【摘要】 目的 探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）治疗方案及药学监护的内容。 方法 以2007年12月收治的1例COPD患者为例，结合COPD治疗指南，为COPD急性加重期患者制定个体化的药学监护计划并实施全程的药学监护。 结果 患者COPD急性加重期的药物治疗方案有效合理。通过全程的药学监护，及时发现和解决了患者药物治疗的问题，为临床合理用药提供了意见。 结论 对COPD患者实施药学监护具有可行性和实用性。【Abstract】 Objective To investigate the treatment and pharmaceutical care for chronic obstructive pulmonary disease (COPD) patients. Methods In December 2007, a patient with COPD was diagnosed, and based on the clinical data, COPD treatment guidelines were adopted to analyze treatment plans. For patients with acute exacerbation of COPD, individualized pharmaceutical care plan was proposed, and pharmaceutical care was performed during the whole course of disease. Results The drug treatment for the one patient with acute exacerbation of COPD was effective and reasonable. Treatment problems were observed and solved through pharmaceutical care which had given reasonable suggestions for medication. Conclusion The implementation of pharmaceutical care for COPD patients is feasible and practical.
目的 探讨临床药师在支气管哮喘住院患者的药学监护作用。 方法 临床药师在呼吸科参与具体药物治疗的1例支气管哮喘住院患者药学监护过程进行分析总结。 结果 临床药师通过全程的药学监护，及时发现并解决相关药物治疗问题，为临床提供合理建议，加强了患者用药的安全性。 结论 临床药师实施药学监护对患者个体化治疗具有极其重要的意义。
【摘要】 目的 验证临床药师对我院中药注射剂合理使用进行干预的效果。 方法 对比分析2010年临床药师干预前后中药注射剂的合理使用情况，随机抽取2010年1-6月合格病历1 000份，设为非干预组；随机抽取2010年9月-2011年2月合格病历1 000份，设为干预组；评估临床药师的干预作用。 结果 非干预组中药注射剂的使用率为31.10%，干预组为19.00%，差异有统计学意义（χ2=38.991，P=0.000）；非干预组适应证不合理的为6.00%，干预组为2.10%，差异有统计学意义（χ2=19.570，P=0.000）；非干预组发生不良反应15例，干预组发生3例，两组不良反应发生率差异有统计学意义（χ2=8.073，P=0.004）；中药注射剂的用法用量趋于规范。 结论 临床药师对中药注射剂临床使用的干预行之有效，对促进医院安全、有效、合理使用中药注射剂起到了积极作用。【Abstract】 Objective To explore the effects of clinical pharmacists intervention on traditional chinese medicine injection. Methods Compared the rational usage of traditional Chinese medicine injection in 2010 after the intervention of clinical pharmacists. A total of 1 000 clinical case records from January to June 2010 were randomly selected and was named as the non-intervention group; another 1 000 clinical case records from September 2010 to February 2011 were randomly selected and was named as the intervention group. The effect of the clinical pharmacists were evaluated. Results The utilization rate of the Chinese medicine injection was 31.10% in non-intervention group and 19.00% in the intervention group with a significant difference between the two groups (χ2=38.991，P=0.000). The irrationality of indication was 6.00% in non-intervention group and 2.10 in the intervention group with a significant difference between the two groups （χ2=19.570，P=0.000）. The adverse reaction was found in 15 patients in non-intervention group and in three patients in the intervention group with a significant difference between the two groups（χ2=8.073，P=0.004）. The usage and dosage of Chinese traditional medicine injection was tend to be normative. Conclusion The intervention on traditional Chinese medicine injection by clinical pharmacists is effective, which is a important part in promoting the rational use of traditional Chinese medicine injection.
目的 分析都江堰市人民医院药品不良反应（ADR）的发生情况及引发ADR的相关因素，为临床合理用药及正确评价ADR的发生提供参考。 方法 对医院2009年1月－2011年12月收集上报至全国ADR监测网络的168例ADR报告，进行回顾性分类与统计分析。 结果 ADR报告例数最多的为临床科室，男女病例数比为0.87∶1，静脉给药途径引发的ADR最多（占77.98%）；抗感染药物的ADR发生率最高（占61.90%）；皮肤及其附件损害最常见占（27.98%）。 结论 抗感染药物和中药注射剂是ADR监测的重点药物，应加强ADR监测及相关知识的宣传，提高合理用药水平，减少药源性疾病的发生。
ObjectiveTo explore the application of the dorsal foot hexagonal flap for reconstruction of the web space in the fourth and fifth toe syndactyly combined with polydactyly.MethodsBetween May 2016 and October 2019, 27 patients (34 feet) with the fourth and fifth toe syndactyly combined with polydactyly were treated, including 12 males and 15 females with an average age of 22.8 months (range, 10 months to 8 years). There were 7 bilateral feet and 20 unilateral foot. Twenty-four of which were incomplete and 10 were complete syndactyly of the fourth and fifth toes, and the fifth toes showed various degrees of fibular deflection. All the 34 feet were treated with one-stage reconstruction of the toe web with the dorsal foot hexagonal flap, and the correction of the fibular deviation of the fifth toe was made by removing the tibial polydactyly and using the articular surface dressing or wedge osteotomy.ResultsAll wounds healed by first intention without skin-frafting. All patients were followed up 6-36 months (mean, 18 months). There was no flexion contracture and obvious scar hyperplasia in all the patients, and the width and slope of the toe webs were normal. Three of the 34 webs developed web creep, and the rest of the toe webs were normal in depth. All 34 feet were corrected with peroneal fibular deviation, and the function of toe flexion was good. All parents of the children were satisfied with the outcome.ConclusionThe reconstruction of toe webs with dorsal foot hexagonal flaps for the treatment of the fourth and fifth toes syndactyly combined with polydactyly requires no skin graft. The operation is simple with high survival rate of the flap, the appearance and function of the toes are good, and the effectiveness is satisfactory.
Objective To explore the best centrifuge condition for preparing rabbit leukocyte-poor platelet-rich plasma (LP-PRP) by using single centrifugation method. Methods Sixteen healthy New Zealand rabbits, aged 3-4 months, were utilized in the investigation. A total of 15 mL anticoagulated blood was extracted from the central ear artery of each rabbit, with a repeat of the blood collection procedure after 1 and 2 months. The obtained blood specimens were individually subjected to centrifugation at a radius of 16.7 cm and speeds of 1 200, 1 300, 1 400, and 1 500 r/min (equivalent to centrifugal forces of 269×g, 315×g, 365×g, and 420×g) for durations of 2, 3, 4, and 5 minutes, resulting in a total of 16 groups. Following centrifugation, collect plasma from each group to a distance of 1.5 mL from the separation plane. The volumes, platelet enrichment coefficient, and platelet recovery rates of LP-PRP in each group, under varying centrifugation conditions, were methodically computed and subsequently compared. Results The volume of LP-PRP obtained under all centrifugation conditions ranged from 1.8 to 7.6 mL. At a consistent centrifugal speed, an extension of centrifugation time leaded to a significant increase in the volume of LP-PRP, accompanied by a declining trend in the platelet enrichment coefficient of LP-PRP. When centrifuged for 2 minutes, the volume of LP-PRP at speeds of 1 200 and 1 300 r/min was less than 2.0 mL, while the volume of LP-PRP obtained under other conditions was more than 2.0 mL. When centrifuged for 4 and 5 minutes, the volume of LP-PRP obtained at each speed was more than 4 mL. LP-PRP with a platelet enrichment coefficient more than 2.0 could be prepared by centrifuging at 1 200 r/min for each time group and 1 300 r/min for 2 and 3 minutes, and the highest LP-PRP platelet enrichment coefficient could be obtained by centrifugation for 2 minutes at a speed of 1 200 r/min. The platelet recovery rates of LP-PRP obtained by centrifugation at 1 200 r/min for 4 and 5 minutes, as well as centrifugation at 1 400 r/min for 5 minutes, were both greater than 60%. There was no significant difference between the groups when centrifuged at 1 200 r/min for 4 and 5 minutes (P>0.05). Conclusion In the process of preparing rabbit LP-PRP using a single centrifugation method, collecting 15 mL of blood and centrifuging at a radius of 16.7 cm and speed of 1 200 r/min for 4 minutes can prepare LP-PRP with a volume exceeding 2.0 mL, platelet enrichment coefficient exceeding 2.0, and platelet recovery rate exceeding 60%. This centrifugal condition can achieve the optimal LP-PRP action parameters in the shortest possible time.