Application of a comprehensive risk assessment method for occupational disease hazards of employers in occupational health classification management of wooden furniture manufacturing factories / 环境与职业医学

Background The contradiction between science and operability has always existed in the model of classified occupational health supervision and management. Comprehensive risk assessment method for occupational disease hazards of employers provides risk grading and classification for occupational health management, and it's a new attempt to explore classification supervision and law enforcement. Objective To apply a comprehensive risk assessment method for occupational disease hazards of employers to estimate health risk level of wood furniture enterprises, discuss its advantages and disadvantages, and provide a basis for improving the classified management of occupational health. Methods Seven typical factories were selected in counties with highly concentrated wooden furniture manufacturing. Occupational health field investigation and testing were carried out to estimate occupational disease hazard risk level (Ⅰ, Ⅱ, and Ⅲ). A self-rated checklist was applied to score occupational health management status by interviewing employers, one by one, and to determine occupational health management status grade (A, B, and C) by the score. Thus, a comprehensive risk level (Class A, Class B, and Class C) of a specific factory was obtained from a matrix of occupational disease hazard risk level and management status grade. Risk verification was carried out based on any abnormality reported by regular occupational physical examination in past 3 years. Results Defects in occupational health management were identified in all 7 factories, among which 6 were grade C with key nonconformities (poor), and 1 was grade B (medium). Disqualified occupational disease hazards were found in 6 of 7 factories, and the workstation-specific disqualified rates were 26.09% (12/46) for noise, 14.71% (5/34) for wood dust (hard), and 12.50% (1/8) for xylene. Level Ⅱ (medium) of occupational disease hazard risk was estimated in 5 of 7 factories, while level Ⅲ (high) in 2 factories. All 7 factories were class C (high risk) accessed by the comprehensive risk assessment method for occupational disease hazards. The occupational health surveillance documents showed 636 batches of regular occupational physical examination were ordered by the 7 employers, and a total of 37 workers from 5 factories reported abnormalities in physical examination, among which 3 workers reported dust exposure and 34 workers reported noise exposure. Conclusion The comprehensive risk assessment method for occupational disease hazards of employers is not able to perform with satisfaction in occupational health classification of wooden furniture manufacturing factories yet. It is necessary to expand the pilot to improve this assessment method and develop an efficient supervision mechanism to ensure the authenticity of the data before it is popularized and applied in classified occupational health management.

Research and reference on the classification management system of prescription drugs and non-prescription drugs in Canada / 中国药房

OBJECTIVE To provide reference for improving the classification management of prescription drugs and non- prescription drugs in China by learning from the classification management system of prescription drugs and non-prescription drugs in Canada. METHODS The content and experience of classification management system of prescription drugs and non-prescription drugs in Canada were analyzed， and the thinking of the classification management of prescription drugs and non-prescription drugs in China was proposed. RESULTS ＆＆CONCLUSIONS According to the classification of prescription drugs and non-prescription drugs， drugs can be divided into class Ⅰ drugs， class Ⅱ drugs， class Ⅲ drugs， unclassified drugs in Canada. Specific evaluation factors and management requirements have been established for drug classification. Canada has established a set of systematic management systems and technical standards， which has reference value for improving the classification management system in China. It is suggested to further improve the drug classification management system and supporting policies， strengthen fine classification management of prescription drugs and non-prescription drugs and improve classification registration and transformation review standards in China， by learning from Canadian prescription drug and non-prescription drug system and management model.

Research on the Classification Management of Digital Therapeutics Software / 中国医疗器械杂志

According to the current domestic laws and regulations of the medical devices classification management, combined with the characteristics of digital therapeutics products and the existing status of classification management of medical software products in China, and drawing on international classification management experience, this study discusses and analyzes the attribute definition and classification of digital therapeutics software products, with a view to provide reference for the classification management of digital therapeutics software products.

Analysis of Provincial Antibiotic Classification Management Lists in China / 中国药房

OBJECTIVE：To provide re ference for scientific management and rational use of antibiotics. METHODS ：Provincial antibiotic classification management lists were retrieved from official websites of provincial health administrative departments ， CNKI and other search engines from Apr. 2012 to Mar. 2020. The difference and adjustment of those lists were analyzed descriptively. RESULTS & CONCLUSIONS ： Since April 2012， 30 provinces released provincial antibiotic classification management lists ，among which only 10 provinces updated the lists. In the provincial classification management lists ，the list of Jiangsu included the most antibiotics （208 kinds），that of Xinjiang involved the least （101 kinds）. Among the 253 antibiotics included in the provincial lists ，134 antibiotics had two management levels ，and 19 antibiotics had three management levels. The 10 antibiotics with the most times of adjustment in the provincial lists mainly include nitimidazoles ，β-lautam compound preparations and quinolones. There was the phenomenon that the same antibiotics were simultaneously included or withdrawn from the lists ，and the grading management level was increased or decreased in the provincial adjustment. Provincial classification management lists updated slowly in China ，and the quantity and classification of drugs selected in the list were quite different. It is suggested that provincial health administrative departments should continuously optimizeand improve classification management list of antibiotics ， and form a long-term mechanism of dynamic adjustment of list and inter-provincial evidence sharing ，so as to promote the rational clinical use of antibiotics ，and curb bacterial resistance.

Analysis of Changes in Medical Device Classification Concept of the New EU Regulations / 中国医疗器械杂志

By comparing new medical device regulations with existing directives in the European Union, the revising ideas of new EU medical device regulations, especially the changes of the classification management concepts, were analyzed to provide clues for the industry to interpret the new EU regulations, and references for the classification management innovation in our country.

Study on the Implementation Status,Difficulties and Countermeasures of Retail Pharmacies'Classifica-tion Management in China / 中国药房

OBJECTIVE:To provide reference for improving classification management and specifying standards of retail phar-macies in China. METHODS:The implementation status and standards of retail pharmacies'classification management in China were analyzed by using the method of comparative analysis. In view of the effects of classification management on retail pharmacy and its implementation difficulties,corresponding improvement measures were put forward. RESULTS & CONCLUSIONS:There are difference in the implementation status and standards of retail pharmacies'classification management in the national provinces and cities. Since the implementation of pilot in 2007,the main effects include retail pharmacies facing the survival of the fittest whipsaws pattern,the remote township small retail pharmacies facing a transition;the main implementation difficulties include gov-ernment failing to give a full propoganda the classification management of retail pharmacies,the construction of licensed pharma-cist team to be strengthened. It is suggested to include the ability of pharmaceutical care and credit level into the standard,imple-ment dynamic management,and complement classification management of retail pharmacies with the construction of licensed phar-macist team.

Study on the Classification Management of Off-label Drug Use in Our Hospital / 中国药房

OBJECTIVE:To promote the normative management of clinical off-label drug use. METHODS:The degree of devi-ation from the drug instructions and the risk degree were comprehensively considered,and the off-label drug use were classified in-to three different situations for classifying approval and informed consent classifying;situation and effects after classifying were evaluated. RESULTS:The classifying included occasional or small amount off-label use on dosage and drugs solvent (the first), regular off-label use on route or administration(the second)and super-indications drug use with contraindications(the third). The approval was classified as follows as confirmed with signature by doctor,approved by medical department,approved by pharmaceu-tical committee and ethics committee accordingly;informed consent classifying were signing informed consent,informing and re-cording in medical record,informing orally. Off-label drug use approval process was officially initiated from Feb. 2014 to Jun. 2016 in our hospital,51 off-label drug use applications from 13 clinical departments were received,with 16 items belonging to the second situation,35 items belonging to the third. Finally 42 applications were approved and 9 were not. No relevant new/serious ad-verse drug reactions/ events occurred in process of the approved off-label drug use. And no off-label drug use not approved was found to continue to be used in our hospital. CONCLUSIONS:Classification management methods for off-label drug use in our hos-pital have shown high operability,improved the off-label drug use behavior of physicians.

The role of ICU classification management / 中国小儿急救医学

The assessment work is important for pediatric intensive medicine in developed countries, including the assessment work for economic rationality and the suitability of the technology in PICU,which provides an objective basis for the government health sector decision-making and medical care work guide.So far,domestic counterparts have not paid enough attention to the assessment work.PICU assessment work is basically blank,which needs to be strengthened.

Role of nursing classification and marking management in ICU nursing management / 现代临床护理

Objective To probe into the role of nursing classification and marking management in ICU nursing management. Methods According to the admission date,the first 87 patients hospitalized in our department were assigned into the control group and another 84 into the intervention group.Then the human resources were divided based on the ABCD nursing classification and marking management for ICU.The two groups were compared in terms of adverse events.Results The incidences of pressure sores, non-planned extubation,improper clinostatism for using respirator,hypoglucycaemia during reinforced treatment with insulin, respirator-associated pulmonary pneumonia,tube-associated infection,and multidrug resistant bacteria in the intervention group were all significantly lower than those in the control group (allP<0.05).Conclusion The nursing classification and marking management for ICU nursing management can enhance the nursing quality.

Statistical Investigation of Antibacterial Drugs Classification Management Directory in Different Provinces of China / 中国药师

Objective: To evaluate the rationality and practicability of the provincial directory of antibacterial drugs classification management in China. Methods: The directories at the provincial level published after May 2012 were collected from the government websites of health department in different provinces, cities and autonomous regions. The name, number, grading and classification were counted and anzlyzed. According to the relative national standards, the rationality, practicability and existing problems were ana-lyzed, and some revision sugestions were proposed. Results:Up till now, 30 dirctories were issued with the average recording number-varieties of 147. 1(101-194). The average number of unrestricted, restricted and special use level was 56. 4(37-66), 53. 7(34-68) and 37(24-75), respectively. The top 5 was cephalosporins(29. 5), penicillins(24. 8), antifungi drugs(14. 7), quinolones(12. 8) and aminoglycosides(10). Overall, the directories were rational and practicable. However, 29 kinds of antibacterial drugs were with-out registered number of approval, which was not reasonable or practicable. The other problems were inappropriate classification and grading, name writing mistakes, ect. Conclusion:The directories should be revised in time to correct the existing promblems and im-prove the directories.

A proposal: Atopic Dermatitis Organizer (ADO) guideline for children

Atopic dermatitis (AD) is the most common chronic inflammatory skin disorder in children, with a worldwide cumulative prevalence in children of 8-20%. The number of AD patients is beyond the level that can be dealt with at clinics and it is time to make an effort to reduce the number of AD patients in the community. Thus, caregivers and all persons involved with AD management, including health care providers, educators, technologists and medical policy makers, should understand the development and the management of AD. Although a number of guidelines such as Practical Allergy (PRACTALL) report have been developed and used, community understanding of these is low. This is probably because there are still remarkable differences in management practices between specialists and between countries and most of the reported guidelines have been prepared for physicians. From the viewpoint of providing a basis for a multidisciplinary team approach, easily comprehensible guidelines for organizing treatment of AD, i.e. an Atopic Dermatitis Organizer (ADO), are required. guidelines should be simple and well organized. We suggest an easy approach with a new classification of AD symptoms into early and/or progressive lesions in acute and/or chronic symptoms. The contents of this ADO guideline basically consist of 3 steps approaches: conservative management, topical anti-inflammatory therapy, and systemic anti-inflammatory therapy.

Reflection on Breakthrough of the Implementation of National Essential Drugs System in China / 中国药房

OBJECTIVE: To look for the breakthrough for the implementation of national essential drugs system in China. METHODS: Based on relevant literatures, the disadvantage of establishment of National Essential Drug System and its main reason were considered. RESULTS: Five disadvantages of establishment of National Essential Drugs System were as follows: early starting, slow process and some links against essential drug system; clear direction of national drug policy without significant effectiveness; Essential Drugs List didn’t occupy high dominant position. National Essential Drugs System lacked of legal status and liability subject. CONCLUSION: National Essential Drug System should be escalated from policy of government to national policy, and legislation of National Essential Drug System should be strengthened. Government at all levels is liability subject to implement National Essential Drugs System and perform classification management system of essential drug.