某院2012年门急诊抗菌药物处方的合理性分析

目的分析我院门急诊抗菌药物临床使用情况,促进抗菌药物合理应用。方法采用回顾性分析法,抽查本院2012年1～12月门急诊抗菌药物处方6000张,根据临床药理学知识及文献资料、药品说明书,统计分析抗菌药物的使用情况。结果审查处方6000张,抗菌药物不合理处方556张,占抗菌药物处方的9．27％,主要在无指征使用、给药方案不合理,用药量过大等方面存在问题。结论我院抗菌药物使用基本合理,但存在一定问题,需要加强管理和学习,以期达到更加合理使用。     

孟鲁司特联合布地奈德治疗哮喘50例疗效观察

目的探讨孟鲁司特联合布地奈德治疗哮喘的临床效果。方法选择江苏大学附属人民医院2006年11月至2010年11月支气管哮喘患者100例,随机分为观察组和对照组。对照组给予常规治疗,同时给予布地奈德雾化吸入,观察组在对照组治疗基础上给予孟鲁司特口服。测定两组患者治疗前后肺功能。结果观察组治疗后FEV1/FVC%和PEF分别与对照组治疗后比较,差异有统计学意义(P<0.05);观察组咳嗽、胸闷、喘息缓解时间与对照组比较,差异有统计学意义(P<0.05);观察组白天和夜间发作次数分别与对照组比较,差异有统计学意义(P<0.05)。结论孟鲁司特联合布地奈德能够显著改善哮喘发作患者临床症状,改善患者肺功能,临床效果显著。     

早期肠内营养对休克后患者炎性反应的疗效研究

目的 研究早期肠内营养(EN)对休克患者内毒素及肿瘤坏死因子-α(TNF-α)的作用及全身炎性反应综合征(SIRS)的影响.方法 休克67例随机分为早期EN组和肠外营养(TPN)组,检测两组患者肠内营养治疗前、治疗后1、3、5 d血浆中内毒素与TNF-α水平;统计两组SIRS的持续时间与多器官功能障碍(MODS)的发生...     

LSS法估算COPD患者茶碱缓释片单用及联用加替沙星时稳态药-时曲线下面积

目的用有限采样法（limited sampling strategy,LSS）估算慢性阻塞性肺疾病（COPD）患者单用茶碱缓释片及联用加替沙星时稳态药一时曲线下面积（AUC0-12^ss）。方法测得16名COPD患者口服茶碱缓释片稳态时（单用及联用加替沙星）的血药浓度,以多元线性回归法建立（AUC0-12^ss与不同时间点的血药浓度的关联数学模型,并用Jackknife法进行验证。结果单点预测时可以采用给药后2h或4h的血药浓度值预报药-时曲线下面积,单用茶碱回归方程为：AUC0-12^ss=-3．01＋11．15C2（R^2=0．97,P〈0．05）或AUC0-12^ss=-1．34＋10．91 C4（R^2=0．97,P〈0．05）。联用加替沙星的回归方程：AUC0-12^ss-3．14＋10．27 C2（R^2=0．90,P〈0．05）或AUC0-12^ss=-9．68＋11．74 C4（R^2=0．96,P〈0．05）。二点预测可用给药后2h及12h的血药浓度值,单用茶碱回归方程为：AUC0-12^ss=-0．28＋8．47 C2＋3．18 C12（R^2=0．98,P〈0．05）。联用加替沙星回归方程为：AUC0-12^ss=5．74＋3．64 C2＋8．54 C12（R^2=0．99．P〈0．05）。结论考虑到给药后2h为药物的达峰时间,推荐单点预测时用给药后2h的血药浓度值;用2个浓度点进行预测采用给药后2、12h的血药浓度值。     

教育人学视野中我国药学本科教育现状分析及对策

通过教育人学理论分析得出我国药学本科教育现状,得出药学本科教育存在“人的缺失”和“科学世界的占领”两方面问题的结论,提出在药学拳科教育中要树立教育人学观念、推行跨学科教育、建立带教教师制度、改革药学教育内容、采用多样化教学方式、鼓励多方合作办学、使用多元化评价方式的对策。     

玉屏风胶囊治疗过敏性鼻炎随机双盲平行对照多中心临床研究

目的观察玉屏风胶囊治疗过敏性鼻炎的临床疗效和安全性。方法用随机双盲平行对照多中心临床试验方法,共入选288例过敏性鼻炎患者,随机分成试验组和对照组(3∶1),分别服用玉屏风胶囊和辛芩颗粒,疗程为20d。结果治疗20 d后,疾病疗效总有效率,试验组为81.34%,对照组为67.14%,试验组总有效率明显高于对照组(P<0.01);中医证候疗效总有效率,试验组为80.38%,对照组为65.71%,试验组总有效率明显高于对照组(P<0.01)。结论玉屏风胶囊具有疗效好,不良反应发生率低,复发率低等优点,是治疗过敏性鼻炎的理想药物。     

玻璃纤维桩修复下颌前磨牙残根、残冠的临床疗效

目的评价ParaPost Fiber Lux玻璃纤维桩修复下颌前磨牙残根、残冠的临床效果。方法选择98例患者共123颗患牙,行完善的根管治疗后,随机分为两组：A组62颗牙行ParaPost Fi-ber Lux桩核系统修复,B组61颗牙行成品螺纹桩加树脂核系统修复,所有患牙完成桩核后制作金属熔附烤瓷全冠,随访1-2年,通过临床检查和X线检查记录修复效果。采用SPSS11.0软件包对残根、残冠成功率作χ^2检验。结果在随访中,A组有4颗出现牙龈充血、水肿,其余牙无松动,无折裂,冠边缘密合,牙周指数正常;B组有7颗牙发生修复体脱落,3颗牙根折,3颗出现牙龈充血、水肿。A组成功率（93.55%）高于B组（78.69%）,有统计学意义（P〈0.05）。结论 ParaPost Fiber Lux纤维桩系统修复下颌前磨牙残根、残冠,是一种较为理想的桩核修复系统。     

临床生物化学检验课程PBL教学探讨

在临床生物化学检验课程中实施PBL教学,可提高学生自主学习、获取信息、解决问题、团队合作、创新思维等方面的能力。同时也存在师资力量不足、课程教学体系不匹配、学生能力不足等方面的问题,并提出相应改进策略。     

Understanding the effects of COVID-19 stigmatisation on job performance: a survey of frontline healthcare workers

The level of stigmatisation among health care providers has increased during the COVID-19 pandemic, and understanding the effect of COVID-19 stigmatisation on job performance has become increasingly important. The study explores the influence of COVID-19 stigmatisation on job performance among frontline health workers via the mediating role of anxiety. Furthermore, the moderating effect of resilience in the association between COVID-19 stigmatisation and anxiety is further examined. Participants were made up of 820 frontline health workers working in the epicentres of the Bono Ahafo, Western, Greater Accra, and Northern regions of Ghana. The hierarchical regression technique was employed in estimating the relationship between the variables. COVID-19 stigmatisation among frontline health workers directly affected anxiety and performance. In addition, the results showed that resilience moderated the relationship between COVID-19 stigmatisation and anxiety. The findings again demonstrated that anxiety partially mediated the association between concern for disclosure and public attitude and negative experience and job performance, whereas personalised stigma was insignificant. The study provides implications for establishing anti-stigma interventions and programs to enhance job performance among health workers.

Key messages

1. Many healthcare workers are subject to stigmatisation during the COVID-19 pandemic.
2. The study employs hierarchical regression methods to examine the impacts of COVID-19 stigmatisation on job performance among frontline health workers.
3. The health management team should strengthen interventions to control the stigma experienced by health workers during COVID-19 treatments.

     

Abnormal Prefrontal Brain Activation During a Verbal Fluency Task in Treatment-Resistant Depression Using Near-Infrared Spectroscopy

ObjectiveThe study investigated cognitive performance and brain function between treatment-resistant depression (TRD) and non-TRD patients to find potential neurobiological markers associated with refractoriness in depression patients. MethodsFourteen TRD patients, 26 non-TRD patients and 23 healthy controls (HC) were included in the present study. The neural function of prefrontal cortex (PFC) and cognitive performance among the three group were examined using near-infrared spectroscopy (NIRS) during verbal fluency task (VFT). ResultsBoth TRD and non-TRD groups exhibited significantly worse VFT performance and lower activation of oxygenated hemoglobin (oxy-Hb) changes in the bilateral dorsolateral PFC (DLPFC) compared to the HC group. Within the TRD and non-TRD groups, VFT performance was no significant difference, but activation of oxy-Hb changes in dorsomedial PFC (DMPFC) in TRD patients was significantly lower than non-TRD patients. In addition, activation of oxy-Hb changes in right DLPFC were negatively correlated with the severity of depressive symptoms in depression patients. ConclusionBoth TRD patients and non-TRD patients exhibited lower oxy-Hb activation in DLPFC. TRD patients exhibit lower oxy-Hb activation in DMPFC than non-TRD patients. fNIRS maybe a useful tool for predict depressive patients with or without treatment resistant.