Intervening measures for improper prescription in clinic:introduction and empirical analysis

目的:介绍福建省某三甲医院干预不合理处方的措施并进行分析,探讨提高处方质量的方法。方法:参照2010年2月10日卫生部印发的《医院处方点评管理规范(试行)》,结合本院近年来对不合理处方干预的资料与经验,深入分析各种不合理处方的干预措施及其综合应用的有效性。结果:处方自动监测系统(PASS)干预、审核药师审核退回、调配发药药师拦截、临床药师介入进行回顾性汇总分析、宣传教育行政干预等措施相结合是提高处方质量的有效方法。结论:不合理处方的干预要有统一可行的标准,医院通过各个环节紧密配合,临床药师介入处方干预的各个环节,配合行政干预,加强宣传教育,共同对不合理处方进行干预,有望在不合理处方干预方面取得成效。Objective:Intervening measures for improper prescription in a Three-A hospital of Fujian province was introduced and analyzed to discuss the approach improving the prescription quality.Methods: The data and experiences in our hospital in recent years were collected and analyzed.According to "Tentative Management Regulation of Prescription Comment in Hospital" issued by Ministry of Health,China on February 2010,various intervening measures for improper prescription were fully discussed.Results: Following measures could be integrated into application to improve prescription quality: intervene with prescription automatic screening system(PASS),withdraw after reviewed by a senior pharmacist,intercept by a dosage pharmacist,intervention through review analysis by clinical pharmacist,and administrative disturbance through health education.Conclusion: A uniform practicable standard is needed in the field of intervention for improper prescription.Cooperation between different sectors of a hospital,clinical pharmacist involvement in all phases of prescription intervention,assistant with administrative disturbance,and health education are expected to make progress in improving improper prescription

Ultrasound Guided Percutaneous PDT For Advanced Liver Cancer A Report of 30 Cases

为探讨治疗中晚期肝癌的理想方法，扩大和发展光动力疗法，自1994年6月起，我们应用光动力疗法（PdT）治疗中晚期肝癌30例，其中肝细胞癌28例、腺癌2例。肿瘤直径7~10CM的13例、10CM以上至16CM的17例。伴肺转移5例、骨转移5例、门静脉或腔静脉浸润4例。首次治疗19例、其他方法治疗无效或复发者11例。本研究采用氩激光泵浦染料激光器系统，获得630nM波长的连续波治疗光。光敏剂选用血卟啉衍生物（HPd）。治疗时通过b超引导经皮肝穿，将光纤导入肿瘤组织中布点照射。治疗后未见肝功能明显损伤，未出现肝穿出血、腹膜炎等严重并发症，没有一个月内病情恶化者。有14例患者只作一次治疗，其中5例出院后失访；另9例肿瘤部分缓解率为22%。16例患者接受二、三次治疗，肿瘤部分缓解率达到62%。随访病例中有8例已存活1年以上。patients with advanced liver cancer were treated by interstitial photodynamic therapy (PDT).These included 28 hepatocellular carcinoma and two adenocarcinoma, 19 primary tumors and 11 recurred Following other treatments.The diameter of tumors were 7 10 cm in 13 cases and 10 16 cm in 17 cases.In this study, an argon laser pumped dye laser system was used to give a CW laser beam at 630 nm which was split and coupled into three optical Fibers.The patients received injection of photosensitizer of hematoporphyrin derivative (HpD) i.v.at a dose of 5 mg/kg body weight 48 h prior to laser irradiation.Then the Fibers were inserted into tumor by ultrasonic visualization guided percutaneous liver puncture.The inserted irradiation points were spaced in entire tumor volume and the tumor was irradiated with a light output power of 300 mW For 12 minuts per point.Totally 52 treatments were perFormed in 30 patients.Among them, 14 cases were treated by only one time and 16 cases 2 or 3 times.The Follow up were carried out in 25 cases For 3 18 months.The results show that signiFicant remission was 22% (2/9) in those patients by only one treatment and 62% (10/16) in those by 2 or 3 treatments.The reduction rate of tumor size was over 90% in Five out of six cases aFter 3 treatments.8 patients have been surviving over one year.No obvious change was Found in all patients examined by liver Function test, renal Function test and blood routine examination.The level of AFP depicted a descending tendency aFter PDT.Our Findings indicate that PDT is eFFective and saFe For the treatment of large liver cancers including those recurred Following hepatic resection and those Failed in hepatic artery inFusion embolic chemotherapy.福建省“八五”攻关资

Anxiety and depression status of patients with breast cancer and analysis of the related factors

目的:确定乳腺癌手术患者焦虑、抑郁状况及主要相关因素,为临床心理干预提供依据。方法:采用焦虑自评量表、抑郁自评量表及自行设计的调查问卷,对230例术后患者进行焦虑、抑郁评定和相关因素的分析。结果:乳腺癌患者焦虑和抑郁的发生率分别为56.09%、49.57%。乳腺癌手术患者常见焦虑、抑郁情绪的相关因素为年龄、文化程度、付费形式、家庭月收入、肿瘤分期等。结论:乳腺癌患者焦虑、抑郁的发生率较高,临床护理中要加强心理干预,以改善围手术期乳腺癌患者的心理状态

乳腺癌患者配偶焦虑抑郁状况的调查及相关因素分析

目的:评估乳腺癌患者配偶的焦虑抑郁状况,分析影响焦虑抑郁的相关因素。方法:采用问卷方式,调查蚌埠医学院第一附属医院肿瘤外科110名乳腺癌患者配偶。该问卷由焦虑自评量表(SAS)、抑郁自评量表(SDS)和人口社会学资料组成。结果:乳腺癌患者配偶焦虑和抑郁的发生率分别为43.36%和40.91%。SAS、SDS评分与国内常模比较差异均有统计学意义(P<0.01)。乳腺癌患者配偶常见焦虑、抑郁情绪的相关因素为年龄、文化程度、付费形式、家庭月收入、肿瘤分期等。结论:乳腺癌患者配偶焦虑、抑郁的发生率较高,临床护理中要加强对配偶的心理干预

Application of Interstitial Photodynamic Therapy For Liver Cancer under Real time US Guidance

报道30例超声引导间质性激光动力学疗法（InTErSTITIAlPHOTOdynAMICTHErAPy，IPdT）治疗中晚期肝癌新方法的临床应用结果，旨在评价其临床应用价值。采用氩激光泵浦染料激光器，获得630nM波长的连续治疗光，光敏剂选用血卟啉衍生物（HPd），于超声引导下将光纤导入肿瘤组织内进行间质性照射。结果表明：1有14例患者仅行一次治疗（其中5例失访），肿瘤部分缓解率为22%，16例患者接受2~3次治疗，肿瘤部分缓解率达62%。随访病例中已有8例存活一年以上。2所有病例未见严重并发症。这种治疗方法是一种有效而安全的治疗肝癌新方法。To evaluate the eFFicacy of interstitial photodynamic therapy (IPDT) For liver cancer, 30 patients with liver cancer were treated with IPDT under US guidance.An argon laser pumped dye laser system was used to give a CW laser beam at 630 nm.The patients were injected intravenously with photosensitizer hematoporphyrin derivative (HpD) at a dose of 5 mg/kg body weight 48 h beFore IPDT.Then the optical Fibers were inserted into tumor under ultrasound guidance, the tumors were irradiated with CW laser.Clinical results showed that ①14 cases were treated only one time, the partial remission rate of the tumor was 22%, 16 cases were treated by 2￣3 times, the partial remission rate of tumors was 62%.In 8 cases the survival time was over one year; ②No severe complication and side reaction were Found aFter IPDT in this series.It is suggested that IPDT is a saFe and eFFective new method For treatment of liver cancer.福建省“八五”攻关基