Effect of medical care linkage-continuous management mode in patients with posterior circulation cerebral infarction undergoing endovascular interventional therapy

BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.

Secondary Warehouse Management System of Medical Low Value Consumables under SPD Mode and its Working Method

Objective:To study the secondary warehouse management system and operation mode of medical low value consumables under SPD mode.Methods:From August 2018 to August 2019,the management mode of the secondary warehouse management system of medical low value consumables was selected.According to the management method,it can be divided into the observation group and the control group.The relevant data of the observation group was based on SPD mode,and the data of the control group was based on the traditional mode.According to the improvement of the two groups of data management effect,data integration and analysis are carried out to judge the effectiveness of the SPD mode of medical low value consumables secondary warehouse management system and its working mode.Results:During the analysis of the two groups of data,the relevant data were analyzed.The data validity of the observation group was higher(94.0%),and the differences of the limitations and problems in the management process had more advantages,while the relevant data corresponding to the two groups of data had significant differences(P<0.05).Conclusion:According to the current research results,Based on the collection,storage and central management of data electronic medical record information,the secondary warehouse management system of medical low value consumables under SPD mode is connected with clinical information system and management information system,which realizes the unification,resource integration and efficient operation of different business systems in the hospital,so as to help improve the quality and efficiency of medical care,prevent and reduce medical errors,Control and reduce medical expenses.

Storage and Parallel Loading System Based on Mode Network for Multimode Medical Image Data

Since Multimode data is composed of many modes and their complex relationships,it cannot be retrieved or mined effectively by utilizing traditional analysis and processing techniques for single mode data.To address the challenges,we design and implement a graph-based storage and parallel loading system aimed at multimode medical image data.The system is a framework designed to flexibly store and rapidly load these multimode data.Specifically,the system utilizes the Mode Network to model the modes and their relationships in multimode medical image data and the graph database to store the data with a parallel loading technique.

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years＇medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

Application status and development of big data in medical education in China

With the development of information technology, big data has been widely used in medical education in China. Through the analysis of the definition, characteristics and development process of big data, summarized the transformation of domestic big data medical education mode compared with the traditional medical education mode in the teaching mode reform, research method innovation, teaching courses optimization, teaching key extension and the teaching quality monitoring. Based on this, this paper expounds the impact and challenge of big data on medical education, and makes an outlook on its development prospect, indicating that the future development of big data will be open, popular and trending. At the same time, some suggestions on further optimization direction of China's big data medical education are put forward.

RF design and study of a 325 MHz 7 Me V APF IH-DTL for an injector of a proton medical accelerator

A compact interdigital H-mode drift-tube linac (IH-DTL) with the alternating-phase-focusing (APF) method, working at 325 MHz was designed for an injector of a proton medical accelerator. When fed in with a proper RF (radio frequency) power, the DTL cavity could establish the corresponding electromagnetic field to accelerate the ‘‘proton bunches’’ from an input energy of 3 MeV to an output energy of 7 MeV successfully, without any additional radial focusing elements. The gap-voltage distribution which was obtained from the CST■ Microwave Studio software simulations of the axial electric field was compared with that from the beam dynamics, and the errors met the requirements within ± 5%. In this paper, the RF design procedure and key results of the APF IH-DTL, which include the main RF characteristics of the cavity, frequency sensitivities of the tuners, and coupling factor of the RF power input coupler are presented.

Research on the path of medical service combination from the perspective of departmental cooperation

As an innovative mode of social endowment, combining medical care with modern medical care technology and old-age service is an important direction of a series of social problems caused by the deepening of aging and the intensification of aging process in China. It is the inevitable choice for the development of Chinese characteristics for the aged. At present, with the continuous development of the combination of medical care and rehabilitation, the process of combination of medical care and breeding is slow, and the problems of inter departmental cooperation, high cost of resource integration and low service efficiency have emerged. The paper puts forward that multi head management of different responsibility management body is a bottleneck problem that hinders the integration of medical care. From the objective and subjective two points of view, the administrative system level barrier and the inter departmental interest game are the important reasons that obstruct the medical support and break through the estrangement of the Department and realize the cooperation. Then, according to the theory of large part system reform, the author boldly proposes the idea of establishing a new comprehensive functional department that specializes in the management of pension related affairs.

A Study on the Cultivation of Professional Values among Rural-Orientated Targeted Medical Students in Shaanxi Province

Objective:Through investigation,we can grasp the current situation of the professional identity of rural-orientated targeted medical students in Shaanxi Province,so as to cultivate these medical students to establish correct professional values,thus improving the performance rate.Methods:Questionnaires were distributed,and interviews were carried out in three colleges and universities in Shaanxi Province.Results:Targeted medical students lack professional understanding,and their professional identity needs to be improved through medical education.Conclusion:It is suggested that colleges and universities should take measures such as setting up courses and lectures,strengthening communication between teachers and students,carrying out ritual education and social practice,as well as selecting teaching teachers to strengthen the professional values of targeted medical students。

Current Situation of the Teaching of Ophthalmology in General Practice Medical Education and the Application of TBL

Ophthalmology is an integral part of general practice education,and it is of great significance to have some knowledge on ophthalmology even if the general practitioner is not an ophthalmologist.The subject characteristics,the traditional mode of teaching,and the cognitive deviation of students have greatly influenced its teaching quality.The application of team-based learning(TBL)in ophthalmology education responds to the demand of modern medical education.Building a team,designing questions that combine theory and clinical practice,as well as employing a fair scoring system can stimulate students’learning interest and improve their learning autonomy and ability to ask questions and solve problems.

医用耗材SPD管理模式在某三级公立医院的应用实践与成效

目的 通过构建SPD供应链管理模式下医用耗材精细化管理模式,并在某三级公立医院予以实践应用,探讨其应用实践与具体成效。方法 基于SPD模式的构建,从单台手术耗材消耗量、中心库盘点时间、临床科室耗材领用与盘点时间、高值耗材计费异常情况等方面分析模式应用前后的效果。结果 某三级公立医院应用SPD模式后,单台手术耗材消耗均值从(13520.83±1182.14)元下降至(12328.91±1366.50)元,单台手术成本降低,且结果具有统计学意义(t=5.661,P=0.030);中心库盘点时间大大减少,临床科室耗材库存周转天数从平均10天/次下降至2天/次,耗材领用与盘点用时减少,工作效率得到提升(P<0.05);应用SPD模式后,高值耗材计费异常情况得到显著改善(P<0.001)。结论 SPD模式是一种契合科技、医改政策以及医院高质量发展的高效管理模式,可有效提升公立医院医用耗材精细化管理水平。

新医科背景下以学生发展为中心的医学生理学教学模式实践

新医科建设背景下医学教育目标是以理论知识与实践能力为基础,着重培养创新能力,提升学生综合素质,培养复合型、创新型卓越医师。该研究以学生发展为中心,通过首次创新的IPA教学模式、注重教学中的课程思政教育、逻辑思维能力培养、情景教学运用及课程多元化评价等教学新探索,构建医学生理学教学模式的创新与实践,经过5年的探索和实践,以创新教学模式促学、促教、促建,进一步提高教学质量,培养一流医学人才。

Thoughts on the Innovative Design of the Integrated Service Mode of Pharmacies and Elderly Care Centers

Objective To evaluate the service model that integrates medical treatment and elderly care to provide a reference for the development of pharmacies and elderly care centers.Methods Through the literature investigation and case analysis,the domestic integrated medical treatment and elderly care service model was analyzed,and new ideas for the integration of pharmacies and elderly care centers were provided.Results and Conclusion The integrated service model of pharmacies and elderly care centers is designed and the integration mode of pharmacies,hospitals and elderly care centers is proposed by analyzing their advantages.The“pharmacy+elderly care”mode and the“pharmacy+medical treatment+elderly care”mode that integrates pharmacies,hospitals,and elderly care centers are put forward to predict its new development opportunities in the future.

基于BOPPPS的翻转课堂教学模式在急诊与灾难医学教学中的应用

目的探讨基于BOPPPS的翻转课堂教学模式在急诊与灾难医学教学中的应用效果。方法选取2021年9—11月蚌埠医学院临床医学实验班40名学生作为观察组,采取基于BOPPPS的翻转课堂教学模式学习急诊与灾难医学所有课程。同时选取2020年9—11月蚌埠医学院临床医学实验班40名学生作为对照组,采取传统教学模式学习急诊与灾难医学课程。比较两组学生的期末考试(理论考试和技能考试)成绩及教学效果评价。结果观察组学生的成绩(临床技能和理论知识)高于对照组,差异有统计学意义(P<0.05);观察组对该课程培养了解决问题的能力、该课程提高了分析能力、该课程促进知识的记忆、该课程有助于提高学习动力、有信心解决不熟悉的问题、总的来说对课程很满意的评价高于对照组,差异有统计学意义(P<0.05);观察组对课程过于理论化和抽象化及对这门课有很多压力的评价低于对照组,差异有统计学意义(P<0.05)。结论基于BOPPPS的翻转课堂教学模式有利于培养学生解决问题的能力、分析能力和学习主动性,提高教学效果和质量,在推动医学教学改革方面发挥重要作用。

医学生生理学翻转课堂教学模式探索与实践

生理学为基础医学与临床医学的专业基础课,课程难度大且有效教学时间少,传统的教学模式很难确保课堂效果。翻转课堂教学模式为时下我国高校教学改革探索的新方向,该文基于生理学知识特点,构建适合医学生的生理学翻转课堂教学模式。该模式既能促进学生对生理学相关知识的学习,帮助学生对知识进行内化,还能提高学生们学习的积极主动性与参与度,因而能更加有效地达成医学生生理学课程教学目标。

基于FMEA法的住院药房智能药柜用药安全研究

目的提高住院药房智能药柜(ADC)的用药安全管理。方法采用失效模型和效应分析(FMEA)法,经医院护士、药师等讨论后,从信息系统、人员操作、药品信息、硬件设备、管理方法5个方面建立20个失效模型(包括32个风险点),汇总为调查问卷,并通过专家咨询和药师讨论后建立问卷评分标准。于干预前发放问卷进行调查,根据发现的风险对其中30个可操作的风险点设定干预措施,持续干预5个月后(干预后)再次进行问卷调查,比较干预前后的风险优先级数(RPN)。结果干预后,30个风险点的RPN值均不同程度降低,其中22个显著降低(P<0.05)。管理方法方面的全部风险点RPN值均显著降低(P<0.05);硬件设备方面的全部风险点RPN值均无显著改变(P>0.05)。结论FMEA法用于住院药房ADC的用药安全研究,可减少其用药风险,促进药护共同管理安全使用ADC规则的形成,尤其适用于麻醉药品等特殊药品的用药管理。

党建引领视角下医疗卫生人才培养的实践研究

加强党建工作建设,充分发挥党组织领导核心的作用,为医疗卫生教育机构深化医疗人才培养提供坚强保障。在党建引领背景下对医疗卫生人才培养进行探索和研究,构建全员、全方位、全过程育人体系,聚焦党建引领,建强育人队伍,凸显全员育人合力,培养兼具扎实专业理论和综合素质能力的复合型人才成为重要的育人目标。推动党建引领实践育人工作,即有利于强化党对医疗卫生教育机构的领导,还有利于创新党建引领、医疗卫生教育机构主导和社会力量参与的实践育人模式。文章从党建引领,在医疗人才培养的实践探索、实践策略等方面,探索党建引领实践育人策略,以为相关工作提供一定的借鉴和参考依据。

新医科背景下药学专业人才创新能力培养的探索

新医科是教育部提出的“四新”建设之一,培养医药学人才关系到健康中国战略的顺利实施和实现。深入剖析药学专业原教学体系的不足,结合新医科理念,重新定位培养目标,确定毕业要求,优化课程体系,完善实习实践,改革教学模式,构建“一中心三融合三维度五结合”层进式融合“理论、实践与思政”的药学专业创新人才培养模式,提升新时代大学生的创新能力。

基于科研创新导向的医学统计学教学模式探索与实践

医学统计学教学对医学生科研创新能力的培养至关重要。为培养医学生的科研创新思维和意识,提升医学生解决实际科研问题的能力,探索实施医学统计学教学新模式。文章对医学统计学教学模式现状进行分析,阐述了存在的问题,提出基于科研创新培养为导向的医学统计学教学改革,就教学案例、教学模式、考核评价等的改革提出了具体方法和思路,多途径激发医学生的科研思维和创新意识,提升医学生科研创新能力。

基于“阳光医院”模式药物治疗联合多维度心理干预对倒班医务人员失眠的疗效

目的观察“阳光医院”模式下药物联合多维度心理干预对倒班医务人员失眠的影响,为改善一线倒班医务人员身心健康提供参考。方法纳入武汉市患有失眠的倒班医务人员140例,采用随机数字表法分为治疗组和对照组各70例,对照组给予药物治疗,治疗组基于“阳光医院”模式给予药物治疗联合多维度心理干预。基线期、访视1(基线+干预1个月)、访视2(基线+干预3个月),采用匹兹堡睡眠质量指数量表(PSQI)、失眠严重指数量表(ISI)、爱泼沃斯嗜睡量表(ESS)、疲劳评估量表(FAS)评估两组睡眠情况,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、抑郁症自我评估量表(PHQ-9)、焦虑自评量表(SAS)评价两组心理状态。结果治疗组各方面均优于对照组。(1)睡眠:治疗组与对照组PSQI量表7个维度评分及总分、ISI、ESS、FAS总分在不同时间段均存在组内差异(P<0.05);其中,两组PSQI评分在访视2时差异有统计学意义(P<0.05);两组访视1、访视2时睡眠质量、睡眠效率评分、ESS、FAS均差异有统计学意义(P<0.05)。(2)心理状况:两组不同时间段HAMD、HAMA、PHQ-9、SAS评分均差异有统计学意义(P<0.05);访视2时两组HAMA、SAS评分均差异有统计学意义(P<0.05)。结论基于“阳光医院”模式的药物治疗联合多维度心理干预,短期可明显改善倒班医务人员嗜睡、疲劳症状和睡眠质量、睡眠效率及焦虑抑郁情绪,长期可明显改善整体失眠情况及焦虑情绪。

JCI理念为框架的模式在消毒供应室医用器械管理中的应用效果

目的 探讨国际医疗卫生机构认证联合委员会(JCI)理念为框架管理模式在消毒供应室医用器械管理中的应用效果。方法 采用随机数字表法将2019年1月至2020年1月在消毒供应室工作的30例医护人员,随机分为对照组和试验组,每组15例。对照组采用常规管理模式,试验组采用以JCI理念为框架的管理模式。观察2组护理服务质量、综合素质、医护人员满意度和器械管理效果进行评价。结果 2组护理质量比较,试验组护理流程、质量监管、安全意识、感染风险评分显著高于对照组(P<0.05)。2组管理前综合素质评分比较,差异无统计学意义(P>0.05)。2组管理后安全知识掌握、主动服务意识、风险防控能力和专业素养均高于管理前,差异均有统计学意义(P<0.05)。试验组管理后安全知识掌握、主动服务意识、风险防控能力和专业素养均高于对照组,差异均有统计学意义(P<0.05)。试验组医务人员满意率,灭菌、清洗、检查、包装、发放和回收合格率明显高于对照组,差异均有统计学意义(P<0.05)。结论 JCI理念为框架管理模式在消毒供应室医用器械管理中的应用效果良好,能有效提高护理质量与护理安全性,增加医护人员满意度,可用于医疗管理之中。