Use of oximeter in the monitoring of acral blood circulation in post-limb-fracture patients / 现代临床护理

Objective To access the efficacy of oximeter in blood oxygen saturation monitoring in limb fracture patients. Method Monitor the blood oxygen saturation level in 200 patients with limb fractures , and determine whether blood circulation disorders exist in these patients accordingly. Results Within the 200 patients, 107 had normal blood oxygen saturation level, 50 patients had possible blood circulation disorder , 40 patients had blood circulation disorder, 3 patients had critical limb ischemia among which 2 were diagnosed as osteofascial compartment syndrome , and one as partial breakage of arteriovenous vessels. All the patients recovered well after prompt and proper treatment. Conclusion Blood oxygen saturation monitoring in post-limb- fracture patients using a oximeter can discover blood circulation disorders promptly , thus ensure proper treatment and avoid mal-practice and missed diagnosis.

Literature Analysis of Vitamins Utilization in Parenteral Nutrition Prescription in China during 2006-2015 / 中国药房

OBJECTIVE:To investigate the application of vitamins in parenteral nutrition (PN) prescription,and to provide reference for rational use of vitamins in PN. METHODS:Usingparenteral nutritionintravenous nutritionprescription analy-sisrational drug useanalysis of medical orderas keywords,the literatures about the rationality analysis of PN prescriptions were retrieved from CNKI and Wanfang database during 2006-2015,and the utilization of vitamin included in literatures were ana-lyzed and summarized. RESULTS:A total of 34 literatures were included. There were 158874 prescriptions,among which vitamin was used in 145400 prescriptions (91.52%). 12 or 13 kinds of vitamin were used in 73508 prescriptions (46.27%);over-dose drug use was found in 53388 prescriptions(33.60%),and vitamin was not completely added into 18504 prescriptions(11.65%);no vitamin was added into 1663 prescriptions (1.05%). The proportion of the prescriptions including 12 or 13 kinds of vitamin was the highest in northern China (52.00%). 12 or 13 kinds of vitamin were added into the prescriptions and the author believed that the proportion of excessive use of vitamin,incomplete addition of water-soluble vitamin and fat-soluble vitamin in class three grade A hospitals were all lower than hospitals below class three grade A. The prescriptions including 12 or 13 kinds of necessary vi-tamin were adopted in oncology department(97.72%),internal medicine department(86.62%),intensive care unit(77.99%)and surgery department(52.83%). CONCLUSIONS:The standardized use of vitamin PN prescriptions occupies low proportion in Chi-na. It is necessary to enhance the conception that multiple recommended vitamins should be added into PN.

Analysis of the Antitumor Essential Medicines Contained in Drug Reimbursement List in China Cities / 中国药房

OBJECTIVE:To provide reference for promoting the prior usage of essential medicines and scientifically selecting of antitumor medicines in the national and local drug reimbursement list. METHODS:Entering the Human Resources and Social Se-curity Bureau websites in 10 cities(Beijing,Shanghai,Guangzhou,Nanjing,Wuhan,Xi’an,Chengdu,Shenyang,Jinan and Gui-yang),drug reimbursement list was downloaded to statistically analyze the containing of antitumor medicines(including 24 essential medicines). RESULTS:In antitumor medicines,there were 5 cities with more than 100 varieties,of which Shanghai had 255 vari-eties,which was far more than other cities;the numbers of medicines in class A were near 30 in all the cities except Beijing(67 va-rieties),and the number of class B was highest in Shanghai and lowest in Beijing. All the drug reimbursement lists in 10 cities con-tained 24 antitumor essential medicines,however,the classification was different according to the dosage forms,among which, parts of formulations of cytarabine(injections),doxorubicin(injections),busulfan (often release oral dosage forms),fluorouracil (often release oral dosage forms,injections),cyclophosphamide(often release oral dosage forms,injections),methotrexate(often release oral dosage forms,injections)and cisplatin were classified as class A medicines in all cities;oxaliplatin(injections)and pa-clitaxel (injections) were classified as class B medicines;busulfan,fluorouracil,cyclophosphamide and methotrexate were classi-fied as class B in Shanghai only. CONCLUSIONS:There are some differences in the distribution of antitumor essential medicines in drug reimbursement list in each city,the varieties in developed cities are relatively more,and developing cities are less. It is sug-gested to consider the tumor epidemiology characteristics and economic situations,reasonably select antitumor essential medicines into drug reimbursement list and reasonably adjust the proportion of class A and B to ensure the basic medication and drugs’reim-bursement.

Effect of psychological intervention on the mental conditions and the quality of life of patients with radiation encephalopathy / 现代临床护理

Objective To explore the effect of psychological intervention on the mental conditions and the quality of life of patients with radiation encephalopathy(REP).Methods thirty-five patients with REP from radiotherapy for nasopharyngeal carcinoma were divided into the control group(n=17)and the experiment group(n=18)according to their registration sequence. The control group was managed with conventional nursing,and the experiment group with individualized psychological intervention in addition to routine nursing for 12 weeks.The two groups were compared in terms of depression and quality of life by Hamilton Depression rating Scale(HAMD)and The short-form health survey questionnaire(SF-36).Results The two groups before treatment showed no statistical difference in scores by HAMD and SF-36(P>0.05).The experiment group was superior to the control group after intervention in depression and quality of life(P<0.01).Conclusion Psychological intervention may alleviate REP in the patients at poor psychological status and improve their quality of life.

Followed up Investigation on Pharmaceutical Care Indices After Intervention on Rational Drug Use / 中国药房

OBJECTIVE :To explore the influencing factors of rational drug use(RDU)and time length of effect after intervention on RDU.METHODS:A field investigation was carried out on the core indices of international RDU index by the way of comparison.The investigation was carried out at three stages:1 year before intervention,1 year after intervention,and 4 years after intervention.Data statistics was analyzed by SPSS 11.1 software.RESULTS:The number of drug varieties per capita dropped from 2.76(before intervention)to 2.09(1 year after intervention),and remained 2.08(P

Investigation and Evaluation of Clinical Safety of Clindamycin Injection / 中国药房

OBJECTIVE: To utilize the clindamycin injection safely.METHODS: 167 cases of hospitalized patients, who underwent clindamycin injection during the period between March 22, 2004 and April 27, 2004 were followed up and analyzed through the self-made questionnaires. RESULTS: 98 cases were for preventing infections; 76 cases were for treating infections; in 107(47+60) cases clindamycin injection was used in combination with other anti-infective drugs to prevent and treat infections; the average dosage was 0.6g～1.2g,bid,and the average length of time was (17?15)d;the incidence of ADR was 6.6%(11/167), and the main clinical manifestations were sickness, vomiting, diarrhea, numbness of mouth and lip, fever, and mycoinfection. CONCLUSION: Only by strict control of signs for drug use and ways of administration can the clinical safety be improved.

Discussion on Training On-the-job Pharmacist in Clinical Practice / 中国药房

OBJECTIVE:To explore an effective mode and way to quickly train on-the-job pharmacist to become clinical pharmacist in China.METHODS:With the reference to the process and current situation of clinical pharmacist training both domestically and abroad,the background,systems and policies about clinical pharmacist training were compared and the per?sonal working experience of the author was considered,then an efficient mode for domestic on-the-job pharmacist training was put forward.RESULTS&CONCLUSION:On-the-job pharmacist training in China should be carried out in steps,which includes theoretical study and clinical practice,establishment of evaluation system,and writing of scientific papers,only by doing this can we really train the clinical pharmacists in clinical practice,ensure the safe,rational,effective and economic medication and reduce the waste of health resources.

Study on intervention and comparison of rational use of antibiotics on perioperative period of clean incision and clean-defiled incision / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore a set of scientific evaluation and intervention methods on perioperatur period which fits for China's situation, and to promote the development of rational drug use.</p><p><b>METHODS</b>Two would tertiary general hospitals were selected and separated in to intervention group and control group. Intervention was carried out and compared at the same period on inpatient surgical cases of thryroidectomy, mastectomy, cholescystectomy, and hysteromyomectomy plus appendix.</p><p><b>RESULTS</b>The average drug costs was decreased from 1 601.27 yuan to 1 489.59 yuan and the average antibiotics use from 740.20 yuan to 352.03 yuan (P < 0.01) in the intervention group pre and post intervention. There was a remarkable improvement on the rationality of antibiotics use in intervention group, from 31.35% to 91.81% (P < 0.01) pre and post intervention, implemented in the hospital.</p><p><b>CONCLUSION</b>It is practicable and effective to implement rational drug use where intervention was carried out, since it plays an active role on promoting safely, effectively and economic antibiotic use in China.</p>

Application of Question-asking Approach in the Classroom Teaching of“Rational Administration of Anti-infectives” / 中国药房

OBJECTIVE:To apply the question-asking approach to the teaching of“Rational Administration of Antiin?fectives”for medical undergraduates.METHODS:Teaching design was conducted before classroom teaching,which included designing questions and making two sets of test papers(the questions were the same for the two sets)for book-open written examination,interactive question-asking teaching approach was applied in classroom teaching process.RESULTS:The class?room was very active and students’enthusiasm of learning was greatly motivated,students’average score of this subject in?creased from50.2in the pretest to96.6at the end of classroom learning,which was of significant difference(P

Analysis of the Safety of Puerarin Injection Used in 135 Patients / 中国药房

OBJECTIVE:To understand the safety of Puerarin injection in clinical use.METHODS:The adverse drug re?actions(ADRs)and administration of Puerarin injection at Xuanwu Hospital from Oct.2002to Feb.2003were investigat?ed.RESULTS:According to the dosage in drug intruction,the Puerarin injection was diluted in0.9%sodium chloride of5%glucose solution and infused alone with a infusion rate of40～60drops/min,which would be safe and induce less ADRs,and use in overdose markedly increased the incidence of ADRs.CONCLUSION:Use of this preparation should strictly be in accordance with the specification.

Study on the Changes of Biochemical Indices and Blood Pressure Induced by Methylprednisolone Injection in the Treatment of SARS / 中国药房

OBJECTIVE:To provide scientic basis for clinical use of hormone.METHODS:The influence of methylpred?nisolone injection(MP)on levels of serum potassium,sodium,calcium,blood sugar,blood pressure,blood lipid,and protein was observed.RESULTS:MP had the most obvious influence on serum calcium and protein,while it had the least influence on triglyceride.Along with the increases of dosage of drug and patient’s age,the changes of biochemical indices induced by MP w_ ere more obvious.The changes of serum sodium and blood pressure were greater in male patients under age40in comparison with those in females.Supplement of potassium,calcium and protein could postpone the influence of drug on serum calcium and protein but could not reduce the incidence rates.CONCLUSION:The use of hormone should adhere to individualized principle and adopt the minimum dosage with expected therapeutic efficacy to reduce the occurrence of adverse reactions.

Analysis of the Prescriptions for Old Patients with Gender and Age Differences in Beijing / 中国药房

0 05) CONCLUSION:The health problems and rational use of drugs in the aged should be given more concerns,especially in the patients between the ages of 60 and 69 years The reason why the consultation rate of man is higher than that of women should be found out The use of injection preparations and the kinds of drug for combined use ought to be decreased

Field Survey of International RDU Indicators / 中国药房

OBJECTIVE:In order to promote the rational drug use in China,we undertook a multi-center international indicators field survey of rational drug use(RDU).METHODS:According to the international RDU indicators of WHO/IN?RUD,a multi-center,random and on-site survey to the prescriptions and patients was carried out on the same day at7dif?ferent level hospitals.RESULTS:Prescription indicators:the average number of drugs per prescription was2.63;the percent?age of antibiotics prescribed was38.3%;and the percentage of preparations for injection prescribed was20.4%;the percentage of drugs prescribed from essential drug list(EDL)was69.6%.Patient care indicators:average consultation time was7.17minutes;average dispensing time was15.4seconds;percentage of drugs actually dispensed was100%;percentage of drugs ac?tually labeled was99%;percentage of patients'knowledge of correct dosage was86.3%.CONCLUSION:It is practicable and effective to get the data by using the indicators of WHO/INRUD.The rational drug use and the care from doctors and phar?macists to the patients are not enough in China,which remains to be improved.

Analysis of Drugs Used for Senile Out-patients With Distinction of Sex in 22 Hospital of Beijing in 1998～1999 / 中国药房

OBJECTIVE:To gain a clear idea of difference of drug requirement and DDD between senile women and men patients,so as to provide a scientific basis for safely,effectively,economically and rationally preventing and treating diseases of senile patients and improving their quality of life METHODS:A 2-year(1998～1999)prescription database,which was set up by PRESCRIPTION ANALYSIS research group of 22 hospitals in Beijing,was used for this study Information of senile out-p_atients(≥60 years old)was collected and analysed Foxpro software was used for statistics and analysis RESULTS:The prescription rate for senile male patients was 11 6%,whereas that for senile female patients was 8 3% Proportion of injection for per hundred male out-patients was 17 0% and that for female patients was 20 4% The main kinds of drugs used for both male and female patients were cardiovascular drugs and vitamins,the DDDs of which were lower than those defined by WHO and drug directions,however,the DDDs for male patients were higher than those for female The rate of consultation for cardiovascular disease was high in both sexes Prostate diseases in senile male patients and diabetes in female should be given more concern The drugs used for both sexes accorded with National Essential Drugs List(men 85%;women 87 5%) CONCLUSIO_N:The rate of prescription and DDDs for senile male patients were higher than those for female,however,the proportion of injections for per hundred male patients was lower than that for female

Survey and Analysis of the Psychotic Adverse Reactions in SARS Patients Treated with Glucocorticoid / 中国药房

80mg, P7 days, P 0.05) .The immunopotentiators could increase the morbidity of psychotic reactions .CONCLUSION: Overdose and long - course of glucocorticoid therapy may increase the morbidity of the psychotic adverse effects.