Clinical Practice of Evidence-Based PDCA Cycle Management Model in Accelerated Recovery of Lung Cancer Patients

Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.

Comparative analysis of empirical and deep learning models for ionospheric sporadic E layer prediction

Sporadic E(Es)layers in the ionosphere are characterized by intense plasma irregularities in the E region at altitudes of 90-130 km.Because they can significantly influence radio communications and navigation systems,accurate forecasting of Es layers is crucial for ensuring the precision and dependability of navigation satellite systems.In this study,we present Es predictions made by an empirical model and by a deep learning model,and analyze their differences comprehensively by comparing the model predictions to satellite RO measurements and ground-based ionosonde observations.The deep learning model exhibited significantly better performance,as indicated by its high coefficient of correlation(r=0.87)with RO observations and predictions,than did the empirical model(r=0.53).This study highlights the importance of integrating artificial intelligence technology into ionosphere modelling generally,and into predicting Es layer occurrences and characteristics,in particular.

Aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorders:progress of experimental models based on disease pathogenesis

Neuromyelitis optica spectrum disorders are neuroinflammatory demyelinating disorders that lead to permanent visual loss and motor dysfunction.To date,no effective treatment exists as the exact causative mechanism remains unknown.Therefore,experimental models of neuromyelitis optica spectrum disorders are essential for exploring its pathogenesis and in screening for therapeutic targets.Since most patients with neuromyelitis optica spectrum disorders are seropositive for IgG autoantibodies against aquaporin-4,which is highly expressed on the membrane of astrocyte endfeet,most current experimental models are based on aquaporin-4-IgG that initially targets astrocytes.These experimental models have successfully simulated many pathological features of neuromyelitis optica spectrum disorders,such as aquaporin-4 loss,astrocytopathy,granulocyte and macrophage infiltration,complement activation,demyelination,and neuronal loss;however,they do not fully capture the pathological process of human neuromyelitis optica spectrum disorders.In this review,we summarize the currently known pathogenic mechanisms and the development of associated experimental models in vitro,ex vivo,and in vivo for neuromyelitis optica spectrum disorders,suggest potential pathogenic mechanisms for further investigation,and provide guidance on experimental model choices.In addition,this review summarizes the latest information on pathologies and therapies for neuromyelitis optica spectrum disorders based on experimental models of aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorders,offering further therapeutic targets and a theoretical basis for clinical trials.

Solar flare forecasting based on a Fusion Model

Solar flare prediction is an important subject in the field of space weather.Deep learning technology has greatly promoted the development of this subject.In this study,we propose a novel solar flare forecasting model integrating Deep Residual Network(ResNet)and Support Vector Machine(SVM)for both≥C-class(C,M,and X classes)and≥M-class(M and X classes)flares.We collected samples of magnetograms from May 1,2010 to September 13,2018 from Space-weather Helioseismic and Magnetic Imager(HMI)Active Region Patches and then used a cross-validation method to obtain seven independent data sets.We then utilized five metrics to evaluate our fusion model,based on intermediate-output extracted by ResNet and SVM using the Gaussian kernel function.Our results show that the primary metric true skill statistics(TSS)achieves a value of 0.708±0.027 for≥C-class prediction,and of 0.758±0.042 for≥M-class prediction;these values indicate that our approach performs significantly better than those of previous studies.The metrics of our fusion model’s performance on the seven datasets indicate that the model is quite stable and robust,suggesting that fusion models that integrate an excellent baseline network with SVM can achieve improved performance in solar flare prediction.Besides,we also discuss the performance impact of architectural innovation in our fusion model.

Landslide Susceptibility Mapping Using RBFN-Based Ensemble Machine Learning Models

This study was aimed to prepare landslide susceptibility maps for the Pithoragarh district in Uttarakhand,India,using advanced ensemble models that combined Radial Basis Function Networks(RBFN)with three ensemble learning techniques:DAGGING(DG),MULTIBOOST(MB),and ADABOOST(AB).This combination resulted in three distinct ensemble models:DG-RBFN,MB-RBFN,and AB-RBFN.Additionally,a traditional weighted method,Information Value(IV),and a benchmark machine learning(ML)model,Multilayer Perceptron Neural Network(MLP),were employed for comparison and validation.The models were developed using ten landslide conditioning factors,which included slope,aspect,elevation,curvature,land cover,geomorphology,overburden depth,lithology,distance to rivers and distance to roads.These factors were instrumental in predicting the output variable,which was the probability of landslide occurrence.Statistical analysis of the models’performance indicated that the DG-RBFN model,with an Area Under ROC Curve(AUC)of 0.931,outperformed the other models.The AB-RBFN model achieved an AUC of 0.929,the MB-RBFN model had an AUC of 0.913,and the MLP model recorded an AUC of 0.926.These results suggest that the advanced ensemble ML model DG-RBFN was more accurate than traditional statistical model,single MLP model,and other ensemble models in preparing trustworthy landslide susceptibility maps,thereby enhancing land use planning and decision-making.

Global Piecewise Analysis of HIV Model with Bi-Infectious Categories under Ordinary Derivative and Non-Singular Operator with Neural Network Approach

This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV infection model has a susceptible class,a recovered class,along with a case of infection divided into three sub-different levels or categories and the recovered class.The total time interval is converted into two,which are further investigated for ordinary and fractional order operators of the AB derivative,respectively.The proposed model is tested separately for unique solutions and existence on bi intervals.The numerical solution of the proposed model is treated by the piece-wise numerical iterative scheme of Newtons Polynomial.The proposed method is established for piece-wise derivatives under natural order and non-singular Mittag-Leffler Law.The cross-over or bending characteristics in the dynamical system of HIV are easily examined by the aspect of this research having a memory effect for controlling the said disease.This study uses the neural network(NN)technique to obtain a better set of weights with low residual errors,and the epochs number is considered 1000.The obtained figures represent the approximate solution and absolute error which are tested with NN to train the data accurately.

Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A Chinese multicenter study

BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.

Exploiting fly models to investigate rare human neurological disorders

Rare neurological diseases,while individually are rare,collectively impact millions globally,leading to diverse and often severe neurological symptoms.Often attributed to genetic mutations that disrupt protein function or structure,understanding their genetic basis is crucial for accurate diagnosis and targeted therapies.To investigate the underlying pathogenesis of these conditions,researchers often use non-mammalian model organisms,such as Drosophila(fruit flies),which is valued for their genetic manipulability,cost-efficiency,and preservation of genes and biological functions across evolutionary time.Genetic tools available in Drosophila,including CRISPR-Cas9,offer a means to manipulate gene expression,allowing for a deep exploration of the genetic underpinnings of rare neurological diseases.Drosophila boasts a versatile genetic toolkit,rapid generation turnover,and ease of large-scale experimentation,making it an invaluable resource for identifying potential drug candidates.Researchers can expose flies carrying disease-associated mutations to various compounds,rapidly pinpointing promising therapeutic agents for further investigation in mammalian models and,ultimately,clinical trials.In this comprehensive review,we explore rare neurological diseases where fly research has significantly contributed to our understanding of their genetic basis,pathophysiology,and potential therapeutic implications.We discuss rare diseases associated with both neuron-expressed and glial-expressed genes.Specific cases include mutations in CDK19 resulting in epilepsy and developmental delay,mutations in TIAM1 leading to a neurodevelopmental disorder with seizures and language delay,and mutations in IRF2BPL causing seizures,a neurodevelopmental disorder with regression,loss of speech,and abnormal movements.And we explore mutations in EMC1 related to cerebellar atrophy,visual impairment,psychomotor retardation,and gain-of-function mutations in ACOX1 causing Mitchell syndrome.Loss-of-function mutations in ACOX1 result in ACOX1 deficiency,characterized by very-long-chain fatty acid accumulation and glial degeneration.Notably,this review highlights how modeling these diseases in Drosophila has provided valuable insights into their pathophysiology,offering a platform for the rapid identification of potential therapeutic interventions.Rare neurological diseases involve a wide range of expression systems,and sometimes common phenotypes can be found among different genes that cause abnormalities in neurons or glia.Furthermore,mutations within the same gene may result in varying functional outcomes,such as complete loss of function,partial loss of function,or gain-of-function mutations.The phenotypes observed in patients can differ significantly,underscoring the complexity of these conditions.In conclusion,Drosophila represents an indispensable and cost-effective tool for investigating rare neurological diseases.By facilitating the modeling of these conditions,Drosophila contributes to a deeper understanding of their genetic basis,pathophysiology,and potential therapies.This approach accelerates the discovery of promising drug candidates,ultimately benefiting patients affected by these complex and understudied diseases.

A promising approach for quantifying focal stroke modeling and assessing stroke progression:optical resolution photoacoustic microscopy photothrombosis

To investigate the mechanisms underlying the onset and progression of ischemic stroke,some methods have been proposed that can simultaneously monitor and create embolisms in the animal cerebral cortex.However,these methods often require complex systems and the effect of age on cerebral embolism has not been adequately studied,although ischemic stroke is strongly age-related.In this study,we propose an optical-resolution photoacoustic microscopy-based visualized photothrombosis methodology to create and monitor ischemic stroke in mice simultaneously using a 532 nm pulsed laser.We observed the molding process in mice of different ages and presented age-dependent vascular embolism differentiation.Moreover,we integrated optical coherence tomography angiography to investigate age-associated trends in cerebrovascular variability following a stroke.Our imaging data and quantitative analyses underscore the differential cerebrovascular responses to stroke in mice of different ages,thereby highlighting the technique's potential for evaluating cerebrovascular health and unraveling age-related mechanisms involved in ischemic strokes.

Vertical gradients of neutral winds observed by ICON and estimated by the Horizontal Wind Model during the geomagnetic storm on August 26−28,2021

The Michelson Interferometer for Global High-resolution Thermospheric Imaging(MIGHTI)onboard the Ionospheric Connection Explorer(ICON)satellite offers the opportunity to investigate the altitude profile of thermospheric winds.In this study,we used the red-line measurements of MIGHTI to compare with the results estimated by Horizontal Wind Model 14(HWM14).The data selected included both the geomagnetic quiet period(December 2019 to August 2022)and the geomagnetic storm on August 26-28,2021.During the geomagnetic quiet period,the estimations of neutral winds from HWM14 showed relatively good agreement with the observations from ICON.According to the ICON observations,near the equator,zonal winds reverse from westward to eastward at around 06:00 local time(LT)at higher altitudes,and the stronger westward winds appear at later LTs at lower altitudes.At around 16:00 LT,eastward winds at 300 km reverse to westward,and vertical gradients of zonal winds similar to those at sunrise hours can be observed.In the middle latitudes,zonal winds reverse about 2-4 h earlier.Meridional winds vary more significantly than zonal winds with seasonal and latitudinal variations.According to the ICON observations,in the northern low latitudes,vertical reversals of meridional winds are found at 08:00-13:00 LT from 300 to 160 km and at around 18:00 LT from 300 to 200 km during the June solstice.Similar reversals of meridional winds are found at 04:00-07:00 LT from 300 to 160 km and at 22:00-02:00 LT from 270 to 200 km during the December solstice.In the southern low latitudes,meridional wind reversals occur at 08:00-11:00 LT from 200 to 160 km and at 21:00-02:00 LT from 300 to 200 km during the June solstice.During the December solstice,reversals of the meridional wind appear at 20:00-01:00 LT below 200 km and at 06:00-11:00 LT from 300 to 160 km.In the northern middle latitudes,the northward winds are dominant at 08:00-14:00 LT at 230 km during the June solstice.Northward winds persist until 16:00 LT at 160 and 300 km.During the December solstice,the northward winds are dominant from 06:00 to 21:00 LT.The vertical variations in neutral winds during the geomagnetic storm on August 26-28 were analyzed in detail.Both meridional and zonal winds during the active geomagnetic period observed by ICON show distinguishable vertical shear structures at different stages of the storm.On the dayside,during the main phase,the peak velocities of westward winds extend from a higher altitude to a lower altitude,whereas during the recovery phase,the peak velocities of the westward winds extend from lower altitudes to higher altitudes.The velocities of the southward winds are stronger at lower altitudes during the storm.These vertical structures of horizontal winds during the storm could not be reproduced by the HWM14 wind estimations,and the overall response to the storm of the horizontal winds in the low and middle latitudes is underestimated by HWM14.The ICON observations provide a good dataset for improving the HWM wind estimations in the middle and upper atmosphere,especially the vertical variations.

LoRa Sense:Sensing and Optimization of LoRa Link Behavior Using Path-Loss Models in Open-Cast Mines

The Internet of Things(IoT)has orchestrated various domains in numerous applications,contributing significantly to the growth of the smart world,even in regions with low literacy rates,boosting socio-economic development.This study provides valuable insights into optimizing wireless communication,paving the way for a more connected and productive future in the mining industry.The IoT revolution is advancing across industries,but harsh geometric environments,including open-pit mines,pose unique challenges for reliable communication.The advent of IoT in the mining industry has significantly improved communication for critical operations through the use of Radio Frequency(RF)protocols such as Bluetooth,Wi-Fi,GSM/GPRS,Narrow Band(NB)-IoT,SigFox,ZigBee,and Long Range Wireless Area Network(LoRaWAN).This study addresses the optimization of network implementations by comparing two leading free-spreading IoT-based RF protocols such as ZigBee and LoRaWAN.Intensive field tests are conducted in various opencast mines to investigate coverage potential and signal attenuation.ZigBee is tested in the Tadicherla open-cast coal mine in India.Similarly,LoRaWAN field tests are conducted at one of the associated cement companies(ACC)in the limestone mine in Bargarh,India,covering both Indoor-toOutdoor(I2O)and Outdoor-to-Outdoor(O2O)environments.A robust framework of path-loss models,referred to as Free space,Egli,Okumura-Hata,Cost231-Hata and Ericsson models,combined with key performance metrics,is employed to evaluate the patterns of signal attenuation.Extensive field testing and careful data analysis revealed that the Egli model is the most consistent path-loss model for the ZigBee protocol in an I2O environment,with a coefficient of determination(R^(2))of 0.907,balanced error metrics such as Normalized Root Mean Square Error(NRMSE)of 0.030,Mean Square Error(MSE)of 4.950,Mean Absolute Percentage Error(MAPE)of 0.249 and Scatter Index(SI)of 2.723.In the O2O scenario,the Ericsson model showed superior performance,with the highest R^(2)value of 0.959,supported by strong correlation metrics:NRMSE of 0.026,MSE of 8.685,MAPE of 0.685,Mean Absolute Deviation(MAD)of 20.839 and SI of 2.194.For the LoRaWAN protocol,the Cost-231 model achieved the highest R^(2)value of 0.921 in the I2O scenario,complemented by the lowest metrics:NRMSE of 0.018,MSE of 1.324,MAPE of 0.217,MAD of 9.218 and SI of 1.238.In the O2O environment,the Okumura-Hata model achieved the highest R^(2)value of 0.978,indicating a strong fit with metrics NRMSE of 0.047,MSE of 27.807,MAPE of 27.494,MAD of 37.287 and SI of 3.927.This advancement in reliable communication networks promises to transform the opencast landscape into networked signal attenuation.These results support decision-making for mining needs and ensure reliable communications even in the face of formidable obstacles.

Reduced mesencephalic astrocyte-derived neurotrophic factor expression by mutant androgen receptor contributes to neurodegeneration in a model of spinal and bulbar muscular atrophy pathology

Spinal and bulbar muscular atrophy is a neurodegenerative disease caused by extended CAG trinucleotide repeats in the androgen receptor gene,which encodes a ligand-dependent transcription facto r.The mutant androgen receptor protein,characterized by polyglutamine expansion,is prone to misfolding and forms aggregates in both the nucleus and cytoplasm in the brain in spinal and bulbar muscular atrophy patients.These aggregates alter protein-protein interactions and compromise transcriptional activity.In this study,we reported that in both cultured N2a cells and mouse brain,mutant androgen receptor with polyglutamine expansion causes reduced expression of mesencephalic astrocyte-de rived neurotrophic factor.Overexpressio n of mesencephalic astrocyte-derived neurotrophic factor amelio rated the neurotoxicity of mutant androgen receptor through the inhibition of mutant androgen receptor aggregation.Conversely.knocking down endogenous mesencephalic astrocyte-derived neurotrophic factor in the mouse brain exacerbated neuronal damage and mutant androgen receptor aggregation.Our findings suggest that inhibition of mesencephalic astrocyte-derived neurotrophic factor expression by mutant androgen receptor is a potential mechanism underlying neurodegeneration in spinal and bulbar muscular atrophy.

Physiology and health assessment,risk balance,and model for endstage liver disease scores:Postoperative outcome of liver transplantation

BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.

Modeling and Comprehensive Review of Signaling Storms in 3GPP-Based Mobile Broadband Networks:Causes,Solutions,and Countermeasures

Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important and scarce network resources such as bandwidth and processing power.There have been several reports of these control signaling turning into signaling storms halting network operations and causing the respective Telecom companies big financial losses.This paper draws its motivation from such real network disaster incidents attributed to signaling storms.In this paper,we present a thorough survey of the causes,of the signaling storm problems in 3GPP-based mobile broadband networks and discuss in detail their possible solutions and countermeasures.We provide relevant analytical models to help quantify the effect of the potential causes and benefits of their corresponding solutions.Another important contribution of this paper is the comparison of the possible causes and solutions/countermeasures,concerning their effect on several important network aspects such as architecture,additional signaling,fidelity,etc.,in the form of a table.This paper presents an update and an extension of our earlier conference publication.To our knowledge,no similar survey study exists on the subject.

基于PDCA循环的成本会计本科课程“三位一体”混合教学模式设计与应用

传统本科教学是以教师为中心,知识灌输为主的教学模式。基于PDCA循环的“三位一体”混合教学模式是将线上与线下一体化、理论教学与案例教学一体化、课堂教学与其他教学环节一体化,三者融合为一体。文章设计“三位一体”混合式PDCA教学循环,探索其在成本会计本科课程教学中的应用。

PDCA循环模式在医院内部审计管理中应用的效果分析

目的分析PDCA循环模式在医院内部审计管理中的应用效果。方法选取2021年10月—2023年9月滨州市中心医院的148名与审计工作有关的工作人员(包括其他职能部门)作为研究对象,根据PDCA循环模式在医院内部审计管理中落实的时间分为两阶段,2021年10月—2022年9月行常规管理,为常规组,2022年10月—2023年9月行PDCA循环管理,为研究组。比较两组工作质量评分、工作沉浸程度、工作人员专业能力评分。结果研究组工作质量评分、工作沉浸程度、专业能力评分均高于常规组,差异有统计学意义(P均<0.05)。结论在医院内部审计管理中,PDCA循环管理模式的实施可有效提升审计相关工作人员的专业能力,提升审计工作质量,提高审计相关工作人员的工作沉浸度。

标准化PDCA循环管理在助理全科医生培训中的应用效果

目的:研究助理全科医生培训中应用标准化PDCA循环管理提高教学质量的效果。方法:数据取自蚌埠市第一人民医院2022年1月—2023年12月符合纳入标准的48名助培全科医生,依照双盲法分为参照组、研究组各24例,分别采取常规管理和PDCA循环标准化管理,将两组管理效果比较分析。结果:管理前两组考核成绩、管理质量无差异,P>0.05;管理后较参照组,标准化PDCA循环管理组考核成绩更高、管理质量评分更高,标准化PDCA循环管理组满意率(95.83%)高于参照组(75.00%),P<0.05。结论:标准化PDCA循环管理用于助理全科医生培训中可提高助理全科医生培训的管理质量、考核成绩,获得认可,值得推崇。

基于多学科协作管理模式结合PDCA质量管理工具对中药注射剂的管控效果分析

目的:探讨多学科协作管理模式结合PDCA质量管理工具用于医院中药注射剂管理的成效,为促进中药注射剂的合理应用提供参考。方法:成立多学科协作管理小组,运用PDCA质量管理工具,采取综合干预措施管控河北省中医院(以下简称“该院”)中药注射剂的临床应用。以2020年为干预前、2021年为第1阶段干预后、2022年为第2阶段干预后,对比干预效果。结果:干预前,该院中药注射剂合理使用率为92.38%(3 008/3 256),第1阶段干预后、第2阶段干预后分别升高至94.64%(3 740/3 952)、97.34%(3 766/3 869),与干预前的差异有统计学意义(P<0.001),中药注射剂不合理使用情况得到明显改善。第2阶段干预后,在超疗程、未冲管方面较第1阶段干预后明显改善,差异均有统计学意义(P<0.001),且未发现中西药混合输注、溶剂剂量不适宜、给药途径不适宜、溶剂种类选择不当等问题。干预后,中药注射剂相关不良反应占药品总不良反应的比例呈逐年降低趋势,尤其是第2阶段干预后较干预前明显降低,差异有统计学意义(P=0.013)。结论:在医院中药注射剂管理中运用多学科协作管理模式结合PDCA质量管理工具,可使管理质量显著提高,该方法值得在医院药事管理中推广。

基于 PDCA 体系的“一思五早”模式在医学研究生培养中的探索与实践

在国家“健康中国”建设目标指引下,医学人才培养和科技创新是推动医学进步、促进人民健康的重要策略。四川大学华西医院脑血管病中心以培养临床和科研复合型人才为目标导向,构建了临床、教学、科研“三位一体”的育人框架,基于PDCA循环体系实践管理学与循证医学理论和方法,对研究生进行规范化培养和个体化指导,践行“一思五早”培养模式,为培养德才兼备的高水平医学研究生探索方法路径。

PDCA在提高神经内科住院患者用药相关知识知晓率的应用研究

目的 探讨应用PDCA循环的质量管理提高对住院患者用药相关知识知晓率的影响。方法 选取2021年4—10月在厦门大学附属第一医院神经内科住院的158例患者为研究对象。根据改进时间进行分组,2021年4月未改进病例73例为改进前组,2021年6—10月改进后的病例85例为改进后组。改进后组应用PDCA循环法对导致住院患者用药相关知识知晓率低的原因进行分析,比较应用PDCA前后住院患者用药相关知识知晓率。结果 改进后组应用PDCA循环模式的质量管理后,住院患者用药相关知识知晓率高于改进前组,住院患者用药相关知识知晓率由47.95%提高到76.47%(P <0.05)。结论 运用PDCA循环模式的质量管理对提高住院患者用药相关知识知晓率是行之有效的,提升了神经内科住院患者用药安全,预防用药不良行为的发生。