Objective To compare the effectiveness of propafenone,(intravenous and oral) and lanatoside C in reversing atrial fibrillation (AF) and their safety in non-rheumatic patients.Methods Ninety-seven recent onset(≥0 5h～41days) AF patients were included. Subjects with valvular heart disease, heart failure (NYHA heart function≥Ⅲ degree),myocardial infarction, sick sinus syndrome, atrioventricular block(≥Ⅱ degree), preexcitation syndrome and hyperthyroidism were excluded. Three groups were subdivided according to the results:⑴ The group of intravenous propafenone(groupⅠ):thirty-three patients were given intravenous injection propafenone 70 mg within 7 minutes, the non-converted patients were given another 140 mg (0 5～1mg/min) intravenous infusion. ⑵The group of oral loading dose propafenone: Thirty-two patients were given propafenone 450 mg orally(groupⅡ).⑶The group of intravenous lanatoside C(groupⅢ):Thirty-two patients were given intravenous lanatoside C 0 4 mg within five minutes and another 0 2 mg must be added to if AF was not reversed in 4 hours. EKG, blood pressure, symptoms, AF reversing and ventricular rate were closely observed under heart monitoring all patients. The time from intravenous injection or receiving the drug to reversing the AF to sinus rhythm was recorded. Observing the reversal rate and time of the three groups of patients for 30 minutes,1h, 2h, 4h, 8h respectively, we could get the results as follows.Results Average reversal time is: group Ⅰ (0 8?0 4)h, group Ⅱ(4 1?1 8)h. group Ⅲ(3 7?2 0)h, There was a prominent difference (P0 05).Conclusion Of the above three methods in reversing AF, the average reversal time of intravenous propafenone is the shortest, and the have the most efficient reversal rate.

Objective To explore the application effect of quality control circle(QCC)in the construction of a new model for abdominal pain centers in county-level comprehensive hospitals.Methods A total of 160 patients with non-traumatic abdominal pain admitted to the department of emergency of Baiyin Central Hospital from June 2021 to October 2022 were selected as research objects.Divided by March 2022,from June 2021 to February 2022,and 80 patients with non-traumatic abdominal pain admitted to the department of emergency before the establishment of QCC management mode from June 2021 to February 2022 were given routine treatment and nursing care.After establishing the QCC theme,the targets were set according to the 10 steps of QCC activities,the circle members drew up the strategies and carried out the second development of the strategies one by one,evaluated the feasibility,economy,urgency and circle ability,formulated the treatment plan for the patients with abdominal pain,carried out the standardized treatment,selected the most suitable method to carry out and review,and finally evaluated the effect.The difference of tangible outcomes(the average response time for pre hospital emergency treatment,average response time for in-hospital emergency treatment,waiting time for abdominal special examination,consultation waiting time,emergency department retention time,and emergency surgery entry time,triage accuracy,incidence of adverse events)and non-tangible outcomes(problem-solving ability,personal qualities,sense of responsibility,communication and coordination ability,self-confidence,teamwork ability,enthusiasm,and mastery of QCC)between pre-and post-QCC patients were compared.Results ①Tangible results:after QCC,the average response time for pre hospital emergency treatment,average response time for in-hospital emergency treatment,waiting time for abdominal special examination,consultation waiting time,emergency department retention time,and emergency surgery entry time were significantly shortened compared to before QCC[pre hospital emergency response time(minutes):2.15±0.05 vs.4.25±0.25,average response time for in-hospital emergency treatment(minutes):58.32±10.25 vs.100.22±25.25,waiting time for abdominal special examination(minutes):29.78±6.44 vs.40.22±8.59,consultation waiting time(minutes):9.05±2.12 vs.13.15±3.12,emergency department retention time(minutes):58.60±9.25 vs.76.00±12.02,emergency surgery time(minutes):115.25±20.25 vs.153.22±25.32,all P<0.05],triage accuracy significantly improved compared to before QCC[98.75%(79/80)vs.87.50%(70/80),P<0.05],incidence of adverse events significantly decreased compared to before QCC[16.25%(13/80)vs.35.00%(28/80),P<0.05].Intangible achievements:after the implementation of QCC,circle members had significantly improved their problem-solving ability scores,personal qualities scores,sense of responsibility scores,communication and coordination ability scores,self-confidence scores,teamwork ability scores,enthusiasm scores,and mastery of QCC scores compared to before QCC(problem-solving ability scores:3.75±0.26 vs.2.89±0.19,personal qualities scores:3.76±0.24 vs.2.92±0.28,sense of responsibility scores:3.63±0.22 vs.3.20±0.33,communication and coordination ability scores:4.25±0.30 vs.3.20±0.33,self-confidence scores:3.52±0.30 vs.2.90±0.19,teamwork ability scores:3.63±0.29 vs.3.00±0.18,enthusiasm scores:3.63±0.27 vs.2.97±0.22,mastery of QCC scores:3.38±0.22 vs.2.91±0.27,all P<0.01),with significant intangible achievements.Conclusion Conducting QCC activities can improve the management level of abdominal pain patients and enhance the quality of medical care.