With the social development, the importance of medical records has become increasingly prominent.This paper analyzes the methods and shortcomings of the current medical record quality control and proposes a new mode under two-level randomized blind method combining with the experience of our own hospital.This new mode, through reconstructing the work team, adjusting work pattern and task allocation, supervising problems rectification, combining with experts′ supervising terminal record, inspecting link record randomly, handling dissent, evaluating connotation quality and assessing performance, effectively reduced the defect rate of medical records, improved the archiving rate and promoted the quality of medical records, which is worth promoting.

Purpose To evaluate the fatty infiltration of lower limbs by using iterative decomposition of water and fat with asymmetry and least squares estimation quantitative fat imaging(IDEAL-IQ)technique in idiopathic inflammatory myopathy(IIM)patients,and to analyze the correlation between muscle fat fraction(FF)and clinical assessments.Materials and Methods Thirty-two patients with IIM were diagnosed by muscle biopsy and 32 age-,gender-matched healthy volunteers(control group)were recruited.T1WI,T2WI in axial view and IDEAL-IQ sequence of thighs were scanned on each subject.FF values of the anterior,interior and posterior thigh muscles were measured on the FF image generated in the IDEAL-IQ sequence,and medical research council scale score of the IIM group were collected.The difference of muscle FF value between the IIM group and control group was compared,the correlation between FF value and muscle strength of thigh muscles was also analyzed.Results The mean FF values of anterior,interior and posterior thigh muscles in IIM group were 16.60±3.67,6.77±4.92 and 17.32±4.01,respectively,which were significantly higher than those in control group(2.58±2.57,1.40±0.64 and 1.57±0.19),with statistically significant differences(t=-7.29,-6.91,-4.85;all P<0.05).Spearman test showed that the mean FF value was significantly correlated with course of disease(r=0.587,P<0.001).The mean FF values of anterior,interior and posterior thigh muscles were significantly correlated with muscle strength(r=-0.885,-0.761,-0.594;all P<0.001).Conclusion The IDEAL-IQ technique can quantitatively and objectively analyze the severity of muscle fat infiltration in IIM patients,and its degree is correlated with the muscle strength,which has significant clinical application value.

Objective:To explore the effect of different posture angles on the pain and comfort in patients with early esophageal cancer after endoscopic submucosal dissection (ESD), so as to provide a basis for patients to choose the best position after ESD.Methods:This study was a randomized controlled trial. One hundred and twenty patients with early esophageal cancer who underwent ESD in the Department of Gastroenterology, Nanjing Drum Tower Hospital from March 2021 to March 2022 were selected as the study subjects, and they were randomly divided into 4 groups of 30 patients each according to the randomized numerical method. Group A was the conventional group, which was in the free position after the operation, and groups B, C, and D were the experimental groups, with group B in the head-high-feet-low 30° position, group C in the head-high-feet-low 45° position, and group D in the head-high-feet-low 60° position. The pain scores after returning to the room after the operation, at 8, 16, 24 h after the operation and comfort scores at 24 h after the operation of the patients in the four groups were evaluated by Numeric Rating Scale (NRS) and General Comfort Questionnaire (GCQ).Results:There were 17 males and 13 females in group A; there were 20 males and 10 females in group B; there were 22 males and 8 females in group C; there were 19 males and 11 females in group D. All patients were aged 30-85 years old. The time main effect, grouping main effect, and interaction effect of postoperative pain NRS score among four groups of patients were all statistically significant ( F=618.13, 12.14, 6.75, all P<0.01). There was no significant difference in the NRS scores of patients after returning to the room after the operation among the four groups ( P>0.05). The NRS scores in group D at 8 and 16 h after the operation were (1.93 ± 0.64), (0.60 ± 0.47) points, lower than the (2.87 ± 1.14), (1.97 ± 1.22) points, (2.17 ± 0.83), (1.97 ± 1.61) points, (2.30 ± 0.75), (0.80 ± 0.61) points in groups A, B, and C, the differences were statistically significant ( t values were 0.79-4.72, all P<0.05). The NRS scores in group B at 24 h after the operation was (0.23 ± 0.18) points, lower than the (1.53 ± 1.08), (0.30 ± 0.21), (0.46 ± 0.25) points in groups A, C, and D, the differences were statistically significant ( t= 5.32, 1.34, 1.37, all P<0.05). The GCQ total scores at 24 h after the operation were (96.96 ± 3.05), (99.77 ± 3.21), (93.53 ± 3.76), (92.20 ± 3.69) points in group A, B, C, D, the difference was statistically significant ( F= 29.59, P<0.05). Moreover, the GCQ total scores at 24 h after the operation in group B were higher than those in groups A, C, and D, and the differences were statistically significant ( t=3.15, 7.01, 8.52, all P<0.05). Conclusions:Targeted body position management can effectively reduce postoperative pain and improve patient comfort in early esophageal cancer patients undergoing ESD.