【摘要】 目的 评价临床心血管系统药物的利用情况与趋势。 方法 利用excel表格对四川省建筑医院2008年1月－2010年12月全部心血管系统药物处方的种类、销售金额、用药频度值（DDDs）等进行统计分析。 结果 3年中，心血管系统药物的销售金额呈逐年上升趋势。在销售金额和DDDs的前10名排名中主要包括钙通道阻滞类药物、调血脂药物和中成药等。 结论 临床心血管系统药物应用基本合理，对于疗效显著、不良反应轻微、价格合理的药物患者依从性好，临床使用广泛。【Abstract】 Objective To investigate the use of cardiovascular drugs in our hospital (Sichuan Architecture Hospital) from 2008 to 2010, and evaluate its future tendency. Methods Excel was used to analyze the variety, consumption, defined daily dose (DDDs) of cardiovascular drugs used during 2008 to 2010 statistically in our hospital. Results During these three years, the consumption of cardiovascular drugs increased from year to year. The calcium channel blockers, lipid-modulating drugs and traditional Chinese medicines ranked high in the sum and DDDs column in Excel. Conclusion The use of cardiovascular drugs is rational in our hospital. The safe and effective drugs with reasonable price and better compliance are widely applied.
目的:評价益生菌在预防和治疗儿童喘息性疾病中的效果。方法:将393例喘息性疾病患儿分为观察组206例,对照组187例,对照组187例常规治疗,观察组206例在对照组187例常规治疗的基础上给予口服双歧杆菌三联活菌肠溶胶囊。结果:观察组治愈时间明显少于对照组,两组比较差异有显著性(Plt;005),观察组总复发率为342%,对照组总复发率为433%,两组比较差异有显著性(Plt;005)。结论:添加益生菌对预防和治疗儿童喘息性疾有积极的效果。
Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.
Objective To assess the effectiveness and safety of autologous stem cell transplantation after high-dose chemotherapy in first-line treatment of follicular lymphoma. Method Randomized controlled trials (RCTs) of autologous stem cell transplantation after high-dose chemotherapy in first-line treatment of follicular lymphoma were collected from MEDLINE (1990-2009), EMBASE (1990-2009), OVID (1990-2009), and the Cochrane Library (Issue 2, 2009), and the proceedings of ASH were searched manually. The methodological quality of included studies was evaluated, and data analysis was performed with software STATA 10.0 and RevMan 4.3. Result A total of 4 RCTs involving 941 patients were included. The results of meta-analysis showed that overall survival rate (HR=0.82, 95%CI 0.49 to 1.15), event-free survival rate (HR=0.35, 95%CI 0.24 to 0.47), total remission rate (RR=0.35, 95%CI 0.96 to 1.30), and secondary malignant tumor incidence rate (RR=1.68, 95%CI 0.47 to 6.07). Conclusion According to the present evidences, autologous stem cell transplantation after high-dose chemotherapy can not improve overall survival rate and total remission rate, but can improve event-free survival rate, and do not increase secondary malignant tumor incidence rate. However, more high-quality, multiple-center, large-sample randomized controlled trials are required.
Objective To systematically search for evidence related to the prevention and management of kinesiophobia in patients undergoing total knee arthroplasty at home and abroad, evaluate and integrate the evidence, and to provide reference for clinical nursing practice. Methods Domestic and international evidence-based resource databases, including UpToDate, BMJ (British Medical Journal) Best Practice, National Institute for Health and Clinical Excellence guidelines network, JBI (Joanna Briggs Institute) evidence-based healthcare center database, Cochrane Library, Registered Nurses’ Association of Ontario website, China guidelines network, Web of Science, PubMed, SinoMed, China National Knowledge Infrastructure, and Wanfang were searched. Evidence related to the prevention and management of kinesiophobia after total knee arthroplasty was collected, and the search period was until June 30, 2023. The evidence extraction and integration were conducted on the literature that meets the requirements. Results A total of 10 papers were ultimately included, including 1 guideline, 1 expert consensus, 2 systematic evaluations, 4 randomized controlled studies, and 2 cohort studies. A total of 17 pieces of evidence were extracted from 5 aspects, including risk assessment, health education, intraoperative pain management, rehabilitation exercise, and patient participation. Conclusion The prevention and management of kinesiphobia after total knee arthroplasty include evidence from multiple aspects, which can provide evidence-based basis for orthopedic and rehabilitation medical staff to develop intervention plans for kinesiphobia and promote rapid recovery of patients with total knee arthroplasty.
Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.
Objective To explore the efficacy of endovascular therapy in elderly patients with acute ischemic stroke. Methods The acute ischemic stroke patients who received endovascular therapy between January 2020 and January 2023 were retrospectively enrolled. According to age, patients were divided into the elderly group (≥ 80 years old) and other age groups (<80 years old). The baseline data, green channel data, nerve function deficit, recanalization and complication information were collected, and the patients were followed up. Modified Rankin Scale (mRS) was used to evaluate patients prognosis at 3 months after onset. Score less than or equal to 2 points was defined as good prognosis and over 2 points was defined as poor prognosis. Results A total of 138 patients were included, and 7 patients were lost to follow-up. Finally, 131 patients were included. Among them, there were 50 cases in the elderly group and 81 cases in the other age group. There were statistically significant differences in age, hypertension, atrial fibrillation, and vascular recanalization between the elderly group and the other age group (P<0.05). There was no statistically significant difference in the other baseline data, complications, 3-month prognosis, or mortality between the two groups (P>0.05). The results of multivariate logistic regression analysis showed that the National Institute of Health Stroke Scale score at admission [odds ratio (OR)=1.150, 95% confidence interval (CI) (1.033, 1.281), P=0.011], pulmonary infection [OR=2.933, 95%CI (1.109, 7.758), P=0.030], and hypoproteinemia [OR=3.716, 95%CI (1.226, 11.264), P=0.020] affected the mRS score at 3 months after onset. Conclusions Among the patients with acute ischemic stroke undergoing endovascular therapy, there is no difference in the occurrence of complications or short-term prognosis between elderly patients and other age patients. However, the attention should still be paid to reducing the occurrence of complications in patients, strengthening their nutritional support, and thereby improving their prognosis.