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OBJECTIVE： To analyze the characteristics of adverse drug reactions/events （ADR/ADE） caused by TCM injections in 18 third grade class A hospitals from Xi’an， and to provide reference for rational drug use in clinic. METHODS： Totally 304 ADR/ADE cases of TCM injection reported by 18 third grade class A hospitals of Xi’an were analyzed statistically during 2013-2018 in respect of gender and ages， time distribution of ADR/ADE， distribution of ADR/ADE-inducing drugs， organs/systems involved in ADR/ADE and clinical manifestations， grading of ADR/ADE， outcome and relationship evaluation， drug combination. RESULTS： Totally 6 683 cases of ADR/ADE cases were reported in same period， 304 cases were caused by TCM injection （4.55％）. Among 304 cases of ADR/ADE， the number of women （162 cases， 53.29％） was slightly higher than that of men （142 cases， 46.71％）. The age of patients was mainly over 40 years old （223 cases， 73.35％）. Among them， 118 cases （38.82％） were over 60 years old. ADR/ADE occurred within 1 min to 10 days after administration， especially within 30 min after administration （123 cases， 40.46％）. ADR/ADE involved 36 varieties， mainly including agent for promoting blood circulation and dredging， agent for reinforcing and tonifying and agent for clearing away heat and detoxification， and Danhong injection accounted for the highest proportion （43 cases， 14.14％）. A total of 352 ADR/ADE case times occurred in 304 patients， mainly lesion of skin and appendents （164 case times， 46.59％）， followed by cardiovascular system lesions （54 case times， 15.34％） and systemic lesions （51 case times， 14.49％）. The main clinical manifestations were mainly pruritus （117 case times）， followed by rash （68 case times） and palpitation （34 case times）. Among 304 ADR/ADE reports， 26 cases （8.55％） were severe， 8 cases （2.63％） were new ADR/ADE， 302 cases （99.34％） were cured or improved， 2 cases （0.66％） were unknown， but none of them died. 266 cases （87.50％） were evaluated as likely to be related. 46 patients （15.13％） had combined use of drugs， including 9 cases of combined use of TCM injection and 37 cases of combined use of chemical medicine injection. CONCLUSIONS： TCM injections had a high incidence of ADR/ADE due to the complexity of their components， individual differences and clinical use. Most of them were rapid-onset ADR/ADE within 30 min and mild ADR/ADE commonly seen in lesion of skin and its appendents. The incidence could be reduced by rational clinical use and drug monitoring. For cardiovascular diseases and other basic diseases， attention should be paid to distinguishing their primary diseases from ADR/ADE caused by TCM injections， and more attention should be paid to their individualized drug use.
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OBJECTIVE：To investigate drug use in an obstetrics and gynecology hospital and confirm the types of drugs that need to be monitored so as to provide reference for rational drug use in clinic. METHODS： Activity based classification （ABC） analysis， Vital-Essential-Nonessential Medicine （VEN） analysis and ABC-VEN matrix analysis were used to statistically analyze the types of drugs in the inpatients and outpatients of this hosptial during Jan. 2016-Dec. 2017， and consumption sum in the hospital so as to determine the types of monitoring focus drugs. RESULTS： The drugs were divided into class A， B， and C by using ABC analysis， and the constitute ratio of them were 6.08％， 7.71％ and 86.21％； the constitute ratio of consumption sum were 70.97％， 19.07％ and 9.96％， respectively. The drugs were divided into class V， E and N， and the constitute ratio of them were 36.51％， 43.61％ and 19.88％； constituent ratios of their consumption sum were 31.89％， 33.89％ and 34.22％， respectively. The drugs were divided into group Ⅰ （class AV， AE， AN， BV， CV）， group Ⅱ （class BE， CE， BN） and group Ⅲ （class CN） by using ABC-VEN matrix analysis； the constitute ratios of accumulative number of drug type were 40.56％， 44.43％ and 15.01％，while those of accumulative consumption sum were 77.29％， 20.52％ and 2.19％， respectively. Among class N， the constituent ratio of consumption sum of class AN as Chinese patent medicine， blood substitutes and perfusion solutions were higher， being 12.48％ and 7.92％； that of class BN as Chinese patent medicine was higher， being 3.21％； those of class CN as Chinese patent medicine， sex hormones and modulators of the genital system were higher， being 1.14％， 0.50％. CONCLUSIONS： In the Obstetrics and Gynecology Hospital， consumption sum of class A is the main part of the total consumption sum of drugs， and they should be seleted according to therapeutic efficacy. Active regulatory policies should be adopted for class V and E so that more drug types that possess cost- effectiveness advantages； for class N， management control and reasonable utilization should be monitored closely to reduce irrational drug use. Some Chinese patent medicines， blood substitutes and perfusion solutions among class AN should be monitored and controlled emphatically.
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Objective: To provide reference for promoting the use of Tengyao in the treatment of pelvic inflammatory diseases (PID). Methods: From January to March 2017, 111 health workers in department of gynaecology were investigated. The quantitative research of KAP questionnaire was used, and the content of questionnaire included personal information, knowledge, attitudes and practices. Results: A total of 111 copies of questionnaire were distributed and 95. 5% of them were effective. Interviewees' overall knowledge was at low level while the attitude was at high level; the main way to obtain knowledge was coming from colleagues (76. 42% ); working lifetime and speciality classification had significant impacts on the level of knowledge (P<0. 05); the majority of interviewees were willing to learn the relevant knowledge through training sessions (54. 72% ) and new media (27. 36% ); 48 inter-viewees would like to continue to use Tengyao for treating PID. The main problem of Tengyao in the treatment of PID was inconvenient operation (63. 64% ). Totally 83. 96% of interviewees considered that the dosage forms of Tengyao should be improved, and 50. 94% of interviewees considered that the clinical efficiency evaluation should be studied. Conclusion: Interviewees'overall knowledge is still at low level, especially in the junior medical staff. Pharmacists should improve the knowledge level of medical staff by meeting train-ing, and study how to improve the dosage forms and evaluate the clinical efficiency of Tengyao.
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OBJECTIVE: To provide scientific evidence for the further improvement of hospital antibacterial management, the formulation of related management decisions and long-acting mechanism. METHODS: Technique for order preference by similarity to ideal solution (TOPSIS) was used to select 8 evaluation indexes as utilization rate of antibiotics in the inpatients to synthetically evaluate the effect of antibacterial management in 10 third grade general hospitals of Xi'an from 2012 to 2016. RESULTS: Results of synthesis evaluation by TOPSIS method showed that the least effect was in 2012 [coefficient of proximity from the object of evaluation to the optimal value (Ci) =0]; the effect of antibacterials management was improved gradually during 2013-2015, and there was the best effect in 2015 (Ci=0. 918 3); but declined in 2016 (Ci=0. 838 5). Only one evaluation index (the rate of microbial examination in the inpatient receiving special use of antibacterials) was improved significantly in the 5 years(P＜0. 01), but there was no statistical significance in the data of other 7 indexes (P＞0. 01). CONCLUSIONS: The effect of antibacterials management in 10 third grade general hospitals of Xi'an was on the rise from 2012 to 2015, but was declined in 2016. It might be slack. A long-acting management mechanism of antibacterial management is needed to be established, in order to consolidate the achievements from "special rectification for clinical antibacterial use" and further improve the normal and dynamic operation of antibacterial management measure. TOPSIS method is objective and comprehensive method for synthesis evaluation of the effect of antibacterial management, and is of significance to antibacterial supervision and use.
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OBJECTIVE:To investigate clinical efficacy and safety of Teng medicine combined with Gongyankang granules in the treatment of chronic pelvic inflammatory disease(CPID). METHODS:A total of 141 CPID outpatients were selected from our hospital during Jul. 2015-Jun.2016,other patients were divided into control group(65 cases)and observation group(76 cases)ac-cording to random number table. Control group was given Gongyankang granules 9 g orally,bid;observation group additionally re-ceived Teng medicine hot compress on lower abdomen for 30 min until it was cool,once a day,on the basis of control group. Both groups began the medication since third day after the menstrual period,for consecutive 20 d. TCM syndrome,local sign scores and clinical efficacies were compared between 2 groups before and after treatment,and the occurrence of ADR and recur-rence were observed in 2 groups. RESULTS:Before treatment,there was no statistical significance in TCM syndrome scores or lo-cal sign scores between 2 groups (P>0.05). After treatment,TCM syndrome scores and local sign scores of 2 groups were de-creased significantly,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). Clinical total response of observation group were 92.11％,which were significantly higher than 70.77％ of control group, rate recurrence rate of observation group were 2.99％,which were significantly under than 15.79％ of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Teng medicine hot compress combined with Gongyankang granules show significant efficacy for CPID,can improve TCM syndrome and local sign and reduce recurrence rate with good safety.
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Objective To investigate the effect of gypenoside on lipopolysaccharide (LPS)-mediated inflammatory response. Methods The BV2 microglia cell line was cultured in vitro. The BV2 microglia cells were divided into four groups: normal control, LPS (10 ng/ml), GP + LPS (GP 20 μg/ml, LPS 10 ng/ml), and GP (20 μg/ml). After 24 h cultivation, ELISA was used to detect the levels of tumor necrosis factor α(TNF-α), interleukin (IL)-1β, and IL-6. Immunocytochemistry staining and Western blot were used to detect the expression levels of nuclear factor (NF-κB) and suppressor of cytokine signaling 1 (SOCS-1). Results Compared with the normal control group, the release of TNF-α, IL-1β and IL-6, as well as the expression level of NF-κB in the LPS group were increased significantly (all P 0. 05 ). Conclusions GP can significantly inhibit the LPS-mediated microglial inflammatory response. SOCS-1 protein may be involved in GP inhibiting LPS-mediated microglial inflammatory response.