Cause analysis and prevention of drug shortage in medical institutions / 药学实践杂志

Objective To analyze the reason of drug shortages in medical institutions and take corresponding prevention measures to ensure drug supply .Methods The drug outbound orders in 2012 were retrospectively analyzed to trace the pro‐curement plan of badly‐needed drugs and the delivery time of supplier .Excel was used to carry out classification and statistics for the information of drug shortages combined with the explanations that the supplier failed to supply to summarize the exter‐nal cause and internal cause of drug shortages in medical institutions .Results In 2012 ,the dispensing department received a to‐tal of 46862 plans ,and 1423 items were badly‐needed drugs .The drug shortage rate was 3 .0% .643 times of drug shortages were caused by external causes which accountedfor 45 .2% of all the shortages ;780 times of the drug shortages were caused by internal causes which accounted for 54 .8% .Price inversion accounted for 40 .7% in the external causes that lead to the drug shortages ,and it was the top of the external causes for drug shortages .The low‐priced small varieties and generic drugs ac‐counted for 71 .2% of drug shortages caused by external causes;in the internal causes of drug shortages ,the inventory control accounted for 45 .0% ,ranked the first .Conclusion The scientific and reasonable drug price ,the improvement of bidding poli‐cy ,the joint effort of all parties of drug supply chain ,and the enhancement of the early warning and management of the badly‐needed drugs can reduce drug shortage .

Accuracy of remifentanil target-controlled infusion system in children / 中华麻醉学杂志

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients (aged 3-12 years and weighing 10-40 kg) scheduled for elective ear-nose-throat or urological surgery were randomly divided into two groups (n =15 each):2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ).Anesthesia was induced with intravenous injection of propofol 2 mg/kg and TCI of remifentanil.Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentration of remifentanil was set at 2 or 4 ng/ml.Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness.The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil,intravenous infusion of propofol and intermittent intravenous injection of boluses of vecuronium.The target plasma concentration of remifentanil remained unchanged and bispectraI index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 through adjusting the infusion rate of propofol.Arterial blood samples were taken at 5,10,20,30,40,50 and 60 minutes after TCI of remifentanil was started for determination of blood remifentanil concentrations by high performance liquid chromatography.Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated.Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations jn both groups (P ＜ 0.05).The MDPE,MDAPE and wobble were 20.0％,30.0％ and 25.0％ respectively in group Ⅰ,and 17.5％,17.5％ and 12.5％ respectively in group Ⅱ.The MDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ (P ＜ 0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old,the accuracy is not high.

Accuracy of remifentanil target-controlled infusion system in children / 中华麻醉学杂志

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients, aged 3-12 yr, weighing 10-40 kg, scheduled for elective ear-nosethroat or urological surgery, were randomly divided into 2 groups with 15 patients in each group:2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ). Anesthesia was induced with iv injection of propofol 2 mg/kg and TCI of remifentanil. Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentrations of remifentanil were set at 2 or 4 ng/ml. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness. The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil, iv infusion of propofol and intermittent iv boluses of vecuronium. The target plasma concentration of remifentanil remained unchanged and bispectral index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 by adusting the infusion rate of propofol.Arterial blood samples were taken at 5, 10, 20, 30, 40, 50 and 60 min after TCI remifentanil was stared for determination of blood remifentanil concentrations by high performance liquid chromatography. Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated. Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations in both groups (P＜0.05). The MDPE, MDAPE and wobble were 20.0% , 30.0% and 25.0% respectively in group Ⅰ , and 17.5%, 17.5% and 12.5% respectively in group Ⅱ . TheMDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ(P＜0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old, the accuracy is not high.

Effect of berberine on expression of transforming growth factor-beta1 and type IV collagen proteins in mesangial cells of diabetic rats with nephropathy / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the effect and mechanism of berberine on diabetic nephropathy in experimental rats.</p><p><b>METHOD</b>The rat model of diabetic nephropathy was induced by injection of streptozocin (STZ). The rats were divided into 6 groups: control group, model group, 3 berberine treatment groups and Xiaoke Wan (XKW) treatment group. The fasting blood glucose (FBG), kidney weight/body weight (KW/BW), blood urea nitrogen (BUN), creatinine (Cr) and urinary protein (Upro) were tested 8 weeks later. The expression of transforming growth factor-beta1 (TGF-beta1) and type IV collagen (IV-C) proteins in renal tissue of diabetic rats with nephropathy were observed by optical micrography.</p><p><b>RESULT</b>Berberine could reduce the levels of FBG, KW/BW, BUN, Cr, Upro and the expression of TGF-beta1 and IV-C proteins in renal tissue of diabetic rats with nephropathy.</p><p><b>CONCLUSION</b>Berberine may protect renal function and slow down the progression of diabetic nephropathy in rats by suppressing the expression of TGF-beta1 and IV-C proteins in renal tissue.</p>

Improvement of the Determination Method of Main Component in Lincomycin Hydrochloride Eye Drops / 中国药房

OBJECTIVE:To improve the determination method for lincomycin hydrochloride eye drops so as to eliminate the interference of the bacterial inhibitor ethylparaben on the content of the main component.METHODS:The determination was performed by HPLC with phosphoric buffer (pH 6.8)-methanol (40∶ 60) as the mobile phase replacing the mobile phase of borax buffer (pH6.0)-methanol (4∶6) recommend in state chemicals standard technique (Method A).The contents of ethylparaben-contained sample and ethylparaben-free sample determined by HPLC were compared with those determined by Method A.RESULTS:There was no significant difference in the content of ethylparaben-free sample between the two determination methods,but the content of ethylparaben-contained sample determined by Method A was higher than both the labeled amount and that determined by the improved method.CONCLUSION:The improved method is applicable for the content determination of lincomycin hydrochloride eye drops.

Study on Extraction Technology of Berberine from Rhizoma Coptidis by the Method of Orthogonal-test Optimization / 中国药房

OBJECTIVE:To optimize the extraction technology of berberine from Rhizoma Coptidis.METHODS:The or?thogonal-test method was adopted to research the effects of5factors,including the concentration and volume of alcohol,the concentration of H 2 SO 4 ,the duration and times of extraction on the yielding rate of berberine from Rhizoma Coptidis.RESUL TS:The optimum technology of extracting berberine from Rhizoma Coptidis was described as follows:The concentration of al?cohol containing0.25%H 2 SO 4 was80%,and volume of alcohol was6times raw herb.To extract the herb for3times was optimum and duration of extraction was1.5h for each time.CONCLUSION:The content of berberine in the product is over90%,so this technology is suitable for industrialized production.