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Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.
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OBJECTIVE@#To investigate the effect of G protein-coupled receptor 17 (GPR17) on hypoxia injury in retinal ganglion cells .@*METHODS@#CoCl (400 μmol/L) was used to induce hypoxic injury in RGC-5 cells. The expression of GPR17 and the effect of GPR17 ligands were investigated, and the role of GPR17 in hypoxia injury was further studied by transfection of RGC-5 cells with GPR17 small interfering RNA (siRNA). The cell viability was determined by MTT and the cell apoptosis rate was detected by flow cytometry analysis. The expression of GPR17 mRNA was determined with RT-PCR.@*RESULTS@#mRNA expressions of GPR17 in RGC-5 cells with and without CoCl treatment were 0.36±0.05 and 0.26±0.08(<0.01). Compared with hypoxia without any treatment, pretreatment with GPR17 agonists (LTD, UDP, UDP-G) significantly reduced cell viability (the survival rates of cells decreased by 29.6%, 31.8% and 33.9%, all <0.01), while the effect of GPR17 antagonist (cangrelor) was the opposite (the survival rates of cells increased by 33.2%, <0.01). Transfection with GPR17 SiRNA inhibited hypoxia-induced up-expression of GPR17 mRNA (<0.01)and reduced cell apoptosis[rates of cell apoptosis were(39.73±2.06)%,(42.50±3.64)% and (24.98±2.16)% for blank control, NC siRNA and GPR17 siRNA groups, <0.01].@*CONCLUSIONS@#GPR17 may mediate hypoxia injury in RGC-5 cells, while the knockdown of GPR17 can reduce the hypoxia injury.
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Humans , Apoptosis , Cell Hypoxia , Genetics , Cell Line , Cell Survival , Cobalt , Gene Expression Regulation , Gene Knockdown Techniques , Hypoxia , Genetics , Receptors, G-Protein-Coupled , Genetics , Metabolism , Retinal Ganglion CellsABSTRACT
Objective: To analyze the common dosage of oral liquid preparations used in a children's hospital in order to provide reference for the best drug specifications for children's medicines. Methods: The prescription data of patients containing oral liquid preparations were collected from January 2014 to December 2016 and used for the analysis in the sample hospital. The most commonly used doses were compared with the existing specifications to provide suggestions on the best specifications for children. Results: There were 11 kinds of oral liquid preparations commonly used in the children's hospital. Only 4 kinds of drugs met with the best drug speci-fications for children, and the others were not able to meet the clinical needs in the children's hospital. Conclusion: The best specifi-cations of children's medicines need to be readjusted.
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Objective:To analyze the safety of generics and lactation of commonly used drugs in outpatient and emergency department of a children's hospital in Shanghai to formulate the related high-risk medicines list. Methods:According to the drug directory for outpatient and emergency department in the sample hospital,the medication assistant software was used to check the safety level of the related drugs used during pregnancy and lactation. Drugs with pregnancy safety grade D or X,and the lactation safety grade L4 or L5 involved in the high-risk pregnancy or breast-feeding drug list. Results:Of the 151 kinds of infusion medicines commonly used in outpatient and emergency department in the sample hospital, a total of 118 kinds were with a specified level of pregnancy safety,which accounted for 78.15%,and a total of 86 kinds were with a clear indication of the safety level of lactation,which accounted for 56.95% of the total number of medicines. A total of 25 kinds of drugs labeled pregnancy safety grade D or X, which accounted for 16.56%, and 21 species were with lactation safety L4 or L5, which accounted for 13.90% of the total number of drugs. The drugs with high pregnancy or lactation risk in the outpatient and emergency department of the sample children's hospital were anti-tumor drugs,anti-infective drugs,some cardiovascular drugs and central nervous system drugs. Conclusion:There are still many deficiencies in the information about the safety of pregnancy or breast-feeding in the existing medicines used in the sample hospital,which need to be improved.
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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.
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Objective:To establish a calculation model of drug preparation difficulty coefficient for outpatient pharmacy intrave -nous admixture center ( OUIVA) in a children's hospital, and construct the performance model .Methods: All the prescriptions in a week in OUIVA of Shanghai children's medical center were randomly selected .According to the actual difficulty level in the process of outpatient and emergency drug preparation , a basic drug difficulty coefficient and difficulty coefficient addition method was constructed . The difficulty index of every prescription was calculated .All the prescriptions in a week were randomly selected , and according to the difficulty coefficient analysis method , the daily difficulty coefficient of the prescriptions was calculated in order to build a performance model for OUIVA in the hospital .Results:The difficulty coefficient of medicine mainly included four basic difficulty coefficients and nine difficulty addition coefficients .According to the statistics , the average difficulty coefficient of daily prescriptions was (3.83 ± 2.86 )with the highest difficulty coefficient of 35, and the prescription data showed that there was significant difference between outpa -tient and emergency prescriptions and daytime blood tumor prescriptions .Conclusion:A performance model based on the difficulty co-efficient for OUIVA in children ' s hospital is a more scientific reflection to the daily work .
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Objective: To study the correlation between the empty bottle volume, negative pressure and gas production of the freeze-dried powder in the out-patient pharmacy intravenous admixture center of a children' s hospital in order to provide reference for the drug production. Methods:20 ml Syringes were used to measure the volume of empty bottles, negative pressure and produced gas. The relationship between the theoretical drug dissolution volume and the actual dissolution volume was compared, and the precautions for the drug production were put forward. Results:Among the tested 30 drugs, 6 ones were with the actual dissolution volume half of the theoretical dissolution volume, 8 ones were with negative pressure in the bottles, and 3 ones were with produced gas after dissol-ving. It was appropriate that the empty bottle volume be 4 ml larger than the theoretical dissolution volume, and it was appropriate that the negative pressure volume of drugs was slightly larger than the theoretical dissolution volume. Negative pressure should be still kept in the bottles after the gas production. Conclusion:The design of part of freeze-dried powder injection needle shows defects resulting in drug mixing difficulties to a certain extent.
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Objective: To study the dosages of capsules commonly used in children to provide reference for the addition of capsule specification for children.Methods: According to the application situation of capsule dosages commonly used for the inpatients in one children's hospital from January 1, 2013 to September 1, 2016, and combined with the usage rates of various drugs with different dosages, the addition of the minimum dosage of capsules was proposed.Results: Totally 10 species of commonly used capsules were selected from the children's hospital, and among them, 4 ones met the requirements of clinics, and the other 8 ones needed the specification addition, including clostridium butyricum capsules (210 mg) and polysaccharide ferric complex capsules (25 mg).Conclusion: The existing capsule specification can not fully meet the clinical requirements in the children's hospital.Therefore, appropriate dosage adjustments are still needed.
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Objective: To establish the standardized management mode for emergent medicines of inpatient area based on JCI. Methods:The expiry verification data of emergent medicines in hospital wards were collected from 2013 to 2015. The number and the amount of emergent medicines expired in the last three months in each calendar month during the three years were analyzed, the exist-ing problems in the management mode were found out and gradually optimized using PDCA cycle. Results:From 2013 to 2015, the re-placement amount of emergent medicines expired in the next month was 3497. 37 yuan. The number of emergent medicines expired in current month was 62. A total of 420 times of emergent medicines didn' t meet the requires of expiry verification from 2013 to 2015. After the check-in form redesign for emergent medicines and the standardization of replacement process, the number of expired medi-cines in the rescue carts was reduced, and the validity and quantity of drugs in all the rescue vehicles could be clearly shown in the new form. Conclusion:The standardization of emergent medicine management model can guarantee the safety of emergent medicines used in patients.
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Objective To develop a solid-phase extraction and HPLC method for the determination of midazolam and its hydroxy metabolites in child plasma. Methods Blood plasma samples were collected twenty four hours after treated with midazolam by continuous infusion of 2μg·kg-1·min-1 in our intensive care unit, the concentration of midazolam and its metabolites in plasma was detected by solid-phase extraction and RP-HPLC. The separation was performed on ZORBAX Eclipse XDB～C18 column(4.6 ×250mm,5μ m) with 7.56mmol/L ammonium sulfate - acetonitrile as mobile phase. The flow rate was 1.0ml/min,the column temperature was 25℃ and the wavelength of UV detector was 254nm. Results The retention time of 4-hydroxymidazolam, 1'-hydroxymidazolam and midazolam was detected as 8.14,9.09 and 11.18 min. The average recoveries for midazolam and its metabolites was 98.88% ～100.01% ,and RSD ＜ 4%. 29 patients took part in the study, the average plasma concentration of midazolam, 1'-hydroxymidazolam and 4-hydroxymidazolam was 0.68,0.28 and 0.08mg/L. Conclusion It is suitable for convention monitoring of the midazolam and its hydroxy metabolites concentration in the plasma
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Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS) for submucosal tumors in upper gastrointestinal tract, and its influence on choice of endoscopic therapies. Methods A total of 82 submucosal tumors from upper gastrointestinal tract were examined by EUS, and treated by various endoscopic therapeutic techniques including fulguration with high frequency current ( FHFC), endoscopic mucosal resection (EMR) and endoscopic band ligation according to orion, size and property of the lesion. The diagnoses of 58 reseeted samples were determined by routine pathological examination and immunohistochemistry. All patients were followed up with routine endoscopy and EUS. Results FHFC was applied in 26 lesions originated from muscularis mucosa, EMR was used in 17 flat lesions originated from muscularis mucosa, and endoscopic band ligation in 38 lesions from muscularis propria and 1 tumor from muscularis mucosa. The diagnostic accuracy of EUS was 91.4% (53/58). Except for post-operative bleeding in 1 patient, no other complications were observed. A total of 79 cases were followed up for 3-24 months, and no recurrence was found. Conclusion EUS can display the origin and property of submucosal tumors in upper gastrointestinal tract and guide the selection of endoscopic therapy, which is effective and safe in treatment of submucosal tumor in upper gastrointestinal tract.
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OBJECTIVE:To investigate the use and trend of lipid modifying agents in 83 Shanghai hospitals during the period 2004～2006.METHODS:Lipid modifying agents used in 83 Shanghai hospitals were analyzed statistically in respect of the kinds,consumption sum and DDDs etc.RESULTS:During the period 2004～2006,the use of lipid modifying agents increased year by year,with mean annual incremental rate of 15.40% in consumption sum and 15.37% in DDDs,but the average daily costs had no significant change.Leading the list in terms of consumption quantity were simvastatin,pravastatin and fenofibrate.CONCLUSION:The development trend of lipid modifying agents is promising.
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OBJECTIVE:To develop a method for the determination of midazolam in child plasma.METHODS:Plasma level of midazolam in twenty two ICU children with mechanical ventilation was detected by solid-phase extraction-HPLC after treatment with midazolam for 24h.The separation was performed on Zorbax Eclipse XDB C18 column with acetonitrile — 7.56mmol? L-1 ammonium sulfate(gradient elution) as mobile phase.The flow rate was 1.0mL? min-1,the column temperature was 25℃ and the wavelength of UV detector was 254nm.RESULTS:The calibration curves for midazolam had a good linearity over the range of 0.05～ 25.00mg? L-1(r=0.999 8).The average recovery for midazolam was 99.29%.Both the intra-day RSD and inter-day RSD were less than 4%.The limits of quantitation for midazolam was 0.01mg? L-1.CONCLUS-ION:The method is sensitive,accurate,simple and rapid,and applicable for clinical blood drug level monitoring of midazolam.
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AIM: To explore the correlation between drug concentration of etoposide (VP16) and CYP3A activity (CA) in leukemia. METHODS: The urinary 6?-hydroxycortisol/hydrocortisone ratio is a useful marker for CA. Concentration of VP16 in plasma and CA was determined by HPLC in 20 leucemia patients, and the correlation analysis was performed using the SPSS software. RESULTS: Correlation analysis between drug concentration of VP16 and CA in leukemia was poor correlated (r = 0.725), but concentration of VP16 and lgCA showed a good correlated (r =0.969). CONCLUSION: It is feasible to adjust the therapeutic regimen of VP16 by determining CA.
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OBJECTIVE:To make out the current situation and trend of antibiotics used in hospitals of Shanghai and to make objective evaluation METHODS:To investigate antibiotics used in 47 hospitals of Shanghai during the period 2000～2002 in respect to the sum of money of consumption,kinds of drugs,frequency of use and DDDs RESULTS:During the period 2000～2002,the average annual consumption of antibiotics accounted for 21 24% of the sum of money for total consumption of drugs and droped with an average rate of 1 9% In which,antibiotics for injection rised with a rate of 10 59% successively,and oral antibiotics decreased with a rate of 10 82% In amount of consumption,Ceftriaxone,Cefuroxime and Ceftazidime occupied the front places of antibiotics for injection And the corresponding order of oral antibiotics were Cefaclor,Cefradine and Amoxicillin CONCLUSION:The consumption of cephalosporins was the highest in the order of sum of money of antibiotics The market prospects of antibiotics for injection will be wide and bright
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OBJECTIVE:To establish the preparation process of inclusion complex of diclofenac sodium-?-cyclodextrin (DS-?-CD) eyedrops METHODS:The DS-?-CD was prepared by the stir method and identified with instrumental method The content of diclofenac sodium was detected by UV,HPLC RESULTS:The inclusion ratio of DS-?-CD was(67 48?2 96)% There was no difference between diclofenac sodium and DS-?-CD in UV absorption spectrum The crystal diffraction peak of DS inclosed in DS-?-CD disappeared in X-ray CONCLUSION:The DS-?-CD can be used as eyedrops in clinical practice
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OBJECTIVE:To find out the situation of antidiabetic drugs used in 47 hospitals of Shanghai and to make objective evaluation as reference for production,sale and consumption departments.METHODS:To investigate the hypoglycemic drugs used in 47 hospitals of Shanghai during the period 1998～2001 in respect to the sum of money of consumption,kinds of drugs,DDDs and DDC.RESULTS:In recent 4 years,the annual rate of growth of antidiabetic drugs were 11.98% in DDDs?6.32% in DDC and 19.05% in sum.Among the increasing ranges of antidiabetic drugs in DDDs,joint venture drugs occupied the first place,imported drugs came second,and domestic drugs got the least.CONCLUSION:Antidiabetic drug is a kind of common drug which has developmental future.
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OBJECTIVE:To discuss the development strategy of hospital preparations in new situation METHODS:To analyse existing circumstance and problems confronting us in development of hospital preparations RESULTS & CONCLUSION:In order to promote the development of hospital preparations,we should reform our work in respect to transformation of production,adjustment of kinds,promotion of R & D of new preparations and establishment of regional hospital preparation center
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OBJECTIVE:To investigate the current situation and developing trend of the use of antidepressants in hospitals of Shanghai.METHODS:Using DDD as index,the data of antidepressants used in47hospitals in Shanghai during the period2000～2002were analyzed.RESULTS:The average annual increase rate of sum of money for antidepressants was15.33%.The sum of money for selective serotonin reuptake inhibitors(SSRIs)accounted for92.17%,and that of fluoxetine accounted for60.02%of the total antidepressants used.CONCLUSION:SSRIs occupied the antidepressants marketing predominance.
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OBJECTIVE:To evaluate the economic effectiveness in different pharmacotherapeutic schemes for Hp infection in children.METHODS:To analyze four therapeutic schemes for Hp infection in children with cost - effectiveness analysis.RESULTS: The cost- effectiveness ratios of four therapeutic schemes were 14.92,8.85,8.37 and 8.58 respectively. CONCLUSIONS: scheme C(clarithromycin + bismuth potassium citrate + metronidazole)is the best one.