将《处方管理办法(试行)》引入临床医学处方教学

新颁布的<处方管理办法(试行)>对临床处方进行了一些新规定,对处方定义进行了修正,对医师处方权的获得进行了规范,对处方格式新增了费别和临床诊断2项,规定麻醉药品处方、急诊处方、儿科处方、普通处方的印刷用纸应分别为淡红色、淡黄色、淡绿色、白色,并对电子处方进行了规范.这些规定在临床医学处方教学中均应补充,使临床医学生知识结构能适应医疗改革进程.

太极拳:易行有效的医学运动处方

本文通过太极拳对一些常见病作用的综述研究,表明太极拳运动是一种安全、简便易行的辅助治疗手段。可应用于临床,作为一剂医学运动处方介绍给相应的患者。

全科医学处方决策中的医患误解：定性研究

目的发现并描述全科诊疗过程中全科医师与患者在处方决策中的误解。设计本研究为定性研究，纳入了英格兰的中西部和东南部的20所全科医学诊所的20位全科医生和35位患者。主要研究开具处方时，全科医生和患者之间的误解可能导致或确实发生的不良后果。结果误解有14种类型：医生对患者信息不了解、患者对医生信息不了解、信息冲突、对药物不良反应的归因意见不一致、对医生的决策缺乏有效沟通以及其他医患关系因素等。所有这些误解都与患者没有充分表达自己的期望和偏好有关，并且没有对医生的决定做出有效回应。这些误解均导致了潜在的或实际发生了的不良后果，如患者的依从性下降。许多误解都缘于假象或猜测。特别是有些医生似乎没有意识到患者的想法与成功开具处方之间的关系。结论患者的充分参与是非常重要的，参与不足导致的不良结果不容忽视。作者将根据这些结果建立一种教育干预措施来改善这种状况。

Evaluation of Antitumor,Immunomodulatory and Free Radical Scavenging Effects of A New Herbal Prescription Seaweed Complex Preparation

Seaweed Complex Preparation （SCP） is a clinical traditional Chinese medicine preparation which is composed of seven traditional Chinese herbs, and it has been used for treatment of lung cancer, liver cancer and digestive cancer. However, little infor- mation is available about the pharmacodynamic basis. The antitumor, immunomodulatory and free radical scavenging effects of SCP were evaluated in this study. Transplanted tumor in vivo method was used to determine the antitumor effect. The effects on spleno- cyte proliferation and phagocytosis of macrophages in tumor-bearing mice were measured by the MTT method and the phagocytizing cock red blood cell （CRBC） method respectively. The scavenging activities of SCP on DPPH and hydroxyl radicals in vitro were investigated. It was found that the medium-dose and high-dose of SCP could significantly inhibit the growth of transplanted hepatic tumor of murine hepatocarcinoma cell line H22, and promote proliferation of splenocytes and phagocytosis of macrophages. SCP possessed noticeable scavenging activities on DPPH and hydroxyl radicals. The antiturnor effects of SCP might be achieved by im- proving immune system and scavenging free radicals, which is in accordance with the viewpoint of traditional Chinese medicine in promoting the body resistance and eliminating pathogenic factors for cancer treatment.

Issuing the Antibiotics for Children with and without Prescription in Pharmacies in Republic of Macedonia

The use of medicines for infants and children is presenting one unique set of challenges, because children are the most vulnerable population in any society. In this study, we set out to present the characteristics and classification of antibiotics recommended for children according to WHO, EMA and EBM. Also, the aim of this study was to analyze the most prescribed pediatric antibiotics in 2013 in Republic of Macedonia compared with standard treatments. Presented data was collected according to the number of prescribed recipes of pediatric dosage forms covered by the Fund of Republic of Macedonia. The obtained results showed that the most prescribed pediatric antibiotic is amoxicillin with clavulanic acid （875mg ＋ 125mg） in form of tablet, with 280 863 prescribed recipes which corresponds to the recommendations of EBM.

SVM for density estimation and application to medical image segmentation

A method of medical image segmentation based on support vector machine (SVM) for density estimation is presented. We used this estimator to construct a prior model of the image intensity and curvature profile of the structure from training images. When segmenting a novel image similar to the training images, the technique of narrow level set method is used. The higher dimensional surface evolution metric is defined by the prior model instead of by energy minimization function. This method offers several advantages. First, SVM for density estimation is consistent and its solution is sparse. Second, compared to the traditional level set methods, this method incorporates shape information on the object to be segmented into the segmentation process. Segmentation results are demonstrated on synthetic images, MR images and ultrasonic images.

Essential factors of Sui Zheng Shi Liang strategy in Type 2 diabetes treatment assessed by questionnaire

OBJECTIVE: Sui Zheng Shi Liang strategy (regulating prescription dosage with different syndromes) is an important part of syndrome differentiation and treatment in Traditional Chinese Medicine (TCM). Questionnaires were given to doctors and patients to study the essential factors (indicators and timing) of Sui Zheng Shi Liang strategy in the treatment process of type 2 diabetes (T2DM). METHODS: Two questionnaires were designed for diabetes patients and their doctors. The questionnaires included the most important indicators for determining the patient's condition, the ability of TCM in treating T2DM, the length of time it takes for TCM to be effective, and when to adjust the prescription dosage.The frequency of answers was calculated, summarized, and analyzed after the survey. RESULTS: Twenty questionnaires from doctors and 90 questionnaires from patients were included in the analysis. Doctors and patients recognized thatTCM could decrease blood glucose, improve syndromes, and delay complications. Doctors were mainly concerned about glycosylated hemoglobin, while the patients were concerned about fasting plasma glucose for determining whether treatment was effective. Doctors also paid attention to changes in blood sugar and syndromes 2 weeks after medication was given as the indication to adjust the prescription dosage, while patients were concerned about these factors in 4 weeks.The prescription should be regulated when there are side effects or the medication is ineffective. CONCLUSION: The essential factor in the treatment process of T2DM in Sui Zheng Shi Liang strategy is that if fasting blood glucose level did not decrease after 4 weeks of treatment, the Chinese medicine prescription should be adjusted.

Randomized,double-blind,parallel-controlled clinical trial on correspondence of prescriptions and Traditional Chinese Medicine syndrome of ischemic stroke

OBJECTIVE:To investigate the effect of correspondence of prescriptions and the traditional Chinese medicine(TCM) syndrome of ischemic stroke.METHODS:Based on standard syndrome diagnosis and a series of effective formulas,a randomized,double-blind,parallel-controlled clinical trial on correspondence of prescriptions and the TCM syndrome of ischemic stroke was conducted.The formulas were dynamically changed according to the patient's TCM syndrome.RESULTS:The treatment was composed of a series of formulas changed daily according to the TCM syndrome.Treatments which were composed of a series of formulas had similar short-term(1 month after onset) effects in improving mild and moderate neurological deficits compared with treatments composed of only one formula.However,patients treated with a series of formulas showed improved subjective symptoms in the short-term and a decreased risk of stroke recurrence within three months after onset.CONCLUSION:Complete(series of formulas) and incomplete(only one formula) correspondence of prescriptions and TCM syndrome have similar effects on the central clinical manifestation of ischemic stroke,such as neurological deficit and activities in daily living.However,they have significant differences regarding individual dysfunctions,such as subjective symptoms.