我院门诊处方用药情况分析

目的分析我院门诊处方不合理用药情况，促进临床合理用药。方法采用回顾性调查方法，随机抽取我院2006年10月。2007年9月门诊处方12346张，进行逐一审查分析。结果绝大多数处方用药合理，不合理用药处方总计1132张（占9．17％），主要表现为5个方面：联合用药品种过多、给药间隔时间及剂量不当、药理作用拮抗、抗菌药物使用不当、存在off-label用药行为。结论我院存在一定程度的不合理用药现象，临床医师应提高药学知识水平，医院药学应开发合理用药软件系统，以便更好地防治疾病、提高药物疗效、减少药物不良事件的发生。     

门诊不合理用药处方分析

2006年6～10月，本院药监小组以《抗菌药物应用指导原则》、《临床药理学》及文献资料为依据，每月随机抽查一日门诊处方，其中，6月1101张，7月1203张，8月1109张，9月1008张，10月1107张。进行合理用药（特别是合理联合使用抗菌药物）情况归类分析，为临床用药提供参考。在抽取的5528张处方中，共发现不合理用药处方153张，不合格率2．76％，主要表现在如下几方面：     

浅析门诊处方书写质量

目的：处方书写正确与否,是合理、安全用药的前提,直接关系到患者的治疗效果与生命安危。不合格处方在某种程度上将导致不合理用药。现对执行《处方管理办法》以来本单位门诊处方进行书写质量调查分析。方法：抽查2008年下半年门诊的33502张西药处方进行分析。结果：合格处方32946张,处方合格率98．34％。不符合书写要求的处方556张。处方的不合格率为1．66％。结论：定期抽查处方进行分析。规范处方书写,加强药师对处方的审核能力,药剂科做好药讯工作,临床医师提高药学知识,合理用药、减少医疗纠纷及药物不良反应的发生。     

某干休所门诊部处方点评及存在问题分析

目的：探讨门诊部处方点评情况,为更好地实施处方点评制定、促进合理用药。方法：抽取2012年1月～2013年6月的处方12922张,统计不合理处方张数,不合理处方原因,并对不合理处方点评。结果：598张为不合理处方,不合格率为4．6％,其中不规范处方215张（36％）,用药不适宜处方383张（64％）,错误率较高的是用法、用量;联合用药方面。结论：该门诊部处方存在一定数量的不合理性,药师与医师应积极沟通,指导临床合理用药,为患者提供更好的药学服务。     

基层医院门诊处方800张分析

目的了解我院不合理用药处方的情况，提高药师指导医生和病人合理用药的能力。方法随机抽取门诊及病房处方800张，从中挑选出不合理用药处方进行归类分析。结果不合理用药处方25张，不合格率为2．96％。不合理用药发生频率较高的是药物配伍不合理，药物用法不合理及选药不合理等。结论我院存在一定程度的不合理用药现象，主要是由临床医生的专业缺陷引起的，药师应具备药学综合性知识，加强用药指导。     

“4R”法药学服务工作模式在乡镇医院的开展应用

目的探讨＂4R＂法药学服务工作模式在乡镇医院的开展应用。方法随机抽取审查门诊处方10 080张和720例住院患者医嘱,审核临床用药是否合理,并进行分析总结。结果临床用药中主要为对症选药不合理,不合格率为12.6%;用药剂量不合理,不合格率为13.2%;给药途径不合理,不合格率为5.0%;给药时间不合理,不合格率为3.9%等。结论 ＂4R＂法药学服务模式的开展,可以为乡镇基层医院临床医生和患者提供药学服务,有利于为患者提供安全、合理、经济、有效的药物治疗。     

临床不合理用药处方分析

目的：了解我院不合理用药处方的情况,提高药师指导医生和病人合理用药的能力。方法：随机抽取门诊及病房处方18790张,从中挑选出不合理用药处方进行归类分析。结果：不合理用药处方556张,不合格率为2．96％。不合理用药发生频率较高的是药物配伍不合理,药物用法不合理及选药不合理等。结论：我院存在一定程度的不合理用药现象,主要是由临床医生的专业缺陷引起的,药师应具备药学综合性知识,加强用药指导。     

我院门诊处方点评与干预

目的 监测门诊用药情况,了解不合理用药原因并提供干预措施,提高门诊合理用药.方法 由临床药学组对2011年每月随机抽查门诊处方5次,每次700张;全年共42000张处方进行统计分析评价并汇总计算年度指标,同时将全年的不合理处方作回顾性分析.结果 2011年门诊42000张处方合格率为:97.80%,不合理处方总数为:924张,不合格率为2.2%.其中不规范处方为795张,占处方总数的1.90%;用药不适宜处方为110张,占处方总数的0.26%;超常处方为19张,占处方总数的0.05%,以不规范处方为主.结论 我院门诊药物使用基本合理,处方点评对促进合理用药起着重要作用.     

10000张门诊处方中不合理用药分析

目的了解省妇幼保健院门诊处方中不合理用药情况,为提高临床合理用药水平提供依据。方法随机抽取全院临床科室2007年1月～12月门诊西药处方10000张逐一审查,对其中不合理用药处方进行分类统计分析。结果不合理用药处方合计732张（占7．32％）,不合理用药主要表现在四个方面,根据处方数所占的比例,依次为：联合用药不合理229张（31．3％）、重复用药202张（27．6％）、选药不当166张（22．7％）、用法不合理135张（18．4％）。结论省保健院存在着一定程度的不合理用药现象,主要是因为某些临床医师对合理用药的认识存在局限性,以及某些药剂人员的业务水平不高所致。临床医师与药师均应努力学习,并加强两者之间的沟通与协调,有效的避免不合理用药现象的发生,确保患者用药的安全有效。     

加强门诊处方管理促进合理用药

目的：提高处方质量,减少不合理处方,促进合理用药。方法：以《处方管理办法》及《医院处方点评管理规范（试行）》为依据,对本院门诊处方进行分类分析．结果：随机抽查门诊处方5000张,不合格处方237,不合格率为4．74%。结论：本院门诊处方用药基本合理,但也应加强处方管理,确保安全用药。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.