Objective To analyze drug use for 23 sick and wounded hospitalized in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital, during one month after Lushan earthquake, so as to provide references for the drug use for the sick and wounded women and children. Methods Medication information was retrospectively investigated in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. We extracted data including hospitalization duration, medication prescriptions, types and costs of essential medicines, types and costs of antibiotic medicines using the HIS system. Discharge diagnosis was standardized and classified according to ICD-10. Indicators of rational drug use included defined daily dose (DDD), defined daily dose statistic (DDDs), drug utilization index (DUI), children defined daily dose (cDDD), children drug utilization index (cDUI), proportion of essential medicines, proportion of antibiotic medicines, mismatch of medicine and diagnosis, repeated drug use, improper combination of drug, incorrect usage and dosage, and frequently drug change. Medication information was evaluated and discussed by the prescription working group. Discrepency was resolved by consulting with the panel. Results A total of 23 sick and wounded women and children were assessed during one month after Lushan Earthquake. There were 13 sick and wounded children in the department of pediatrics (mainly manifested as bronchial pneumonia) and 10 sick and wounded women in the department of gynaecology and obstetrics (mainly involved in cesarean delivery). Proportions of essential medicines were 13/13 in the department of pediatrics and 9/10 in the department of gynaecology and obstetrics. Proportions of antibiotic medicines were 10/13 in the department of pediatrics and 8/10 in the department of gynaecology and obstetrics. Irrational drug use was mainly caused by improper use of antibiotics. Conclusion The drug use for 23 hospitalized sick and wounded is rational in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. Evaluation methods of rational drug use in high-risk population are urgently needed. Using cDDD and cDUI is an active exploration for the evaluation of pediatric drug use, which needs more practice to test and improve.
ObjectivesTo evaluate the current situation and rationality of electronic prescription in retail pharmacies in Chengdu, so as to provide references for further improving the sales of prescription drugs in retail drugstores and the level of rational drug use.MethodsA set of evaluation index system was constructed, and a prescription review group was set up. Eventually, 7 200 sample electronic prescriptions were collected for retrospective analysis and evaluation.ResultsPrescriptions from private medical institutions constituted the majority (3 543, 49.21%), and the majority of patients were junior and middle-aged, primarily respiratory diseases (38.24%) and circulatory diseases (17.11%), etc. The average quantity of drugs was 1.60 per prescription, percentage of antimicrobial use was 65.25%, percentage of essential medicines used was 34.92%, and reasonable rate of prescription was 95.21%.ConclusionsElectronic prescription services mode for retail pharmacy follows with the trend of “Internet + drug circulation” and complies with the rules of reasonable medical guidance and medication. However, optimizations are required, such as the lack of high-quality medical resources and the urgent need to optimize structure of prescription, and it is still essential to strengthen the management of antibacterial drugs and national essential medicines.
Objectives To analyze the development and implementation of the national drug policy in order to provide decision-making for the establishment of the Chinese national drug policy. Methods Nineteen electronic databases, the WHO, the World Bank, and governmental websites were included in this study. A pre-designed data extraction form was used to collect information. The data were analyzed and described by a pre-designed analytic framework. Result A total of 182 studies were included in this review. The main points of common concern in the national drug policy were: drug regulation and quality assurance, rational use of drugs, drug supply, the selection of essential drugs, human resource development and training, traditional medicine, drug financing and affordability, drug research, monitoring and assessment of the nation drug policy, technical cooperation, and the national pharmaceutical industry. The selection of essential drugs, quality assurance, supply, pricing, and supply of traditional medicine were gradually carried out in China. Pharmaceutical research, monitoring and evaluation, as well as the development of pharmaceutical industry and technical cooperation within it should be further strengthened. Conclusion China should establish related organizations and working procedures; speed up the implementation of the legislation of national drug policy; integrate the mechanism of essential drugs selection and supply system; regulate the order of medicine production and regulation; establish scientific and reasonable pricing mechanisms for drugs and assessment systems; strengthen the monitoring and evaluation of national drug policy and update and improve the national drug policy.
With the continuous promotion of China’s medical and health system reform, the problem of unreasonable medical examination has gradually become prominent after the elimination of “raising healthcare by medicine” and “raising healthcare by medical device”, which has become the core of aggravating the economic burden of patients’ diseases. Based on the current situation of medical examination control mechanism in China, this study explores the medical examination control mechanism including institutional restraint mechanism, supervision and management mechanism, quality control mechanism from external regulation and internal control, so as to regulate the medical examination behavior, realize the normalization of supervision and management, promote the continuous improvement of medical examination quality, in order to enhance the rationality of medical examination. It is expected to provide a theoretical basis for health departments to explore and perfect the control mechanism of the medical examination.
Objective To investigate drug usage and costs of angina inpatients in Karamay Central Hospital in 2014 and to provide evidence and reference for evidence-based pharmacy study of single disease in circulation system. Methods The information of drug use and expenditure of angina inpatients were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results We included 351 angina inpatients in Karamay Central Hospital in 2014 whose average age was 69.44±10.65 years old. Fifty-one kinds of drugs were used for angina therapy. The expenditure of drugs was 122.46 yuan per person. The symptomatic treatment drugs included 11 kinds of drugs. The top 3 usage drugs were isosorbide denigrates, aspirin, nitroglycerin. The secondary prevention medicines included 35 kinds of drugs, and were prescribed for 1 953 times; the anti-hypertensive drugs were most prescribed. The Chinese patent medicine were prescribed for 69 times. The compound Danshen dripping pill was the most prescribed drug. In total expenditure, the cost of clopidogrel, atorvastatin, irofiban ranked top three. Rivaroxaban, tirofiban, low molecular weight heparin were the top 3 drugs for per-time expenditure. Conclusion The top 3 used drugs are isosorbide denigrates, aspirin, nitroglycerin for angina inpatients in Karamay Central Hospital in 2014, while the top 3 total expenditure drugs are clopidogrel, atorvastatin and irofiban.
Objective To study the relationship between the expression ratio of induced nitric oxide synthase (iNOS) over glial fibrillary acidic protein (GFAP) and the time of injury after brain concussion in rat, in order to acquire a new visual angle for determining injury time of cerebral concussion. Methods Eighty-five healthy Sprague-Dawley rats were divided into three groups randomly: model group (n=25), experimental group (n=55), and control group (n=5). The rats in the model group were used to confirm the attack hight to make the model of brain concussion; according to the time of execution, rats in the experimental group were then subdivided into 11 groups with 5 rats in each subgroup, and their execution time was respectively hour 0.5, 1, 3, 6, 12, 24, 48, 96, 168, 240, and 336; the rats in the control group were executed after fed for 24 hours. After the model of cerebral concussion was established through freefalling dart method, hematoxylin-eosin staining and immunohistochemistry staining of iNOS and GFAP were conducted for the brain of the rats. All related experimental results were studied by using microscope with image analytical system and homologous statistics. Results The ratio of positive expression of iNOS over that of GFAP increased gradually during hour 0.5- 3 after injury in brain (from 5.03 to 10.47). At the same time, the positive expression of iNOS increased significantly (from 14.61% to 37.45%). However, the increase of the positive expression of GFAP was not obvious. Between hour 3 and 12, the ratio began to decline to 4.98, which was still at a high level, and during the same time period, the positive expressions of iNOS and GFAP also experienced the same change pattern. Later, the ratio began to decline between hour 12 and 336 after injury (from 4.98 to 0.95). All ratios at this time were lower than those between hour 0.5 and 12. The positive expression of iNOS and GFAP both increased to a climax before declining. Conclusions The ratio of positive expression of iNOS over GFAP and the respective change pattern of iNOS and GFAP can be used as the evidence of estimating the injury time of cerebral concussion. We can use the ratio of two or more markers to provide a new visual angle for concluding the concussion injury time.
Objective To comparatively analyze the rationality of emergency medication after Wenchuan earthquake with that after Lushan earthquake in West China Hospital of Sichuan University, based on the use of medicine of the victim’s disease spectrum. Method By using Excel, defined daily dose system (DDDs) and drug utilization index (DUI) were used as the evaluation indexes to analyze the rationality of emergency medication in West China Hospital of Sichuan University within one month after Wenchuan earthquake and Lushan earthquake. Results Within one month after Wenchuan and Lushan earthquake, there were 1 839 and 488 victims treated in the hospital, respectively. Within one month after the two earthquakes, the variation tendency of DDDs of drugs and number of victims was consistent, and the consistency was better in Lushan earthquake than that in Wenchuan earthquake. Among the 60 drugs which DDDs were ranked top five in their pharmacological class (top ten for antimicrobials) in Wenchuan earthquake, the majority of them were injections (injections vs. non-injections: 70.0% vs. 30.0%); the results showed that the medication (DUI=1) only accounted for 10.0%, the medication (DUI<1) accounted for 28.3%, which implied that the use of drugs was insufficient, the medication (DUI>1) accounted for 61.7%, which implied that drugs were overused; the average of DUI was 1.61. And in Lushan earthquake, injections also accounted for a larger proportion than non-injections (63.3%vs. 36.7%); the results showed that the medication (DUI=1) accounted for 15.0%, the medication (DUI<1) accounted for 38.3%, the medication (DUI>1) accounted for 46.7%; the average of DUI was 1.30. Conclusions Base on the DUI, we draw the conclusion that the rationality of emergency drug use and the timeliness of emergency drug supply were better in Lushan earthquake than those in Wenchuan earthquake. But the rationality of using the DUI, which is an evaluation index for normal conditions, to evaluate the emergency conditions still needs to be further verified.
Objective To explore the change of constitution in thyroid diseases of West China Hospital between 2000 and 2012， in order to provide clinical evidence. Methods Clinical data， including gender， age， and pathological diagnosis of patients with thyroid disease who underwent primary thyroid surgery in our hospital from 2000 to 2012 were collected retrospectively and analyzed statistically. Results A total of 9 642 patients were enrolled， including 1 893 male patients and 7 749 female patients. The ratio of male to female patients was 1 to 4.09. In male patients， the proportion of thyroid carcinoma were significantly higher than those of female group （P=0.02）；in male patients younger than 45 group， the proportion of thyroid carcinoma were significantly higher than those of female group （P＜0.01）. There was no statistical difference on the proportion between male and female patients older than 45 group （P=0.90）. Proportion of thyroid carcinoma， especially proportion of papillary thyroid carcinoma （PTC） increased in general. Proportion of Hashimoto thyroiditis （HT） increased in general too. HT with thyroid carcinoma accounted for an increasing proportion of all patients with HT. Proportion of nodular goiter （NG） increased at first and then declined. Proportion of thyroid adenoma （TA） decreased on the whole. Conclusions Proportion of thyroid carcinoma， especially proportion of PTC increase in recent years on the whole in patients underwent surgery. All these changes need to be given sufficient attention.
Objective To study the relationship between the expression ratio of heat shock protein (HSP) 70 to C-fos in organs outside the brain after brain concussion and the time of injury in rats, in order to provide a new visual angle for determining injury time of brain concussion. Methods The model of brain concussion was established through free falling method. Then the rats were executed at 30 minutes, 1 hour, and 3, 6, 12, 24, 48, 96, 168, 240, 336 hours after injury. Immunohistochemistry staining of C-fos and HSP70 were used in the materials from the main organs including heart, liver, spleen, lung and kidney. All related experiment results were studied by using a microscope with image analytical system and homologous statistics. Results From 30 minutes to 6 hours after injury, the proportion of HSP70 immuno-positive cells increased slowly, while the proportion of C-fos immuno-positive cells increased rapidly, and the ratio of HSP70/C-fos positive cells was on the decline. From 6 to 12 hours after injury, the proportion of HSP70 immuno-positive cells rose continuously, while the proportion of C-fos immuno-positive cells started to decrease, and the HSP70/C-fos ratio showed a rising tendency. From 12 to 336 hours after injury, the proportion of HSP70 immuno-positive cells decreased slowly, while the proportion of C-fos immuno-positive cells decreased rapidly, and the HSP70/C-fos ratio was still on the rise. Conclusions The proportion of positive cells and ratio of the two markers in the main organs including heart, liver, spleen, lung and kidney are similar to those in the brain of rats after brain concussion. Observing the proportion of positive cells of the two markers together with their ratio in the main organs outside the brain may provide a reference for the determination of injury time after brain concussion.
Objective To analyze the rationality of emergency medication in the West China Hospital after Lushan earthquake based on the actual drug use of earthquake victims. Methods We applied DDDs and DUI as evaluation index, input data using Excel software, and analyzed if the emergency medication was required for the injury/illness and the rationality of emergency medication. Results Earthquake victims mainly had trauma and wound infection and they were given antibiotics as main treatment one week after the earthquake. Drugs for the respiratory system and digestive system were mainly used in patients who mainly manifested as non-traumatic diseases and internal diseases four weeks after the earthquake. Among 49 kinds of drugs which could be calculated for the value of DUI, injection accounted for a larger proportion than non-injection (59.18% vs. 40.82%). The results showed that, the medication (DUI=1) only accounted for 12.24%; the medication (DUIlt;1, Mean=0.65) accounted for 38.78%, which implied insufficient drug use; the medication (DUIgt;1, Mean=1.77) accounted for 46.94%, which implied drug overuse. Conclusion Medication for every system is basically timely and rational when treating symptoms and causes in the West China Hospital within one month after Lushan earthquake. However, the rationality of emergency medications using DUI=1 under normal conditions still needs to be further verified.