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11 April 2021, Volume 19 Issue 4
    

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    Drug in the Future
  • A new small molecule drug with targeting mitochondrial function for the treatment of type 2 diabetes—Imeglimin
    ZHOU Yuan-cheng, NIE Lu
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 1-5. https://doi.org/10.3969/j.issn.1672-3384.2021.04.001
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    • Lastest Drug
  • Drug for endogenous Cushing syndrome—Osilodrostat
    LIU Yi-cong, ZHANG Hai-ying
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 6-9. https://doi.org/10.3969/j.issn.1672-3384.2021.04.002
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    • Original Article
  • The demand of primary caregivers for children's medication： a national investigation
    HUO Ji-ping, WANG Xiao-ling, YANG Xing-hua, WANG Xing-he, ZHENG Ai-ping, YANG Jian, XU Xin-wen, ZHANG Hong, YU Guo-chao, YAN Jin-ling, MA Shu-li, DONG Lin, XIE Juan, YANG Hui, PENG Jing, HUANG Jie, MA Chun-yan, ZHAO Rui-ling, REN Yan-li, ZHANG Shan, MA Zhi-min, SHEN Kun-ling, ZHAO Zhi-gang
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 10-15. https://doi.org/10.3969/j.issn.1672-3384.2021.04.003
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    Objective To explore the need of primary caregivers on medication for children， and promote medication safety for children. Methods The purposive sampling method was used， and an electronic questionnaire survey on children's medication needs among pediatric caregivers in 104 hospitals from June 1 to August 31， 2018 was conducted.SPSS 25 software was used for data analysis. Cronbach's α coefficient and KMO value was used as evaluation indexes for reliability and validity of the questionnaire， respectively. Results A totall of 49 982 valid questionnaires showed that primary caregivers obtained drugs' information mainly from physicians （59.11%）， pharmacists （55.09%） and drugstore clerks （42.87%）.The highest proportion of pediatric drugs was purchased according to doctors' prescriptions （70.82%）. Attentions on pediatric drugs were mainly concentrated in security （77.57%）， effectiveness （56.52%）， brand （52.25%）， and whether to be included in the drug list of national basic medical insurance reimbursement（79.91%）.Fruit granules （54.43%） and liquid formulations （51.11%） were the most acceptable dosage forms for children.Training about the preparation and administration of drugs in family medicine cabinet（68.63%）， rational use of common medicines（64.91%）， and the training of children's emergency knowledge（43.19%）were needed.Medication knowledge on safety medication， antibiotics， fever， and cold were needed at the highest level. Conclusion Safety， efficacy， palatability of dosage forms and whether to be included in the drug list of national basic medical insurance reimbursement was important factors for medication chooseing for children.Caregivers had a high demand for medication knowledge for children's medication knowledge. Medical institutions should further strengthen the education and popularization of medication knowledge for children， in order to promote the safety medication for children.
  • Establishment of substitute list for the targeted shortage-drugs in the emergency department
    ZHAO Fei, ZHAO Zi-nan, ZHOU Ying-yu, JI Li-wei, YAO Hui-qing, ZHAO Ming, SUN Xue-lin, ZHU Yuan-chao, FENG Yu-fei, ZHANG Ji-chun, FU Chun-yi, LI Ke-xin, HU Xin
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 16-21. https://doi.org/10.3969/j.issn.1672-3384.2021.04.004
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    Objective To explore the alternative medicine of the shortage-drugs in the emergency department， and provide the evidence to establish the list of alternative drugs for the targeted shortage-drugs. Methods With the focus shortage drugs designated by the National Health Commission， the initial list of alternative drugs for shortage drugs in emergency department was established by collecting the drug use and function databases from two different sources. After expert consultation and approval， 33 Grade-A medical institutions were investigated by questionnaire to determine the alternative drugs and the degree of substitution. Results Of total 47 shortage-drugs involved in the emergency department， 20 （42.6%） could not be replaced， 17 （36.2%） could be replaced by other drugs with the same formulation， and 10 （21.3%） could be considered to be replaced by other drugs with the same formulation. Conclusion The proportion of the shortage-drugs that can not be replaced in the emergency department is high. It is necessary to strengthen the management， early warning and response measures for the irreplaceable drugs in short supply and the drugs in short supply.
  • The risk prediction models of contrast-induced nephropathy in the coronary angiography / percutaneous coronary intervention population： a literature analysis
    MIAO Si-meng, LI Dan-dan, PAN Chen, SHEN Su, TAN Ling, WEN Ai-ping
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 22-27. https://doi.org/10.3969/j.issn.1672-3384.2021.04.005
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    Objective To summarize the risk prediction models of contrast-induced nephropathy （CIN） in the coronary angiography （CAG） / percutaneous coronary intervention （PCI） population， and provide a reference for early identification of high-risk group. Methods PubMed，Embase，Cochrane Library，CNKI，Wanfang and VIP databases were searched from the date of establishment to August 1， 2020. The literatures about risk prediction models of contrast-induced nephropathy in the CAG/PCI population were collected，and the relevant data were extracted for descriptive statistical analysis. Results A totally of 488 articles were retrieved. Finally， 31 valid articles were included，of which 4 were multicenter studies. Seventeen models were developed by Chinese researchers and 14 by foreign researchers. Twenty-nine models were established by logistic regression， and 2 were modeled by random forest method. Predictors of 31 models mainly included renal insufficiency （27，87%）， age （23，74%）， cardiac insufficiency （20， 65%）， diabetes （15， 48%）， intra-aortic balloon pump （12， 39%）， contrast medium volume （9， 29%）， hypotension（8， 26%）， anemia （5， 16%） and hypertension （4， 13%）， etc. In terms of model performance， only 3 models （10%） fully reported the discrimination and calibration degree of training set and validation set， while other models missed some indicators. Conclusion There were a relatively large number of CIN risk prediction models for CAG/PCI patients. However， the reporting of model performance， especially the calibration， was incomplete， and the predictors of each model were quite different. It is necessary to verify the existing models and further investigate their clinical applicability.
  • Lanreotide Acetate for injection in the treatment of acromegaly： a health technology assessment
    ZHANG Qi, MEN Peng, Suo-di ZHAI
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 28-33. https://doi.org/10.3969/j.issn.1672-3384.2021.04.006
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    Objective To provide evidence-based references for the clinical treatment and decision-makers by evaluating the efficacy， safety and economics of Lanreotide Acetate for injection in the treatment of acromegaly. Methods Therelevant studies were searched and screened systematical. Evaluation scales were used to evaluate the methodological quality of the included studies. The included randomized controlled trials were analyzed quantitatively， and other types of studies were analyzed qualitatively and comprehensively. Based on the cost-minimization analysis， the economics of postoperative treatment between Lanreotide and Octreotide microspheres were compared. Results A total of 4 systematic reviews/Meta analyses， 5 RCTs， and 3 pharmacoeconomic studies were included， and the overall methodological quality was good. In terms of symptom control rate and biochemical index control rate， the efficacy of Lanreitide Acetate for injection and Octreotide microspheres were equivalent. In general， Lanreotide Acetate for injection was well tolerated， and the incidence of adverse reactions was lower than that of Octreotide microspheres. The results of pharmacoeconomic studies suggested that the cost of drug treatment in the Lanreitide group is lower than that in the Octreotide microspheres at the equivalent dose. Conclusion Lanreitide Acetate for injection in the treatment of patients with acromegaly has the same clinical effect as Octreotide microspheres， with good safety and tolerance.At equivalent doses， Lanreotide is a cost-saving drug treatment option.
  • The anti-infective treatment of carbapenem-resistant Klebsiella pneumoniae meningitis in adults： a literature analysis
    CHEN Yue, ZHU Man, LIU Lei
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 34-38. https://doi.org/10.3969/j.issn.1672-3384.2021.04.007
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    Objective To study the anti-infective treatment of carbapenem-resistant of adult carbapenem-resistant Klebsiellapneumoniae （CRKP） meningitis. Methods The reports on CRKP meningitis treatment in Chinese and English databases were retrieved， and the basic characteristics of patients， etiology and drug sensitivity test， drug treatment regimen and prognosis were analyzed. Results From January，1990 to March ，2020，a total of 10 literatures and 47 cases were detected， including 8 case reports and 2 retrospective analyses. All patients under went neurosurgery and most of them had implants. Most of them were infected with single pathogen. The main drug treatment regimenwas intravenous combined with local administration， and the drugs included Ceftazidime/Avibactam， Polymyxin， Amikacin， Tigecycline， and so on. More than two drugs were used for intravenous-drip combined treatment except Ceftazidime/Avibactam. The average duration of anti-infective therapy was （30.1 ± 8.7） days. The cure rate was 58.8% and all the 3 patients who were treated with Ceftazidime/Avibactam intravenously were cured， however， there was a large bias. Conclusion The treatment of CRKP meningitis is difficult.The choice of drugs is limited， and the course of treatment is long， which needs clinical attention.
  • Effect of low dose Methoxamine Hydrochloride on neonatal blood gas indexes and hemodynamics of pregnant women during cesarean section
    ZHANG Hai-qing, BAO Yong-xin, YAN Zuo-li, NIU Liang
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 39-43. https://doi.org/10.3969/j.issn.1672-3384.2021.04.008
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    Objective To explore the effect of low-dose Methoxamine Hydrochloride on neonatal blood gas indexes and hemodynamics of pregnant women during cesarean section. Methods A total of 87 pregnant women who underwent cesarean section in Qingdao Women's and Children's Hospital from August 2016 to November 2017 were as the research objects， and they were divided into observation group （44 cases） and control group （43 cases） by random number table method. All pregnant women underwent combined spinal-epidural anesthesia， the observation group received an intravenous injection of 1 mg Methoxamine Hydrochloride immediately after the anesthesia was completed， and the control group received an intravenous injection of 2 mL normal saline. Measurement and comparison of changes in systolic blood pressure （SBP）， diastolic blood pressure （DBP） and heart rate （HR） of the two groups of pregnant women before and after anesthesia， including basic value after entering the room （T0）， immediately after anesthesia （T1）， 1 min after anesthesia （T2）， 5 min after anesthesia （T3）， 1 min before the newborn is delivered （T4）， 5 min after the newborn is delivered （T5）. The Apgar score was used to assess the physical state of the newborn 1 min after birth， simultaneously measure and compare the neonatal cord venous blood pH， blood gas index partial pressure of oxygen （PO2） and carbon dioxide （PCO2） levels. Results Compared with the results of HR measurement， the HR of observation group was significantly lower than T0 at T1 （P<0.05）， and T4 was significantly higher than T0 （P<0.05）， there was no significant difference compared with T0 at other time points （P>0.05）； The HR at T1 of the control group was significantly lower than T0 （P<0.05）， and the HR at T2-T5 was significantly higher than T0 （P<0.05）， and the HR at T2-T5 of the observation group was significantly lower than that of the control group （P<0.05）. Compared with SBP and DBP at different time points， the SBP and DBP at T1-T4 of the observation group and the control group were significantly lower than that at T0 （P<0.05）， and the SBP and DBP in observation group were significantly higher than those in control group at T1-T5 （P<0.05）. The Apgar score of newborns in observation group was significantly higher than that in control group ［（9.1±0.8） points vs.（8.0±0.8） points］ （P<0.05）， and the PO2 level was significantly higher than that of control group［（28±4） kPa vs. （25±3） kPa］， the PCO2 level was significantly lower than that of the control group ［（46±6） kPa vs. （51±6） kPa］ （P<0.05）. There was no significant difference in the incidence of adverse reactions between pregnant women in observation group and control group （13.64% vs. 11.63%） （P>0.05）. Conclusion In the cesarean section， the application of low-dose Methoxamine Hydrochloride can help pregnant women and newborns maintain the blood pressure，HR and blood gas indexes level after anesthesia， with little adverse reactions， and has positive significance for improving the safety of the cesarean section. This program has a value of promotion and application.
  • Analysis on the differences of ophthalmic drugs between national medical insurance drug catalogue and other drug catalogues
    MEI Long, LI Sa, ZHANG Yu-xuan, MEI Dan, ZHEN Jian-cun
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 44-48. https://doi.org/10.3969/j.issn.1672-3384.2021.04.009
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    Objective This study contrasted the medicines list of ophthalmic medications in the reimbursement medicine list of mainland China（Mainland and Chinese Taiwan）， Australia， the United Kingdom and WHO essential medicines list ，Aim to provide reference for modifying the medical insurance catalogue in China. Methods Collect all the medicines used in ophthalmology department with in Chinese mainland health insurance catalogue， the pharmaceutical benefits scheme in Australia（PBS）， British national formulary（BNF）， Chinese Taiwan health care directory and WHO essential medicines list （EML）. Comparing the similarities and differences. Results A total of 143 topical ophthalmic medicines were included in these five medicine lists. There are 67 items of medications in mainland China， accounting for 46.85% of the total. There are 47 items of listed in PBS， 101 items in BNF， 86 items of Chinese Taiwan and 16 items of WHO EML. The 5 catalogues contain 7 items at the same time， accounting for 4.90% of the total. There are 15 items are included in the national medical insurance catalogue while others are not， accounting for 10.49% of the total. 84 items were not listed in， while others are， accounting for 58.74% of the total. Conclusion The ophthalmic medication of our national reimbursement medicine list has a little different from other catalogues but it almost covers each kind of ophthalmology disease. The types of drugs can meet the clinical needs. Targeted agents are the most in all catalogues， but ophthalmic compound preparations need to be increased.
  • The effect of arthroscopic shoulder repair combined with Sodium Hyaluronate intraarticular injection on recovery of the shoulder function in patients with rotator cuff injury
    JIANG Ya-ming, LI Shi-fang
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 49-53. https://doi.org/10.3969/j.issn.1672-3384.2021.04.010
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    Objective To discuss the effect of arthroscopic shoulder repair combined with Sodium Hyaluronate injection on the shoulder function in patients with rotator cuff injury. Methods 120 patients with rotator cuff injury in Chongqing Kaizhou District People's Hospital were selected from September 2017 to September 2019， they were randomly divided into observation group （n=60） and control group （n=60）. The control group was treated with arthroscopic shoulder repair， the observation group was given Sodium Hyaluronate 2 mL based on this treatment during the operation and at the second and third week after the operation， the inflammatory response ［C reactive protein （CRP）， interleukin 8 （IL-8）， tumor necrosis factor α （TNF-α）］， shoulder pain ［visual analogue score （VAS）］， shoulder function ［the Constan Murley shoulder score （CMS）， the University of California at Los Angeles shoulder rating scale （UCLA）］ and complications were compared between the two groups. Results The CRP， IL-8 and TNF -α in the observation group and the control group at 4 weeks after operation were significantly lower than those in the before operation， the CRP， IL-8 and TNF-α in the observation group［（4.0±0.7） mg/L， （41±5） ng/L，（15.5±1.9） ng/L］ after operation were significantly lower than those in the control group［（5.6±0.9） mg/L， （55±6） ng/L， （18.3±2.0） ng/L］， the difference was statistically significant （P<0.05）. The VAS score in the observation group and the control group at 1 and 3 months after operation was significantly lower than that in the before operation， the CMS and UCLA scores in the observation group and the control group at 1 and 3 months after operation were significantly higher than those in the before operation， the VAS score in the observation group［（2.38±0.46） scores， （1.57±0.21） scores］ at 1 and 3 months after operation was significantly lower than that in the control group［（2.94±0.52） scores， （1.92±0.32） socres］， the CMS and UCLA scores in the observation group ［CMS：（76±8） scores， （87±9） scores； UCLA：（27.7±3.1） scores， （33.2±3.8） scores］ at 1 and 3 months after operation were significantly higher than those in the control group［CMS：（68±7） scores， （79±8） scores； UCLA：（22.5±2.6） scores， （28.6±3.2） scores］ （P<0.05）. There was no significant difference in the incidence of complications between the observation group and the control group （P>0.05）. Conclusion Arthroscopic shoulder repair combined with Sodium Hyaluronate injection can effectively improve the inflammatory response and pain symptoms of patients with rotator cuff injury， which is helpful to the recovery of shoulder function， and it has the good safety， it's worth for further clinical promotion.
  • Analysis on changes in anti-tumor drug in WHO essential model list and the effect on revision of national essential medicines list
    YAN Jia-qing, LIU Min, MA Ying-lin, LE Kai-di, DONG Bin, LI Guo-hui
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 54-57. https://doi.org/10.3969/j.issn.1672-3384.2021.04.011
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    Objective The differences of anti-cancer drug list between national essential medicines list 2018（NEML-2018） and WHO essential model list 2019（WHO-EML-2019） were compared in order to provide reference for the improvement of NEML in the future. Methods The differences in category， content， formulation， dosage forms， special identification for children as well as indications for use were compared between the two lists， and the existing problems were also analyzed. Results The anti-cancer drug list in NEML-2018 was basically consistent with the epidemic characteristics of cancer in China. Compared with WHO-EML-2019， the number of anti-cancer drugs included in the two lists was 35 and 59； the dosage form for injection and oral was 26-40 and 15-30 respectively. Otherwise， special indications for clinical use and identification for children were lacked in NEML-2018. Conclusion Compared with WHO-EML-2019， some disadvantages were still existing in NEML-2018 including category， content， formulation， dosage forms and special indications. Taking WHO-EML as reference， evidence-based evaluation and pharmacoeconomic analysis should be considered in the future revision of anti-cancer drug list in NEML.
  • Analysis on the usage and rationality of medication administration through nasal feeding tubes for intensive care unit patients
    ZHANG Ying, GU Qing, LIU Li-hong
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 58-62. https://doi.org/10.3969/j.issn.1672-3384.2021.04.012
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    Objective The general situation and rationality of medication administration through feeding tubes for hospitalized intensive care unit （ICU） patients were evaluated and analyzed in the Capital Medical University Affiliated Beijing Chaoyang Hospital （west campus）， so as to provide reference and suggestions for clinical medication administration and operation through feeding tubes. Methods Retrospective analysis method was used to collect the medical records of 58 patients in ICU ward from January to June in 2020 who were given drugs through nasal feeding， and statistical analysis was conducted on medication administration and rationality. Results Medication administration through nasal feeding tubes included a total of 90 drug varieties， medical orders for nasal feeding were 6890 items， and the frequency were 27 532 times. Among them， inappropriate application of drug dosage form occurred 3499 times （12.71%）； inappropriate between nasal feeding tube and drug characteristics occurred 417 times （1.51%）； unreasonable compatibility between drugs occurred 1012 times （3.68%）； unreasonable administration timing occurred 786 times （2.85%）； simultaneous administration of multiple drugs occurred 15 769 times （57.28%）； and unreasonable drug pretreatment operations occurred 714 times （2.59%）. Conclusion There are some unreasonable conditions in clinical nasal feeding medication in ICU ward of our hospital. It is necessary to strengthen the theoretical knowledge in training and clinical practice guidance on nasal feeding medication for medical staff， and intervene by rational drug use software to improve the rationality of nasal feeding medication therapy.
    • Medication in Primary Care
  • General clinical diagnosis and treatment thinking series： hyperventilation syndrome
    JIN Feng
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 63-66. https://doi.org/10.3969/j.issn.1672-3384.2021.04.013
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    • Drug and Clinic
  • The role of clinical decision support system in rational use of proton pump inhibitors
    LI Hui-bo, Suo-di ZHAI
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 67-71. https://doi.org/10.3969/j.issn.1672-3384.2021.04.014
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  • Progress for the application of the Pharmaceutical Care Network Europe classification system to drug-related problems in hospitalized patients
    LI Hui-xin, CAI Jun, ZHANG Yu-sheng, ZHANG Jin-ping
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 72-75. https://doi.org/10.3969/j.issn.1672-3384.2021.04.015
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  • A summary analysis of clinical pharmacists' intervention in community patients' medication consultation issues under the medical complex
    WANG Rui-tao, MEI Dan, DU Li-ping, LUAN Wei-li, LI Xin, ZHAO Bo-lu, NIU Jun-ping, LI Ning, CHEN Bin-bin
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 76-78. https://doi.org/10.3969/j.issn.1672-3384.2021.04.016
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  • Application and drug concentration monitoring of Digoxin in 106 hospitalized children
    CHEN Wen-wen, JIANG Yong-xian, TAO Wan-jun, YANG Jia, LI Gen
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 79-82. https://doi.org/10.3969/j.issn.1672-3384.2021.04.017
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    • Medication Therapy Management
  • Pharmaceutical practice of an abnormal increase in international standardization ratio in Warfarin anticoagulant patients： a case report
    WANG Pei-xiang, WANG Yu-ying, DUAN Jing-li
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 83-85. https://doi.org/10.3969/j.issn.1672-3384.2021.04.018
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  • Pharmaceutical administration of a child with skin and soft tissue infection caused by mycobacterium abscess
    HE Xiao-jin, ZHONG Xu-li, ZHANG Jun-li, WANG Xiang-yan, LIN Ai-hua, PENG Wen-xing
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 86-89. https://doi.org/10.3969/j.issn.1672-3384.2021.04.019
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  • A case of desensitization treatment with recombinant human granulocyte stimulating factor
    ZHANG Ming-hui, ZENG Ling-rong, HUANG Xue-mei, YANG Yan
    CLINICAL MEDICATION JOURNAL. 2021, 19(4): 90-92. https://doi.org/10.3969/j.issn.1672-3384.2021.04.020
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