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In order to expand the breadth and depth of pharmaceutical services, in March 2022, a tertiary hospital opened a physician-pharmacist joint clinic based on clinical specialty clinics. The hospital formulated a fixed outpatient scheduling system, clarified service targets, established outpatient treatment processes and quality management systems, and standardized pharmacist communication models, to provide patients with " one-stop" standardized pharmaceutical services. As of December 2022, the pharmaceutical joint outpatient service had opened more than 100 consultations and served 1 709 patients. This practice provided reference for promoting the high-quality development of pharmaceutical services in medical institutions in China.
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Under the policy background of zero addition of drugs and consumables in public hospitals, with clinical practice as the guide and information platform as the means, the hospital constructed an intelligent management system for hospitals′ drugs and consumables through the Internet of things. The hospital adopted the intelligent medicine cabinet extended ward management, consumables " one material, one code" two-level warehouse management mode, reengineering the material supply process.Finally, it can realize the whole process traceability of information, unify the flow of goods and data, save human resources, improve the efficiency of operation and management, and achieve the purpose of ensuring safety, reducing costs and increasing benefits.
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Objective To observe and analyze the clinical effect of noninvasive sputum aspiration combined with atomization inhalation in the treatment of pediatric bronchiolitis. Methods Totally 79 children with bronchiolitis diagnosed from January 2016 to December 2017 were selected. The children were divided into observation group (40 cases) and control group (39 cases) by double blind method of stratified random sampling. The observation group were treated with atomization inhalation after noninvasive sputum aspiration;and the control group were treated with the traditional inhalation of sputum according to the condition of the disease.The improvement effect of the symptoms before and after the treatment of the two groups was compared. Results After treatment, the improvement of symptoms in the two groups included cough, fever, wheezing, shortness of breath, lung rales, daily sputum aspiration and hospital stay were (5.34±1.06) d, (1.82±0.35) d, (2.66±0.85) d, (1.76±0.39) d, (4.37±1.29) d, (6.38± 1.39) times, (6.31 ± 0.82) d in the observation group, (6.25 ± 0.98) d, (2.34 ± 0.41) d, (3.08 ± 0.94) d, (2.56 ± 0.41) d, (5.39 ± 1.33) d, (8.31 ± 1.52) times, (8.25 ± 1.09) d in the control group, the difference was statistically significant( t=2.084-8.954, P<0.05). Respiratory function improvement including arterial oxygen saturation,heart rate,respiratory rate was 0.96±0.03, (110.85±4.16) times/min, (29.49±1.87) times/min in the observation group, 0.92±0.03, (119.34±4.22) times/min, (35.14±1.95) times/min in the control group,the difference was statistically significant(t=5.925, 9.005, 13.146, P<0.05). The effective rate of the observation group was 97.50％ (39/40), which was significantly higher than that of the control group 79.49％(31/39), the difference was statistically significant (χ2=4.688, P<0.05).The satisfaction rate of the family members of the observation group of the nebulization and sputum suction service was 100.00％(40/40), which was significantly higher than that of the control group (87.18％, 34/39), the difference was statistically significant (χ2=13.698, P<0.05). Conclusions Noninvasive sputum aspiration combined with atomization inhalation is effective in the treatment of pediatric bronchiolitis. It can relieve airway obstruction, improve asthma symptoms, shorten the time of hospitalization, and the operation is convenient and safe.
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As an important part of medical supplies, the logistics management of high-value medical consumables becomes a key link in modern hospital administration. Compare between the management of high-value medical consumables and modern supply chain management. Based on 4R theory, discusses and analyses the management of high-value medical consumables in Fuwai hospital. By means of 4R theory, modern supply chain management has been optimized for the actual consumable management. And found out a effective method to resolve bullwhip effect caused by the limitations of high-value medical consumables. This research demonstrate modern hospital want to win the competitive initiative only by the improvement of material flow management level.
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Objective It aims to investigate the relationships among the categories of Comprehensive Version for Stroke as described in the International Classiifcation of Functioning, Disability and Health (ICF) Core Set, and to provide new supports for Judicial Appraisal of functioning in stroke by ICF functioning mapping.Methods The variables of 59 categories of ICF assessment scale and the samples of 106 persons’ are selected and used in the least absolute shrinkage and selection operator (LASSO) for mining dependencies among those variables. The graphical modeling and analyzing with the software Gephi provides a visual map of the correlations among those classiifcations. Results 59 interconnected categories which organized into the functioning mapping. b340, b735, b175 and b152 are centrally positioned categories because of their high correlation.Conclusion Functioning mapping by graphical modeling can reveal complex relational structures embedded in functioning classiifcations, which provides the support for using ICF to appraisal stroke.
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Objective To assess the value of nuchal translu-cency in combination with non-invasive prenatal DNA test in fetal with chromosomal disease. Methods A total of 713 cases with single pregnancies, with 11 ~ 14 gestational weeks, were enrolled in this study. We measured the thickness of nuchal translu-cency, If the thickness was abnomal, the pregnant women would receive the non-invasive prenatal DNA test on voluntary basis and were followed up. Results There were 27 cases with abnormal NT among 713 cases. Twenty-one cases received non-invasive prenatal DNA test , the test results showed that 3 cases were trisomy 21 , 1 cases was trisomy 18. Among the 17 cases with normal chromosome karyotype, 6 cases were found abnomal during the follw-up. Two cases were found abnomal among the 6 cases undergo the non-invasive prenatal DNA test.The thickness of NT, ranging from 3.7 mm to 4.4 mm, was trisomy 21, with the average of 4.0 mm, and the thickness of NT was 5.0mm and was trisomy 18. Conclusions The application of nuchal translu-cency in combination with non-invasive prenatal DNA test could improve the ability to find fetal chromosomal disease and to decrease the birth defect.
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In order to improve the teaching quality of experimental teaching of laboratory diagnosis and to cultivate the clinical ideation of medical students,we have been trying a series of reform in this course and obtained good results.Here,our experience in the selection of teaching contents,the improvement of teaching methods,and the setting of experimental assessment have been summarized and investigated.
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Objective To evaluate the effects of pacing in right ventricular septum (RVS) on hemodynamics among atrioventricular sequential dual chamber pacing Methods Twenty patients with high grade or complete atrioventricular block received permanent dual chamber pacemaker ( DDD ),were randomized into right ventricular septum pacing group (RVS)and right ventricular apex pacing group (RVA)according to the ventricular leads position.The QRS duration of the ECG,the left ventricular ejection (LVEF),the interventricular mechanical delay( IVMD )and the plasma levels of brain natriuretic peptide (BNP)were compared before and after operations.Results Compared with the preoperation,the mean QRS duration ( ( 187.00 ± 15.67 ) ms and (94.00 ±9.17 ) ms),the IV MD ( (43.20 ± 6.79 ) ms and ( 15.00 ± 4.08 ) ms ),the level of BNP ( ( 89.70 ± 8.30) ng/L and (40.00 ± 4.73 ) ng/L) increased( P ＜ 0.05 ) and LVEF decreased significantly ( (53.70 ± 1.34) % and (58.60 ±1.65 )% ,P ＜ 0.05 ) in RVA group,but didn't change in RVS group (P ＞ 0.05 ).After three months following up,the mean QRS duration and the IVMD in RVS group( (119.00 ±7.38 )ms,(19.00 ±4.59)ms) were shorter than that of RVA group( ( 187.00 ± 15.67) ms,(43.20 ± 6.79) ms) ( P ＜ 0.05 ),the LVEF was higher and the plasma level of BNP was lower than that of RVA group ( (57.00 ± 2.00) % and ( 53.70 ± 1.34) %,(44.20 ± 9.18 ) ng/Land ( 89.70 ±8.30) ng/L,P ＜0.05).Conclusions The RVS pacing could keep the normal ventricular activation sequence and biventricular contraction synchrony farthest without side effects on hemodynamics in comparison with the RVA pacing.The RVS pacing is more approaching physiological rhythm than the RVA pacing.
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Objective To culture preadipocytes in vitro and to study the cell compatibility of PLGA scaffolds,collagen scarfolds and hyaluronic acid-based scaffolds and tO choose the optimal seeding method.Methods The preadipocytes from human abdominal adipose tissue were isolated and cultured in enzyme-digesting method.The generation of human preadipocytes was planted on PLGA scaffolds,collagen scaffolds and hyaluronic acid-based scaffolds.and the cell compatibility was observed by MTT method.The seeding efficiency of human preadipocytes on scaffolds.human preadipocytes were seeded to hyaluronic acid-based scaffolds by static culture and stirred culture.Results Compared compatibility of preadipocyte with three different scaffolds,there was great difference between hyaluronic acid-based scaffolds and PLGA scaffolds.Difference also existed between hyaluronic acid-based scaffolds and collagen scaffolds that were different from PLGA scaffolds.Among them,hyaluronic acid-based scaffolds was the best.Conclusion Hyaluronic acid iS a better scaffolds material for adipose tissue engineering compared with PLGA and collagen.The seeding efficiency of stirred culture is higher than static culture,which is an optimal method for cell seeding tO 3-D scaffolds.
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@#Objective To study the effects of the staging acupuncture combined with physical therapy on the neural function, motor function and activities of daily living in stroke patients. Methods 166 cases were divided into two groups: 83 cases in the treatment group were treated with staging acupuncture combined with physical therapy; 83 cases in the control group were treated with traditional acupuncture combined with physical therapy. They were evaluated with modified Edinburgh-Scandinavia Stroke Scale (MESSS)，Fugl-Meyer Assessment (FMA), and Bathel Index (BI) before and 2 months after treatment. Results There was no significant difference between these 2 groups before treatment (P>0.05), but were significant differences in MESSS, FMA and BI (P<0.05) after treatment. The incidence of recovery after treatment was 90.36% in treatment group, significantly better than that of the control group (74.49%, P<0.05). Conclusion In comparison with the traditional acupuncture, the staging acupuncture can significantly improve the effect on stroke based on the physical therapy.
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Objective To investigate the electrocardiographic characteristics and assess the efficiency of ra-diofrequency catheter ablation(RFCA) in ventricular arrhythmia arising from the aortic sinus of Valsalva. Methods Eighteen patients(6 males and 12 females)were selected to undergo RFCA for ventficular arrhythmia originating from the left aortic sinus of Valsava. All of them were symptomatic,but without evidence of structural heart disease. Activation mapping was performed in the endocardium of the aortic sinus of Valsalva,then ablation was performed at the site with the earliest ventricular wave in endocardium electrograms. At the same time, coronary and aortic angiog-raphy were performed to assess the anatomic relationship between the ventricular tachycardia (VT)/ventricular pre-mature contraction (VPC) origin and coronary arteries and aortic valve before the RF energy delivery. Results Eighteen patients were successfully managed, with no major complications related to the procedure. VT eliminated and VPC counts on 24-hour ECG monitoring decreased significantly after the ablation[18 474(12 399,26 812)/24h vs 4 (1,7)/24 h, Wilcoxon signed-rank test, P<0.05]. During a follow-up period of 6 monthes, there was no recur-rence. Conclusions Ventricular arrhythmia arising from the aortic sinus of Valsalva has specific electrocardiograph-ic characteristics, and it can be successfully and safely treated under the guidance of activation mapping.
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OBJECTIVE: To develop an HPLC method for the determination of salvianolic acid B in Qianlie kangxin granules.METHODS: The sample was determined on DiamonsilTM C18(250 mm?4.6 mm,5 ?m) with the mobile phase consisted of methanol-acetonitrile-water-formic acid(25∶10∶64∶1) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 286 nm.RESULTS:The linear range of salvianolic acid B was 0.206～1.854 ?g(r=0.999 9).The average recovery rate for salvianolic acid B was 98.0%(RSD=1.5%,n=6).CONCLUSION: The established method is simple,reliable,stable in results and reproducible,and it is applicable for the quality control of Qianlie kangxin granules.
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Objective To study the efficacy of arthroscopy in the management of patella fracture.Methods Arthroscopic techniques were employed for treating 42 patients with fresh simple patella fracture.After blood clots and fragments were cleaned up,the fracture was reduced by manipulation.Two Kirschner's pins were parallelly inserted percutaneously for internal fixation of the fracture.Then a modified tension band fixation with percutaneous wire interposition was made.Results The operation time was(1.2~3) hours(mean,2.2 hours).The time to bone union was 7~10 weeks(mean,7.5 weeks).The postoperative hospital stay was 7~14 days(mean,8.5 days).Follow-up checkups in 37 patients for 6 months ~ 4 years(mean,19.2 months) revealed bone union in all the patients and no joint instability or traumatic arthritis.The curative results were classified as excellent in 34 patients,good in 2 patients,and fair in 1,the rate of excellent or good results being 97.3%(36/37).Conclusions Arthroscopic management of patella fracture has advantages of accurate reduction and fixation,little invasion,early postoperative functional training,and quick recovery.
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We made our specific teaching program for these students with evidence-based medicine theory,according to their teaching characteristics. They studied the research methods of evidencebased medicine,and learned to search informations,write reviews,discuss clinical cases, design subjects under the guidance of teachers. Their scientific research ability was improved after these practices and training program.
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Orthopaedic surgery is a fast developing subject in clinical surgery.Based on the characteristics of the orthopaedic surgery and aiming to enhance the medical students’practical ability of basic skills and clinical thinking we adopt the explorative clinical teaching which can be helpful to training students’initiative of finding and working out a solution by themselves and cultivating their capability of innovation and creation.