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

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.

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

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

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

ObjectiveTo enrich and quantitatively analyze peripheral circulative carcinoma cells by magnetic activated cell sorting (MACS) in colorectal cancer patients.MethodsBlood samples, preoperatively collected from 21 patients with colorectal cancer and 9 healthy volunteers, were labeled by anti-cytokeratin (CK) with magnetic microbeads, and passed through magnetic columns; CK +carcinoma cells were separated from the samples, and quantified by flow cytometry.ResultsCK +CD45 -cells could not be detected from the samples without MACS; in the sample undergoing MACS, the concentrations of CK +CD45 -cells were significantly higher in patient group than in control group(P

Objective To evaluate the implementation effect of continuous nursing care in patients after percutaneous coronary intervention. Methods Totally 200 patients underwent coronary intervention were equally divided into the control group and the experimental group. Randomization was done by sealed envelopes. Routine nursing was applied inthe control group while the patients inthe experimental group werenursed continuously. Compliance of taking medication, the incidence of major adverse cardiac events (MACE events), satisfactory rate of the patients and the occurrence of stent restenosis were compared between the two groups. Results There was a significant difference between the experimental group and the control group in compliance of taking medication from the 6th month. According to the Morisky measurement, the score of the 6th month in the experimental group was 8.00 ± 0.00, while the control group was 7.66 ± 0.82. There was a statistical significance between the two groups (t=-4.086, P<0.01); the score of the 12th month in the experimental group was 7.94 ± 0.48, and for the control group, the score was 7.28 ± 1.58, the difference was statistically significant (t=-3.899, P<0.01). The major adverse cardiac events (MACE events) were 1% (1/100) and 4%(4/100) for the experimental and control group respectively. The satisfactory rate of the patients in the experimental group and the control group were 98%(98/100) and 81%(81/100) separately. The difference between the two groups was of statistical significance (χ2=36.39, P<0.01). The restenosis rate of the two groups was 1.2% (1/82) and 2.5% (2/79) separately, which was of no significance (χ2=0.392, P=0.613). Conclusions Continuous nursing can significantly improve the patients′ medication compliance, reduce the occurrence of MACE events, and improve the satisfaction of nursing care.

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.