药物治疗临床决策的要点

药物治疗的临床决策是I临床思维的结果,是对于具体病例药物治疗的全面的个体化的设计,是通过分析、比较、判断和选择,在众多方案中组织一个最适宜该患者的方案。药物治疗临床决策的要点包括总体安排（病症的分析及处置、治疗目标的安排、处理措施的选择、预期结果和靶指标的确定、治疗矛盾的处理和治疗风险的规避）,治疗方案（药物选择和联合、剂型、给药途径、剂量、给药间隔、疗程和替补方案）,药学监护计划（考核疗效、监护不良反应、观察治疗方案的执行情况和用药依从性）以及用药指导。     

三种市售中/长链脂肪乳注射液理化指标比较

Objective To compale the physical and chemical parameters of three market available medi-an/long chain fat emulsions.Methods The quality properties were determined and compared according to the fat emulsion injection quality standards in the Chinese Pharmacopeia Convention,the United States Pharmacopeia Con-vention,and the National Standard.Results Products A:the pH value was between 8.2-8.3;the particles with a size larger than 1 μm were 1.23%-1.53% and no particles were larger than 5 μm;the mean particle size was 0.246-0.256μm;the acid value was 0.2;the peroxide and methoxyl aniline values were 0 and 0.9-1.4;the he-molysis phosphatide was 0.6-0.9 g/L. The contents of fat,glycerin,and triglycerides were more than 97% of the labeled amounts;the content of phosphorus was 0.46-0.49 g/L. Products B:the pH value was between 8.2;the partocles with a size larger than 1 μm were 0.81%-1.62% and no particles were larger than 5 μm;the mean parti-cle size was 0.239-0.241 μm;the acid value was 0.4-0.5;the peroxide and methoxyl aniline values were 0 and 0.8-1.4;the hemolysis phosphatide was 0.2-0.6 g/L. The contents of fat,glycerin,and triglycerides were more than 94% of the labeled amounts;the content of phosphorus was 0.42 g/L. Products C:the pH value was between 7.7-8.1;the particles with a size larger than 1 μm were 0.42%-0.86% and no particles were larger than 5 μm;the mean particle size was 0.249-0.262 μm;the acid value was 0.3-0.4;the peroxide and methoxyl aniline values were 0 and 1.8-2.9;the hemolysis phosphatide was 0.5-0.8 g/L. The contents of fat,glycerin,and triglycerides were mole than 96% of the labeled amounts;the content of phosphoms was 0.44-0.46 g/L. Conclusion All properties of the median/long chain fat emulsions produced by the three manufacturers met the National Standard.     

支气管哮喘的雾化吸入治疗

哮喘是一种慢性气道疾病,需长期治疗。主要给药途径有静脉给药、口服给药和吸入给药等,吸入给药为首选给药途径。通过吸入给药,药物可直接到达靶器官,这种给药方法起效快,用药量少,全身副作用小。     

临床药师在戒烟门诊中的作用

吸烟有害健康已成为全社会关注的公共卫生问题,全世界每年因吸烟死亡的人数达500多万,与烟草相关的疾病占全球死因第一位。世界卫生组织（WHO）定义烟瘾为一种慢性依赖性疾病。烟草依赖又称尼古丁依赖,特点为无法克制的尼古丁觅求冲动,以及强迫性地、连续地使用尼古丁,以体验其带来的欣快感和愉悦感,并避免可能产生的戒断症状,吸烟成瘾的实质就是尼古丁依赖。     

如何构建医院品管圈内训师团队

组建种子内训师与骨干内训师两级团队,利用微格教学、专题讲座等方法培养骨干内训师;建立4级管理体系,明确激励机制与退出机制,全面管理内训师团队。截止2018年,全院共完成品管圈活动近1 100圈,参与人员数超过13 000人次,拟定对策3 600余项,建立标准作业书1 700余份。内训师团队的建立与管理,可以较好地提升质量持续改进活动水平。     

特异性环氧化酶-2抑制剂对胃肠道、肾脏及心血管系统的安全性

目的：探讨特异性环氧化酶-2抑制剂的安全性。方法：查阅国外近几年的部分相关文献。结果：特异性环氧化酶-2抑制剂与传统非甾体抗炎药相比有较高的胃肠道安全性，目前研究显示两者对肾脏和心血管的作用相似。结论：发生肾脏或心血管不良事件危险性较高的患者使用特异性环氧化酶-2抑制剂治疗时应注意安全。     

华法林用药咨询和用药教育实践与分析

华法林是目前临床上常用的口服抗凝药.但是华法林起效慢,疗效易受年龄、个体差异、药物相互作用、日常饮食、自身疾病状况等诸多因素影响,因而用药剂量不易掌握,易引起出血或治疗不达标.     

程序性死亡因子-1抑制剂在血液系统恶性肿瘤治疗中的研究进展

免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)的应用是一种新型免疫治疗手段。阻断程序性死亡因子-1(programmed death 1,PD-1)与其配体(PD-L1)结合,可避免免疫逃逸,恢复机体免疫应答,发挥其抗肿瘤效应,是目前抗肿瘤治疗中炙手可热的方法之一。PD-1抑制剂在越来越多的实体瘤治疗中表现出较好疗效,但在血液系统恶性肿瘤中的应用仍相对有限。本文回顾PD-1抑制剂在血液系统恶性肿瘤中的临床研究,探讨其临床应用前景。