Outpatient care services are usually the patient's first contact between the patients and the most bas-ic health care. The provision of outpatient care contributes to immediate and large gains in health status. The pay-ment method is one of the most common incentive methods applied by purchasers to guide the performance of outpa-tient care providers. This systematic review applied cochrane review method, and searched, screened, assessed and synthesized the relevant original studies. 19 studies were finally included. It was found that existing payment methods combined with P4 P interventions could probably slightly improved the health professionals' use of some tests and treat-ments ( adjusted RR median = 1 . 095 , range 1 . 01 to 1 . 17 ) , but may have led to little or no difference in patients' utilisation of health services ( adjusted RR median = 1 . 01 , range 0 . 96 to 1 . 15 ) and may have led to little or no difference in the control of blood pressure or cholesterol ( adjusted RR = 1 . 01 , range 0 . 98 to 1 . 04 ) . Pay for per-formance involves a complex design, each detail design may contain different incentive effect, therefore policy makers intend to apply pay-for-performance to guide the behavior of health providers, the design on each components of pay for performance should be analyzed in order to find more potential intervention points.

Objective To explore the effects of diversified continuing nursing on recovery of patients with breast cancer after modified radical mastectomy. Methods A total of 90 patients with breast cancer after modified radical mastectomy were divided into observation group ( 45 cases ) and control group ( 45 cases ) according to random number table method. Patients in two groups received health guidance before leaving hospital, while those in observation group also received continuing nursing after leaving hospital. One month after leaving hospital, recovery of flaps and function of affected upper limb were evaluated. Results The flaps recovery of patients in observation group were better than those in control group with a significant difference ( P<0. 05). There were statistically significant differences in horizontal abduction of shoulder joint, upward abduction of shoulder joint, dorsiflexion of middle finger, distance of seventh cervical vertebra between two groups ( P<0. 05). Conclusions Diversified continuing nursing can effectively reduce complications of breast cancer after modified radical mastectomy and promote function recovery of the upper limb of patients.

Purpose/Significance To deeply analyze the research progress on the application of medical knowledge graph in the field of stroke,to discuss the problems of the development of stroke knowledge graph in China,and to put forward suggestions for the construc-tion of stroke knowledge graph.Method/Process By reviewing and analyzing the relevant literature,the application of medical knowledge graph in the field of stroke is sorted out and summarized.Result/Conclusion There are still many deficiencies in the development of stroke knowledge graph in China,and in the future,in-depth research can be carried out from four aspects,namely,expanding the ap-plication scope of knowledge graph,promoting the fusion of knowledge graph,developing more efficient algorithms,and upgrading to cog-nitive graph by joint artificial intelligence(AI).