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OBJECTIVE：To provide reference for the development and application of pharmacy popular-science video courseware. METHODS ：Combined with the problems existing in the medication of patients with chronic diseases at the present stage and the key points of medication management ，the theme ，content and form of this popular-science were determined ；the video shooting and production were completed ，and publicity and promotion were carried out. Questionnaire survey was conducted ， and the reception of pharmacy outpatient service in our hospital was counted ；the broadcasting effects of popular-science video were analyzed. RESULTS ：The theme of popular-science video courseware was determined to be self-medication management of patients with chronic diseases at home assisted by pharmacists. Combined with the “five moments ”of medication safety proposed by WHO ， the content included six units as knowing pharmacists ，understanding drugs ，taking drugs ，adding drugs ，checking drugs ，and discontinuing drugs. PPT video was used to explain the contents of each unit ，with an average duration of about 25 min. After the first unit was launched ，a total of 39 327 hits were received within two months. A total of 100 questionnaires were sent out ，97 questionnaires were collected （recovery rate of 97.0％）. Among them ，80（82.5％）thought it helpful to watch the video. Within two months after the broadcast of unit 1 video，the reception volume of pharmacy outpatient department of our hospital （1 160 person times ）increased by 104.2％ compared with the two months in the same period last year （568 person times ），and increased by 18.7％ compared with the two months before the broadcast （977 person times ）；99 patients came to the pharmacy outpatient department to consult because of watching the video ，and 55.6％ of the registered patients consulted the demonstration of video courseware and repeatedly mentioned related problems. CONCLUSIONS ：It is a beneficial exploration for pharmacists to develop popular-science video courseware with the theme of safe and rational drug use. It is the direction for future work to increase the scope of disease types ，target different groups of people or focus on different types of drugs and promot them in various forms.
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Objective:To evaluate the effect of combined teaching of optical laryngoscope and general laryngoscope on anesthesia undergraduate practice.Methods:A total of 40 anesthesia undergraduate students were randomly divided into group A (using the optical laryngocope only in the first month and the general laryngoscope only in the second month, n=20), and group B (using the general laryngocope only in the first month and the optical laryngoscope only in the second month, n=20). The teaching effect was evaluated through the first month and the second month of tracheal intubation assessment and questionnaire survey results. SPSS 23.0 was used for t test and chi-square test. Results:In the first month, the success rate was 90% in group A and 60% in group B, which showed that the success rate of group B was lower, with significant differences ( P < 0.05). The time for tracheal intubation in group A was (61.8±5.0) s, and that in the group B was (83.0±4.9) s, showing that the time of group B was longer, with significant differences ( P < 0.05). The complications in group A was 5%, and that in group B was 14%, showing that the group B had more cases of implications, with significant differences ( P < 0.05). In the second month, there was no significant difference in the one-time success rate, the time for tracheal intubation, and complications between the two groups ( P > 0.05). There was no significant difference in one-time success rate and complications between groups. Both groups showed that the time for general laryngoscope intubation was longer, with significant differences ( P < 0.05). All of the students believed that applying optical laryngoscope teaching was beneficial and could enhance the interest of learning, and the combination of the two methods was better. Conclusion:Using the optical laryngoscope first and then the general laryngoscope teaching is more beneficial for students to master the two methods of tracheal intubation, improve the success rate, reduce complications, and cultivates their self-confidence.
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OBJECTIVE:To construct the structure equation model for the burden of chronic disease inpatients in primary hos-pital before and after the implementation of zero price policy,and analyze the changes of burden factor loading. METHODS:6 pri-mary hospitals were randomly selected in Danyang,Jiangsu province. The data of hospitalization expenses for chronic diseases(hy-pertension,diabetes,bronchitis)were collected before and after the implementation of zero price policy. Using drug cost,nursing fees,inspection fees and treatment fees as independent variables,hospitalization burden as latent variable,SPSS and AMOS 24.0 software were adopted to establish the model. RESULTS:The burden factor loading of inpatients changed greatly before and after the implementation of zero price policy. χ2=24.586,χ2/df=1.446, RMSEA=0.019,GFI=0.995,AGFI=0.989,CFI=0.988,NFI=0.963 manifested good model fitting. Factor loading of drug cost increased greatly,indicating the burden of inpatients was reduced after the implementation of zero price policy. Factor loading of inspection fees and treatment fees increased significantly,the charac-terization effects of them to the burden of inpatients were enhanced. Factor loading of nursing fees was the lowest,and it had the weakest effects on the burden of inpatients,of which the government should enhance the regulation. CONCLUSIONS:Established model has good reliability and validity. It can reflect the change of burden factor loading of inpatients before and after the implemen-tation of zero price policy.
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Objective:To observe the clinical effect of sodium bicarbonate combined with endoscopic lithotripsy for gastrolithiasis. Methods:A total of 84 gastrolithiasis patients in our hospital from Jan 2014 to Dec 2015 wore randomly divided into the observation group and the control group (each of 42 cases), control group was given conventional endoscopic lithotripsy, the observation group was given sodium bicarbonate based on the use of endoscopic hithotnipsy. The two groups of patients with an average of endoscopic lithotripsy times, bezoar disappeared time, complications were observed. Results:The cumulative success rate in the observation group was higher that in the control group (P<0.05),the lithothipsy times in the observation group was less than that in the control group (P<0.05) . Conclusion:Sodium bicarbonate combined with endoscopic lithotripsy for gastrolithiasis has good clinical curative effect,reduce the repeated lithotripsy,accelerate the dissolution of stones.
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Hydrogen evolution from water electrolysis is one of the effective ways to obtain clean hydrogen energy in the future. Pt-based materials are the efficient catalysts in hydrogen evolution reaction, but it is expensive, difficult to recycle, which impedes its application in the development of hydrogen energy and economy. Therefore, it is the key trend to develop efficient non-noble metal electrocatalysts with the aim of providing cost-competitive hydrogen energy. In this review, we highlighted the recent research efforts toward the synthesis of noble metal-free electrocatalysts for the hydrogen evolution reaction ( HER) , mainly focusing on nanomaterial catalysts supported on carbon fiber materials. We reviewed several important kinds of heterogeneous non-noble metal electrocatalysts, including sulfides, selenides, carbides, phosphides, and oxides. In the discussion, emphasis was given to the synthetic methods of these HER electrocatalysts, and the strategies for performance improvement. In addition, this paper also briefly summarized the application of carbon fiber material as substrate in the field of electroanalytical chemistry.
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Objective To analyze the risk factors of emergence agitation (EA)in the adult patients during the recovery peri-od after general anesthesia in postanesthesia care unit(PACU).Methods 2 056 adult patients undergoing elective surgery under general anesthesia in PACU were selected,aged more than 18 years old,sex unlimited The following factors of age,gender,body mass,ASA grade,preoperative combined disease,education level,premedicatiou,general anesthesia mode,midazolam use for induc-tion,anesthesia time,operation site,operation mode,operation time,intraoperative blood loss,intraoperative fluid replacement,re-covery time in PACU,body temperature,urinary catheter,urine volume,etc.were recorded.According to whether EA occurring during recovery from general anesthesia,the patients were divided into the quiet group and the EA group.The multivariate Logistic regression was performed to analyze and screen the risk factors for the occurrence of EA.Results 127 cases developed EA during recovery from anesthesia.The occurrence rate of EA was 6.18%.The Logistic regression analysis indicated that high grade ASA, large quantity of intraoperative fluid replacement,placing urinary catheter and postoperative pain were the risk factors for EA(P <0.05).Conclusion Highgrade ASA,large quantity of intraoperative fluid replacement,placing urinary catheter and postoperative pain are the risk factors for EA during the recovery period after general anesthesia in PACU.
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Objective To investigate the effect of Shenfu injectio on insulin resistance in rabbits undergoing cardiopulmonary bypass (CPB) . Methods Thirty New Zealand white rabbits of both sexes weighing 2.2-2.5 kg were randomly divided into 3 groups (n = 10 each): group I sham operation (group S); group Ⅰ CPB and group Ⅰ CPB + Shenfu injectio (group SFI). In group IE (group SFI) Shenfii injectio 10 ml/kg was injected intraperitoneally (IP) once a day for 2 days and at 30 min before anesthesia. In group Ⅱ and Ⅲ the duration between aortic cross-clamping and unclamping was 60 min. MAP was maintained at 50-60 mm Hg during CPB. The plasma glucose and insulin concentrations were measured immediately after induction of anesthesia (T_1), immediately after aortic cross-clamping (T_2) , and at 5, 35 and 75 min after aortic unclamping (T_3, T_4 , T_5) and insulin resistance index (HOMA-IR) was calculated. The expression of insulin receptor substrate-1 (IRS-1), phosphatidyl-inositol 3 kinase (PI3Kp85) and glucose transporters (CLUT4) in skeletal muscle was detected at 150 min of CPB by immuno-histochemistry. Results Compared with the baseline values at T_1 , plasma glucose and insulin concentrations and HOMA-IR were significantly increased at T_(2-5) in all 3 groups ( P < 0.05) . CPB significantly increased the plasma glucose and insulin concentrations and HOMA-IR at T_(2-5) in group Ⅱ and Ⅲ as compared with group S ( P < 0.05). The expression of PI3Kp85 and GLUT4 in muscle was significantly decreased in group Ⅱ and Ⅲ as compared with group S ( P < 0.05). Shenfu injectio significantly decreased plasma glucose concentration and HOMA-IR and increased plasma insulin concentration in group fD as compared with group Ⅱ . Shenfu injectio significantly attenuated the CPB-induced changes in IRS-1, PI3Kp85 and GLUT4 expression in muscle. Conclusion Shenfu injectio can ameliorate CPB-induced insulin resistance and the mechanism may be related to the up-regulation of the expression of insulin signal transduction molecules in skeletal muscle.
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The solvent extraction of rare earths with mixtures of di-( 2-ethylhexyl) phosphoric acid (D2EHPA,H2A2) and sec-nonylphenoxy acetic acid (CA100,H_2B_2) has been carried out. The separation abilities among rare earths were determined and compared with those with D_2EHPA alone. The mechanism of synergistic extraction of lanthanum was discussed. The methods of slope analysis and constant mole were used to examine the extraction stoichiometry. Effects of acidities,concentrations of extractants,and temperature on the extractabilities have been investigated. The results showed that the synergistic effects decrease with increasing atomic numbers of rare earths. At proper ratios of the extractants,the separation abilities of some rare earths with D2EHPA +CA100 were higher than those with D2EHPA alone,which may be applied to the separation of these rare earths. The extracted complex of lanthanum with D2EHPA + CA100 was determined as LaH5A6B2. The synergistic extraction is endothermically driven.