Experiencia inicial en hepatectomías videolaparoscópicas / Initial experience in laparoscopic liver resections

RESUMEN Antecedentes: La cirugía hepática videolaparoscópica ha experimentado un importante desarrollo; sin embargo, la mayoría de las hepatectomías continúan haciéndose por vía convencional. Objetivo: presentar la experiencia y aplicabilidad de hepatectomías videolaparoscópicas. Material y métodos: análisis retrospectivo de pacientes sometidos a una hepatectomía entre agosto de 2010 y diciembre de 2019. Analizamos variables preoperatorias, intraoperatorias y posoperatorias. Para evaluar la aplicabilidad, se dividió la muestra en: Etapa 1: agosto de 2010 a diciembre de 2013; Etapa 2: enero de 2014 a diciembre de 2016, Etapa 3: enero de 2017 a diciembre de 2019. Resultados: de 385 hepatectomías realizadas, 119 fueron videolaparoscópicas: 53 (44%) fueron to talmente laparoscópicas, 64 (54%) mano-asistidas y 2 híbridas. La aplicabilidad global fue 31%. En la etapa 1: 23% , en la 2: 30% y en la 3: 44% (p < 0,05). Fueron patología maligna en la etapa 1: 36%, en la 2: 67% y en la 3: 72% (p < 0,05). Hepatectomías mayores: 13%, 31% y 32% en etapas 1, 2, y 3, respectivamente (p < 0,05). El índice de conversión fue 12%, 0% y 11%, respectivamente (p NS). Se utilizó clampeo pedicular en: 6%, 5% y 45%; (p < 0,05). Las complicaciones en la etapa 1 fueron 30%, en la 2: 28% y en la 3: 17%, siendo complicaciones Dindo-Clavien III o más, el 6%, 13% y 5%, respectivamente, p NS. Conclusiones: Aa pesar de su complejidad, las hepatectomías videolaparoscópicas son técnicamente reproducibles. Adquiriendo experiencia, podemos aumentar la aplicabilidad, a favor de la patología oncológica y complejidad, sin comprometer la seguridad del paciente.

ABSTRACT Background: Despite laparoscopic liver resection has significantly evolved, most hepatectomies are performed by the conventional approach. Objective: The aim of this study is to present the initial experience and applicability of laparoscopic liver resections. Material and methods: We conducted a retrospective analysis of patients undergoing liver resection between August 2010 and December 2019. Perioperative, intraoperative and postoperative variables were analyzed. To evaluate applicability, the sample was divided into 3 stages: stage 1, from August 2010 to December 2013; stage 2, from January 2014 to December 2016; and stage 3, from January 2017 to December 2019. Results: Of 385 liver resections performed, 119 were laparoscopic procedures: 53 (44%) were pure laparoscopic procedures, 64 (54%) were hand-assisted (64 patients) and 2 corresponded to hybrid procedures. Global applicability was 31%. In stage 1 1: 23%, in 2: 30% and in 3: 44% (p < 0.05). Malignant lesions: stage 1: 36%, stage 2: 67% and stage 3: 72% (p < 0.05). Major liver resections: 13%, 31% and 32% in stages 1, 2, and 3, respectively (p < 0.05). Conversion rate was 12%, 0% and 11%, respectively (p NS). Hepatic pedicle clamping was used in 6%, 5% and 45%; (p < 0.05). Complications in stage 1 were 30%, in stage 2: 28% and in stage 3: 17%, and Clavien-Dindo complications grade 3 or greater were 6%, 13% and 5%, respectively, p NS. Conclusions: Laparoscopic liver resections are complex procedures but technically reproducible. Applicability increases with the acquisition of experience, not only in malignant lesions but also in complex lesions ensuring safety for the patient.

Characteristics and development assumptions of personalized traditional Chinese medicine granules / 中国中药杂志

Personalized traditional Chinese medicine(TCM) granules are positioned as a solid dosage form of TCM decoctions, boasting strong applicability and wide application range. The market prospect of personalized TCM granules is promising in that their preparation by mixed decoction makes up for the shortcoming of formula granules like the Chinese patent medicine granules and classical TCM prescription granules whose components cannot be changed flexibly. However, such factors as insufficient basic research, equipment mismatch, and low process commonality have limited their clinical application. After analyzing the characteristics of perso-nalized TCM granules, their production status, and the bottlenecks restricting their development, this paper pointed out the meaning and key points of developing a generalized preparation process for personalized TCM granules and affirmed the vital roles of the preparation and process prediction system and the on-line detection technology in improving the productivity of granulation. Finally, some assumptions on technology development for solving the specific problems of personalized TCM granules were shared to provide some ideas for the application and development of personalized TCM granules in clinical practice.

Applicability of respiratory severity score and modified TAL criteria in pediatric age group for grading and management of acute respiratory illness

Background: Acute respiratory tract infections (ARI) are the leading cause of death in children in the world (11.9 million per year) with the greatest number of deaths occurring in developing countries like India. We compared respiratory severity scoring system RSS (Respiratory Severity Score) with Modified TAL, so that we can find out which of the above scores are better and whether they can be implemented to assess pediatric ARI patients.Methods: This prospective observational study was conducted in Pediatrics wards, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra and data were collected from 290 children below 12 years of age by purposive sampling. All the children presenting with respiratory symptoms were subjected to these scoring system (RSS AND MODIFIED TAL) at the time of admission and were classified based on the scores obtained in respective scoring system. Data was analysed using frequencies, percentages and contingency tables and comparison was made between the above scoring systems to find which one is better applicable in pediatric ARI patient.Results: Incidence of pediatric patients presenting with only respiratory tract infections who are admitted in ward was 25.15 %, with more incidence being reported in children below 12 months (49.31%), males more affected. For both the ARI scoring systems (RSS and MOD TAL) as the severity increased so is the number of patients requiring oxygen and duration of hospitalization increased significantly (p<0.05), with RSS having stronger association.Conclusions: Both the scoring systems predicted that on admission if the score is more than chances of requirement of oxygen is more and also duration of hospitalization is more, with RSS being better predictor.

Dental age estimation of Jordanian children: applicability of Demirjian method / Estimativa de idade dentária em crianças jordanas: aplicabilidade do método Demirjian

ABSTRACT Objectives: To evaluate the accuracy of Demirjian method in estimating the chronological age of male and female Jordanian children and to establish a new dental age curve if the Demirjian method was not found to be accurate. Methods: Orthopantomograms (OPTs) of 1374 Caucasian Jordanian children (684 females and 690 males) aged 4 to16 years were selected and the dental age was determined by Demirjian method. The chronological ages of the children were obtained by subtracting their birthdates from the date of taking the radiograph. The OPTs were obtained from Archives of Dental Teaching Clinics /XXX and other private orthodontic practices in Irbid and Amman. Results: Demirjian method overestimated chronological age in female and male subjects aged 4 to 8 years. Afterwards, the method underestimated chronological age in females aged 9-11 years and 14-16 years. In male subjects, chronological age was underestimated in subjects aged 9-12 years and 15-16 years. New the dental age curves for Jordanian females and males were constructed. The constants for the quadratic model for the new curves were (b0=-25.341, b1=17.557, b2=-0.623) for females and (b0=-29.809, b1=17.396, b2=-0.595) for males. Conclusion: Demirjian method overestimated the chronological age of Jordanians below the age of 8 years and underestimated the age of Jordanians above 8 years. A new DA standard for Jordanian children was developed and tested for accuracy.

RESUMO Objetivo: Avaliar a precisão do método Demirjian na estimativa da idade cronológica de crianças jordanianas do sexo masculino e feminino e estabelecer uma nova curva de idade dentária, se o método Demirjian não for acurado. Métodos: Foram selecionados radiografias panorâmicas (OPTs) de 1374 crianças jordanianas caucasianas (684 do sexo feminino e 690 do sexo masculino) com idades entre 4 e 16 anos, e a idade dentária foi determinada pelo método de Demirjian. As idades cronológicas das crianças foram obtidas subtraindo as datas de nascimento a partir da data da realização da radiografia. Os OPTs foram obtidos em Archives of Dental Teaching Clinics / XXX e outras clínicas ortodônticas particulares em Irbid e Amã. Resultados: O método Demirjian superestimou a idade cronológica em indivíduos do sexo feminino e masculino com idades entre 4 e 8 anos. Posteriormente, o método subestimou a idade cronológica em mulheres de 9 a 11 anos e 14 a 16 anos. Nos homens, a idade cronológica foi subestimada nos indivíduos de 9 a 12 anos e 15 a 16 anos. Novas curvas de idade dentária para mulheres e homens jordanianos foram construídas. As constantes para o modelo quadrático para as novas curvas foram (b0 = -25.341, b1 = 17.557, b2 = -0.623) para mulheres e (b0 = -29.809, b1 = 17.396, b2 = -0.595) para homens. Conclusão O método Demirjian superestimou a idade cronológica dos jordanianos abaixo de 8 anos e subestimou a idade dos jordanianos acima de 8 anos. Um novo padrão DA para crianças jordanianas foi desenvolvido e testado quanto à precisão.

Research on the Applicability of Drug Quality Standards in National Drug Sampling and Testing / 中国药学杂志

OBJECTIVE: To provide a reference to the use of quality standards in national drug sampling and testing, and establish the implementation plan. METHODS: By carding the approval process and usage flow of drug standards, analyzing approval form, authorized department, revise and numbering methods of the standard, composition and influencing factors of standard serviceability were studied. RESULTS AND CONCLUSION: The correctness and accuracy of the quality standards have a tremendous impact on national drug sampling and testing which is a significant measure of post-marketing surveillance. The article focuses on three aspects including the correctness, accuracy and orderliness, and then some solutions are proposed such as establishing the implementation plan and multi sector coordination, which can solve the problem of using standards in national drug sampling and testing.

Applicability of CT examination decision rules in head injured children / 中华急诊医学杂志

Objective To explore the applicability of the three commonly used CT examination decision rules in Chinese head injured children. Methods This prospective observational study included 1538 children and adolescents (aged < 18 years), who were treated at the Emergency Department of First Hospital of Shanxi Medical University after head injuries. The three clinical decision rules include the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE; UK); the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury, that was developed by the Pediatric Emergency Care Applied Research Network (PECARN; USA), and the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule. Diagnostic accuracy had been evaluated by using the rule-specific predictor variables to predict each rule-specific outcome measure in populations who met inclusion and exclusion criteria for each rule. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and ROC curve were referred to the diagnostic accuracy. Indicators were characterized by 95％ CI. Results Of the 1538 patients, CTs were obtained for 339 patients (22.04％). Forty-nine patients (3.19％) had positive CT results, 8 patients (0.52％) underwent neurosurgery, 2 patients (0.13％) died, and 1 patient (0.07％) may be missed. In this study, CHALICE was applied for 1394 children (90.70％; 95％ CI: 89.24％-92.15％), PECARN for 801 children (52.11％; 95％ CI: 49.62％-54.61％), and CATCH for 325 patients (21.15％; 95％CI: 19.10％-23.19％). The validation sensitivities of CHALICE, PECARN, and CATCH rules were 92.6％(74.2％-98.7％), 100％ (56.1％-100％), and 85.7％ (42.0％-99.2％), respectively; the specificities were 78.1％(75.7％-80.2％), 48.0％ (44.5％-51.5％) and 70.8％ (65.4％-75.6％); positive predictive value were 7.7％ (5.1％-11.3％), 0.9％ (0.4％-1.9％) and 6.1％ (2.5％-13.2％); and negative predictive value were 99.8％ (99.2％-100％), 99.1％ (98.1％-99.6％), and 99.6％ (97.2％-100％), respectively. Conclusions The clinical decision rules of CHALICE, PECARN and CATCH have high sensitivities. The specificity of PECARN rule is lower than those of CHALICE and CATCH rules. The above three clinical decision rules can be used for the decision of CT examination in Chinese children with head injury in practice.

Areview of the applicability of the health education model of the teach-back method / 中国实用护理杂志

Teach-back method is a new research topic of health education in recent years, which has been widely applied in the field of health education in foreign countries, and has achieved good effect. Relevant reports of the method use were also reported in China.These reports show that this method can significantly improve the compliance of patients, and improve the rehabilitation effect. This paper will detail from the definition, implementing methods, advantages and application status at home and abroad of Teach-back method.The aim is to enhance the familiarity of the method in Health education professionals and let it will be better to use to work in public service.

Clinical application evaluation and revision suggestions of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for pelvic inflammatory disease / 中国中药杂志

To evaluate the clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for pelvic inflammatory disease and provide reference for the revision of the Guideline. Questionnaire research was conducted from applicability and application evaluation. A total of 1 311 copies of valid questionnaires were obtained, including 717 questionnaires on applicability evaluation and 594 questionnaires on application evaluation. There were 83 items from 4 aspects in the applicability questionnaire. In statistical agreement rates of those items to reflect the application status of the Guideline, the rates of 8 items were all more than 95% except for rates of "content integrity", "comparison with the diagnosis and treatment scheme of his/her unit (individual)" and "economy of clinical application", 94.70%, 93.86% and 93.17% respectively. In statistical agreement rates of those items to reflect the quality of the Guideline, the rates of 3 items were all more than 97%, except the rate of "whether syndrome classification is reasonable" item was 95.26%. Among the items that reflect the local purchase difficulty and price evaluation of Chinese patent medicine recommended in the Guideline, most clinicians thought the prices were modest. There were 56 items from 6 aspects in the application evaluation questionnaire. In statistical agreement rates of those items to reflect the application rationality of the Guideline, the rates of 3 items were all more than 96%, except rate of "whether syndrome classification is reasonable" item was 91.58%. In statistical agreement rates of those items to reflect the clinical application effect of the recommended regimen in the Guideline, the traditional application of traditional Chinese medicine decoction had generally better application effect, whereas Chinese patent medicines were less effective. In statistical agreement rates of those items to reflect the overall evaluation of clinical application, the rates of "overall effect" and "overall safety" were all more than 96%, except the rates of "overall economy" item was 92.42%. It indicates that the overall effect of this Guideline is relatively well. It is suggested to improve the classification of syndrome differentiation and increase the species of Chinese medicine decoction and Chinese patent medicines, and to standardize the duration and course of medication. The next revised work should not only uptake the experiences of prominent TCM doctors and all kinds of research achievements, but also regularly update and strengthen the publicity of the Guideline.

Clinical application evaluation of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection / 中国中药杂志

A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection(hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process, and the data was real and reliable. The survey's results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section, clinicians proposed increasing medication guidance, updating the Guideline timely, as well as increasing treating methods and techniques, strengthen propaganda and promotion, and improve the use of evidence-based methods. In the evaluation of effectiveness, the majority of clinicians agreed that the definition in both traditional Chinese medicine (TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn't have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover, specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic TCM therapy treating uncomplicated lower urinary tract infection remained to be developed.

Clinical application evaluation and revision suggestions of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for community acquired pneumonia / 中国中药杂志

To clarify the clinical application of the group standard (T/CACM 1035-2017) of the Chinese Society of Traditional Chinese Medicine (TCM), the clinical practice guideline on traditional chinese medicine therapy alone or combined with community acquired pneumonia, and to understand the clinical applicability of the Guideline. The clinical workers trained in terms of the Guideline in hospitals at all levels in China were selected as the research objects. A total of 494 questionnaires on application evaluation and 511 questionnaires on applicability evaluation were collected to construct the database of the post-effect evaluation of the Guideline. Excel software was used for statistical analysis. The overall evaluation of the Guideline was 92.31%, 91.06%, 87.45% respectively in efficacy, safety and economy. The Guideline was well used in clinical application, and 99.41% of the patients were willing to follow the recommended scheme. The agreed ratio in rationality evaluation was 97.98%, 92.37%, 94.53% and 92.71% in treatment rules, syndrome differentiation and classification, prevention of complications, and rehabilitation method. The effective rate of the prescriptions recommended in the Guideline was all above 65%. More than 80% of the prescriptions were Tanreqing Injection, Yinqiao Powder, Qingjin Huatan Decoction, Maxing Shigan Decoction, Shengmai San and Shashen Maidong Decoction. Adverse reactions, unknown active components and economy of Chinese patent medicines were the important factors affecting drug use and efficacy, providing a clinical basis for updating and revising the standard.

Development and validation of a high throughput LC–MS/MS method for simultaneous quantitation of pioglitazone and telmisartan in rat plasma and its application to a pharmacokinetic study / 药物分析学报

Management of cardiovascular risk factors in diabetes demands special attention due to their co-existence. Pioglitazone (PIO) and telmisartan (TLM) combination can be beneficial in effective control of cardiovascular complication in diabetes.In this research,we developed and validated a high throughput LC–MS/MS method for simultaneous quantitation of PIO and TLM in rat plasma. This developed method is more sensitive and can quantitate the analytes in relatively shorter period of time compared to the previously reported methods for their individual quantification. Moreover, till date, there is no bioanalytical method available to simultaneously quantitate PIO and TLM in a single run. The method was validated according to the USFDA guidelines for bioanalytical method validation.A linear response of the analytes was observed over the range of 0.005–10μg/mL with satisfactory precision and accuracy. Accuracy at four quality control levels was within 94.27%–106.10%. The intra-and inter-day precision ranged from 2.32% to 10.14% and 5.02% to 8.12%,respectively.The method was reproducible and sensitive enough to quantitate PIO and TLM in rat plasma samples of a preclinical pharmacokinetic study.Due to the potential of PIO-TLM combination to be therapeutically explored,this method is expected to have significant usefulness in future.

Clinical Applicability Assessment on Traditional Chinese Medicine Clinical Practice Guideline of Perirectal Abscess (ZYYXH/T322-341-2012) / 中国中医药信息杂志

Objective To evaluate the clinical applicability of Traditional Chinese Medicine (TCM) Clinical Practice Guidelines of Perirectal Abscess (ZYYXH/T322-341-2012); To provide the evidences for the revision. Methods Questionnaire survey was performed in this study. 50 surgeons in department of anorectal surgery from different hospitals were asked to fill in a questionnaire designed by State Administration of TCM, and the investigated data were statistically analyzed in respect to the general information, quality, and application status. Results 76% of investigated surgeons were familiar with the guideline, but only 48% of them have used this guideline. In statistical agreement rates of those items to reflect the quality of the guideline, except for rates of "syndrome classification is reasonable" item was 76%, and "recuperating reserve is reasonable" item was 0%, which were referred as not qualified, the rates of the other items were all more than 90%. In statistical application rates of items to reflect the application of the guide, except for the rate of "comparing with expert experiences", the rates of the other items were all more than 90%. Conclusion The general applicability of TCM Clinical Practice Guidelines of Perirectal Abscess is relatively well. The next revised work should uptake not only the experiences of prominent TCM doctors, but also the therapeutic programs of distinctive hospitals and all kinds of research achievements.

Comparison of Applicability Test of Sterile Examination Method for Artemether Injection / 中国药师

Objective:To develop a more suitable sterile examination method for artemether injection in order to control its quality better. Methods:The direct inoculation and the membrane filtration was respectively used for the sterile examination of artemether in-jection. Results:In the direct inoculation method, Staphylococcus aureus, Bacillus subtilis and Clostridium perfringens grew well in the test tubes containing artemether injection in 24 h, and Escherichia coli, Aspergillus niger and Candida albicans grew well in 48 h. In the membrane filtration method, Staphylococcus aureus grew well in 24 h in the test group containing artemether injection, and the other 5 strains grew well in 48 h. Conclusion:The positive strains can grow well in the applicability test of both methods. However, due to the simpler operation and higher accuracy of membrane filtration method, it is recommended to be used for the sterile test of artemether injection.

Clinical Applicability Assessment on Traditional Chinese Medicine Clinical Practice Guideline of Perirectal Abscess (ZYYXH/T322-341-2012) / 中国中医药信息杂志

Objective To evaluate the clinical applicability of Traditional Chinese Medicine (TCM) Clinical Practice Guidelines of Perirectal Abscess (ZYYXH/T322-341-2012); To provide the evidences for the revision. Methods Questionnaire survey was performed in this study. 50 surgeons in department of anorectal surgery from different hospitals were asked to fill in a questionnaire designed by State Administration of TCM, and the investigated data were statistically analyzed in respect to the general information, quality, and application status. Results 76% of investigated surgeons were familiar with the guideline, but only 48% of them have used this guideline. In statistical agreement rates of those items to reflect the quality of the guideline, except for rates of "syndrome classification is reasonable" item was 76%, and "recuperating reserve is reasonable" item was 0%, which were referred as not qualified, the rates of the other items were all more than 90%. In statistical application rates of items to reflect the application of the guide, except for the rate of "comparing with expert experiences", the rates of the other items were all more than 90%. Conclusion The general applicability of TCM Clinical Practice Guidelines of Perirectal Abscess is relatively well. The next revised work should uptake not only the experiences of prominent TCM doctors, but also the therapeutic programs of distinctive hospitals and all kinds of research achievements.

Screening of the makers of chromosome 12 and evaluate the applicability of Beijing local standard DB11/T828.3-2011 / 中国比较医学杂志

Objective To screen the markers of chromosome 12, which is vacant in the Beijing local standard DB11/T828.3-2011 for genetic quality control of miniature pigs in Beijing, and to study the applicability of the local standard by comparison of two different methods for evaluation of the genetic quality of the same population.Methods According to the literature, we selected four pairs of microsatellite markers of chromosome 12 and studied the polymorphism through monitoring the genetic quality of two populations of China Agricultural University miniature pigs.We screened the highly polymorphic markers of chromosome 12, combined them with the microsatellite primers of the standard 18 pairs of chromosomes to establish the whole chromosome method.We compared and analyzed the applicability of the local standard DB11/T828.3-2011 through monitoring the genetic quality of the same population of miniature pigs with different method.The data were processed and analyzed using software Popgen32.Results All the screened four pairs of microsatellite markers of chromosome 12 were highly polymorphic (PIC>0.5).The local standard showed a chromosome coverage of 94.7%, stability of amplification of 96.0%, and certified that the China Agricultural University miniature pig III was qualified, while the China Agricultural University miniature pig I was not qualified.When the markers of chromosome 12 were added, the whole chromosome method showed result of 100% chromosome coverage and 96.6% amplification stability, both of the two populations of pigs were certified as qualified.Conclusions The four screened markers of chromosome 12 are all highly polymorphic, and provide a support for supplement of the local standard DB11/T828.3-2011.

The Feasibility of the Connection between the Drug Patents Examination and the New Drug Registration / 中国药学杂志

OBJECTIVE: To improve the feasibility of the connection between the drug patents examination and the new drug registration and design the connecting pattern between them, which will enhance the appearance on the market for the patent drugs, eventually increase the drug choice for the public. METHODS: To find the connecting space between drug patents examination and the evaluation standards for drug registration by comparing the "novelty", "inventiveness", "practical applicability" standards for a patent with the "safety", "efficacy" and "quality" standards for drug registration. RESULTS AND CONCLUSION: A large connecting space between the practical applicability standard for a patent and the evaluation standards for drug registration is found in this paper. The practical applicability standard for a patent can be adjusted dynamically according to the evaluation standards for drug registration based on the development level of the pharmaceutical industry, interests of patent holders and the public, etc.

Validity and Applicability of Clinical Ladder System Model for Nurses / 임상간호연구

PURPOSE: The purpose of this study was to verify the validity and applicability of the Clinical Ladder System(CLS) Model for nurses and to suggest a model for nurses in general hospitals as well as tertiary hospitals. METHODS: After refining questionnaires through focus group participation, a survey was carried out with 50 nurse managers and 500 staff nurses from 6 tertiary hospitals and 4 general hospitals. S-CVI and i-CVI for validity and applicability were calculated. Differences in validity and applicability by the type of hospitals and characteristics of respondents were analyzed using t-test and ANOVA. RESULTS: S-CVI for validity and applicability of the CLS model were over 0.8 in two types of hospitals and the validity and applicability of the CLS model were confirmed. No differences were found in the total score for validity between the 2 types of hospitals, but in applicability, general hospitals had significantly lower applicability than tertiary hospitals. Some items showed difference according to characteristics of the respondents. CLS models were postulated based on the study results. CONCLUSION: The CLS model refined through this study can be used for nurses. In application, modifications are needed according to the conditions of each hospital.

Neutralization of Lecithin and Polysorbate-80 in Antibacterial Activity of Traditional Chinese Medicine Preparations / 中国药师

Objective:To investigate the neutralization of lecithin and polysorbate-80 in antibacterial activity of oral solid tradition-al Chinese medicine preparations without Chinese medicinal herb powder. Methods:According to the requirements in Chinese Pharma-copeia (2015 edition), the applicability of microbial counting method was tested in the diluent containing lecithin and polysorbate-80 and the conventional diluent, respectively, and the results were compared. Results: The recovery results of applicability of microbial counting method using neutralizers (lecithin and polysorbate-80) conformed to the standard of Chinese pharmacopoeia (2015 edition). Conclusion:The combination of lecithin and polysorbate-80 has notable neutralization in antibacterial activity of oral solid traditional Chinese medicine preparations without Chinese medicinal herb powder.

Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine / 中国中药杂志

This study is to assess the Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine in clinical application and provide evidence for further guideline revision. The assessment was divided into applicability assessment and practicability assessment. The applicability assessment based on questionnaire survey and the traditional Chinese medicine (TCM) practitioners were asked to independently fill the Questionnaire for Applicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The practicability assessment was based on prospective case investigation and analysis method and the TCM practitioners-in-charge filled the Case Investigation Questionnaire for Practicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The data were analyzed in descriptive statistics. 151 questionnaires were investigated for applicability assessment and 1 016 patients were included for practicability assessment. The results showed that 88.74% of them were familiar with the guidelines and 45.70% used them. The guidelines quality and related items were similar in applicability assessment and practicability assessment, and scored highly as more than 85.00% except the "recuperating and prevention". The results suggested that the quality of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine was high and could better guide the clinical practice. The "recuperating and prevention" part should be improved and the evidence data should be included in future guideline revision, so that the clinical utilization rate could be increased.

Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine / 中国中药杂志

To evaluate the clinical applicability and application of Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine, 11 diseases from Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine were evaluated by methods of questionnaire and prospective case study at 16 construction units for traditional Chinese medicine standards research and extension. Results showed that 361 clinical doctors accepted the applicability survey of guidelines, and 87.26% of them were more familiar to the guideline and 25.21% of them used the guideline. In syndrome differentiation and treatment related contents, rationality of prescription medication and syndrome classification was higher, accounted for 91.69% and 86.98% respectively, but the rationality of recuperation prevention was lower, accounted for 44.6%. 75.62% clinical doctors believed that the Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine was applicable. The application of the guidelines is evaluated by prospective observation of 2 935 cases. The higher compliance between the guideline and clinical practice was present in TCM (traditional Chinese medicine) disease diagnosis and WM (western medicine) disease diagnosis, accounted for 98.30% and 94.11% respectively. The lower compliance was present in recuperation prevention, accounted for 59.39%. The safety and economy of the guideline was higher, accounting for 95.64%, 94.75%, respectively. The comprehensive evaluation results showed that the rate of the overall treatment effect with technical level, satisfaction degree or applicability in clinical practice which were 7-9 points is 77.38%, 74.00%, 76.90% respectively. This guideline has a high clinical compliance and can be used as a standard for common diseases of gynecology, but there are also some conditions with poor applicability, which does not conform to the actual situation, and needs to be further revised.