The modernization and internationalization of traditional Chinese medicine (TCM) are the key issues we must face up to. The development of TCM needs to depend on the breakthrough of methods and the innovation of ideology, and the international standardization of scientific research evaluation. The clinical evidence from randomized comtrolled trials (RCT) is valuable and reliable. It has shown that the proportion of RCT identified in TCM journals was less than 30%, and the score of RCT’s quality was less than 3 using Jadad scale. However, the number of systematic reviews on TCM is increasing rapidly after the evidence-based medicine (EBM) was introduced and practiced in China. Until 2004, 43 systematic reviews of TCM were published in China, and the quality of RCT included in those reviews was elevated. It has shown that the efficacy and safety of TCM indicated some advances in treatment of certain kind of diseases. It has been realized that RCT are important in TCM, and improving the quality of RCT is the key step for modernization and internationalization of TCM.
Objective To investigate the current situation, problems of medicinal biotechnology in China, and to provide the relevant countermeasures for its development. Methods We surveyed the units which could carry out medicinal biotechnology projects in 30 provinces except Tibet, and compared the results with that in America.Results The questionnaire were returned from 25 provinces (83.4%), and there were 1 477 medicinal biotechnology projects carried out by 149 units in the past 10 years. These projects ranged from basic biotechnology to regenerative medicine and stem cell researches. The basic research projects constituted quite large percentage among all the projects. But the development levels in different areas were imbalanced, cross correlation with the development levels of economy. An echelon team of talents has been developed, most of them were trained in China. The invested capital differed considerably among units, in general the amounts were insufficient. Most invested capital came from the government. The number of patent application for projects based on independent-developed technology was small. This showed that project principals had a poor understanding of patents. More than half of units did not have a Bioethics Committee. From the search result for documents, the number of articles on stem research of China was close to that in America; and the number of articles on gene treatment and tissue engineering has already exceeded that of America. However, research on gene diagnosis of China was lagging far behind America. Conclusions An echelon team of talents has been developed, most of them are trained in China.We should give full play to the advantage of the distribution of qualified personal resources in developed economical areas so as to promote the applicability and popularity of medicinal biotechnology in less developed areas.Regarding to applicability and development, we should first develop applied technology to form the core competetiveness of basic research, technology development and application; we should also strengthen the training in ethics and regulation to establish a set of scientific assessment of medicinal biotechnology and management system.
Clinical pharmacy practice guidelines have developed rapidly in recent years. They provide a series of recommendations for optimizing drug treatment management and improving pharmaceutical care appropriateness and are widely employed in clinical practice. Based on literature review and the experience of guideline development, this paper summarized the meaning, formulation methods, formulation status, and registration of clinical pharmacy practice guidelines, and provided suggestions for the development of guidelines.
目的 调查胃肠道疾病患者围手术期的疼痛状况,为建立无痛病房,优化医疗和护理服务提供依据。 方法 对2011年12月5日-2012年1月14日胃肠外科所有的新住院患者共227例,采用《四川大学华西医院住院病人疼痛现状调查问卷》进行调查,并同期调查胃肠外科27名主管医师对疼痛药物了解状况。 结果 有明确行为能力的216例患者完成调查问卷,其中有195例(90.28%)接受手术治疗,全身麻醉患者193例(占手术患者98.97%),诊断为胃肠道肿瘤163例(占手术人数的83.59%),手术等级为三级146例(占手术人数的74.87%)。有168例(86.15%)患者术后镇痛,在术后镇痛过程中使用镇痛泵156例(92.86%),其中75例(48.08%)认为镇痛泵镇痛“基本有效”,30例(19.23%)认为“无效”。39例术后未使用镇痛泵,其中20例(51.28%)认为“未使用术后镇痛泵”最主要原因为“不了解镇痛泵”。受调查的主管医师了解的疼痛药物仅占罗列药物52种的(20 ± 5.36)种。 结论 疼痛现象在胃肠道疾病围手术期患者中属普遍现象,由于不断增强镇痛意识和镇痛需求与相关知识缺乏的矛盾存在,及较少的医疗护理干预,导致镇痛效果不佳,影响了疼痛管理长效机制的建立和无痛病房的建设。
Objective To investigate the current status of clinical nursing risks to nursing students, so as to provide scientific references for medical universities and policy makers. Methods The self-designed questionnaires were distributed to 360 clinical nursing students in four Third-Level hospitals. The group leaders were trained as investigators regularly. All the other nursing students were asked to fill in the questionnaire alone within 30 minutes. The questions issued were the following four aspects: general information of nursing students, clinical intern operating situation, nursing defects and awareness of nursing risks. Results Among the total 400 questionnaires distributed, 360 valid ones were retrieved (90%). The analysis showed all 21 nursing operations could be performed by students alone, and 80% of the nursing students believed that they were able to do 11 routine operations alone, such as bed-making and vital sign monitoring. The incidence rate of eight nursing defects was between 0.56% and 12.22%. As for the four questions about nursing risks, 49.44% of the nursing students operated alone before getting themselves ready because of their eagerness for such experiences. According to the nursing students, the departments with the highest nursing risks ranked as emergency, operating theatre, surgery, pediatrics, internal medicine, and gynecology and obstetrics. Conclusion The current situation of clinical nursing risks to nursing interns is still far from being satisfactory, so it is necessary to improve the training at university, regulate the clinical education, and ensure the intern safety for nursing students.
Cardiac rehabilitation can safely and effectively improve the quality of patient's life and reduce readmission rate and mortality after cardiac surgery. Early cardiac rehabilitation after cardiac surgery is an indispensable part of cardiac rehabilitation. It can speed up the recovery of patient's exercise endurance, prevention of postoperative complications, shorten the time of returning to the family, increase the confidence of sustained rehabilitation, and lay foundation and set rehabilitation targets for the later stage of cardiac rehabilitation. This paper reviews the development history of early cardiac rehabilitation after cardiac surgery, and summarizes the current status, problems and outlook of rehabilitation management in China.