Participation of pharmacists and patients in web-based pharmaceutical care consultation based on MEDICODE.

BACKGROUND: The participation of providers and patients in medical communication is the core element of shared decision making. Furthermore, web-based pharmaceutical care consultation is increasingly necessary, welcomed and popular. OBJECTIVE: This study aimed to analyze the participation of pharmacists and patients in web-based pharmaceutical care consultation, so as to form the promotion strategy for both parties' participation. METHODS: Data of pharmacist-patient encounters was obtained from the online platform 'Good Doctor Website' from March 31, 2012 to June 22, 2019. MEDICODE was employed to analyze the participation of pharmacists and patients in web-based pharmaceutical care consultation using dialogue ratio, the preponderance of initiative, and dialogical roles (information provider, listener, instigator and participant). RESULTS: This study included 121 pharmacist-patient encounters which discussed 382 specifically named medications. On average, 3.75 specific themes were discussed per medication. Among the 29 specific themes observed, 16 were initiated primarily by patients and 13 by pharmacists, 22 were primarily monologue, 6 were primarily dialogue, and 1 was a combination of the two. Pharmacists and patients were information providers or listeners in most content theme categories, such as possible main effect, possible adverse effect, instructions, warnings, adherence, designation, and observed adverse effect. CONCLUSIONS: Pharmacists and patients exchanged less drug-related information in web-based pharmaceutical care consultation. The exchange had more patient-dominated behaviors and more of a monologue. Furthermore, pharmacists and patients were mainly information providers or listeners in communication. The participation of both parties was insufficient.

Enhanced recovery after surgery pathway reduces the length of hospital stay without additional complications in lumbar disc herniation treated by percutaneous endoscopic transforaminal discectomy.

BACKGROUND: Enhanced recovery after surgery (ERAS) pathway in spine surgery is increasingly popular which can reduce the length of hospital stay (LOS). However, there are few studies on the safety and effectiveness of ERAS pathway in the treatment of single-level lumbar disc herniation (LDH) by percutaneous endoscopic transforaminal discectomy (PETD). The aim of this study was to investigate whether ERAS can reduce LOS of patients with single segment LDH treated by PETD. METHODS: We reviewed the outcomes of all LDH patients (L4/5) who had been treated with PETD at our institution. Quasi-experimental study was adopted between patients treated in an ERAS after PETD with those rehabilitated on a traditional pathway. The two groups were analyzed for LOS, operation time, complications, visual analog scale (VAS), Oswestry Dysfunction Index (ODI), hospitalization expenses (HE), and improved MacNab efficacy assessment criteria (MacNab). RESULTS: A total of 120 single segment LDH patients (ERAS pathway 60 cases, traditional care pathway 60 cases) who were selected from January 2019 to January 2021 met the inclusion criteria. There was a significant difference in mean LOS postoperative VAS scores and ODI on the 3rd day after surgery between the two groups (P < 0.05). The incidence of complications and HE were similar in the two groups (P > 0.05). The mean LOS decreased from 3.47 ± 1.14 days to 5.65 ± 1.39 days after application of ERAS pathway (P < 0.05). CONCLUSIONS: The ERAS pathway reduced LOS without resulting in additional complications after PETD. These findings support the application of the perioperative ERAS pathway in the treatment of single-level LDH with PETD. LEVEL OF EVIDENCE: Level IV, therapeutic.

Functional discovery and production technology for natural bioactive peptides / 生物工程学报

Bioactive peptides play important roles in promoting human health, such as lowering blood pressure, blood sugar and blood lipid, anti-obesity, and anti-cancer. Thus, exploring functional bioactive peptides and developing efficient production technologies are of crucial importance. Herein, we review the development of function discovery and production technology for natural bioactive peptides. Presently, the top-down and bottom-up approaches are mainly used for the function discovery and production of natural active peptides. The top-down approach includes the direct extraction and identification for functional discovery, and the direct extraction, enzymatic hydrolysis and microbial fermentation for production. The bottom-up approach includes the polypeptide modification and database mining for functional discovery, and the chemical synthesis, enzyme synthesis, recombinant expression and cell-free synthesis for production. The top-down approach is usually associated with complicated process, lower efficiency, higher cost, harder quality control, and uncertain functionality, while the bottom-up approach is more suitable for the development of peptide drugs but difficult to be used for functional foods. With the technology development of sequencing and mass spectrometry, it is easier to obtain the proteomic information of various organisms at the molecular level. Based on the proteomic information, the top-down and bottom-up approaches can be combined to overcome the disadvantages of using these two approaches alone, thus providing a new strategy for the rapid development and production of natural active peptides.

Granular cell tumor of the trunk of the facial nerve: A case report.

RATIONALE: Granular cell tumor (GCT) is a relatively uncommon, usually benign lesion that often presents as a solitary, painless cutaneous or submucosal nodule. GCTs of the head and neck are not uncommon; however, involvement of the trunk of the facial nerve is rare. PATIENT CONCERNS: A 55-year-old woman presented a lesion at the posterior border of the left parotid gland. Doppler ultrasound revealed a hypoechoic mass and magnetic resonance imaging disclosed an irregularly shaped lesion with unsharp borders in the posterior aspect of the left parotid gland that was hyperintense on T2-weighted images and enhancing with contrast on T1-weighted images. The remainder of the parotid gland was normal. DIAGNOSIS: Following excision of the mass, diagnosis of a GCT was established and confirmed by immunohistochemistry. INTERVENTIONS: The patient underwent surgical excision of the lesion. OUTCOMES: The patient is currently asymptomatic and without recurrence after 10 months follow-up. LESSONS: GCT involvement of the trunk of the facial nerve is rare. Immunohistochemical staining is helpful for its diagnosis.

Policy analysis for drug supply support reform in Sanming / 中华医院管理杂志

The paper centered on the background,objectives,key actions of the policy and the relationships between policy objectives and key policy actions.Further analysis went on to the three phases of policy implementation and phased achievements,as well as the opportunities and challenges of the policy.These efforts aim at supporting sustainable development of the drug supply support model and hospital reform stage of greater risks and challenges with policy recommendations in Sanming city.

Determination of selenium in hair by material microwave digestion-atomic fluorescence spectrometry / 中华地方病学杂志

Objective To determine the hair selenium level by material microwave digestion-atomic fluorescence spectrometry. Methods The selenium in hair was determined by hydride atomic fluorescence spectrometry after microwave digestion, and the method was improved by exploring the test conditions. The linear relationship and linear range of the standard curve, the detection limit, the precision and the accuracy of the sample determination were implemented under the optimized conditions. The selenium value of standard material of human hair was tested by material microwave digestion-atomic fluorescence spectrometry. Results The selenium detection limit of material microwave digestion-atomic fluorescence spectrometry was 0.095 μg/g, the correlation coefficient of standard curve was 0.9997, the relative standard deviation was 1.32% - 2.48%, the average recovery rate was 93.4% - 98.2%, and the selenium value of standard material of human hair was in the standard value range of uncertainty, which met the requirements. Conclusion The method is simple, accurate and precise, and it is an accurate and reliable method for determination of selenium in hair.

Application of U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture / 中华创伤骨科杂志

Objective To explore application of our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture Methods A retrospective study was done of 5 patients with femoral neck fracture who had been treated from August 2016 to March 2017.They were 3 men and 2 women,aged from 33 to 60 years (average,46.5 years).Thin layer CT scanning was conducted on the patients' affected hip (at the left side in 2 cases and at the right side in 3).Based on their CT data,3D design software and 3D printing technique were used to manufacture the U-shaped transdermal surgical navigator and a real-sized model of the fracture.Operations were simulated using the U-shaped transdermal surgical navigator on the fracture model to determine the angle,depth and location of the screwing.Fixation of the fracture with cannulated screws was conducted after confirmation of satisfactory surgical parameters.The postoperative X-ray films of the patients were reviewed.Evaluations were conducted of the screw position,operating time,volume of operative bleeding,and number of intraoperative X-ray shots.Results The screw positions in the 5 patients were consistent with their preoperative design.Four patients had only one shot of fluoroscopy and one patient 3 shots.Their operating time ranged from 15 to 30 minutes,averaging 22.5 minutes;their bleeding ranged from 5 to 10 mL,averaging 7.5 mL.The 5 patients were followed up for an average of 4.5 months (from 3 to 6 months).By the Harris scoring at their final follow-ups,one was excellent,3 good and one fair.No complications like pain,functional impairment of the joint,or collapse or necrosis of the femoral head occurred during the follow-up.Conclusions Our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design can significandy improve the accuracy and safety of the cannulated screwing for femoral neck fractures.The operation is minimally invasive,reducing operating time and intraoperative blood loss.

Effect of disinfection frequency of dispensing container on bacterial con-tamination of concentrated B solution / 中国感染控制杂志

Objective To reduce infection risk in hemodialysis patients through analyzing the causes of over stand-ard colony forming unit(CFU)and conducting bacteriological detection of hemodialysis concentrated B solution. Methods According to microbial monitoring results of hemodialysis concentrate B solution in a hospital between November 2011 and May 2012,disinfection frequency of B solution was changed and dispensing container was covered during the process of using,four groups were divided according to different measures (group A disinfected twice a week,covered dur-ing the process of using;group B twice a week;group C once a week;group D once every two weeks),monthly bacte-riological detection of B solution was conducted,condition before and after disinfection of four groups were com-pared.Results Bacterial count in group A,B ,C and D was(25.41 ±15.08),(28.24±28.04),(68.58 ±22.58), and (75.25±26.63)CFU/mL,respectively (F =79.00,P <0.01 );bacterial count of group A,B,and C after in-tervention were all lower than group D before intervention (all P <0.01),bacterial count of group A and B was the lowest.The qualified rate of group A was 100.00%,the unqualified rate of group B,C,and D was 13.95%, 24.24%,and 35.94% respectively(χ2 =28.70,P <0.01 ),the unqualified rates of group A,B,and C after inter-vention were all lower than group D.Conclusion Hemodialysis concentrated B solution should be used within 24 hours after preparing,disinfected twice a week,and covered during the process of using ,so as to control B solution colony number within the standard level.

The effect of biyuanshu oral liquid on the formation of Pseudomonas aeruginosa biofilms in vitro / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the effect of biyuanshu oral liquid on the formation of pseudomonas aeruginosa biofilms in vitro.@*METHOD@#Pseudomonas aeruginosa biofilm was established by plate culture and detected by Scanning electron microscopy and AgNO3 staining. After treated with different dosages of biyuanshu oral liquid and erythromycin, the pseudomonas aeruginosa biofilms were observed by AgNO3 staining and the number of viable bacteria were measured by serial dilution.@*RESULT@#The pseudomonas aeruginosa biofilms could be detected by SEM at the seventh culture day and it was consistent with the detection of AgNO3 staining. The biyuanshu oral liquid and erythromycin have the effect on inhibiting the formation of pseudomonas aeruginosa biofilms. But with the already formed pseudomonas aeruginosa biofilms the inhibition was not significant. The serial dilution method showed that the viable counts of bacteria of biyuanshu oral liquid and erythromycin treated groups were significantly lower than those untreated groups (P < 0.05).@*CONCLUSION@#The biyuanshu oral liquid and erythromycin can inhibit the formation of pseudomonas aeruginosa biofilms in vitro.