Objective To explore the effect of quality control circles (QCCs) in improving the delivery health checkup report.Methods QCC was founded with the theme of"improving the quality of health checkup report delivery."First,we planned an activity schedule and identified topics.We then set target focuses for service personnel,distribution modes,and operating environments;planned countermeasures;and selected optimal policies.Circle members implemented the optimal policies jointly.Reports of physical examinations by the Guoyu health management center were selected and analyzed.The total number of reports before improvement (January to December 2015) was 59 189 of which 34 549 (58.4％) were male patients and 24 640 (41.6％) were female patients;their average age was (37.7± 11.4) years.The total number of reports after improvement (December 2016 to January 2017) was 6 568,of which 3 881 (59.1％) were male patients and 2 687(40.9％) were female patients;their average age was (39.9± 11.7) years.We compared the quality indicators and evaluated the comprehensive quality of the patients before and after improvement.A total of 65 531 physical examination reports of subjects examined at the center between February and December 2017 were selected for effect tracking,including 39 230 (59.9％) men and 26 301(40.1％) women,aged (38.1±11.5).Results The on-time delivery rate of the health examination reports from rose from 51.4％ to 94.0％.The ratio of system leakage to sign for reports decreased from 14.5％ to 0.8％.The average time between the examination and when each report was handed over to for distribution decreased from 29.8 hours to 4.2 hours,and the average time between each report being distributed to the providers checking in dropped from 509.8 hours to 72.8 hours,while the average time for the preparation of each report for delivery decreased from 13.5 seconds to 3.1 seconds.The average time between delivery of a report and its being signed decreased from 4.3 seconds to 0.1 seconds.Before the improvement,the expected goals were not met.After improvement,the delivery rate of the health examination reports was 100.0％,the delivery intact rate of the group reports was 100.0％,and the satisfaction rate of the group reports was 99.4％.The comprehensive quality for the members was obviously higher after the improvement than before.After 11 months of tracking,the delivery accuracy rate of health examination report still failed to reach the target value of 100.0％,but all other indicators reached the target value,with good results.Conclusions Application of QCC not only improved the delivery the health checkup reports,but also promoted service quality after medical examinations and ended medical dispute caused by the loss of physical examination reports.

Objective The objective of this study was to utilize proton magnetic resonance spectroscopy (1H-MRS) to assess metabolites in cerebellar nuclei in unmedicated patients with insomnia disorder. Methods 1H-MRS was performed on cerebellar nuclei in 23 unmedicated patients with insomnia disorder (insomnia group) and 18 normal sleepers (control group). N-acetylaspartate (NAA), choline-containing compound (Cho) and creatine (Cr) were measured and the ratios of NAA/Cr and Cho/Cr were determined.Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to assess the subjective sleep quality and insomnia severity of all subjects, while State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) were used to assess the levels of anxiety and depression of all subjects. Sleep parameters of all subjects were measured by polysomnography (PSG). Results Mean NAA/Cr ratio of right cerebellar nuclei in insomnia group was significantly lower than that in control group (1.72±0.37 vs. 2.03±0.50, t=2.280, P=0.028). Mean NAA/Cr ratio of right cerebellar nuclei was significantly higher than that of left cerebellar nuclei within control group (2.03±0.50 vs. 1.68±0.21, t=3.386, P=0.004). There was no significant difference with regard to NAA/Cr ratio between bilateral cerebellar nuclei within insomnia group (t=1.416, P=0.171). Across all subjects, PSQI global scores (r=-0.369, P=0.018), and sleep latency (r=-0.437, P=0.004) and number of awakenings after sleep onset (r=-0.432, P=0.005) measured by PSG were negatively correlated with NAA/Cr ratios of right cerebellar nuclei, while percentages of stage 3 sleep (r=0.377,P=0.015) measured by PSG were positively correlated with NAA/Cr ratios of right cerebellar nuclei,respectively. Conclusion Patients with insomnia disorder have a hemispherically lateralized metabolic disturbance of NAA/Cr in right cerebellar nuclei,indicating that patients with insomnia disorder have neuronal damage in right cerebellar nuclei.