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OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.
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Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.
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OBJECTIVE：To provide reference for improving the rationality of discharged prescriptions. METHODS：According to the prescriptions that were often judged as forbidden or not recommended （such as irrational dosage and course of treatment ， off-label drug use ，drug interaction ，medication suitability ，dosage form ） in the pre-audit system of discharged prescriptions （hereinafter referred to as the “audit system ”）of Union Hospital Affiliated to Fujian Medical University （hereinafter referred to as the“our hospital ”），combined with actual case analysis ，the clinical pharmacists looked for evidence-based evidence and evaluate it，communicated with the clinician for feedback ，maintained the content of misjudgment in the intercepted prescription in real time，set up the relevant rules of audit in the audit system ，evaluated the effect and put forward suggestions to improve the scientificity and accuracy of the audit results of the discharged prescription. RESULTS & CONCLUSIONS ：For prescriptions that were judged to be forbidden or not recommended by the system ，such as the limited daily dose of Morphine hydrochloride tablet in patients with cancer pain ，the daily maximum dose of calcium sulfate D 3 after thyoidetomy ，hyper-indication use of megestrol acetate after chemotherapy for rectal cancer ，off-label usage of vitamin B 6 after postpartum delivery ，the combined use of clopidogrel bisulfate and oxcarbazepine after intracranial infection ，clinical contraindication of enteral nutrition powder after intestinal obstruction ，unsuitable dose of Dabigatran ester capsule after atrial fibrillation surgery and so on ，the clinical pharmacist looked for evidence-based evidence ，evaluated and communicated with the clinician . The relevant rules were updated to the audit system in real time. On the whole ，the audit system improves the work efficiency and the scientificity and accuracy of the audit results，but it is necessary to improve the professional knowledge level of the pharmacists ，the ability to find and use evidence-based evidence ，the accuracy of the audit system and the acceptance and recognition of the audit results by doctors ，so as to enhance the rationality of the discharged prescription ，reduce medication security risks.
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Objective To investigate the performance of MicroScan WalkAway 96 Plus (MSW) system in detection of carbapenem-resistant Enterobacteriaceae (CRE).Methods A total of 81 stock CRE strains were used in this study. Bacterial identification and antimicrobial susceptibility test were performed by MSW system. Beta-lactamases genes blaKPC,blaIMP,blaVIM, blaOXA-48 and blaNDM were amplified by PCR and subjected to sequencing analysis. Disk diffusion method and PCR were used as gold standard to evaluate the performance and reliability of MSW system in identifying carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.Results Overall, 69.1 % (56/81) of the Enterobacteriaceae strains were identified as CRE by the MSW system. The results of PCR showed that 48 strains were carbapenemase-producing Enterobacteriaceae. When carbapenemase-producing Enterobacteriaceae strains were identified by the instrument using an advanced expert system, the sensitivity was 93.8 % and specificity was 42.4 %. The positive predictive value was 70.3 %, the negative predictive value was 82.4 % and the predictive accuracy value was 72.8 %.Conclusions The MicroScan WalkAway 96 Plus system has shown good performance in detection of CRE.
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OBJECTIVE:To study the excitation mechanisms to clinical pharmacists at present in the hope of promoting clinical pharmacy.METHODS:Maslow's hierarchy of needs was introduced to study the psychological state of clinical phar-macists.RESULTS:The results showed that the needs of clinical pharmacists at 5 levels failed to be satisfied at present,which was one of the negative factors resulting in slow development of clinical pharmacy.CONCLUSION:Hierarchy of needs should be applied and effective measures should be taken to encourage clinical pharmacists and give free rein to their activity.
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OBJECTIVE:To improve the rational use of antibiotics,and to reduce the incidence of adverse drug reactions and the waste of medical resources.METHODS:Multiple intervention measures were taken to promote the rational use of an?tibacterials.RESULTS&CONCLUSION:The measures were effective.Rational use of antibacterials is a integrated and comprehensive mechanics,in which the department of pharmacy should play its role as a wise regulator,active participant,coordinator and communicator.
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OBJECTIVE:To discuss measures taken to improve the auditing quality of the electronic prescriptions.METHODS:The problematic prescriptions in our hospital audited from June,2002to June,2004were analyzed statistically.RESULTS:Of the total audited621092prescriptions,8542were problematic prescriptions,which made up1.4%.Of the total problematic prescriptions,6749involved obvious misinput,which accounted for79%;1281involved overmaximal doses of narcotic drugs and psychotropic substances,which accounted for15%;427involved misinput of penicillins,which accounted for5%;85involved irrational prescriptions,which accounted for1%.CONCLUSION:The auditing quality of the electronic prescriptions can be improved through measures like improving the electronic prescription auditing system,enhancing pharmacist auditors'general quality,etc.
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OBJECTIVE:To prepare warfarin sodium granules(WSG)and to establish it’s quality control methods .METHO_DS:To prepare WSG with part.aeq.geometric method,to optimize the amounts of all sorts of agents in the formulation in terms of dissolution time and abilityof WSG by orthogonal experiment.To determin the content of WS by UV. RESULTS:The formulation was designed and optimized,the WSG’s size were evenly.The concentration of WS was linear within the range of 5.92～17.86?g/ml with r=0.9 998(n=7),the average recovery rate was 101.26%～101.84%(n=5)with the RSD lower than 1.0%.The solution dissolved by granules is stable within 10 days.CONCLUSIONS:The preparation method is simple and feasible,the content determination methods is accurate,realible and sensitive,suitable for the quality control of WSG.The dissolved solution can be divided in accurate doses.