Dose estimation in etiology of occupational radiogenic neoplasms: A case analysis / 中国辐射卫生

Objective To analyze the problems and solutions in the diagnosis of a patient with occupational radiogenic neoplasms. Methods The dose conversion method was selected in dose estimation. Personal dose equivalent, skin absorbed dose, and reported detection data were converted into red bone marrow absorbed dose. The upper 95% confidence limit of the probability of causation (PC 95%) was calculated. Results The PC 95% of cancer due to radiation in the worker was 66.38%, which suggested occupational radiogenic neoplasms. Personal dose data were missing in dose estimation. The current dose estimation standard lacked bedside radiography and CT operation type, and the dose conversion formula was not perfect. Conclusion In the judgment of occupational radiogenic neoplasms, the estimated dose showed uncertainty. There is an urgent need to formulate and promulgate dose estimation standards that are operational and in line with the current development of radiological diagnosis and treatment technology and equipment.

Exploring the Accessibility by Using the Hydroxycobalamin Preparations of High Concentration in Treating Methylmalonic Acidemia / 罕见病研究

Methylmalonic acidemia(MMA) is one of the common diseases in hereditary organic acid metabolism disorder. The disorder is mainly treated by using vitamin B12 which comes in various forms.The use of the methylcobalamin and adenosylcobalamin in China cannot meet the needs of children with MMA. Parenteral use of hydroxocobalamin of high concentration has significant advantages in the treatment of MMA. But, the accessibility to hydroxocobalamin is challenging now.Through the supervision and adjustment of hydroxocobalamin, we explored the strategy of using the drugs. Meanwhile, we are considering the oral use of the hydroxocobalamin as supplement to treatment. Solving the challenges of the hydrococobalamin is helpful to meet the treatment of MMA and to provide a new possibility for the use of medication for rare diseases. The improvement in policy and supervision measures will facilitate the development, involvement, and production of hydroxocobalamin, so that the patients will have a good chance of access to the treatment.

Psychological Status and Influencing Factors of Staff at Centers for Disease Control and Prevention in Sichuan Province during the Outbreak of Coronavirus Disease 2019 / 中国医学科学院学报

Objective To assess the psychological status of staff at the centers for disease control and prevention(CDC) in Sichuan during the outbreak of coronavirus disease 2019(COVID-19) and explore the influencing factors. Methods The staff at Sichuan provincial,municipal,and county(district)-level CDC were selected by convenience sampling.Their basic information,work status,training status,work difficulties,and support from the work group were collected from the self-filled questionnaires online.The Generalized Anxiety Disorder Scale and the 9-question Patient Health Questionnaire were respectively employed to measure the anxiety and depression of the staff.The stepwise Logistic regression was carried out to analyze the influencing factors of anxiety and depression in CDC staff. Results Among the 653 staff,58.35% and 50.06% presented anxiety and depression,respectively.The regression results showed that age(OR=0.95,95%CI=0.92-0.97) and mental support from the work group(OR=0.61,95%CI=0.45-0.82) were the protective factors while physical fatigue(OR=1.82,95%CI=1.20-2.74),work pressure(OR=1.61,95%CI=1.21-2.12),and insufficient protective equipment(OR=1.92,95%CI=1.06-3.49) were the risk factors for depression of CDC staff.Age(OR=0.97,95%CI=0.94-0.99),length of sleep per day(OR=0.74,95%CI=0.56-0.96),and participation in technical training(OR=0.33,95%CI=0.12-0.95) were the protective factors while mental fatigue(OR=1.68,95%CI=1.18-2.41),work pressure(OR=2.94,95%CI=2.08-4.17),and unclear incentive system for overtime(OR=1.99,95%CI=1.23-3.23) were the risk factors for the anxiety of CDC staff. Conclusion The anxiety and depression status of CDC staff during the COVID-19 outbreak were worrying,which were mainly affected by age,sleep,supply of protective equipment,incentive system,fatigue,and work pressure.

Efficacy of sintilimab combined with apatinib in treatment of advanced non-small cell lung cancer / 肿瘤研究与临床

Objective:To observe the efficacy of sintilimab combined with apatinib in the treatment of advanced non-small cell lung cancer (NSCLC).Methods:Eighty-two patients with advanced NSCLC who were admitted to Nantong Cancer Hospital from October 2019 to September 2020 were selected for a prospective controlled study. They were divided into control group (treated with apatinib) and combination group (treated with sintilimab + apatinib) using the random number table method, with 41 cases in each group. The short-term clinical efficacy, tumor markers [neuron specific enolase (NSE), cytokeratin 19 fragment antigen (CYFRA21-1)], adverse reactions during treatment and survival were compared between the two groups.Results:The objective remission rate and clinical control rate in the combination group were higher than those in the control group [41.46% (17/41) vs. 19.51% (8/41), 85.37% (35/41) vs. 58.54% (24/41)], and the differences were statistically significant ( χ2 values were 4.66 and 7.31, both P < 0.05). The levels of NSE and CYFRA21-1 in the combination group were lower than those in the control group after treatment [(19.04±2.54) ng/ml vs. (21.35±3.11) ng/ml, (4.58±1.02) μg/L vs. (6.07±1.84) μg/L], and the differences were statistically significant ( t values were 3.68 and 4.54, both P < 0.001). There were no statistical differences in the incidence rates of gastrointestinal reaction, bone marrow depression, fatigue, and liver and kidney function damage between the combination group and the control group during treatment (all P > 0.05). The survival rate of the combination group was higher than that of the control group (71.79% vs. 47.50%), and the difference was statistically significant ( χ2 = 4.84, P = 0.028). Conclusions:Sintilimab combined with apatinib may improve clinical efficacy, reduce tumor marker levels, and improve short-term survival rate of advanced NSCLC patients.

Glycosides from flower buds of Lonicera macranthoides / 中草药

Objective: To study the glycosides from the 70% ethanol extract of Lonicera macranthoides. Methods: The compounds were isolated and purified by column chromatography of HP-20 macroporous resin, silica gel, ODS, Sephadex LH-20, and semi-preparative RP-HPLC. Their structures were elucidated by physicochemical properties and spectral analyses. Results: Eight compounds were isolated and identified as 7,3’,4’-trimethoxylquercetin-3-O-α-L-arabinadosyl-(1→6)-O-β-D-glucopyranoside (1), 7,3’,4’-trimethoxylquercetin-3-O-rutoside (2), quercetin-3-O-β-D-glucopyranoside (3), (2E,6S)-8-[α-L-arabinopyranosyl-(1″→6’)- β-D-glucopyranosyl]-2,6-dimethyloct-2-eno-1,2″-lactone (4), kankanoside E (5), betulalbuside A (6), shomaside F (7), and amarantholidoside V (8), respectively. Conclusion: Compound 1 is a new compound named methoxylquercetinside, while compounds 5-8 are isolated from the genus of Lonicera for the first time.

Multi-dimensional Focus on the Management and Clinical Use of Biosimilar Products / 中国药房

OBJECTIVE：To provide reference for summarize the management and clinical use levels of biosimilar products . METHODS：Related policies and regulations about approval and application of biosimilar products were retrieved from domestic and foreign supervision departments and WHO. The biosimilar products were described from multi-dimensional aspects of whole life cycle of drugs ，generic name and prescription ，indication extrapolation ，clinical drug exchange ，pharmacovigilance，medical insurance payment system ，education and training. RESULTS & CONCLUSIONS ：Biosimilar products refer to therapeutic biological products which are similar to the reference drugs which have been approved for marketing in terms of quality ，safety and effectiveness. In R&D ，production，circulation，use and supervision links，the management of biosimilar products has its own characteristics in different countries/areas/organization. In the R&D stage ，biosimilar products do not need to independently verify their safety and effectiveness ，but only step by step use analytical methods to gradually clarify their high similarity with reference drugs in terms of structure and function. The name of biosimilar products in China is the same as that of the original drugs ，and the general name was used in prescription. For FDA to approve the indication extrapolation of biosimilar products ，it needs to be based on the data and information at the time of application ，the safety and effectiveness information of reference drugs ，and the consideration of relevant scientific elements of indications. It needs to be evaluated and used conditionally under supervision. The standard of FDA approval is strict，that is to say ，the approval standard of realizing interchangeability is higher than that of biological similarity which has no such concept in China. The enterprise community ，regulatory agencies ，academic institutions and hospital drug rooms need to communicate and exchange ，and further strengthen post market risk control and safety monitoring. China’s medical insurance department should establish an appropriate payment system and encourage the use of biosimilar products through the payment system. Meclical workers should learn the characteristics of biosimilar products so that they can make good use of biosimilar products in practice on the basis of understanding their technical evaluation.

An equation for calculating the osmolarity of adult total nutrient admixture / 中华临床营养杂志

Objective:To establish a predictive equation for the osmolarity of parenteral nutritional prescription in China.Methods:From July 2019 to September 2019, 2 480 individualized samples of 328 different parenteral nutritional prescriptions (adult) of Peking Union Medical College Hospital were collected, and the osmolarity of parenteral nutritional solution samples was determined by a freezing point reduction method. Pearson χ2 test and a multiple linear regression analysis were utilized to establish a prediction equation for the osmolality of parenteral nutritional solution. Results:The average osmolarity of parenteral nutritional prescription was (1 164.20 ± 252.59) mOsm/kg, and the best fitting equation was (9.66A+ 7.88G+ 3.52F+ 36.4Na+ 27.55K+ 3.38P+ 7.46W-250)/V.Conclusion:The osmolarity is determined accurately and effectively by the fitting equation, which provide a benefit reference for the formulation, review and selection of clinical parenteral nutrition prescription especially in China.

Two new ursane-type nortriterpenes from Lonicera macranthoides and their iNOS-inhibitory activities / 中国天然药物

The flower buds of Lonicera macranthoides (Shan Yin-Hua), represent an important traditional Chinese medicine and food ingredient. A phytochemical investigation of the 70% EtOH extract of the flower buds of L. macranthoides resulted in the isolation of 12 triterpenoids (1-12), including two new ursane-type nortriterpenes, 2α, 24-dihydroxy-23-nor-ursolic acid (1) and 2α, 4α-dihydroxy-23-nor-ursolic acid (2). Their structures were established by multiple spectroscopic methods and comparison with literature data. All isolated compounds were evaluated for their anti-inflammatory effects in LPS-activated RAW264.7 cells. Compounds 1 and 2 exhibited inhibitory effects on iNOS at the concentration of 30 μmol·L.

Identification of metabolites of Danshensu in rats / 中国中药杂志

To identify the metabolites of Danshensu in plasma and urine in rats by using UHPLC-LTQ-Orbitrap method. After oral gavage of Danshensu CMC-Na suspension in SD rats, urine and plasma samples were collected and processed by solid phase extraction. ACQUITY UPLC BEH C₁₈ column (2.1 mm×100 mm, 1.7 μm) was utilized, with 0.1% formic acid (A)-acetonitrile (B) solution as the mobile phase for gradient elution. Negative electrospray ion mode based data-acquisition method was established to collect the mass spectrometry data of biological samples. As a result, Danshensu and 21 Danshensu Ⅰ phase and Ⅱ phase metabolites were finally identified according to the accurate mass measurements, mass fragmentation behaviors and comparing with the reference standards. The main metabolic pathways included dehydration, methylation, glucuronide conjugation, sulfate conjugation and their composite reactions. Consequently, our study expounded metabolites of Danshensu in rats based on UHPLC-LTQ-Orbitrap method and provided a reference for further researches on therapeutic material basis and mechanism of Danshensu.

Effects of Salidroside on Keap1-Nrf2 Signal Pathway in Acetaminophen-induced Liver Injury Model Mice / 中国药房

OBJECTIVE:To investigate the protection role and mechanisms of salidroside (SALD) on acetaminophen (APAP)-induced liver injury model mice. METHODS:60 mice were randomly divided into normal group(normal saline),model group (normal saline),positive group (acetylcysteine,150 mg/kg),SALD low-dose,medium-dose and high-dose groups (100, 200,300 mg/kg),with 10 mice in each group. Except for normal group,other groups were given APAP 500 mg/kg intragastrically to induce liver injury model. 1 h before modeling,mice were given relevant medicine intrgastrically for consecutive 5 d. After medication,the serum contents of ALT,AST,ALP and LDH were determined,and the pathohistological changes of the liver tissue were observed by HE staining. The protein expressions of Keap1 (in tranuclear), Nrf2 (in tranuclear), HO-1 (in tracytoplasm),NQO1 (in tracytoplasm) and GCLC (in tracytoplasm) in liver tissue were determined by Western blot assay. RESULTS:Compared with normal group, serum contents of ALT, AST, ALP and LDH in model group were increased significantly(P<0.01). The liver lobuli hepatis disorder and difficult to recognize,liver cell eosinophilic necrosis and other lesions were found in liver tissue. The protein expressions of Nrf2,Keap1,HO-1 and GCLC in liver tissue were decreased significantly (P<0.05). Compared with model group,above indexes of all groups were improved significantly (P<0.05 or P<0.01),except that the decrease of LDH content in serum of mice in SALD low-dose group and the expression improvement of Nrf2 and Keap1 in liver tissue were not significant in positive group. The expression of NQO1 protein in liver tissue of mice was increased significantly in administration groups (P<0.05 or P<0.01);pathohistological exchange of liver tissue in mice was improved in adminstration groups to different extent. CONCLUSIONS:SALD can protect APAP-induced liver injury;the mechanism of which may be associated with promoting Keap1,Nrf2 into the of nucleu and strengthening the protein expression HO-1,NQO1,GCLC in liver tissue.

Consensus for parenteral nutrition solutions compounding / 中华临床营养杂志

Components and compounding of parenteral nutrition solutions were different in different hospitals and different parts of China.In order to raise awareness,reduce improper compounding and improve patient safety,Pharmacy Cooperative Group of Chinese Society for Parenteral and Enteral Nutrition composed the Consensus for Parenteral Nutrition Solutions Compounding,providing evidence for standardization in this field.

Investigation and Analysis of Quality Control of Hospital Pharmaceutical Administration in China / 中国药房

OBJECTIVE:To investigate the situation of hospital pharmaceutical administration in China,and provide basis for developing measures in improving the quality and safety of medication in hospitals. METHODS:According to the organization of National Health and Family Planning Commission,National Quality Control Center of Pharmaceutical Administration drafted the re-search indicators,and adopted internet survey to screen,confirm and statistically analyze the data about pharmacy staffing and drug use management of hospitals in 2014 that was completed and reported as requested by the secondary general hospitals and above in each area selected by Health and Family Planning Commission in provinces (cities,districts). RESULTS:The rates of pharmacy technicians in secondary and tertiary general hospitals were 5.2% and 4.4%,the numbers of clinical pharmacists per hundred-bed were 0.42 and 0.44 person,the numbers of dispensing prescription per person in a day were 119 and 173 in pharmacist in outpa-tient;the monitoring rates for key patients were 1.8% and 6.9%,the rates of intravenous infusion in outpatients were 12.8% and 10.1%,and inpatient were 93.1% and 90.4%;the rates of intravenous infusion of antibiotics in inpatients were 51.8% and 44.3%,and the rates of intravenous infusion of TCM were 34.7% and 29.0%,respectively. CONCLUSIONS:The problems exist-ing in pharmaceutical quality administration in China include lacking of pharmacy technicians,large workload,lacking of clinical pharmacists,imperfect pharmaceutical care model,non-standardized choice and use of intravenous infusion,etc. For these prob-lems,it is suggested to increase the propaganda of health education and management efforts of intravenous drugs,equipped with ad-equate pharmacy technicians and clinical pharmacists,continuously improve the quality evaluation system of hospital pharmaceuti-cal administration in China.

Study on Lean Management of Assets in Public Hospitals Based on Annual Report of State Assets / 中国卫生经济

Objective:Based on annual reports on state assets,public hospitals could enhance the level of lean management about assets.Methods:The comparative analysis method was used to summarize the connection and difference between the annual report and the inventory report of the state assets in administrative institutions.On this basis,it analyzed the difficulties of public hospitals in the preparation of annual reports on state assets.Results:Through the top-level design of asset management,optimizing the process of whole life cycle management and innovating asset management tools,the public hospital not only to solve the difficulties of preparing the annual report on state assets,but also to enhance the level of lean management about assets.Conclusion:Based on the annual reports on state assets,public hospitals should change the traditional management mode of assets,improve the quality and application level of information,boost the lean management of assets,and speed up the establishment of modern hospital management system.

A bioequivalence evaluation of long-chain triacylglycerol/medium-chain triacylglycerol emulsion in beagle dogs / 中华临床营养杂志

Objective Long-chain triacylglycerol (LCT) by three producers,each mixed with the same medium-chain triacylglycerol (MCT),were compared with the brand MCT/LCT in causing focal necrosis of hepatocytes in beagle dogs (a bioequivalence evaluation).Methods 21 beagle dogs (male,0.7-1.5 years old,10-15 kg) were used in this study.According to the sources of the LCT,the animals were divided into Group A (LCT made in China),Group B (LCT made in Japan),Group C (LCT made in Germany),and the control group (the brand 10％ MCT/LCT).Central venous port was placed via the lumber vein of the animals under general anesthesia.After 2 weeks of rehabilitation,MCT/LCT was administered through this port for 28 days at 9 g/ (kg · d) [while the routine dose used clinically was 1 g/ (kg · d)].The laboratory indexes and the pathomorphism of the liver and kidney were studied single blindly.Results Laboratory tests,including liver and kidney function,blood coagulation function and lipid metabolism,did not identify differences among emulsions with different sources of LCT.Liver biopsy at day 28 showed no focal necrosis in Group C and the control group;there was minor damage in Group B;and Group A had obvious liver necrosis.and the pathological findings of other organs are similar.No significant difference was observed in biopsies of other organs.Conclusions Emulsions with different sources of LCT varied in their damage to the liver.Generics with LCT of higher quality were equivalent to the brand MCT/LCT in terms of safety.

Analysis of Compound Drugs Recorded in the National Drug Reimbursement List and Provincial Drug Re-imbursement Lists in 28 Provinces( Regions and Municipalities)of China / 中国药房

OBJECTIVE:To provide reference for the selection and management of compound drugs. METHODS:The variet-ies and frequency of compound drugs recorded in the national drug reimbursement list and drug reimbursement list supplementary varieties in provinces (regions and municipalities) were statistically analyzed,and Spearman test method was used to conduct the correlation analysis for the variety and local economic development level. RESULTS:There were totally 126 varieties of compound drugs recorded in the national drug reimbursement list,covering 19 categories. The varieties of compound drugs in class B supple-mentary drug lists of 28 provinces (regions and municipalities) ranged from 19 to 50;for the supplementary lists of compound drugs in 24 provinces(regions and municipalities),the varieties ranged from 12 to 117. Almost 50% of the compound drugs were recorded in only 1 province(region and municipality),and most compound drugs recorded 1-4 time(s)in provinces(regions and municipalities). There was no significant relationship between the varieties number of supplementary compound drugs and the per capita GDP in a province(region and municipality)(P>0.05,r=-0.180). CONCLUSIONS:The supplementary variety of com-pound drugs in a region has little relationship with the local economic development level. The work progress of recoding the com-pound drugs varies a lot,with large differences in number and high dispersion. It is necessary to clarify the definition of compound drug at a national level,develop unified management policies,standardize the selection criteria for compound drugs and guarantee the clinical medication requirements of patients.

Analysis of Compound Drugs Recorded in the National Drug Reimbursement List and Provincial Drug Re-imbursement Lists in 28 Provinces( Regions and Municipalities)of China / 中国药房

OBJECTIVE:To provide reference for the selection and management of compound drugs. METHODS:The variet-ies and frequency of compound drugs recorded in the national drug reimbursement list and drug reimbursement list supplementary varieties in provinces (regions and municipalities) were statistically analyzed,and Spearman test method was used to conduct the correlation analysis for the variety and local economic development level. RESULTS:There were totally 126 varieties of compound drugs recorded in the national drug reimbursement list,covering 19 categories. The varieties of compound drugs in class B supple-mentary drug lists of 28 provinces (regions and municipalities) ranged from 19 to 50;for the supplementary lists of compound drugs in 24 provinces(regions and municipalities),the varieties ranged from 12 to 117. Almost 50% of the compound drugs were recorded in only 1 province(region and municipality),and most compound drugs recorded 1-4 time(s)in provinces(regions and municipalities). There was no significant relationship between the varieties number of supplementary compound drugs and the per capita GDP in a province(region and municipality)(P>0.05,r=-0.180). CONCLUSIONS:The supplementary variety of com-pound drugs in a region has little relationship with the local economic development level. The work progress of recoding the com-pound drugs varies a lot,with large differences in number and high dispersion. It is necessary to clarify the definition of compound drug at a national level,develop unified management policies,standardize the selection criteria for compound drugs and guarantee the clinical medication requirements of patients.

Retrospective Analysis of ADR Induced by Shuxuening Injection in Beijing Area during 2003-2013 / 中国药房

OBJECTIVE:To investigate the occurrence of ADR induced by Shuxuening injection in Beijing area,and to pro-vide reference for rational drug use in clinic. METHODS:ADR induced by Shuxuening injection in Beijing area during 2003-2013 was classified statistically in respects of population,organs/systems involved in ADR,clinical manifestations,occurrence time, drug combination and prognosis. RESULTS:Of 1648 ADR cases,the incidence of ADR in the elderly patients was higher than young patients,and that of female patients (60.92％) was higher than that of male patients (39.14％). Multiple organs/systems were involved in Shuxuening injection-induced ADR,and top 3 were nervous system (422 cases,21.33％),skin and its appen-dants (411 cases,20.78％) and others (305 cases,15.42％). Clinical manifestations were skin rash,itching,dizziness and ner-vousness,palpitation,arrhythmia,etc. ADR mostly occurred within 5-30 min after medication. In ADR reports,there were a vari-ety of drugs combined with Shuxuening injection. Shuxuening injection combined with Alprostadil injection was most common(61 cases,accounting for 23.46％ of drug combination). Among 1648 ADR cases,there were 622 cured cases and 1039 cases im-proved,4 cases were not improved,3 cases had sequelae and 1 case died. CONCLUSIONS:Clinical application of Shuxuening in-jection should strictly follow the indications of drug package inserts;differentiation of symptoms and signs is based on specific dos-age,solvent,route of administration,etc. It is necessary to strengthen the prescription check,and strengthen the observation after medication especially for the elderly and other special groups so as to reduce and avoid ADR.

Preliminary Discussion of Career Management of Hospital Pharmacists / 中国药师

Objective:To preliminarily discuss the career management of hospital pharmacists from the perspectives of human re-source management and psychology to provide reference for the human resource management of pharmacy department. Methods: The current situation of career management of hospital pharmacists was analyzed based on the theory of Zone of Proximal Development in de-velopmental psychology, and some concepts and measures for the career management of hospital pharmacists were proposed. Results:The managers of pharmacy department must set up dynamic developing view of their employees, establish individualized management concept, transform their role in human resource management and promote the capability of career management. Measures, such as work shift and determined posts, career guidance, potential discovery, opening up promotion ways and self-management of personal career, could be adopted to develop a scientific and effective system of career management. Conclusion:It is suggested that modern manage-ment theories be utilized in the career management of hospital pharmacists, which may help achieve the joint development of department and individuals.

Hyperglycemia aggravated cerebral ischemia/reperfusion injury by inhibiting mitophagy / 中国药理学通报

Aim Toinvestigatetheroleofhyperglyce-mia in cerebral ischemia/reperfusion(I/R)injury with a middle cerebral artery occlusion(MCAO)rat model anditsmechanism.Methods EightyhealthymaleSD rats were randomly assigned into sham group, I/R group (normoglycemia),hyperglycemic I/R groupⅠ(HG1 )and hyperglycemic I/R groupⅡ(HG2 ).The cerebral I/R model was established by occluding the middle cerebral artery(MCA)in rats.Hyperglycemia was induced by intraperitoneal injection of 50% glu-cose solution.Neurological deficit was determined by Ludmila Belayev test;infarct size and brain edema were measured by TTC staining;mitophagy was ob-served by double immunofluorescent staining and elec-tron microscope.The expressions of autophagy-related proteins(LC3 and Beclin-1 )and apoptosis-related pro-teins(Cyt-C,AIF,caspase-9 and caspase-3 )were ex-aminedbyWesternblotfurtherly.Results Bloodglu-cose level was controlled at 4 mmol·L-1 (normoglyce-mia),10 mmol · L-1 (HG1 ) and 20 mmol · L-1 (HG2)respectively.There were no significant differ-ences between model group and HG1 group in neuro-logical deficit scores,infarct volume and edema size(P>0. 05 ).However,these indications in HG2 group were significantly increased compared with model group (P<0. 05 ).After 3 days of reperfusion,the level of mitophagy was significantly reduced accompanied with increased mitochondria damages in HG 2 group (P <0. 05 ),and the expressions of mitochondrial related ap-optotic proteins(Cyt-C,AIF,caspase-9 and caspase-3 ) were significantly increased accordingly compared to modelgroup.Conclusions Mildhyperglycemiacan not intensify the cerebal ischemic injury.In contrast, severe hyperglycemia significantly aggravates the brain ischemic injury by inhibiting the removal of injured mi-tochondria in a manner of mitophagy,thus amplifying the mitochondrial mediated cascade damage responses.

Analysis of Drug Repercussion in Outpatient Pharmacy in West Branch of One Hospital during 2013-2015 / 中国药师

Objective:To summarize the drug repercussion data in outpatient pharmacy and analyze the reasons to provide sugges-tions for the improvement. Methods: The information was collected from the hospital information system ( HIS) during January 1, 2013 and December 31, 2015, including drug name, category, quantity, amount, reasons for drug repercussion and the other statisti-cal data. Results:During the three years, the number of prescription drugs, amount of money and varieties of drug repercussion were increased. The most common reasons for drug repercussion were the other reasons, withdrawn by doctors and the request of patients. The sum of drug repercussion was positively correlated with the drug price and the amount of drug repercussion. Conclusion:The op-tion simplicity for drug repercussion in HIS is the main reason for drug repercussion bythe other reasons. The occurrence of drug re-percussion should be intervened by such methods as gradually improving the HIS, establishing intervention measures, enhancing the professional quality of pharmacists and so on.