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

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.

Objective To investigate the clinical results, indications and choices of surgical treatment of minimally invasive internal fixation by cannulated compression screws in the treatment of femoral neck fractures. Methods The authors retrospectively analyzed clinical data of 83 patients with femoral neck fractures treated by minimally invasive internal fixation by AO cannulated screws. Results According to the Garden classification, the patients comprised 12 cases of type I, 39 cases of type II, 23 type III and 9 type IV. The mean time from injury to surgery was 63.4 hours, the mean operation time was 65.7 min, the mean intraoperative blood loss was 64 ml and the mean hospital stay was 7.7 days. No wound infection, deep venous thrombosis of leg, pulmonary embolism or breakage of internal fixation occurred. No patients died. Follow-up observation ranged 12～48 months, with a mean of 31.3 months. Normal bone union was obtained in all the cases. Postoperatively, shortening of femoral neck took place in 4 patients (4/83, 4.8%) and different degrees of osteonecrosis happened in 7 patients (7/83, 8.4%). The mean postoperative Harris hip score was 94.6. Conclusions Minimally invasive internal fixation by cannulated compression screws for femoral neck fractures may be an effective alternative. This method is indicated for Garden I/II fractures without displacement in patients above 65 years old, or any types of femoral neck fractures in patients below 65 years old.

Objective To investigate the clinical results of minimally invasive plate fixation for tibial plateau fractures. Methods Minimally invasive plate fixation was adopted in 26 cases of tibial plateau fractures from January 2000 to June 2003. Results Follow-up for 6 months ～ 4 years (mean, 2 1 years) showed bone union in all the patients. The results of therapy were assessed according to the Merchant criteria as follows: excellent in 20, good in 5 and fair in 1. Conclusions Minimally invasive plate fixation in the management of tibial plateau fractures has advantages of minimal trauma, reliable fixation, early movement and fewer complications, being a valuable clinical alternative.