Data Mining Method for Exploring the Composition Law and Therapeutic Mechanism of Chinese medicine of macroscopic

Background:Based on the theory of"cancer toxin"in traditional Chinese medicine(TCM),combined with data mining method,this paper discusses the prescription and medication law of macroscopic"cancer toxin".Methods Sort out the relevant prescriptions of macroscopic"cancer toxin"and carry out correlation analysis.Results The results showed that the main therapeutic drugs for macroscopic"cancer toxin"were invigorating the spleen and Qi,regulating the Qi mechanism,eliminating toxin and pathogenic factors,eliminating dampness and swelling,promoting blood circulation and removing blood stasis,attacking toxin,softening and firmness,and dredging collaterals to relieve pain.Conclusion High frequency medicine embodies the core of tangible macroscopic"cancer toxin"treatment,and the new prescription composition embodies the fundamental treatment.At the same time,the mechanism of macroscopic"cancer toxin"was analyzed to pave the way for further clinical practice.

Pain management in chronic pancreatitis incorporating safe opioid practices: Challenge accepted

Patients with chronic pancreatitis often experience severe,unrelenting abdominal pain,which can significantly impact their quality of life.Pain control,therefore,remains central to the overall management of chronic pancreatitis.Most of the strategies aimed at treating the pain of chronic pancreatitis are based on expert opinion and vary from one institution to another,as there are no uniform guidelines to direct a stepwise approach towards achieving this goal.In this editorial,we comment on best practice strategies targeted towards pain control in chronic pancreatitis,specifically highlighting the use of opioid medications in this patient population.We discuss various safe and efficacious prescription monitoring practices in this article.

处方点评与不合理用药分析

目的:为了提高处方和医嘱质量,促进合理用药,保障医疗安全。方法:开展处方和医嘱点评,发布处方和医嘱点评信息,及时反馈到相关医师。结果:医院处方和医嘱质量明显提高,不合理用药现象逐渐减少。结论:通过处方和医嘱点评,可有效提高处方和医嘱质量,促进合理用药。

Clinical observation of Yiqi Qingdu Prescription(益气清毒方)on the treatment of intermediate-stage and advanced non-small-cell lung cancer

OBJECTIVE:To observe the effects of the Yiqi Qingdu prescription(益气清毒方)on intermediate-stage and advanced non-small-cell lung cancer(NSCLC).METHODS:In total,300 patients with intermediate-stage or advanced NSCLC were randomly and equally divided into three groups using computer-generated random numbers as follows:Western medicine(WM),Chinese medicine(CM),and integrated Traditional Chinese and Western Medicine(IM).After 3 months of treatment,the overall response rate(ORR);disease control rate(DCR);symptom score(SS);Karnofsky performance status(KPS);adverse event score;counts of CD3^(+),CD4^(+),and CD8^(+)cells;CD4^(+)/CD8^(+)ratio;and carcinoembryonic antigen(CEA)level were compared among the groups.RESULTS:The ORRs were 30.36%,20.24%,and 7.87%in the IM,CM,and WM groups,respectively,whereas the DCRs were 85%,75%,and 73%,respectively.Compared to the CM group,the ORR was significantly higher in the WM and IM groups,whereas the DCR was significantly higher in the IM group(all P<0.05).SS was obviously higher in the WM group than in the other two groups(both P<0.01).KPS was significantly lower in the WM group after treatment(P=0.005).The mean number of adverse events was significantly lower in the CM(2.2±1.3)and IM(2.4±1.3)groups than in the WM group(4.6±1.7,both P<0.05).CD3^(+)cell counts were significantly decreased in the WM group(P=0.031).In the IM group,CD8^(+)cell counts were increased after treatment,whereas the CD4^(+)/CD8^(+)ratio was decreased(both P<0.01).Compared with the WM group,CD3^(+)(P=0.01),CD4^(+)(P=0.044),and CD8^(+)(P=0.009)cell counts were significantly higher in the IM group,whereas the CD4^(+)/CD8^(+)ratio was significantly lower(P=0.011).Relative to the CM group,CD8^(+)cell counts were significantly higher(P=0.001)and the CD4^(+)/CD8^(+)ratio was significant ly lower in the IM group(P=0.001).CEA levels were significantly increased in the CM group(P=0.023).CONCLUSION:The Yiqi Qingdu prescription can improve the outcomes of WM in patients with NSCLC.

Pediatric off-label use of psychotropic drugs approved for adult use in Japan in the light of approval information regarding pediatric patients in the United States: a study of a pharmacy prescription database

Background Off-label use of psychotropic prescriptions for pediatric patients has been increasing in Japan.This study sought to clarify pediatric patients' off-label use of psychotropics approved only for adults in Japan.Methods This retrospective study on psychotropic utilization employed a pharmaceutical health insurance claims database supplied by a pharmacy for the fiscal year 2016.Seven psychotropic drugs were examined.For each drug,we calculated the proportion of patients aged < 16 years or who were under the approved age limit set in the United States out of all patients.The maximum daily dose of each drug within the study period was plotted by age.Results Data of 45,715 patients (female:26,799,male:18,916) with 331,920 prescriptions were examined in this study.For each drug,the proportion of pediatric patients aged < 16 years ranged from 0.15 to 1.1%,while the proportion of those under the approved age limit in the United States ranged from 0 to 0.27%.Olanzapine had the highest reported proportion.No drugs other than olanzapine were taken under the approved age limit in the United States.Conclusions We identified the pediatric off-label use of psychotropics that were limited to adult use in Japan.The results indicated the possibility of referring to international guidelines or evidence in clinical practice,but these factors do not discount the existing problems with off-label use.More clinical trials within the pediatric population in Japan are needed to address the issue of off-label use and obtain useful and reliable information in the package inserts for rational use in future pediatric patients.

Trends of Pediatric Outpatients Prescribing in Umm Al Quwain, United Arab Emirates

Background: Data with regard to local drug prescribing in pediatric population is scarce. This study was carried out to investigate the patterns of drug prescribing for pediatric outpatient in a general hospital in the United Arab Emirates. Methods: A total of 707 prescriptions were collected from a governmental hospital in Umm Al Quwain, United Arab Emirates covering the months of June and July, 2014. Encounters issued for patients older than 12 years were rejected. A total of 520 prescriptions for age groups ranging from 1 week to 12 years were studied. Prescriptions were analyzed using WHO drug use indicators. Results: All prescriptions were electronic and head lettered by the name of the hospital. Average number of drugs per prescriptions was 2.6 and all drugs were generics. Name of patient, age and gender and prescriber’s name and E-signature were present in 100%. Patient’s address, allergy and diagnosis were present in 21.15%, 83.26% and 64.42% of prescriptions respectively. Complete dosage regimen was present in all encounters. Patients were prescribed one, two, three, four or more than four drugs per prescription in 23.84%, 27.88%, 26.53%, 12.69%, and 8.65% respectively. The most commonly prescribed therapeutic classes of drugs were antibiotics (44.60%), antihistamines (43.65%), and analgesics/antipyretics (32.30%). The most commonly prescribed drugs among each class were amoxicillin (40%), xylometazoline (61.23%), and paracetamol (87.5%). Conclusion: Present results indicate that prescribing trends for pediatric population seems to be rational. However, there is over use of antibiotics and there are some areas that warrant further attention by the prescribers for a more significantly rational prescribing.

我院开展门诊处方点评及干预实践工作的探讨

目的:通过对本院门诊处方进行点评和用药分析,探讨其对医院合理用药的影响。方法:采用分层抽样调查方法,随机抽取2013年门诊处方共计12 000张,对相关指标进行评价与分析。结果:本次调查确定的不合理处方为1020张,占总处方数的8.5%(1020/12000)。处方合格率不断上升,处方不合格率不断下降由1月的8.56%降至12月的3.54%。结论:通过对门诊处方的点评工作,能够有效地提高门诊处方的合格率,降低不合理用药的情况,从而保障患者用药安全。

Medicine prescription practices of homeopathic undergraduate students in West Bengal,India

OBJECTIVE： To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students. METHODS： A cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences. RESULTS： A total of 328 forms were completed. Of these, 264 （80.5%） homeopathic undergraduate students admitted of prescribing medicines independently and most （40.5%） said that they did this 2-3 times a year. The most common reasons for this were ＇urgency of the problem＇ （35.2%）, ＇previous experience with same kind of illness＇ （31.8%）, and ＇the problem too trivial to go to a doctor＇ （25.8%）. About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital （odds ratio = 5.8; 95% confidence interval 2.247-14.972）. Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses. CONCLUSION： Prescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.