Purpose:To develop a training program on cancer pain management for pharmacists and to evaluate the effectiveness of the training. Methods:The program developed a well-structured curriculum and subsequent evaluation of training effectiveness, guided by the Kirkpatrick four-tier evaluation model, including reaction, learning, behavior, and results. The training approach incorporated mentoring, study groups, and problem-based learning to create an immersive and impactful learning experience. Results:Fifty-three pharmacists participated in the survey. The reaction evaluation results showed that the cumulative percentage of "satisfied" and "very satisfied" with each of the nine statements exceeded 85%. The findings from the learning level assessment revealed that the cumulative percentage of accurate responses to the 13 items on the Cancer Pain Management Questionnaire was 57.7% before training. This percentage rose to 64.2% following the training, showcasing a statistically significant improvement (p=0.014). The behavioral scoring results showed that 53 trainees scored an average of more than 15 points on all four behavioral benchmarks. The pass rate for the trainees was 86.8%. The percentages of trainees who scored proficient, good, and excellent were 18.9% (10/53), 50.9% (27/53), and 17.0% (9/53), respectively. The evaluation of the results showed that all the respondents were engaged in cancer pain management practices. Of these participants, 85.7% (42/49) were members of a multidisciplinary cancer pain management team, and 53.1% (26/49) performed a cancer pain consultation or attended an outpatient clinic. Conclusion:Study results suggested that the training program was effective in all dimensions defined by the Kirkpatrick model. This collective achievement indicates a substantial enhancement in the comprehension and proficiency of pharmacists regarding cancer pain management.

目的 探究2 型糖尿病(T2DM)患者发生药物相关问题(DRPs)的风险因素,构建DRPs风险预测模型,评价分级管理策略对T2DM患者的干预效果.方法 回顾性收集 2020 年 10 月至 2021 年 12 月就诊于重庆市垫江县人民医院内分泌科的T2DM患者596 例,构建T2DM患者发生DRPs的风险预测模型,并通过受试者操作特征(ROC)曲线、校准曲线、临床决策曲线分析(DCA),分别评价模型的区分度、校准度和临床适用性.选取2022 年4-6 月到我院内分泌科就诊的T2DM患者82 例,依据模型预测T2DM患者用药风险,并进行分级药学管理,评价患者的用药依从性和糖化血红蛋白情况.结果 Logistic回归分析结果显示,患者的年龄、病程、用药数量、用药依从性、MTM 与 DRPs 的发生有关(P<0.05),根据筛选变量构建预测模型,训练集的 AUC 为0.713(95%CI:0.663～0.764),验证集的AUC为 0.728(95%CI:0.656～0.800),Hosmer-Lemeshow拟合优度检验显示模型具有较好的拟合度(训练集P =0.986,验证集P =0.772),DCA显示阈值概率在20%～60%,预测模型的净获益最佳.经模型预测后,有56 例患者的预测概率高于 50%,26 例患者预测概率低于 50%,临床药师实施分级管理后,患者用药依从性(t =3.128,P = 0.002)和糖化血红蛋白均发生显著变化(t = 5.875,P<0.001).结论 以患者的年龄、病程、用药数量、用药依从性和药物治疗管理(MTM)构建的DRPs风险预测模型具有一定的临床价值,可为T2DM患者药物治疗管理模式提供新的思路.

目的 研究慢性病患者药物相关问题(DRPs)现状并分析其影响因素.方法 提取重庆市垫江县人民医院2020年10月至2021年2月慢性病患者293例的病历资料,统计其DRPs发生情况.按是否发生DRPs将其分为发生组(132例)和未发生组(161例),比较两组临床资料,并采用二元logistic回归模型分析慢性病患者发生DRPs的影响因素.结果 本研究中DRPs发生率为45.05％,共发现165个DRPs,Bayliff评估结果显示DRPs引起0级危害6个,1级危害有133个,2级危害26个.两组年龄、并发症数量、用药种类、用药依从性比较,差异有统计学意义(P<0.05).多因素分析结果显示,年龄60～75岁、用药种类多、并发症数量多、用药依从性差是慢性病患者发生DRPs的独立危险因素(OR>1,P<0.05).结论 慢性病患者DRPs的发生率较高,患者年龄、并发症数量、用药品种及用药依从性均能影响DRPs的发生风险.

目的 分析骨科Ⅰ类切口手术部位感染(SSI)的相关危险因素.方法 选择重庆市垫江县人民医院骨科2019年9月至2020年9月出院的Ⅰ类切口手术患者病历进行回顾性分析,填写《骨科Ⅰ类切口手术调查表》,采用多因素logistic分析发生感染的独立危险因素.结果 共调查患者1023例,发生SSI 85例,SSI发生率为8.31％.多因素logistic分析结果显示,年龄>60岁、美国麻醉医师协会(ASA)评分Ⅱ级及以上、手术时间>180 min、骨折内固定术及术前未预防使用抗菌药物是骨科Ⅰ类切口手术患者发生SSI的独立危险因素(P<0.05).结论 年龄≤60岁、ASA评分Ⅰ级、缩短手术时长及术前预防使用抗菌药物等可减少骨科Ⅰ类切口手术SSI发生率.

目的 研究妊娠中期(妊娠21～24周)25羟维生素D[25(OH)D]水平与妊娠糖尿病(GDM)发生风险的相关性,以及孕妇血清25(OH)D水平的影响因素.方法 选取2018年10月至2020年10月于该院行产前检查的妊娠21～24周孕妇325例作为研究对象,进行问卷调查,并采集其外周静脉血检测25(OH)D水平.依据25(OH)D水平分为维生素D(VD)正常组[25(OH)D水平大于50 nmol/L]、轻度缺乏组[25(OH)D水平为30～50 nmol/L]和严重缺乏组[25(OH)D水平小于30 nmol/L].采用趋势性χ2检验分析血清25(OH)D与GDM发生风险的相关性,运用Logistic回归模型筛选25(OH)D水平的危险因素.结果 325例孕妇中,25(OH)D缺乏的发生率为69.8％(227/325),GDM的发生率为20.3％(66/325).随着25(OH)D水平的升高,GDM的发生率呈显著下降趋势(χ2趋势=5.791,P=0.016).单因素筛选结果显示,25(OH)D水平与孕妇孕次、妊娠前6个月补充VD和钙片、户外活动时间小于1 h/d相关(筛选界值P<0.1).logistic回归分析结果显示,孕妇孕次、户外活动时间小于1 h/d、妊娠前6个月补充VD和钙片与VD缺乏显著相关(P<0.05).结论 妊娠中期25(OH)D水平不足将会显著增加GDM发生的风险,孕妇应通过增加户外活动时间、及时补充VD和钙片等方式来预防VD水平缺乏,降低孕妇GDM的发生风险.

目的:了解重庆市垫江县人民医院骨科Ⅰ类切口手术期围术期抗菌药物预防使用的现状,为临床合理应用抗菌药物提供一定的参考.方法:采用回顾性调查分析法,抽取我院骨科2019年9月-2020年9月出院的Ⅰ类切口手术患者病历,综合分析围术期抗菌药物使用的合理性.结果:我院骨科593例Ⅰ类切口手术中,抗菌药物预防使用率达74.54％(442/593).手术切口感染率为8.6％(51/593).442例预防性使用抗菌药物的手术中,抗菌药物选择合理率为99.77％(441/442);术前30min-1h给药率99.55％(440/442);预防用药疗程≤24h者217例,占51.79％(217/419);预防用药中不合理95例,用药合理率为78.51％(347/442).抗菌药物使用不合理情况主要包括:无指征预防用药、药物选择不恰当、给药时机不合理、用药疗程偏长及用法用量不适宜.结论:我院骨科Ⅰ类切口手术围术期抗菌药物预防使用率较高,用药疗程偏长,存在较多不合理用药,需进一步加强监督管理,促进围术期抗菌药物的合理使用.

临床药师参与1例肺鳞癌患者口服阿法替尼靶向治疗期间出现顽固性皮疹的药学监护过程,发现阿法替尼导致皮疹后,通过查阅相关指南及文献,对阿法替尼导致的顽固性皮疹进行相关性分析,提高了患者药物治疗的安全性及有效性.

(Z)-2,3-dihydroind-en-1-one ON-prop-2-ynyloxyme was synthesized from 1-indanone and hydroxylamine hydrochloride by condensation, alklation with bromopropyne, The substituted reaction temperature,reaction time and catalyst was investigated.The method is simple, lower cost and a higher yield of the target product,suitable for industrial production.

Objective:To design and synthesize 1,2,3,4-tetrahydroisoquinolines and to determine its inhibition effect on monoamine oxidase(MAO).Methods:1-aminomethyl-1,2,3,4-tetrahydroisoquinoline was synthesized from phenylethylamine via acylation,amination with phthalimide potassium,bisehler-napieralski cyclization,hydrazinolysis and reduction reaction.Then the title compounds were synthesized.Results:Four compounds with tetrahydroisoquinoline moiety were synthesized and their structures were confirmed by infrared spectroscopy,nuclear magnetic resonance spectroscopy and mass spectrometry.Pharmacological test in vitro showed that all the five compounds had certain MAO inhibitory activity,and compound(5~7) displayed preferable selective inhibition on MAO-A.Conclusion:The obtained compounds(5~7) need further study.

Objective:To construct a screening model for monoamine oxidase(MAO) inhibitors in the treatment of neurodegenerative diseases.Methods:Benzylamine and 5-hydroxytryptamine(5-HT) were used as MAO-B and reaction substrates and their activities were measured by UV spectrophotometry,respectively.MAO concentration,substrate concentration,phosphate buffer concentration and pH,reaction time and temperature were optimized.Results:The optimized reaction system conditions were obtained as follows:under the conditions of enzyme pre-incubation time of 20 min and reaction time of 60 min at the temperature of 37 ℃,optimum condition for determination of MAO-B activity was 100 mmol/L phosphate buffer(pH 7.6) and 0.15 mg/ml MAO and 2.00 mmol/L benzylamine,optimum condition for determination of MAO-A activity was 100 mmol/L phosphate buffer(pH 7.4) and 0.40 mg/ml MAO and 5.00 mmol/L 5-HT.Conclusions:A screening model for monoamine oxidase inhibitors in vitro is constructed successfully.Due to its low cost and simple operation,it is suitable for large-scale screening MAO-B and MAO-A inhibitors.

Hydrogen-association classified molecular electronegafivity-distance vector,based on the two-dimensional topological structure,and consists of 10 parameters which express the interaction between four types of atoms.Structure-activity relationship for novel antitumour drug tetraznbigen and its derivatives was studied based on H-MEDV in this paper. Quatitative structure-activity relationship(QSAR) model was constructed by multiple linear regression(MLR) and stepwise multiple regression(SMR).The correlation coefficient(R) is 0.862.Crossvalidation was performed by leave-one-out procedure(LOO) and the correlation coefficient is 0. 713. It showed good performance in predictability and reliability.

建立了新化合物N-氯乙酰基-4-乙酰基-β-苯乙胺、4-[[(羟基)亚胺基]乙基]-N-氯乙酰基-β-苯乙胺和N-氯乙酰基-4-羟乙基-β-苯乙胺的合成方法,并且着重考察了N-氯乙酰基-4-乙酰基-β-苯乙胺的合成条件.结果表明,其合成的最适条件为:原料与三氯化铝的摩尔比为1∶3,原料与乙酰氯的摩尔比为1∶2,在20℃条件下滴加原料的二氯甲烷溶液,滴加完毕后反应体系控制在30℃,在此条件下反应,产物收率可达85％.产品结构通过IR、1H NMR、MS确证.