药物制剂专业物理化学课程教学的思考和探索

物理化学基础知识和基本理论在药物制剂专业中有重要应用,改革物理化学教学,加强物理化学教学内容与药物制剂专业的融合,为学生学习专业课以及将来从事相关专业工作打下坚实的物理化学基础.从更新教学观念、培养学生的学习能力±改革教学内容、教学手段、教学方法±优化实验教学、开设与专业课结合的综合性实验±开阔学生视野、开设有专业特色的专题讲座±倡导探究性学习,培养学生的创新能力±应用现代教学理念,开展问题导向教学、反转课堂式教学±提高物理化学教师的药学知识修养等方面思考和探索物理化学教学改革,提高药物制剂专业物理化学课程教学质量.     

上海市15家医院和药房计算机应用现状调查

目的：分析和讨论了上海市１５家医院药房计算机应用现状。方法：采用问卷调查与访谈相结合的调查方法。结果：多数医院和药剂科计算机网络建设相对滞后,缺乏系统规划和开发经费,软件更新周期长,资源不能共享;药剂科药品管理应用软件档次低,急救更新,药品管理的方法、观念以及系统的维护存在不足,药品数据的综合分析、信息管理和咨询系统开发应用进展缓慢。结论：重视计算机网络化建设,积极培养复合人才,开发和应用综合性的咨询软件。     

丹参的药理作用研究进展

目的探讨丹参的临床新用途,为临床应用提供依据。方法查阅相关文献,进行分析和归纳。结果丹参的药理作用极其广泛．包括心肌保护、扩张血管、抗动脉粥样硬化、抗血栓、改善微循环、调节组织修复和再生、抗菌消炎等作用,近来对其作用机制有了进一步的研究,同时又发现其具有抗肿瘤、抗氧化等作用。结论丹参的药理作用,疗效确切,值得临床推广使用。     

Impact of National Centralized Drug Procurement Policy on Antiviral Utilization and Expenditure for Hepatitis B in China

Background and AimsThe National Centralized Drug Procurement (NCDP) policy was launched in mainland China in April 2019, with entecavir (ETV) and tenofovir disoproxil fumarate (TDF) being included in the procurement list. We conducted the current study to investigate the impact of the NCDP policy on the utilization and expenditures of antiviral therapy for chronic hepatitis B (CHB) in China.MethodsProcurement records, including monthly purchase volume, expenditure, and price of nucleos(t)ide analogs (NAs), were derived from the National Healthcare Security Administration from April 2018 to March 2021. The changes in volumes and expenditures of the first-line NAs and bid-winning products were calculated. The effects of price, volume, and structure related to drug expenditure were calculated by the Addis and Magrini (AM) Index System Analysis.ResultsThe purchase volume of NAs significantly increased from 134.3 to 318.3 million DDDs, whereas the expenditure sharply decreased from 1,623.41 to 490.43 million renminbi (RMB) or 241.94 to 73.09 million US dollars (USD). The proportions of first-line NAs rose from 72.51% (ETV: 69.00%, TDF: 3.51%) to 94.97% (ETV: 77.42%, TDF: 17.55%). AM analysis showed that the NCDP policy decreased the expenditure of all NAs (S=0.91) but increased that of the first-line NAs in the bid-winning list (S=1.13). Assuming the population size of CHB patients remains stable and a compliance rate of ≥75%, the proportion of CHB patients receiving first-line antiviral therapy would increase from 6.36–8.48% to 11.56–15.41%.ConclusionsThe implementation of the NCDP policy significantly increased the utilization of first-line NAs for CHB patients at a lower expenditure. The findings provided evidence for optimizing antiviral therapy strategy and allocating medical resources in China.     

Effects of Public Hospital Reform on Inpatient Expenditures in Rural China

Public hospital reform is one priority area in the healthcare system reform that China launched in 2009. The Chinese government invested over $10bn for pilot projects in public hospital reform in rural China. However, little evidence exists on their effects. Using a quasi‐natural experiment design, we evaluated the effects of a public hospital pilot project in Hubei province on inpatient spending. We obtained inpatient claims data from 1/1/2011 through 6/30/2013 for enrollees in the New Cooperative Medical Scheme in two counties: Danjiangkou, one of the pilot counties selected for reform in September 2012, and Laohekou, a similar, adjacent county serving as the control group. Using a difference‐in‐differences approach with propensity score weighting, we found that total inpatient spending increased ¥1160 (95% CI 1155–1166), out‐of‐pocket spending increased ¥385 (95% CI 382–389), length of stay increased 0.51 days (95% CI 0.50–0.52), but inpatient medication spending decreased ¥147 (95% CI 145–150), post‐policy in Danjiangkou, relative to the control group. The overall reimbursement rate increased by 5.7 percentage points. One of the goals of the recent public hospital reform is to make inpatient services affordable to patients. We found that although patients spent less on inpatient medications, total out‐of‐pocket spending increased considerably after reform. Copyright © 2016 John Wiley & Sons, Ltd.     

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia

BackgroundThe continuing expansion of the pharmacist’s role necessitates continuous evaluation of current practice to identify strategies for improvements. The International Pharmaceutical Federation (FIP) has developed tools to support stakeholders in identifying development needs and planning advancement strategies. The aim of this research was to utilise the FIP Global Competency Framework, version 2 (GbCF v2), and FIP Development Goals (DGs) to evaluate competencies related to pharmacy practice in Saudi Arabia, and to understand the strategies needed to develop and improve the current practice.MethodsThe study involved four phases. Phase 1 involved translation of the FIP GbCF v2 into the Arabic language. Phase 2 was a consensus panel validation to establish the initial relevance of the competencies to current practice. Phase 3 included a national survey distributed to all registered pharmacists in Saudi Arabia. The final phase was conducted through mapping ‘not relevant’ competencies to FIP DGs to identify priorities.ResultsThe translation phase yielded a bilingual framework that could be utilized by pharmacists in Saudi Arabia. The initial validation phase identified 61 behavioral statements (from 124 in the GbCF v2) as ‘highly relevant’ or ‘relevant’ to pharmacy practice. Findings from the national survey identified a list of ‘not relevant’ competencies that could highlight gaps in current practice. The final mapping phase generated a list of three FIP DG priorities: DG5 (competency development), DG8 (working with others) and DG11 (impact and outcomes).ConclusionThe study indicated that competencies in the GbCF v2 were relevant to pharmacists practicing in the country. However, some competencies were perceived as ‘not relevant’ to current practice and these highlighted gaps in the current practice that need attention. Mapping ‘not relevant’ competencies to FIP DGs should be used as a starting point towards developing strategies, systems, and protocols to advance pharmacy practice in Saudi Arabia.     

临床药师对慢性阻塞性肺疾病合并肾功能不全患者药学监护1例

本文报道了1例老年慢性阻塞性肺疾病急性加重伴肾功能不全患者进行临床药师药学监护。此患者入院给予注射用哌拉西林舒巴坦等药物治疗。由于指南中未提及肾功能减退患者哌拉西林舒巴坦的剂量调整方法,临床药师考虑哌拉西林舒巴坦与哌拉西林他唑巴坦的半衰期、排泄时间和排泄比率相似,因此用药方案采用哌拉西林他唑巴坦的剂量调整方法;患者入院第3天复查血常规提示白细胞、血小板计数低于正常值范围,临床药师考虑为哌拉西林舒巴坦的不良反应,停药后白细胞、血小板计数升至正常值范围;另外,临床药师根据患者用药情况,对支气管舒张剂的注意事项、氟康唑胶囊与其他药物的相互作用、双歧杆菌四联活菌片与美罗培南应用时间等方面进行药学监护,后患者病情好转出院。临床药师针对慢性阻塞性肺疾病的正规治疗方案对患者进行用药教育及出院注意事项的指导。     

基于“结构-性质-应用”三位一体的药物化学教学实践

目的：探索“结构-性质-应用”三位一体的药物化学教学实践效果。方法选取漯河医学高等专科学校2009级三年制药学专业1班（n=62）为对照组,2010级三年制药学专业1班（n=70）为实验组。对照组采用传统教学,实验组采用三位一体的药物化学教学。采用定量调查和定性研究相结合评价教学效果。定量研究采用综合测试成绩对比法,定性研究采用问卷调查让实验组学生对三位一体教学的效果进行评价。数据采用SPSS 16.0软件进行统计分析,2组综合测试成绩比较采用秩和检验。结果实验组学生的综合测试成绩明显高于对照组,2组比较差异有统计学意义（Z=2.880,P=0.04）;问卷调查表明,实验组90.00%（63/70）以上的学生对三位一体教学各项效果表示认同。结论三位一体教学能提高学生学习的积极性和主动性,培养学生的创新能力以及解决实际问题的能力,提升药物化学教学质量。     

丹参的药理作用研究进展

丹参是一种中药制剂,近年来对丹参药理作用的研究,无论从深度及广度上都有所进展。丹参的药理作用极其广泛,包括心肌保护、扩张血管、抗动脉粥样硬化、抗血栓、改善微循环、调节组织修复和再生、抗菌消炎等作用,近来对其作用机制有了进一步的研究,同时又发现其具有抗肿瘤、抗氧化等作用。因此丹参在临床上得到广泛应用。     

五种养心安神中药的抗惊厥作用初探

目的：研究远志、酸枣仁、合欢皮、柏子仁和罗布麻叶等五种养心安神药的抗惊厥活性。方法：采用95％乙醇分别对远志、酸枣仁、合欢皮、柏子仁和罗布麻叶进行提取，制备其醇提物；然后采用戊四唑（PTZ）致小鼠惊厥模型对所得5种醇提物的抗惊厥活性进行考察。结果：远志醇提物8g/kg能降低小鼠惊厥发生率，并显著延长小鼠发生惊厥的潜伏期和死亡时间，降低死亡率；酸枣仁醇提物和合欢皮醇提物在8g/kg时都明显延长惊厥小鼠的死亡时间，同时降低小鼠死亡率；柏子仁醇提物和罗布麻叶醇提物对P1Z致小鼠惊厥无影响。结论：远志醇提物、酸枣仁醇提物和合欢皮醇提物均有抗惊厥作用．其中远志醇提物作用最强：柏子仁醇提物和罗布麻叶醇提物无抗惊厥作用。