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In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.
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Objective:To build the performance appraisal index system for scientific research teams in tertiary public hospitals, so as to stimulate creative vitality of scientific researchers and improve high quality construction of research teams.Methods:Combined with literature review and hospital management practice, the performance appraisal index system of hospital scientific research team was initially constructed by using the structure-process-result model.From July to December 2021, the performance appraisal indexes and their weights were determined through two rounds of expert consultation and analytic hierarchy process. The index system was used to evaluate the performance of the National Clinical Medical Research Center for Geriatrics.Results:A scientific research team performance appraisal index system has taken shape, comprising four level-1 indexes, 12 level-2 indexes and 47 level-3 indexes. The weights of the level-1 indexes of scientific and technological innovation, operation management, sustainable development and satisfaction evaluation were 0.407, 0.223, 0.223 and 0.147 respectively. The corresponding level-2 indexes with the highest weights were scientific research output(0.302), management cooperation(0.268), talent training(0.356) and assessment of department satisfaction(1.000). The index judgment matrix passed the consistency test( CR value<0.1), and the weight consistency was good. Applying this index system to evaluate the performance of the National Clinical Medical Research Center for Geriatrics, the total score was 73.40, and the scores of scientific and technological innovation, operation management, sustainable development and satisfaction evaluation indicators were 29.74, 16.14, 14.34 and 13.18, respectively. Conclusions:The performance appraisal index system of scientific research teams constructed in this study is feasible, which can be used as an important tool for building scientific research teams in the hospital.
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Objective:To explore the evaluation dimensions and indicators of research hospital, provide empirical evidence for the construction of research hospital.Methods:Non-probability sampling was adopted, physicians from 9 hospitals in Shanghai that have a National Clinical Medical Research Center or Shanghai Clinical Medical Research Center were invited as survey participants. The physician participants were divided into senior and junior groups. For senior group, a questionnaire including 5 dimensions and 21 indicators was provided. The survey participants were consulted to determine whether the indicators can be used to measure this dimension, and also invited to propose additional dimensions and indicators for improvement.For junior group, two open questions were proposed to explore their needs of support in both clinical service and research.Results:Based on suggestions from the research participants, the research team, and other expert consultant, this article tried to propose 5 dimensions and 21 indicators for evaluating research hospitals. Among them, 11 were indicators compiled by the research team based on the literature review and agreed by more than 2/3 of senior physicians surveyed, while others were proposed based on the survey results. The research team planned to use the entropy method to determine the weights of different indicators, thus, the participants were not required to make judgments on the weights of dimensions and indicators.Conclusions:The evaluation of research hospitals has not yet formed a systematic consensus. Through the exploration and establishment of evaluation dimensions and indicators, identify hospitals that are closer to the development goals of research hospitals can provide a basis for future next-step practices.
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Objective To systematically review the efficacy and safety of tandospirone in the treatment of generalized anx-iety disorder(GAD) and to provide evidence-based references for clinic. Methods Databases include PubMed,Embase,The Co-chrane Library,CBM,CNKI,VIP and Wanfang Data were electronically searched from the inception to November 2016,to collect randomized controlled trials(RCTs)about the tandospirone citrate in the treatment of generalized anxiety disorder.Meta-analysis was performed by RevMan5.3 software after data extraction and quality evaluation. Results A total of 5 RCTs involving 500 patients were included.The results of Meta-analysis showed no significant differences in the Hamilton Anxiety Scale(HAMA) score between experimental group and control group[MD=0.47,95%CI(-0.51,1.45),P=0.34];and there was no significant differences of total effective rate between experimental group and control group[OR=1.03,95%CI(0.64,1.67),P=0.90].The incidence of adverse reactions in experimental group was significantly lower than that of control group,the difference was statistically significant[OR=0. 65,95%CI(0.44,0.95),P=0.03]. Conclusion Tandospirone citrate,as a new type of non-BZDs of antianxiety drug,shows exact clinical curative effect in the treatment of generalized anxiety disorder with mild adverse reaction and good safety.
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OBJECTIVE:To study the effect and mechanism of tandospirone citrate (TC) on blood pressure in spontaneously hypertensive rats (SHR). METHODS:SHR were divided into model group,positive control group (Levamlodipine besylate tab-lets,2.5 mg/kg),TC high-dose,medium-dose,low-dose groups(TC capsules,40,20,10 mg/kg),8 in each group. Other 8 nor-mal rats were chosen as normal control group. The rats were intragastrically administrated medicines,once a day,for 28 d. Systolic blood pressure(SBP)before first administration and after 0.5,1,1.5,2,3,4 h of administration in each group were measured, and SBP after 1 h of administration were measured once every 7 d. After last administration,nitric oxide(NO)content in serum, endothelin,renin,angiotensin Ⅱ(Ang Ⅱ) and norepinephrine (NE) contents in plasma were detected. RESULTS:In single ad-ministration,compared with model group,SBP in 0.5,1 h in positive control group and TC groups after first administration were obviously decreased (P<0.05 or P<0.01),then SBP were obviously decreased only in positive control group and TC high-dose group (P<0.05 or P<0.01). In multiple administration,compared with model group,SBP in 7th,14th,28th day of administra-tion in positive control group and TC high-dose,medium-dose groups were obviously decreased(P<0.05 or P<0.01). Compared with model group,NO content in serum in positive control group,TC high-dose group were obviously increased;endothelin,re-nin,Ang Ⅱ and NE contents in plasma were obviously decreased (P<0.05 or P<0.01). Compared with positive control group, NO content in serum in TC groups was obviously decreased;endothelin,renin,Ang Ⅱ and NE contents in plasma were obviously increased in TC medium-dose group (P<0.05). CONCLUSIONS:TC can obviously decrease the blood pressure of SHR. The mechanism may be associated with adjusting the balance of NO and endothelin,and decreasing renin,AngⅡand NE contents.
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Objective To study the effect of network peer education on the 131I treatment adherence in patients with thyroid cancer.Methods A total of 120 patients with thyroid cancer who performing 131 I treatment from April 2012 to April 2014.They were divided into intervention group 61 cases and control group 59 cases according to the hospital ward number.Control group was given routine health education and intervention group was given network peer education.The data from the habits,drug therapy,grasp the situation,the equivalent monitoring of the relevant knowledge of 4 different dimensions of treatment adherence for patients were investigated and compared before discharge by using questionnaire and examination method.Results The incidence of the good habits,drug therapy,grasp the situation,and the equivalent monitoring reaching the standard were 96.7％(59/61),98.4％(60/61),96.7％(59/61),100.0％(61/61) in intervention group,and 54.2％(32/59),76.3％(45/59),79.7％(47/59),89.8％(53/59) in control group,there were significant differences,x2=29.54,13.38,8.47,4.56,P＜0.01 or ＜0.05.Conclusion Network peer education for patients with thyroid cancer during the 131I treatment can effectively improve the patient's treatment adherence,has positive significance for the treatment.
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Objective To assess the feasibility and safety of combined transgastric and transcolonic endoscopic cholecystectomy in porcine model.Methods Five female miniature swines were subjected to cholecystectomy by the combined transgastric and transcolonic approach using two flexible endoscopes.The gastric wall of the swine was punctured with a needle knife,followed by dilatation with a balloon-dilator via the transgastric access.then a double channel endoscope was advanced into the peritoneal cavity.Another double-channel endoscope was advanced via a transcolonic access.Gallbladder excision was performed using transcolonic endoscope assisted by transgastric endoscope.After eholecystectomy the gastric and the colonic incisions were closed with clips.The animal was examined 14 days after operation.Results Cholecystectomy was failed in 4 swines because of incomplete exposing the gallbladder(3 swines)and hemarrhage during separating the gallbladder from the liver bed(1 swine).Only one swine was successfully performed cholecystectomy.But 3 perforations were found in the diaphragm which might be done by transcolonic endoscope.The swine lost 4 kg 14 days after the operation.The necropsy revealed a complete transmural healing of the gastric incision with minimal adhesions and a complete healing of the colonic incision with heavy adhesions.An abscess with severe adhesions was found in the right lower quadrant.One perforation of the diaphragm healed,and the other two perfolrations merged and formed a diverticulum embedded with the liver.Conclusion Combined transgastric and transcolonic approach appears difficult for cholecystectomy and the safety remains tO be further studied.
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Objective To investigate the feasibility and safety of trans-gastric route combined with trans-colonic or trans-vaginal route endoscopic salpingectomy and liver biopsy, as methods of natural orifice translumenal endoscopic surgery (NOTES). Methods Endoscopic salpingectomy and liver biopsy were per-formed in 4 female porcine models, in 2 of which the procedure was achieved via trans-gastric and trans-co-Ionic route (Group A), while in other 2 was via trans-gastric and trans-vaginal route (Group B). The ani-mals were sacrificed after the procedure and the related complications were observed. Results Abdominal cavity exploration, salpingectomy and liver biopsy could be performed successfully through two combined routes. Perforation of adjacent colon was found in 1 animal with the trans-colonic route NOTES. Conclusion NOTES via trans-gastric and trans-colonic routes or via trans-gastric and trans-vaginal for salpingectomy and liver biopsy are both feasible, while trans-vaginal route seems to be safer than trans-colunic route.
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Objective In this study we discussed the training method for skills of evidence-based nursing(EBN)for nurses in surgical department.Methods We selected 43 nurses in two surgical department as training objects.The trainging procedure was established according to the four steps of evidencebased nursing,putting forward questions,searching for evidences,making observations and applying evidence-based nursing.The nurses were trained according to the procedure.The skills of EBN,ability of obtaining information and satisfaction degree of nurses was evaluated after training.Results The skills of EBN and the ability of obtaining information after training Was statistically different from those before training(P ＜0.01).95% nurses considered that their EBN ability was improved after training. Conclusions The skills of EBN and the ability of obtaining information increased after EBN training in nurses of surgical department.This had instructive significance for the application of evidence-based nureing.
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AIM: To explore whether granulocyte colony-stimulating factor (G-CSF) has the function of curing ischemia cerebral infarction in rats. METHODS: Rat cerebral infarction model was stablished by line occlusion and G-CSF 60 ?g/kg was injected into abdominal cavity an hour later. The technique of TTC and HE staining and immunohistochemistry were used to detect the volume of infarction and pathological change and the infiltration of CD34 positive cells, respectively. RESULTS: The infarction volume of the rat brain was smaller in G-CSF-therapy group than infarction group 24 hours later and the pathological damage is slighter. Both CD34 positive mono-nucleus cells and CD34 positive neuron-like cells were detected in the rat brain of G-CSF-therapy group but not in the control one 24 hours later. CONCLUSIONS: G-CSF can relieve the ischemia degree and reduce the infarction volume. The possible mechanism is that G-CSF plays protection role on the ischemic neuron cells and moblizes stem cells in bone marrow, then stimulates the regeneration and plerosis of brain tissues.