Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

BACKGROUND: Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction (AAMI) is an important factor in occurrence of heart failure which additionally results in poor prognosis. Therefore, the treatment of ventricular remodeling needs to be further optimized. Compound Danshen Dripping Pills (CDDP), a traditional Chinese medicine, exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction. OBJECTIVE: This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale. METHODS: This study is a multi-center, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The total of 268 patients with AAMI after primary percutaneous coronary intervention (pPCI) will be randomly assigned 1:1 to the CDDP group (n=134) and control group (n=134) with a follow-up of 48 weeks. Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction (STEMI), with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI, and the control group treated with a placebo simultaneously. The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide (NT-proBNP) level, arrhythmias, and cardiovascular events (death, cardiac arrest, or cardiopulmonary resuscitation, rehospitalization due to heart failure or angina pectoris, deterioration of cardiac function, and stroke). Investigators and patients are both blinded to the allocated treatment. DISCUSSION This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI. Patients in the CDDP group will be compared with those in the control group. If certified to be effective, CDDP treatment in AAMI will probably be advised on a larger scale. (Trial registration No. NCT05000411).
Humans ; ST Elevation Myocardial Infarction/therapy* ; Stroke Volume ; Ventricular Remodeling ; Prospective Studies ; Microcirculation ; Ventricular Function, Left ; Myocardial Infarction/etiology* ; Treatment Outcome ; Percutaneous Coronary Intervention/adverse effects* ; Heart Failure/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic

This paper introduced a case of ethical conflict between the principle of benefit and the principle of respect in the formulating treatment and nursing plan for patient with chronic wound nonunion by specialist nurses, and used the "structured analysis form of clinical nursing ethics" designed by the Third Affiliated Hospital of Guangzhou Medical University to conduct ethical analysis and ethical decision-making, and solve the clinical nursing ethical problems of complex nursing cases. The practice of the case showed that under the situation of ethical conflict in making nursing treatment plan for patient, the application of structured ethical analysis of clinical nursing is helpful to improve nurses’ ethical decision-making ability and strengthen their ethical thinking. It is suggested to strengthen nurses’ ethical thinking in clinical nursing, continuously improve nurses’ ethical decision-making ability, and cultivate core nursing technology integrating science and humanities, thus to enhance nursing value.