加味栀子豉汤治疗抑郁症临床观察

抑郁征是临床常见病、多发病,发病机理尚不清楚,目前多认为与遗传、性格、生物化学、环境等因素密切相关。中西医治疗效果尚不肯定,笔者运用《伤寒论》名方栀子豉汤加味治疗抑郁症48例,颇具疗效。总有效率治疗组优于对照组。     

温胆汤化裁治疗心系疾病的临床研究概况

本文综述了近年来临床应用温胆汤化裁治疗冠心病、心律失常、高血压病、病毒性心肌炎、心脏神经官能症、高脂血症等心系疾病的概况.凡符合胆胃不和、痰热内扰的病机,不论病种,皆可在临床各科使用温胆汤.本文同时还提出了目前温胆汤治疗心系疾病的临床研究中所存在的诸多问题,如临床研究设计不完善、综合疗效判定标准不统一、随症加减方案不统一、治疗机理不明确、剂型单一等问题.     

胰岛素泵联合小剂量胰岛素静脉滴注治疗糖尿病酮症酸中毒18例临床观察

目的观察胰岛素泵联合胰岛素滴注治疗酮症酸中毒﹙DKA﹚的疗效。方法将2008年4月～2011年6月收治的DKA患者36例分为治疗组18和对照组18例,治疗组给予胰岛素泵全程治疗,结合小剂量胰岛素持续点滴,对照组给予小剂量胰岛素治疗。比较两组患者血糖变化、DKA纠正时间及住院时间。结果治疗组血糖下降相对稳定,酸中毒纠正时间短于对照组,且无反复;治疗过程中治疗组未出现低血糖,对照组出现3例;住院时间治疗组短于对照组。结论胰岛素泵联合胰岛素滴注治疗酮症酸中毒安全有效。     

计算机在药物研究中的综合实践课程设计与实施

作为本科生理论综合应用能力和创新能力的拓展课程,《计算机在药物研究中的综合实践》设置了复合型目标,由理论讲授-验证实验-开放式探索型实验阶段过渡,内容在理论方面注重经典、探索型实验选择方面注重前沿,采用全班集中学习和分组实验教师指导两种方式,取得较理想的教学效果。     

Good design practice for medical devices and equipment,Part II: design for validation

Medical devices and their associated process equipment must be reliable and fit for purpose. In light of the recent changes to the medical device regulations, manufacturers must now take an integrated approach to design, development and validation. Good design practice encourages this integrated approach while ensuring fitness for purpose within commercial reality. A review of current literature related to good design practice carried out in Part I of this paper showed that there is inadequate guidance regarding the integration of validation with design. This paper proposes a practical approach to design for validation aimed at making devices easier and more economic to validate. The approach comes in the form of a model of design for validation that illustrates the basic relationship between design, development and validation and a series of design tactics that were formulated in order to help designers take a more proactive approach to validation during design.     

Pharmacy Students’ Application of Knowledge From the Classroom to Introductory Pharmacy Practice Experiences

Objective. To determine whether and how pharmacy students used knowledge learned in the classroom during their introductory pharmacy practice experiences (IPPEs) in community and hospital settings.Design. To reinforce course concepts and make connections between coursework and practice, students documented examples of how knowledge from first-year courses was used in IPPEs.Assessment. Data submitted were categorized by classroom-based pharmacy course, including the frequency with which each course was cited. For community practice experiences, most student examples of knowledge application related to the self-care therapeutics course, pharmacy practice laboratory course, and dose form/compounding laboratory courses. Hospital IPPE examples were most frequently based on the pharmaceutical calculations course, physiology/pathophysiology course, medicinal chemistry course, and pharmacy practice laboratory course.Conclusion. All prior classroom-based pharmacy courses were cited by students as being useful during IPPEs, although some were more frequently cited than others. This activity provided useful programmatic assessment data.     

A Paradoxical and Persistent Pneumonitis

Abstract

Despite increased awareness of the risks to patients within the health care system, there has been little improvement in patient safety, with 1 in 7 patients experiencing an adverse event during hospitalization. Patients are exposed to harm not only through medical errors but also by physicians' failure to adhere to evidence-based best practices, as patients receive recommended therapies only half of the time. Although much research has been devoted to developing new therapies, little time has been spent investigating the science of health care delivery. We developed 2 models for improving health care delivery that have been successfully utilized in the Michigan Keystone Project to eliminate catheter-related bloodstream infections. The first is the Comprehensive Unit-Based Safety Program (CUSP), which is aimed at changing the culture of safety and provides a framework for addressing patient safety issues at a local level. CUSP takes advantage of local wisdom to identify potential patient harms and create individualized solutions. The second is the Translating Evidence Into Practice (TRIP) model, which evaluates best practices at a hospital or hospital system level, and then creates strategies for implementation at a local level. TRIP seeks to identify barriers to implementation of best-practice medicine and standardize care over multiple care units. Components of the 2 programs are not mutually exclusive and both can be used to mitigate potential patient harms.     

产程中阴道检查代替肛门检查的临床观察

目的 探讨在产程的观察过程中使用碘伏消毒行阴道检查替代肛门检查的临产观察.方法 在产程观察过程中使用使用-山东利尔康碘伏消毒液,其有效碘含量在4.5~5.5/15%的碘伏消毒会阴部行阴道检查(以下用5%的碘伏或碘伏表示).结果 310例产妇无一人感染,可靠率100%.结论 在产程观察过程中,使用5%的碘伏消毒会阴部行阴道检查替代肛门检查在临产上是可以使用的.     

临床护理路径在脑梗死患者护理中的应用

目的:探讨临床护理路径在住院脑梗死患者护理中的应用效果.方法:将86例脑梗死患者按随机数字表法分为路径组和对照组各43例,路径组采取临床护理路径指导下的护理服务模式,对照组采用传统的整体护理模式.结果:路径组患者对疾病相关知识的掌握程度、出院后自护能力和护理服务满意度均高于对照组(P＜0.05);路径组住院时间和医疗费用均少于对照组(P＜0.05).结论:临床护理路径指导下的护理服务模式能促进脑梗死患者疾病的康复,缩短了住院时间,节省了住院费用.     

Critical reflections on school-based occupational therapy

This article describes the process of facilitating change to practice that is more client-centered and occupation-based in a diverse suburban public school district in the USA from 2001 to 2006. The author sets the context, describes the process that included the use of the School AMPS, and considers factors that facilitated and constrained change.