The accreditation of Proficiency Testing Provider ( PTP) has gone through more than a decade in China.Over the past ten years, from nonexistence to existence, the domestic PTPs in the area of laboratory medicine have gradually standardized and developed.By reviewing the international and domestic practice, this paper gives an outline of the present status of the accreditation of PTP in the area of laboratory medicine, explores the difference with other countries, the main problems and some suggestions for improvement, and makes a prospect of the development of the accreditation of PTP in the area of laboratory medicine in China.

Based on the application of the second generation field medical cabin in the practices,the author points out the advantages of it such as advanced equipment,diversified adaptation,fully equipped element,etc.Meanwhile,the author also puts forward problems and relevant suggestions in extension area,equipment configuration and accessories.The suggestion provides basic theoretical evidence for improving the medical cabin devices.

Objective To compare clinical effect of unipolar versus bipolar radiofrequency ablation in treating atrial fibrillation (AF) in elderly patients and discuss the correlated risk factors.Methods From October 2008 to December 2013,a total of 50 elderly patients with organic heart disease and AF underwent radiofrequency ablation surgery.All patients were divided into 2 groups of unipolar (group A,n=20) and bipolar (group B,n=30 patients) radiofrequency ablations.The variations of electrocardiogram (ECG) and ultrasonic cardiogram (UCG) in patients were collected and the complications and the NYHA class of the patients were recorded at 3,6 and 12 months after surgery.The total 43 elderly patients were divided into sinus group and non-sinus group according to their ECG at 12 months after surgery.Results The recovery rates of sinus rhythm at 3,6 and 12 months after surgery were 73.7％(14/19),66.7％(12/18) and 61.1％ (11/18)respectively in group A and 82.8％(24/29),85.2％(23/27)and 88.0％(22/25) respectively in group B.Two groups of the recovery rate of sinus rhythm had a statistically significant difference between the two groups (P＜0.05) at 12 months after surgery.The complication rate in group A was higher than in group B [55.0％ (11 cases) vs.26.7％ (8 cases),P＜0.05].Preoperative history of AF and left atrial diameter were the influencing factors for the sinus rhythm recovery rates (P＜0.05).Conclusions Bipolar radiofrequency ablation for AF is safe and has less complications and high success rate of restoring sinus rhythm.The patients with long preoperative history of AF and left atrium distension have a low success rate of restoring sinus rhythm with a high recurrence rate.

Objective To study the correlation between pain, lower limb strength and physical function in patients with primary osteoporosis. Methods Fifty-seven female patients diagnosed with menopause-related low bone mass or primary osteoporosis using a GE calcaneus bone density detector were involved in this study. The muscle strength of their lower limbs was tested with a Biodex system 4 machine. Pain was assessed with a visual analogue scale, and physical function (PF) with the SF-36 instrument. Results Low back pain was significantly correlated with PF, and so was leg pain. Leg pain was also significantly correlated with the strength of the extensors of the dominant leg during low velocity and medium velocity movement. Leg pain was not, however, significantly correlated with the strength of the flexors of the dominant leg during low and medium velocity movement. Conclusions Pain predicts poor physical function in patients with primary osteoporosis or low bone density. During low and medium velocity movement, leg pain significantly predicts poor muscle strength in the extensors of the dominant lower leg, but it has no correlation with the muscle strength of the flexors.

Objective To Investigate the willingness of nurses on multiple-sites practice in Shenyang city and their motivations and concerns on multiple-sites practice, and to provide reference for the implementation of nurses' multiple-sites practice policy. Methods A convenient sampling method was used to conduct a questionnaire survey of 845 registered nurses in Shenyang city. Results 82.13％(694/845) nurses indicated that they were in favor of nurses on multiple-sites practice, and 79.05％(668/845) nurses expressed their willingness to engage in multiple-sites practice. The differences in the age, job title, working hours, monthly income of nurses and whether specialist nurses were statistically different from their willingness to multiple-sites practice (χ2=10.73-96.40, all P<0.01), and whether Chinese medicine nurse (χ2=6.42, P<0.05) was also different in their willingness to multiple-sites practice. Raising their own economic income and worrying about their overworked workload were the biggest drivers (89.37％,597/668) and concerns of nurses practicing multiple points respectively(88.14％,156/177). 82.04％(548/668) and 70.21％(496/668) of nurses believed that multi-practice practice was conducive to improve their self-worth and enhance nursing work skills. The lack of protection of rights and security (70.01％, 124/177) and the unclear medical risk of practice (53.12％, 94/177) were important factors restricting nurses′ multi-practice practice. In addition, nurses believed that the state should improve relevant laws and regulations (83.31％, 704/845) and protect the legal rights of nurses (88.64％, 745/845). Conclusions Nurses are generally optimistic about multiple-sites practice. Under the premise of sufficient energy and perfect legal protection, nurses multiple-sites practice is a practical and effective measure, which can increase the economic and social value of nurses, and at the same time classify the country′s practice. The medical treatment system provides protection of medical resources.

Objective To comprehensively assess the strengths and weaknesses of the 24 antihypertensive drugs procured as Volume-based Procurement(VBP)and innovator drugs by using quantitative evaluation system,and to provide a reference for doctors and patients in medication guidance and pharmaceutical decision-making.Methods The Quantitative Evaluation Criteria in the"Quick Guide to Drug Evaluation and Selection in Chinese Medical Institutions"were refined and optimized.The 24 selected VBP and innovator antihypertensive drugs were quantitatively evaluated according to the optimized quantitative evaluation system with the help of Chinese and English databases such as China Knowledge Network,Wanfang data,Wipunet,Embased,PubMed,and Metstr,as well as guideline search tools such as Meikang MCDEX,Drugwise Data,Up To Date,Medical Pulse and other databases etc.Results Among the 24 antihypertensive drugs,only four innovator drug evaluation scores were higher than those of drugs selected as VBP,namely felodipine tablets,Fosinopril sodium tablets,indapamide extended-release capsules,Irbesartan hydrochlorothiazide tablets.there were five main differences in the evaluation scores,namely economy,consistency evaluation,drug expiry date,global use,and the status of manufacturing enterprises.It was found that 83%of the VBP drugs had higher evaluation scores than those of the innovator drugs.The economic score of the innovator drug was low,and the difference in the scores was between 1-11 points.Conclusion By using the quantitative evaluation system to evaluate the antihypertensive drugs,the advantages and disadvantages of the innovator and VBP antihypertensive drugs can be assessed comprehensively,and the digital characteristics of antihypertensive drugs can be given,and the evaluation score can provide the reference basis for the guidance and decision-making of medication for doctors and patients.

OBJECTIVE： To standardize the management of temporary drug purchase， and to provide reference for drug selection in Hospital Pharmaceutical Administration and Drug Treatment Committee （Pharmaceutical Association）. METHODS： Clinical pharmacists set up drug quantitative scoring table according to the 10 attributes of drugs as effectiveness， safety， economy， etc. 15 temporary purchased drugs submitted by departments in Oct. 2018 were graded according to the rules of the scoring table， and the evaluation results were fed back to Pharmaceutical Association. A retrospective evaluation of 20 temporary purchased drugs which were discussed at the Pharmaceutical Association from Jul. to Sept. 2018 was made according to previous approval model without using drug quantitative scoring table. The effect of pre-intervention was evaluated after using drug quantitative scoring table. RESULTS： Among 15 temporary purchased drugs， 2 of them scored below 60， and the unqualified rate was 13.3％. It suggested that 2 drugs could not be discussed at the meeting. Among 20 temporary purchased drugs that have been discussed at the meeting， 9 of them scored below 60， with the unqualified rate of 45.0％， suggesting that 9 drugs may have wasted the workload of the Pharmaceutical Association. CONCLUSIONS： Drug quantitative scoring table can play a pre-intervention role in the scoring of temporary purchased drugs to a certain extent. At the same time， the table can also be used as a relevant reference for hospital drug evaluation. It is helpful to optimize hospital drug use list and improve the level of rational drug use in clinic.