Continuous renal replacement therapy (CRRT) is an important therapy for patients with severe acute kidney injury. With the development of blood purification, the application of CRRT has been beyond the scope of kidney disease and developed into a comprehensive and integrated organ support platform, providing a hybrid treatment of different blood purification techniques. With the advancement of informatization, it is possible to improve the quality of CRRT treatment to formulate individualized and precise treatment based on the specific information of patients. This article will discuss the precise prescription and development prospective of CRRT from three dimensions: anticoagulation, dosage and volume management.
Objective To explore the serious situation of injection abuse, and its influence to average prescription fee. Methods The subjects of this study were health service settings in rural area of 9 provinces/cities in Midwest of China. The treatment prescription indicators of county and village health service settings were calculated. Results Prescription injection rates of health care facility in rural area of Midwest provinces/cities of China (25.8% to 62.2%,mean: 45.1%) were higher than the standard of WHO (13.4% to 24.1%), and the injection abuse situation was serious. Injection bause caused the increase of prescription fee. Excess usage of injection in health service settings was related to the economic level of the on-site county or village, and also related to the size and load of health service facilities. Conclusion Suggestions are proposed to the government health agency according to the results of the study: enhancing the lawmaking, establishing the related policy and effective measure, training the medical personnel, promoting the mass health education, investigating the effective injection management model in rural area, and reducing the rate of injection.
Objective In order to improve the standing on the studies of Exercise Prescription (EP), a systematic review was conducted to provide reference and theory for further studies. Methods A broad computerized literature search of Medlin via Ovid, PubMed in all fields, Sport Discus, CINAHL, CAM, EMbase, EBM Cochrane Database of SR, and Web of Science was carried out till June 2008. Firstly, four categorical searches were conducted with the following keywords for searches: Exercise Prescription, Physical Fitness, Exercise Therapy, Fitness Assessment, Exercise Test and RCTs, and the searched results were checked by reviewers and duplicate results were removed. Then all titles were manually searched for potential inclusion in the review. Articles retrieved, review articles were examined for further relevant references. Results There were 318 relevant articles, however, the RCTs were only 7, and systematic review and meta-analysis were only one, respectively. Considering the importance and reference values there were 93 articles were included. 1970s was the developing age of EP; 1980s more specific EP were provided for many purposes; 1990s with the techniques developing of physical fitness, exercise therapy, fitness assessment and exercise test, EP for treating and rehabilitating more chronics and civilizing diseases were developed; 2000s the RCTs and CCTs were applied in the EP studies. Conclusions The developing of EP has close relationship with the developing of physical fitness, exercise therapy, fitness assessment, and exercise test. Although the RCTs researches in this field were limited, most of them were positive to support the advantage of EP. How to highly improve the advantages and greatly decrease the risk of EP is still valuable to study in the future.
Transcuataneous electrical nerve stimulation (TENS) analgesia as a non-drug method has received people's more and more attention recently. Considering problems of existing products, such as unstable performance and unsatisfied effectiveness, we developed a new analgesia therapy system for delivery based on bio-feedback TENS in our laboratory. We proposed a new idea for stimulation signal design, that is, we modulated a middle frequency signal by a traditional low frequency TENS wave in the new system. We designed different prescription waves for pain relief during a uterine contraction or massage between contractions. In the end, a bio-feedback TENS method was proposed, in which the waveforms of stimulation signals were selected and their parameters were modified automatically based on feedback from uterine pressure, etc. It was proved through quality tests and clinical trials that the system had good performance and satisfied analgesia effectiveness.
ObjectiveTo analysis the regularity of prescriptions of Chinese Medicine for syndrome of intense fire and heat (syndrome of Shi-Re-Huo-Du), and to provide evidences for the clinical treatment.MethodsCNKI, Sinomed, WanFang Data, VIP and Chinese medical databases were electronically searched to collect literatures about traditional Chinese Medicine for syndrome of Shi-Re-Huo-Du from inception to October, 2018. Two reviewers independently screened literature and extracted data. Then BICOMS 2 software was used to generate the co-occurrence matrix, NetDraw software was used to draw network maps.ResultsA total of 381 literatures involving 335 patients were included. There were 716 prescriptions of Shi-Re-Huo-Du (390 Chinese medicinal herbs), in which the frequently used herb included radix glycyrrhizae (346), Scutellariae Radix (255), Fructus Gardeniae (241), Rehmanniae Radix (239), Moutan Cortex (218), etc. The classification was performed according to traditional efficacy, Qing-re herbs (73), Bu-xu herbs (47), and Hua-tan-zhi-ke-ping-chuan herbs (39), accounted for 40.77% of the total herbs. The results of the analysis showed that the top herbs in Degree and Betweenness were consistent with high-frequency herbs. Among them, Rehmanniae Radix, Fructus Gardeniae, Scutellariae Radix, Moutan Cortex are the most important traditional Chinese herbs. High-frequency herbs are mainly based on Qing-re herbs, and the highest frequency of the herbs combination is Scutellariae Radix-Fructus Gardeniae.ConclusionAlthough there are kinds of herbs for syndrome of Shi-Re-Huo-Du, the commonly used herbs are relatively concentrated, and there is obvious interaction between high-frequency herbs, which is in line with the principle of compatibility of Chinese medicine. The high-frequency Chinese herbs and herb pairs were main components of the Chinese patent medicines and classic prescription. It reflected the rule of medicine used and essence in the treatment of syndrome of Shi-Re-Huo-Du.
Chronic obstructive pulmonary disease (COPD) is one of the major chronic diseases that seriously endanger the health of residents in our country. Exercise is one of the effective interventions to improve the cardiopulmonary function and quality of life of COPD patients. An exercise prescription specifies the frequency, intensity, duration, mode, total exercise volume, and progression of exercise, forming a clear - purpose and systematic exercise guidance plan. Clinical pathways standardize and proceduralize the patient's diagnosis and treatment process. Developing an exercise prescription for the entire process of issuing and implementing exercise prescriptions for COPD patients helps to promote the application of exercise prescriptions and assist in the implementation of related work in primary - level medical institutions. Therefore, we invited a number of COPD experts and sports medicine experts to develop this clinical pathway in combination with domestic and international guidelines, consensuses, and personal experience. Its aims are to simplify the exercise prescription development process, reduce the required level of expertise, enhance the capacity of primary healthcare institutions, and facilitate the application of exercise prescriptions within these settings.
ObjectiveTo probe into the writing quality and rational use of drugs for Emergency Department prescriptions in West China Hospital of Sichuan University. MethodsFrom January 2012 to December 2013, the prescriptions for emergencies were selected randomly. According to prescription management method and standard management of hospital prescription comment requirement, the quality of prescription was analyzed. ResultsFrom 2012 to 2013, the qualified prescription rate increased from 91.45% to 96.70%. The average number of drugs on each prescription was 1 or 2; the utilization rate of antibacterials was below 20.00%; the utilization rate of essential drugs increased from 60.68% to 66.15%; the utilization rate of generic drug name approached 100.00%. However, the utilization rate of injections increased from 82.92% to 85.67%. ConclusionBy prescription reviews, we have listed the problems, and intervened irrational prescription to improve the rate of qualified prescriptions. The high rate of injection utilization is a warning for us to take more effective, more specific and stricter intervention measures.
ObjectiveTo realize the application status and development trend of oral anticoagulant drugs used in respiratory diseases in 72 hospitals in 6 cities from the year 2013 to 2017.MethodsFrom January 2013 to December 2017, we randomly selected the electronic information from 10 working days per quarter in 6 cities including Beijing, Guangzhou, Shanghai, Chengdu, Shenyang, and Zhengzhou, with 12 hospitals in each city, and summarized the information into the prescription database of the hospital prescription analysis project. Through the hospital information system, we screened out the information of outpatient prescriptions and inpatient medical records which used oral anticoagulants. The prescriptions with respiratory diseases related-diagnosis were selected as the research objects by manual screening. The application of oral anticoagulant drugs used in respiratory diseases was statistically analyzed by drug amount, prescription amount, prescribed daily dose (PDD), and defined daily dose (DDD).ResultsFrom 2013 to 2017, the number of warfarin sodium prescriptions was successively 4 769, 5 747, 7 549, 7 261, and 7 151, which had been always ranked the first in the five years, but decreased year by year since 2015. The proportion of warfarin sodium drug use amount decreased year by year from 32.52% in 2013 to 5.03% in 2017. The proportion of prescription and drug consumption sum of new oral anticoagulants increased year by year in the past five years. The PDD/DDD of warfarin sodium, dabigatran etexilate, rivaroxaban, and apixaban were 0.41, 0.73, 0.68, and 0.33, respectively. There were off lable use of new oral anticoagulants.ConclusionsWarfarin still dominates the proportion of oral anticoagulants prescribed in the 72 hospitals in the 6 cities in the five years. The clinicians have made a comprehensive judgment after fully considering the safety, effectiveness, and economy of drug use when formulating drug treatment programs.
With the implementation of the “Health China 2030” strategy, sports medicine has played an increasingly important role in clinical treatment, chronic disease management, and population health promotion. West China Hospital of Sichuan University has actively explored the development and optimization of its sports medicine discipline outpatient management system, establishing a comprehensive model that integrates diagnosis and treatment, functional rehabilitation, exercise-based health management, and extended care services. This article systematically summarizes the practical experiences of the sports medicine outpatient department, including subspecialty setting, exercise prescription services, outpatient assistant mechanisms, online expert teams, multi-campus coordination, and full-process health management. Emphasizing a function-oriented and patient-centered approach, the article also discusses the extended value of outpatient services in translational research, smart healthcare, and preventive health strategies. This model provides a replicable and scalable reference for the development of sports medicine outpatient clinics.
Stroke has a high disability rate, with patients often experiencing varying degrees of motor function impairment. Some patients also have concurrent cardiovascular diseases, leading to varying degrees of cardiopulmonary dysfunction. Formulating exercise prescriptions tailored to stroke patients, selecting appropriate assessment methods, and determining suitable exercise intensity are significant clinical concerns. However, there is a lack of definitive conclusions on how to formulate precise exercise prescriptions based on the assessment of cardiopulmonary and motor functions. This paper reviews the determination of post-stroke exercise loads and current research on stroke and cardiopulmonary fitness, aiming to provide a basis for the precise formulation of exercise prescriptions for stroke patients.