OBJECTIVE:To investigate the application and feasibility of the PDCA cycle management method in pharmacy management of three-level general hospital re-accreditation in our hospital and promote continuous improvement of hospital pharma-cy management. METHODS:Referring to 2011 edition of Detailed Rules for Three-level General Hospital Accreditation,the work of hospital pharmacy management was checked and continually improved based on the PDCA cycle management method. RE-SULTS:After the application of PDCA,prescription error rate in outpatient pharmacy dropped from 0.0314% to 0.0192%;the number of dispense error in center pharmacy decreased by 60.2% and the accuracy rate of drug stock increased from 87.14% to 97.32%;the number of dispensing errors in pharmacy intravenous admixture service reduced from 5.6 bags/week to 1.8 bags/week, and the error rate reduced by 67.86%;the proportions of irrational prescriptions of glucocorticoid drugs dropped from 19.26% to 4.23%. CONCLUSIONS:The application of PDCA cycle management method in pharmacy management of three-level general hos-pital reaccreditation and the establishment of relevant system can obviously improve the work of pharmacy management continuously.

0.05),but there were statistically difference within E15,E19,P2,P10(Pa

Adipates ; analysis ; Air Pollutants, Occupational ; analysis ; Esters ; analysis ; Gas Chromatography-Mass Spectrometry ; methods ; Phthalic Acids ; analysis ; Workplace

Cysts ; complications ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; complications

Objective To study the function and mechanism of GIT1(G protein coupled receptor kinase interacting protein 1)in osteoblast migration.Methods GIT1 and ERK1/2(Extracellular Signal-regulated ki- nase 1/2)were detected in mice primary osteoblasts.The localizations of GIT1 and ERK1/2 were determined by immunofluorescence stain with or without PDGF(platelet-derived grnwth factor)stimulation.The association of GIT1 anti ERK1/2 was analyzed by co-immunoprecipitation and western blot.After stimulation,the co-localization of GIT1 and pERK1/2 in osteoblasts was detected by double-immunnfluorescence stain.The pERK1/2 localization was detected by immunofluorescence stain after GIT1RNAh adenovirus infection of osteoblasts.The role of this associa- tion was determined by wound healing assay.Results The co-immunoprecipitation results showed that GIT1 in- teracted with ERK1/2 in osteoblasts induced by PDGF and this association occurred in focal adhesions.GIT1 RNAh adenovirus significantly inhibited the pERK1/2 translocation to focal adhesions and osteoblast migration induced by PDGF.Conclusion GIT1 associates with ERK1/2 in osteoblasts,which is required for pERK1/2 translocation to focal adhesions and osteoblast migration.

Benzoates ; pharmacology ; Cells, Cultured ; Cellular Senescence ; drug effects ; radiation effects ; Gene Expression Regulation, Enzymologic ; drug effects ; radiation effects ; Humans ; Infant, Newborn ; Male ; Matrix Metalloproteinase 1 ; genetics ; Matrix Metalloproteinase 3 ; genetics ; Methoxsalen ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Retinoids ; pharmacology ; Skin ; cytology ; metabolism ; Time Factors ; Tissue Inhibitor of Metalloproteinases ; metabolism ; Ultraviolet Rays

OBJECTIVETo evaluate the curative effect and surigical skills of reconstruction intramedullary nailing in the treatment of ipsilateral femoral neck and shaft fractures.

METHODSFrom January 2007 to January 2013, 13 patients with ipsilateral femoral neck and shaft fractures were treated by reconstruction intramedullary nailing including 11 males and 2 females with an average age of 38.9 yeas old ranging from 25 to 53 years old. For femoral neck fractures,10 cases were basilar neck fracture, 3 were transcervical fractures and according to Garden classification,10 were type II, 2 were type III and 1 was type IV. For feormal shaft fracture, 5 were type I, 4 were type II, 3 were type III and 1 was type IV according to Winquist classification. The location of all 13 feormal shaft fractures were all in the uper 3/4 of the feormal shaft. Complications and postoperative function were recorded and evaluated.

RESULTSEleven patients were followed up for 23.45 months (12 to 36 months). Time from injury to operation was 5.9 days in average. Malunion of femoral neck fracture happened in 1 patient, nonunion of femoral shaft fracture happened in 2 patients. NO femoral head osteonecrosis, infection and malunion of femoral shaft fracture happened. According to Friedman-Wyman classification, 8 cases get good result, 2 get faii and 1 get poor.

CONCLUSIONReconstruction intramedullary nailing is a good choice for the ipsilateral femoral neck and shaft fractures with the advantages of less soft-tissue trauma and complications.

Adult ; Female ; Femoral Fractures ; surgery ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged

6.24 mmol/L) and sixty healthy persons in the health center of our hospital were investigated as hyperhpidemia group (Hyperlipidemias) and control group (Controls) respectively.Hyperlipidemias were given simvastatin 20 mg?d~(-1) for twelve weeks (Statins).Blood samples of ulnar vein were extracted from Statins at the end of twelve weeks as well as Controls and Hyperhpidemias at the beginning of the experiment. Blood serum,plasma and mononuclearcell were extracted and stored at a refrigerator of-80℃.The level of plasma angiotensinⅡwas detected by the method of radioimmunity.While the expression of RANTES mRNA and protein on mononuclearcell were assessed by real time reverse transcription polymerse chain reaction and Western blot respectively.Results①The plasma angiotensinⅡof Hyperlipidemias was higher than that of Controls [(92.13?22.03) vs (50.85?12.12),P

OBJECTIVETo compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation.

METHODSFrom January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups.

RESULTSAll patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence.

CONCLUSIONFor patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo discuss the clinical effect of closed reduction and interlocking intramedullary nailing in the treatment of femoral shaft fracture.

METHODSFrom March 2006 to December 2011,103 patients with femoral shaft fracture were treated by closed reduction and interlocking intramedullary nailing including 76 males and 27 females with an average age of 36 years old ranging from 19 to 55 years old. According to AO classification,there were 64 cases with type A,27 with type B, 12 with type C. Thirteen cases were open fractures including 5 cases with Gustilo type I , 8 with Gustilo type II . The time of bone healing were observed after operation, the knee function recovery was evaluated by HSS scoring standard at 1 year after operation.

RESULTSThe intraoperative complications included femoral neck fracture in 1 case and proximal femoral fracture in 1 case,both of the patients were treated with reconstructive intramedullary interlocking nail and the fractures healed postoperatively. One patient was suffered from common peroneal nerve injury,which were fully recovered at 4 months later after medical treatment. All the patients were followed up from 12 to 28 months (averaged 22 months). All of the fractures were healed well and the average healing time was 3 to 9 months (averaged 5 months). All the hip joints were recovered to normal function. The average HSS was 90.89±5.06 at 1 year after operation.

CONCLUSIONInterlocking intramedullary nailing is the preferred treatment for patients with femoral shaft fracture. Carefully operating and closed reduction can reduce the complications.

Adult ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Young Adult