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

Objective: To research the protective effects of different extracts from Compound Houttuyniae Herba (CHH) and its mechanism through JAK/STAT-SOCS-1 signaling pathway. Methods: The normal group comprised db/m mice (n = 8). db/db mice were randomly divided into seven groups with eight mice in each group according to the applied treatment method: model group, metformin hydrochloride (MH) group, AG490 group, water extract (WE) group, ethanol extract (EE) group, volatile oil (VO) group, and mixture (MG) group (mixture of above three extract) of CHH. After 8 weeks, the general status, biochemical indicators, and renal histological changes in the mice were evaluated, the total RNA and protein were collected and RT-PCR method was used to examine the effect on mRNA expression of JAK2, STAT3, SOCS1, and Western blot method was used to detect the protein expression of JAK2, P-JAK2, STAT3, P-STAT3, SOCS1, c-fos, and c-jun. Immunofluorescence was used to observe the protein expression of c-fos and c-jun in kidney tissue. Results: Compared with normal group, the serum level of TGF-β1, FN of EE, VO, and MG groups were decreased (P < 0.05). Renal function was also improved but not significantly. Also, the renal histology was improved especially in the mixture group. The protein expression of JAK2, STAT3, P-JAK2, P-STAT3, and the genetic expression of JAK2 and STAT3 in kidney tissue were significantly increased in the model group (P < 0.05). Compared with the model group, the expression of P-JAK2 and P-STAT3 was down-regulated in treatment groups; The expression of SOCS-1 of VO and mixture groups were elevated (P < 0.05). Conclusion: CHH has beneficial effects on diabetic renal injury, which may protect and improve the kidney function and reduce urinary protein, maintain the integrity of the kidney structure and function.

Objective Houttuynia cordata Thunb and Fructus Arctii are two traditional Chinese medicine (TCM) compounds widely used for reducing heat and toxins in the body. In addition, Fructus Arctii has been used in clinical therapy for diabetic nephropathy. On the basis of the TCM theory of heat in diabetes mellitus and the clinical efficacy of Fructus Arctii, the two compounds were used to develop a formula named Compound Herba Houttuyniae. This study evaluated the renoprotective effects of different Compound Herba Houttuyniae extracts and assessed their mechanisms through the Janus kinase/signal transducer and activator of transcription (JAK/STAT)-suppressors of cytokine signaling (SOCS)-1 pathway. Methods The normal group comprised db/m mice (n = 8); db/db mice were randomly divided into six groups according to the applied treatment method: model group (no treatment), AG490 group, petroleum ether extract (PEE) group, ethyl acetate extract (EAE) group, N-butanol extract (NE) group, and water extract (WE) group (n = 6 in each group). The general status, biochemical indicators, and renal histological changes in the mice were evaluated, and the JAK/STAT-SOCS-1 pathway was assessed. Results The NE and WE groups showed a decrease in 24-h urinary protein and albumin levels as well as serum uric acid and fibronectin levels but showed no changes in fasting plasma glucose and hemoglobin A1c levels. The protein expression of JAK2, STAT3, P-JAK2, and P-STAT3 and the gene expression of JAK2 and STAT3 in kidney tissues were significantly increased (P < 0.05) in the model group. Compared with the model group, the expression of P-JAK2 and P-STAT3 was downregulated in the extract treatment groups. The expression of SOCS-1 was increased in the NE and WE groups (P < 0.05). However, the expression of JAK2, STAT3, JAK2mRNA, and STAT3mRNA in the treatment groups did not show any significant differences. Conclusion Compound Herba Houttuyniae showed renoprotective effects in db/db mice, and the strongest effects were observed in the WE and NE groups. The underlying mechanism for these effects might involve the regulation of the JAK/STAT-SOCS-1 pathway.

BACKGROUND:Previous studies have found that the basement membrane matrix can induced the chondrogenic differentiation of bone marrow mesenchymal stem cels, but there is a wide gap between its mechanical properties and practical application, and further research is needed. OBJECTIVE:To prepare a suitable matrigel/chitosan scaffold that has appropriate mechanical properties and remarkable bioactivity for cartilage repair. METHODS: We selected genipin as cross-linking agent, and mixed Matrigel with cross-linked chitosan at different ratios (2:1, 1:1, 1:3). Then rat bone marrow mesenchymal stem cels were seeded on different scaffolds and cultured for 14 days. The mechanical properties of materials were measured by DMA. Cel counting kit-8, FDA staining, ELISA kits and Alcian blue staining were used to measure the bioactivity of materials. RESULTS AND CONCLUSION:The storage modulus of scaffolds was raised from 0.48 kPa to 1.78 kPa with increase ratio of chitosan. Cels spread wel in the early period on al scaffolds, and then the cels on the chitosan scaffold showed reduced chondrogenic activity, but cels on the scaffolds with matrigel could maintain chondrogenic differentiation. The matrigel/chitosan scaffold at a ratio of 1:1 had appropriate mechanical properties and higher levels of colagen II and colagen X at 14 days. The prepared matrigel/chitosan scaffold with decent mechanical performance can promote the differentiation of bone marrow mesenchymal stem cels into chondrogenic lineages, which can be used in cartilage tissue engineering.

Objective To explore the surgical result of unilateral half-pin external fixation in the treatment of distal tibial fracture. Methods For type A fracture, two pins were inserted into the proximal fragment of tibia fracture and another two pins into the distal fragment; for type B and C fracture, distal pins were inserted into the talus and calcaneus. The fracture reduction was performed by distraction of external fixators. A limited open reduction was required in some difficult cases to restore the joint surface, with bone grafting and small fragments fixed with wires or screws. Meanwhile, fracture of fibula was fixed with plate and screws. Results The duration of external fixation was 3.5~8 months (mean, 5 months) in 22 patients. Bone union was achieved in all patients, without serious deep infection, osteomyelitis, or non-union. The patients were followed for 10~32 months (mean, 20 months). Functional exercise was carried out for more than 6 months after the removal of the external fixator. According to the Tornetta’s evaluation standard, excellent results were obtained in 11 patients, good in 7 patients, fair in 3, and poor in 1. Conclusions Unilateral half-pin external fixation combined with limited open reduction and internal fixation is a simple and effective minimally invasive method for the treatment of distal tibial fracture.