Study on Carbapenemase Genotype of Imipenem-resistant Gram-negative Bacilli in Intensive Care Unit of 3 Third Grade Class A Hospitals from Qingdao Area / 中国药房

OBJECTIVE: To analyze carbapenemases genotype of imipenem-resistant Gram-negative bacilli in intensive care unit (ICU) of 3 third grade class A hospitals from Qingdao area, so as to provide reference for drug-resistant bacteria infection prevention and treatment in clinic. METHODS: From Jan. 2013 to Jun. 2016, each 60 strains of imipenem-resistant Klebsiella pneumoniae (IRKP), imipenem-resistant Pseudomonas aeruginosa (IRPA) and imipenem-resistant Acinetobacter baumanii (IRAB) were collected from 3 third grade class A hospitals from Qingdao area. Drug sensitivity test was performed by using Kirby-Bauer method. Phenotypes of carbapenemases were determined by Carba NP trial. PCR was applied to amplify carbapenemase gene; Sanger seqnencing method was adopted for bi-directional sequencing; Blast comparison with GenBank database was conducted. RESULTS: Three kinds of imipenem-resistant Gram-negative bacilli showed high drug resistance to majority commonly used antibiotics as piperacillin, cefazolin, imipenem and cilastatin sodium, gentamicin, etc., but were sensitive to polymyxin B (resistance rate of 0). Among 180 drug-resistant strains, there were 52 strains of class A carbapenems, 13 strains of class B carbapenems and 39 strains of class D carbapenems; the detection rates of them were 28. 89％, 7. 22％ and 21. 67％, respectively. There were 52 strains of KPC-2 gene (IRKP), 4 strains of IMP-1 gene (IRPA), 8 strains of VIM-2 gene (7 strains of IRPA, 1 strain of IRAB), 39 strains of OXA-23 gene (IRAB); the detection rates of them were 28. 89％, 2. 22％, 4. 44％, 21. 67％; all strains were not detected 1MP-2, VIM-1, NDM-1, OXA-24, OXA-58 genes. Results of Blast comparison showed that above detected genes were absolutely homology with the corresponding genes in GenBank database. CONCLUSIONS: Drug resistance of imipenem-resistant Gram-negative bacilli in ICU of 3 third grade class A hospitals is serious in this region, which are nearly no-sensitive to most of commonly used antibiotics in clinic. Main genotypes included KPC-2 (K. pneumoniae), OXA-23 (A. baumanii) and IMP-1 and VIM-2 (P. aeruginosa).

Investigation and Analysis of Patients’Satisfaction and Related Influential Factors to Outpatient Pharmacy in a Third Grade Class-A Hospital in Chengdu / 中国药房

OBJECTIVE:To provide reference for improving the service quality of outpatient pharmacy in hospital. METH-ODS:A questionnaire survey was conducted to investigate and analyze the patients’satisfaction and related influential factors to outpatient pharmacy in a third grade class-A hospital in Chengdu. RESULTS:Totally 165 questionnaires were sent out,and 150 were effectively received with effective recovery of 90.91%. The total score for patients’satisfaction was (44.67 ± 7.81) scores, and the rate of satisfaction was(81.22±14.19)%. The top three entries were“the will you choose to come to our hospital again if necessary”,“the notices about time and place for taking the medicine”and“the overall evaluation of the professional ethics of med-ical staff”,scored 4.38,4.25 and 4.25,respectively;the last three entries were“waiting time for taking medicine”,“the notices about how long it takes to take the medicine”and“service facilities and environmental facilities for drug taking”,scored 3.55, 3.63 and 3.95,respectively. The top three suggestions were“long waiting time for taking medicine and inconvenient”,“noisy envi-ronment,bad order”and“expensive drugs charges but less reimburse”. The univariate analysis and multivariate analysis showed that gender,age,marital status,education,occupation,family income per month,resident,drug taking times and payment etc. factors showed no significant effects on patients’satisfaction scores(P>0.05). CONCLUSIONS:The degree of patients’satisfac-tion in outpatient pharmacy have no obvious specificity and preference,the key to improve the degree of satisfaction lies on strengthening the service of the hospital and the perception of the patients. While the next research will focus on how to find the breakthrough points and key points to improve the experience of waiting,standardize process management and logistics manage-ment,and make patients aware of the service development.

Websites of some class A hospital libraries in eastern China / 中华医学图书情报杂志

After the status quo of class A hospital libraries websites in eastern China was described, the major reasons that led to such a status quo were analyzed, including irrational staff structure, lack of systematic management ideas and fund support, and certain suggestions were proposed for their solution.

Investigation and Analysis of Short Drugs in 5 Third-grade Class-A Hospitals in Anhui Province / 中国药房

OBJECTIVE:To provide empirical reference for protecting the supply of clinical drugs. METHODS:Literature re-view was combined with the conditions of drugs that lost the bidding in the centralized bidding in Anhui province to determine the short drugs need to investigate. Questionnaire was adopted to investigate the situations and reasons of short drugs in 5 third-grade class-A hospitals of 5 areas in Anhui province from Nov. 2013 to Oct. 2014. RESULTS:A total of 5 questionnaires were sent out, and 5 were received with effective response rate of 100%. There were totally 54 short drugs in the 5 third-grade class-A hospitals, including the most serious shortage of drugs for neurocirculatory system,accounting for 20.37%. Shortage was mainly due to the low price of drugs,accounting for 48.15%,and insufficient supply,less suffering patients/low dosage and other reasons. CON-CLUSIONS:In view of the shortage of drugs,government departments should improve the drug pricing and bidding policy,pro-duction enterprises should enhance the enterprise production and development capabilities,business companies should optimize the distribution pattern of network and medical institutions should establish drug management system with a clear division of power and responsibility to relieve the drug shortages.

Study on the Scientific Research and its Corresponding Strategy for 34 third-grade class A hospitals of Fujian Province between the year 2001 and 2010 / 中华医学科研管理杂志

Third-grade class A hospitals undertake three tasks-medical service,scientific research and teaching.scientific research is the motivation for third-grade class A hospitals' continuous development and also an important symbol of their medical and academic level.On the purpose of evaluating overall scientific level of such hospitals this thesis analyze the scientific projects and the outcomes of 34 hospitals by using the method of literature research and questionnaire,extracting advantages for scientific research,seeking their problems and coming up with corresponding strategy.have analyzed the achievements we acquired as well as the problems still existing.According to the reality of Fujian Province,some suggestions are coming up with so as to improve the scientific research.