OBJECTIVE:To provide reference for the rational use of narcotic drugs. METHODS:The utilization of narcotic drugs for inpatients in our hospital during 2012-2014 were collected from HIS,and analyzed statistically in respects of consumption amount,consumption sum,DDDs,B/A,DDC and consumption amount of the different departments,and so on. RESULTS:The quantity and consumption amount of Morphine sulfate sustained-release tablets,Oxycodone hydrochloride sustained-release tablets and Codeine phosphate tablet ranked the first 3 places during 2012-2014. Morphine sulfate sustained-release tablets,Oxycodone hy-drochloride sustained-release tablets and Fentanyl transdermal patch(8.4 mg)steadily occupied the first 3 places in the list of con-sumption sum. In the list of DDDs,Fentanyl transdermal patch and Morphine sulfate sustained-release tablets took up the first 3 places;Morphine hydrochloride injection,Bucinnazine hydrochloride injection and Meperidine hydrochloride injection occupied the last 3 places. B/A value of Morphine sulfate sustained-release tablets and Fentanyl transdermal patch(8.4 mg) in 2012,Oxycodo-ne hydrochloride sustained-release tablets in 2014,Fentanyl transdermal patch(2.5 mg)in 2013 and 2014 were all equal to 1 and synchronized well. Others were all biased. DDC of narcotic drugs kept stable in 3 years,and DDC of Oxycodone hydrochloride sus-tained-release tablets took up the first place,followed by Fentanyl transdermal patch (8.4 mg). Narcotic drugs were consumed in 19 departments,but mainly in the department of oncology and general surgery. In the department of oncology,the consumption amount and sum of oral formulation were both significantly higher than other dosage forms,accounting for more than 88% and 52% respectively. CONCLUSIONS:The variety and dosage form of narcotic drugs could meet the clinical needs and its application is basically reasonable. Besides,the utilization of narcotic drugs in the department of oncology consistent with the basic principles of WHO three steps cancer analgesia treatments.

Fibrosis ; Humans ; Inflammation ; MicroRNAs ; Neoplasms

In the early 20th century,the term Nursing was introduced into China.In 1884,with the arrival of the first batch of missionary nurse,modern nursing initiated by Nightingale was introduced into China and greatly changed the way of care.The missionary nurses were full of enthusiasm for the spreading Gospel of Christ,the love for nursing care and the empathy for Chinese people;and encountered the lack of staff and material,the mis-understanding and resistance from the local people and other multiple tests.With the untiring effort of them and the trained local nurses,China had led the international care in nursing education and practice standard.Based on this,nursing in Shandong gradually rose and had an unprecedented development as a new medical subject.By clearing up and consulting Chinese and English historical materials,this paper reviewed the 60 years of the mission-ary nurses in China,saw the early development of nursing in our country from the budding and development of Shandong nursing and provided more insights for understanding and solving the complex problems contemporary Chinese nursing faces.

WHO has issued three editions of pathologic classification of bladder urothelial carcinoma in 1973,1999 and 2004.The 1973 version classification had been widely and the longest applied.However,WHO 2004 classification had been prevalent in past years.There were two issues in the applications of WHO 2004 classification.On one hand,there were some difficulties in quick grading in a given case.On the other hand,there were some misunderstandings in the conversion of different WHO classification.In this article,the changes of different pathologic classification of bladder urothelial carcinoma were reviewed and the outline of different pathologic classification was generalized.The criterion of all the systems was cell anaplasia.In WHO 1973 version classification,the definition of the various grades was vague.It was relatively precise in WHO 1999 classification.However,the grading of Ⅰ,Ⅱ and Ⅲ in WHO 1999 classification still remained confusions.The major changes in WHO 2004 classification was that this system divided urothelial carcinoma into low-and high-grade,which may solve the heterogenesis of grade Ⅱ in the other two classifications.

Objective To investigate the role and action mechanism of chemokine (C-X-C motif)receptor 3 (CXCR3)in hepatic ische-mia-reperfusion injury (IRI).Methods Forty-eight mice were divided into operation group and sham-operation group.The operation group was treated to establish a mouse model of IRI.Liver tissues were obtained at 3,6,12,and 24 h after IRI,with 6 mice at each time point.The expression of chemokine (C-X-C motif)ligand 9-1 1 (CXCL9-1 1 )and their receptor CXCR3 were measured by real-time PCR and Western blot.The effect of CXCR3 was blocked by its specific antagonist C6.Hepatic injury was estimated based on the activity of hepatic transaminase and morphological indices.The distribution of subsets of infiltrating T cells was analyzed by flow cytometry.All data were expressed as mean ±standard deviation.Comparison between groups was made by one-way analysis of variance.Results Compared with the sham-operation group,the operation group had significantly upregulated expression of CXCL9-1 1 and CXCR3 at all time points after IRI (P<0.05).Blocking CXCR3 significantly protected liver function and morphology (P<0.05).Antagonist C6 significantly re-duced Th1 cell infiltration (P<0.01),but significantly increased Treg infiltration (P<0.01).Conclusion CXCR3 is an ideal therapeu-tic target in IRI treatment due to its relationship with immunoregulation.

OBJECTIVE:To probe the role of responsible pharmacist on irrational medical order intervention in Pharmacy Intra-venous Admixture Service (PIVAS),and to improve rational drug use in our hospital. METHODS:501 115 medical orders from PIVAS of our hospital during Jan.-Jun. 2012 were analyzed retrospectively. Irrational medical orders of 499 189 medical orders dur-ing Jul.-Dec. 2013 were classified and summarized after the establishment of responsible pharmacists system and pharmacist inter-vention. RESULTS:The number of irrational medical orders was 918(0.183 2%),and decreased to 448(0.089 7%)after interven-tion. Irrational medical orders of solvent selection reduced from 134(0.026 7%)to 69(0.013 8%);irrational medical orders of sol-vent volume reduced from 435(0.086 8%) to 206(0.041 3%);irrational medical orders of drug dosage reduced from 241(0.048 1%)to 117(0.023 4%);irrational medical orders of drug compatibility reduced from 51(0.010 2%)to 28(0.005 6%);irrational medical orders of dosing frequency reduced from 17(0.003 4%)to 2(0.000 4%). CONCLUSIONS:What responsible pharmacists intervened in the irrational doctor’s orders of intravenous drip was effective and feasible in PIVAS,improved rational drug use and guaranteed the safety of drug use.

OBJECTIVE:To provide reference for rational use of narcotics drugs in the clinic. METHODS:A total of 5 841 prescriptions of narcotic drugs in our hospital from Jan. 2012 to Dec. 2013 were selected as subjects. The utilization of drugs was an-alyzed statistically using DDDs,DDC and DUI as index. The situation of pharmacists prescriptions dispensing was analyzed with missing rate of unqualified prescriptions as an indicator. RESULTS:7 narcotics drugs DUI≤1.00 in 2012. 9 narcotics drugs DUIs≤1.00 in 2013. The highest missing rate of unqualified prescriptions was 9.33% in the inpatient pharmacy in 2013. The amount and DDDs of Morphine hydrochloride injection,Morphine sulfate sustained-release tablet and Oxycodone sustained-release tablet all in-creased in 2013,compared to in 2012;DUI of all morphine preparation were >1.00. DUI of Codeine phosphate tablet and Bucin-nazine tablet were decreased from 1.64 and 1.11 in 2012 to 1.02 and 0.74 in 2013,tending to be reasonable. The amount and DDDs of Sulfentanyl injection,Remifentanil injection and Fentanyl patch all in 2013,compared to in 2012. CONCLUSIONS:The utilization of narcotics drugs in our hospital basically tend to be rational,but still many deficiencies exist. We should strengthen in-tervention and management on the the utilization of narcotic drugs further.

Objective:To construct an integrated medical care service mode in hemodialysis and explore the application effect of the concept of integrated medical service in hemodialysis patients.Methods:In 2016,100 patients who had regular hemodialysis(lasting for more than 3 months) were selected from July to Septembe ras the control group,while another100 patients who had the regular hemo dialysis (lasting for more than 3 months) and received the concept of integrated medical care service were selected from October to December as the observation group.The treatment compliance,the incidence of hemodialysis complications,and patient satisfaction of twogroups were compared.Results:Both the treatment compliance and patient satisfaction of the participants in the observation group were significantly higher than those in the control group (P ＜ 0.05),while the incidence of hemodialysis complications in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion:The implementation of integrated medical careservice concept can fully deepen the service concept of people-oriented and patient-centered,carry out humanized services,improve the treatment compliance of hemodialysis patients,reduce the complications,promote the cooperation of doctors and nurses,enhance the effect of health education,and improve the patient satisfaction.

Objective To observe brain functional activity of patients with arrhythmia after radiofrequency ablation with amplitude of low-frequency fluctuation (ALFF).Methods Twenty-six patients with anxiety disorder after radiofrequency catheter ablation (RFCA) were included as RFCA group.Age and sex matched twenty-six healthy volunteers were included as control group.The difference of ALFF between the two groups was analyzed by two-sample t test.Partial correlation between extracted values from dysfunctional brain regions and hamilton anxiety scale (HAMA) scores were investigated.Results Compared with control group,ALFF of left middle temporal gyrus,right putamen,left amygdala significantly increased,and left dorsolateral prefrontal cortex (DLPFC),right praecuneus,left middle frontal gyrus and right middle occipital gyus significantly decreased in RFCA group (Alphasim correction,P＜0.01).ALFF values of left DLPFC were negatively correlated with HAMA scores (r=-0.872,P=0.013).Conclusion The brain activity of RFCA patients in resting state is abnormal.ALFF can provide more evidences for the pathogenesis of the disease.

Objective:To explore the effects of quality control circle(QCC) on the complaint management and patient satisfaction in the medical insurance center.Methods:We set up QCC,defined the subject,identified the problems and made the cause analysis,made the countermeasures and implemented them.Results:Mter QCC ac-tivities,patients'major unsatisfactory factors such as long waiting time and poor staff coordination ability were signif-icantly improved.In addition,patient complaints decreased significantly (P ＜ 0.01).Conclusion:The application of QCC management on patient complaints can not only increase patient satisfaction,but also provide an importantway for the hospital to build up the brand.