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OBJECTIVE:To provide a reference for promoting and strengthening pharmaceutical services by retail pharmacies in rural area in Yongzhou of Hunan. METHODS:Investigation was conducted on 13 aspects including the service concept,service mode,service process,service contents,hardwares and softwares and professional quality of practitioners of 357 retail pharmacies in rural area in Yongzhou of Hunan to know about current pharmaceutical services. RESULTS & CONCLUSIONS:In this area, 78.9% of pharmacies operated in the name of a licensed pharmacist or pharmacist who did not work in that pharmacy;only 53.3%of practitioners were pharmacy graduates;the proportion of the practitioners who takes part in training every year was less than 30.0%,average training time was not more than 8 hours;65.3% of practitioners in the pharmacies were not aware of the concept of pharmaceutical services;the pharmacies which were not equipped with basic hardwares and softwares for pharmaceutical servic-es accounted for 47.0%,those which had not established a pharmaceutical service management process accounted for 87.4%;and less than 10.0% of retail pharmacies provided door-to-door pharmaceutical services. Safe,effective and rational drug use should be achieved by intensifying the management and training for retail pharmacy practitioners,standardizing the contents of pharmaceutical services,establishing standard pharmaceutical service process,defining basic hardwares and softwares for pharmaceutical services, strengthening performance appraisal and evaluation for pharmaceutical services and urging the pharmacy to serve society.
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The reoperation for biliary diseases is usually unplanned, and the major reasons leading to this situation include:(1) The initial operation was performed under emergency situation and radical procedure could not be carried out.(2) The surgical procedure was inadequate.( 3 ) The operator was unqualified for the operation. In order to avoid repeated operations,the following principles must be obeyed strictly.Firstly,once the initial operation was failed,the patients must be transferred to large medical center and the reoperation must be performed by hepatobiliary specialists.Secondly,the operator must realize that most of the patients were in poor condition because of the previous operation,and they needed careful evaluation of organ function and adequate supportive treatment before reoperation.Thirdly,various measures must be taken to avoid unplanned operation and ensure the successful implement of radical operation at a time:( 1 ) Operator must learn all the details of previous operation,which include operation procedure,findings during operation and postoperative complications.( 2 ) Cholangiogram of the whole biliary tree is important for surgical planning,ultrasonography,computed tomography (CT),endoscopic retrograde cholangiopancreatography,magnetic resonance cholangiopancreatography, percutaneous transhepatic cholangiography (PTC),or PTC-CT should be performed solely or comprehensively to determine the nature and location of lesions.For bile duct injury,additional examination including CT angiography,magnetic resonance angiography or digital subtraction angiography is necessary to ascertain the accompanied vessel injury.(3) Making individual surgical procedure according to patien's condition and distribution of lesions.
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In this paper,the author analyzed the status quo of use and management of medical devices in low-class clinics and put forward some countermeasures.
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Under market economy, It is of important significance to realize correctly the double natures of health service which affect medical morals in positive and negative, and to find out the relationship between the natures. The countermeasures to construct medical moral engineering are as followings:to Lay-out integrally, develop in every sides and carry out in several steps,to grasp the guide of value and strengthen the principles of medical morals,and to arise the degree of taking part in and have the aid of propagating medium and social opinion.
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That the feudal and superstitious activities resurges in some rural areas affect not only the spiritual and material civilization,but also the people's psychological and physical health.Besides several factors like history,custom and public opinion,the causes of the phenomena include the unreasonable price of medicine,the lack of the professional ethics morals of doctors.Therefore,we should educate the people in rural area,enhance the study of innovation of the medical system,prompt the professional ethics of medical personnel,reduce the effect of feudal and superstitious activities,and guarantee the peasants' health.
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The harm of SARS(severe acute respiratory syndrome) in 2003 is remarkable.Through analyzing the influencing factors of the infectious diseases in late 30 years,we find that the biological factors and social circumstance closely related the infectious diseases.The author suggests that we should build a general hygiene concept which aimed to improve social environment,and make effective public hygiene system the measure to prevent and control the infectious diseases.