Research progress of anti-Acinetobacter baumannii drug / 药学学报

Compared with other drug-resistant strains, Acinetobacter baumannii has the characteristics of serious drug resistance, high mortality and difficulty to treat. As the phenomena of resistance to existing anti-Acinetobacter baumannii drugs continuously occurs, the development of new anti-Acinetobacter baumannii drugs is urgent. This review introduces the clinical application and research progress of anti-Acinetobacter baumannii drugs, aiming to provide help for the research and development of anti-Acinetobacter baumannii drugs.

Experience and enlightenment of generic drug substitution promotion policy in drug use in typical foreign countries / 中国卫生政策研究

Objective:From the link of drug use to improve China's generic drug substitution promotion policy to provide suggestions.Methods:Literature research method was used to explore the ideas and typical measures of promoting generic drug substitution in Europe,the United States,Japan and other countries.Combined with the existing problems in the process of generic drug substitution in China,specific suggestions were put forward to improve the promotion policy of generic drug substitution in the process of drug use in China.Results and conclusions:Through the experience research of Europe,the United States,Japan and other countries,it is found that typical countries outside the region have formed the idea of"accepting generic drugs-scientific and reasonable substitution-continuous feedback and improvement"in the process of promoting generic drug substitution.It is suggested that China incorporate the opinions of doctors and patients into the generic drug substitution decision-making,establish generic drug substitution rules based on risk,strengthen the real-world data research and monitoring and evaluation of generic drug substitution,strengthen the disclosure of generic drug information and policy publicity,further improve the promotion policy of generic drug substitution in the drug use process in China,and promote the alternative use of generic drugs.

Situational diagnosis of the popular use of medicinal plants in pediatrics / Diagnóstico situacional do uso popular de plantas medicinais em pediatria

Abstract This study aimed to describe the use of medicinal plants for the relief and treatment of pediatrics pathologies performed by parents of children registered in a Basic Health Unit. This is a cross-sectional, observational and analytical study that occurred from March until May 2016, with the participation of 176 individuals, using a semi-structured questionnaire as a research instrument. Descriptive statistics were applied for data analysis, using frequency distribution and chi-square test. Among all 177 indications of medicinal use of plants in childhood, considering the plant part and administration method, 61.6% converged with scientific data, 21.5% differed and 16.9% were new indications without a similar record in the literature. These results support the popular use of medicinal plants and show to need for greater awareness about the rational use of phytotherapy and stimulate scientific research, as they bring new elements about the therapeutic potential of different species.

Resumo O objetivo deste estudo foi descrever o uso de plantas medicinais para alívio e tratamento de patologias em pediatria realizado por pais de crianças cadastradas em uma Unidade Básica de Saúde. Trata-se de um estudo transversal, observacional e analítico, que ocorreu nos meses de março a maio de 2016, com a participação de 176 indivíduos, utilizando como instrumento de investigação um questionário semiestruturado. Para análise dos dados aplicou-se a estatística descritiva, com uso da distribuição de frequências e o teste do qui-quadrado. Das 177 indicações de uso medicinal de plantas na infância, considerando a parte da planta utilizada e sua forma de uso, 61,6% convergiram com os dados científicos, 21,5% divergiram e 16,9% foram novas indicações, sem registro semelhante na literatura. Esses resultados, ao mesmo tempo em que respaldam o uso popular de plantas medicinais, apontam a necessidade de maior conscientização sobre o uso racional da fitoterapia e estimulam a investigação científica, pois trazem novos elementos sobre o potencial terapêutico de diferentes espécies.

Establishment and Application of Rationality Evaluation Criteria for Tumor Nutritional Standardized Treatment / 中国药房

OBJECTIVE：To establish the eva luation criteria for the rationality of tumor nutritional standardized treatment ，and to provide reference for nutritional standardized treatment in tumer patients . METHODS ：Based on domestic and foreign guidelines or expert consensus ，the rationality evaluation standard of tumor nutritional standardized treatmentwas formulated in our hospital （Bozhou Municipal People ’s Hospital ）. 50 nutritional treatment medical records in our hospital from Jan. to Jun. 2019 were evaluated by weighted TOPSIS ；according to the evaluation results ，nutritional intervention was carried out ，and 50 nutritional treatment medical records （group B ）from Aug. to Dec. 2019 were re-evaluated by the same method after intervention. RESULTS ： The established evaluation criteria for the rationality of tumor nutritional standardized treatment in our hospital included 18 indicators，such as malnutrition diagnosis ，description of the nature of malnutrition ，nutrition screening and evaluation ，etc. After analysis ，the rational rate of nutritional treatment was only 18％ in group A （Ci of ideal solution with 9 medical records≥0.6），and 78％ in group B （Ci of ideal solution with59 medical records ≥0.6）. There was statistical significance in the rationality of nutritional treatment before and after nutritional intervention （Ci≥0.6）（P＜0.05）. CONCLUSIONS ：The established rational evaluation method of tumor nutritional standardized treatment is feasible ，and the evaluation results are intuitive and reasonable. Nutrition intervention is helpful to reduce the irrational rate of nutritional treatment.

Expert Consensus on Clinical Use and Management of High Concentration of Potassium Chloride Injection in Yunnan Province （2020） / 中国药房

OBJECTIVE：To provide sugge stions for improving the variety of pediatric drugs and ensuring the safety of pediatric drug use in China. METHODS ：The historical evolution of laws and regulations on the marketing approval of pediatric drugs in the United States and the implementation results of relevant policies were summarized. Combined with the current situation of the development of pediatric drugs in China ，some suggestions were put forward to ensure the accessibility and safety of pediatric drug use in China. RESULTS & CONCLUSIONS ：Since 1994，the United States had issued a series of laws and regulations to encourage the development of pediatric drugs. At present ，the marketing approval of pediatric drugs were mainly based on the two laws of Best Pediatric Drug Act（BPCA）and Pediatric Research Equality Act （PREA）. From 1998 to 2019，the amount of supplements of pediatric drug information in drug instructions of the United States showed a fluctuating growth. As of April 2020，854 kinds of drugs had been modified in pediatric instructions ，792 of which had been carried out post marketing pediatric clinical research ，and the problem of incomplete pediatric instructions had also been greatly improved. At present ，China’s policies on pediatric drugs mainly included encouraging R&D innovation ，giving priority to review and approval ，and strengthening R&D technical guidance. Although certain achievements had been made ，there were still some problems ，such as imperfect policies and regulations ，and great difficulties carrying out pediatric drug clinical trials. It is suggested that our country should draw lessons from the American regulations on pediatric drugs ，pediatric research and the catalogue of pediatric drugs ，and establish a system and catalogue of ped iatric drug use suitable for China ’s national conditions ，so as to improve the effectiveness ，safety and accessibilityof pediatric drugs.

Research on Reliability Index and Realization of Magnetic Resonance (MR) Based on Clinical Use Condition / 中国医疗器械杂志

Combined with the clinical use condition of MR in use in Shanghai Sixth People's Hospital, MR components are divided into scanning type I and scanning type II. At the same time, combined with the main loss force of MR components, the research divides MR components into dynamic components and electric thermal components. In this study, a complete set of MR system reliability indexes and implementation methods are given, including system reliability index determination, system reliability allocation, component reliability index realization, system reliability prediction and system reliability verification. At the same time, this study also gives the methods of reliability prediction and reliability verification, and gives the MTBF calculation method of MR system based on clinical use data statistics.

Cântico negro: o uso clínico do conceito de pulsão de morte / Black canticle: the clinical use of the death instinct concept / Canto negro: el uso clínico del concepto de pulsión de muerte / Cantique noir: l'utilisation clinique du concept de la pulsion de mort

Discute-se o conceito de pulsão de morte e seu emprego no caso clínico de um usuário de drogas. Faz-se um apanhado da sua anunciação e das dificuldades em aceitá-lo e utilizá-lo, indicando seu papel central nas patologias não neuróticas. Conjectura-se sobre a elaboração da constituição do aparelho psíquico, e especula-se sobre a mudança de paradigma na psicanálise a partir da introdução da nova dualidade pulsional.

The concept of death instinct and its use in a clinical case of a drug user is discussed. An overview of its announcement and the difficulties in accepting and using it, is made, indicating its central role in non-neurotic pathologies. It is conjectured about the elaboration of the constitution of the psychic apparatus and speculated about the paradigm shift in psychoanalysis from the introduction of the new instinctual dualism.

Se discute el concepto de pulsión de muerte y su uso en un caso clínico de un consumidor de drogas. Se hace una descripción general de su anuncio y las dificultades para aceptarlo y usarlo, lo que indica su papel central en las patologías no neuróticas. Se conjetura sobre la elaboración de la constitución del aparato psíquico y se especula sobre el cambio de paradigma en el psicoanálisis a partir de la introducción de la nueva dualidad pulsional.

Le concept de pulsion de mort et son utilisation dans le cas clinique d'un toxicomane sont discutés ici. On fait un aperçu de son annonce et des difficultés à l'accepter et à l'utiliser, en indiquant son rôle central dans les pathologies non névrotiques. On fait des conjectures sur l'élaboration de la constitution de l'appareil psychique et on spécule sur le changement de paradigme en psychanalyse depuis l'introduction de la nouvelle dualité pulsionnelle.

Investigation and Analysis of Off-indication Drug Use of Folic Acid in Outpatient / 中国药学杂志

OBJECTIVE: To understand the current situation of off-indication drug use of folic acid in our hospital, to explore the rationality of the use of folic acid in combination with the latest guidelines, Meta-analysis and other data, to put forward suggestions for improvement and to provide reference for the rational use of folic acid in clinic. METHODSE: Retrospective study method was used to select all outpatient prescriptions of folic acid in our hospital from January 2019 to October 2019. According to the "drug instructions", relevant guidelines and consensus of experts, the data were processed and analyzed by Excel software. RESULTS: A total of 12 087 patients were included, including 11 226 patients using 5 mg folic acid and 861 patients using 0.4 mg folic acid. The results showed that there were 18 departments using 5 mg folic acid. The diagnosis of folic acid was found in nervous system, immune system and kidney system. Sixteen departments, including obstetrics, family planning, gynecology and respiratory medicine, used 0.4 mg folic acid, which were mainly diagnosed as pregnancy examination, infertility, menopause, postoperative lung cancer and so on. CONCLUSION: At present, there is a universal phenomenon of off-indication drug use of folic acid. In the current study, clinical pharmacists should strengthen the evaluation of rational use of folic acid in the aspects of over-indication.

Discussion on Clinical Use and Technical Requirements of Scored Tablets / 中国药学杂志

OBJECTIVE: To discuss the technical requirements of scored tablets combining with the current situation of clinical use of scored tablets and the domestic and national technical requirements. METHODS: The FDA guidance on tablet scoring was introduced in detail, on this basis, the general considerations on the technical requirements of generic scored tablets were put forward. RESULTS: AND CONCLUSION: It was suggested that the evaluation criteria should be established on the basis of taking a full consideration on product characteristics in the process of research and development, scored tablets should be developed in accordance with clinical needs, and specification description should be standardized for clarifying the clinical use of the scored tablets.

Analysis on the Policy Measures of Clinical Use Incentives and Risk Control for Biosimilars in the European Union / 中国药学杂志

OBJECTIVE: The supervision of biosimilars in EU is based on scientific and reasonable principles. It not only had lots of laws, regulations and policy guidelines on marketing approval, but also made great efforts in clinical use and risk monitoring. To provide reference for the supervision and management of biosimilars in China. METHODS: Through the data summary and system comparison, the article described and analyzed the clinical use incentives and post-marketing risk control policies of biosimilars in EU countries. RESULTS: It is found that under the background of perfecting the regulatory systems and policies, EU countries encourage the vigorous development of the biosimilar industry and strictly control the drugs' safety, effectiveness and clinical risks. CONCLUSION: China could learn from the EU experience, encourage the development of biosimilars by improving pricing, reimbursement, clinical substitution and other policies. At the same time, we should also pay attention to the specificity of biosimilars, ensure that clinical risks are controllable and drugs are safe and effective.

Problems of Clinical Use in Pediatric Drug and Countermeasures Analysis in China / 中国药房

OBJECTIVE： Te analyze the problems of clinical use in pediatric drug in China， and to put forward related countermeasures and suggestions. METHODS： Using “children” and “pediatrics” as retrieval words， registered drug information were retrieved from the website of China Food and Drug Administration； the data of pediatric drug use prescription was retrieved from hospital prescription system of 9 hospitals； all drug information were retrieved from national drug data management system； off-label drug use investigation and the literatures of pediatric drug use in medical institutions （5 representative third grade general medical institutions） were retrieved from CNKI and Wanfang database. General information and problems of pediatric drug use in China were investigated. RESULTS： A total of 170 009 items of registered drug information were retrieved， including 2 784 drug information items labeled with ”children” or ”pediatrics”， accounting for 1.64％；320 000 drug prescriptions from hospital prescription system of 9 hospitals covered 22 treatment areas involving 1 186 drugs and 51 dosage forms. Only 10％ suitable for children. The retrieval results of database showed that the incidence of children off-label drug use in outpatients prescriptions of 5 hospitals was in high level， mainly manifesting as without the information of pediatric drug use， hyper-indication drug use， hyper-dosage drug use. There were many problems in clinical pediatric drug use in China， such as less variety for children， single dosage form and specification， widespread off-label drug use， lack of scientific reference for drug use， difficulty in developing pediatric drug clinical trials， etc. CONCLUSIONS： Although the policies to protect children’s clinical drug use have been introduced in China， the problems facing children’s clinical drug use in China are still very serious. While further implementing relevant policies， it is necessary to establish a linkage management system led by government departments， with the full participation and mutual cooperation of society， enterprises， medical institutions and patients so as to guaratee the safety of pediatric drug use in clinic.

Analysis of the Historical Evolution of “Eighteen Incompatible Medicaments ”and“Nineteen Medicaments of Mutual Restraint ” of TCM and Its Clinical Application / 中国药房

OBJECTIVE： To investigate the historical evolution and clinical application of “eighteen incompatible medicaments” and “nineteen medicaments of mutual restraint” of TCM， and to provide reference for enriching the contents of rational use of TCM. METHODS： Through the methods of literature mining， using “eighteen incompatible medicaments” “nineteen medicaments of mutual restraint” “incompatible medicaments” “clinical use” “ADR” “ADE” as keywords， retrieved from CNKI， Wanfang， VIP database （from the date of database establishment to August 2018） and library of Henan University of TCM， related literatures about “eighteen incompatible medicaments” and “nineteen medicaments of mutual restraint” were extracted and combed， and the history and clinical application of them were summarized and analyzed. RESULTS & CONCLUSIONS： “Eighteen incompatible medicaments” is one of the main contents of TCM basic theory. The word is first published in Shubencao， which is the concrete embodiment of the “opposite” in the “seven compatibility regularities” of TCM， and the number of “eighteen incompatible medicaments” of TCM recorded in the medical books of TCM is different from each other in the past dynasties. “Nineteen medicaments of mutual restraint” is one of the taboos of TCM compatibility， which is first found in Shennong’s Herbal. There are mixed use of “mutual inhibition” “incompatible” and “mutual restraint” in all dynasties， and there is still controversy about the attribution of “seven compatibility regularities” of “nineteen medicaments of mutual restraint” among physicians. Regardless of ancient medical books， modern medical books， various editions of Chinese Pharmacopeia， literature reports and clinical applications， there are compatibility usage of drug pairs of “eighteen incompatible medicaments” and “nineteen medicaments of mutual restraint”. Among them， 8 kinds of set prescription preparations containing drug pair of “eighteen incompatible medicaments” were involved in 2015 edition of Chinese Pharmacopoeia （part Ⅰ）， most of which were Aconitum carmichaelii/Aconitum kusnezoffii-Bletilla striata/Ampelopsis japonica； 9 kinds of set prescription preparations containing drug pair of “nineteen medicaments of mutual restraint” were also involved， most of which were Syringa oblate-Curcuma rcenyujin， Cinnamomum cassia-Halloysitum rubrum. Although there are medical records or literature pointing out that it can be used to treat critical and difficult diseases， and some studies have preliminarily confirmed the compatibility rationality of individual incompatibility medicaments/medicaments of mutual restraint， the conclusions of relevant studies are not entirely consistent， and the intensity of research evidence is not high， and the research evidence is insufficient.  Basic researches should be strengthened and large-scle， multiple-center and high-quality  clinical studies are needed to confirm this conclusion so as to guaratetee the rationality and safety of drug use in clinic.

Clinical efficacy and practicability analysis of circulating tumor cells / 实用肿瘤学杂志

Circulating tumor cells(CTCs)are a special type of biomarker that can be used as a diagnostic tool to predict the prognosis of multiple tumors.At present,although circulating tumor cells have not been full clinically application,studies on circulating tumor cells have shown high clinical efficacy,especially in the fields of breast cancer,lung cancer,prostate cancer and colorectal canc-er.This article reviews the research progress of circulating tumor cells in metastatic cancer and non-metastatic cancer,analyzes the clinical efficacy and practicability of circulating tumor cells.

Prediction and Enlightenment of Optimal Single-batch Production for Five Oral Solutions in a Hospital / 中国药师

Objective: To predict the optimal single-batch production and annual production batches for five oral solutions in order to support equipment upgrade and control reasonable cost as well as provide reference for optimizing production management of new preparation room. Methods: The clinical use of the five oral solutions in four consecutive validity periods was retrospectively analyzed. Decision analysis was used to predict the optimal single-batch production and annual production batches for the five oral solutions. The weight coefficient was adjusted according to the clinical characteristics of each preparation. Results: The optimal single-batch produc-tion for the five oral solutions was five to seven times larger than the current scale while the annual production batches were greatly re-duced. In particular, compound ammonium chloride and glycyrrhiza oral solution ( formerly known as brown mixture) were reduced from 95 batches to 13 batches per year. Conclusion: The optimal prediction can provide reference for the appropriate adjustment of production scale of hospital preparations to lower the cost of single packaging production. At the same time, it is also beneficial to the overall management of production equipment selection and future scale design for new preparation room.

Validation of the mobile wireless digital automatic blood pressure monitor using the cuff pressure oscillometric method, for clinical use and self-management, according to international protocols

The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ± SD, which ranged in 0.1 ± 2.6 mmHg for systolic blood pressure (SBP) and 0.5 ± 2.2 mmHg for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean ± SD) was 2.3 ± 4.7 mmHg for SBP and 2.0 ± 4.2 mmHg for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5 mmHg and a standard deviation that did not exceed 8 mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.

Clinical Application Analysis of Andrographolide Total Ester Sulfonate Injection, a Traditional Chinese Medicine Licensed in China / 华中科技大学学报（医学）（英德文版）

Andrographolide total ester sulfonate (ATES) injection is one of the products of traditional Chinese medicine (TCM) currently used against viral infection in China.ATES injection was approved for manufacturing and marketing in January 2002.It is indicated for acute respiratory infections,tonsillitis,chronic obstructive pulmonary disease,influenza,foot and mouth disease,bronchiolitis,herpangina,mumps,infectious mononucleosis and psychosis.However,its usage also carries risk.We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-word clinical application using the hospital centralized monitoring method.A total of 848 cases were enrolled in this study.In these cases,it was mainly used for postoperative anti-inflammation and treating upper respiratory infection,pneumonia and bronchitis.Among them,39.86％ were contraindicated.Irregular medication of adults and children accounted for 1.91％ and 23.38％,respectively.Improper choice of solvent accounted for 3.18％.The choice of intravenous drip versus aerosol inhalation was reasonable.A case of adverse events (AEs) was observed in the monitoring period,and the incidence of adverse drug reaction (ADR) of ATES injection was 0.12％.ATES injection in our hospital is relatively safe with a low incidence of adverse reactions.The study assesses the clinical usage and adverse reactions of ATES injection,and provides suggestions for rational use in clinical practice.

Investigation and Analysis on the Clinical Use of Curcumae Rhizoma in Jiangsu Province Based on Ingredi-ent and Efficacy Difference / 中国药房

OBJECTIVE:To provide reference for clinical rational use of curcumae rhizoma. METHODS:According to litera-ture retrieval,the chemical structures,ingredient and efficacy difference of curcumae rhizoma with different sources and difference processed products were summed up. According to literature retrieval,telephone consultation and network retrieval,the production status of products with different sources and difference processing and the application in clinic and preparations in Jiangsu province were analyzed. RESULTS:The volatile oil content was the highest in Curcuma wenyujin;curcumin content was the highest in Cur-cuma phaeocaulis;the contents of 4 main active ingredients(curdione,curcumol,germacrone and curcumin)were relatively lower in Curcuma kwangsiensis,and there were quite different ingredients in the C. kwangsiensis from different producing areas. Results of investigating the annual output of medicinal materials in Sichuan,Guangxi and Zhejiang in 2016 showed,the annual output of C. kwangsiensis was the highest,and C. wenyujin and C. phaeocaulis were relatively lower. In the investigated 14 manufacturers producing curcumae rhizoma oil in China,12 took C. wenyujin and 2 took C. phaeocaulis as raw material. While the 9 manufactur-ers in Jiangxi province mostly took C. wenyujin(locally produced)as raw material,which was not from the genuine producing ar-ea-Zhejiang province. In the 10 third-grade class-A TCM hospitals and 20 retail TCM pharmacies in Jiangsu province,the C. phaeo-caulis and C. kwangsiensis were mainly used,in which,the use proportion of C. kwangsiensis accounted for about 70%,and C. wenyujin used little in clinic. The main processed product in clinic was curcumae rhizoma processed by vinegar,and crude product was rarely used. CONCLUSIONS:Currently,the clinical use of curcumae rhizoma shows problems in narrow selection of pro-cessed products and uneven quality,which can be solved by cultivating fine varieties in producing areas,increasing the planting amount of C. phaeocaulis,drug regulatory authorities'strict rules for processed products of curcumae rhizoma in hospitals and re-tail pharmacies.

Investigation and Analysis on the Clinical Use of Curcumae Rhizoma in Jiangsu Province Based on Ingredi-ent and Efficacy Difference / 中国药房

OBJECTIVE:To provide reference for clinical rational use of curcumae rhizoma. METHODS:According to litera-ture retrieval,the chemical structures,ingredient and efficacy difference of curcumae rhizoma with different sources and difference processed products were summed up. According to literature retrieval,telephone consultation and network retrieval,the production status of products with different sources and difference processing and the application in clinic and preparations in Jiangsu province were analyzed. RESULTS:The volatile oil content was the highest in Curcuma wenyujin;curcumin content was the highest in Cur-cuma phaeocaulis;the contents of 4 main active ingredients(curdione,curcumol,germacrone and curcumin)were relatively lower in Curcuma kwangsiensis,and there were quite different ingredients in the C. kwangsiensis from different producing areas. Results of investigating the annual output of medicinal materials in Sichuan,Guangxi and Zhejiang in 2016 showed,the annual output of C. kwangsiensis was the highest,and C. wenyujin and C. phaeocaulis were relatively lower. In the investigated 14 manufacturers producing curcumae rhizoma oil in China,12 took C. wenyujin and 2 took C. phaeocaulis as raw material. While the 9 manufactur-ers in Jiangxi province mostly took C. wenyujin(locally produced)as raw material,which was not from the genuine producing ar-ea-Zhejiang province. In the 10 third-grade class-A TCM hospitals and 20 retail TCM pharmacies in Jiangsu province,the C. phaeo-caulis and C. kwangsiensis were mainly used,in which,the use proportion of C. kwangsiensis accounted for about 70%,and C. wenyujin used little in clinic. The main processed product in clinic was curcumae rhizoma processed by vinegar,and crude product was rarely used. CONCLUSIONS:Currently,the clinical use of curcumae rhizoma shows problems in narrow selection of pro-cessed products and uneven quality,which can be solved by cultivating fine varieties in producing areas,increasing the planting amount of C. phaeocaulis,drug regulatory authorities'strict rules for processed products of curcumae rhizoma in hospitals and re-tail pharmacies.

Study on the Regularity of Clinical Use of Gypsum from TCM Prescriptions / 中国药房

OBJECTIVE:To investigate the efficacy difference of gypsum in oral and external prescriptions,so as to provide reference for safe and effective drug use in clinic. METHODS:According to Chinese Medical Classics(electronic books)and Selected Dictionary of Chinese Medical Prescriptions,the prescriptions containing gypsum from the Eastern Han Dynasty to the Modern Times (up to 1979)were summarized;the regularity of clinical use of gypsum by physicians in past dynasties were analyzed. RESULTS:A total of 682 prescriptions containing gypsum were collected. According to the time,there were 169 prescriptions of the Song Dynasty (24.8％)and 152 prescriptions of the Qing Dynasty(22.3％);there were 138 prescriptions of the Ming Dynasty(20.2％)and 118 prescriptions of the Modern Times(up to 1979,17.3％);there were 53 prescriptions of the Jin and Yuan Dynasty(7.8％)and 52 prescriptions of the Han Dynasty,the Jin Dynasty,Northern and Southern Dynasties,and Tang Dynasty(7.6％). Gypsum mainly showed the efficacy of clearing heat-fire,relieving restlessness and slaking thirst,promoting wound healing and tissue regeneration, astringing dampness and stopping bleeding,etc. Among them,there were 516 prescriptions of clearing heat-fire (75.7％),69 prescriptions of relieving restlessness and slaking thirst(10.1％),56 prescriptions of promoting wound healing and tissue regeneration (8.2％),20 prescriptions of astringing dampness and stopping bleeding(2.9％),21 prescriptions of other efficacy(tooth fixation, cosmetology,health care and so on,3.1％). This indicated that the effect of gypsum was mainly clearing heat-fire;gypsum could treat heat-induced disease by combining with other drugs. It could be used in following prescriptions,such as yangming heat syndrome, syndrome of flaring heat in Qifen and Xuefen(Ying),Qifen fever complicated with syndrome of deficiency of Qi and Yin,other meridians complicated with excess-heat syndrome,miscellaneous dosease due to internal injury. In addition,gypsum could be cyed erally or externally,and it can be taken orally after being calcined. CONCLUSIONS:By studying the prescriptions of gypsum used by physicians in past dynasties,it can promote the further use of gypsum,and give better play its clinical efficacy.

Establishment of Clinical Use Management Mode of Adjuvant Therapy Drugs in Our Hospital / 中国药房

OBJECTIVE:To standardize the clinical use of adjuvant therapy drugs. METHODS:To establish the clinical use management mode of adjuvant therapy drugs in our hospital and summarize the usage amount and irrational drug use of adjuvant therapy drugs before and after implementing the management,and the management effect was assessed. RESULTS:The manage-ment mode of adjuvant treatment drugs in our hospital included ensuring the directory for adjuvant therapy drugs,establishing the management system and ensuring its basic principles,then conducting drug use review with the ranking of drug dosages and mak-ing full use of evidence-based medical evidence,as well as developing principle of classification disposal for the irrational drug use (off-indications,overdose,ultra treatment) of adjuvant therapy drugs. After more than one year of management practice,the use of adjuvant therapy drugs in our hospital is increasingly standardized. The sales amount of adjuvant therapy drugs to all drugs was reduced from 20.90％ before management(Aug. 2014-Jul. 2015)to 15.99％(reduced by 5％)after management(Aug. 2015-Jul. 2016). Compared with Aug. 2015,the sales amount of 48 varieties in the 93 adjuvant therapy drugs was dropped more than 15％in Aug. 2016,and irrational drug use decreased obviously. CONCLUSIONS:The established management mode of adjuvant thera-py drugs in our hospital has effectively improved clinical rational drug use and reduced medical costs.