基层医院中药调剂工作常见问题及建议

中药调剂是临床工作的重要一环,笔者在基层医院工作多年,发现基层医院调剂过程中存在许多问题,本文对调剂工作存在的问题进行探讨,并提出改进措施,以期提高中药调剂水平,确保临床疗效.     

医院中药调剂中出现的问题及对策分析

中药治疗是医院治疗患者的重要措施,中药调剂属于治疗的关键环节。但是,医院在中药调剂过程中也容易出现了问题,不尽快解决会对患者身体健康造成不利影响,严重可导致患者生命受到威胁。因此,文章就医院中药调剂中出现的问题提出相应对策,以期引起医院、工作人员的重视,为提高用药质量,保障患者生命健康打下基础。     

小包装中药饮片在调剂过程中的体会

中药是祖先留给我们的宝贵财富,传统的散装中药在现代调剂的过程有着一些不足。文章结合目前我院正在使用的小包装中药饮片,提出在使用过程中的优势及遇到的一些问题,供同行参考。同时希望可以提高中药调剂效率,减少调剂差错,提高患者对中医药的信任度。     

小包装中药饮片在中药配方调剂中准确率高的探讨

目的分析研究小包装中药饮片在中药配方调剂过程中调剂剂量准确率高的特点。方法将使用传统包装中药饮片调剂的中药配方的单剂量重量与使用小包装中药饮片调剂的中药配方的单剂量重量作为对照组和观察组,对传统包装中药饮片在中药配方调剂中单剂药重量出现剂量误差概率与小包装中药饮片在中药配方调剂中单剂药重量出现剂量误差概率进行比较分析。结果对照组合格率为30.0%,低于观察组的100.0%,差异有统计学意义(P0.05)。结论在中药配方调剂工作中大力推广小包装饮片对保证饮片调剂剂量的准确率具有重要意义。     

中药调剂对处方疗效的影响分析

中药调剂工作的主要内容是依据医生所开具的临床处方进行中药配制,步骤通常包括审方—计价—中药调配—复核—分装—发药等,中药调剂工作是中医治疗中关键环节之一,其对临床处方疗效的发挥具有重要影响。为进一步完善中药调剂过程,提高中药调剂工作质量,本文特从中药调剂中各个环节对处方疗效影响的角度进行分析、探讨。     

中药调剂专业一体化之探讨

中药调剂专业需要具有扎实的理论功底和娴熟的实践操作能力.笔者在多年的教学过程中发现,依然按照传统的教学模式出现了许多问题.近几年在职业教育改革中,一体化教学改革进行的如火如荼.笔者结合本专业,试图探讨中药调剂专业一体化改革之路.     

中药饮片调剂中复核的重要性

中药调剂是中医辩证施治的基础环节,直接关系到治疗效果。从当前中药饮片的工作现状来看,其调剂效率和规范性都有待进一步提高。为规范中药调剂,提高中药治疗的效果,文章分析了中药饮片调剂中存在的主要问题,并探讨了中药饮片调剂复核的一般程序,提出了提高其准确性的复核方法,以期对中药饮片调剂有指导意义。     

规范处方调剂给药的重要性

目的探讨中药处方调配过程中存在的几点问题,加以分析并规范化。方法从多年中药处方调配工作中发现问题,分析出现问题的关键。结果从处方用名不规范、处方书写不规范、中药饮片炮制不规范、调剂人员工作失误4个方面进行分析。结论为患者提供优质的全方位药学服务,确保医疗安全,中药处方调剂给药规范化是非常重要的。     

中药调剂工作中应注意的问题

中药调剂工作中应注意的问题中国医科大学附属第一临床学院药剂科魏广彬加强中药的调剂与管理工作对确保药物的临床治疗效果以及对患者的身心健康至关重要。这就要求中药调剂人员必须熟炼掌握中药的药性及配伍禁忌，药物的常用剂量、药品的别名、脚注等诸方面的知识，方能...     

处方分析在中药调剂中的应用效果研究

目的：探析处方分析在中药调剂中的运用效果。方法：以中医药基本理论为依据,对相关资料进行查找,归纳总结处方分析在中药调剂中的主要作用。结果：处方分析在中药调剂中具有检查处方书写规范性、降低用药重复出现几率、核查中药配伍禁忌、错误用法、使用剂量以及为中药调剂奠定良好基础的作用。结论：在中药调剂工作中,处方分析作为其中的一个关键环节,不仅可以有效降低人为因素导致用药错误的出现几率,在一定程度上还能实现处方用药的安全性、合理性,为患者提供保障。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.