120急救箱内药品的管理

通过实施针对性措施,如统一配置、建立急救药品查对登记本、制定药品一览表、规范摆放位置和数量等可减少急救箱内药品过期、标识模糊及药效降低等造成的药品浪费和使用中的不安全因素,大大缩短护士交接班查对药品的时间,提高工作效率,满足急救时间紧迫的工作需要。     

中心药房手工摆药与自动药品分装机的效能对比

目的探讨自动药品分包机与传统手工摆对比给药房工作带来的变革效果。方法结合医院药房工作情况,将我院中心药房的自动分药机模式与手工配药模式进行比较分析。结果自动单剂量药品分包机比人工摆药所需的药师数量、药品准备和摆药及核对时间、人力成本均减少且分包数量、速度、准确率和用药安全都得到提高。结论通过自动化分装机的变革使药房对药品管理,工作效率,药学服务都有提升,值得推广使用。但药品分包机带来的日耗材成本,固定维修及保养成本也值得注意和期待解决。     

全自动片剂摆药机的应用体会

目的探讨改变医院药房的服务保障模式。方法总结2011年3月～2012年3月全自动片剂摆药机3 000例药物摆放和查对的经验体会。结果全自动片剂摆药机的引进节省了人力资源,增加了护士与患者的接触时间。结论通过对全自动片剂摆药机的使用,为护士对药物的查对带来了方便,既提高了医护人员的工作效率,又将现代科学技术的发展成果造福于每一位患者。     

全自动口服药品摆药机系统及其在医院中的应用研 究

目的：通过对全自动口服药品摆药机系统的全面介绍,以期提高其在实际工作中的应用水平。方法：介绍全自动口服药品摆药系统（TR一200FDS）的主要结构及工作流程,并讨论了医院信息系统（HIS）的接口融合。结果：摆药机在医院药房的使用规范了医生处方,提高了摆药准确性,避免了药品污染,体现了以患者为中心的宗旨,受到患者、护士及药师的广泛好评。结论：药房应用全自动口服药品摆药机提高了医院药学服务水平,是医院药房的发展趋势。     

一次性自动溶药器在化疗药物配制中的临床应用价值研究

目的:探究一次性自动溶药器在化疗药物配制中的临床应用价值.方法:于2016年1月~2017年1月将40名体检合格的护士平均分配到呼吸肿瘤内科、普外肿瘤内科、血液内科、肿瘤内科,随机分为对照组和观察组,每组各20名护士.对照组护士使用传统的一次性注射器配备化疗药物,观察组护士使用一次性自动溶药器配备药物,观察并比较两组护士的配药时间、12个月内人体内血小板及白细胞水平、胃肠道不良反应情况等.结果:观察组护士的配药时间明显短于对照组,差异具有统计学意义(P<0.05);配药6个月后,观察组护士体内血小板及白细胞水平、胃肠道不良反应情况等均优于对照组,时间越久,差异越明显(P<0.05),具有统计学意义.结论:在化疗药物配制中应用一次性自动溶药器能够有效缩短配药时间,降低医护人员的工作强度,提高护理人员的工作效率,同时还能减少化疗药物配制中的环境污染和对医护人员的职业伤害.     

过氧化氢低温等离子灭菌技术灭菌过程中过氧化氢浓度的相关影响因素分析

目的：探究过氧化氢低温等离子灭菌技术在灭菌过程中过氧化氢浓度的影响因素。方法：采用不同面积的器械垫、不同数量的金属管腔和不同材质的器灭菌过程械盒分别探究灭菌面积、灭菌装载数量、灭菌材质三个因素在灭菌过程中对过氧化氢浓度的影响。结果：随着器械垫面积的增加和管腔数量的增加，过氧化氢浓度呈现下降的趋势，其中器械垫面积对过氧化氢浓度的影响最大。此外，不同材质的器械盒对过氧化氢浓度的影响也不同，其中硅树脂器械盒对过氧化氢浓度的影响最小，其次是聚乙烯器械盒，最后是铝合金器械盒。结论：在使用过氧化氢低温等离子灭菌方式对手术器械灭菌时，要规范装载，控制器械垫的面积及器械的数量，同时用器械盒装载时应选用合适的器械盒，保证灭菌质量。     

高校社区家庭过期药品现状分析

目的通过分析高校医院所回收过期药品的相关信息,了解高校社区家庭过期药品的主要品种构成及过期时间,进而探讨家庭过期药品产生的主要原因及对策。方法在高校医院门诊大厅设立过期药品回收箱,对2015年5月1日-2016年4月30日所回收过期药品的类型、数量、效期等进行统计、分析。结果共回收261种过期药品。其中外用药、感冒用药及心脑血管用药为所回收药品中的主要类型,分别占比17.24%,14.18%及13.03%。回收的药品中,76种(29.12%)药品的过期时间为1年以内,70种(26.82%)药品的过期时间为2年以上,57种(21.84%)药品的过期时间为1年至2年;此外,回收的药品中还存在43种(16.48%)未过期的药品及15种(5.74%)效期无法识别的药品。所回收药品的数量共389盒,其中数量排名前10位的药品回收数量为330盒;速效救心丸、九味痔疮胶囊、养血清脑颗粒的回收数量分别为55盒、45盒及40盒。结论高校社区家庭过期药品问题严峻,可通过提高社区居民正确管理家庭小药箱的能力,提倡药品小包装生产,支持药品拆零销售,加强处方管理及完善过期药品回收机制等途径减少家庭过期药品的产生。     

精神专科医院使用智能药柜管理病区备用药品和高警示药品的效果分析

探讨改善病区药品的管理模式和方法,以期提升护士和药师的工作效率,实现药品效期和库房的精细化管理。分析自本院病区2017年12月引进智能药柜使用前后工作模式的变化,通过对流程的改进分析依托物联网技术,借助智能药柜设备,开发智能药柜管理系统。智能药柜管理系统的应用使病区基数药品管理由封闭式改变成开放式,通过智能化和权限式管理,药品的库存和成本管理更科学。智能药柜规范了药品管理,促进了医疗安全,有利于提高病区药品管理的综合水平,提高高警示药品管控水平,保证临床用药安全,提高管理效率。智能药柜权限设置的持续改进,让管理更高效更细致,从源头上保证智能药柜药品使用的安全性和有效性。     

药品说明书 细看有名堂

生活中，常有一些患者忘记了医嘱，又不会看药品说明，于是便自作主张或想当然用药，结果产生了一系列不良影响。有一位老年患者，到药店买了一瓶利福平眼药水。该药包装有两层，上层盒盖内有一红色药片，下层是数毫升的澄清溶液。正确的使用方法是将药片放入溶液中充分溶解、摇匀/这时溶液变为红色0，然后滴眼用。而这位患者却错误地把药片先用水服了下去。稍微懂得一些药品知识或仔细阅读一下药品说明，类似这样的错误就可以避免。另一位患高血压病的老年患者，平时很少按规律服用降压药。结果有一天血压上升到了,12.3千帕/.3-2.45毫米汞…     

中国药品费用走势分析

采用药品费用分解方法,将药品费用的变化指数分解为3个部分:数量指数、价格指数和混合效应指数,剖析各部分的变化趋势。数据来源于2002—2005年北京市和广东省佛山市的13家医院所采购的抗生素和循环系统2类药品的数据。结果发现:控制药品价格不是抑制药品费用的有效手段,药品费用不断上涨的原因是药品用量的增加和药品的替代效应共同作用的结果,应考虑如何促进药品的合理使用。     

Capture of culicids in urban areas: evaluation of the resting box method

OBJECTIVE: To evaluate the occurrence of adult culicid populations in urban areas and measure the sensitivity of the resting box collection method. METHODS: Mosquito were collected in 1999 and 2000, in two cities in the State of S?o Paulo, Brazil: Ocau?u and Uchoa. In each city, 15 blocks were drawn by lots and then one home in each block was drawn. Two resting boxes were installed at each home: one inside and the other outside the house. Monthly collections were carried out at each home, over a 13-month period, using manual aspirators inside and outside the home and inside the boxes. The captured specimens were taken to the laboratory for screening and identification according to species and sex. RESULTS: Out of the 2,112 culicid specimens collected, 99.7% were of four species: Culex quinquefasciatus, Aedes aegypti, Cx. declarator and Cx. coronator. The distribution of these species in Ocau?u was 83.3%, 3.2%, 10.8% and 24%, respectively, and in Uchoa it was 83.8%, 8.4%, 4.4% and 3.0%, respectively. Among the females of the genus Culex, 34.3% were captured in the resting boxes and 59.9% were collected from inside the house. Among the females of Ae. aegypti, 17.6% were found in the resting boxes and 82.4% inside the home. CONCLUSIONS: The great majority of the specimens collected belonged to four species of culicids, and Cx. quinquefasciatus was the most common. Proportionally, the females of Ae. aegypti were found more inside the home than were those of the genus Culex. Resting boxes present potential for use as surveillance devices, but their use needs to be more thoroughly evaluated.     

Identification of nematode larvae by coal cultures in closed boxes

A method is described for the identification of concentrated larvae from coal cultures in closed boxes. The condensation drops formed beneath the lid of the culture box are taken up with an L-shaped pipette. The sample taken up is added to a drop of Lugol's solution on a slide and examined under the microscope. The details of the nematode structure are clearly visible. Great care should be taken to avoid a possible cutaneous contamination.     

Utilization of Boxes for Pesticide Storage in Sri Lanka

Pesticide self-poisoning is now considered one of the two most common methods of suicide worldwide. Encouraging safe storage of pesticides is one particular approach aimed at reducing pesticide self-poisoning. CropLife Sri Lanka (the local association of pesticide manufacturers), with the aid of the Department of Agriculture, distributed lockable in-house pesticide storage boxes free of charge to a farming community in a rural district of Sri Lanka. Padlocks were not provided with the boxes. These storage boxes were distributed to the farmers without prior education. The authors carried out a cross-sectional follow-up survey to assess the usage of boxes at 7 months after distribution. In an inspection of a sample of 239 box recipients’ households, 142 households stored pesticides in the provided box at the time of survey. Among them, only 42 (42/142, 29.65%) households had locked the box; the remaining households (100/142, 70.4%) had not locked the box. A simple hand over of in-house pesticide storage boxes without awareness/education results in poor use of boxes. Additionally, providing in-house storage boxes may encourage farmers to store pesticides in and around houses and, if they are not locked, may lead to unplanned adverse effects.     

爱克宁、敌百虫箱击杀致乏库蚊实验研究

目的 探讨药物箱对致乏库蚊进箱停留的影响及杀灭效果。方法 将诱蚊箱内壁衬的黑布浸泡相应杀虫剂即成为爱克宁箱、敌百虫箱，在实验室和现场测试效果作对比评价。结果 爱克宁对致乏库蚊有很强的驱避作用，未能达到停留击杀目的；敌百虫不存在驱避作用，蚊虫自然进箱率高，在5．0g／m^2用量的情况下，对长时间停留的致乏库蚊仍有一定的击杀作用，接触6h死亡率为86．8％。结论 利用药物箱杀灭致乏库蚊仅作了初步的观察和探讨，但理想的药物还有待继续实验研究。     

Comparison of techniques for detection of domestic infestations with Triatoma infestans in Brazil

The detection of infestations of Triatominae in houses in regions endemic for Chagas's disease is a criterion frequently used in the selection of areas, or of individual houses, for treatment in insecticide campaigns as well as in the evaluation of insecticide performance.Several different methods for detecting domestic infestations with Triatominae were compared: night capture, capture of live bugs with the aid of a flushing-out agent and use of card boxes of the Gómez-Núñez type. The flushing-out and Gómez-Núñez box methods were found to be equally sensitive, although each failed to detect some infestations which the other detected. The night capture method was slightly more sensitive but was found to be impractical for insecticide trials. Improvement to the flushing-out method, notably the introduction of a systematic search technique, made it much more sensitive than the Gómez-Núñez box method for heavily infested houses and for houses three months after insecticide treatment.Although the sensitivity of the Gómez-Núñez box method increases when the boxes are left in place for a long time, this also limits the value of the information obtained regarding the evaluation of insecticides. On the basis of the results presented, the flushing-out method using a systematic search of the house was found to be the most suitable sampling technique, but it is recognized that this method still has limitations.     

Sterility maintenance assessment of moist/wet material after steam sterilization and 30-day storage

Moist/wet materials stored after autoclaving are considered contaminated and not recommended for use. This study evaluates the maintenance of sterility in moist/wet material after being submitted to steam sterilization and stored for a period of 30 days. Aiming to support decision-making in emergency situations, 40 surgical boxes packed in nonwoven cloth covering Spunbound, Metblouwn, Spunbound (SMS): half (the experimental group) were placed in an autoclave but the drying phase was interrupted, yielding moist/wet materials and the other half (the negative control group) underwent the complete cycle. The external parts of each surgical box were deliberately contaminated with Serratia marcescens and subsequently stored for 30 days. After this period, the boxes' contents were submitted to sterility tests and no growth was observed. The presence of moisture inside the surgical boxes did not interfere with maintaining their sterility.     

Fate and Effects of 2,4,6-Trinitrotoluene (TNT) from Dumped Ammunition in a Field Study with Fish and Invertebrates

2,4,6-Trinitrotoluene (TNT) is the major explosive ingredient in ammunition dumped into lakes and sea after World War II. The aim of the present field study was to study the fate and effect of TNT and its degradation products from dumped ammunition. Artillery shells were cleaved longitudinally to expose TNT and placed in open boxes filled with sediment, and then placed at the sea bottom. Sediment samples were taken in each box at the start and after 3, 9, 13, 20, 24, 33, and 36 months, and the sediments were tested for toxicity with bioassays using Nitocra spinipes (96 h), Hyalella azteca (96 h), and Daphnia magna (24 and 48 h). The result from the bioassays showed no impact of dumped ammunition on the survival of H. azteca and mobility of D. magna. Bioassays with N. spinipes showed significant differences in toxicity between control boxes and boxes with shells after 9 months and thereafter. The mean mortality (± SD) of N. spinipes in boxes with shells was 63 ± 22%, and the mortality in control boxes was 23 ± 17%. No continuous increase in sediment toxicity over time was found. After 3 years, cages with European flounder (Platichtys flesus) and blue mussels (Mytilus edulis) were attached to the boxes. The fish were examined for biochemical and physiological effects 8 weeks later. Exposure to ammunition, which had rested on the sea bottom 3 years, caused no significant effects on body indices, hematological variables, and detoxification and antioxidant enzymes activities in the flounder. The sediment, bile, and blood plasma of exposed fish, and hepatopancreas of exposed mussels, contained no detectable levels of TNT and its metabolites. Only minor disappearance of TNT from the shells could be detected by visual inspection on site (by scuba divers). This study suggests that the survival of sensitive benthic organisms, e.g., N. spinipes, might be negatively affected at an ammunition dumping site.     

药物联合针灸治疗心脏神经官能症的探讨

目的探讨美托洛尔片、曲美他嗪片联合针刺八脉交会穴"内关"公孙"对心脏神经官能症的临床治疗效果。方法确诊心脏神经官能症患者90例,随机分为三组,对照一组予美托洛尔片、曲美他嗪片常规剂量口服治疗,对照二组针刺八脉交会穴"内关"公孙"治疗,治疗组用美托洛尔片、曲美他嗪片联合针刺八脉交会穴"内关"公孙"治疗,四周为1个疗程。结果美托洛尔片、曲美他嗪片联合针刺八脉交会穴"内关"公孙"治疗组与对照组比较,心悸、胸闷气短、头昏头痛、疲劳、睡眠障碍等症状改善更明显,疗效差异有显著性(P<0.05)。副反应发生率比较没有显著差异(P>0.05)。结论美托洛尔片、曲美他嗪片联合针刺八脉交会穴"内关"公孙"对心脏神经官能症的临床治疗效果确切。     

药物联合针灸治疗心脏神经官能症的探讨

目的探讨美托洛尔片、曲关他嗪片联合针刺八脉交会穴“内关”“公孙”对心脏神经官能症的临床治疗效果。方法确诊心脏神经官能症患者90例,随机分为三组,对照一组予美托洛尔片、曲美他嗪片常规剂量口服治疗,对照二组针刺八脉交会穴“内关”“公孙”治疗．治疗组用美托洛尔片、曲美他嗪片联合针刺八脉交会穴“内关”“公孙”治疗,四周为1个疗程。结果美托洛尔片、曲美他嗪片联合针刺八脉交会穴“内关”“公孙”治疗组与对照组比较,心悸、胸闷气短、头昏头痛、疲劳、睡眠障碍等症状改善更明显,疗效差异有显著性（P〈0.05）。副反应发生率比较没有显著差异（P〉0．05）。结论关托洛尔片、曲美他嗪片联合针刺八脉交会穴“内关”“公孙”对心脏神经官能症的临床治疗效果确切。     

Number of food items as an indicator of nutrient intake

Total food duplicates for 24 hours were collected from farmers in Japan, once in 1977–1981 (109 subjects) and then in 1991–1992 (72 subjects). Nutrients (including energy, protein, fat, some minerals, and several vitamins) in each food item in the food duplicate were estimated taking advantage of the values given in the Standard Tables of Food Compositions in Japan. The number of the food items in each food duplicate was counted excluding duplication. Analyses demonstrated that the daily nutrient intake (especially that of energy, protein and vitamin B₁) has a significant association with the number of items of food taken a day, that the daily intake of most nutrients is sufficient when 30 food items were taken a day, but that the sufficient supply of calcium and iron needs an intake of more than 30 food items.