Clinical pharmacy practice guidelines have developed rapidly in recent years. They provide a series of recommendations for optimizing drug treatment management and improving pharmaceutical care appropriateness and are widely employed in clinical practice. Based on literature review and the experience of guideline development, this paper summarized the meaning, formulation methods, formulation status, and registration of clinical pharmacy practice guidelines, and provided suggestions for the development of guidelines.
Objective To investigate the disease constitution and cost of inpatients in Gaozha Central Township Health Center (GzC) in Wuzhong City of Ningxia Hui Autonomous Region from 2008 to 2010, so as to provide baseline data for further research. Methods A questionnaire combined with a special interview was carried out, and case records and cost information of GzC inpatients in 2008, 2009 and 2010 (from January to November) were collected. The diseases in discharge record were classified according to International Classification of Diseases (ICD-10) based on the first diagnose and the cost was analyzed. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Results a) The total number of the inpatients was 1124, 642 and 747 in 2008, 2009 and 2010, respectively. The female was more than the male in both 2008 (59.34% vs. 40.66%) and 2009 (60.75% vs. 39.25%), and their disease spectrum included 17 categories, which accounted for 81% of ICD-10; b) The top six most commonly seen systematic diseases with a constituent ratio from 86.63% to 92.06% in recent three years were as follows: the respiratory system, digestive system, circulatory system, genitourinary system, injury and toxicosis, skeletal musculature and connective tissue disease. Except the injury and toxicosis, the other five systematic diseases were commonly seen in females rather than in males; c) The top 15 monopathies in recent three years were pulmonary infection, tracheitis or bronchitis, coronary heart disease, soft tissue injury, gastritis or chronic gastritis, upper respiratory infection, hypertension, urinary tract infection, prolapse of lumbar intervertebral disc, pelvic inflammation, fracture, pneumocardial diseases, superficial injury, chronic cholecystitis and arthritis; d) The main burdens of disease for inpatients focused on 35-54 age groups, then followed by the age groups above 55 in 2008 and 2009. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males. Pulmonary infection focused on the age groups above 35; the onset of hypertension increased obviously and a sharp rise of hypertension existed in the 45-54 age groups in 2008, but the hypertention focused on 35-44 age groups in 2009; e) The total inpatients with top 15 monopathies accounted for 64.06% to 71.21%, including 8-9 chronic diseases ranking higher in 2010, and 6-7 acute diseases focusing on infection and injury; and f) The average costs of chronic diseases were higher than those of acute diseases. Conclusion a) There is a big gap between GzC and Yong’an Central Township Health Center (YaC) regarding the level of the regional economic development, the situation of disease burden and cost of inpatients. The former is demonstrated as general Central Township Health Center, while the latter as affluent Central Township Health Center in western China; b) In recent three years, the main systematic diseases are in respiratory, circulatory and digestive system; the inpatients suffer from more chronic diseases rather than acute diseases in their young age; the acute diseases mainly include infection and injury, and the pulmonary infection has ranked as the first during the past three years; c) The inpatients in 2008 and 2009 are mainly in ages of 35 to 54, and then are over 55 years old. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males; d) The patients’ average costs of chronic diseases for hospitalization and drug in 2010 were lower than those of YaC. Consideration on reasonable constitution of the cost for hospitalization should be paid attention to; and e) It is urgent to strengthen the construction of infrastructure and informatization in GzC.
目的:了解参与“5?12”四川大地震救援医护人员的应急减灾与备灾现状,为促进备灾教育和备灾行为提供参考依据。方法： 用自行设计的调查表,对参加四川大地震医疗救援的223名医护人员及其所在医疗机构的应急减灾与备灾情况等进行调查。结果: 本调查中的全体医护人员所在医疗机构地震发生时均采取了积极的应急减灾处理,成功地履行了医护人员救死扶伤的神圣使命。经历大地震后,95.1%～83.9%医护人员所在医疗机构对急救减灾对策、物资应急供应装备与后勤保障方面的备灾措施进行了加强与完善,但信息畅通的保障与备灾行动的落实方面尚存在不足;85.7%～64.6%医护人员所在医疗机构建立或完善了相关备灾规章制度与指南。结论： 经历“5?12”大地震后,医疗机构在应急救治能力的储备、救援人员的反应力与意识、信息畅通、物资供应保障等方面具有了一定的备灾基础,同时也提示了对于促进备灾教育和备灾行动的落实以及进一步完善相关制度/手册的必要性和迫切性。
Choroidal metastasis of lung cancer is rare in clinical, which is easy to missed diagnosis or misdiagnosis, special research and discussion are not much. This article mainly introduces the current situation of choroidal metastasis of lung cancer in China, the characteristics of clinical and ophthalmoscopic examination, angiography and imaging, the methods of early detection, early diagnosis and the progress of individualized comprehensive treatment. It is expected to attract the attention of thoracic surgeons, conducive to improve the quality of life and prognosis of patients.
ObjectiveTo analyze the research status and hot spots of health technology assessment (HTA). MethodsDatabases including China National Knowledge Infrastructure (CNKI) and PubMed were searched to collect published studies on HTA. The software of BICOMS-2 and VOSviewer 1.6.10 was used to draw the network diagram and to conduct cluster analysis of keywords. ResultsA total of 1170 studies in Chinese and 8584 studies in English were included. The number of HTA-related publications increased annually, among which countries with the most publications were the United States, the United Kingdom, and Canada. Fudan University had the largest number of studies published in Chinese and York University had the largest number of studies published in English. The research topics mainly focused on hospital HTA, HTA decision transformation research, pharmacoeconomic evaluation, etc. The most frequent diseases were cancer and depression. Emerging keywords were real-word evidence, randomized controlled trials, cost-benefit analysis, etc. ConclusionHTA-related studies increase annually. Many HTA-related studies are performed in developed countries, such as the United States and the United Kingdom. The relevant research topics involve hospital HTA, HTA decision-making transformation research, and pharmacoeconomic evaluation. Current research focus is on the evaluation of health economics in the field of cancer based on the evidence of real-world research and randomized controlled trials.
Total hip arthroplasty is an end-stage treatment for hip diseases such as hip osteoarthritis and osteonecrosis of the femoral head. Traditional surgery models are still mostly used in China, and related day surgery models abroad have shown that day surgery for total hip arthroplasty is as safe and feasible as traditional pattern without increase in complications and readmission. It can also shorten the length of hospitalization for patients, reduce hospitalization costs, thereby speeding up bed turnover and increasing the utilization of medical resources. This article reviews the patient admission, perioperative management, anesthesia and surgical techniques, post-discharge rehabilitation and nursing care of patients undergoing day surgery for total hip arthroplasty, and aims to providea reference for the development of day surgery for total hip arthroplasty in China.
Objective To understand current situation of medical service and management in Yong’an Central Township Health Center (YaC) through on-the-spot investigation, in order to provide references for personal employment and essential medicines list implement in township health centers. Methods Questionnaire and focus interview were carried out, which included the general information, human resources, medical service and management, and the practice of essential medicines list. Results The hardware equipments of YaC were fine, and the target population had fairly good health and economy status. The ratio of General Practitioner (GP)/ nurse and GP/ pharmacist were all above the national average level. The members with college degree and above accounted for 61.6%, and about 88% staffs were with or below primary profession titles. There was a balance between personnel flow out and in. The drug income accounted for 53.6% of the whole in 2009 and the medical expenses increased compared to 2008. Essential medicines list was put into practice in April 1st of 2010 with no relevant technical documents as correspondence. Conclusion YaC, as a good representative of fairly well-off rural Township Health Center in western China, needs to cope with challenges of irrational personnel structure, low educational background and professional title of the staff and human resources flow, and requires developing policy and adopting measures step by step. The management of YaC may be influenced by zero-profit price of the essential medicine, and appropriate subsidy and policy support are necessary to maintain current service quality.