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OBJECTIVE To investigate the basic situation of developing pharmacy outpatient departments in Chinese tertiary medical institutions and analyze the influencing factors. METHODS The research targeted the pharmacy outpatient department managers of hospitals and conducted a survey through Sojump in March 2023. Various independent variables were selected from the hospital’s own characteristics， the management of the pharmacy outpatient departments， and the construction of the pharmacist team for Logistic and linear regression analysis， with the aim of separately analyzing the factors influencing the establishment of pharmacy outpatient departments and the factors affecting the total number of patients served by these departments throughout the year 2022. RESULTS & CONCLUSIONS A total of 1 304 medical institutions of different levels nationwide participated in this survey， with 714 tertiary hospitals. Among the tertiary hospitals， 377 （52.80%） had established pharmacy outpatient departments， including 321 grade-A tertiary hospitals， 48 grade-B tertiary hospitals and 8 other tertiary hospitals. The 377 tertiary hospitals collectively operated 1 739 pharmacy outpatient departments， covering 19 specialized fields， with the highest proportion found in the cardiovascular field （including anticoagulation） at 16.45%. Tertiary hospitals in North China， Central China， East China and South China regions had more pharmacy outpatient departments. The establishment of pharmacy outpatient departments was found to be influenced by tertiary grade-B status （P＝0.010） and the annual outpatient volume of the hospital （P＝0.008）， although the impact was relatively small. The factors influencing the number of patients served by pharmacy outpatient departments were the annual outpatient volume of the hospital （P＝0.042） and the number of pharmacists engaged in clinical pharmacy work （P＝0.004）. The proportion of tertiary hospitals in China that have established pharmacy outpatient departments is insufficient. It is necessary to further accelerate the construction of pharmacy outpatient departments and appropriately expand the talent pool of hospital pharmacy teams based on the needs of pharmacy outpatient departments and patients， in order to meet the requirements of medical practice and patient care.
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OBJECTIVE To investigate the current situation of pharmaceutical clinic service in medical institutions in China and provide experience and suggestions for promoting the development of pharmaceutical clinics. METHODS Questionnaire survey was used to investigate the development of pharmaceutical clinics in medical institutions of 31 provinces （autonomous regions and municipalities directly under the central government） in March to April 2023， and the descriptive analysis was conducted. The regression analysis was carried out for the influential factors of pharmaceutical clinic service. RESULTS A total of 1 368 questionnaires were distributed in this survey and 1 304 valid questionnaires were collected with the effective response rate of 95.32%. A total of 463 medical institutions carried out pharmaceutical clinic service， the rate of which was 35.51% （463/1 304）； the rates of pharmaceutical clinics in tertiary， secondary， primary and other medical institutions were 52.80%， 17.18% and 5.88%， respectively. The frequency of opening pharmaceutical clinics was 3.17 days per week on average， with an average of 5.99 visiting pharmacists in each medical institution. Among the visiting pharmacists， clinical pharmacists accounted for the vast majority （88.68%， 2 459/2 773）. There were various categories of pharmaceutical clinics， including joint clinics and pharmacist-independent clinics； among pharmacist-independent clinics， pharmaceutical specialty/specialty disease clinics were the main ones， accounting for 89.72% of the total number of pharmaceutical clinics. The value of pharmacists in pharmaceutical clinics was manifested in various forms， among which the proportion of medical institutions charging pharmaceutical clinics was 10.80%. The main experiences in developing pharmaceutical clinics were to attach importance to discipline construction and personnel training. The main difficulties in developing pharmaceutical clinics were low compensation levels and a shortage of talent.The number of clinical pharmacists， the number of visiting pharmacists in pharmaceutical clinics and additional compensation were positively correlated with the amount of pharmaceutical clinic services（P＜0.05）. CONCLUSIONS In recent years， pharmaceutical clinics have made significant progress； in the future， it is still necessary to further strengthen discipline construction and talent cultivation， pay attention to the value embodiment of pharmacists， to promote the healthy development of pharmaceutical clinics.
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Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research， we believe that five aspects need to be prioritized for a strong system. First， we should change the perspective on public health， using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”， to lead the public health system development. Second， we should develop a suitable public health system and continuously improve the health capacity for governance. Third， we should make it clear that the goal of building a strong system is not far-fetched， and we need to consolidate the existing institutional advantages of China’s public health system： when encountering major problems， we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However， we need to make up for shortcomings one by one， especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth， we should pursue excellence and consolidate the“suitable” mechanism proven in the process of coping with the COVID-19， so that efficient mechanisms to deal with major issues can be used in routine work， and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response，so as to achieve the balanced development of regions categories and units.Finally， it is necessary to strengthen the coordination of government and research institutions， in the aspects of technological innovation， talent team building and accurate consulting services， and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.
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Objective To investigate the clinical effect of atorvastatin calcium on carotid artery plaque in patients with cerebral infarction.Methods From January 2016 to September 2017,100 patients with cerebral infarction in the Second People's Hospital of Yuyao were selected.According to random number table method,the patients were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated by intravenous injection of ginkgo leaf extract and dipyridamole injection.The observation group was treated by intravenous injection of ginkgo leaf extract and dipyridamole injection combined wth atorvastatin calcium therapy.The clinical effects and changes of blood indicators were compared between the two groups.Results Before treatment,the IMT thickness,plaque thickness,blood flow velocity,TG,TC,LDL-C,HDL-C,plasma viscosity,erythrocyte aggregation index,erythrocyte volume,fibrinogen and erythrocyte sedimentation rate (ESR) between the two groups had no statistically significant differences (all P ＞ 0.05).After treatment,the IMT thickness,plaque thickness,blood flow velocity,TG,TC,LDL-C,HDL-C,plasma viscosity,erythrocyte aggregation index and hematocrit,fibrinogen,ESR and total effective rate in the observation group were significantly better than those in the control group,and the differences between the two groups were statistically significant(t =5.012,6.225,8.147,6.225,5.110,6.021,5.002,5.012,6.002,5.102,5.042,6.053,x2 =8.125,all P ＜ 0.05).Conclusion Atorvastatin calcium tablets combined with intravenous injection of ginkgo leaf extract and dipyridamole in the treatment of atherosclerotic cerebral infarction can effectively improve blood rheological parameters and blood lipid parameters,and the treatment effect is better than ginkgo leaf extract and dipyridamole.
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Objective To investigate the correlation of plasma brain natriuretic peptide (BNP) level with serum albumin, serum total bilirubin and thrombin time in patients with liver cirrhosis.Methods RandomLy selected from January 2014 to June 2016 to our hospital diagnosis and hospitalization of 200 cases of cirrhosis patients, according to the standard of Child-Pugh classification provided by Chinese Medical Hepatology Division in 2006, 48 cases were Child A group, 96 cases were Child B group and 56 cases were Child C group.The plasma BNP, serum albumin, serum total bilirubin, prothrombin time and QTc interval of electrocardiogram were analyzed in the clinical data of each group of patients and the correlation between plasma BNP and their correlation.Results The levels of plasma BNP in Child A, B and C groups were higher than those in B group and B group.The correlation between plasma BNP and Child's grade showed a positive correlation, and the results of each group were statistically different (P<0.05).The plasma BNP level was negatively correlated with ALB ( P<0.05 ) .The level of plasma BNP was positively correlated with ALB ( P <0.05 ) .The correlation between plasma BNP and PTIL was correlated with TBIL.The correlation between plasma BNP and TBIL was significantly correlated with TBIL ( P <0.05), The higher the plasma BNP, the regression analysis showed that plasma BNP and TBIL were positively correlated, the difference was statistically significant (P<0.05).The correlation between plasma BNP level and QTc was analyzed.The QTc interval of plasma BNP level was higher than that of the control group ( P<0.01 ) , and the difference was statistically significant ( P <0.01 ) .Conclusion The plasma BNP level in patients with liver function is closely related to ALB, TBIL, PT, QTc interval, and has the value of evaluating and predicting liver function.
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Objective To study curative efficacy of aluminum phosphate gel combined with omeprazole in treatment of peptic ulcer and its effects on Gas, TGF-αlevels.Methods 80 patients of peptic ulcer who received therapy from April 2015 to April 2016 in our hospital were selected as research objects.According to random number table, those patients were divided into the observation group and the control group, 49 patients in each group.the control group was treated with omeprazole, while the observation group was treated with aluminum phosphate gel combined on the basis of control group.Then Transforming growth factor, adverse reaction and curative effect were compared.Results After treatment, the serum levels of Gas and TGF-αin both groups were improved (P<0.05); Two weeks after treatment,the level of GAS in the observation group were lower than those in the control group(P<0.05), TGF-αlevel was higher than that in control group(P<0.05); The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05); The total effective rate in the observation group was higher than that in the control group(P<0.05). Conclusion Combined use of aluminum phosphate gel and omeprazole in the treatment of peptic ulcer can effectively improve the patient-related serum markers, improve the quality of ulcer healing, significant efficacy, high safety and low incidence of adverse reactions.
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In recent years , increasing use of drugs has given rise to more and more Adverse Drug Reaction ( ADR) cases in China.However, due to the absence of ADR compensation legislation in China , these victim's rights cannot be restituted.By analyzing experiences from Germany , Sweden, Japan, USA, and Taiwan, as well as the current situation and difficulties of ADR compensation in China , this paper provides suggestions for ADR compensa-tion policy in China , which is to constitute an ADR compensation system based on funds .
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Following an analysis of the problems and challenges of hospitals regulation in China and a comparative study of situations at home and abroad,this paper presented six policy proposals for the reform of public hospitals regulatory system in China.The policy suggestions included definite regulatory objectives,defined relationship between public hospitals and government,strengthening both economic regulation and social regulation, establishing multivariate regulatory system, introducing flexible regulatory methods and full utilization of the third-party impact,which met the requirements of public hospital in healthcare reform in China and propelled the reform forward.