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Research Progress on Exercise Prescription: A Systematic Review

Objective　In order to improve the standing on the studies of Exercise Prescription (EP), a systematic review was conducted to provide reference and theory for further studies. Methods　A broad computerized literature search of Medlin via Ovid, PubMed in all fields, Sport Discus, CINAHL, CAM, EMbase, EBM Cochrane Database of SR, and Web of Science was carried out till June 2008. Firstly, four categorical searches were conducted with the following keywords for searches: Exercise Prescription, Physical Fitness, Exercise Therapy, Fitness Assessment, Exercise Test and RCTs, and the searched results were checked by reviewers and duplicate results were removed. Then all titles were manually searched for potential inclusion in the review. Articles retrieved, review articles were examined for further relevant references. Results　There were 318 relevant articles, however, the RCTs were only 7, and systematic review and meta-analysis were only one, respectively. Considering the importance and reference values there were 93 articles were included. 1970s was the developing age of EP; 1980s more specific EP were provided for many purposes; 1990s with the techniques developing of physical fitness, exercise therapy, fitness assessment and exercise test, EP for treating and rehabilitating more chronics and civilizing diseases were developed; 2000s the RCTs and CCTs were applied in the EP studies. Conclusions　The developing of EP has close relationship with the developing of physical fitness, exercise therapy, fitness assessment, and exercise test. Although the RCTs researches in this field were limited, most of them were positive to support the advantage of EP. How to highly improve the advantages and greatly decrease the risk of EP is still valuable to study in the future.

Analysis of Narcotic Drugs Prescription for the Outpatients

【摘要】　目的　分析宜宾市第二人民医院2009年门、急诊麻醉药品的使用情况，促进麻醉药品使用的合理化和规范化。　方法　对2009年门急诊1 420张麻醉药品处方进行统计，统计处方总数，麻醉药品临床使用分布情况，根据药品分类分别统计麻醉药品的用药总量，各种麻醉药品的处方所占的比例，实际用药总天数等。对非癌症处方以用药频率及药物利用指数（DUI）为指标，癌症处方以用药天数及平均日用药量为指标进行进行统计、分析、评价。　结果　门急诊的麻醉药品有8种，盐酸吗啡缓释片的总用量居首位，盐酸哌替啶针在急诊处方中出现频率较高，芬太尼透皮贴剂的用药频度较小，药物利用指数均≤1。　结论　宜宾市第二人民医院的急诊麻醉药品使用基本合理。A total of 1 420 pieces of narcotic drugs prescriptions for the outpatient in our hospital in 2009 were extracted. The total number of prescriptions, the distribution of the clinical use of narcotic drugs, the total amount of narcotic drugs according to different types, the proportion of each kind of narcotic drug prescription and the actual number of medication durations were counted and analyzed. Defined daily dose (DDD) and drug use index (DUI) of the non-cancer drugs prescription; meanwhile, the number of drug-using days and average daily amount of cancer drug prescription were statistically analyzed.　Results　There were eight kinds of narcotic drugs for the outpatients. The most total amount of narcotic drugs was morphine hydrochloride sustained release tablets; the medication frequency of pethidine injection in the emergency prescription was high and the medication frequency of transdermal fentanyl was low. The narcotic drugs utilization index was lower than one.　Conclusion　The use of narcotic drugs in our hospital is rational.

门诊儿科处方不合理用药的调查与分析

【摘要】　目的　了解分析门诊儿科处方用药情况，促进合理用药。　方法　随机抽取2009年1-12月的门诊儿科处方10 800张，根据《医院处方点评管理规范（试行）》及文献资料，对不合理用药处方进行分类和统计。　结果　不合理用药主要表现为遴选的药品不适宜，药物联用不适宜，溶媒不合理，用法、用量不适宜等。　结论　儿科医师应更好地掌握药物相关知识，提高门诊儿科处方的合理用药水平。

加强门急诊药师培训提高处方交待的准确性

摘要:处方交待是医院药学人员开展药学服务的主要形式,其提供给患者的科学性、通俗性,直接影响到患者用药的依从性和用药的有效性。本文就我院对门急诊药师培训的一系列内容进行总结。目的是提高药师解释医嘱的能力,让药师更好地指导患者合理使用和正确服用药物,使药物发挥应有的作用。

Survey on Rational Use of Drug in Different Ranks of Hospitals in Sichuan Province

Objective　To investigate the awareness of rational use of drug (RUD) on medical workers in hospitals of different ranks, the establishment and execution of relevant strategies in hospitals of different ranks, and the main factors affecting RUD on medical workers, so as to provide references for the generalization of RUD. Methods　A certain number of different ranks of hospitals in Chengdu and Zigong were randomly selected by the convenience sample method. Medical workers in each hospital were selected through face-to-face interviews with a self-designed questionnaire. Monte Carlo Chi-square analysis was applied on the hospital ranks and formulation of RUD guidelines, and logistic regression analysis was performed on the awareness of RUD knowledge of the respondents. Results　Among 700 questionnaires distributed, 672 were retrieved (response rate 96.0%). The numbers of respondents who were familiar with the Pharmaceutical Affairs Councils (PACs) as well as the Pharmacy and Therapeutics Committees (PTCs) were 217 (32.29%) and 83 (12.35%), respectively. The number of respondents who understood the concept of essential medicine was 502 (74.71%). A total of 441 (61.16%) medical workers had been trained on RUD, 199 (29.61%) medical workers denied there were PTCs in their hospitals, and 60.71% of the medical workers mentioned that the use of drug was monitored and controlled with the feedback in their hospitals. The result of logistic regression analysis indicated that the professional title (P=0.038), awareness of essential medicine (Plt;0.001) and participation of RUD training (P=0.008) were the factors influencing the awareness of RUD. Conclusion　Both management and education should be executed at the same time to elevate the level of rational use of drug. In order to increase the level of RUD we should complete monitoring institution and improving RUD awareness of workers. Additionally enhancing the rationality of medication should be performed by establishing guidelines of treatment or medication. Improving personal knowledge, scientific information and medication custom should be performed by standardizing regulations, strengthening management, emphasizing education and promoting communication between doctors and patients.

The Effect of Using “Education Prescription” in the Evidence Retrieval Teaching Practice

Objective　To observing about how effect is the education prescription using by the medical students, looking into whether the manner can attach the students attention and improve on the retrieval ability for them. Methods　Choosing one of the cases come from PubMed and drawing out a clinical question. Asking total 100 students to search literature and write search strategy, search results and the reason about the results by chosen (similar to appraisal evidence), and their self-evaluation of this process. Results　Of the 100 students, 96 (96%) searched PubMed/MEDLINE, and 79 (79%) searched second research database, 28 (28%) searched Science Citation Index (Web of Science), 38 (38%) chosen one of ten articles according with the articles chosen by the overseas doctors. We found no students weren’t interesting in the education prescription, but 65 (65%) didn’t think the education prescription be easy achieved, at the same time they mentioned that the retrieval problems were solved or profited came from the practice. Conclusions　Filling education prescription can attract students attention and induct them to learn the basic concept of EBM, and to practice how to searching evidence and the feedback of students can help improve on teaching work.

Injection Overuse Situation in Health Service Settings in Rural Area of Midwest Part of China

Objective　To explore the serious situation of injection abuse, and its influence to average prescription fee. Methods　The subjects of this study were health service settings in rural area of 9 provinces/cities in Midwest of China. The treatment prescription indicators of county and village health service settings were calculated. Results　Prescription injection rates of health care facility in rural area of Midwest provinces/cities of China (25.8% to 62.2%,mean: 45.1%) were higher than the standard of WHO (13.4% to 24.1%), and the injection abuse situation was serious. Injection bause caused the increase of prescription fee. Excess usage of injection in health service settings was related to the economic level of the on-site county or village, and also related to the size and load of health service facilities. Conclusion　Suggestions are proposed to the government health agency according to the results of the study: enhancing the lawmaking, establishing the related policy and effective measure, training the medical personnel, promoting the mass health education, investigating the effective injection management model in rural area, and reducing the rate of injection.

History of Drug Treatments Including Formularies,Current Situation and Strategy

麻醉药品管理改进的探索与实践

目的　改进麻醉药品管理措施，促进此类药品的管理。 方法　于2011年5月开始对麻醉科进行电子麻醉区域单元设置，建立夜间存放单个毒麻药盒的药柜，麻醉科主任参与医嘱和处方的点评和管理。记录改进前后每日每名药品管理护士所花时间、毒麻药盒入柜数、不合格处方数，并行统计学分析。 结果　每日每名护士药品管理时间改进前为（6.88 ± 2.10） h，改进后为（5.62 ± 2.31） h，比较有统计学意义（t=9.354，P=0.000）；66个毒麻药盒夜间入柜率改进前80%，改进后达100%，比较有统计学意义（χ2=12.29，P＜0.05）；不合格红处方发生率改进前4.8%，改进后发生率0.8%，比较有统计学意义（χ2=5.95，P＜0.05）。 结论　全面系统地进行麻醉药品管理，能够及时满足手术患者的麻醉需求，确保麻醉药品的安全和质量。

医院常见不合理用药处方点评及防范

【摘要】　目的　对处方用药状况进行调查和点评，充分掌握临床容易出现的不合理处方，提醒药师、医师引起注意，减少不合理用药，提高合理用药水平，确保患者用药安全。　方法　对照《处方管理办法》、《医院处方点评管理规定管理（试行）》，收集崇州市人民医院2010年2-7月门诊、病区各科室不合理处方，结合药品说明书以及药师查阅的相关文献资料，对其不合理处方进行点评。　结果　不合理处方包括遴选的药品不适宜、适应证不适宜、用法用量不适宜、联合用药不适宜、重复给药、超常处方。　结论　合理用药不仅涉及药师、医师，同时涉及护士和患者。只有多方面参与，建立合理用药监督机制，努力开展临床药学监护，才能够提高合理用药水平，减少不合理用药现象的发生。