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OBJECTIVE To provide a reference for establishing an automatic checking mode and improving the checking efficiency of the unit dose dispensing system of oral drugs in hospital. METHODS The automatic checking process reengineering team was established in our hospital. ECRSI method was adopted to sort out the verification process and mode of drug bags for the unit dose formula of our hospital through five principles of eliminating， combining， rearranging， simplifying and increasing， and the hardware series problem and the problem of excessive system false-positive proportion were optimized. The drug bags for the unit dose formula were randomly selected from 10 wards， the efficiency and external error rates of manual check and automatic checking mode before and after optimization were compared， and the false-positive reporting failure in automatic checking mode was also compared before and after optimization. RESULTS After the establishment of the automatic checking mode of the unit dose formula for oral drugs， the average checking time of drug bags was significantly shorter than that of manual checking mode in the other 8 wards except for cardiovascular and renal departments （P＜0.05）. After the optimization of the automatic checking mode， the average checking time of drug bags in all wards was significantly shorter than that in manual checking mode （P＜0.05）. Compared with before optimization of the automatic checking mode， the average checking time of drug bags was shortened by 0.43 s， and the average checking time of drug bags in half of the wards was shortened significantly （P＜0.05）. At the same time， the false-positive proportion decreased from 96.83% before optimization to 92.76% after optimization （P＜0.05）. The external error rate dropped from 0.039‰ in manual checking mode to 0.019‰ before optimization and 0.015‰ after optimization （P＜0.05）. CONCLUSIONS Based on ECRSI method， the automatic checking mode for the unit dose dispensing system of oral drugs can effectively reduce the average checking time of drug bags， reduce external error and improve the work efficiency of pharmacists.
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Objective:To analyze drug-related problems (DRPs) of hospitalized elderly patients with limited life expectancy.Methods:A total of 261 patients aged ≥ 70 years with limited life expectancy according to the 1-year mortality prediction index, who were admitted in the geriatric ward of Peking Union Medical College Hospital from January 2015 to December 2021 were included. According to Strand system, the categories, medications and interventions of DRPs were analyzed.Results:Among 261 patients, 187 (71.6%) had 672 DRPs. The most common DRPs were related to drug safety, including 271 (40.3%) adverse drug reactions and 149 over dosages (22.2%). A total of 207 drugs were involved in DRPs, and the top 5 classes with higher frequency of DRPs were antiinfectives for systemic use(20.7%,139/672), nervous system drugs(19.4%,130/672), alimentary tract and metabolism drugs(16.5%,111/672), cardiovascular system drugs(16.1%,108/672), and blood and hemopoietic organs drugs(13.7%,92/672). The recommendations were given by pharmacists for all 672 DRPs, and 643 were accepted by physicians (95.7%). The therapy need to be adjusted in 564 recommendations and the medications need to be monitored in 108 recommendations. In recommendations of therapy adjustment, 49.6%(280/564) were related to deprescribing. The deprescribing with higher frequency included antiinfectives for systemic use(29.6%, 83/280), lipid modifying agents(7.9%,22/280) and antithrombotic agents(7.9%,22/280). Patients with severe disability had significantly higher average DRPs(2 vs. 1) and average deprescribing(1 vs. 0) than patients without severe disability( Z=-4.83, Z=-3.61, all P<0.001). Conclusion:Drug safety is the most common DRP in limited life expectancy elderly inpatients, particularly for those with severe disability.
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Malaria is a serio us and life-threatening infectious disease that has a profound impact on human life. Artemisinin is still the first-line drug for clinical antimalarial treatment recommended by the World Health Organization. The antimalarial activity of artemisinin is mainly reflected in the peroxide bridge structure. Artemisinin-based combination therapy （ACT）is the first-line treatment for malaria in many countries. ACT mainly include artemether-lumefantrine ，artesunate-amodiaquine and dihydroartemisinin- piperaquine，etc. Compared with artemisinin monotherapy ，ACT has the advantages of shortening the length of hospital stay ， speeding up parasite clearance ，and saving economic costs ，etc. However ，there are still problems such as drug resistance. This article reviews the application status ，advantages and disadvantages of ACT at home and abroad in recent years ，in order to provide ideas for the subsequent screening of long-acting adjuvant antimalarial drugs in ACT and to solve the problem of drug resistance.
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OBJECTIVE：To pro vide reference for exposure protection countermeasures for Novel coronavirus （SARS-CoV-2） infection in hospital pharmaceutical staff. METHODS ：According to the recommendations of related medical staff protection guideline，combined with the characteristics and prevention and control requirements of novel coronavirus pneumonia （COVID- 19），based on the basic principle of exposure protection ，actual exposure risk of infections for hospital pharmaceutical staff were evaluated，and the countermeasures for exposure protection were constructed under the epidemic condition of COVID- 19. RESULTS：According to the standard prevention principle and the risk evaluation of infection exposure ，most of the pharmaceutical posts in the hospital belonged to low-risk exposure posts ，and only a few posts belonged to medium-and high-risk exposure posts. Personal protective equipment should be provided according to the exposure risk level of different pharmaceutical posts and work demand. At the same time ，infection protection training should be strengthened ；environment and facilities in pharmacy should be cleaned and disinfected. CONCLUSIONS ：Standard prevention principle should be followed by hospital pharmaceutical staff during epidemic period. Based on the characteristics and exposure risks of pharmacy posts ，and according to the regulations of the hospital，personal protection for hospital pharmaceutical staff should be conducted according to the exposure risk level determined by the pharmaceutical department and relevant management regulations to avoid over-protection or inadequate protection ，so as to ensure the smooth and safe development of pharmaceutical care.
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OBJECTIVE： To provide reference for improving emergency capacity of the hospital pharmacy department in response to the novel coronavirus pneumonia （COVID-19） epidemic. METHODS ：According to the related regulations and requirements of Law of the People ’s Republic of China on the Prevention and Control of Infectious Diseases ，combined with the situation of COVID- 19 epidemic prevention and control ，and management experience of relevant hospitals ，on the basis of in-depth analysis of drug supply and quality assurance ，drug dispensing management ，provision of clinical pharmaceutical services and other related material support of hospital pharmacy department，integrated emergency management model was constructed for COVID- 19 epidemic prevention and control ，and the precautions and response measures of each link were sorted out. RESULTS ：Integruted emergency management mode for COVID-19 epidemic prevention and control in hospital pharmacy department included but was not limited to human resource management，drug and disinfection products supply management （mainly including key treatment drugs and disinfection product list formulation，control，inventory increase ，etc.）；drug dispensing management （mainly including prescription ，pharmacy window ， planning quantitative reserve ， drug return ， etc.）；clinical pharmaceutical care management （mainly including providing pharmaceutical information support ，online pharmaceutical service ，monitoring drug safety ，etc.）；personnel protection and disinfection （mainly including personnel protection ，environment and window ，equipment and container ，paper prescription disinfection，etc.）；special management of donated drugs ；prevention and control knowledge training ；pharmaceutical education and scientific research management ，etc. CONCLUSIONS ：The integrated emergency management model for epidemic prevention and control is helpful for hospital pharmacy to manage public health emergencies. During the outbreak of COVID- 19，hospital pharmacy department should start integrated emergency management mode for epidemic prevention and control ，strengthen the risk control of each link ，and play a good role in the key functional departments in the special period.
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OBJECTIVE：To provid e reference for pharmaceutical workers to better understand Novel Coronavirus Infection ： Expert Consensus on Guidance and Prevention Strategies for Hospital Pharmacists and the Pharmacy Workforce （hereinafter referred to as “expert consensus ”），and to apply and practice in specific work ，so as to give full play to the role of pharmacists to help fight the epidemic.METHODS ：The background of the formulation and revision of the expert consensus were introduced ，and its main contents and viewpoints were interpreted. RESULTS & CONCLUSIONS ：The text of expert consensus is divided into 8 parts，mainly including disease diagnosis and treatment [SARS-CoV- 2 infection related background ，clinical manifestations and diagnosis， treatment]，hospital pharmacy （prevention and control strategy ，work guidance ），drug and facility support management（key drug/facility/equipment support ，management and use of the drug in special circumstances ），information sources and related resources ，etc.，which comprehensively and detailedly provide information ，guidance and strategies for coronavirus SARS-CoV-2 infection prevention and control to play the role of pharmacists in hospital pharmacy well ，do well in the protection of staff in different pharmaceutical posts ，drug security work in response to epidemic situation ，and develop pharmaceutical care. So far，the understanding of SARS-CoV- 2 in the pharmaceutical industry is relatively limited. Based on the accumulated experience and progress in epidemic prevention and control ，the expert consensus will be updated and improved continuously ，so as to provide guidance and help for hospital pharmaceutical personnel.
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Objective To observe the effect of variable frequency vibration therapy while sitting in an anti-spasmodic posture on spasticity and the motor function of the upper limbs among stroke survivors.Methods Thirty stroke survivors with upper limb spasticity were randomly divided into a treatment group and a control group,each of 15.Both groups were given routine rehabilitation training for 4 weeks while the treatment group was additionally provided with variable frequency vibration training while sitting in anti-spasmodic postures.Before and after the treatment,the modified Ashworth scale (MAS) was used to assess spasticity.The root mean square (RMS) value of the surface electromyogram amplitude of the affected biceps when extended passively and those of the triceps,obliques and multifidus in maximum isometric contraction was measured and recorded.The motor function of the affected upper limbs was evaluated using the active range of motion (A-ROM) of the shoulder,elbow and wrist,as well as a Fugl-Meyer assessment (FMA).Moreover,ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI).Results After the treatment,significant improvement was observed in the average MAS,A-ROM,RMS,FMA and MBI results in both groups compared to those before the treatment.Moreover,the results in the treatment group were significantly better than those of the control group,on average.Conclusions Variable frequency vibration therapy while sitting in an anti-spasmodic posture combined with traditional rehabilitation is more effective than the latter alone in relieving spasticity as well as improving motor function and ability in the activities of daily living among stroke survivors with the upper limb spasticity.
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Objective:To investigate the impact of butylphthalide on homocysteine, CRP and nerve function in the patients with a-cute progressive cerebral infarction. Methods:Totally 122 cases of patients with acute cerebral infarction were randomly divided into the observation group (n=60) and the control group (n=62). The control group was treated with the routine treatment, and the ob-servation group was treated with butylphthalide additionally. The treatment course was two weeks. The total effective rate, blood Hcy, the level of plasma CRP and the changes of neurological function deficits scale in both groups before and after the treatment were ob-served and compared. Results:The overall response rate in the observation group (81. 67%) was significantly higher than that in the control group (64. 52%). After the treatment, the blood Hcy and CRP in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observation group was significantly lower than that of the control group(P<0. 05). The neuro-logical function deficits scale in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observa-tion group was significantly lower than that of the control group at the same period. The two groups during the treatment showed no sig-nificant adverse reactions. Conclusion: The effect of butylphthalide in the patients with acute cerebral infarction is effective, which can reduce blood Hcy, the level of plasma CRP and the neurological function deficits scale, and improve the neurological function with-out obvious adverse reactions during the treatment course.