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Objective To study and explore the influence of pharmacy service quality improvement on the relationship between doctors and patients .Methods Our hospital began to implement the improvement measures of quality in pharmaceutical service since January 2016,200 patients'families were randomly selected as the observation group by using cluster sampling method during 12 months of 2016.The other 200 cases'families in the 12 months of 2015 before the implementation of pharmacy services quality improvement measures were randomly selected as control group by using cluster sampling method .The waiting time to get the medicine , the incidence of pharmacy service satisfaction,error event,the quality of pharmaceutical service score ,complaint rate,incidence of medical disputes (this should be clear and concise ) of the two groups were compared by conducting a questionnaire survey .Results The waiting time to get the medicine of the observation group was (7.75 ±3.29) min,which was significantly shorter than (11.87 ±4.16)min of the control group (t=10.986,P<0.05).The satisfaction rates for pharmacy pharmacist envi-ronment,attitude,patients in the observation group were 97.50％,96.00％,94.50％,respectively,which were signifi-cantly higher than 84.50％,82.50％,82％in the control group (χ2 =26.635,18.996,15.068,all P<0.05).The pharmacy service quality score of the observation group was (89.65 ±14.52) points,which was significantly higher than (74.93 ±10.24)points of the control group (t=11.716,P<0.05).The pharmacy service error event rate of the observation group was significantly lower than that of the control group (χ2 =9.225,P<0.05),and the rate of complaints,the incidence rate of medical dispute cases in the observation group were significantly lower than those in the control group (χ2 =4.737,4.592,all P<0.05).Conclusion Application of pharmacy quality improvement measures is effective in shortening the waiting time and improving the quality of pharmaceutical care ,and it is helpful to improve the family members'evaluation to pharmacy environment , pharmacists'service attitude and their visits , thereby improving the relationship between doctors and patients and reducing the disputes between doctors and patients .
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Objective To investigate the relationship between thyroid hormone and uric acid (UA) and body mass index (BMI) in patients with type Ⅱ diabetes and normal thyroid function.Methods Total of 313 patients with type Ⅱ diabetes and normal thyroid function were selected.BMI,fasting blood glucose (FBG),the metabolism of blood lipid,thyroid hormones and UA indicators were examined and the correlations of thyroid hormone,BMI and UA were analyzed.Results (1) The patients were divided into two groups according to gender,and FT3,FT4,and UA of male were found to be significantly higher than those in female (P＜0.01).TSH,SBP,HDL-C in female were significantly higher than those in male (P＜0.01);(2) The patients were divided into three groups according to BMI Level.Thyroid-stimulating hormone (TSH),three iodine armour gland original glycine (TT3),free three iodine thyroid glycine (FT3),UA,and FBG in overweight and obesity groups were found to be higher than those in normal weight group (P ＜ 0.05);(3) The patients were divided into two groups according to the TSH level.Serum uric acid,TT3,FT3,fasting insulin in the group with TSH above 2.5 uIU/L were found to be higher than those in the group with TSH under 2.5 uIU/L (P ＜ 0.05);(4) Patients were divided into two groups according to the UA level.TSH,FT3 in male with high uric acid were found to be higher than those in male with normal uric acid (P ＜ 0.05);TSH was in female with high uric acid was found to be higher than that in female with normal uric acid (P ＜ 0.05).Conclusion Thyroid hormone in patients with type Ⅱ diabetes can be used to assess the body weight and uric acid,which is of great clinical importance.
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Objective To analyze the concentration changes of insulin and c peptide of in portal vein and peripheral blood, and explore the feasibility of using insulin and c peptide concentration changes in assessment of liver function. Methods The portal vein and peripheral blood samples were extracted from 82 clinical liver cancer patients, and the insulin and c peptide concentration were detected. The differences in the insulin and c peptide concentration in portal vein and peripheral blood were statistically analyzed. Results The insulin concentration in the portal vein and peripheral blood values were 32.43 μ U/ml and 8.05 μ U/ml, respectively, there was a significant difference (P0.05) . Conclusion Liver metabolizes insulin as the target organ of insulin, while c-peptide dose not be metabolized in vivo, so it is possible to assess liver function by comparative analysis of the metabolic rate of insulin and c-peptide changes.
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Objective To investigate risk factors of nocturnal hypoglycemia in patients with type 2 diabetes mellitus,to seek quantitative indicators for early warning,and to evaluate the effects of intervention.Methods 24-h blood glucose of 1147 patients with type 2 diabetes mellitus with well-controlled hyperglycemia were determined by continuous glucose monitoring system (CGMS).Incidences of hypoglycemia were compared between groups with different 3 h postprandial blood glucose levels after supper.Results The rates of hypoglycemia,asymptomatic hypoglycemia,and nocturnal hypoglycemia were respectively 37.23％,22.75％,and 18.31％.Nocturnal hypoglycemia set in most frequently by 22:00-2:00 (RR =1.72,x2 =31.667,P＜0.01).The hypoglycemia incidence was reduced in intervention group than that in control group (9.67％ vs 16.76％,x2 =8.79,P ＜0.01).Conclusions Nocturnal hypoglycemia happens commonly in patients with type 2 diabetes.It usually sets in by 22:00-2:00.Appropriate intervention may prevent the hypoglycemic events.
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Objective To investigate the effects of subclinical hypothyroidism (SCH) on blood glucose and metabolic parameters in type 2 diabetes (T2DM) . Methods A total of 973 T2DM patients were recruited, and the clinical data, biochemical and thyroid function parameters were measured. One hundred and forty eight T2DM patients were diagnosed as SCH (SCH group) and 152 euthyroid patients were selected as control group (NSCH group) . Results (1) The prevalence of SCH in type 2 diabetes was 15.3% (148/973) . (2) Compared with the NSCH group, the prevalence of overweight/obesity was significantly higher in SCH group (54.1%vs 35.5%,<0.01) as well as hypertension (64.9%vs 52%, <0.05) . There was no significant difference in HbA1c control and prevalence of dyslipidemia and hyperuricemia between two groups. Conclusion SCH may have some adverse effects on blood pressure and BMI in T2DM.
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Aim: To improve the synthesis for 2, 5-anhydro-3,4, 6-tri-O-benzyl-D-glucitol. Methods: Dehydration of D-mannitol, followed by a reaction sequence of selective protection, benzylation, deprotection, tritylation, benzy-lation and removal of the trityl group, afforded the title compound. Results: Based on the improvement of the reported synthetic route, 2,5-anhydro-3,4,6-tri-O-benzyl-D-glucitol was synthesized in seven steps from D-mannitol with a total yield of 8. 3% . Conclusion: This new method features mild reaction conditions and facile work-up.