ABSTRACT
In order to comply with canceling the drug price addition policy in the new medical reform program, meet the requirements of meticulous management and intensified medication safety, and improve the efficiency of pharmacies, the hospital pharmaceutical supply chain must be rebuilt by modern logistics and information technologies. This article compared three models of current hospital pharmaceutical chain and considered the supply chain management model of cooperating with the third party as the most effective one in the aspects of cost, efficiency,quality control management and so on. System deployment and implementation Methods of this model were further elaborated from the aspects of Hospital Information System(HIS) reform, management strategy, system architecture and security.
ABSTRACT
The paper sets forth the system architecture of Traditional Chinese Medicine (TCM) for chronic disease tracking management platform based on remote monitoring technology,including business architecture,technical architecture and key technology modules;builds the new mode of chronic disease management and recovery based on household self-management and gives full play to the role of TCM in home care and disease prevention.
ABSTRACT
Discharge against medical advice (DAMA) conflicts with the purpose of disease treatment in children. Some research has shown that there are high proportions of extremely preterm infants and infants with asphyxia or congenital malformation in neonates with DAMA. This suggests that the sustainable development of neonatology needs cooperation and co-development with obstetrics, neonatal surgery, and radiology to reduce the rate of DAMA. With reference to the current status of research in both China and other countries, this article reviews the causes for DAMA and the strategies for reducing the rate of DAMA, in order to provide a theoretical basis for effectively reducing the rate of DAMA from the neonatal intensive care unit, improving treatment outcomes of the neonates, and increasing hospitals' comprehensive benefits.
Subject(s)
Humans , Infant, Newborn , Ethics, Medical , Health Services Needs and Demand , Insurance, Health , Intensive Care Units, Neonatal , Patient Discharge , Prenatal Care , Treatment RefusalABSTRACT
Objective To investigate the bacterial distribution and drug resistance in urinary tract infection from Sichuan Provin‐cial Antimicrobial Resistant Investigation Net during 2011-2012 .Methods The distribution and drug resistance data of pathogens isolated from urine specimens of urinary tract infection cases were collected from the members of Sichuan Provincial Antimicrobial Resistant Investigation Net ,and the results were counted and analyzed .Results There were 54 hospitals enrolling in the investiga‐tion .A total of 12 420 pathogenic strains were isolated from urinary tract infection in the survey .The top 5 predominant bacteria were Escherichia coli(46 .5% ) ,Excrement enterococcus (7 .0% ) ,K lebsiella pneumoniae (5 .8% ) ,Dung enterococcus (5 .7% ) and Pseudomonas aeruginosa(3 .7% ) .The resistant rates of Escherichia coli ,K lebsiella pneumoniae and Pseudomonas aeruginosa to imipenem were 16 .0% ,16 .7% and 16 .0% ,and to levofloxacin were 55 .2% ,28 .2% and 27 .7% ,respectively .The resistant rates of Excrement enterococcus and Dung enterococcus to vancomycin were 4 .1% and 1 .4% respectively .Conclusion Escherichiacoli and Enterococcus are still the predominant organism in urinary tract infection cases .Clinical treatment should refer to the results of drug sensitive test .
ABSTRACT
Objective To study the mutations of outer-membrane porin gerte (oprD) in imipenem-resistant Pseudomonas aeruginosa.Methods The PCR was applied to detect the oprD gene from the 34 clinical imipenem-resistant Pseudomonas aeruginosa.DNA sequence was proceeded to analysis the nuclentide sequence of the oprD gene and the deduced amino acid sequence.To analysis the mutation and the function of the oprD domain,those mutations were compaired with the standard Pseudomonas aeruginosa ATCC27853 and 2 clinical imipenem-susceptibility isolates.Results oprD gene mutation was wide and diverse.The rate of the mutation was 92.3% (12/13),mutations were concluded dot mutation,deletion mutation and insert mutation,those result in the amino sequence change and frame shift in L2 and L3 loops of outer membrane protein D,hampering the combine of oprD and imipenem.Some new mutations were found.They were 1 079,1 114,1 196,1 206,1 288,1 300,1 301 bases and 115,127,154,158,185,189 aminos.All above mutations were not deteced in ATCC 27853 and 2 clinical imipenem-susoeptibility isolates.Conclusions The wide and diverse mutations in oprD gene result in amino acid change and/or frame shift L2 and L3 loops,hampering the binding of IMP and oprD.Those may result in resistance to imipenem in Pseudomonas aeruginosa.