ABSTRACT
Objective To explore the methods that clinical pharmacists' participation in the clinical path management of cerebral infarction.Methods A total of 252 cases of cerebral infarction from January 2016 to June 2017 in People's Hospital of Hechuan District were selected.The control group (n=126) received conventional cerebral infarction clinical pathway.However,clinical pharmacists were participated in the observation group (n=126);In the observation group,the pathway of clinical pharmacists for cerebral infarction was improved by the PDCA circulation method,and a total of 2 cycles were performed.The hospitalization and medicine cost,hospitalization time,complication rate,as well as medication compliance were observed and compared.Results The hospitalization expenses,medicine expenses,hospitalization time,complication rate and medication compliance of patients in the observation group were better than that in control group (P＜0.01).The indicators above of the observation group for the second cycles in patients were better than that of the first cycle (P＜0.05).Conclusion The participation of clinical pharmacists using PDCA method in clinical pathway management is helpful to reduce hospitalization expenses and complications and improve medication compliance in patients with cerebral infarction.
ABSTRACT
OBJECTIVE:To provide reference for further promoting rational use of antibiotics in hospitals and curbing bacterial drug resistance. METHODS:Retrospective investigation and comparative analysis were made on the clinical application of antibiotics,the inspection of microbial specimens before use of antibiotics,the detection of multidrug-resistant bacteria,the occurrence of nosocomial infection before and after multi-sectoral participation in the prevention and control of multi-resistant bacteria infection in our hospital(from Jul. 2015 to Jun. 2016 as before intervention and from Oct. 2016 to Sept. 2017 as after intervention) in order to evaluate the intervention effect of this work. RESULTS:After intervention,the utilization rate of antibiotics,antibiotics use intensity and rate of combined use decreased from 64.15%,48.86 DDDs/hundred person per day, 35.87% to 57.67%,36.58 DDDs/hundred person per day,11.47%,respectively (P＜0.05). Both the de-escalation use rate of special grade antibiotics and the rate of antibiotics choice based on the drug sensitivity test increased from 12.45% and 48.28% to 56.63% and 77.89%(P＜0.001). Microbiological specimen inspection rate, total specimen inspection rate before using non-restricted use,restricted use and special use antibiotics and the sterile specimen inspection rate before using antibiotics increased from 23.58%,43.15%,71.76%,36.37% and 20.82% to 40.61%,58.43%,95.77%,51.33% and 38.27%, respectively(P＜0.05 or P＜0.01). The detection rate of MRSA,CRE and MDR-PA decreased from 4.43%,2.80%,1.99% to 1.36%,1.26%,0.80%,respectively (P＜0.05 or P＜0.01),and the detection rates of multi-resistant bacteria decreased from 16.21% to 10.68%(P＜0.05). Meanwhile,the incidence of nosocomial infection decreased from 1.41% to 1.08%(P＜0.05),and there was no outbreak of nosocomial infection. CONCLUSIONS:The intervention effect of multi-department participation in prevention and control of multi-resistant bacterial infection is significant,which helps to promote rational use of antibiotics and curb bacterial drug resistance,and it is necessary to continue to operate as a long-term management mechanism.
ABSTRACT
Objective To study the genetic regulation mechanism of colorectal LST,polypoid adenomas and clolrectal cancer by detecting the expression of p53,c-myc and Ki-67 in these three lesions.Methods The expressions of p53,c-myc,Ki-67 were determined via two-step of immunohistochemistry method in LST,polypoid adenomas,invasive colorectal cancer and their significant difference were compared.Statistical analyses were used to analyze the correlation among Ki-67 expression and p53,c-myc expression in these three group lesions.Results Immunohistochemical staining was performed in 38 LST,62polypoid adenomas and 36 colorectal cancer.For p53 and c-myc,the positive rates in LST,polypoid adenomas and colorectal cancer were significantly different from each other.For Ki-67,the positive rates in LST and polypoid adenomas were significantly lower than that in colorectal cancer,but there was no statistical significant difference between LST and polypoid adenomas.The expression of Ki-67 did not correlate with p53and c-myc both in LST and polypoid adenomas.But in colorectal cancer,the expression of Ki-67 was strongly related to p53 and c-myc.Conclusion The expressions of p53,c-myc and Ki-67 were different in LST,polypoid adenomas and colorectal cancer,indicating that their genetic regulation mechanism might be different,and the genetic avenue for LST may be different from polypoid adenomas.