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OBJECTIVE： To re-evaluate t he methodology quality of published systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase， SinoMed，CNKI，Wanfang database ，VIP，CBM and other databases ，systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression were collected during the inception to Dec. 2019. After literature screening and data extraction ， methodology quality of included literatures were evaluated by using the AMSTAR scale. RESULTS ：A total of 33 systematic reviews/Meta-analysis were included ，involving 523 RCTs and 41 020 patients. Average score of AMSTAR methodological quality evaluation was 6.76. Citalopram ，duloxetine and paroxetine were effective for the therapy of post-stroke depression ，but the conclusions about the effectiveness among antide-pressants were not consistents. The ADR incidence of Paroxetine was low. It was not clear that sertraline and citalopram may improve the neurological function of patients. CONCLUSIONS ：The methodological quality of systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression is medium ，and the conclusions about the effectiveness of antidepressants ，improvement of daily life ability and the recovery of neurological function are still controversial.
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Objective: To explore the changes of amplitude of low-frequency fluctuation (ALFF) in specific frequency bands (slow-4: 0.027-0.073 Hz, slow-5: 0.010-0.027 Hz), and to investigate the longitudinal spontaneous neuron activity changes in patients with left basal ganglia region infarction. Methods: Resting-state fMRI data of 25 patients with left basal ganglia region infarction (infarction group) and 26 normal participants (control group) were obtained. Based on two group contrasts of chronic phase and acute phase, chronic phase and normal control, the method of mixed effect analysis was used to compute the frequency differences and group differences. Then post-hoc test was used to examine the group differences at slow-4 and slow-5 frequency band separately. Results: ALFF analysis results showed significant frequency difference between the 2 frequency bands, with activated brain region of slow-4 located in subcortical region, and slow-5 located in default mode network. At slow-4 frequency band, in the contrast of chronic phase and acute phase, patients in chronic phase showed increased ALFF value at bilateral superior parietal lobule, precuneus, occipital cortex and contralateral temporal cortex, while decreased ALFF value at bilateral cingulum gyrus and supplementary motor area. In the contrast of chronic phase and normal control, ALFF values of chronic phase patients decreased at contralateral posterior cingulate (PCC) and ipsilateral precentral gyrus, whereas increased at contralateral lateral frontal lobule and frontal pole. There was no significant difference of two group contrasts at slow-5 frequency band. Conclusion: Slow-4 frequency band is sensitive to show spontaneous brain activity in patients with left basal ganglia region infarction, and the cortical function is reconstructed during motor recovery.
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OBJECTIVE：To investigate drug use in an obstetrics and gynecology hospital and confirm the types of drugs that need to be monitored so as to provide reference for rational drug use in clinic. METHODS： Activity based classification （ABC） analysis， Vital-Essential-Nonessential Medicine （VEN） analysis and ABC-VEN matrix analysis were used to statistically analyze the types of drugs in the inpatients and outpatients of this hosptial during Jan. 2016-Dec. 2017， and consumption sum in the hospital so as to determine the types of monitoring focus drugs. RESULTS： The drugs were divided into class A， B， and C by using ABC analysis， and the constitute ratio of them were 6.08％， 7.71％ and 86.21％； the constitute ratio of consumption sum were 70.97％， 19.07％ and 9.96％， respectively. The drugs were divided into class V， E and N， and the constitute ratio of them were 36.51％， 43.61％ and 19.88％； constituent ratios of their consumption sum were 31.89％， 33.89％ and 34.22％， respectively. The drugs were divided into group Ⅰ （class AV， AE， AN， BV， CV）， group Ⅱ （class BE， CE， BN） and group Ⅲ （class CN） by using ABC-VEN matrix analysis； the constitute ratios of accumulative number of drug type were 40.56％， 44.43％ and 15.01％，while those of accumulative consumption sum were 77.29％， 20.52％ and 2.19％， respectively. Among class N， the constituent ratio of consumption sum of class AN as Chinese patent medicine， blood substitutes and perfusion solutions were higher， being 12.48％ and 7.92％； that of class BN as Chinese patent medicine was higher， being 3.21％； those of class CN as Chinese patent medicine， sex hormones and modulators of the genital system were higher， being 1.14％， 0.50％. CONCLUSIONS： In the Obstetrics and Gynecology Hospital， consumption sum of class A is the main part of the total consumption sum of drugs， and they should be seleted according to therapeutic efficacy. Active regulatory policies should be adopted for class V and E so that more drug types that possess cost- effectiveness advantages； for class N， management control and reasonable utilization should be monitored closely to reduce irrational drug use. Some Chinese patent medicines， blood substitutes and perfusion solutions among class AN should be monitored and controlled emphatically.
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OBJECTIVE: To provide scientific evidence for the further improvement of hospital antibacterial management, the formulation of related management decisions and long-acting mechanism. METHODS: Technique for order preference by similarity to ideal solution (TOPSIS) was used to select 8 evaluation indexes as utilization rate of antibiotics in the inpatients to synthetically evaluate the effect of antibacterial management in 10 third grade general hospitals of Xi'an from 2012 to 2016. RESULTS: Results of synthesis evaluation by TOPSIS method showed that the least effect was in 2012 [coefficient of proximity from the object of evaluation to the optimal value (Ci) =0]; the effect of antibacterials management was improved gradually during 2013-2015, and there was the best effect in 2015 (Ci=0. 918 3); but declined in 2016 (Ci=0. 838 5). Only one evaluation index (the rate of microbial examination in the inpatient receiving special use of antibacterials) was improved significantly in the 5 years(P＜0. 01), but there was no statistical significance in the data of other 7 indexes (P＞0. 01). CONCLUSIONS: The effect of antibacterials management in 10 third grade general hospitals of Xi'an was on the rise from 2012 to 2015, but was declined in 2016. It might be slack. A long-acting management mechanism of antibacterial management is needed to be established, in order to consolidate the achievements from "special rectification for clinical antibacterial use" and further improve the normal and dynamic operation of antibacterial management measure. TOPSIS method is objective and comprehensive method for synthesis evaluation of the effect of antibacterial management, and is of significance to antibacterial supervision and use.
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Objective: To provide reference for promoting the use of Tengyao in the treatment of pelvic inflammatory diseases (PID). Methods: From January to March 2017, 111 health workers in department of gynaecology were investigated. The quantitative research of KAP questionnaire was used, and the content of questionnaire included personal information, knowledge, attitudes and practices. Results: A total of 111 copies of questionnaire were distributed and 95. 5% of them were effective. Interviewees' overall knowledge was at low level while the attitude was at high level; the main way to obtain knowledge was coming from colleagues (76. 42% ); working lifetime and speciality classification had significant impacts on the level of knowledge (P<0. 05); the majority of interviewees were willing to learn the relevant knowledge through training sessions (54. 72% ) and new media (27. 36% ); 48 inter-viewees would like to continue to use Tengyao for treating PID. The main problem of Tengyao in the treatment of PID was inconvenient operation (63. 64% ). Totally 83. 96% of interviewees considered that the dosage forms of Tengyao should be improved, and 50. 94% of interviewees considered that the clinical efficiency evaluation should be studied. Conclusion: Interviewees'overall knowledge is still at low level, especially in the junior medical staff. Pharmacists should improve the knowledge level of medical staff by meeting train-ing, and study how to improve the dosage forms and evaluate the clinical efficiency of Tengyao.
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OBJECTIVE:To investigate clinical efficacy and safety of Teng medicine combined with Gongyankang granules in the treatment of chronic pelvic inflammatory disease(CPID). METHODS:A total of 141 CPID outpatients were selected from our hospital during Jul. 2015-Jun.2016,other patients were divided into control group(65 cases)and observation group(76 cases)ac-cording to random number table. Control group was given Gongyankang granules 9 g orally,bid;observation group additionally re-ceived Teng medicine hot compress on lower abdomen for 30 min until it was cool,once a day,on the basis of control group. Both groups began the medication since third day after the menstrual period,for consecutive 20 d. TCM syndrome,local sign scores and clinical efficacies were compared between 2 groups before and after treatment,and the occurrence of ADR and recur-rence were observed in 2 groups. RESULTS:Before treatment,there was no statistical significance in TCM syndrome scores or lo-cal sign scores between 2 groups (P>0.05). After treatment,TCM syndrome scores and local sign scores of 2 groups were de-creased significantly,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). Clinical total response of observation group were 92.11％,which were significantly higher than 70.77％ of control group, rate recurrence rate of observation group were 2.99％,which were significantly under than 15.79％ of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Teng medicine hot compress combined with Gongyankang granules show significant efficacy for CPID,can improve TCM syndrome and local sign and reduce recurrence rate with good safety.
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OBJECTIVE:To investigate the effectiveness of antibacterial clinical application special rectification activity,and to provide reference for rational use of antibacterials. METHODS:Referring to rational antibacterials application index stated in Na-tional Antibacterial Clinical Application Special Rectification Activity in 2013,the utilization of antibacterials in 36 secondary hospi-tals from Xi’an area during 2nd quarter in 2015 were analyzed retrospectively in terms of drug use index,types,consumption sum,DDDs and DDC,etc. RESULTS:Among 36 secondary hospitals from Xi’an area,there were only 3 hospitals up to the anti-bacterials use indicator standard(8.33%);antibacterial use of 91.66% inpatients was up to the standard;55.56%of antibacterials use density was up to the standard;50.00% of outpatient antibacterials drug prescriptions was up to the standard;77.78% of emer-gency antibacterials drug prescriptions was up to the standard;13.89% of antibacterials was used in typeⅠincision surgery for pro-phylactic use. Restricted use antibacterial accounted for 48.53% in consumption sum and Non-restricted use antibacterial accounted for 75.31% in DDDs. The consumption sum(12 771 265.34 yuan)and DDDs(291 542.31)of cephalosporin ranked first,mainly were second generation cephalosporin(accounting for 35.22% of consumption sum and 42.98% of DDDs). Top 10 drugs in the list of consumption sum were all injection;there was no special class of antibacterials but some antibacterias with high price and poor efficacy in top 10 ones. Top 10 drugs in the list of DDDs were non-restricted use and restricted use antibacterials with low price and good efficacy,among which there were 6 oral dosage forms. CONCLUSIONS:The application of antibacterials is still can not reach national standard in 36 secondary hospitals from Xi’an area. It is necessary to be further strengthen the management of inpa-tient antibacterial use density,the proportion of antibacterials used in outpatient and emergency patients,prophylactic application of antibacterials in type Ⅰ incision,the application of antibacterials with high price and poor therapeutic efficacy should be monitored closely.
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Objective To investigate current status of narcotic analgesic use in patients with cancer pain in our hospital, in order to promote the rationalization of prescribing narcotic drugs and the rational use of analgesics. Methods A total of 400 narcotic prescriptions ( 100 of outpatients and 300 of inpatients ) in Tongji hospital were randomly selected from March to May in 2014.Basic index and consumption of anesthetic drugs, money consumption distribution on different tumor types, and unreasonable prescription were analyzed. Results The overall prevalence of irrational prescriptions was 11. 00%, with 13.00% from inpatient and 10. 33% from outpatient, respectively. Reasons for irrational prescriptions mainly included vague instructions on dosage and administration, incomplete clinical diagnosis, lack of pharmacist check and inappropriate dosage. In the basic indexes, proportions of reasonable prescription and drugs within the national formulary were higher in the inpatient than in the outpatient service.The average money consumption of outpatient prescription was significantly higher than that of inpatient prescription.Most types of diagnosis were lung cancer in outpatient and inpatient departments, and total cost of lung cancer drugs was the highest.Morphine hydrochloride of outpatient had the highest average consumption, followed by codeine phosphate of the outpatient and the inpatient, and oxycodone hydrochloride controlled-release tablets cost more in inpatient. Conclusion The narcotic analgesic used in our hospital is basically rational. Most doctors prescribe according to the guidelines, but standardized training of prescription for cancer patients with pain medication needs to be strengthened, and supervision of narcotic analgesic medication should be enhanced.
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Objective To investigate the anti-inflammatory and analgesic effects of extracts from Garden Balsam seeds in order to provide theoretical basis for rational clinical application. Methods The mouse ear swelling induced by xylene, the body torsion induced by acetic acid or hot plate method, the rat foot swelling induced by egg white and granuloma model were set up to study anti-inflammatory and analgesic effects of extracts from Garden Balsam seeds. Results The water extracts at the middle and high doses reduced the body torsion counts of mice (P<0. 05), alleviated the rat toe swelling, but did not affect mice ear swelling. The extracts at the high dose prolonged pain threshold at 60 min (P<0. 01) and 90 min (P<0. 05); the alcohol ex-tracts at the middle and high doses significantly lowered body twisting counts (P<0. 01), attenuated the ear swelling of mice (P<0. 05), remarkably prolonged the pain threshold (P<0. 01)at 30 min, weakened the rat foot swelling, and elevated 60 min pain threshold at the high doses (P<0. 01), but the extracts exerted no effects on the rats granuloma. Conclusion The extracts from Garden Balsam seeds have anti-inflammatory and analgesic effects.
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Objective:To investigate and evaluate the effect of antibacterial agents clinical use and management training for medi-cal institutions in Hubei province in order to promote rational antibacterial drug use. Methods:A questionnaire was designed, inclu-ding basic conception, medication principle, mechanism and medication feature etc. The data were studied by SPSS 13. 0 software to analyze the knowledge level of antibacterial agents in medical staffs. Results: Medical staffs had good acquisition in the knowledge points involved in choice questions. The correct percentage of each scoring in essay questions differed considerably within the range of 7. 88%-99. 01%. Management rules could be well understood, while the definition of antibacterial drugs and the difference between antibacterial drugs and antibiotics were paid little attention. Conclusion: The overall knowledge level of rational antibacterial agents use in the trainees is promising with comprehensive understand of the management rules. It's necessary to distinguish antibacterial a-gents from antibiotics more clearly.