中药处方点评在中药调剂中的应用分析

目的 分析中药处方点评在中药调剂中的应用效果.方法 抽取未开展中药处方点评前在本院应用中药进行治疗的82例患者作为对照组;并选取实施了中药处方点评后在本院应用中药进行治疗的82例患者作为观察组.对照组患者在常规中药调剂下用药治疗,观察组患者则在融入处方点评的中药调剂下进行治疗.比较两组用药风险事件发生率、治疗有效率、不...     

Accuracy of radiographer comment following a two-month experiential and blended learning in appendicular skeleton X-ray interpretation: The Singapore experience

IntroductionThe value of combined blended and experiential learning on radiographer diagnostic comment has not been explored. This study aims to examine the accuracy of image interpretation comment of radiographers who received a period of blended and experiential learning in Radiographer Abnormality Detection Systems (RADS).MethodsWe evaluated the diagnostic opinions of 13 radiographers who received a blended training and experiential learning (a process of self-learning and reflection) in RADS. Radiographers' opinions on 16,483 images were examined using the final radiologists’ report as a reference standard. For each radiographer, we recorded the number of true positive, true negative, false positive and false negative opinions and MedCal® was used to calculate diagnostic performance and error rates. A t-test was used to assess whether the number of images read was associated with performance and whether the radiographers retained performance over time.ResultsSensitivity ranged from 87.4 (84.0–90.2) to 98.9 (97.5–99.7) with a mean of 94.3 (93.6–94.8). Specificity varied from 96.4 (94.8–97.5) to 99.9 (99.41–100.0) with a mean of 98.2 (97.9–98.4). Diagnostic accuracy ranged from 93.1 (91.5–94.4) to 99.5 (98.9–99.8) with a mean of 96.9 (96.6–97.1). The mean false positive rate was 0.018 (range: 0.010–0.031) with a false negative rate of 0.057 (range: 0.026–0.11). There were no differences in performance between the first and latter nine months of providing opinions and the number of images reviewed was not associated with performance.ConclusionRadiographers who received blended and experiential learning in RADS provide accurate diagnostic comments on plain emergency appendicular skeleton radiographs.Implication for practiceA combined blended and experiential learning can equip radiographers to provide diagnostic opinion on plain appendicular skeleton radiographs.     

As You Like It

I have developed something of a reputation for criticizing freely and frequently at our meetings and in my writings. You say you like this and find it useful and entertaining. As you like it, you are welcome to more of it. My comments and criticisms are presented under the following headings: (1) criticize at your peril; (2) how it all started (unjustly accused!); (3) abbreviations (a source of perennial aggravation, confusion, and waste of time); (4) mysterious bodies in mesotheliomas; (5) call a crystal a “crystal,” not a “crystalloid”; (6) electron microscopy-a study of osmium artifacts; (7) length-to-diameter ratio of microvilli (mission impossible); (8) lamellar bodies (a popular but debased term); (9) amyloid filaments, not fibers; (10) filaments and microtubules do not branch; (11) there is no such thing as pseudomelanosis; (12) botched histochemistry (just about every gastrointestinal tract pigment was misdiagnosed by histochemistry); (13) intranuclear Russell bodies, not “Dutcher bodies”; and (14) nuclear pores and virus-like particles (a new development in an old farce).     

2015年天津中医药大学第二附属医院中药注射剂超说明书用药情况分析

目的 对2015年天津中医药大学第二附属医院中药注射剂超说明书用药情况进行调查分析,为临床合理用药提供参考.方法 随机抽取2015年天津中医药大学第二附属医院中药注射剂门急诊处方3526份,从适应症、给药剂量及频次、溶媒选择、疗程、给药途径等方面进行超说明书用药分析.结果 中药注射剂存在一定程度超适应症、超剂量、溶媒选择不当、超疗程及超给药途径用药等超说明书用药的情况.疏血通注射液的超适应症处方数最多,为154例,构成比为24.06%.在超给药剂量及频次方面,醒脑静注射液的发生率最高.注射用灯盏细辛的超溶媒数最多;在超疗程方面,注射用血栓通的处方数最多;注射用丹参多酚酸盐的超给药途径数最多.结论 加强处方点评与反馈,对超说明书用药进行有效干预,促进中药注射剂的合理使用.     

阳痿中医分型与HAD心理量表测评对照研究

目的：探讨HAD心理测评与中医分型的关系。方法：选用阳痿患的常见证型进行HAD心理测评。结果：本病A（焦虑）型行为的支持率占83．7％，D（抑郁）型行为的支持率为95．3％。结论：本病的治疗应积极的引入焦抑型行为干预，尤其是抑郁型行为干预。     

2010—2012年西安医学院附属宝鸡医院门诊中成药处方点评

目的:提高门诊药房的中成药处方质量,促进中成药的合理使用。方法:随机抽取西安医学院附属宝鸡医院(以下简称"我院")2010-2012年门诊中成药处方4 965张,参考2010年《医院处方点评管理规范(试行)》和《处方管理办法》对处方进行点评。结果:共抽查的4 965张处方中,合格处方4 725张,不合格处方240张,处方合格率为95.17%。不合格处方主要表现为用药与诊断不符,重复用药,剂型、剂量及用法不合理,书写不规范等。结论:我院处方书写欠规范,合理用药水平有待加强。     

开展专项处方点评及问责对我院中药注射剂使用合理性的影响

目的回顾分析我院开展专项处方点评及问责对中药注射剂使用合理性的影响。方法随机抽取2012年3月至2014年2月我院消耗金额、用药频度排名靠前的中药注射剂当月出院病历各10份,进行专项处方点评和干预,对比干预前后中药注射剂使用合理性的变化。结果干预后,适应证不适宜及病历中无用药分析记录情况明显减少(P<0.01),用法用量错误、溶媒种类及用量错误、疗程偏长的情况改变不大(P>0.05)。结论对中药注射剂的专项处方进行点评和干预,使本院中药注射剂的合理使用水平有了一定的提高,但仍然存在一些不合理的问题,需行进一步的干预。     

不合理用药分析并典型案例点评

目的：分析处方点评工作中暴露的问题,促进临床合理用药。方法以随机抽样法抽取该院每月门诊处方100张,共计1200张,临床药师对处方逐一进行审查,对不合理用药处方进行统计分析,并对其中的部分典型不合理处方进行点评。结果不合理处方122张,占总抽查处方数的10．17％,不合理处方类型主要包括临床诊断不明确、药物用法、用量不合理、溶媒选择或合用不合理、无指征使用抗生素、药物配伍不当等。结论医院用药基本合理,但仍有小部分处方用药不合理,需大力改进;处方点评是了解临床用药水平的重要手段,通过定期进行处方点评,剖析临床用药存在的问题,及时发现,合理干预,将有利于提高临床医师合理用药水平。     

《琅嬛青囊要》校注拾零

《琅嬛青囊要》乃清代浙江绍兴医者陈太初之医学理论及临证经验著述,后世医家对其几近无人问津,迄今尚无任何相关研究.此次《琅嬛青囊要》一书由中央财政支持,立项整理出版.在校注过程中,发现历代医学目录著作对其版本的著录存在错误之处,经详细考证而予以订正.同时,在对文本内容进行了细致校勘后,对有关疑难字词及所用典故等进行了注释,使其更具科学性与实用性.此项工作的完成,可谓填补了陈太初医学研究及其医著《琅嬛青囊要》研究之空白.