最新刊期
卷 31 ， 期 8 ， 2020
- 摘要：OBJECTIVE：To understand the current management situation and problems of residual drugs in medical institutions in China ，evaluate the practice effect of corresponding control mode of our hospital and to explore the countermeasures to reduce the production of residual drugs and standardize its management. METHODS ：By random sampling ，30 third-level hospitals and 20 second-level hospitals in different regions were selected respectively during May 1st to 31st in 2019. For the pharmaceutical personnel，doctors，nurses and other non-pharmaceutical personnel ，a self-designed questionnaire on the status quo of residual drugs in medical institutions was issued. Excel 2010 software was used to count basic data of valid questionnaire ，and the causes ， management status ，disposal status and possible hazards of residual drugs in medical institutions were analyzed. A management mode of residual drugs was established and implemented （involving reducing the generation of sources ，implementing process management，and strictly implementing disposal ）. The effects of the model were evaluated ，then the countermeasures and suggestions were put forward . RESULTS & CONCLUSIONS：A total of 400 questionnaires were sent out ，and 311 valid questionnaires were collected with effective recovery rate of 77.75％. The causes of drug residual were complicated ，which included the“combination”of the same drugs ，the pre-order dispensing ，adverse drug reactions ，poor compliance of patients ，wrong order imput，sudden transfer ，discharge or death of patients ，wrong dispensing or nurse check error ，etc. The management status of residual drugs was chaotic ，the disposal methods lacked of standardization ，which may lead to harm such as deterioration ，illegal Δ 基金项目：重庆市技术预见与制度创新项目（No.cstc2018jsyj- recycling and pollution . The established whole-link residual zdcxX0093） drug management model in our hospital ，mainly included ＊主管药师 ，硕士。研究方向 ：药事管理 、抗肿瘤药理 。电话： measures of introducing Clinical Departments Residual Drug 023-68774769。E-mail：513293274@qq.com Safety Management Regulations to clarify the responsibilities # 通信作者：主任药师，博士生导师，博士。研究方向：药事管理、 of management group ， clinical department ， pharmacy 临床药学。电话：023-68755580。E-mail：zrcq73@163.com department； using rational medication control software to 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·897· reduce prescription error ；increasing the frequ ency of drug inventory ；introducing Drug Withdrawal and Refund Management to clear out drug withdrwal process ；independently researching and developing “Residual Drug Recovery Management System ”to standardize and simplify the recovery process ；bringing the residual drugs into special fund project management for medical assistance. According to the operation management practice from Jan. to Oct. 2018，a total of more than 1 million yuan worth of residual drugs were recovered. The residual drugs that did not meet the recovery conditions should be destroyed according to the specified process ，and the case number of non-standard notification of ward management would significantly reduced. The whole-link mode management established by our hospital can effectively reduce the production of residual drugs and standardize their management and disposal. It is suggested that the state or province should issue special regulations on the management of residual drugs in medical institutions ，and each medical institution should formulate specific management measures suitable for its own unit. Meanwhile ，the management of residual drugs in medical institutions should be further standardized systematically by actively exploring the ways to reduce residual drugs ，formulating the corresponding financial account processing standards ， supporting incentive mechanism and other measures.关键词：Medical institution;Residual dru g;Whole-link control mode;Drug management;Practice
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provi de reference for classification ，selection and management of antibacterial drugs in medical institutions. METHODS ：The adjustment of antibacterial drug list in 2019 edition of National Basic Medical Insurance ，Work Injury Insurance and Maternity Insurance （called“New List ”for short ）was introduced. The politic reference of selection and adjustment of antibacterial drugs and the principle of classification selection in medical institutions were sort out. The challenges which may bring to pharmaceutical administration and clinical use in medical institutions were investigated. RESULTS & CONCLUSIONS： Three new varieties of the antibacterial drugs in the New List have been added ，including Doxycycline injection，Faropenem granules and Metronidazole oral regular-release preparations. Nine product specifications were excluded ，such as Tetracycline oral regular-release preparations ，Dirithromycin oral regular-release preparations ，etc. The limitation of indications and/or indications of 19 regulations was modified ，and some antibacterial requirements were limited to patients with clear evidence of drug sensitivity test or severe infection. When classifying and selecting antibacterial drugs ，medical institutions should take the existing policy documents as the basis ，strictly implement the relevant provisions of antibacterial drug management ，give priority to meeting various national prescription sets and drug list varieties ，select drugs with sufficient evidence-based treatment basis ，drug quality and safety ，and take into account the convenience and economy of drug use ，supply guarantee service capacity of drug production and circulation enterprises and local situation of pathogenic bacteria resistance. The adjustment of New List also brings challenges to use and management of antibacterial drugs in medical institutions. For example ，New List emphasizes“limited drug sensitivity evidence ”for many antibacterial specifications. But if the clinicians choose drugs mechanically according to the drug sensitivity results and ignores the experience treatment in anti-infection treatment ，another type of “abuse”may be abused ；in addition，the indications of myxomycetin B and colistin （sulfate myxomycetin ）are completely different ，which also deserves further study.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To invest igate the medication regulation of Tibetan medicine prescription of Punica granatum seeds， and to analyze the pharmaceutical property of it in the treatment of “Sanweihuo”（Me drod gusm) dysfunction induced-related diseases. METHODS ：Using Clinical Notes of Tibetan Medicine ，Medicine Standard of the Ministry of Public Health ：Tibetan Medicine as standard ，Tibetan medicine prescriptions of P. granatum seeds recorded in Sibu Yidian ，Yuewang Yaozhen and other medical records were collected ，and TCMISS V 2.5 software was used to analyze main indication and medicine frequency statistically. The core medicine combinations of the prescriptions were analyzed with Apriori algorithm （support degree ≥50％， confidence degree ≥90％)，and medication regulations were analyzed. Tibetan medicine “Ro Nus Zhu rJes ”vector model was used to analyze the properties of Tibetan medicine prescription of P. granatum seeds in the treatment of high frequency diseases ，and K-means cluster analysis was carried out for seventeen effectiveness. RESULTS ：A total of 300 Tibetan medicine prescriptions of P. granatum seeds were collected ，involving 104 kinds of main indications ，among which frequency of 18 kinds of indications was more than or equal to 10 times，including“non-indigestion syndrome ”（Ma Zhu ba) （76 times)，“wood cloth disease ”（Smug po) （46 times)，“edema”（Chu nad) （34 times)，etc. Totally 322 kinds of Tibetan medicines were involved. Among them ，21 flavors were more than or equal to 50 in frequency ，including Piper longum （192 times)，Amomum kravanh （164 times) and Carthamus tinctorius（134 times)，etc. Fifty-six core combinations were obtained ，mainly including P. granatum seeds-P. longum （192 times)， P. granatum seeds-A. kravanh （164 times) and P. granatum seeds-C. tinctorius （134 times). The prescriptions （13 pieces) with six flavors as pungent ，sweet and sour ，and with prominent medicinal properties such as roughness ，heat and dry effects could be used to treat “non-indigestion syndrome ”，and then included into type Ⅰ. The prescriptions （13 pieces) with six flavors as bitter ，sweet and pungent ，and with prominent medicinal properties such as cooling ，dull and heavy effects could be used to treat “wood cloth disease”，and then included into type Ⅱ. The prescriptions （11 pieces) with six flavors as sweet ，sour and pungent ，and with prominent medicinal properties such as dull ，heavy and moistening effects could be used to treat “edema”，and then included into type Ⅲ. CONCLUSIONS ：Tibetan medicine P. granatum seeds is often used in combination with the isothermal medicines such as P. longum ，A. kravanh . P. granatum seeds are also commonly found in cool prescriptions ，revealing that Tibetan medicine pays attention to “Sanweihuo”while treating diseases ，which embodies the academic thought of Tibetan medicine that “there is cooling in temperature ，and there is temperature in cooling ”.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To e stablish the method for simultaneous determination of 10 kinds of active components in Tibetan medicine Siwei jianghuang prescription ，and to optimize its decoction technology. METHODS ：HPLC method was adopted. Using soaking time ，the amount of added water ，decoction time and decoction times as factors ，comprehensive score of the contents of 10 kinds of components and solid extracts rate as response values ，one the basis of single factor test ，Box-Behnken response surface method was used to optimize its decoction technology. RESULTS ：The linear range of gallic acid ，corilagin，magnoflorine， ellagic acid ， hydrochloric jatrorrhizine ， hydrochloride palmatine ， hydrochloride berberine ， bisdemethoxycurcumin， demethoxycurcumin and curcumin were 0.280 6-1.683 6，0.289 6-1.737 6，0.320 8-1.924 8，0.116 0-0.696 0，0.018 9-0.113 5， 0.013 3-0.079 9，0.092 3-0.553 8，0.025 5-0.153 0，0.036 1-0.216 3，0.041 0-0.245 7 µg（all r were 0.999 9），respectively. The limits of quantitation were 0.28，14.48，3.21，11.60，1.89，4.44，0.46，0.26，0.36，0.41 ng，respectively. The limits of detection were 0.11，4.14，1.24，3.32，0.58，1.33，0.13，0.09，0.14，0.12 ng，respectively. RSDs of precision ，stability and reproducibility tests were all lower than 3％. The recoveries were 92.56％-103.69％（RSDs were 0.90％-3.81％，n＝6）. The optimal decoction technology included soaking 60 min，adding 8-fold（mL/g）water，decoction for twice ，lasting for 65 min each time. In 6 validation tests ，comprehensive scores were 3.323 2-3.422 4，and the absolute value of the relative error with the predicted value （3.437 4）was less than 2％.CONCLUSIONS：Established method is simple and repeatable ，and can be used for simultaneous determination of 10 kinds of active components in Siwei jianghuang prescription. Optimized decoction technology is stable and feasible.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To optimize the water extraction and ethanol precipitation technology of Zhuang medicine Baijin granules. METHODS ：HPLC method was adopted to determine the content of bergenin in Baijin granules extract. The extraction routes of Baijin granules （water decoction ，70％ ethanol reflux extraction ，water decoction combined with 70％ ethanol reflux extraction）was screened primarily with the yield of extract and the experiment of reducing uric acid of mice. The orthogonal test was adopted to optimize water extraction technology of Baijin granules with water multiple ，extraction time and extraction times as factors，taking the extraction yield and the bergenin content as index ，then the validation test was carried out. The orthogonal test was adopted to optimize the alcohol precipitation process of Baijin granules including the relative density of medicinal materials ， alcohol content and the alcohol precipitation time ，then the validation test was carried out. By the experiment of reducing uric acid ， the effects of medicinal materials extract of Baijin granules extract were compared before and after ethanol precipitation. RESLUTS：Established method for content determination of bergenin with linearity range of 0.007 2-0.288 mg/mL，had good precision，reproducibility，stability and accuracy. The initially chosen extraction process of Baijin granules was water decoction extraction. The optimal water extraction technology was soaked for 0.5 h，then decocted for 3 times with 14-fold water （mL/g）and 1.0 h each time. The optimal ethanol precipitation process was to concentrate the water extract to a relative density of 1.0 g/mL with alcohol content of liquid at 60％ and precipitated for 12 h. Validation tests showed that RSDs of extract yield and beragenin content were all lower than 2％（n＝3）. The experiment of pharmacodynamics showed that water extract （before ethanol precipitation ）and water extract after alcohol precipitation could significantly decrease the level of uric acid in hyperuricemia model mice （P＜0.01）. There was no statistical significance in the reduction of uric acid between 2 groups（P＞0.05）. CONCLUSIONS ：The optimized water extraction technology can obtain good extract yield and bergenin content ，and combined with ethanol precipitation technology for removing excess impurities would not affect the pharmacodynamics. The water extraction and ethanol precipitation technology is feasible，and can be used for extracting the medicinal materials of Baijin granules and its edulcoration.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To optimi ze the ratio of four comp onents of Compound renshen jianti formulation （Panax ginseng ， Dioscorea oppositifolia ，Lycium barbarum fruit，Alpinia oxyphylla ），and to investigate its anti-fatigue activity and acute toxicity. METHODS：The water extract of Compound renshen jianti formulation was prepared by water extraction ，concentration and decompression drying. By single factor tests ，using weight-bearing swimming time as index ，the effects of four factors were investigated，such as the amount of P. ginseng ，D. oppositifolia ，L. barbarum fruit，A. oxyphylla . On the basis of single factor tests，using comprehensive score of weight-bearing swimming time ，serum urea nitrogen content ，liver glycogen content and AUC of blood lactate after exercise as index ，the formulation was optimized by Box-Behnken response surface method. The mice was divided into blank control group （water），positive control group （Renshen hongjingtian capsules ，0.135 g/kg）and compound low-dose，medium-dose and high-dose groups [the optimal ratio of Compound renshen jianti formulation extract （called“optimal compound formulation ”for short ）4.08，8.16，12.24 g/kg，by crude drug] ，intragastric administration of drug or distilled water 20 mL/kg，once a day ，for consecutive 30 d. The weight-bearing swimming time ，the contents of serum urea nitrogen ，liver glycogen and blood lactate AUC after exercise were used to optimize its anti-fatigue activity of optimal compound formulation. The comprehensive score was calculated based on the measured data of mice in the compound formulation middle-dose group ， and the difference between it and the theoretical prediction value was compared. The mice were given optimal compound formulation intragastrically （total dose 16.00 g/kg， by extract）. The general state ， body mass change ， toxic characteristics and death of mice were observed and recorded for 14 days. Median lethal dose （LD50）and maximum tolerated dose （MTD）were measured. RESULTS ：The optimal formulation ratio of Compound renshen jianti formulation included that P. ginseng 1.5 g，D. oppositifolia 10 g，L. barbarum fruit 10 g，A. oxyphylla 3 g. Results of anti-fatigue activity validation test showed that the optimal compound formulation could significantly prolonged weight-bearing swimming time ，reduced serum content of urea nitrogen ，blood lactate content and its AUC （except for low-dose group ），while significantly increased the content of liver glycogen （P＜0.05 or P＜0.01）. Average comprehensive score of medium-dose group was 96.95，which was only 0.06％ different from the theoretical prediction value of 97.01. The results of acute toxicity test showed that there was no death in mice. The oral MTD of the optimal compound formulation was more than 15 g/kg，which was non-toxic. CONCLUSIONS ：The optimal Compound renshen jianti formulation has effective anti-fatigue activity of mice ，and has no significant toxic effect.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish an HPLC fingerprint for Fengliaoxing fengshi dieda wine ，and to determine the contents of 10 effective constituents. METHODS ：HPLC method was adopted. The determination was performed on Inertsil ODS- 3 C18 column with mobile phase consisted of acetonitrile - 0.1％ phosphoric acid water （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was 25 ℃ ，and detection wavelength was set at 210 nm（10-15 min，hydrochloride ephedrine ， hydrochloride pseudoephedrine ），300 nm（70-120 min，cinnamaldehyde），345 nm（15-70 min，neochlorogenic acid ，scopolin， chlorogenic acid ，cryptochlorogenic acid ，scopoletin，isochlorogenic acid A ，isochlorogenic acid C ）. The sample size was 10 μL. Using scopoletin peak as reference ，HPLC fingerprints of 10 batches of samples were drawn. The similarity evaluation was performed by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）to confirm common peak. RESULTS：There were 18 common peaks in HPLC chromatograms of 10 batches of samples ，and the similarity was above 0.980. Totally 12 components including hydrochloride ephedrine ， hydrochloride pseudoephedrine ， neochlorogenic acid ， scopolin， chlorogenic acid ，cryptochlorogenic acid ，scopoletin，isochlorogenic acid B ，narigin，isochlorogenic acid A ，isochlorogenic acid C and cinnamaldehyde widentified. The linear range of hydrochloride ephedrine ，hydrochloride pseudoephedrine ，neochlorogenic acid， scopolin， chlorogenic acid ， cryptochlorogenic acid ， scopoletin， isochlorogenic acid A ， isochlorogenic acid C and cinnamaldehyde were 2.475-247.5，2.600-260.0，3.820-382.0，3.900-390.0，3.060-306.0，4.760-476.0，4.540-454.0，4.900-490.0， 4.540-454.0，7.590-759.0 μg/mL（r＞0.999 0）. The limits of quantitation were 0.320 0，0.350 0，0.021 4，0.024 3，0.036 8，0.025 7， 0.152 1，0.042 9，0.025 1，0.350 3 μg/mL，respectively；the limits of detection were 0.160 0，0.180 0，0.007 9，0.004 0，0.001 2， 0.007 3，0.076 0，0.001 4，0.008 1，0.201 4 μg/mL，respectively. RSDs of precision ，stability and reproducibility tests were all lower than 2％. The recoveries were 95.03％-106.85％（RSD were 0.67％-2.68％，n＝6）．The contents were 0.013 3- 0.214 1 mg/mL. CONCLUSIONS：Established fingerprint is stable ，accurate and specific ，and can be used for quality control of Fengliaoxing fengshi dieda wine ；the content determination method is rapid ，accurate and reliable ，and can be used for simultaneous determination of 10 components.关键词：Fengliaoxing fengshi dieda wine;HPLC;Fingerprints;Content determination
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To estab lish the quality standard of Tetrastigma hemsleyanum stem and leaves dispensing granules ， and to determine the contents of 5 active ingredients simultaneously. METHODS ： Chlorogenic acid ， isoorientin and isoorientin-2′-O-rhamnoside in T. hemsleyanum stem and leaves dispensing granules were identified by TLC. The total flavonoids of the 3 batches granules were determined by UV spectrophotometry （by isoorientin ）. The granule sizes ，moisture contents ， dissolvability，and content uniformity were determined. Using isoorientin as internal reference ，relative correction factors of other components were established. QAMS method was adopted to determine the contents of neochlorogenic acid ，chlorogenic acid ， orientin，isoorientin and isoorientin- 2′-O-rhamnoside，which were compared with the results of ESM method. RESULTS ：TLC spots of chlorogenic acid ，isoorientin and isoorientin- 2′-O-rhamnoside were clear and well-separated ，without interference from negative control. The linear range of isoorientin were 7.73-61.82 μ g/mL（r＝0.999 9）. RSDs of precision ，stability and reproducibility tests were all lower than 2％. The recoveries were 93.75％-97.85％（RSD＝1.41％，n＝6）. The average percentages that the 3 batches granules could not pass through sieve No. 1 - moisture contents were 4.63％，5.18％ and 4.03％（n＝3）. were dissolved within 5 min ，and content uniformity were 4.8％-5.0％. Which were all in line with the relevant provi-sions of granules in 2015 edition of Chinese Pharmacopoeia . The linear range of 5 ingredients were 2.325-93 μg/mL（r＝0.999 9），5.125-205 μg/mL（r＝0.999 9），1.150- 46 μg/mL（r＝0.999 3），2.625-105 μg/mL（r＝0.999 9），4.725-189 μg/mL（r＝0.999 9），respectively. RSD of precision ，stability and reproducibility tests were all lower than 3％. The recoveries were 99.78％-106.13％（RSD＝2.33％，n＝6），95.07％-103.32％ （RSD＝2.72％，n＝6），97.17％-105.43％（RSD＝2.98％，n＝6），95.52％-101.33％（RSD＝2.46％，n＝6），99.42％-105.56％ （RSD＝2.34％，n＝6）. Using isoorientin as internal reference ，relative correction factors of neochlorogenic acid ，chlorogenic acid ， isoorientin and isoorientin- 2′-O-rhamnoside were 0.731，0.805，0.821，0.590，respectively. The contents were 0.828-1.123， 2.379-3.118，0.281-0.880，1.039-1.393，2.121-3.209 mg/g by QAMS method ，while the contents were 0.803-1.099，2.345-3.085， 0.269-0.872，1.309-1.393，2.113-3.201 mg/g by ESM method ，there was no significant difference in the content determination results between QAMS and ESM method （P＞0.05）. CONCLUSIONS ：Established quality standard is simple and rapid ，and can be used for quality control of T. hemsleyanum stem and leaves dispensing granules. Established QAMS method is accurate and efficient，and it can be used for simultaneous determination of 5 active ingredients of T. hemsleyanum stem and levels dispensing granules.关键词：Tetrastigma hemsleyanvn stem and leaves dispensing granules;Quality control;TLC;UV;QAMS;Content
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To struc turally modify shikimic acid ，and to investigate the reversal effects of its derivatives on paclitaxel-resistant human breast cancer cells MCF- 7/PTX. METHODS ：Using shikimic acid as the lead structure ，1-position carboxyl group was structurally modified to synthesize a series of shikimic acid derivatives through esterification ，amidation， hydrogenation and reduction ，etc. Using non-drug resistant cells MCF- 7 as reference ，MTT assay was used to screen derivatives with inhibitory activity as well as half-inhibitory concentration （IC50）and reversal index （RI）of derivatives to MCF- 7/PTX. With the drug resistance-related transgelin 2 as the target ，the molecular docking of the active derivatives with the drug resistance-related protein was carried out by using Glide 1.0 computer-aided design software. RESULTS ：Totally 15 derivatives were obtained （T1-T15）， of which T 4-T15 were obtained for the first time. MTT assay showed that （3R， 4S， 5R） -N-benzyl-3， 4， 5-trihydroxy-1-cyclohexene-1-formamide（T7），（3R，4S，5R）-N-（3，4，5-trihydroxy-1-cyclohexenylmethyl）-benzylamine（T14）， （3R，4S，5R）-3，4-O-isopropyl-5-O-acetyl-1-cyclohexene-1-methyl formate （T15）inhibited MCF- 7 and MCF- 7/PTX cells to a certain extent ；IC50 values of T 7，T14 and T 15 combined with pacliaxel to MCF- 7/PTX cells were significantly lower than that in negative control （Paclitaxel alone ）group（P＜0.05）. RIs of T 14 and T 15 were higher ，and RIs of the highest dose were 8.8 and 9.3， which were equivalent to positive control verapamil （10.8）. Th e results of molecular docking showed that the hydroxyl groups at positions 3，4 of T 7 could form multiple hydrogen bonds with ； Arg625 and Asp 627 in the catalytic region of transgelin 2. In addition to the hydrogen bond mentioned above at T 7，the mail：batistuta28@126.com secondary amine side chain at position 1 of T 14 could also form hydrogen bond with Glu 657 of transgelin 2. When the hydroxyl group on the T 15 mother nucleus was derived from the donor group ，the binding of the hydroxyl group to transgelin 2 was closer and the inhibition was enhanced. CONCLUSIONS ： The derivatives T 7，T14 and T 15 have certain reverse activity to paclitaxel-resistant human breast cancer cells. The polyhydroxy structure of the mother nucleus is the main structural region of the hydrogen bond between shikimic acid and its derivatives and transgelin 2. The derivation of its power supply group or the introduction of secondary amines and hydrophobic groups into the 1-carboxyl group of shikimic acid is benifit for enhancing the drug resistance reversal effect of derivative .关键词：Shikimic acid derivative;Transgelin 2;Breast cancer;Paclitaxel resistance;Reversal effect
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To evaluate in vitro antioxidant activities of 4 different polar parts of ethanol extract from Amomum tsao-ko，and to lay a foundation for the research and development of antioxidant chemical components in the plant. METHODS ： The dried fruits of A. tsao-ko were crushed ，then were hearted and reflux extracted with 95％ ethanol. The extraction fluid was concentrated by rotary evaporation and evaporated in water bath to obtain the ethanol extract. The extract was dispersed in water ， and then extracted with petroleum ether ，ethyl acetate and n-butanol organic solvents one by one. Each solvent extract was combined and the lower water phase were collected. Finally ，the petroleum ether part ，ethyl acetate part ，n-butanol part and water part were obtained，after rotary evaporation concentration and water bath evaporation. Through in vitro antioxidant activity tests ，using 2， 6-di-tert-butyl-4-methylphenol（BHT）as positive control ，DPPH radical ，superoxide anion radical scavenging ability and Fe 3+ reducing ability of different polar parts of ethanol extract from A. tsao-ko were investigated. RESULTS ：The scavenging rates of 4 polar parts of ethanol extract from A. tsao-ko on DPPH radical were all over 80％；the order of scavenging ability was ethyl acetate part＞BHT＞n-butanol part ＞petroleum ether part ＞water part. Those of the 4 polar parts to superoxide anion radical were between about 30％-40％ mostly；the order of scavenging ability was n-butanol part ＞petroleum ether part ＞water part ＞ethyl acetate part ＞ BHT；but those were weaker than their scavenging ability to DPPH r adical. The polar parts of ethanol extract also had a certain reduction ability to Fe 3+；the order of the reduction ability was n-butanol part ＞BHT＞ethyl acetate part ＞petroleum ether part ＞ water part on the whole ，but that of water part rose to the stron- gest when its concentration was 4.0 μg/mL. CONCLUSIONS： The different polar parts of ethanol extract from A. tsao-kom have certain in vitro antioxidant capacity ，but the order of antioxidant activity of different polar parts was not the same in different antioxidant activity tests ；ethyl acetate part has the 163.com strongest scave nging effect on DPPH radical ，n-butanol part has the strongest scavenging ability on superoxide anion radical and reducing ability on Fe 3+.关键词：Amomum tsao-ko;Ethanol extract;Polar parts;Antioxidant activity;in vitro
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To investigate the inhibitory effects of total alkaloids of Gelsemium elegans （TAG） on the proliferation and angiogenesis of human colon cancer cells. METHODS ：Human colon cancer cell line HT- 29 and HUVEC were cultured in vitro . After the intervention of low- ，medium-，high-dose TAG （40，80，120 μg/mL），the morphology of the two cells was observed by fluorescence inversion microscope. The survival rate of HT- 29 cells and HUVEC was detected by CCK- 8 assay. Flow cytometry was used to detect HT- 29 cell cycle. The migration rate ，invasion rate and tube number of HUVEC were observed by scratching test ，Transwell invasion experiment and tube formation experiment. RESULTS ：Compared with blank group ，HT-29 cells and HUVEC were decreased to different extents in TAG groups ；dead cells were observed ，and the survival rate of both decreased significantly （P＜0.05 or P＜0.01）. The proportion of HT- 29 cells at G 2/M phase in TAG groups as well as those at G 0/G1 phase in medium-dose group were increased significantly ；the proportion of HT- 29 cells at S phase in TAG groups as well as those at G 0/G1 phase in high-dose group were decreased significantly （P＜0.05 or P＜0.01）. Survival rate ，migration rate and invasion rate of HUVEC were decreased significantly in TAG groups ，and tube number was also decreased significantly at each time point during 4-24 h（P＜0.01）. CONCLUSIONS ：TAG have inhibitory effect on the proliferation of human colon cancer HT- 29 cells and HUVEC，can change HT- 29 cell cycle ，inhibit the migration ，invasion and tube formation of HUVEC.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To establish a method for simultaneous determination of gallic acid ，protocatechuic acid ，mangiferin， homomangiferin，hyperoside and isoquercetin in Mangguo zhike tablets. METHODS ：HPLC was adopted. The determination was performed on Phenomenex Gemini C 18 column with mobile phase consisted of 0.1％ phosphoric acid water solution-acetonitrile （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was set at 258 nm. The column temperature was set at 30 ℃，and sample size was 5 μL. Gallic acid was used as the internal substance，and the correction factors of gallic acid ， protocatechuic acid ，mangiferin，homomangiferin，hyperoside and isoquercetin were calculated ；the results of quantitative analysis of multi-components by single marker method （QAMS） were compared with those of external standard method （ESM）. RESULTS：The linear range of gallic acid ，protocatechuic acid ，mangiferin，homomangiferin，hyperoside and isoquercetin were 45.75-183 0 μg/mL（r＝0.999 9），2.525-101.0 μg/mL（r＝0.999 9），65.33-261 3 μg/mL（r＝0.999 6），9.058-362.3 μg/mL（r＝ 0.999 9），3.885-155.4 μg/mL（r＝0.999 9），1.870-74.8 μg/mL（r＝0.999 9），respectively. The limits of quantification were 0.571， 0.643，1.053，0.854，0.830，1.500 μg/mL，respectively. The limits of detection were 0.171，0.193，0.316，0.256，0.249，0.450 μg/mL， respectively. RSDs of precision ，stability and reproducibility tests were all lower than 3％ . The average recoveries were 98.8％-101.9％（RSD＝1.3％ ，n＝6），94.3％-101.5％（RSD＝3.3％，n＝6），97.9％-100.5％（RSD＝0.9％，n＝6），98.2％- 101.6％ （RSD＝1.2％，n＝6），102.3％-106.1％（RSD＝1.3％，n＝6）， 96.6％ -99.3％（RSD＝1.0％ ，n＝6），respectively. RCFs of 73） protocate-chuic acid ， mangiferin， homomangiferin，hyperoside and isoquercetin were 0.568 3，0.500 3，0.687 6， 0.939 1 and 0.826 3，using gallic acid as internal substance . The content ranges of protocatechuic acid and other 4 com- ponents measured by QAMS were 0.197-0.440，3.262-11.250， 0.201-1.196，0.168-0.381，0.115-0.293 mg/tablet，respectively. The content ranges measured by ESM were 0.198-0.441，3.239-11.570，0.206-1.194，0.171-0.380，0.119-0.298 mg/tablet， respectively. By comparing the content determination results by QAMS and ESM ，the relative errors were －3.80％-0.74％，and there was no statistical significance （P＞0.05）. CONCLUSIONS ：The established QAMS method is accurate ，reliable and repeatable，and can be used for content determination of 6 medicinal components in Mangguo zhike tablets.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To compare chemical composition types and ginsenoside content of Panax notoginseng flowers with different growing years ，and to explore the effect of growing year on the quality of P. notoginseng flowers. METHODS ：Each 10 batches of biennial，triennial and quadrennial P. notoginseng flower were collected and determined by HPLC. The determination was performed on Shim-pack GIST C 18 column with mobile phase consisted of acetonitrile- 0.05％ phosphoric acid solution （gradient elution ）at the flow rate of 0.5 mL/min. The column temperature was set at 30 ℃，and the detection wavelength was set at 203 nm. The sample size was 20 μL. Similarity Evaluation System of TCM Chromatogram Fingerprint was used to establish the fingerprint of 30 batches of samples ，identify the diagnostic components and analyze the similarity. Cluster analysis was conducted by using SPSS 22.0 software. The contents of ginsenoside Rb 1，Rb2，Rb3 and Rc in 30 batches of P. notoginseng flower with different growing years were determined by above HPLC . The quality control analysis was conducted by using SPSS 22.0 software. RESULTS：Established fingerprint showed good precision ，stability and reproducibility. There were good linear relationship （R2＞ 0.999），quantitative limit ，precision，stability，repeatability and accuracy of the content determination method . Six common components as ginsenoside Rb 1， Rb2， Rb3 and Rc were Δ 基金项目：云南省地方高校联合专项（No.KX182504Y） identified in P. notoginseng flower with different growing ＊助教，硕士。研究方向：中药资源开发 。电话：0876-2684947。 E-mail：wshuangzaiqiang@163.com years by fingerprint ；ginsenoside Rd was identified in triennial # 通信作者 ：研究员，硕士。研究方向 ：中药资源开发 。电话： P. notoginseng flower. The similarities of the fingerprints 0876-8883731。E-mail：gaomingju@163.com among 10 batches of biennial ，triennial and quadrennial P. 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·969· notoginseng flower were 0.881，0.952 and 0.945，respectively. The similarity among samples with different growing ye ars was more than 0.817. Thirty batches of P. notoginseng flower could be grouped into 4 categories，the category Ⅱ was quadrennial samples，the category Ⅲ was triennial samples ，while the categories Ⅰ and Ⅳ were mostly biennial samples and a small number of triennial and quadrennial samples. RSDs of 4 ginsenosides contents and their total contents in biennial samples were 8.90％-21.43％ and total saponin contents were 11.65％-17.76％，respectively. RSDs of 4 ginsenosides contents and their total contents in triennial samples were 6.45％-14.23％，and total saponin contents were 15.74％-19.30％. RSDs of 4 ginsenosides contents and their total contents in quadrennial samples were 7.50％-18.86％，and total saponin contents were 15.92％-20.16％. The results of quality control analysis showed that biennial samples mainly distributed in the areas of Ⅱ and Ⅲ ；triennial and quadrennial samples mainly distributed in the areas of Ⅰ and Ⅱ ；the order of ginsenosides content was Ⅰ ＞Ⅱ ＞Ⅲ. CONCLUSIONS：Chemical components of P. notoginseng flower with different growing years are generally close in types but there still a re some differences ，among which the content of ginsenosides in biennial samples is lower ，fluctuates more ，and the overall quality is slightly poor ；the content of ginsenosides in triennial and quadrennial samples is higher ，fluctuates less ，and the overall quality is higher and tends to be stable.关键词：Panax notoginseng flowers;Growing year;HPLC;Fingerprint;Ginsenosides;Content determination
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference for improving TCM treatment of pulmonary nodule. METHODS ：The experience of famous TCM doctors in the TCM treatment of pulmonary nodule was searched by computer ，the formulations of the cases were sorted out ，and the data were recorded into the TCMISS V 2.5 for data analysis ，and the medicine frequency was counted. Apriori algorithm and association rules were used for statistical analysis of core combination of formulations （support degree was 16，confidence degree was 0.65）. Inner core combination and new combination were extracted according to the entropy clustering method of complex system （correlation was 6，penalty was 2）. RESULTS ：A total of 25 literatures were input ，including 64 formulations in total ，166 medicinal materials. For the prescriptions of pulmonary nodule ，the frequency of single ingredient from high to low was Bolbostemma paniculatum ，Glycyrrhiza uralensis ，Astragalus membranaceus ，Prunella vulgaris ，Ostrea gigas，Angelica sinensis ，Pinellia ternate ，Ligusticum chuanxiong ，Mori Corlex ，etc. The main compatibility of the drug model is to invigorate Qi ，dissipate phlegm ，invigorate Qi and activate blood circulation ，and promote Qi and softness ，such as “G. uralensis，B. paniculatum ”“A. membranaceus ，B. paniculatum ”“A. membranaceus ，G. uralensis ”，etc；10 core combinations of the drug were found out ， such as Begonia fimbristipula-Rhodiola rosea-Bupleurum Chinense ， Cervus elaphus Clematis chinensis-Buffalo Horn，etc. There were 5 new prescriptions ，i.e. B. fimbristipula-R. rosea-B. chinense-Setaria italic ，C. elaphus-C. chinensis-Buffalo Horn-French chalk ，A. sinensis-L. chuanxiong-Morus alba- Mori Corlex -P. vulgaris-Ganoderma lucidum ，Hedyotis diffusa-Prunus persica-Trichosanthes kirilowii-Achyranthes bidentata-Eupolyphaga sinensis- Cinnamomi Ramulus ，A. bidentata-E. sinensis-Ephedra sinica-Curcuma aromatica-Curcuma longa-Concretio silicea . CONCLUSIONS ：Most modern doctors believe that the interaction of phlegm and blood stasis is the main pathogenesis of pulmonary nodule ，and the treatment is mainly based on the treatment of lung ，spleen，liver and kidney ，focus on the elimination of symptoms and phlegm ，the elimination of blood stasis and the soft and hard treatment ，pay attention to the weak body of the patient. TCM treatment of pulmonary nodule has a good prospect.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To pro vide reference for reducing the error of Markov model in pharmacoeconomic evaluation. METHODS：Referring to foreign literatures ，the errors in Markov model were explained. The commonly used correction methods were introduced ：half-cycle correction ，trapezoidal rule ，Simpson’s 1/3 rule，Simpson’s 3/8 method and life table method and their implementation in Excel and TreeAge software. RESULTS & CONCLUSIONS ：The error of Markov model was caused by the discretization process and could be corrected by the within-cycle correction methods. Half-cycle correction ，was the most commonly used correction method and could be corrected by adding half of the results of the first cycle and subtracting half of the results of the last cycle. By trapezoidal rule ，the interval was represented by the mean value of the first end point value of the interval ，and the area of right trapezoid was the cummulative result. Simpson’s 1/3 rule and Simpson ’s 3/8 rule took another point in the interval on the basis of trapezoidal correction and the continuous curve where these three points were represented the whole curve. By life table method ，the person-years of survival was the product of the group distance of the age group and the mean value of the number of survivors of the age group and the next age group ，and the total person-years of survival was the sum of person-years of survival of each age group. In Excel ，the fuction was set according to the method principle to realize the correction ；in Tree Age software，the function expression of Init Rwd ，Inor Rwd and Final Rwd were set to realize the correction. When using Markov model for pharmacoeconomic evaluation ，if the selection of periodic correction method is based on the ease of modeling and the universality of application ，the trapezoid rule method is recommended ；based on the accuracy of results ，it is suggested to use Simpson’s 1/3 method，so as to improve the accuracy of Markov model.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To inv estigate therapeutic efficacy and safety of recombinant human interferon gel combined with Baofukang suppository in the treatment of cervical high-risk human papillomavirus （HPV）infection. METHODS ：Totally 259 patients with persistent high-risk HPV infection diagnosed and treated in gynecology department of the First Affiliated Hospital of Hainan Medical University from Aug. 2017 to Sept. 2019 were selected and divided into interferon group （n＝82），Baofukang suppository group （n＝86）and combination group （n＝91）according to random number table. The patients in interferon group and Baofukang suppository group were given Recombinant human interferon α2b gel 1 g, qd or Baofukang suppository 1 capsule，qd； the patients in combination group were given Recombinant human interferon α2b gel and Baofukang suppository 1 capsule，qd；for 3 months. Then the clinical efficacy ，negative time of HPV ，duration of abnormal secretion ，LCT test results ，cervical inflammation score ，HPV relative light unit/critical value （RLU/CO）and the incidence of ADR were recorded. RESULTS ：The total effective rate of combination group was significantly higher than that of interferon group and Baofukang suppository group ， the negative time of HPV and duration of abnormal secretion in combination group were significantly shorter than interferon group and Baofukang suppository group （P＜0.05）. Before treatment ，the normal rate of LCT of 3 groups were 0，and there was no statistical significance in cervical inflammation score and HPV RLU/CO among 3 groups（P＞0.05）. After treatment ，normal rate of LCT was increased in 3 groups，compared with before treatment （P＜0.05），and normal rate of LCT in combination group was significantly higher than interferon group and Baofukang suppository group. The cervical inflammation score and HPV RLU/CO were significantly lower than before treatment ，and the combination group was significantly lower than interferon group and Baofukang suppository group （P＜0.05）. There was no statistical significance in above indicatora after treatment betwent interferon group and Baofukang suppository group and the incidence of ADR among 3 groups during medication （P＞0.05）. CONCLUSIONS：The application of recombinant human interferon gel combined with Baofukang suppository is effective and safe way in the treatment of cervical high-risk HPV infection.关键词：Recombinant human interferon;Baofukang suppository;Cervix;High-risk HPV;Infection;Clinical observation
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To provide reference for the early diagnosis and selection of treatment regimens of pregnancy- associated breast cancer （PABC）. METHODS ：The disease characteristics ，treatment process and prognosis of 2 cases of PABC were analyzed in our hospital. The relevant literature published from Jan. 1986 to Apr. 2019 in PubMed database was retrieved. The case reports that the title ，keywords or abstracts involved “Breast cancer and pregnancy ”“Pregnancy-associated breast cancer ” “Breast cancer during pregnancy ”“Breast carcinoma during pregnancy ”“Case reports ”were included. Cases which didn ’t meet the definition of PABC were excluded. The general information ，tumor clinical characteristics ，drug treatment plan ，maternal/fetal prognosis and other information of patients were extracted for summary and descriptive statistical analysis. RESULTS & CONCLUSIONS：Two patients were both diagnosed during lactation. The prognosis was good after neoadjuvant chemotherapy and surgical resection. A total of 36 case reports were obtained through literature search and screening ，as well asclinical data of 45 patients（39 diagnosed during pregnancy and 6 diagnosed during lactation ）.Neoadjuvant chemotherapy AC regimen （doxorubicin+ cyclophosphamide）was used in 35.0％（14/40）of cases after excluding the cases without relevant information ；elective caesarean section was performed in 59.5％（22/37）of cases ，37.8％（14/37）of cases were delivered ，and 1 case chose to terminate pregnancy；survival rate of patients was 80.8％（21/26），and the average weight of newborns was 2 407 g（1 015-3 830 g）. Six patients each received taxanes during pregnancy and 9 patients during postpartum. The determination of chemotherapy for PABC should comprehensively consider a variety of factors. It is necessary to comprehensively weigh the benefit risks of the mother and child，try to avoid chemotherapy in early pregnancy ，and especially consider the impact of chemotherapy on the fetus. The chemotherapy regimen is still dominated by anthracyclines. Based on this ，an individualized regimen is formulated and close monitoring should be performed when using paclitaxel.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To systematically evaluate therapeutic efficacy and safety of Breviscapine injection combined with routine treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD），and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase，CBMdisc，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Breviscapine injection combined with routine treatment （trial group ） versus routine treatment （control group ）in the treatment of AECOPD were collected. After literature screening and data extraction ， the qualities of literatures were evaluated with modified Jadad scale ；Meta-analysis was performed by using Rev Man 5.2 statistical software. RESULTS ：A total of 19 RCTs were included ，involving 1 930 patients. Results of Meta-analysis showed that total response rate [OR ＝2.80，95％ CI （1.96，4.01），P＜0.000 01]，FEV1[MD＝0.65，95％ CI（0.57，0.72），P＜0.000 01]， FEV1％[MD＝5.33，95％CI（0.31，10.35），P＝0.04]，FVC[MD＝0.69，95％CI（0.23，1.16），P＝0.004]， FEV1/FVC [MD ＝ 4.83，95％CI（0.98，8.67），P＝0.01]，PEF [M D＝0.95，95％CI （0.57，1.33），P＜0.001]，PaO2 [MD＝4.70，95％CI（2.02， No.81402991） + 7.37），P＜0.001]，CD3 level [MD ＝5.11，95％ CI（3.04， 7.18），P＜0.001] and CD 4+ level [MD ＝2.62，95％CI（1.78， qq.com 3.47），P＜0.001] of trial group were significantly higher than those of control group ；PaCO2 [MD＝－3.33，95％CI（－5.02， －1.65），P＜0.001]，CD8+ level [MD ＝－2.55，95％CI（－4.28，－0.82），P＜0.004]，cough relief time [MD ＝－1.93，95％CI （－2.24，－1.63），P＜0.001]，sputum remission time [MD ＝－2.19，95％CI（－2.48，－1.89），P＜0.001]，wheezing remission time [MD ＝－1.59，95％CI（－1.86，－1.32），P＜0.001] and hospital stay [MD ＝－1.73，95％CI（－2.06，－1.39），P＜0.001] of trial groups were significantly lower or shorter than those of control group ；there was no statistical significance in CD 4+/CD8+ between 2 groups [MD ＝－0.11，95％CI（－0.23，0.01），P＝0.06]. In terms of safety ，3 studies reported the occurrence of ADR ， and no serious ADR occurred. CONCLUSIONS ：Breviscapine injection can improve clinical efficacy and lung function ，enhance immunity in patients with AECOPD with good safety.
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发布时间：2022-06-21 - 摘要：OBJECTIVE：To syste matically evaluate the effects of non-selective β-blockers（NSBB）on mortality of patients with cirrhosis and ascites ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，Web of Science ，CNKI and Wanfang database ，randomized controlled trials （RCTs）and cohort studies about the effects of NSBB on mortality of patients with cirrhosis and ascites were collected from the date of database establishment to Sept. 30th，2019. The patients in the trial group were treated with NSBB ，the patients in the control group were treated with blank control or isosorbidemononitrate ，variceal ligation or other measures to prevent variceal bleeding. After literature screening and data extraction ，the quality of RCTs and cohort studies were evaluated by using bias risk evaluation tool recommended by Cochrane system evaluator manual 5.1.0 and Newcastle-Ottawa scale . Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：Totally 18 studies were included ，involving 8 649 patients，4 RCTs and 14 cohort studies. Results of Meta-analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group [RR ＝0.85，95％ CI（0.65，1.11），P＝0.22]，severe ascites [RR ＝0.58，95％ CI（0.15，2.22），P＝0.42] or refractory ascites [RR ＝0.85，95％CI（0.61，1.20），P＝0.36] and the control group. Subgroup analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group and control group according to the research method （RCT vs. cohort study ）and the type of drug use （P＞0.05）. CONCLUSIONS ：The use of NSBB does not increase the incidence of all-cause mortality in cirrhosis patients with ascites ，or even in those with severe ascites or refractory ascites.关键词：Non-selective β-blockers;Cirrhosis;Ascites;Mortality;Meta-analysis
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发布时间：2022-06-21 - 摘要：OBJECTIVE： To investigation occupational exposure and exposure outcome of antineoplastic in medical staff ，to provide support for their safety in Sichuan Province. METHODS：The respondents included doctors ，nurses，technicians and pharmacists from 11 related departments including tumor department ，hematology department ，PIVAS and pharmacy department in 4 third-level class A hospitals mainly in Sichuan Provincial People ’s Hospital and 6 second-level and below hospitals. Self-designed questionnaires were adopted to investigate general information of medical staff ，cognitive status to occupational exposure hazards ， occupational exposure and exposure outcome and protective behaviors and make suggestions of the investigation. RESULTS：A total of 350 questionnaires were sent out and 304 were recovered ，with effective recovery rate of 86.86％. Among 304 investigated pharmacentical staff ，involving 253 female（83.22％），51 male（16.78％），the most of persons aged 20-29 years old （43.42％）. The most of persons （66.78％）had a bachelor degree. The largest number of occupation was nurses （55.26％）；the pharmacy department had the largest number （21.71％）；working hours were mainly 8 h/day（84.21％）；working years were the most less than 5 years（39.47％）. 121 persons（39.80％）were aware of the potential hazards of occupational exposure to antineoplastic drugs，and 131 persons（43.09％）only knew a little about the Δ 项目基金：国家临床重点专科建设项目；四川省科研院所基本科 exposure hazards ；in PIVAS ，15 persons （71.43％） were 研业务项目（No.2018YSKY0017） ＊药师，硕士研究生。研究方向：临床药学。E-mail：370951417@ aware of the potential hazards of occupational exposure to qq.com antineoplastic drugs ，accounting the highest proportion among # 通信作者：主任药师，硕士生导师。研究方向：国家药物政策、药 all departments ； the proportion of technicians and other 事管理、医院药学。电话：028-87393436。E-mail：289302309@qq.com medical staff who did not know the occupational exposure 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·1009· hazard was the highest ，being 60％；the longer the total working time ，the higher the cognition degree of occupational exposure hazards （P＝0.035 8）. The most exposed antineoplastic drug was cyclophosphamide 165 persons（54.28％） and pemetrexed disodium 57 persons（18.75％）was the least. The total time of occupational exposure of medical staff in different departments was mainly short-term exposure ，among which the number of exposed persons in hematology department was the most （85.71％）. 67 persons（22.04％）reported that they had physical discomfort after excluding the influence of other physical diseases ，mainly the increase of alopecia （73.13％）；the propertion of medical staff who had physical discomfort in hematology department was the most（50.00％）；the number of nurses who had physical discomfort （31.55％）was the most. 155 persons（50.99％）could not understand the antineoplastic drug protection measures ，41 persons （13.49％） had received relevant training ，108 persons （35.53％）understood the occupational protection of antineoplastic drugs. The highest level of awareness of protective measures was found among the medical staff in PIVAS ，and only 14.29％ of the staff did not understand the protective measures. In term of occupation，the proportion of nurses who had received relevant training was the highest （19.05％）. CONCLUSIONS ：Medical staffs have a low level of knowledge about occupational exposure hazards and self-protection measures of antineoplastic drugs. The government should strengthen the construction of occupational protection regulations and standards for medical staff ；hospitals should strengthen internal management and attach great importance to the management of occupational protection in hospitals ； medical staff should increase awareness ，skills and reduce the risk of occupational exposure.关键词：Sichuan province;Antineoplastic drugs;Occupational exposure;Medical staff;Questionnaire investigation
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