Objective. To explore the practice of comprehensive pharmacy management mode under the strategy of healthy China. Methods. Combining with hospital practice, the advantages and disadvantages of comprehensive pharmacy management mode were discussed and considered. Results. The comprehensive pharmacy has advantages in improving work efficiency, optimizing resource allocation, refining pharmacy management, checking the compatibility of Chinese and Western medicines, and improving service quality, and it also increases the labor intensity of staff and is prone to prescription dispensing errors. Conclusion. Hospitals with mature conditions and permission can use the management mode of comprehensive pharmacy.

目的:借助信息技术,对静脉用药集中调配中心(pharmacy intravenous admixture services,PIVAS)的各工作环节进行全流程优化,减少PIVAS输液差错的发生,保障患者输液安全.方法:充分调研分析PIVAS各环节可能出现的差错和原因,绘制鱼骨图,针对重点环节引入信息技术,建立医嘱审核的三重防火墙,在PIVAS管理平台上完善审方规则数据,建立全肠外营养制剂(TPN)审核模块,建立"不合理医嘱干预记录"管理模块;制定批次调整规则,对药品货位等药品信息进行标识,完善输液标签内容数据库等.结果:通过比较引入信息技术前后两个阶段的各环节差错评价指标,结果表明PIVAS各工作环节在引入信息技术后,其差错率大幅下降,同时还提高了工作效率.结论:应用信息技术,对进入PIVAS系统的医嘱进行全流程管理,不仅可以减少输液差错发生率,还可以提高工作效率,保障输液的及时与安全.

Objectives: This study aims to explore the weight loss effect and safety of semaglutide as a conventional anti-obesity drug systematically in obese or overweight patients without diabetes. Methods: The randomized controlled trials (RCTs) of semaglutide in obese or overweight patients without diabetes were retrieved from PubMed, Cochrane Library, EMBASE, and ClinicalTrials.gov from database inception until 2 May 2022. Data extraction and quality assessment of studies meeting the inclusion criteria were performed, and statistical analysis was conducted by Review Manager 5.3 and Stata 14. Results: Eight studies involving 4,567 patients were enrolled in the meta-analysis. Compared with placebo, semaglutide induced a significant body weight loss (MD: −10.09%; 95% CI: −11.84 to −8.33; p ˂ 0.00001), elicited a larger reduction in body mass index (MD: −3.71 kg/m2; 95% CI: −4.33 to −3.09; p ˂ 0.00001) and waist circumference (MD: −8.28 cm; 95% CI: −9.51 to −7.04; p ˂ 0.00001), achieved weight loss of more than 5, 10, 15, and 20% with a higher proportion of participants. Semaglutide exhibited a positive effect on blood pressure, C-reactive protein, and lipid profiles, expressed more adverse effects than placebo, mainly gastrointestinal reactions. The results were stable and reliable with dose-dependence. Conclusion: Semaglutide indicated a significant weight loss with an acceptable safety for obese or overweight patients without diabetes.

目的:探索新型冠状病毒肺炎（COVID-19）疫情下江汉方舱医院药事管理与药学服务模式,为国内参与疫情防控的医院药师提供参考。方法:成立药事应急领导小组,构建药事管理组织架构;明晰方舱医院特色的包括药事管理、人员管理和药品管理的应急管理体系;创立"方舱"式药学服务模式,从保障药品供应、设立急救药车、设计特定的药品包装袋、开展特色的合理用药医嘱审核、创新性利用新媒体微信平台提供"零接触"药学咨询服务、创立方舱广播电台宣讲合理用药知识等方面,为患者提供相关药学服务。结果:为1 312例COVID-19轻症患者提供了药学服务,不仅保障了药品的及时供应,而且通过用药审核和用药指导减少了用药风险,提高了患者的用药依从性,帮助患者重建战胜病情的信心。结论:依据方舱医院药事管理策略建立的全新药学服务模式在战胜COVID-19疫情中发挥了重要作用,可以推广实施。

目的:分析武汉某大型三甲医院静脉用药调配中心(PIVAS)退药存在的风险因素,讨论存在的问题及原因,进一步优化退药流程.方法:多部门联合,通过行政干预、信息化技术干预和规范标准操作流程等措施,有效减少不合理/不规范退药.结果:流程优化后,PIVAS不规范处方量、退药数量等都有显著下降,药师工作效率提升.47个病区退药数量整体下降15.34％,病区退药数量最高下降幅度达55.45％,流程优化前后5个病区的退药数量差异有统计学意义(P＜0.05).结论:可从加强合理用药知识培训、创新技术管理、多部门联合等多个方面减少退药风险因素,提高临床合理用药水平.

Objectives To describe the pharmacy administration and pharmaceutical care in a module hospital during the coronavirus disease 2019 (COVID-19) epidemic and provide reference for domestic and foreign pharmacists participating in the epidemic prevention and control. Setting The study was performed in a Jianghan module hospital constructed at the Wuhan Convention and Exhibition Center in Wuhan, China. This is 1 of the first 3 module hospitals. Practice description One thousand eight hundred forty-eight patients were admitted to the Jianghan module hospital, and 1327 cases (71.81% of the total number) were cured and discharged. Pharmacists have successfully completed the tasks of purchase, storage, and free distribution of drugs worth ¥1.03 million (approximately $146,000), reviewed about 20,000 electronic orders, provided one-on-one online medication consultation for 484 patients, and held 5 lectures on rational drug use knowledge, which could help reduce irrational drug use and minimize the risk involved. Practice innovation The new COVID-19 "module" pharmaceutical care model is equipped with new features such as pharmacy emergency command group, organizational structure for pharmacy administration, electronic control of drug prescription, and "zero contact" pharmaceutical care relying on the new media platform "WeChat." This platform provides relevant pharmaceutical care for patients, such as ensuring drug supply, setting up critical care drug trolleys, designing specific drug packaging bags, creating a module radio station to broadcast rational drug use information to the patients, and other aspects. Evaluation With the continuous improvement of the module hospital and the progress in in-depth knowledge about COVID-19, some aspects such as patient admission criteria and variety of drugs need to be adjusted depending on the actual situation. Results The pharmacists provided pharmaceutical care for 1848 patients with mild COVID-19 disease. They not only ensured the timely supply of the drugs but also reduced the incidence of drug-induced risks through medication review and guidance, thereby improving patient compliance and helping the patients rebuild their confidence in overcoming the disease. Conclusion The new COVID-19 module pharmaceutical care model has played an important role in overcoming the epidemic situation of COVID-19 in China and thus can be implemented on a broader scale.

目的:总结COVID-19疫区大型三甲医院静脉用药调配中心（简称PIVAS）防控策略,为全国大型医院PIVAS面对突发公共卫生事件时提供参考。方法:将PIVAS区域五级细分,对各区域清洁消毒和人员进出实行分级管理,加强重点物资管理,同时合理调配人力资源,强化防疫知识培训,关注员工身心健康,给予人文关怀。结果:COVID-19疫情期间,PIVAS有序运行,保障了输液质量安全,有利于降低临床配液压力,在疫情防控中发挥了重要作用。结论:面对突发COVID-19事件,需要及时出台强有力的应对决策,并严格遵循,落到实处。通过科学防控、理性应战,一定能打赢COVID-19战役。

目的:总结"零接触"信息化药学服务在疫区大型三甲医院防控COVID-19疫情的应用。方法:创新性地利用多种信息技术途径,如App手机软件、医院官网和官微公共平台、微信个人平台、药学信息系统、药品数据库等,为药师培训考核和门急诊、隔离病房、方舱医院、居家慢病等不同类型患者用药提供"零接触"信息化药学服务。结果:实现患者全就诊环节的闭环药学信息服务管理,涵盖药师远程培训、患者在线用药咨询、电子处方/医嘱审核、临床用药提示、在线药品快递等。结论:疫情期间,充分发挥"零接触"信息化药学服务的独特优势,不仅有利于提高工作效率、补充线下医疗资源,而且可以避免交叉感染、缓解公众紧张焦虑情绪,有助于打赢疫情阻击战。

目的:分析审方系统滤出的不合理医嘱与实际情况的相符性,为实现精准的临床用药事前干预提供依据.方法:选择2016年5月至2017年5月智能审方系统自动滤出的最严重级别警告,进行人工二次审核分析.按照审查类型细分,选择占比最大的"配伍禁忌"项深入研究.统计排名靠前的科室与药品,对系统警报结果进行分型和分析.结果:"配伍禁忌"严重警报8016条,占严重级别问题医嘱的比例达到84％,占问题医嘱比例为4.06％,占总医嘱比例为0.07％.排名靠前的科室主要为外科手术科室,药品为临床使用较频繁且物化性质不稳定的注射剂.系统警报结果分为3类:核查无误类、循证证据不足或存在争议类、系统误报类.其中系统误报类2360条,占比29.44％.结论:无效甚至错误的审核结果不利于临床安全合理用药的开展,智能系统亟需药师的深度参与,以提高数据的精准性.临床配伍禁忌问题需要行政干预、知识储备、医嘱规范录入、说明书完善等各方面的配合解决.

目的:考察山萘酚对人卵巢癌SKOV-3细胞生长、凋亡的影响及作用机制.方法:采用CCK-8法检测山萘酚对SK-OV-3细胞增殖的影响;流式细胞术和AnnexinV-FITC/PI凋亡试剂盒检测SKOV-3细胞的凋亡情况;RT-PCR检测NICDmRNA的表达;Western Blot方法检测Notch1蛋白的表达.结果:山萘酚对卵巢癌SKOV-3细胞有显著的增殖抑制作用,且呈一定的剂量依赖性;凋亡检测结果表明,山萘酚能够促进卵巢癌SKOV-3细胞凋亡的发生;RT-PCR结果显示山萘酚干预组(80 μmol· L-)NICD mRNA的表达水平明显降低(P＜0.05),Western Blot结果显示山萘酚干预组(80 μmol· L-1)Notch1蛋白表达水平显著降低(P＜0.05).结论:山萘酚能明显抑制卵巢癌SKOV-3细胞的体外增殖,诱导细胞凋亡其机制可能是通过干预Notch1的表达.

Objective To study using rules and safety of oxiracetam injection and provide reference for clinically reasonable application.Methods In twelve sentinel hospital of Hubei province,all hospitalized patients using oxiracetam injection were monitored centralizedly in observation period (September 1,2016 to March 31,2017).The patient's demographic information,clinical diagnosis,drug usage and dosage,course of treatment,solvent,combination and incidence of adverse drug reactions (ADRs) were analyzed,and the risk factors influencing ADRs were studied.Results A total of 6 519 cases were recorded.There were 19 cases of ADRs (0.29％).Patients aged 40 to 90 years accounted for 90.31％.ADRs occur mostly in 3 days after medication (57.89％).17 ADRs are mild (89.47％),and 2 ADRs are new and serious.Skin and appendages disorders (pruritus) are the most common (36.84％).Statistical analysis showed no significant difference (P＞0.05) in incidence rate of ADR between different genders,age groups,allergic history,diseases and dosage form.Conclusion The drug instructions and clinical medication need to further improved.In clinical use of oxiracetam injection,particular attention should be paid to the course of treatment,dosage and solvent.To avoid or reduce ADRs,it is important to closely observe patients' drug reactions and dispose immediately.

[This corrects the article DOI: 10.18632/oncotarget.20885.].

选购保健食品三原则 理性购买 保健食品的基本属性是食品.需要明确保健食品不是药品,它只适用于特定人群食用,只具有调节身体机体功能的作用,不以治疗为目的,不能替代药品治疗疾病. 选择正规销售渠道购买 不要听信夸大宣传和虚假宣传产品功能的所谓健康知识讲座、专家报告、会议销售、电视电话销售、免费试用等活动,盲目购买保健食品.切勿贪图价廉、大降价或到街头摊贩处购买,以免买到假冒或掺假产品,危害身体健康.

Statins have been widely used for the treatment of cardiovascular diseases. However, the most severe adverse effect of statins is myotoxicity, in the form of myopathy and other similar ones. Identifying whether it is a statins-induced muscle symptoms plays an important role in the use of statins. In this paper, we propose an approach to analyse the neglected influencing factors of statin-induced myopathy in a coronary heart disease case by using the technology of knowledge graphs. Through the n-of-1 trial, we can verify the accuracy of the knowledge graphs for this task. Furthermore, Knowledge graph of adverse reactions and symptoms is expected to assist physicians in determining adverse events in the future.

The incidence of depression has increased dramatically in recent years and the quality use of antidepressants has drawn extensive concerns worldwide. In this paper, firstly, we analyze current barriers regarding the use of antidepressants. Secondly, a new informative system which is developed using knowledge techniques is proposed, and its role in the management of antidepressants is discussed. Three main functions of the current version of Knowledge Graphs for Depression (DepressionKG, version 0.6) are presented. Besides, we conduct a semi-structured focus group interview to evaluate this system. The results indicate that DepressionKG has the potential to be a feasible, evidence-based tool for healthcare professionals.

Objective:To assess the clinical use of dezocine injection. Methods:The application of dezocine injection in the in-patients during December 2015 and November 2016 in a hospital was statistically analyzed and evaluated from indications, dosage, treatment course and combined drug use, etc. Results:A total of 12847 patients with the age range of 0-97 and the average age of (49 ± 15. 6) years old were treated with dezocine injection. The top three departments using dezocine injection were orthopaedics (12. 70％), hand surgery (10. 30％) and liver surgery (9. 39％). Totally 132 patients were with overdose(1. 03％), and mainly in cardiac surgery. The medication course of 1042 patients was more than one week(8. 11％), which was too long, while most of the pa-tients were with tumor. Conclusion:The clinical use of dezocine injection in the hospital is basically reasonable. However, clinicians still need more training to minimize the risks involved in the process of clinical medicine application.

出现扭伤、挫伤等,可适当涂抹些活血化瘀、消肿止痛的药.但要注意下面几个问题. 第一,扭伤处是否破溃.一旦破溃,则严禁使用正红花油等活血止痛类药物,否则会导致血流速度加快,使肿胀加重.

目的:从原发性高血压(HPN)与慢性心力衰竭(CCF)的双视角,利用Cochrane方法系统评价缬沙坦与卡托普利的疗效,为临床药物选择提供循证证据.方法:计算机检索PubMed、EMbase、Web of Science、Cochrane Library、 CBM、CNKI、维普和万方等数据库,检索时限均为从建库至2013年6月.由2名评价者按照纳入与排除标准以及Cochrane协作网推荐的方法独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 4.2软件进行Meta分析.结果:HPN有效性部分纳入13个研究,1 222例患者,CCF有效性部分纳入9个研究,852例患者.与卡托普利比较,缬沙坦治疗HPN和CCF的效果总体上优于卡托普利.在治疗HPN方面,缬沙坦降低收缩压效果优于卡托普利[WMD=-1.88(95％CI,-3.84 ～0.08),P=0.05];在治疗CCF方面,缬沙坦提高左心室射血分数(LVEF)效果优于卡托普利[WMD=-3.15 (95％ CI,0.79 ～5.52),P＜0.01].安全性部分纳入17个研究,合并分析结果显示缬沙坦治疗HPN和CCF的不良反应发生率低于卡托普利[OR =0.23(95％ CI,0.16 ～0.32),P＜0.01].结论:基于现有临床循证医学证据,缬沙坦治疗原发性高血压与慢性心力衰竭的有效性和安全性均优于卡托普利,是临床治疗高血压及慢性心力衰竭较好的用药选择.

Resolvins, an endogenous lipid mediator derived from eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) of fish oil, has been reported to have anti-inflammatory and antitumor effect in various pathogenic processes. However, there are no studies about the effects of resolvin D1 and E1 on concanavalin A-induced hepatitis. Hence, the present study is to illustrate whether resolvin D1 and E1 inhibit concanavalin A-induced liver injury, liver cancer and underlying mechanisms by which they may recover. C57BL/6 mice were pretreated with resolvin D1 and E1 for 4 h, and then injected with concanavalin A for 12 h. Subsequently, blood and liver tissue were collected at 0, 2, 4, 8 and 12 h for different analysis. Analysis of inflammatory cytokines indicated that the inhibition of necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-1β and IL-6 could be performed by resolvin D1 and E1. Moreover, Toll-like receptor (TLR) 4 expression, NF-κB and AP-1 activity also have been confirmed to have key roles in the development of liver injury. They were significantly suppressed in the treatment group, compared to model. In addition, resolvin D1 and E1 markedly downregulated CD4+ and CD8+ cell infiltration in the liver. A long-term concanavalin A treatment for 32 weeks was performed to analyze the changes of hepatitis to liver cancer and the antitumor effect of resolving D1 and E1. These results indicated that resolvin D1 and E1 prevent concanavalin A-induced liver injury and the changes of hepatitis to liver cancer in mice through inhibition of inflammatory cytokine secretion and NF-κB/AP-1 activity. Thus, they could be novel target to be considered in the process of finding sufficient drug to protect against various forms of hepatitis and liver cancer.

BACKGROUND:Previous studies have indicated that intake of dietary flavonoids or flavonoid subclasses is associated with the ovarian cancer risk, but presented controversial results. Therefore, we conducted a meta-analysis to derive a more precise estimation of these associations. METHODS:We performed a search in PubMed, Google Scholar and ISI Web of Science from their inception to April 25, 2015 to select studies on the association among dietary flavonoids, flavonoid subclasses and ovarian cancer risk. The information was extracted by two independent authors. We assessed the heterogeneity, sensitivity, publication bias and quality of the articles. A random-effects model was used to calculate the pooled risk estimates. RESULTS:Five cohort studies and seven case-control studies were included in the final meta-analysis. We observed that intake of dietary flavonoids can decrease ovarian cancer risk, which was demonstrated by pooled RR (RR = 0.82, 95% CI = 0.68-0.98). In a subgroup analysis by flavonoid subtypes, the ovarian cancer risk was also decreased for isoflavones (RR = 0.67, 95% CI = 0.50-0.92) and flavonols (RR = 0.68, 95% CI = 0.58-0.80). While there was no compelling evidence that consumption of flavones (RR = 0.86, 95% CI = 0.71-1.03) could decrease ovarian cancer risk, which revealed part sources of heterogeneity. The sensitivity analysis indicated stable results, and no publication bias was observed based on the results of Funnel plot analysis and Egger's test (p = 0.26). CONCLUSIONS:This meta-analysis suggested that consumption of dietary flavonoids and subtypes (isoflavones, flavonols) has a protective effect against ovarian cancer with a reduced risk of ovarian cancer except for flavones consumption. Nevertheless, further investigations on a larger population covering more flavonoid subclasses are warranted.