如何有效地开展二级医院临床药学工作

临床药学服务是以"以病人为中心"为服务理念,以促进合理用药为核心的一门综合学科.临床药学是医院药学工作的重要组成部分,也是医疗工作的重要组成部分,医院医疗质量的提高,合理用药起着很重要的作用,所以搞好医院临床药学服务工作,提高合理用药概率,能使医院医疗质量得到很大提高.     

医院信息系统的发展方向--2008年美国医院信息技术大会情况介绍

随着信息技术的发展和以患者为中心的服务理念的树立，电子健康档案和区域医疗信息机构日益成为医院信息系统发展的方向。目前我国的区域医疗信息机构构建还属于起步阶段。本文将对电子健康档案和区域医疗信息机构的基本概念、建设目标、相关主题等内容进行介绍，并对以大中型医院为主体我国医疗机构在搭建区域医疗信息合作平台工作中所应进行的准备工作提出建议。     

新医改形势下医院药学学科的职能转变

医院医疗工作的重要组成部分之一就是药学服务,随着新医疗体制改革药学部门功能、药师职能将会发生较大转变。为了满足新医改对医院药学学科提出的新要求、保证医疗结构整体工作的稳定有序进行,药学学科药师应当深入了解新医改内容,掌握医院药学学科的未来发展趋势,并据此确定新时期药师的职能,在未来工作中通过各种方式有效应对这些转变,在医疗服务中充分发挥药师的作用。     

现代医院中医学工程部门的职能定位

作者根据改革开放以来医学工程学科在医院的建设与发展,结合工作中的经验与体会,提出医学工程部门在医院中的职能定位应该从"医疗设备维修"转变到"确保医疗设备安全有效使用"上来,以充分发挥医学工程部门的作用,从而为医院的医疗临床工作提供更坚实的医学工程技术保障.     

医院药学部门工作要适应时代发展的要求

1 医院药学部门是医院医疗工作的重要组成部分医院药学是应用学科,医、药、护、技是医院整体预防、治疗活动中不可分割的四个技术支持系统,他们的工作都是医疗行为,医师以正确的诊断和治疗为病人提供服务;药师要参与临床药物治疗,与医师、护师共同对病人的药物治疗负责,以正确的调配处方、正确的选药和合理用药为病人提供服务;护师以熟练执行医嘱和热情细致的生活护理和医疗心理为病人提供服务;医技科室要为临床诊断和治疗提供相应的科学依据,为病人提供服务.     

浅谈医院药师的角色转变

伴随我国医疗改革的不断进行,医院药师的职责发生着转变.从以"卖药"为主,转变到以"出卖技术,出卖服务"为主.医院药师正积极参与着临床药学工作,开展药学情报等工作.为医院、为社会提供更好、更优质的药学服务.     

医院文化建设与护理管理之我见

为了适应医疗护理改革的需要,全面提高护理管理与护理教学水平,卫生部和国家中医药管理局联合召开了医院管理年工作会议,部署了在全国开展"以病人为中心,以提高医疗服务质量为主题"的医院管理活动.此次活动的开展将推动各级、各地医院在医疗服务质量、医疗安全、医疗服务、医疗费用等各方面的改革.     

病案质量及医疗环节质量的管理与监控

"以病人为中心,以提高医疗服务质量为主题"的医院管理年活动,明确了医院各项工作都要服务和服从于医疗质量和医疗安全,是常抓不懈的主题及立院之本[1].活动的开展是进一步提高医院医疗质量与安全、提升服务品牌的一个良好契机,本文就我院近年来医疗质控管理实践,谈谈病案内涵质量及医疗环节质量的管理及监控.     

开展医院管理年活动强化急诊科医疗管理

随着2005年医院管理年活动的开展,我院紧紧围绕医院管理年的"质量、安全、服务、费用"为管理核心内容,本着以病人为中心、以提高医疗服务质量为主题全面开展工作.几年来,注重加强急诊医疗管理,提高医疗质量,保障医疗安全,取得一定成效,为临床医疗工作提供一些可借鉴的经验.     

强化管理创新工作促进医院可持续发展

中国医科大学盛京医院自2005年4月以来,积极参加卫生部、国家中医药管理局开展的"2005年医院管理年"活动,紧密结合医院实际,以持续改进医疗质量和保障医疗安全为核心内容,以加强人性化服务和诚信服务为重点,强化管理、创新工作、全面落实卫生部医院评价指南的各项任务,取得了可喜的成果,为医院可持续发展奠定了坚实的基础.     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…