PDCA循环在减少药品调剂差错中的应用

目的:通过对产生药房调剂差错原因的分析,找到减少调剂差错的方法。方法:采用美国著名的质量管理专家戴明(W.E.Deming)博士于20世纪50年代初提出的PDCA循环来总结归纳造成调剂差错的主要原因,并寻求可能减少差错的措施。对比采用措施前后一个月内的差错数,来验证措施是否行之有效。PDCA循环,是英文计划(Plan)、实施(Do)、检查(Check)和处理(Action)的缩写。PDCA循环理论最早应用于企业管理,取得了良好的效果,被管理界公认为有效的管理方法之一。结果:比较两个月的调剂差错数量,差错发生件数从290起下降到154起,下降了46.7%。结论:为减少调剂差错数量所采取的措施是行之有效、可采用的。     

Selective Estrogen Receptor Modulation by Larrea nitida on MCF-7 Cell Proliferation and Immature Rat Uterus

Larrea nitida is a plant that belongs to the Zygophyllaceae family and is widely used in South America to treat inflammatory diseases, tumors and menstrual pain. However, its pharmacological activity remains unclear. In this study we evaluated the property of selective estrogen receptor modulator (SERM) of Larrea nitida extracts (LNE) as a phytoestrogen that can mimic, modulate or disrupt the actions of endogenous estrogens, depending on the tissue and relative amount of other SERMs. To investigate the property of SERM of LNE, we performed MCF-7 cell proliferation assays, estrogen response element (ERE)-luciferase reporter gene assay, human estrogen receptor (hER) binding assays and in vivo uterotrophic assay. To gain insight into the active principles, we performed a bioassay-guided analysis of LNE employing solvents of various polarities and using classical column chromatography, which yielded 16 fractions (LNs). LNE showed high binding affinities for hERα and hERβ with IC₅₀ values of 1.20 ×10⁻⁷ g/ml and 1.00×10⁻⁷ g/ml, respectively. LNE induced 17β-estradiol (E2)-induced MCF-7 cell proliferation, however, it reduced the proliferation in the presence of E2. Furthermore, LNE had an atrophic effect in the uterus of immature rats through reducing the expression level of progesterone receptor (PR) proteins. LN08 and LN10 had more potent affinities for binding on hER α and β than other fractions. Our results indicate that LNE had higher binding affinities for hERβ than hERα, and showed SERM properties in MCF-7 breast cancer cells and the rat uterus. LNE may be useful for the treatment of estrogen-related conditions, such as female cancers and menopause.     

舟山市3例发热伴血小板减少综合征的病原学与遗传特征

目的 对舟山市3例疑似发热伴血小板减少综合征(SFTS)病例进行病原学鉴定、确诊,并分析其遗传特征.方法 选用巢式RT-PCR测定新布尼亚病毒核酸及L、M、S3个特异性基因,并对基因扩增产物进行测序,测序结果与GenBank上公布的序列进行比对确认.用DNAStar软件构建进化树与序列距离表.用间接免疫荧光法测定患者恢复期和急性期血清新布尼亚病毒IgG抗体滴度.结果 3例SFTS患者急性期血清中均能检测到新布尼亚病毒的3个特异性基因片段,其中S基因核苷酸序列与舟山市同类基因核苷酸序列的同源性在94.4％～ 100.0％,患者恢复期血清病毒抗体滴度较急性期增高4倍以上.结论 经过病原学鉴定,3例临床疑似患者确诊为发热伴血小板减少综合征的新近感染病例.舟山市新布尼亚病毒的遗传特征比较稳定.     

Behavioral interventions for Cambodian female entertainment and sex workers who use amphetamine-type stimulants

Conditional cash transfer (CCT) and cognitive-behavioral treatments are evidence-based approaches to reduce stimulant use and sexual risk taking. We describe the adaptation and implementation of sequential behavioral interventions for Cambodian female entertainment and sex workers (FESW) who use amphetamine-type stimulants (ATS): (1) a 12-week CCT intervention; and (2) a 4-week cognitive-behavioral aftercare (AC) group. An ongoing cluster randomized stepped wedge trial in 10 Cambodian provinces is enrolling FESW with confirmed recent ATS use to examine the effectiveness of CCT + AC. In the first six provinces, 138 of the 183 eligible FESW (75 %) enrolled in CCT and completed a median of 25 (interquartile range 9–32) of the 36 urine screening visits. Of the 84 participants who were eligible for AC, 79 completed at least one session (94 %) and 57 completed three or more sessions (68 %). Culturally tailored behavioral interventions to reduce ATS use and optimize HIV prevention are feasible in resource-limited settings.