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Ninety eight patients with chronic hepatitis B (CHB) admitted to Department of Infectious Diseases, Yongkang First People′s Hospital from January 2017 to June 2018 were randomly divided into two groups. On the basis of entecavir+dicyclool treatment, patients in control group (48 cases) received health education and weekly telephone follow-up from the nurses, while patients in intervention group (50 cases) received health guidance from doctors and psychological counseling and communication from the nurses. All patients were followed up for 8 weeks. The illness perception, negative emotions, quality of life, and medication compliance were evaluated with the Revised Illness Perception Questionnaire (IPQ-R), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), SF-36 and Morisky Medication Adherence Scale (MMAS-8) in two groups, respectively. The results showed that, after 8 weeks, the disease identity, serious consequences, treatment control and disease correlation; SAS and SDS scores; physiological function, emotional function, energy and social function were significantly improved in control group( t=2.30, 3.45, 2.35, 2.23, 5.04, 6.03, 2.03, 2.79, 2.02, 2.34, all P<0.05). All dimension of illness perception; SAS and SDS scores; physiological function, physiological function, emotional function, energy, mental health, social function and general health were also improved significantly in intervention group ( t=4.06, 5.44, 6.91, 8.53, 5.65, 8.77, 7.25, 6.06; 12.71, 11.91, 2.27, 2.60, 4.48, 2.82, 3.65, 3.461, 2.82,all P<0.05). And the personal control, disease correlation and emotional expression; SAS and SDS scores; emotional function and mental health in intervention group were better than those in control group ( t=1.49, 2.74, 2.60, 5.02, 5.18, 5.56, 13.72, all P<0.05). In addition, the medication compliance of patients in both groups was significant improved ( Z=5.56, 13.72, all P<0.01), and the improvement was more marked in the intervention group ( Z=3.22, P<0.01). The study indicates that the comprehensive psychotherapy can more significantly improve the degree of illness perception, negative emotions, quality of life and medication compliance in patients with chronic hepatitis B.
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Objective@#To investigate the influence of pharmaceutical care pathway on cancer-related fatigue (CRF) and negative emotion in patients with advanced lung cancer undergoing chemotherapy.@*Methods@#Patients with advanced lung cancer admitted to the oncology department of Yongkang first people′s hospital from January 2017 to June 2018 for chemotherapy were randomly divided into two groups:61 cases received conventional clinical pathway management (control group), and 64 cases received conventional clinical pathway combined with pharmaceutical pathway management (intervention group). Fatigue, anxiety, depression scores were compared between the two groups before and after 2, 4 cycles chemotherapy.@*Results@#There was no significant difference in baseline condition between the two groups (P>0.05). After 4 cycles of chemotherapy, emotional, physical and cognitive fatigue scores in the intervention group were lower than control group (t=2.975, 1.512, 2.393, P<0.05). With the increase of chemotherapy cycles, scores of fatigue dimensions in control group were increased (F=44.274,21.740,29.261,7.206, P<0.05). In the intervention group, there were statistically significant differences in scores of fatigue dimensions (F=17.083, 15.902, 17.055, 10.543, P<0.01), among which, scores of behavioral and physical fatigue dimensions were increased (P<0.01), while scores of emotional and cognitive fatigue dimensions were decreased (P<0.01). In terms of negative emotions, depression scores in the intervention group were lower than those in control group at 2 cycles of chemotherapy (t=2.578, P<0.05), and at 4 cycles, anxiety and depression scores were lower than control group (t=7.004, 7.454, P<0.05). As the chemotherapy cycle increased, anxiety and depression scores in the control group increased (F=12.333, 14.819, P<0.05), while those in the intervention group decreased (F=4.992, 3.826, P<0.05).@*Conclusion@#The pathway of clinical pharmaceutical care can significantly improve the CRF and negative emotions of patients with advanced lung cancer undergoing chemotherapy.
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Objective To investigate the influence of pharmaceutical care pathway on cancer-related fatigue (CRF) and negative emotion in patients with advanced lung cancer undergoing chemotherapy. Methods Patients with advanced lung cancer admitted to the oncology department of Yongkang first people's hospital from January 2017 to June 2018 for chemotherapy were randomly divided into two groups:61 cases received conventional clinical pathway management (control group), and 64 cases received conventional clinical pathway combined with pharmaceutical pathway management (intervention group). Fatigue, anxiety, depression scores were compared between the two groups before and after 2, 4 cycles chemotherapy. Results There was no significant difference in baseline condition between the two groups (P>0.05). After 4 cycles of chemotherapy, emotional, physical and cognitive fatigue scores in the intervention group were lower than control group (t=2.975, 1.512, 2.393, P<0.05). With the increase of chemotherapy cycles, scores of fatigue dimensions in control group were increased (F=44.274,21.740,29.261, 7.206, P<0.05). In the intervention group, there were statistically significant differences in scores of fatigue dimensions (F=17.083, 15.902, 17.055, 10.543, P<0.01), among which, scores of behavioral and physical fatigue dimensions were increased (P<0.01), while scores of emotional and cognitive fatigue dimensions were decreased (P<0.01). In terms of negative emotions, depression scores in the intervention group were lower than those in control group at 2 cycles of chemotherapy (t=2.578, P<0.05), and at 4 cycles, anxiety and depression scores were lower than control group (t=7.004, 7.454, P<0.05). As the chemotherapy cycle increased, anxiety and depression scores in the control group increased (F=12.333, 14.819, P<0.05), while those in the intervention group decreased (F=4.992, 3.826, P<0.05). Conclusion The pathway of clinical pharmaceutical care can significantly improve the CRF and negative emotions of patients with advanced lung cancer undergoing chemotherapy.
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Objective To monitor the changes of T lymphocyte subsets during chemotherapy in patients with non-small cell lung cancer(NSCLC).Furthermore,to analyze the relationship between chemotherapy curative effect and the T lymphocyte subsets.Methods 42 cases with NSCLC were selected as the subjects,and 28 people undergoing health examination were selected as control group.All NSCLC patients just received NSCLC standard chemotherapy,then respectively determined T lymphocyte subsets at pre-chemotherapy and after 2,4 courses of chemotherapy.Every two cycles of chemotherapy we would evaluate the effect of chemotherapy.Results Before chemotherapy,the patients′ CD+3(t=3.222,PSD>PD.Conclusion Chemotherapy can improve the NSCLC patients′ T lymphocyte subgroup,and improve the situation related to the curative effect of chemotherapy.
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Objective To investigate the clinical effects of the treatment of cancer pain control by the partic-ipation of pharmacist,and the effect on cancer patients and families mental state and quality of life.Methods Clini-cal pharmacists took participate in the standardized treatment of pain,before and after different intervention,NRS scale was used to assess the patients'pain,self -rating anxiety scale(SAS)and self -rating depression scale(SDS)were used to assess the patients and families'psychological mental status.SF -36 scale was used to assess the quality of life.Results Compared with pre -intervention,two weeks later,the overall situation of patients with pain was signifi-cantly improved[NRS score (4.72 ±1.13)points vs.(3.57 ±0.97)points,t =7.722,P <0.01].Patients and their families,anxiety and depression significantly alleviated [patients:SAS (32.56 ±4.66 )points vs.(60.31 ± 4.27)points,t =38.180,P <0.01,SDS (45.89 ±5.46)points vs.(68.34 ±6.23)points,t =28.250,P <0.01;families:SAS(33.76 ±4.82)points vs.(50.31 ±6.47)points,t =15.593,P <0.01,SDS (32.89 ±3.54)points vs. (52.34 ±6.23)points,t =15.593,P <0.01 ].At the same time,the patients and families'quality of life were improved.Conclusion Clinical pharmaceutical care can relieve the body pain,meanwhile,those could effectively relieve the anxiety,depression and other negative psychology of cancer patients and families,improve the whole quality of life.
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Objective To discuss the related factors of the malignant tumor complicated with venous throm-boembolism(VTE),which may provide the clinical evidence for prevention,diagnosis and treatment of this disease. Methods Retrospectively reviewed the clinical data of patients with malignant tumor who were diagnosed with VTE from June 2012 to June 2015 in our hospital.Results Among 74 cases with tumor merger VTE,female with thrombosis was higher than the male.67.57% of the tumor with VTE patients was 45 -80 years old.Lung cancer patient with VTE was the highest almost 36.49%.Patients with deep vein catheterization,a history of surgery or merging of hyper-tension were easy occurred VTE,those were 14 cases (18.92%),12 cases (16.22%)and 11 cases (14.86%) respectively.57 VTE patients underwent radiotherapy or chemotherapy treatment.The platelet count,D -dimer, fibrinogen and CRP were associated with thrombosis.Among 74 cases with VTE,67 cases (90.54%)accepted anticoagulation therapy.Conclusion Sex,tumor disease,chemotherapy or radiotherapy treatment,medical history and coagluative function index were associated with VTE.Early diagnosis and treatment is the key to reduce mortality and improve prognosis of malignant tumor with VTE.
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Objective: To observe the influence of epidermal growth factor tyrosine kinase inhibitors (EGFR-TKIs) on peripheral blood T lymphocyte subsets, and its efficacy and safety in the treatment of non-small cell lung cancer (NSCLC) patients.Methods: A total of 35 cases with NSCLC in our hospital were selected as the observation group and 28 healthy persons undergoing health examination at the same time were used as the control group.All the NSCLC patients were with EGFR mutations and accepted the EGFR-TKIs therapy.Flow cytometry was employed to detect T lymphocyte subsets in peripherial blood (including CD3+,CD4+,CD8+,CD4+/CD8+ and NK lymphocy-tes)in one week before the treatment, at the 1st, 2nd and 4th cycle after the EGFR-TKIs treatment, and the curative effect and safety were evaluated as well.Results: Before the chemotherapy, the levels of CD3+, CD4+, CD4+/CD8+ and NK lymphocytes in the NSCLC patients were significantly lower than those in the control group (PSD>PD.The adverse reactions caused by EGFR-TKIs were slight, and all could be improved markedly after the symptomatic treatment.Conclusion: EGFR-TKIs can significantly regulate the expression of T lymphocyte subsets in NSCLC patients and improve the immune function of the patients with promising safety.
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Objective To study the application of 99Tcm in rabbit cerebral thromboembolic stroke and thrombolysis effect of recombinant tissue plasminogen activator (rt-PA).Methods The 0.5 mL radioactive pertechnetate sodium (specification:5 mCi/2mL and radiation intensity 92.5 MBq/mL) was combined with 30 μL stannous chloride (5 mg/mL),and the 20 μL mixture was joined to whole blood,red blood cells,and plasma for labelling.Then 50 μL CaCl2 (0.5 mol/L) and bovine thrombin (50 IU/mL) were doped in mixture,and rapidly sucked into a polyethylene plastic pipe (PE80).Thrombus was formed for 2 h at 37 ℃ and cut into small pieces of 10 mm.Autologous blood clots combined with 99Tcm from external carotid artery were injected to internal carotid artery of rabbit,the radioactivity (counts per minute,CPM) was measured by gamma counting instrument,and the improvement of rt-PA 4.5 mg/kg (clinical equivalent dose) on this model was observed.Results After thromboembolism,CPM increased approximately by (5.1 ± 1.3) times,which suggested that the model was reliable.The rt-PA 4.5 mg/kg had significant progressive thrombolysis effect.Conclusion 99Tcm tracer technology could be applied to rabbit cerebral stroke model,which is stable and reliable
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Objective: To retrospectively analyze the efficacy and safety of three high-dose opioids in the treatment of cancer pain in our hospital.Methods: The medical records of 73 patients with severe cancer pain were collected, and according to the taken drugs, they were divided into group A (sustained-release morphine tablets, 25 ones), group B (sustained-release oxycodone tablets, 36 ones) and group C (transdermal fentanyl, 12 ones).Evaluation of patients with average of pain NRS,breakthough pain NRS,dosage of opioids,quality of life on admission and in 24h after the 4 weeks treatment;In addition,the other analgesic medications,auxiliary medicines,and adverse drug reations were recorded at the same time.Results: The NRS was significantly lowed in the three groups after the 4-week treatment (P＜0.01), and that in group B was lowest with notable difference when compared with that in group A (P＜0.05).The number of breakthrough pain also significantly decreased in the three groups after the treatment (P＜0.01), and there was no significant difference among them (P＞0.05).The doses of opioids analgesics after the 4-week treatment were significantly higher than those on admission (P＜0.01), and the doses in group B were slightly lower than those in the other two groups, while there was no significant difference among them (P＞0.05).The quality of life in the three groups was improved significantly after the treatment (P＜0.01), and no significant difference was shown among them (P＞0.05).The other pain medications and auxiliary medicines used in the three groups were similar (P＞0.05).The incidence of adverse reactions in the three groups had no significant difference (P＞0.05).Conclusion: The standardization of the three high-dose opioids analgesics can control pain effectively and improve the quality of life, which is worthy of clinical promotion.In addition, oxycodone shows the best analgesic effect, whiel fentanyl transdermal patches have the lowest incidence of adverse reactions.
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Objective To investigate the situation of drug use in wards of the Maternal and Child Health Hospital of Yongkang,then analyzed the situation of irrational drug for facilitating the rational drug use.Methods 2 691 discharged inpatient medical records were randomly extracted in the Maternal and Child Health Hospital of Yongkang from January 2016 to June 2016,in which the irrational medication orders were analyzed statistically according to Hospital Prescription Review Management Regulations(Trial) and other relative provisions.Results Of the 2 691 medical records,2386(87.4％) records were rational and 305 (12.6％) records were non-rational.The irrational use of drugs manifested in the following aspects such as selection of the drug menstruum,usage,dosage,combination,antibacterial drug prevention and repeated drug use,etc.Conclusion Clinical pharmacists through the medical orders for clinical medication monitor,sequentially can reduce and avoid the happening of irrational drug use,and promote the clinical safety and rational drug use.
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Objective To investigate and analyze the application of three steps therapy analgesics in good pain management(GPM)-ward,in order to provide rational analgesics drug application in clinical practice.Methods Through the hospital HIS system,the application data of analgesics in GPM-ward from Jan.2014 to Dec.2015 were collected and analyzed.Results The sum and proportion of the strong opioid drug was lined first.The total DDDs of the three -stage analgesics ranked from high to low was celecoxib >tramadol >oxycontin >morphine >fentanyl trans-dermal.The celecoxib was usually assisted the other;in addition,tramadol's DDDs and expense amount decreased, which was in the line with NCCN guidelines.Moreover,oxycontin's DDDs and expense amount increased.As well as, anesthesia prescription qualified rate was 93.5%,medical record standard rate was 80.5% in 2014,prescription qual-ified rate was rose to 97.5%,medical record standard rate was rose to 91.5% in 2015.Conclusion The application of cancer pain drug was basically rational in GPM-ward,which is in line with the principles of cancer pain relief by the mouth,by the clock,by the ladder and for the individual.