Risk factors of bronchopulmonary dysplasia in very preterm infants: a national multicenter study / 中国小儿急救医学

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Study on the Situation of Price and Distribution Cost about 63 Kinds of Drugs and Policies of Regulation Price in Hubei Province / 中国药房

OBJECTIVE:To provide reference for formulating drug price regulation policy and promoting reasonable drug price. METHODS:According to WHO and HAI drug price standard investigation,questionnaire survey(supplemented by field investigation)about sale price of 63 commonly used drugs with large consumption sum was conducted among 3 districts of different economic development levels in Hubei province. Median price ratio(MPR)was calculated statistically. Primary interview survey(supplemented by literature investigation)about drug distribution cost was conducted among managerial staff of pharmaceutical wholesale and retail enterprises,hospital pharmacy administrators. Suggestions were put forward to control distribution cost and standardizing drug price based on analysis and discussion. RESULTS:Totally 120 questionnaires were sent out,and 118 were effectively received,with effective recovery of 98.33%. Thirty managerial staff from drug wholesale and retail enterprises,hospital pharmacy department were interviewed for investigation of drug distribution cost. MPR of 63 drugs ranged 0.05-44.55 in different types of sample institutions. Among 67 specifications of 53 kinds of drugs,median retail price of 38 specifications(56.72%)was higher than international reference price in first-level sample medical institutions. Among 79 specifications of 63 kinds of drugs,median retail price of 57 specifications(72.15%)was higher than international reference price in second-level sample medical institutions. Among 80 specifications of 63 kinds of drugs,median retail price of 63 specifications(78.75%)was higher than international reference price in third-level sample medical institutions. Among 50 specifications of 37 kinds of drugs,median retail price of 42 specifications(84.00%)was higher than international reference price in sample pharmaceutical retail enterprises. In all sample institutions,maximum MPR of 13 specification were lower than 1;those of 12 specification ranged from 1 to <2;those of 23 specifications ranged from 2 to <5;15 specification ranged from 5 to <10;those of 17 specification were higher than 10. MPR of third-level medical institution samples were higher than those of second-level and first-level ones,and pharmaceutical retail enterprises(P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than those of first-level medical institutions(P<0.01). There was no statistical significance in the levels of MPR between second-level medical institutions and pharmaceutical retail enterprises(P>0.05). MPR of sample institutions in well-developed regions were higher than in medium-developed or less-developed regions(P<0.01). MPR of sample institutions in medium-developed regions were higher than in less-developed regions(P<0.01). MPR of original drugs were all higher than those of generic drugs in different types of sample institutions(P<0.01). There was no statistical significance in MPR of original drugs among different types of sample institutions(P>0.05). At the same time,MPR of generic drugs in third-level medical institution samples were higher than in second-level and first-level ones and pharmaceutical retail enterprises (P<0.05 or P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than in first-level ones(P<0.05). There was no statistical significance between second-level medical institution samples and pharmaceutical retail enterprises(P>0.05). Drug production and circulation cost,centralized bidding and purchasing price in Hubei province were higher than the national level. CONCLUSIONS:The drug price of Hubei province is in high level,especially that of three-level medical institutions is higher than other institutions;drug price of well-developed region is higher than those of medium-level and less-developed region;the price of original drugs are higher than those of generic drugs. The cost of pharmaceutical industry,drug circulation cost and the addition of drug price during application link eventually lead to the higher retailing price of drugs. Comprehensive policy measures need to be taken to control the cost of the whole process of drug distribution and to regulate the price of drugs.

Preparation and in vitro Property of Voriconazole Sulfonated Butyl Ether-β-Cyclodextrin Inclusion Compound / 中国药师

Objective: To prepare voriconazole (VCZ) sulfonated butyl ether-β-cyclodextrin (SBE-β-CD) inclusion compound and study the properties in vitro.Methods: VCZ SBE-β-CD inclusion compound was prepared respectively by a stirring method, an ultrasonic method and a grinding method, and the one with the highest inclusion rate and inclusion compound yield was chosen as the final preparation method.The formula and preparation process were optimized by an orthogonal design.The inclusion compound was identified by differential scanning calorimetry and solubility determination, and the in vitro dissolution was determined as well.Results: The stirring method had the highest inclusion rate and inclusion compound yield, and the optimal preparation and formula conditions were as follows: the inclusion temperature was 25℃, the stirring time was 4 h and the amount ratio of VCZ to SBE-β-CD was 1∶1.After the optimization, the inclusion rate was (86.14 ± 0.69)%, and the yield of inclusion compound was (97.11 ± 0.31)%.After the inclusion, the characteristic peak of VCZ disappeared and the solubility of VCZ increased significantly.Compared with those of VCZ, the dissolution rate and amount of VCZ inclusion compound both increased notably.Conclusion: VCZ SBE-β-CD inclusion compound can be prepared by the stirring method, which lays foundation for the further studies on VCZ eye drop.

Determination of Isomeric Impurity in Fasudil Hydrochloride by HPLC / 中国药师

Objective:To establish an HPLC method for the determination of isomeric impurity in fasudil hydrochloride. Meth-ods:The chromatographic method was carried out on a Kromasil 100-5 Phenyl C18 column with phenyl bonded silica as the filler (250 mm × 4. 6 mm, 5 μm), and phosphate buffer (10 mmol· L-1 ammonium dihydrogen phosphate, adjusting pH to 4. 0 with 1% phos-phoric acid) -acetonitrile (80∶ 20) was used as the mobile phase. The detection wavelength was 275nm and the column temperature was 40℃. The flow rate was 1. 0 ml· min-1 , and the injection volume was 10 μl. Results:Fasudil hydrochloride and its derivative was linear within the range of 0. 148-2. 960 μg·ml-1(r=1. 0000) and 0. 101-2. 014μg·ml-1(r=0. 999 9), respectively. The av-erage recovery of isomer impurity in fasudil hydrochloride was 101. 9% with RSD of 0. 98%(n=9). Conclusion:The method is sim-ple,accurate and reproducible,which can be used for the quality control of fasudil hydrochloride and its isomer.

The gene mutation in one neonate with Finnish type congenital nephrotic syndrome / 临床儿科杂志

Objective To investigate the NPHS1 gene mutations in Finnish type congenital nephrotic syndrome (CNF). Methods Clinical data of one neonate with CNF and the results of NPHS1 gene detection in the neonate and his parents were retrospectively analyzed. Results The male neonate who was born at gestational age of 34 weeks presented with breathing difficulties after birth, and then glycosuria, proteinuria, and hematuria at 3 days of age. The CNF was clinically diagnosed. The neonate carried two heterozygous mutations in NPHS1 gene, c.1699?>?C, p.(Cys567Arg) and c.3523_3524de1TT, p.(Leu1175Valfs). His father carried the heterozygous mutations of c.1699?>?C, p.(Cys567Arg). His mother carried the heterozygous mutations of c.3523_3524de1TT, p.(Leu1175Valfs). Conclusions The NHPSI gene mutation of c.1699?>?C, p.(Cys567Arg) and c.3523_3524de1TT, p.(Leu1175Valfs) may cause CNF. The mutation of c.1699?>?C, P. (Cys567Arg) has not been reported at home and abroad.

Investigation of stroke-preventing knowledge and influential factors in hypertensive patients from the communities of Guangzhou / 现代临床护理

Objective To investigate the current situations in stroke-prevention knowledge and influential factors in hypertensive patients from the communities of Guangzhou.Methods 94 hypertensive patients visiting the community health service centers in Guangzhou participated in the survey using stroke-preventing knowledge questionnaire.Results The total score on the stroke-preventing knowledge was(62.70±18.39).By stepwise regression analysis,those female and well-educated scored higher. The score on monitoring the blood pressure was the lowest(43.09±25.77).There were mistakes in medication,physical exercises and living habits.Conclusions The hypertensive patients in the communities in Guangzhou lack of stroke-preventing knowledge.In the stroke-preventing education,those male patients as well as those with less education deserves more attention.

Correlation between stroke preventing knowledge and health behavior in hypertensive and stroke patients / 现代临床护理

Objective To explore the correlation of stroke-preventing knowledge and health behavior in hypertensive and stroke patients.Methods A convenience sampling method was used.The stroke knowledge questionnaire(SKQ)and health promoting lifestyle profileⅡ(HPLPⅡ)were used to investigate 106 hypertensive natients and 336 stroke natients.Results The score on health knowledge was 61?43~70?99 and the total score of HPLP II was 2?22~2?59.Pearson's correlation coefficient between the two variables was 0?273~0?441(P<0?01).Conclusions The hypertensive patients with stroke have less stroke-preventing knowledge and their health behaviors are poor.Those with better health knowledge are better at healthy behaviors.It deserves our attention during health education for those with stroke of first and second stages.

Standardized management of patients with coronary heart disease in Yuetan Community of Beijing / 中华全科医师杂志

nses (P<0.01).Standardized management is favorable in community management of patients with coronary heart disease.

A STUDY OF PSS THERAPY ON REFRACTORY NEPHROSIS IN CHILDREN / 中国海洋药物

The changes of the hemorheology, plasma cholesterol and albumin and clinicaleffects in 36 children with refractory nephrosis after treatment with polysaccharide sulfate (PSS) were observed. The results showed that the indices of hemorheology and the plasma cholesterol decreased obviously and the albumin increased obviously than the control group ( P