【摘要】 目的 探討慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）治療方案及藥學監護的內容。 方法 以2007年12月收治的1例COPD患者為例，結合COPD治療指南，為COPD急性加重期患者制定個體化的藥學監護計劃并實施全程的藥學監護。 結果 患者COPD急性加重期的藥物治療方案有效合理。通過全程的藥學監護，及時發現和解決了患者藥物治療的問題，為臨床合理用藥提供了意見。 結論 對COPD患者實施藥學監護具有可行性和實用性。【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 探討臨床藥師在支氣管哮喘住院患者的藥學監護作用。 方法 臨床藥師在呼吸科參與具體藥物治療的1例支氣管哮喘住院患者藥學監護過程進行分析總結。 結果 臨床藥師通過全程的藥學監護，及時發現并解決相關藥物治療問題，為臨床提供合理建議，加強了患者用藥的安全性。 結論 臨床藥師實施藥學監護對患者個體化治療具有極其重要的意義。
【摘要】 目的 驗證臨床藥師對我院中藥注射劑合理使用進行干預的效果。 方法 對比分析2010年臨床藥師干預前后中藥注射劑的合理使用情況，隨機抽取2010年1-6月合格病歷1 000份，設為非干預組；隨機抽取2010年9月-2011年2月合格病歷1 000份，設為干預組；評估臨床藥師的干預作用。 結果 非干預組中藥注射劑的使用率為31.10%，干預組為19.00%，差異有統計學意義（χ2=38.991，P=0.000）；非干預組適應證不合理的為6.00%，干預組為2.10%，差異有統計學意義（χ2=19.570，P=0.000）；非干預組發生不良反應15例，干預組發生3例，兩組不良反應發生率差異有統計學意義（χ2=8.073，P=0.004）；中藥注射劑的用法用量趨于規范。 結論 臨床藥師對中藥注射劑臨床使用的干預行之有效，對促進醫院安全、有效、合理使用中藥注射劑起到了積極作用。【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 分析都江堰市人民醫院藥品不良反應（ADR）的發生情況及引發ADR的相關因素，為臨床合理用藥及正確評價ADR的發生提供參考。 方法 對醫院2009年1月－2011年12月收集上報至全國ADR監測網絡的168例ADR報告，進行回顧性分類與統計分析。 結果 ADR報告例數最多的為臨床科室，男女病例數比為0.87∶1，靜脈給藥途徑引發的ADR最多（占77.98%）；抗感染藥物的ADR發生率最高（占61.90%）；皮膚及其附件損害最常見占（27.98%）。 結論 抗感染藥物和中藥注射劑是ADR監測的重點藥物，應加強ADR監測及相關知識的宣傳，提高合理用藥水平，減少藥源性疾病的發生。
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.