJECTIVE To sum marize the pro cedure and informatization construction of centralized volume-based procurement（VBP）in our hospital ，in order to give references for normal development of centralized VBP. METHODS The standardized workflow system was established ，including using flow chart method to establish standardized workflow ，carrying out procedure training and inspection of procedure implementation ， and continuously conducting procedure optimization. The information system was developed for the task links that needed a lot of calculation to improve the automation level of information processing. RESULTS & CONCLUSIONS Eight specific work procedures were established in our hospital ，including the work procedures of submitting the demand data of centralized VBP and the implementation of centralized VBP ，and has taken measures such as procedure training ，establishing supervision and inspection system and using auxiliary means to promote the implementation of the procedure ，so as to optimize the procedure and work form. An informatization platform for the clinical task allocation of the agreed purchase quantity of centralized VBP and a supervision platform for the daily use of VBP were also established in our hospital，then the two tasks with a large amount of calculation could be finished. Standardized workflow system and informatization platform construction has improved the operation and supervision efficiency of centralized VBP in our hospital ，ensured the completion of centralized purchase tasks and saved human resources ，which has a certain promotion value.
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Centralized drug procurement in large quantities is a major step to deepen the medical and healthcare system reform, to improve the mechanism of drug price formation, and to give full play to the role of medical insurance in guiding drug prices in China. Combined with the practice of centralized drug purchasing in public hospitals, the authors sorted out the practical problems and causes from four aspects which affected the implementation of centralized drug purchasing policy in public hospitals: selection on centrally purchased drugs, procurement and supply, clinical use, and hospital financial operation. On this basis, suggestions were put forward to provide reference for the normalization of centralized drug procurement work, such as coordinating national and regional drug collection policies, reasonably setting distribution costs, extending the agreed procurement period, and carrying out special evaluation for drug collection.
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After the outbreak of COVID-19, due to environmental pollution in the isolated ward and operational constraints caused by protective clothing and other factors, intravenous drugs in the designated hospitals should be centralized. Combined with the existing process mode, the process of pharmacy intravenous admixture services was optimized, the operation mode of the operation platform was adjusted, the scheduling mechanism was optimized, and the node control process of " first verify and five checks" was explored and developed, so as to meet the 24 h needs of COVID-19 patients. According to the characteristics of COVID-19 drug treatment, the focus of prescription review was adjusted to ensure the drug safety of patients. Other measures included implementing paperless prescription to reduce unnecessary media; implementing segmented infusion distribution management to ensure no cross infection; hierarchical control and configuration environment, strengthening the protection and management of pharmacists, to avoid the risk of personnel infection; optimizing human resource allocation and improving work efficiency. This process reengineering and optimization established the emergency management mode of centralized intravenous drug deployment under the background of COVID-19, which ensured the intravenous drug demand and safety of COVID-19 patients. The treatment work was carried out orderly, and could provide reference for the pharmaceutical department in medical institutions to deal with major public health emergencies in the future.
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In designated hospitals for critical patients with COVID-19 in Wuhan, time-efficient pharmaceutical emergency protection system was of great significance for epidemic prevention. Described in the paper are measures taken by the pharmaceutical department of the hospital as follows. These measures include launching an emergency response mechanism, formulating a catalogue of COVID-19 key therapeutic drugs, urgently purchasing therapeutic drugs, transforming the processes of emergency pharmacy, establishing a drug donation management system, building a COVID-19 pharmaceutical care team, and setting up a " cloud pharmacy" to meet the drug needs of patients with non-COVID-19 chronic diseases, in addition to strengthening personnel protection of pharmacists. During such an epidemic, the pharmacy administration works in a professional, comprehensive, complex and systematic emergency program, which guaranteed the safety of drug supply, medication and enabled the treatment to be carried out in an orderly manner.
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Objective Supramolecular hydrogels were the hydrogels consisting of a solid 3D network with noncovalent bonds.Its unique properties such as biocompatibility,biodegradability,free sol-gel transformation and stable drug release ability make it widely exploited for various biomedical applications.This paper mainly focused on the use of supramolecular hydrogels in all types of biomedical application such as biosensor,cell culture,tissue engineering,gene engineering and drug delivery by research literature reviews.They hope that this focus review will contribute topromote the use of supramolecular hydrogels.
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Objective:To investigate and analyze the influencing factors in the implementation of essential drugs in the medical in-stitutions in Hubei in order to provide reference for promoting the implementation of national essential drugs. Methods: The medical staff participating in the training class of clinical application guidelines and formulary of national essential drugs in Hubei (2014) was surveyed by a questionnaire to analyze and evaluate the statistical influencing factors in essential drugs implementation. Results: A-mong the factors affecting the implementation of essential drugs, the score of rational use was the highest (3. 86) followed by that of medicine quality, rational varieties of essential drugs, affordability and management system, and the factors with score below 3. 0 were pharmacy trusteeship and income of essential drugs in medical institutions. Conclusion: Based on the investigation and evaluation of influencing factors, the corresponding measures should be adopted, which can further improve the basic drug system and enhance the use effects of essential drugs.
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Objective To investigate current status of narcotic analgesic use in patients with cancer pain in our hospital, in order to promote the rationalization of prescribing narcotic drugs and the rational use of analgesics. Methods A total of 400 narcotic prescriptions ( 100 of outpatients and 300 of inpatients ) in Tongji hospital were randomly selected from March to May in 2014.Basic index and consumption of anesthetic drugs, money consumption distribution on different tumor types, and unreasonable prescription were analyzed. Results The overall prevalence of irrational prescriptions was 11. 00%, with 13.00% from inpatient and 10. 33% from outpatient, respectively. Reasons for irrational prescriptions mainly included vague instructions on dosage and administration, incomplete clinical diagnosis, lack of pharmacist check and inappropriate dosage. In the basic indexes, proportions of reasonable prescription and drugs within the national formulary were higher in the inpatient than in the outpatient service.The average money consumption of outpatient prescription was significantly higher than that of inpatient prescription.Most types of diagnosis were lung cancer in outpatient and inpatient departments, and total cost of lung cancer drugs was the highest.Morphine hydrochloride of outpatient had the highest average consumption, followed by codeine phosphate of the outpatient and the inpatient, and oxycodone hydrochloride controlled-release tablets cost more in inpatient. Conclusion The narcotic analgesic used in our hospital is basically rational. Most doctors prescribe according to the guidelines, but standardized training of prescription for cancer patients with pain medication needs to be strengthened, and supervision of narcotic analgesic medication should be enhanced.
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Objective:To investigate and evaluate the effect of antibacterial agents clinical use and management training for medi-cal institutions in Hubei province in order to promote rational antibacterial drug use. Methods:A questionnaire was designed, inclu-ding basic conception, medication principle, mechanism and medication feature etc. The data were studied by SPSS 13. 0 software to analyze the knowledge level of antibacterial agents in medical staffs. Results: Medical staffs had good acquisition in the knowledge points involved in choice questions. The correct percentage of each scoring in essay questions differed considerably within the range of 7. 88%-99. 01%. Management rules could be well understood, while the definition of antibacterial drugs and the difference between antibacterial drugs and antibiotics were paid little attention. Conclusion: The overall knowledge level of rational antibacterial agents use in the trainees is promising with comprehensive understand of the management rules. It's necessary to distinguish antibacterial a-gents from antibiotics more clearly.
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Objective To discuss the CT manifestations of renal leiomyosarcoma. Methods 9 cases of renal leiomyosarcoma proved by pathology were analyzed retrospectively. Results CT imaging showed homogeneous hyperattenuation in two cases. Heterogeneous in density with necrosis inside was observed on the CT scan in six cases. After contrast medium administration heterogeneous enhancement with cystic and necrotic areas could be revealed in all cases on both CT scan. Conclusion Large renal mass with intra-tumor necrosis,cystic and hemorrhagic change is the characteristic manifestations of renal leiomyosarcoma. But differential diagnosis from renal carcinoma by CT clinical setting is difficult before surgery, and final diagnosis should depend on pathology examination.
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Objective To study retrospectively X -ray manifestations of pulmonary injury due to acute ammonia intoxica. Methods Chest X-ray manifestations of 37 cases of pulmonary injury due to acute ammonia intoxica were analyzed, and one-year follow-up was performed. Results Early pulmonary injuries included lung marking increase, lobular, interstitial emphesema and pulmonary edema, and the symptoms at late stage consisted of CB, pulmonary interstitial fibrosis and bullae. Conclusion Pulmonary injury due to acute ammonia intoxica is irreversible.
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Objective To study the scan parameter of spiral CT angiography in aortic dissection.Methods 34 cases with aortic dissection successively underwent SCTA were studied retrospectively.The CT scan parameters,methods of posteriorimage treating were reviewed and analysed one by one.Results In 34 cases,32 cases were diagnosed as aortic dissection and classified correctly,in accordance with the result of operation and DSA,the quality of image was satisfied and the rate of success at least above 88.9%.The use of main scan parameters:(1)the ascend aortic dissection:slice thickness 4 mm,reconstruction interval 2 mm,pitch 1.25;tube current 175 mA;(2)involed in ascend,arch,descend and throacic aorta dissection:slice thickness 5 mm,reconstruction interval 2～3 mm,pitch 1.5;tube current 150 mA;(3)involved in abdominal aortic dissection:slice thickness 6～8 mm,reconstruction interval 2～3 mm,pitch 1.5 or 1.75;tube current 125 mA.The tube voltage all were 120 kV,the dosage of contrast media was 90～100 ml;the delayed scan time was choiced 20 second in throacic aortic and 25 second in abdominal aortic.The posterior image methods main used MPR,SSD,MIP and VR. Conclusion To set a sensible scaning plan,choose and match scan parameters properly according to the scaning length,can avoid the shortage of restrain SCTA scaning length and get satisfied image.
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Objective To study the diagnostic value of imageology for pyelic carcinoma.Methods The accuracy of qualitative diagnosis and sensitivity were analyzed by comparing various imaging examinations in 19 patients with pathologically proved pyelic carcinomas.Results Irregular filling defect and hydronephrosis were seen in the renal pelvis and calyces on intravenous pyelography(IVP).On CT scan,when the tumor was small,soft tissue mass was in the renal pelvis and the calyces.When the renal parenchyma involved by tumors,the soft tissue masses with unhomogeneous density,liquefaction necrosis in the renal pelvis and the parenchyma were seen.On contrast-enhanced CT scan,enhancement from slight to moderate was found in the lesion.The lesions were detected by IVP in 9/12 cases,by BUS in 10/16 cases,by CT in 18/19 cases and by MRI in 3/3 cases.Conclusion IVP and CT are the first method of choice to diagnose the pyelic carcinoma,BUS can be used as a screening method.While in evaluating the tumor involving the parenchyma of the ren or distant metastasis,CT and MRI are superior to IVP.
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Object To study the anti endotoxic effect of syringic acid (SA) which was isolated from Radix Isatidis (Banlangen in Chinese, BLG). Methods SA was extracted and isolated from BLG and made to 1% solution. The content of SA pretreated ET was quantitatively determined using Limulus Test. Then the ability of fever induction of endotoxin (ET) pretreated with SA was measured using endotoxin induced fever test in rabbits. At last, the lipopolysaccharide (LPS) induced death in mice pretreated with and without SA was compared. Results Being pretreated with SA, 83.16% ET was destroyed, the ET induced fever in rabbits relieved markedly and the LPS induced death rate in mice dropped from 68% to 20%. Conclusion SA isolated from BLG has anti endotoxic effects.