OBJECTIVE: To establish a controllable management system for clinical pharmacy so as to ensure its quality.METHODS: The clinical pharmacy work was programmed by applying classical PDCA management.RESULTS: By using PDCA cycle,the working system and standards for clinical pharmacists were able to be set up and the performance of clinical pharmacists could be evaluated so as to be preliminarily approved by the clinic.CONCLUSION: The PDCA management can be applied in the clinical pharmacy as well as in the management of hospital pharmacy.

Biomarkers ; Disease Susceptibility ; Humans ; Pneumoconiosis ; etiology

Adolescent ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Cord ; pathology ; Spinal Cord Injuries ; diagnosis ; diagnostic imaging ; etiology ; pathology ; Spine ; diagnostic imaging ; Tomography, X-Ray Computed

Because of lots of ethical problems,military medical triage has been unaccepted by general doctors.But it's adopted by American Army in front of facts of the war.The main principles of the military medical triage are justice and efficiency.They practice the military medical triage through tow steps.First,all patients are assigned into urgent,immediate ,delayed,minimal or ambulatory and expectant status in decreasing order of medical urgency.Second,choosing the model of triage depends on nonaustere,austere or extreme conditions.The ethical issues of American military medical triage focus on four aspects - how to deal with minimally injured patient treatment first,how to treat expectants,how to care for noncombatant casualties and who decide the model of triage.

Humans ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal

Anti-Bacterial Agents ; poisoning ; Education, Veterinary ; Ethers ; poisoning ; Veterinary Drugs ; poisoning

After summing up the experience of recent years' clinic teaching, ICU department in Fangcun Branch of Second Clinical Medical College of Guangzhou University of TCM comes to a conclusion that, the clinical teaching of ICU should pay attention to and ensure effective implementation of beginning educationg. And following the PDCA method (Plan, Do, Check & Act) will make the work orderly, normative and controllable and meanwhile raise the students' observing and analysis ability as well as their operation and doctor-patient communication ability. In this way we can mostly enhance the effect of teaching.

Objective To investigate the risk factor profile of pneumonia caused by pandrug-resistant Acinetobacter baumannii (PDRAB)in intensive care unit for better distinction between PDRAB infection and colonization.Methods The clinical data of 99 patients diagnosed as A.baumannii pneumonia between February 2009 and March 2012 in Fangcun Hospital,a branch of Guangdong Provincial Hospital of Traditional Chinese Medicine,were reviewed and analyzed retrospectively.The risk factors associated with pandrug-resistance in A.baumannii were examined with multivariate logistic regression analysis.Results ICU stay,duration of invasive ventilation,longer duration of treatment with carbapenems,beta-lactam/beta-lactamase inhibitor,or quinolone antibiotics,use of ≥3 classes of antimicrobial agents,≥3 invasive procedures (including indwelling gastric canal, catheterization,central venous catheter,arterial sheath),and fiberoptic bronchoscopic treatment were associated with PDRAB pneumonia (P <0.05).Multivariate logistic regression analysis showed that use of ≥3 classes of antibiotics,fiberoptic bron-choscopic treatment,and longer duration of treatment with beta-lactam/beta-lactamase inhibitor were independent risk factors predicting the emergence of PDRAB pneumonia.Conclusions We should pay more attention to these risk factors in clinical prac-tice for better differentiation between PDRAB infection and colonization so that appropriate control measures can be taken pro-actively.

Objective To investigate the clinical results of limited exposure and indirect reduction in treatment of tibial plateau fractures. Methods 41 cases of tibial plateau fractures were treated with limited exposure and indirect reduction. According to Schatzker classification, there were 6 cases of type Ⅰ, 13 type Ⅱ, 11 type Ⅲ, 6 type Ⅳ, 3 type Ⅴand 2 type Ⅵ. Type I fractures were reduced in the close manner by applying large reduction forceps and fixed with percutaneous lag screws. Type Ⅱ, type Ⅲand Type Ⅳfractures were reduced by applying large reduction forceps and fixed by percutaneous plating after restoring joint surface and bone grafting. Type Ⅴand Type Ⅵfractures were reduced by applying fracture distracter and large reduction forceps before they were fixed with percutaneous plating. The clinical outcomes were assessed according to Rasmussens system. Results 36 patients were followed up from 6 to 60 months, with an average of 30.2 months. No deep vein thrombosis, infection, or compartment syndrome was found postoperatively. All the 36 fractures united. Overall, 25 (69%) patients were rated as excellent, 8 (22%) good, and 3 (9%) fair. Conclusion In treatment of tibial plateau fracture, limited exposure and indirect reduction has advantages of less dissection, stable fixation, early movement, better joint function and fewer complications.

Objective To discuss the feasibility,indications,surgical techniques,and outcome con- cerning the application of less invasive stabilization system (LISS) for complex proximal femoral fractures.Methods We treated 12 complex proximal femoral fractures using femoral LISS reversely from June 2005 to May 2006. They were five complex intertrochanteric fractures and seven subtrochanteric ones.By AO classification,two were type 31-A2.2,two type 31-A2.3,one type 31-A3.3,one type 32-A3.1,three type 32-B1.1,one type 32-B2.1, and two type 32-B3.I.The patients were treated with closed or indirect reduction and fixation with percutaneous LISS plate reversely.Results There were no major postoperative complications in this study.The mean operation time was 65 minutes (range,50 to 90 minutes),the mean intra-operative blood loss was 142 milliliters (range,50 to 400 milliliters),and the mean postoperative hospital stay was 9.3 days (range,6 to 15 days).All patients had a clinical follow-up;the mean follow-up time was 7.2 months (range,3 to 14 months).Ten cases healed clinically three months postoperatively,one periprosthetic fracture healed four months and one pathological fracture healed six months after operation.At the final radiographic follow-up,no collapse,varus deformity,cutting-out,hardware failure,or avascular necrosis was found.Conclusions Femoral LISS used reversely can provide secure fixation for proximal femoral fractures biomechanically and anatomically.It is also easy and safe.It is particularly suitable for old patients with intertrochanteric fractures complicated with disorders of internal organs and severe osteoporosis or patients with complex proximal femoral fractures.It is important to be skillful in indirect reduction and positioning of guide wire into hole A,and to avoid immediate weight-bearing postoperatively.