OBJECTIVE:To explore the influential factors for plasma concentration of paliperidone palmitate injection for pa-tients with schizophrenia. METHODS:37 schizophrenia patients who used Paliperidone palmitate injection and took plasma concentra-tion monitoring in Wuxi Mental Health Center from Sept. 2012 to Jun. 2015 was selected,the results were statistically analyzed,and the influential factors were preliminary explored. RESULTS:Totally 37 times were conducted for the plasma concentration monitoring for paliperidone with the average plasma concentration of(17.72±13.46)ng/ml,and 24 times(accounting for 64.86%)in the range of(10-60 ng/ml);the average plasma concentration of male patients was lower than that of female patients,the difference was statisti-cally significant(P<0.05);there was no significant difference in the average plasma concentration among different ages(P>0.05);there was also no significant difference in plasma concentration/dose ratio in patients with different daily dose(P>0.05);the average plasma concentration of patients with combination treatment was higher than that of single drug,the difference was statistically signifi-cant(P<0.05);and there was no significant difference in the average plasma concentration of relieved patients and ineffective treat-ment patients(P>0.05). CONCLUSIONS:The plasma concentration of paliperidone palmitate is affected by age,combination treat-ment and other factors,clinic can optimize the therapeutic regimen based on monitoring results of plasma concentration and patients’ symptoms to promote the rational drug use.

Objective To summarize the working effect of nursing counterpart support in one first class, grade three hospital from 2011 to 2013, and provide a reference and evidence for the further strategy made. Methods With the help of National Health Planning Commission and Ministry of Finance which provide an arena for developing audit and acceptance of 2010 national key clinical specialized subject construction, 23 primary hospitals were selected to investigate nursing counterpart support from 2011 to 2013 by questionnaire including three aspects: quality of care, talent team building and specialized development and 13 clauses. Results Nursing counterpart support acquired a breakthrough at aspects of quality of care, talent team building and specialized development including specialized nurses 88, technical backbone 36 people, learning to serve 51 people. The satisfaction of patients in support primary hospital was ( 98. 17 ± 1. 23 ) score, night-shift allowance (26. 84 ± 17. 33), implementation of post management hospital 52. 2%, the rate of ward acquired quality accounting for 81. 4%, rate of beds/nurses (2. 51 ± 0. 72), and averagely nurse′s satisfaction (95. 27 ± 3. 47). Conclusions Counterpart support had a positive effect on promoting the development of primary hospitals.

Objective To introduce the application of grafting mechanism on a classⅢ grade A hospital's nursing counterpart support to county-level hospitals in Shanxi Province, and to summarize its effects and existing problems, so as to promote nursing counterpart support work and provide reference for the increase of the efficiency of counterpart support. Methods From 2014 to 2016, grafting mechanism was carried out in 23 county-level hospitals nursing counterpart supported by a classⅢ grade A hospital of Shanxi Province through 4 segments: field investigation, content selection, cultural integration and guided implementation. The evaluation of various mechanisms before and after grafting and the nurse satisfaction, patient satisfaction, high quality nursing service, as well as key discipline construction were statistically analyzed in 23 count-level hospitals. Results 100% of the 23 county-level hospitals applied grafting mechanism. A total of 20 nursing mechanism were grafted, focusing on 7 personnel systems, 3 performance management systems and 10 nursing quality management systems. The evaluation level of various mechanisms was significantly improved in the county-level hospitals after mechanism grafting. Nurse satisfaction increased from (87.6±15.2) to (89.7±16.8);patient satisfaction increased from (92.3±17.5) to (94.1±18.1); and high quality nursing service score increased from (73.5±12.9) to (75.8±14.0), and the differences were statistically significant (t=5.725, 4.042, 6.493;P< 0.01). A total of 5 of the county-level hospitals were approved provincial key discipline construction projects. Conclusions The mechanism of grafting plays a significant role in nursing counterpart support activities. Its theories and practice are worth of promoting.

Objective? To compare the reliability and validity of Intensive Care Delirium Screening Checklist (ICDSC) and Neelon and Champagne Confusion Scale (NEECHAM) when evaluating non-mechanical ventilation patients in Neurosurgery Department. Methods? A total of 100 non-mechanical ventilation patients in the Neurosurgery Department of a ClassⅢ Grade A hospital in Shanxi Province from August to December 2018 were selected. The non-operative patients were assessed on the third day after admission, and the operative patients were assessed on the third day after operation. Qualified nurses assessed the patients at 00:00—1:00, 8:00—9:00 and 16:00—17:00 with ICDSC and NEECHAM. Psychiatrists assess the patients at 16:30—17:30 on the same day by Richmond Agitation and Sedation Scale (RASS) and Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Using the results of DSM-IV as the gold standard, the curve of ROC was drawn, and the sensitivity and specificity of the two scales were compared. Results? Area under ROC Curve (ROCAUC) of ICDSC was 0.891 (95%CI: 0.826-0.956,P＜0.01). The ROCAUC of NEECHAM was 0.987 (95% CI: 0.970-0.999, P＜ 0.01). When the optimal threshold of ICDSC was 4.25, the sensitivity and specificity were 87.8% and 76.2% respectively. When the optimal threshold of NEECHAM was 23.5, the sensitivity and specificity were 98.0% and 92.9% respectively. Conclusions? The misdiagnosis rate of NEECHAM is lower than ICDSC, and the diagnostic efficacy, authenticity, reliability and diagnostic value of NEECHAM are higher than ICDSC. NEECHAM is more suitable for nurses to evaluate delirium in neurosurgery patients without mechanical ventilation.