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@#Objective To investigate characteristics of bleeding caused by combination of aspirin with ticagrelor in the treatment of Ischemic stroke (IS) and Transient Ischemic Attack (TIA),and analyze the risk factors influencing the occurrence of bleeding. Methods 501 patients with IS and TIA who were treated with aspirin combined with ticagrelor were included. And baseline and clinical data of the subjects were collected on the first day after admission,and the occurrence of bleeding events within one year was followed up. Patients were divided into two groups according to whether there was bleeding. Baseline and clinical data of the two groups were compared,and risk factors of bleeding events were analyzed by logistic regression. Results After 1 year of follow-up,a total of 89 patients were found to have bleeding,with a total bleeding rate of 17.76%,a fatal bleeding rate of 5.39% and a non-fatal bleeding rate of 12.38%. In 5.19% of patients,ticagrelor was discontinued due to bleeding,while in 7.58% of patients,the dosage of ticagrelor was halved due to bleeding. Logistic regression analysis found that age,smoking history,history of myocardial infarction,history of peptic ulcer and CRUSADE score≥41 are risk factors for bleeding events (P<0.05). Conclusion 17.76% of IS and TIA had bleeding events during aspirin combined with ticagrelor,and age,smoking history,history of myocardial infarction,history of peptic ulcer disease,and higher CRUSADE score were risk factors for bleeding.
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OBJECTIVE:To provide reference for clinical rational drug use. METHODS:Medication error(ME)cases report-ed from outpatient department from Oct. 2014 to Sept. 2015 in our hospital were analyzed,including ME category,classification, cause and proportion of persons who triggered or detected ME. RESULTS:Among 207 reports,there was no case of category A, 199 cases of category B,8 cases of category C,no of categories D-I. Among them,162 cases occurred in the links of prescrip-tions by doctors (78.26%),45 cases (21.74%) occurred in the links of dispensing prescriptions by pharmacists,the top 3 ME were improper usage(42.59%),improper administration route(40.74%)and inappropriate solvent(5.56%);the top 3 dispensing errors were variety error(40.00%),specification error(28.89%)and number errors(24.44%). The main causes for prescription errors were incomplete information system(56.17%)and drug information missing of doctors(43.83%);the main causes for dis-pensing errors were double specifications of drugs(35.56%),similar drug name(28.89%)and staffsntired(26.67%). In terms of the persons who triggered ME,the proportions of pharmacists,nurses,patients or their families were 97.58%,1.45% and 0.97%, respectively. CONCLUSIONS:Further strengthening information system and the on-the-job training for physicians and pharmacists can reduce the ME to some extent.
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OBJECTIVE:To improve the teaching quality of pharmaceutical standard training. METHODS: By introducing the overview of adopting elicitation teaching in the pharmaceutical standard training in Beijing,the training effect was summarized and role and significance were studied. RESULTS:Supervisors applied five teaching modules in the elicitation teaching in the pharmaceu-tical standard training which are concluded“pharmaceutical education and rational use of medicine”“comments of prescription and rational use of medicine”“prescription transfers and rational use of medicine”“medicine counseling and rational use of medicine”“pharmaceutically communication and rational use of drugs medicine”,the result showed that participants had mastered more than 90%of what they had learned;with 92.5%of participants felt elicitation teaching could help improve students’interests in pharma-cy,and strengthen responsibility;80.0% of the participants believed that part of the modules strengthen the training of clinical think-ing;the training of satisfaction to 100%. CONCLUSIONS: The elicitation teaching mode can not only improve the teaching quality in pharmaceutical standard training,but also strengthen communication and feedback between teachers and students,students and students to make students more deeply understand and master knowledge and improve teaching quality.
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OBJECTIVE To give a general introduction to the infection in the hospital,and supervision to key departments in order to prevent nosocomial infection occurrence. METHODS A vertical analysis was made on the basis of the survey involving the following three periods: the first period covered the second half of the year 2000(from Jul to Dec 2000),the second period covered the second half of the year 2002(from Jul to Dec 2002),and the third period covered the second half of the year 2004(from Jul to Dec 2004). RESULTS The periodical supervision and the vertical analysis in the same period showed the following: the rates of the infected patients in the departments showing a tend to go on rising from 2000 to 2002,and showing a tend to decline from 2002 to 2004. CONCLUSIONS The control of using antibiotics must be emphasized and they should be applied in a scientific and reasonable way.The key points include the management of purchasing drugs,clinical indications and usages,supervise and news feedback,etc.All of these measures could prevent the occurrence of nosocomial infection effectively.