In view of the expansion of workforce and campus of the pharmacy department, an institutional WeChat account is built to optimize management and communication efficiency, and to achieve flat and fine management mode.Such an account, developed by both third parties and independent means, serves as the mobile officing platform for the department.This platform spans two campuses and covers all the staff in real time, not only raising management efficiency but also building another communication channel among the staff.

OBJECTIVE:To provide reference for the informational and automatic management in Pharmacy intravenous admix-ture service (PIVAS). METHODS:The composition and practical application of PIVAS automatic management system developed in our hospital were introduced,and ratio of irrational medical order,drug dispensing efficiency and the numbers of error before and after application were compared to evaluate its effect. RESULTS & CONCLUSIONS:The work process was intelligently opti-mized,PIVAS automatic management system developed in our hospital composed by automatic prescription audit system,intelli-gent drug dispensing system,intelligent liquid preparation system,automated sorting system and automatic transportation system, which respectively achieved the automated audit of prescription,intelligent drug dispensing and labeling,responsibility traced in drug dispensing,intelligent mixed deployment of intravenous infusion,automated sorting and transportation of finished products of transfusion liquid. The ratio of irrational medical order decreased from 2.07%to 1.73%,time of drug dispensing and labeling short-ened from(3.15±0.53)h to(1.55±0.27)h,numbers of error within daily dispensing decreased from 0.26±0.78 to 0.06±0.13, numbers of error within daily sorting of finished products of transfusion liquid decreased from 6.57 ± 1.76 to 0.07 ± 0.17. The con-struction of the system achieves the information and automation of major work in PIVAS and improves the management level of PI-VAS.

OBJECTIVE:To adopt SIMPLE pharmaceutical care mode in chronic disease management of bronchial asthma and COPD patients,and to evaluateits the effect. METHODS:By random sampling,a total of 200 bronchial asthma and COPD patientsselected from respiration department in the First Affiliated Hospital of Soochow University during Sept. 2016-Jun. 2017 were divided into control group(100 cases)and intervention group(100 cases)by simple randomization. Control group received routine treatment. Intervention group additionally received education on quitting smoking,effective use of the inhaler,monitoring detection indexes, selecting drugs correctly,scientific life style. Inhaled device scores,lung function indexes (FEV1％,FEV1/FVC),the number of patients with acute attack/exacerbation,clinical effective control rates,ADR occurrence rates,compliance of using apparatus(MMAS-8 score)were compared between 2 groups before enrollment,3 and 6 months after enrollment. RESULTS:Commpared with during enrollment,inhaled device score,clinical effective control rate and MMAS-8 score of intervention group incereased significantly 3,6 months after enrollment,while patients with acute attack/exacerbation ≥2 times decreased significantly,with statistical significance (P<0.05). Compared with control group,inhaled device score,clinical effective control rate,MMAS-8 score and FEV1％ of intervention group increased significantly,patients with acute attack/exacerbation ≥2 times decreased significantly 3 and 6 months after enrollment with statistical significance (P<0.05);the ADR occurrence rate was lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Chronic disease management of bronchial asthma and COPD patients with SIMPLE pharmaceutical care mode can improve medication compliance and clinical efficacy,and reduce ADR.

OBJECTIVETo investigate the value of transesophageal echocardiography to guide the implantation of 2 pieces of MitraClip during transcatheter mitral valve repair operation.

METHODSFrom October 2013 to June 2014, 6 transcatheter mitral valve repair operations were performed in our hospital for symptomatic patients with severe functional mitral regurgitation (MR), transesophageal echocardiography was applied to guide the implantation of 2 pieces of MitraClip. Clinical data are retrospectively analyzed to evaluate implantation timing and approach of the 2nd piece of MitraClip, as well as the immediate effect of the interventional therapy.

RESULTSAfter implantation of 1st piece of MitraClip, transesophageal echocardiography evidenced MR ≥ grade 2 with central regurgitation and immediate mitral average transvalvular pressure gradient < 3 mmHg (1 mmHg = 0.133 kPa) in these 6 patients and 2nd piece of MitraClip was implanted in these patients. After implantation of 2nd piece of MitraClip, it is observed via transesophageal echocardiography that mitral regurgitations were reduced by ≥ 2 grades for all 6 patients. For 3 patients, MR was reduced to grade 1. For the other 3 patients, MR is reduced to grade 2. Among the 3 patients whose MR was reduced to grade 2, 2 operations were stopped because immediate mitral average transvalvular pressure gradient equaled to 3 mmHg, and the rest 1 operation was stopped because MR was too diverse and not able to select proper position to implant the next MitraClip. All 6 operations are completed successfully.There were no myocardial infarction, death or complications requiring mitral valve surgery after the MitraClip procedure. There were also no MitraClip detachment, thrombus embolism, mitral valve apparatus injuries, mitral stenosis, pericardial tamponade post procedure.

CONCLUSIONSTransesophageal echocardiography plays an important role to guide the implantation of 2 pieces of MitraClip in transcatheter mitral valve repair operation. Mitral average transvalvular pressure gradient and initial position of regurgitation after implantation of the previous MitraClip are critical determinants for decision making if the next piece of MitraClip can be implanted or not.

Echocardiography, Transesophageal ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; surgery ; Mitral Valve Stenosis ; surgery ; Prostheses and Implants ; Prosthesis Implantation ; methods ; Retrospective Studies

OBJECTIVE:To promote the realization of intelligent management for narcotic and first type psychotropic drugs (narcotic and psychotropic drugs for short)in hospital. METHODS:With the aid of fingerprint identification technology and hardware devices such as intelligent storage cabinet,intelligent management for narcotic and psychotropic drugs were designed and developed in our hospital,including prescription dispensing,cardinal drug supplement,empty bottle recycling,changing shifts, etc. The effects of the system were evaluated 30 d before and after the implementation of the system through comparing related indexes. RESULTS:The application of intelligent management system for narcotic and psychotropic drugs realized intelligent dispensing of narcotic and psychotropic drugs,automatic checking during cardinal drug supplement,automatic information record during empty bottle recycling,automatic record during changing shifts,intelligent and information management on"five specific management"for narcotic and psychotropic drugs. Compared with before the implementation of the system,the duration of daily changing shifts was shortened from(13.62±0.40)min to(8.67±0.33)min,shortening by 4.95 min in average(n=30).The time of prescription dispensing was shortened from(30.36±0.48)min to(10.56±0.46)min,shortening by 19.80 min(n=30). The collecting time of cardinal drug supplement was shortened from(12.72±0.97)min to(0.13±0.03)min,shortening by 12.59 min (n=30). No drug dispensing error was found after the implementation of the system. CONCLUSIONS:The system is stable and convenient,which promotes that intelligent management for narcotic and psychotropic drugs is in line with the requirements of"five specific management". It also realizes intelligent and information operation,improves work efficiency and error prevention ability.