The suprachoroidal space is a potential space between the sclera and choroid. Suprachoroidal spacedrug delivery is becoming an applicable method to the ocular posterior segment diseases. Because it targets the choroid, retinal pigment epithelium and retina with high bioavailability and safety, while maintaining low levels elsewhere in the eye. In recent years, new discoveries has been carried out in different areas of interest, such as drug delivery methods, pharmacokinetics and clinical trials. Clinical trials with suprachoroidal space injection of triamcinolone acetonide are executed with promising findings for patients with noninfectious uveitis and diabetic macular edema. Suprachoroidal space triamcinolone acetonide injectable suspension is the first and currently the only agent specifically approved for uveitic macular edema by Food and Drug Administration. Nowadays, many clinical trails with suprachoroidal space drug delivery have been explored, although there are still many risks and uncertainties. With the development of technology in the future, suprachoroidal space drug delivery appears to be a promising treatment modality for ocular posterior segment diseases.
Objectives To analyze the labeling of drug items for patients with renal insufficiency in our hospital so as to provide reference for rational use of drugs. Methods The drug instructions used in No.1 Hospital of Jilin University in 2017 were collected. According to the classification of pharmacology, the instructions of the top 9 drugs system were selected. The annotation of drug items for patients with renal insufficiency in these pharmaceutical instructions was analyzed. Results A total of 812 drug instructions were included, in which 72.17% did not mark drug instruction for renal insufficiency patients. According to the administration system, the highest unlabeled rate were digestive system drugs; according to the method of administration, the highest unlabeled rate was external preparation of drugs, accounting for 83.33%; according to production enterprises, the highest unlabeled rate were domestic drugs, accounting for 75.55%. There were only 23.40% of the tagging items having guidance of medication, and some with a certain degree of confusion in the annotation. Conclusion The unlabelling situation of drug instructions for renal insufficiency patients is very serious. It should arouse the attention of pharmaceutical manufacturers and the pharmaceutical supervisory department is suggested to strengthen the supervision of drug instructions and regulate the contents of drug labeling in drug instructions, so as to guide the rational use of drugs in clinical practice.
PURPOSE:Studying the multidrug resistance(MDR) phenotype occurring in retinoblastoma and its mechanism. METHODS:Using the procedure of stepwise increase in drug concentrations to obtain a retinoblastoma subline which resistant to 600ng/ml vincristine (HXO-RB/VCR). Characteristics of this drug-resistant cell line were investigated by cell counting,drugcontents determinatin,drug sensitivity evaluation and radiation sensitivity test. RESULTS:This cell line was cross-resistant to VDS,MMC VP16，ADM ,DDP,CBP,but not resistant to BCNU and 5-Fu. It was proved to be collaterally sensitive to MTX,and the response to 60Co gamma;-ray was modified slightly in HXO-RB/VCR cell line. Intracellular levels of VCR was much higher in HXO-RB44 cells than in the resistant subline. Those cross-resistances can be reversed by verapamil partly. CONCLUSIONS:MDR and radiation resistance of retinoblastoma can be induced by exposing to VCR and reversed by verapamil partly. （Chin J Ocul Fundus Dis,1997,13: 6-9）
ObjectiveTo retrospectively investigate the drug use of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011, and to compare with outpatients with lung cancer concurrently, so as to evaluate the rationality of drug use among over-60-year inpatients with lung cancer in the West China Hospital. MethodsThe information of over-60-year inpatients with lung cancer as initial diagnosis in the West China Hospital in 2011 was collected from the hospital information system (HIS), including patient information, drug use information, cost information, etc. Data rearrangement and analysis by classes and costs were carried out using Microsoft Excel 2010 software. Resultsa) There was 2 215 person-times of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011. A total of 5 classes, 63 kinds of anti-tumor and adjuvant therapy drugs were involved. The total drug use frequency was 12 398 person-times. The average medicine cost was 774.93 yuan. b) The ratio of patients using 1 to 4 kinds of drugs was 34.31%, 5 to 10 kinds was 41.9%, and 11 to 15 kinds was 12.63%. c) For etiological treatment, the ratio of chemotherapy drugs was 99.45%, and the most used was cisplatin. d) For symptomatic treatment, the ratio of analgesics was 66.69%; the ratio of antitussive drugs was 21.33%; and the ratio of skeletal related events prevention drugs was 11.98%. e) For anti-ADR treatment, the ratio of antiemetic drugs was 55.07%; the ratio of stomach protection drugs was 32.63%; and the ratio of hepatic protection drugs was 12.30%. f) For other treatment, the ratio of immunopotentiating drugs was 59.46%; and the ratio of hematopoietic growth factor was 25.42%. g) For Chinese patent medicine, drugs used over 400 person-times were Diyushengbai tablet, Javanica oil emulsion injection, Aidi injection, and Huisheng oral liquid. h) For single/combined treatment, the ratio of two-drug combined chemotherapy was 78.38%, one analgesics drug treatment was 66.21%, one hepatic protection drug treatment was 83.41%, two-drug combined antanacathartic treatment was 45.88%, one stomach protection drug treatment was 90.53%, one immunopotentiating drug treatment was 90.53%, one hematopoietic growth factor treatment was 82.31%, and one Chinese patent medicine treatment was 37.39%, respectively; and antitussive and skeletal related events prevention drugs were used alone. i) The use frequency of the top 10 drugs were: pantoprazole, tropisetron, ondansetron, diphenhydramine, thymopentin, cisplatin, Diyushengbai tablet, tramadol, Javanica oil emulsion injection, and Aidi injection. j) Compared with outpatients, inpatients drug use frequency was higher in chemotherapy, analgesics, antiemetic, stomach protection, hepatic protection drugs, and Chinese patent medicine; but lower in skeletal related events prevention drug; and similar to the drug use situation of outpatients in immunopotentiating drugs and hematopoietic growth factor drugs. ConclusionThe antitumor therapies were mainly the combination of two chemotherapy drugs or single drug regimen for over-60-year inpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antiemetic and stomach protection drugs. Chinese patent medicine and immunopotentiating drugs are in common use as well.
ObjectiveTo retrospectively analyze antibiotic resistance and clinical characteristics of Klebsiella pneumoniae strains for guiding the rational use of antibiotics in the area of the Bai nationality.MethodsThe antibiotic resistance and clinical characteristics of Klebsiella pneumoniae strains were retrospective analyzed, which were isolated from specimens of inpatients in First People’s Hospital of Dali between May 2016 and May 2017.ResultsAmong the 1 342 samples of various kinds of samples, 262 strains of Klebsiella pneumoniae were isolated, with the detection rate of 19.52% (262/1342). Clinical isolated strains were mainly from the new pediatric, intensive care unit, respiratory medicine, pediatrics, and mostly from sputum specimens (78.24%, 205/262). By screening of 22 kinds of antimicrobial agents, all strains had ampicillin resistance (100.00%), while none of these strains had ertapenem resistance. Extended-spectrum β-lactamases (ESBLs) positive strains’ resistance rate was higher than ESBLs negative strains (χ2=261.992, P<0.01). There were 76 drug resistant profiles, most of which were multidrug-resistant bacteria except 116 (44.27%) strains were resistant to ampicillin antibiotics only. And the number of strains in other resistant types ranged from 1 to 16. Only one of 262 strains had amikacin resistance, two of them were resistant to imipenem and meroenan.ConclusionsThere are many multidrug-resistant bacteria in Klebsiella pneumoniae in the population of Bai nationality, and there are no extensively drug resistant bacteria and pandrug-resistant bacteria strains. The strains of carbapene-resistant antibiotics should be worthy of clinical attention.
Objective To find out an effective technique torepair large segmental infected bony defect.Methods Calcium phosphate cement(CPC) incorporated with bone morphogenetic protein and gentamycin was embedded in the massive reconstituted bovine xenograft(MRBX), then CPC-MRBX was obtained after CPC’s solidification. In vivo test was applied to test the drug delivery capability of CPC-MRBX, in which it was implanted in the dorsal muscle pouch of 18 rabbits. The drug concentration of animal blood and surrounding soft tissue of the CPC-MRBX in the muscle pouch was measured 1, 2, 5, 10, 15, 20, 25, 30 and 35 d after operation, 2 rabbits each time. Large segmental infected femur defect in the rabbit model was created to test the repairing capability of CPC-MRBX. External fixation was done 1.5~2.0 cm above the knee, the most adjacent nail to fracture site was 0.5～0.8 cm away, and proper pressure was applied to the graft. In experimental group(n=25), the bony defect was replaced by CPC-MRBX, while in the control group(n=15) dissected bone block was re-implanted in original position. The animal was subjected to radiographic, histological examination at 4, 8, 16 and 24 weeks. The general condition was observed after the operation.Results CPC-MRBX was easily made under normal temperature and pressure. In viro drug delivery test showed that the drug concentration of the tissue remainedabove the minimal inhibitory concentration of staphylococcus 30 d after operation and no significant increase of blood drug concentration was observed. In experimental group, no adverse influence was observed. Four weeks after operation, the animal could bear load, bony callus around the graft was observed by X-ray, and abundant chondral tissues that grew into CPC-MRBX were observed by histological method. Eight weeks after operation, progressively increasing bony callus around the graft was observed, external fixation could be removed, normal function was restored, and CPC was degenerated dramatically while new bone tissues were growing. Sixteen weeks after the operation, more new bone tissues grew and CPC was degenerated furtherly while marrow tissues were taking shape. Twenty-four weeks after the operation, femur healed completely and CPC was degenerated completely. In the control group, the autograft remained unhealedon X-ray at 4 weeks, and osteomyelitis manifestation such as inflammatory cells infiltration and osteolysis was detected at 4 weeks. All the animals in the control group died before the 8th week, 4 of which showed positive hemoculture. Conclusion CPC-MRBX is readily available and can be applied to repairing large segmental infected bony defect.30 d after operation and no significant increase of blood drug concentration was observed. In experimental group, no adverse influence was observed. Four weeks after operation, the animal could bear load, bony callus around the graft was observed by X-ray, and abundant chondral tissues that grew into CPCMRBX were observed by histological method. Eight weeks after operation, progressively increasing bony callus around the graft was observed, external fixation could be removed, normal function was restored, and CPC was degenerated dramatically while new bone tissues were growing. Sixteen weeks after the operation, more new bone tissues grew and CPC was degenerated furtherly while marrow tissues were taking shape. Twenty-four weeks after the operation, femur healed completely and CPC was degenerated completely. In the control group, the autograft remained unhealedon X-ray at 4 weeks, and osteomyelitis manifestation such as inflammatory cells infiltration and osteolysis was detected at 4 weeks. All the animals in the control group died before the 8th week, 4 of which showed positive hemoculture.Conclusion CPC-MRBX is readily available and can be applied to repairing large segmental infected bony defect.
Objective To investigate the drug resistance and homogeneous analysis of Acinetobacter baumanii in emergency intensive care unit ( EICU) . Methods Four multidrug-resistant Acinetobacter baumannii ( MDR-Ab) strains isolated fromnosocomial inpatients fromJuly 25 to September 7 in 2009 were collected and tested for drug sensitivity and MIC determination as well. The A. baumannii isolates were typed with pulsed-field gel electrophoresis ( PFGE) to determine whether they derived fromthe same clone.Results Four isolates from nosocomial inpatients were resistant to multiple antibiotics including carbapenem. The PFGE types identified from four isolates were A and B. The A. baumannii isolates did not derived from the same clone. Conclusion The prevalence of nosocomial infection is not due to transmission of the same strains among different individuals in EICU.
ObjectiveTo investigate the development, production and use of children’s drugs in Sichuan Province, analyze the problems existing in these links, and provide suggestions for ensuring that children’s needs for drugs are met. MethodsThe self-filling electronic questionnaire was used to investigate the production, procurement and use of children’s drugs in 14 pharmaceutical companies producing children’s drugs and 20 general hospitals with pediatric departments or children’s hospitals in Sichuan province. ResultsThe 14 surveyed pharmaceutical companies reported that 116 children’s drugs were being developed or produced (75 first-class children’s drugs with exact medication information for children, 41 second-class children’s drugs only noted as children's discretionary reduction or use according to clinician’s instructions), out of which 109 (93.97%) drugs had been approved for marketing, 21 (18.10%) were national essential medicines and 76 (65.52%) were covered by national basic medical insurance. The dosage forms of first-class children's drugs were mainly tablets (28, 37.34%) and granules (19, 25.34%), while oral solution (3, 4.00%), syrup (5, 6.67%) and other dosage forms suitable for children were less. According to the surveyed results on the use of children's drugs in hospitals, there were 57 children’s drugs whose minimum use units needed to be manually divided into smaller ones on average in each hospital, and it was the most common operation pattern that pharmacists informed nurses, patients or patients’ family members of the dose splitting methods and then splitting drugs’ minimum use units by themselves. ConclusionThere is a great demand for splitting minimum use units of drugs whose strength is too big for children in medical institutions, and some children’s drugs need to be developed and further modified to meet the clinical children’s drug needs. We should further increase investments and policy supports for the children’s drugs, promote children’s clinical trials, and encourage the research and development of children’s drugs.
ObjectiveTo explore the appropriate intervention measures to reduce the influence of drug repercussion by pediatric hospital inpatients on nursing work. MethodBetween March 1st and 28th, 2014, statistical analysis on the characteristics of pediatric drug-return by drug repercussion questionnaires was carried out. ResultsEach drug repercussion took much time of the nurses (median of 5.00 minutes per time). The frequency of drug repercussion in the internal medicine department was more than that in the surgical department; the most drug repercussions were found in the respiratory medicine department, reaching 26.84%. The main category of drug repercussion was aerosolized medication (39.32%). The drug repercussion mainly resulted from lack of patients' education and doctor-related administration, which had a proportion of 31.44% and 27.19%, respectively. ConclusionsThe wards which have more drug repercussions should be under the supervision according to the analysis of drug repercussion. Meanwhile, improving patients' education and training of medical staff can reduce the pediatric hospital inpatients' drug repercussion and also may reduce the bad effects on nursing work.