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A patient with SARS-CoV-2 infection was adimitted to Shanghai Shibei hospital of Jing'an District in early 2023. According to the patient's complaits， clinical manifestations， physical symptoms， laboratory examination， radiological image results， plus lumbar puncture， the patient was diagnosed with novel coronavirus encephalitis. The patient was discharged from the hospital after a combined treatment of Chinese and western medicine.
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OBJECTIVE To accurately identify the rare adverse drug reactions （ADR） of vancomycin-pancytopenia in order to promote its safe use. METHODS Through a case report of a child with suppurative hip arthritis who developed pancytopenia combined with delayed drug fever caused by intravenous infusion of vancomycin，Naranjo score method and related literature were used to summarize the association between the ADR and vancomycin and its possible mechanism， and suggestions for rational use of vancomycin in pediatric patients were put forward. RESULTS & CONCLUSIONS The association of pancytopenia combined with delayed drug fever and vancomycin in this child is “very likely”. In clinical practice， it is difficult to distinguish between pancytopenia combined with delayed drug fever from fever and hematopenia caused by aggravation of infection. Medical staff should increase their awareness of vancomycin rare ADR such as pancytopenia， and pharmacists should assist medical staff in timely screening for ADR. The initial dose of vancomycin infusion for children should start from 60 mg/（kg·d），and the blood concentration should be monitored 48 h after the first infusion and the dose should be adjusted in time to maintain the valley concentration of vancomycin at 5-15 mg/L to prevent the occurrence of ADR caused by excessive blood concentration. For children who have been using vancomycin for more than one week，the blood routine should be rechecked regularly. Once pancytopenia occurs，the drug should be stopped immediately，and symptomatic treatment should be given according to the situation.
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Internal auditing for infrastructure projects carried at multi-campuses of a hospital to support hospital strategic growth, is a crucial means in raising the business performance and capacity. A public hospital made a research-based audit to examine infrastructure projects across multi-campuses since 2021. At the pre-trial stage, the audit plan was created in a " two-coordination" manner to define the scope of authority and responsibility of audit objectives; at the in-trial stage, audit priorities were focused on in advance through intelligent early warning, and full-course audit guidance and quality control was made through online real-time audit operation system; at the post-trial stage, efforts were focused on resolving problems, summarizing audit findings. The authors introduced the practice of the hospital and further explained the specific application methods and achievements through case analysis, providing reference for internal audit of infrastructure projects in multi-campus hospitals, for reference in likewise internal auditing.
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OBJECTIVES@#To retrospectively analyze homicide cases of death after injection and provide reference for forensic identification.@*METHODS@#Six homicide cases of death after injection which were investigated by the Criminal Investigation Team of Shanghai Public Security Bureau were collected and analyzed, including case situation, scene investigation, autopsy and other materials.@*RESULTS@#The 6 cases were premeditated crimes, 5 cases took place in private spaces, and 5 cases involved the victims approached by suspects' decoy. There were no obvious abnormalities at the scene of the 6 cases. In 6 cases, the victim's body surface injury was mild or no, lividity color was abnormal, and the needlestick injury showed different manifestations from conventional medical measures.@*CONCLUSIONS@#Death after injection is a highly concealed crime and easy to be ignored. For the suspected injection injury found in autopsy, it is necessary to carefully examine, identify and analyze, be alert to the situation of injecting poison (drug) and do a good job in evidence fixation and material extraction.
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Autopsy , China/epidemiology , Homicide , Poisons , Retrospective StudiesABSTRACT
Objective:To explore the application effect of symptom-guided mind mapping combined with case analysis in the emergency nursing teaching of practice nursing students in the department of cardiology.Methods:A total of 60 nurses who had internship in the Department of Cardiology in The First Affiliated Hospital of Xinjiang Medical University from August 2019 to April 2020 were included in the study, and they were averagely divided into control group and study group based on the admission sequence. The control group used traditional teaching, and the study group used symptom-guided mind mapping combined with case analysis. After 3 months of internship, the teaching effect of the two groups of intern nurses was evaluated through the cardiology emergency nursing assessment. A questionnaire survey was used to compare the evaluation of the two groups of intern nurses on their own professional ability. SPSS 22.0 was used for t test and chi-square test. Results:The practice nurses in the study group had higher scores of cardiology emergency nursing skills, comprehensive emergency response capabilities, disease assessment and observation capabilities, and total scores than those of the control group, with statistically significant differences ( P<0.05). The recognition rate of self-professional ability such as ability to combine theory with practice (96.67% vs. 70.00%), ability to discover and deal with problems (86.67% vs. 56.67%), comprehensive emergency response ability (83.33% vs. 46.67%), teamwork ability (93.33% vs. 73.33%) and condition assessment and observation ability (90.00% vs. 53.33%) of the study group was significantly higher than that of the control group ( P<0.05). Conclusion:The symptom-guided mind mapping combined with case analysis has a significant effect on the emergency nursing teaching of cardiology practice nursing students, and can effectively improve the teaching effect and self-professional recognition rate of the practice nurses.
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Objective:To explore the application of mixed BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, summary) combined with case analysis teaching in nursing practice teaching in the department of endocrinology.Methods:Forty-five nurses of Batch 2017 who practiced in the Department of Endocrinology were selected as the control group, using traditional teaching; 45 practical nursing students of Batch 2018 were selected as the research group, using mixed BOPPPS combined with case analysis teaching. After the teaching, the teaching effect was evaluated by the theoretical and practical skill operation assessments, and the satisfaction with the teaching was investigated through the questionnaire. SPSS 22.0 was used for t test and chi-square test. Results:The scores of basic theory [(28.31±2.07) vs. (24.66±2.15)] and professional theory [(67.01±3.05) vs. (55.62±3.20)] in the theoretical assessment of practical nurses in the research group were higher than those in the control group, with significant differences ( P<0.05); the scores of each sub-item of the practical skills operation assessment were better than those in the control group, with significant differences ( P<0.05); in terms of teaching satisfaction, the research group was better than the control group in such 10 aspects as whether to improve the level of theoretical and practical skills operation, whether to improve the awareness of humanistic care and whether to improve the nurse-patient communication ability, etc., with significant differences ( P<0.05). Conclusion:The BOPPPS combined with case analysis teaching significantly improves the theoretical and practical skills and comprehensive literacy of the endocrinology practical nursing students, and the teaching satisfaction is significantly better than that of the traditional teaching, which is of promotion value.
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Objective:To explore the value of case analysis combined with role revelation in cultivating thinking ability of surgical nursing training.Methods:A total of 87 newly recruited nurses who needed to rotate in the surgical system of Fenyang Hospital, Shanxi Medical University from January 2019 to October 2020 were selected as the study subjects. They were divided into control group ( n=43) and study group ( n=44). The control group used traditional teaching, and the study group used case analysis combined with role revelation. The clinical thinking ability of nurses was evaluated by written examination of clinical thinking ability and clinical thinking ability score table. SPSS 22.0 was used for t-test. Results:The scores of written examination of clinical thinking ability (history collection, preliminary clinical diagnosis, preliminary nursing measures, auxiliary examination interpretation, comprehensive analysis of diagnosis and treatment process, nursing and discharge diagnosis, and health education) of nurses in the study group were significantly higher than those in the control group ( P<0.05). The scores of clinical thinking ability (critical thinking ability, system thinking ability and evidence-based thinking ability) of nurses in the study group were higher than those in the control group, and the difference was statistically significant ( P<0.05). Conclusion:Case analysis combined with role revelation in the surgical nursing training of new nurses is helpful to improve the trainees' clinical thinking ability.
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OBJECTIVE：To prov ide a reference for the diagnosis and treatment of invasive fungal infection in children. METHODS：Four male children with invasive fungal infection in critical condition ，aged from 3 months to 17 years，were treated in our hospital. The types of diseases included pneumonia ，endocarditis，meningitis and pulmonary infection. The pathogens involved Trichosporon asahii ，Candida portugal ，Malassezia globosa ，Pichia guilliermondii ，Alternaria alternate and Candida krusei. Clinical pharmacists comprehensively followed up the treatment and reviewed the literature to assist doctors in formulating treatment plans. They provided Fluconazole sodium chloride injection （6 mg/kg，ivgtt，qd），Caspofungin acetate for injection （loading dose 32 mg，maintenance dose 25 mg，ivgtt，qd），Fluconazole capsules （400 mg，p.o.，qd）and Voriconazole for injection（200 mg，i.v.，q12 h）+Capofungin acetate for injection （loading dose 70 mg，maintenance dose 50 mg，i.v.，qd）and other symptomatic treatment ，and closely monitored the changes of relevant indicators and the occurrence of ADR during the treatment of children. RESULTS ：The doctor adopted the clinical pharmacist ’s suggestion ，three cases were relieved and one was not cured. No serious ADR was found. CONCLUSIONS ：Once similar infections are found in clinic ，timely targeted treatment should be given in combination with the types of pathogens and drug resistance characteristics ，so as to effectively control the disease. The real cases provided in this article can provide evidence for the treatment of children with fungal infection.
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Hepatocellular carcinoma has a high morbidity and mortality, which has seriously harmed human health. Several targeted therapies have been approved for the first- and second-line treatment of advanced hepatocellular carcinoma. The emergence of immunotherapy has brought the treatment of hepatocellular carcinoma into a new era. Targeted and immunotherapeutic agents have synergistic effects in mechanism, also the combination of these two therapies has been clinically beneficial to patients with advanced hepatocellular carcinoma. At the same time, in addition to the systemic therapy of targeted combined immunological, applying appropriate local therapy can provide a longer survival period or even a chance of cure for that some patients. The authors introduce the diagnosis and treatment of a case of advanced hepatocellular carcinoma who achieved pathological complete remission by first-line immunotherapy combined with anti-angiogenesis targeted therapy.
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OBJECTIVE：To summarize and analyze t he clinical characteristics of acarbose-induced skin ADR ，and to provide reference for its therapy. METHODS ：Clinical pharmacists participated in the treatment of a patient with acarbose-induced skin ADR. The patient developed erythema multiforme several days after oral administration of Acarbose tablets （100 mg/d）. After consultation by dermatology and clinical pharmacy ，considering that the adverse reaction was related to acarbose ，clinical pharmacists suggested to stop the drug. Based on the above cases ，clinical pharmacists searched Wanfang database ，CNKI， PubMed，Embase and other databases to collect case reports of skin ADR caused by acarbose ，summarize its general situation （gender，age，usage and dosage ，etc.），latency，ADR（diagnosis and manifestation ），intervention and outcome ，etc. RESULTS ： The doctor adopted the pharmacist s’advice，stopped the use of acarbose ，and gave symptomatic treatment as Methylprednisolone sodium succinate for injection 40 mg（intravenous injection ，qd）+Medloratadine tablets 8.8 mg（oral administration ，qd）+Calamine lotion（for external use ）. The patient improved and was discharged after 10 days. A total of 12 literatures involving 12 patients were retrieved. Among the 13 patients included in the analysis （including the above clinical case and 12 literature cases ），there were 8 males and 5 females，and 8 patients of them aged 50 and over；the dosage of acarb ose in most patients was within the requirements of the drug instructions. The primary diseases of 12 patients were diabetes mellitus. The latency of skin ADR in 11 patients was within 6 days of administration. Among the 13 patients，the ADR were diagnosed as rash in 4 cases，pustulosis in 3 cases， erythema multiforme in 2 cases， urticaria in 2 cases， maculopapular rash in 1 case and lip swelling in 1 case. The ADR of 1 patient improved after drug withdrawal ，and 12 patients also improved after drug withdrawal and symptomatic treatment such as glucocorticoid or antihistamine. Acarbose was re-used in 2 patients after the improvement of first skin ADR ，and skin ADR occurred again ，and the ADR were improved after drug withdrawal and symptomatic treatment. CONCLUSIONS ：Skin ADR are acarbose-induced rare ADR ，mostly within 6 days of medication ，and are more likely to occur in middle-aged and older men. When the patients suffer from ADR ，the drug should be stopped in time and given glucocorticoids or antihistamines for symptomatic treatment. Clinical pharmacists should do a good job in drug publicity and education ，remind patients to closely monitor relevant indicators and ensure drug safety.
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OBJECTIVE：To pro vide reference f or resolving structural imbalance of “supply and demand dislocation ”in each stage of new drug R&D funds in China. METHODS ：Through analyzing the fund demand in each stage of new drug R&D and the problem of “supply and demand dislocation ”in detail ，a financing scheme matching the fund demand of each stage was designed ， and analyzed with the financing process of “Wanke”. RESULTS & CONCLUSIONS ：In the basic stage of new drug R&D ，there was a large demand for funds ，but there were great technical risks ，transformation risks and investment risks ，little attention and support from investors ，resulting in the lack of R&D funds in this stage. It is suggested to increase the investment of R&D enterprises themselves. In the stage of new drug discovery ，the risks of R&D and investment were still high ，more funds were needed and funds were in short supply. It is suggested to attract more venture capital into this stage. From preclinical stage to clinical stage Ⅱ，there was a greater demand for funds. It is suggested that this stage should mainly rely on venture capital and pledge financing with patents. From the clinical stage Ⅲ to pre-marketing ，R&D had entered the mature stage with less investment risk. Therefore ，more venture capital could be obtained in this stage ，and there was a situation of excess capital. At this time ，in addition to venture capital ，R&D enterprises can also choose listing financing. In the post-marketing stage ，the sales right of a certain region in the product sales link could be transferred to provide new reserve funds for the next round of new drug R&D ，so as to achieve a virtuous circle of R&D activities. One of the reasons for the success of “Wanke”R&D financing lied in the combination of various financing methods in the financing process. It is suggested that China should improve the financial financing system and patent value evaluation system at the national level ，so as to promote the drug patent pledge financing in China as soon as possible. Finally ，new drug R&D institute must establish the concept of independent innovation ，speed up the output of technological innovation results ，so as to achieve the improvement of China ’s independent R&D capability.
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OBJECTIVE：To accumulate relevant experience of clinical pharmacists consultation ，and to promote clinical safe and rational drug use. METHODS ：From different approaches ，the clinical pharmacists analyzed and evaluated of drug use in 4 consultation cases ，i.e. a patient of pulmonary infection after liver transplantation was treated with antifungal therapy by voriconazole，which resulted in excessive blood concentration of voriconazole ；a hemoptysis patient with pulmonary infection was found fibrinogen decreased ，after treatmented with anti-infective and hemostatic drugs ；a patient with pulmonary infection after lung transplantation ，followed by the increase of urea and creatinine after anti-infective therapy ；a patient with grand mal epilepsy after kidney transplantation was treated with phenobarbital and diazepam ，the blood concentration of tacrolimus decreased significantly. The pharmaceutical consultation opinion was put forward and the treatment plan was optimized by clinical pharmacists. RESULTS ：Clinical pharmacists put forward pharmaceutical consultation suggestions for four consultation cases ， which were adopted by doctors. Case 1 was stopped voriconazole and omeprazole，and changed to pantoprazole for gastric protection. The steady-state valley concentration of voriconazole decreased from 12.38 μg/mL to 6.86 μg/mL，and the liver function of transaminase and total bilirubin were improved. Case 2 was stopped cefoperazone-sulbactam and hemocoagulase ，given vitamin K1，fibrinogen，cryoprecipitation，plasma for symptomatic treatment. The fibrinogen was gradually increased from 0.74 g/L to 2.88 g/L，and then remained within the normal range. Case 3 was adjusted the dosages of nephrotoxicity-related drugs （meropenem， levofloxacin，ganciclovir and Compound sulfamethoxazole were adjusted to 1 g q 12 h，250 mg qd ，94 mg qd and 2 tablets qd respectively）. The renal function indicators of urea decreased from 37.6 mmol/L to 7.8 mmol/L；creatinine decreased from 173 μmol/L to 68 μmol/L；the renal function returned to normal ，and the infectious indicators also improved. Case 4 adjusted the oral dose of tacrolimus increasing to 2 mg q 12 h，and oral dose of Pentaester soft capsule was increasing to 1 g bid. The blood concentration of tacrolimus increased from 0.8 ng/mL to 5.9 ng/mL，which reached the expected value ，and there was no further fluctuation during hospitalization. CONCLUSIONS ：Clinical pharmacists consultation mainly focuses on the following 66295644。 aspects， such as individual treatment p lan adjustment ， judgment and treatment of ADR ，adjustment of medicationplan for special population ，optimization of treatment plan for drug interactions ，so as to guarantee the safe use of drugs in clinic.
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Objective To analyze the main practices of capitation payment system reform in the case areas and put forward enlightenments and suggestions in this regard. Methods The implementation practices of the case areas were summarized, and descriptive statistical analysis was carried out on the implementation effects. Results By analyzing the effectiveness of the case areas′reform, it was found that the case areas are curbing the excessive growth of medical expenses (for example, outpatient fees per visit of Dingyuan county-level hospitals decreased from 245.11 yuan in 2015 to 218.40 yuan in 2017), increasing the actual compensation ratio of residents ( for example, the actual compensation ratio of Funan increased from 59.80% in 2015 to 63.28% in 2017), forming a medical treatment pattern within the county (for example, out-of-county compensation ratio in Dingyuan decreased from 37.38% in 2015 to 31.13% in 2017), achieving double-way referrals (for example, the number of referrals to superior hospitals of Jimo increased from 98 in 2015 to 328 in 2017), improving the subsidence of quality services, and controlling the risks of medical insurance funds. Conclusions At present, the reform of the case areas has been implemented steadily and achieved results. It is recommended to further improve such aspects as reform coordination, insurance standard setting, incentive mechanism establishment, and leadership to ensure the reform progress.
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Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults,and to provide evidences for clinical management.Methods The data of clinical manifestations,laboratory examinations,chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed.The chi-square test was used for the categorical variables,and the rank sum test was used for the continuous variables of non-normal distribution.Results Compared with patients in HAdV55,those in HAdV7 group displayed more diarrhea (12.1％ [26/214] vs 2.6％ [6/235],x2 =15.583),more laryngeal lymphatic follicles (33.2％ [71/214] vs 17.9％ [42/235],x2 =23.566),more tonsil enlargement (56.5％ [121/214] vs 20.0％ [47/235],x2 =63.870) with secretions (33.2％ [71/214] vs 11.5％ [27/235],x2 =30.878),more leukocytosis (24.8％ [53/214] vs 14.0％ [33/235],x2 =8.318),more monocytosis (78.0％ [167/214] vs 52.8％ [124/235],x2 =31.364),more thrombocytosis (7.1％ [15/212] vs 3.8％ [9/235],x2 =5.835),more elevated level of C-reactive protein (80.8％ [97/120] vs 64.3％ [137/213],x2 =10.020),more abnormalities of liver function (alamne aminotransferase [ALT]:13.5％ [28/207] vs 5.6％ [13/232],x2 =8.111) and myocardial enzymes (creatine kinase [CK]:37.6％ [77/205] vs 26.4％ [61/231],x2 =6.246),creatine kinase isoenzymes ([CK-MB]:35.6％ [73/205] vs 11.1％ [24/216],x2 =35.600),and all the differences were statistically significant (all P ＜ 0.05,0.01).Compared with patients in HAdV7 group,those in HAdV55 group displayed longer duration of diseases (7 [5]days vs 6[5] days,Z=-2.632),more sore throat (72.8％ [171/235] vs 62.1％ [133/214],x2 =0.016),more headache (62.1％ [146/235] vs 16.4％ [35/214],x2 =97.527),more pharyngeal congestion (93.6％ [220/235]vs 74.8％ [160/214],x2 =30.602),more leukopenia (14.0％ [33/235] vs 24.8％ [53/214],x2 =8.318),and more elevated level of lactate dehydrogenase (12.6％ [29/230] vs 6.3％ [13/205],x2 =4.881),more pneumonia (71.5％ [168/235] vs31.8％ [68/214],x2 =70.846) (all P＜0.05,0.01).Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different.The type 55 infection is more likely to develop to pneumonia,while the type 7 infection has wider tissue tropism.
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With the increasing frequency and impact of public health incidents in the world's medical and health services in recent years,it has become extremely necessary to train public health talents suitable for the medical environment in China.This article mainly discusses the training model of professional postgraduate students in public health in Australian universities (Sydney University and Melbourne University) and Japanese universities (Tokyo University and Hokkaido University).Both countries attach importance to the education of practical ability.Australian universities focus on the training of allround and comprehensive public health talents,while Japanese universities emphasizes the training of professional public health talents.At present,there is a lack of a clear understanding of public health and detailed standards in China,which is the main problem of public health education in China.A detailed and efficient training model of public health talents should be established based on the unique features of our country.
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Objective To summarize the general characteristics and identification considerations of appraisal of post-traumatic epilepsy （PTE） in forensic clinical expertise. Methods Descriptive statistics were made on the general situations （age and sex）, injury sites, PTE grading, clinical manifestations and blood drug concentrations of 30 cases of PTE. Chi-square test was performed on the differences of sex composition, age group incidences, injury sites, clinical manifestations and PTE grading. Fisher's exact probability method was used to test the differences in clinical manifestations and PTE grading of each site and the differences in PTE grading of different clinical manifestations. Results PTE occurred more frequently among 21 to 40 year olds, more in males than in females, and more frequently in the temporal lobe and frontal lobe. The clinical manifestations were mostly partial seizures and the PTE grading was mostly mild PTE. There were no statistical significance in the differences in distribution of clinical manifestations and PTE grading of injury sites （P>0.05）. The difference in the PTE grading of different clinical manifestations had no statistical significance （P>0.05）. The blood drug concentration of the three identified people did not reach the effective concentration, which affected the final identification opinion. Conclusion In the identification of PTE, in addition to strictly grasping the necessary factors of identification, such as the history of craniocerebral trauma, and epileptic seizures, it is also suggested that attention should be paid to the detection of blood drug concentration. Overall analysis and comprehensive evaluation should be made.
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Adult , Female , Humans , Male , Young Adult , Craniocerebral Trauma , Epilepsy, Post-Traumatic , Incidence , Retrospective StudiesABSTRACT
OBJECTIVES@#To analyze the characteristics of medical malpractices in orthopaedic surgeries, to explore principles and methods in medical legal identification, and to provide basic data for uniform medicolegal standard for the future medical identification.@*METHODS@#A retrospective analysis was conducted on 100 cases of medical malpractices in orthopaedic surgery, among the 364 cases archived in Medicolegal Expertise Center of Xi'an Jiaotong University during 2002-2015.@*RESULTS@#In the 100 cases of orthopedic medical malpractices, with 104 hospitals involved in, 95 cases were judged with medical errors and the other 9 cases with no error. The top 3 reasons for errors were （1） inadequate observation or estimation of diseases （27.9%）, （2） intraoperative improper operation （17.3%）, and （3） delayed or missed diagnosis and treatment （12.5%）. The consequences of medical malpractices were mostly disability （61%）, followed by prolonged diseases （31%） and death （8%）. With regard to the causal relationship between medical errors and consequences, 95 cases （91.4%） were with causality and the other 9 cases （8.6%） with no causality. Specifically, 56 cases （53.9%） were with medical errors as the secondary causes accounting for 25% causative potency, and 20 cases （19.2%） were with medical errors as the major causes accounting for 75% causative potency.@*CONCLUSIONS@#It is pivotally important for determining the causative potency of medical errors to analyse the causes of damages in orthopaedic surgery and to distinguish subjective factors from objective ones of medical errors.
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Humans , Malpractice , Medical Errors , Orthopedic Procedures/standards , Orthopedics , Retrospective StudiesABSTRACT
At present medical disputes still happen sometimes though governments at all levels, health departments and hospitals pay more and more attention to correctly guide patient's behavior, regulate doctor's behavior in diagnosis and treatment, purify therapeutic environment, strengthen legislation and protect the legitimate rights and interests of doctors and patients. The causes of medical disputes are great many, and the fundamental reason is that the medical behavior from the beginning to the end is related to the life and health, naturally accompanying medical risk and hiding dispute, therefore what we ought to do is not to absolutely eliminate the risk, but to reduce the risks and disputes. In this report, to explore the causes of medical disputes and risks and look for ways to reduce them, the survey of questionnaires was carried out and practical cases of medical disputes were analyzed in hospitals. Seventy-seven cases of medical disputes from 2013 to 2015 had been completed by arbitration or court decisions, and the final arbitral ideas were as follows: invalid doctor-patient communication, low technology and insufficient management were the main causes of medical disputes; the survey of 483 questionnaires on doctors and nurses in the hospital showed that in addition to the above 3 reasons, there were other deep reasons, namely heavy working intensity, low quality of patients or their family members, and the insufficient management runs through all the links in the way. Therefore, to reduce medical disputes, the following aspects should be commenced: effective communication between doctors and patients; improving doctors' clinical diagnosis and treatment ability; optimizing medical management; correcting medical work attitude;timely medical consultation; attaching importance to medical records; doctor's order leaving some leeway or allowing for unpredictable circumstances; constructing healthy hospital culture; paying attention to the physical and mental health of medical staff; actively improving the medical dispute settlement mechanism and related legal system construction.
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The whole process of consultation practice of clinical pharmacist for one case of pseudomonas aeruginosa intracranial in-fection was introduced and the role of clinical pharmacist in the anti-infective treatment was discussed. The three consultation recom-mendations of clinical pharmacist were accepted by doctors,and the patient's intracranial infection was effectively controlled and the pa-tient discharged soon. Pharmacists can help doctors develop anti-infective drug program through pharmacy thinking,horizontal thinking and risk thinking to guarantee the safety and effectiveness of patients' medication.
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Objectives To explore the effect of case analysis method in clinical nursing practice teaching of cardiology diseases.Methods 48 nursing undergraduates in cardiology department from July 2015 to May 2017 were selected into experimental group and 50 nursing undergraduates from July 2013 to June 2015 in cardiology department were retrospectively divided into control group.The control group adopted small lectures to explain the nursing assessment,diagnosis and nursing measures to the students.In experimental group,case analysis method was applied into nursing practice teaching,which concluded guiding group students to choose common kinds of typical cases firstly,collecting the patient's information,reviewing nursing assessment,diagnosis and intervention of the selected disease,and finally comparing cases with theoretical knowledge.After that,group students should apply case analysis method to clinical nursing practice under the guidance of teachers.Finally,academic performance,overall nursing assessment,and acceptance of the case analysis method in the above two groups were compared.Results The results of experimental group in academic performance [(81.70 ± 3.22) vs.(75.63 ± 3.01)] and in overall nursing examination [(91.93 ± 3.07) vs.(84.27 ± 3.08)] were significantly superior to control group.Meanwhile,the experimental group students showed higher acceptance of case analysis method.Conclusion Case analysis method can help nursing undergraduates to combine theoretical knowledge and clinical practice better,make deeper understanding of theoretical knowledge,apply it in clinical practice neatly,and improve students' ability of critical thinking.