Assessment on Energy Self-Sufficiency Rate for Building Integrated Photovoltaics and Fuel Cell System in Japan

A building integrated photovoltaic (PV) and fuel cell (FC) system is proposed for assessment of the energy self-sufficiency rate in a city in Japan. The electricity consumed in the building is mainly supplied by solar panels, while the gap between the energy demand and supply is solved by the FC that is powered by the H2 produced by water electrolysis with surplus power of PV. A desktop case study of using the proposed system in Tsu city which is located in central part of Japan, has been conducted. The results found that the self-sufficiency rates of PV system to electricity demand of households (RPV) during the daytime in April and July are higher than those in January and October. The results also reveal that the self-sufficiency rate of FC system to the electricity demand (RFC) is 15% - 38% for the day when the mean amount of horizontal solar radiation is obtained in January, April, July and October. In addition, it is found the optimum tilt angle of solar panel installed on the roof of the buildings should be 0 degree, i.e., placed horizontally.

Energy Characteristics of an Integrated Power Generation System with Photovoltaic and Fuel Cell

An integrated energy system (with photovoltaic (PV) and fuel cell (FC) for building) is proposed and assessed in term of its energy self-sufficiency rate in seven cities (Nagoya, Toyota, Tajimi, Takayama, Ogaki, Hamamatsu, Shizuoka) in Tokai region in Japan in this paper. In this work, it is considered that the electricity requirement of the building for household users is provided by a building integrated photovoltaic (BIPV) system and the gap between the energy demand and BIPV supply is fulfilled by the FC. The FC is powered by the electrolytic H2 produced when PV power was in surplus. Based on the study of applying the proposed system in seven cities, which clarifies the effectiveness of the integrated BIPV, electrolytic H2 and FC power generation system, a universal system model has been developed in this paper. It has been observed that the monthly power production from BIPV as well as FC system are higher in spring and summer, while they are both lower in autumn and winter at all considered locations. The self-sufficiency rate of the FC system is higher with decreasing households’ number and it has been observed that 16 is the most appropriate number of households in a building, whose electricity demand could be fully covered by the integrated PV and FC system. Due to its climate condition, Hamamatsu is the best city in the region for installing the proposed system. The correlation between the households’ number and self-sufficiency rate of the FC system per solar PV installation area can be expressed by the regression curve in the form of y = ax-b well.

抗肿瘤药审方规则的设置优化及实施效果评价

目的探讨抗肿瘤药审方规则设置及优化流程,提高处方合理率,降低不合理处方退费率。方法统计抗肿瘤药规则设置优化前(2021年12月~2022年3月)规则维护后(2022年4月~2022年7月)的门诊处方。比较规则设置优化前后处方合理率及退费率评价实施效果。结果设置了抗肿瘤药规则,建立了规则优化模式,形成了超说明书用药规则库。门诊处方合理率由96.53%提高到99.19%(P<0.001),处方退费率由1.11%降至0.23%(P<0.001),差异有统计学意义。结论我院维护的抗肿瘤药审方规则库提高了处方合理率,保障临床用药的同时提高了患者用药安全性及合理性。

临床药师对住院高血压患者实施标准化管理的实践

高血压是一种常见慢性病,若未及时有效治疗,可损伤心、脑、肾这些重要脏器的结构和功能,其导致的临床并发症不仅致残、致死率高,且消耗很多的医疗和社会资源,给家庭和社会造成巨大的负担。高血压患者通常需要长时间的标准化治疗方能达到控制血压,延缓、降低靶器官损害及临床并发症发生等目的;但由于患者难以得到科学、系统、标准化的药学服务,因此该类患者对疾病、药物治疗知识认知不足,不合理用药情况多见,存在大量误区,导致药物治疗的依从性差,最终无法达到降压目标,影响整体治疗效果。基于以上原因,笔者在住院高血压患者标准化管理方面进行了研究并进行总结,旨在探索建立针对高血压患者的药学服务模式,为今后临床药师开展慢病管理工作提供参考。

某医院2019—2022年麻醉药品使用情况分析

目的对某医院2019—2022年麻醉药品使用情况进行分析,以期加强麻醉药品的规范管理,保障麻醉药品在临床中合理使用。方法调取该医院信息系统中2019—2022年麻醉药品的使用数据,包括药品的名称、规格、数量、使用金额,计算各品规销售金额占比、用药频率(DDDs)、限定日费用(DDC)、使用金额排序与DDDs的排序比(B/A)。并对2019—2022年该医院麻醉药品的处方点评结果进行汇总分析。结果4年间,该院麻醉药品共使用18个品规;使用金额总体呈增长趋势,且每种麻醉药品的使用金额每年排序相对稳定;DDDs稳居前三位的是吗啡缓释片(30 mg)、芬太尼贴剂(8.4 mg)和芬太尼贴剂(4.2 mg);DDC相对稳定,前3名分别是羟考酮注射液、注射用瑞芬太尼(1 mg)和注射用瑞芬太尼(2 mg);所有麻醉药品的B/A处于0.1~3.5之间。该院麻醉药品处方医嘱点评合格率在97%以上。结论该院麻醉药品的临床使用基本合理,用药符合医院学科特色,能够全面、认真地贯彻并落实麻醉药品相关法律法规,符合麻醉药品的安全性、有效性、经济性和适宜性原则。

基于DRG支付的药事管理干预对基层医院静脉输液合理使用的影响

目的促进医院合理使用静脉输液。方法基于疾病诊断相关分组(DRG)支付进行药事管理干预,干预时间为2021年10月至12月,干预手段包括加强宣传教育培训,梳理静脉输液药品品种与疾病谱,制订病种相应临床路径,增加输液处方专项点评内容,将不合理处方开具情况纳入绩效考核,开展信息系统管控。通过医院信息系统与合理用药软件提取医院门/急诊与住院部2021年1月至9月(药事管理干预前)与2022年1月至9月(药事管理干预后)的病例资料,分析干预前后全部处方及含抗菌药物、含中药注射剂、含激素类药物(或辅助药品)处方中静脉输液相关指标及住院病例DRG相关药事指标。结果静脉输液相关指标,与干预前比较,干预后的门/急诊患者总体及不同类型药物静脉输液率(以人次、处方数计)均显著降低(P<0.01),住院患者除抗菌药物外的静脉输液率(以人次计)均显著降低(P<0.01);门/急诊与住院患者药品使用金额均不同幅度降低;门/急诊患者处方退回修改率显著升高(3.54%比2.41%,P<0.01);患者对静脉输液服务的总满意度显著升高(94.20%比73.20%,P<0.01)。DRG相关指标,与干预前比较,干预后的住院患者DRG总权重、病例组合指数(CMI)及基本药物使用金额占比均升高,费用消耗指数、时间消耗指数和患者次均费用均降低,且患者死亡率及静脉输液药品结构比、辅助药品结构比、次均药费、次均辅助药费均降低。结论该药事管理模式显著降低了静脉输液率,并提高了医院合理用药水平,减少了患者的就医费用,并提高了患者满意度,继而整体提升了该院的医疗服务能力。

合理用药对肺炎克雷伯菌耐药率的影响研究

目的从肺炎克雷伯菌(KP)耐药率与抗菌药物用药频度(DDDs)相关性出发,分析合理用药与耐药率的关系,为抗菌药管理提供新思路。方法回顾性调查分析本院2019一2021年KP对常见抗菌药的耐药率和同期DDDs的相关性,并结合DDDs确定重点抗菌药物,再分析抗菌药用药合理性和KP耐药率变化。结果头霉素类、喹诺酮类、大环内酯类的DDDs分别与KP对头孢曲松、阿莫西林克拉维酸钾、哌拉西林/他唑巴坦、复方新诺明的耐药率呈正相关,差异均有统计学意义;抗菌药物哌拉西林钠/他唑巴坦和左氧氟沙星用药合理性均有提高;同期KP对细菌耐药率总体呈下降趋势,其中2019一2021年下降显著。结论KP的耐药率与DDDs存在一定的相关,合理用药可改善细菌耐药率。

我院肿瘤化疗患者止吐药物使用的合理性分析

目的 为肿瘤化疗患者合理使用止吐药物提供参考。方法 利用医院信息系统收集2022年10月1日-11月30日我院肿瘤科、放疗科、妇科、消化科等9个科室使用止吐药物的肿瘤化疗患者资料,统计患者化疗药物和止吐药物的使用情况,并分析止吐药物不合理用药情况。结果 共纳入520例患者,有248例患者(47.69%)使用的化疗药物致吐风险等级为中度,135例患者(25.96%)为高度。520例患者共使用5-羟色胺3受体拮抗剂461例次(73.06%),包括帕洛诺司琼333例次、昂丹司琼106例次、托烷司琼15例次、格拉司琼7例次,其中优先使用国采药品及国家基本药物的患者仅148例次(32.10%);使用神经激肽1受体拮抗剂共170例次(26.94%),包括福沙匹坦112例次、阿瑞匹坦58例次。162例患者(31.15%)的止吐药物使用不合理;不合理用药类型中,以止吐方案不合理最多(22.40%),其次为药物经济性不合理(19.13%)。结论 我院肿瘤患者使用的化疗药物致吐风险等级主要为中、高风险,在止吐方案、药物经济性等方面存在不合理情况。建议医生、护士、临床药师及医院相关部门应多团队协作,加强止吐药物用药标准化全程监管,根据抗肿瘤药物致吐风险等级合理选择止吐药物,提高对指南的遵循度,以保障患者用药安全、有效、经济。

西药治疗中的合理用药策略及其对患者疗效的影响分析

目的分析西药治疗中合理用药策略与常规用药策略对患者疗效的影响。方法选取2022年1~6月在本院呼吸内科、消化内科、泌尿内科或心内科住院且实施常规用药策略的68例患者作为对照组,2022年7~12月在本院呼吸内科、消化内科、泌尿内科或心内科住院且实施合理用药策略的68例患者作为观察组。对比两组患者病情缓解情况、不良反应发生情况、生活质量、用药依从性。结果观察组的总缓解率94.12%显著高于对照组的60.29%,差异具有统计学意义(P<0.05)。观察组不良反应发生率5.88%显著低于对照组的35.29%,差异具有统计学意义(P<0.05)。观察组生理功能、生理角色、身体疼痛、总体健康、精神健康、社交功能、精神角色、健康变化评分分别为(87.11±2.92)、(89.35±3.11)、(85.94±3.94)、(90.12±2.82)、(89.90±2.53)、(91.73±3.55)、(88.37±3.12)、(88.03±2.54)分,均显著高于对照组的(74.26±3.27)、(71.46±3.56)、(71.09±4.64)、(72.58±4.29)、(72.31±3.79)、(75.98±3.42)、(73.30±3.68)、(72.14±4.13)分,差异具有统计学意义(P<0.05)。观察组的总依从率94.12%高于对照组的66.18%,差异具有统计学意义(P<0.05)。结论与常规用药策略相比,西药治疗中合理用药策略在提高患者病情缓解率、降低不良反应发生率、改善生活质量和提高用药依从性方面具有显著优势。

北京市密云区19家基层医院集中处方点评结果分析

目的通过集中处方点评,了解北京市密云区基层医院用药现状,发现其不合理用药问题,通过反馈,规范临床医师处方行为,促进全区合理用药水平整体提高。方法对比密云区19家基层医院2016年、2019年和2022年3次集中处方点评结果,从处方合格率、存在问题类型等进行分析。结果3次集中点评处方数分别是2284张、1938张和1900张,合格处方数分别是2058张、1702张和1801张,占比为90.11%、87.82%和94.79%。2022年集中点评处方合格率与2016年、2019年比较,差异有统计学意义(P<0.001)。处方中不合理问题类型主要是临床诊断书写不全、无中医证型诊断、适应证不适宜、用法、用量不适宜、联合用药不适宜及重复用药等。结论密云区基层医院处方合格率近几年稳步提升,但医师处方还存在一定程度的不合理用药现象。应进一步加强对临床医师、药师合理用药的培训,加强处方管理,促进临床安全、合理用药。

鱼源无乳链球菌和海豚链球菌耐药性及合理用药研究

[目的]探讨鱼源无乳链球菌、海豚链球菌对不同抗生素的耐药特性和与实际生产用药效果的相关性,为鱼源链球菌感染合理化用药提供参考依据。[方法]统计比较2013—2022年已报道文献以及笔者所在实验室纯化分离的183株鱼源链球菌对13种常规抗菌药物的耐药特性,结合生产实际用药效果评价药敏试验的科学指导性。[结果]141株无乳链球菌对磺胺嘧啶、复方新诺明、磺胺异恶唑、新霉素以及42株海豚链球菌对磺胺嘧啶、新霉素具有高耐药率,分别为100%、100%、99%、82%、100%、100%,而141株无乳链球菌和42株海豚链球菌对青霉素、氨苄西林、阿莫西林、多西环素、恩诺沙星、环丙沙星、氧氟沙星、左眼氟沙星、氟苯尼考等无耐药现象,与2013—2022年已报道文献统计发生高耐药率与低耐药率的药物类型大致相同;药敏试验判定为高耐药率的磺胺类药物在鱼源链球菌感染治疗中有75%以上的有效率。[结论]鱼源链球菌药敏试验中磺胺类、氟苯尼考等药物按现有判定标准并不适用,应重新建立新的判定标准和渔药说明书剂量;鱼源链球菌在氟苯尼考、多西环素、恩诺沙星、环丙沙星、氧氟沙星、左氧氟沙星等药物的体外敏感性测试结果与实际临床用药效果不一致,单一感染时谨慎使用。

中药饮片调剂管理在中药合理用药中的作用探讨

目的:分析中药饮片调剂管理在中药合理用药中的作用。方法:选取2021年7月—2022年7月金昌市中心医院1000份中药饮片处方作为研究对象,随机分为常规管理组(给予常规中药饮片管理)和调剂管理组(予以中药饮片调剂管理),各500份。比较两组工作差错、点评合格率、患者不良反应。结果:调剂管理组工作差错发生率低于常规管理组,差异有统计学意义(P=0.033);调剂管理组点评合格率高于常规管理组,差异有统计学意义(P=0.006);调剂管理组患者不良反应发生率低于常规管理组,差异有统计学意义(P=0.034)。结论:中药饮片调剂管理在中药合理用药中的应用效果较好,可减少调剂差错、配伍禁忌等工作失误发生,提高处方点评合格率,以减少用药不良反应,同时还有助于提高调剂人员的综合素养。

Copositive approximation by rational functions with prescribed numerator degree

The paper proves that, if f（x） ∈ L^p[-1,1],1≤p〈∞ ,changes sign I times in （-1, 1）,then there exists a real rational function r（x） ∈ Rn^（2μ-1）l which is eopositive with f（x）, such that the following Jackson type estimate ｜｜f-r｜｜p≤Cδl^2μωφ（f,1/n）p holds, where μ is a natural number ≥3/2＋1/p, and Cδ is a positive constant depending only on δ.

MNTZ RATIONAL APPROXIMATION FOR SPECIAL FUNCTION CLASSES IN Ba[0,1] SPACES

In this paper, we research the Miintz rational approximation of two kinds of spe- cial function classes, and give the corresponding estimates of approximation rates of these classes.

Energy Assessment of Building Integrated Photovoltaics and Fuel Cell Systems: Design Study for Building(s) of Mie, Japan

A building integrated energy system (photovoltaic (PV) and fuel cell (FC)) is proposed for assessment of the energy self-sufficiency rate in five cities of Mie prefecture in Japan. In this work, it is considered that the electricity requirement of the building is provided by the building integrated photovoltaic (BIPV) system and the gap between the energy demand and BIPV supply is fulfilled by the FC. The FC is powered by the electrolytic H2 produced from the surplus power of PV. A design study of using the proposed system in five cities in Mie prefecture, which are in center part of Japan, has been performed. It has been observed that the monthly power production from BIPV is higher in spring and summer, while it is lower in autumn and winter at all considered locations. The self-sufficiency rate of the FC system is higher with decreasing households’ number and it has been observed that the 12 households are more suitable for full cover of the electricity demand by the combined system of PV and FC. The relationship between the households’ number and self-sufficiency rate of the FC system per solar PV installation area can be expressed by exponential curve. The coefficient of the exponential curve can predict the suitable city for the BIPV system with FC system utilizing electrolytic H2 generated by using excess energy from the PV system.

基于智能信息管理系统的门诊麻精药品全流程管理

目的基于临床合理用药管理系统和医院信息管理系统规范门诊麻精药品处方审核与调剂流程。方法运用焦点管理循环模式(FOCUS-PDCA)循环法聚焦问题、发现问题、原因分析、对策拟定、实施改进措施,通过临床合理用药管理系统设置麻精药品适应证、用法用量、用药疗程等精细化审核规则;医师通过医院信息系统(HIS)中的电子病历系统建立癌症疼痛患者和中、重度慢性疼痛患者门诊病历,药师查询患者是否住院及历史处方取药间隔后调配处方。结果对8种麻醉和第一类精神药品、7种第二类精神药品分别设置精细化审核规则;门诊癌症疼痛患者和中、重度慢性疼痛患者均建立电子病历。门诊麻醉药品和第一类精神药品处方退费率由11.41%降低到2.32%,第二类精神药品处方合理率由86.81%提升至97.83%。结论通过精细化设置麻精药品处方审核规则、规范麻精药品处方调剂流程等措施实现了门诊麻精药品全流程管理,提高了门诊麻精药品处方合理率,确保了患者用药的合理性和安全性。

Application of a Multi-Agent System (MAS) to Rational Credit Rating

A Multi-Agent System （ MAS ） is a promising approach to build complex system. This paper introduces the research of the Inner-Enterprise Credit Rating MAS （ IECRMAS）. To raise the rating accuracy, we not only consider the rating-target＇s information, but also focus on the evaluators＇ feature information and propose the rational rating-group formation algorithm based on an anti-bias measurement of the group. We also propose the rational rating individual, which consists of the evaluator and the assistant rating agent. A rational group formation protocol is designed to coordinate autonomous agents to perform the rating job.

A Simple Adaptive Rate Control for H.264/AVC

The purpose of this paper is to improve allocation of the number of bits without skipping the frame by accurately estimating the target bits in H.264/AVC rate control.In our scheme,we propose an enhancement method of the target frame rate based H.264/AVC bit allocation.The enhancement uses a frame complexity estimation to improve the existing mean absolute difference(MAD)complexity measurement Bit allocation to each frame is not just computed by target frame rate but also adjusted by a combined frame complexity measure.Using the statistical characteristic,we obtain change of occurrence bit about QP to apply the bit amount by QP from the video characteristic and applied in the estimated bit amount of the current frame. Simulation results show that the proposed rate control scheme could not only achieves time saving of more than 99%over existing rate control algorithm,but also increase the average PSNR of reconstructed video for around 0.02～0.78 dB in all the sequences.

医用耗材使用精益化监管方法研究

目的:探讨医用耗材使用监管方法,为医用耗材使用精益化监管提供数据支撑。方法:采用医用耗材出库数量与计价数量误差率、重点监管耗材人均使用金额和耗占比3项指标,对季度耗材使用情况评估。选取2021-2022年医疗保障中心医用耗材使用数据,计算通用医用耗材出库与计价数量差异、重点监管耗材-功能性敷料人均使用金额和耗占比,评估医用耗材使用精益化监管效果。结果:2021年第一季度与2022年第四季度相比较,一次性使用输液器和输液接头2种通用医用耗材误差率由39.62%和17.79%降低至2.2%和3.66%;功能性敷料人均使用金额从720.98元降低至119.21元;耗占比由23.62%降低至13.57%。结论:出库数量与计价数量的误差率、功能性敷料人均使用金额和耗占比3项指标可用于医用耗材使用精益化动态监管,在医院医用耗材合理性使用监管中具有重要作用。