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OBJECTIVE To investigate the effect of gene polymorphism on opioid-induced constipation. METHODS The target genes related to opioid-induced constipation were screened out through searching guidelines， databases and evidence-based medical data， and then 100 cancer pain patients who received opioid drugs for analgesia were included as the study subjects. According to whether there were adverse effects of constipation after medication or not， they were divided into test group and control group， with 50 cases in each group. The target gene was detected by PCR or fluorescence in situ hybridization. The SNPStats program was used to carry out Hardy-Weinberg balance test and correlation analysis between gene polymorphism and opioid-induced constipation. The multivariate Logistic regression analysis was used to explore the relevant predictive factors of opioid-induced constipation， and receiver operating characteristic （ROC） curve of subjects was drawn to analyze the effectiveness of each predictive factor in predicting opioid-induced constipation. RESULTS CYP2D6， CYP3A5*3， ABCB1 and OPRM1 were selected as target genes for detection. The results of genotype detection showed that the frequency distribution of CYP2D6 （rs1065852， rs1135822， rs16947， rs28371725， rs28371735）， CYP3A5*3 （058rs776746）， ABCB1 （062rs1045642）， OPRM1 （047rs1799971） alleles were consistent with Hardy-Weinbergbalance test. The correlation analysis results showed that the proportion of genotype GG and AG in CYP3A5*3 （058rs776746， 163.com A＞G） and genotype AA and AG in OPRM1 （047rs1799971， A＞G） of patients was significantly higher in test group than that in the control group （P＜0.05）. Multivariate Logistic regression analysis showed that medication duration， CYP3A5*3 and OPRM1 gene polymorphism could be used as predictors of opioid- induced constipation in patients （P＜0.05）. The ROC curve analysis results showed that the areas under the ROC curves for medication duration and CYP3A5*3， OPRM1 gene polymorphism were 0.648， 0.640 and 0.670， respectively， with the optimal cutoff values of 124.0， 0.5 and 0.5， respectively. CONCLUSIONS Genotype GG and AG in CYP3A5*3 （058rs776746，A＞G） and genotype AA and AG in OPRM1 （047rs1799971，A＞G） are associated with opioid-induced constipation， which are expected to become clinical predictors of opioid-induced constipation， and more attention should be paid to the occurrence of constipation in patients who have been taking opioids for a long time.
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OBJECTIVE To conduct a c omprehensive clinical evaluation method of Chinese patent medicine ，and to provide reference for rational clinical drug use. METHODS Taking the top 10 Chinese patent medicine injections for promoting blood circulation and removing stasis in Shandong province from 2016 to 2020 collected by the National Rational Drug Use Monitoring Network as an example ，the method combining health technology assessment with objective judgement analysis is used to construct the comprehensive evaluation index system ；based on evidence-based medical evidence and pharmacoeconomic model ，the safety ， effectiveness and economy of the drug were evaluated comprehensively ，and the scores were quantified. RESULTS & CONCLUSIONS The final scores of the 10 kinds of Chinese patent medicine injections were between 26 and 37 scores. Safflower yellow for injection scored the highest score in the treatment of cerebral infarction and angina pectoris of coronary heart disease ， while Ginkgo diterpene lactone meglumine injection and Shuxuening injection had the highest scores in the treatment of coronary heart disease. The clinical comprehensive evaluation method of Chinese patent medicine based on evidence-based medical evidence and pharmacoeconomic model can clarify the comprehensive value of Chinese patent medicine in clinic ，promote rational drug use in clinic ，and provide basis for the next adjustment of medical insurance catalogue and essential medicine catalogue ，decision-making of centralized procurement of related drugs.
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Objective:To investigate and analyze the clinical application and adverse reactions of scopolamine butylbromide injection to promote the rational use in clinics. Methods:Totally 3695 effective cases treated with scopolamine butylbromide injection were collected from January 2016 to July 2017, and the age, sex, cause of drug use, medication days, combined use, high risk factors, and names, types and clinical manifestations of adverse reactions induced by scopolamine butylbromide were classified and statistically analyzed. Results:The overall incidence of adverse reactions of scopolamine butylbromide was 0.22%. The drug use rate was 44.36% in high-risk patients. The incidence of adverse drug reactions in high-risk patients was 1.83%,and that in low-risk patients was 0.24%, and the difference was 7.63 times. Combined drug use was common, and 1.98% of the combined use had potential drug interactions. Conclusion:The requirements of drug instructions should be strictly followed,and high-risk patients and drug combination should be paid much attention in order to reduce the risk of adverse drug reactions and ensure the drug safety.
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Objective To determine the off -label use of antibacterial agents,we investigated and analyzed the current status about off -label use of antibacterial agents.Methods The random sampling was conducted to select the outpatient prescription including antibacterial agents from January to April in 2016.According to drug instructions,the off -label drug use of prescription was analyzed.Results 1 264 prescriptions involving 58 kinds of drugs were analyzed.The main categories of off -label drug use were no pediatric and elderly information(23.42%), indication(4.1 5%),dosage (6.31 %),dosage range (62.95%)and administration route (3.1 5%).Conclusion The off -label use of antibacterial agents is common in our hospital.It's in need to regulate off -label drug use.