OBJECTIVE To investigate the application status of prescription pre-review systems in healthcare institutions of Yunnan province， evaluate their system functions and management capabilities， and provide a practical basis for promoting rational drug use. METHODS A questionnaire survey was conducted among public healthcare institutions at or above the secondary level in Yunnan province to investigate the deployment status of the systems. A capability maturity assessment framework was constructed， encompassing 6 dimensions and 39 indicators， including real-time prescription review， prescription correlation review， rule setting， evidence-based information support， prescription authority management， and system operation management. This framework was then used to evaluate the institutions that had implemented the pre-review systems. RESULTS A total of 100 valid questionnaires were collected， with 37 institutions having adopted prescription pre-review systems， mainly tertiary hospitals. The system predominantly adopted a modular architecture and was embedded into the hospital information system through application programming interfaces and middleware， providing certain capabilities for real-time prescription risk identification. Evaluation results indicated that basic functions such as reviewing indications， contraindications， and drug compatibility performed well， while deficiencies remained in functions related to parenteral nutrition prescription， review of drug dosage for specific diseases， individual patient characteristic recognition， and rule setting. Moreover， the construction of review centers and establishment of management systems were also not well-developed. CONCLUSIONS The overall application rate of prescription pre-review systems in Yunnan province remains low. System functions and management mechanisms require further improvement. It is recommended to enhance information infrastructure in lower-level institutions and explore regionally unified review models to promote standardized and intelligent development of prescription review practices.

Objective:To investigate the mediating effect of work engagement on the relationship between nurses′ perception of authentic leadership and their innovative behavior, providing insights for enhancing nurses′ innovative practices.Methods:A convenience sampling method was employed to recruit registered nurses from 37 hospitals in Anhui Province between January and March 2022. The Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were utilized to conduct a cross-sectional survey. SPSS 25.0 was used to analyze the correlations among nurses′ perception of authentic leadership, work engagement, and innovative behavior, while AMOS 26.0 was employed to assess the mediating effect of work engagement between nurses′ perception of authentic leadership and innovative behavior.Results:A total of 3 200 questionnaires were distributed, and 2 994 valid questionnaires were collected. Among the 2 994 participating nurses, 2 907 (97.1%) were female and 87 (2.9%) were male, 1 002 (33.5%) aged 22-25 years, 1 374 (45.9%) aged 26-39 years, 467 (15.6%) aged 40-49 years, and 151 (5.0%) aged 50 years or older. The total scores of the Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were (68.23 ± 13.15), (51.49 ± 11.65) and (38.28 ± 8.35) points, respectively. Pearson correlation analysis revealed significant positive correlations between nurses′ perception of authentic leadership and work engagement ( r=0.473, P<0.01), between nurses′ perception of authentic leadership and innovative behavior ( r=0.530, P<0.01), and between work engagement and innovative behavior ( r=0.553, P<0.01). The mediating effect analysis indicated that work engagement partially mediates the relationship between nurses′ perception of authentic leadership and innovative behavior ( β=0.18, P<0.01), with a mediation effect ratio of 34.62%. Conclusions:Nurses′ perception of authentic leadership can indirectly influence their innovative behavior through work engagement. It is recommended that nursing managers prioritize the enhancement of authentic leadership and foster work engagement among nurses to stimulate their innovative behavior.

Objective:To investigate the current status of innovative behavior among male nurses in the Anhui Province, conduct potential profile analysis and explore its influencing factors, providing reference for formulating intervention stratigies to enhance innovative behavior among male nurses.Methods:From January to February 2022, a stratified convenience sampling method was used to select clinical male nurses as the participants from five tertiary and first-class comprehensive hospitals in Anhui Province. A cross-sectional survey was conducted using the general demoraphic questionnaire, Nurse Innovation Behavior Scale, Authentic Leadership Scale, and Psychological Capital Questionnaire. Potential profile analysis was conducted on the innovative behavior characteristics of male nurses, and single factor analysis and Logistic regression analysis were used to test the differences in male nurses' innovative behavior characteristics.Results:Among the 220 male nurses, 107 (48.64%) were under the age of 30, accounting for the largest proportion. The innovative behavior score of participants was (38.83 ± 7.80) points, which could be divided into three categories: low-level silent type (27.3%, 60/220), medium-level conservative type (44.5%, 98/220), and high-level active type (28.2%, 62/220). Compared to the low-level silent type, male nurses with higher levels of perceived authentic leadership were more likely to belong to the medium-level conservative type ( OR = 1.055, 95% CI 1.019 - 1.093, P<0.05) and the high-level active type ( OR = 1.124, 95% CI 1.066 - 1.184, P<0.01). The higher the level of psychological capital, the greater the probability that male nurses belong to the medium-level conservative type ( OR = 1.088, 95% CI 1.050 - 1.128, P<0.01) and the high-level active type ( OR = 1.273, 95% CI 1.196 - 1.355, P<0.01). Conclusions:The innovative behavior of male nurses in Anhui Province was at a medium level and had obvious classification characteristics. Nursing managers should focus on low-level silent type and medium-level conservative type male nurses, and adopt targeted interventions and support based on different category characteristics to improve their innovation behavior capacities in clinical settings.

Objective To study the management effect of the intelligent management mode of anesthet-ic medicine box.Methods The intelligent reconstruction of the management mode of anesthesia box in the de-partment of surgical anesthesiology was carried out,and the differences in the taking and return time in 3-month before and after applying the medicine box intelligent management,error rate,and information tracking were compared,and the management effect of the medicine box was compared between the intelligent manage-ment and the traditional mode.Results The prescription modification rate,accounting error rate,discrepancy rate of person and box,and omission rate of registration had statistical differences between the traditional management mode and intelligent management mode(P<0.05).The single medicine box management work-ing time for anesthetist getting the medicine box,returning the medicine box,taking the refrigerator medicine,generating prescription and charge in intteligent management mode was shortened compared with the tradi-tional management mode,and the difference was statistically significant(P<0.05);the working time of drug management such as drug counting,prescription checking,registration records checking,drug adding and daily inventory checking in the intelligent management mode was shortened compared with the traditional manage-ment mode,and the difference was statistically significant(P<0.05).Conclusion Compared with the tradi-tional mode,the anesthetic box management intelligent mode has high efficiency and strong reliability,moreo-ver is more conducive to the standardized management of anesthetic drugs in the operating room.

Objective:To investigate the mediating effect of work engagement on the relationship between nurses′ perception of authentic leadership and their innovative behavior, providing insights for enhancing nurses′ innovative practices.Methods:A convenience sampling method was employed to recruit registered nurses from 37 hospitals in Anhui Province between January and March 2022. The Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were utilized to conduct a cross-sectional survey. SPSS 25.0 was used to analyze the correlations among nurses′ perception of authentic leadership, work engagement, and innovative behavior, while AMOS 26.0 was employed to assess the mediating effect of work engagement between nurses′ perception of authentic leadership and innovative behavior.Results:A total of 3 200 questionnaires were distributed, and 2 994 valid questionnaires were collected. Among the 2 994 participating nurses, 2 907 (97.1%) were female and 87 (2.9%) were male, 1 002 (33.5%) aged 22-25 years, 1 374 (45.9%) aged 26-39 years, 467 (15.6%) aged 40-49 years, and 151 (5.0%) aged 50 years or older. The total scores of the Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were (68.23 ± 13.15), (51.49 ± 11.65) and (38.28 ± 8.35) points, respectively. Pearson correlation analysis revealed significant positive correlations between nurses′ perception of authentic leadership and work engagement ( r=0.473, P<0.01), between nurses′ perception of authentic leadership and innovative behavior ( r=0.530, P<0.01), and between work engagement and innovative behavior ( r=0.553, P<0.01). The mediating effect analysis indicated that work engagement partially mediates the relationship between nurses′ perception of authentic leadership and innovative behavior ( β=0.18, P<0.01), with a mediation effect ratio of 34.62%. Conclusions:Nurses′ perception of authentic leadership can indirectly influence their innovative behavior through work engagement. It is recommended that nursing managers prioritize the enhancement of authentic leadership and foster work engagement among nurses to stimulate their innovative behavior.

Objective:To investigate the current status of innovative behavior among male nurses in the Anhui Province, conduct potential profile analysis and explore its influencing factors, providing reference for formulating intervention stratigies to enhance innovative behavior among male nurses.Methods:From January to February 2022, a stratified convenience sampling method was used to select clinical male nurses as the participants from five tertiary and first-class comprehensive hospitals in Anhui Province. A cross-sectional survey was conducted using the general demoraphic questionnaire, Nurse Innovation Behavior Scale, Authentic Leadership Scale, and Psychological Capital Questionnaire. Potential profile analysis was conducted on the innovative behavior characteristics of male nurses, and single factor analysis and Logistic regression analysis were used to test the differences in male nurses' innovative behavior characteristics.Results:Among the 220 male nurses, 107 (48.64%) were under the age of 30, accounting for the largest proportion. The innovative behavior score of participants was (38.83 ± 7.80) points, which could be divided into three categories: low-level silent type (27.3%, 60/220), medium-level conservative type (44.5%, 98/220), and high-level active type (28.2%, 62/220). Compared to the low-level silent type, male nurses with higher levels of perceived authentic leadership were more likely to belong to the medium-level conservative type ( OR = 1.055, 95% CI 1.019 - 1.093, P<0.05) and the high-level active type ( OR = 1.124, 95% CI 1.066 - 1.184, P<0.01). The higher the level of psychological capital, the greater the probability that male nurses belong to the medium-level conservative type ( OR = 1.088, 95% CI 1.050 - 1.128, P<0.01) and the high-level active type ( OR = 1.273, 95% CI 1.196 - 1.355, P<0.01). Conclusions:The innovative behavior of male nurses in Anhui Province was at a medium level and had obvious classification characteristics. Nursing managers should focus on low-level silent type and medium-level conservative type male nurses, and adopt targeted interventions and support based on different category characteristics to improve their innovation behavior capacities in clinical settings.

Objective:To investigate the risk factors for 1-year survival rate in patients with spinal metastasis secondary to lung cancer.Methods:The data of 343 patients with spinal metastases secondary to lung cancer from January 2011 to December 2018 were retrospectively studied. There were 188 males (54.8%) and 155 females (45.2%) with an average age of 59.47±10.21 years old (range 23-91 years). The patients were divided into operation group (150 cases, 43.7%) and non operation group (193 cases, 56.3%). The demographics, types of primary tumor, non spinal metastasis, visceral metastasis, spinal metastasis and segments, pathological fractures of vertebra, Frankel classification, physical function status (Karnofsky performance scale, KPS), visual analogue score (VAS), the spinal instability neoplastic score (SINS) were recorded and analyzed. The impact of different treatments on the survival prognosis of patients with spinal metastasis was evaluated. The independent factors affecting survival in those patients were analyzed by Cox proportional hazards regression model.Results:The peak incidence of spinal metastases was found in the age group of 46-60 years (43.7%, 150/343). 38.5% (132/343) of the patients had pathological fractures of the involved vertebral body. 58.3% (200/343) of the patients had extraspinal bone metastasis. 36.2% (124/343) of the patients had visceral metastasis. Among the primary tumors, adenocarcinoma was the most common tpye (61.5%, 211/343), followed by large cell lung cancer (12.5%, 43/343), small cell lung cancer (6.4%, 22/343), squamous cell cancer (6.1%, 21/343) and mixed cell lung cancer (5.3%, 18/343). The type of lung cancer cells in about 8.2 (28/343) patients was unknown. Among the surgical patients, 21 patients underwent minimally invasive surgery (14.0%), 28 patients underwent simple decompression surgery (18.7%), 76 patients underwent separation surgery (50.7%), and 25 patients underwent radical surgery (16.6%). 59.3% (89/150) of the patients had a better neurological function than before surgery. The average survival time of all patients was 9.88 months with the median survival time of 8 (5,14) months. The survival rates were 62.1% (213/343), 30.0% (103/343), and 3.8% (13/343) at 6, 12, and 24 months, respectively. The average survival time of patients in the operation group was 10.24 months with the median survival time of 9 (5, 15) months, and the average survival time of patients in the non operation group was 9.41 months with the median survival time of 7 (5, 13) months with no significant difference between the groups (χ 2=0.300, P=0.584). Multivariate Cox proportional hazard regression model analysis showed that radiotherapy [ HR=1.913, 95% CI(1.471, 2.488), P<0.001], chemotherapy [ HR=1.313, 95% CI(1.040, 1.658), P=0.022], targeted drug therapy [ HR=1.683, 95% CI(1.221, 2.319), P=0.001], KPS [ HR=1.593, 95% CI(1.140, 2.225), P=0.006] and pathological type (non-small cell lung cancer) were independent factors affecting the 1-year survival rate of patients with spinal metastasis secondary to lung cancer [ HR=0.322, 95% CI(0.225, 0.460), P<0.001] with significant difference. Conclusion:Surgical treatment can improve both the neurological function and general status of patients with spinal metastasis. Treatments of radiotherapy, chemotherapy, and targeted drug therapy can significantly improve 1-year survival rate, while a KPS less than 50 points and a primary lung cancer other than adenocarcinoma were independent risk factors reducing 1-year survival rate.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Objective:To develop a risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer, and to verify its predictive efficiency, so as to provide reference for risk assessment and nursing intervention of nausea and vomiting in patients with primary liver cancer.Methods:A cross-sectional survey was used. The risk assessment tool was compiled by using literature analysis, Delphi expert consultation and analytic hierarchy process. 153 patients with primary liver cancer who underwent transcatheter arterial chemoembolization in the Department of Intervention, Jiangsu Cancer Hospital from May 2022 to April 2023 were selected for assessment by using convenience sampling method. Receiver operating characteristic curve, sensitivity, specificity and Youden index were used to test the prediction efficiency of risk assessment tools.Results:Among 153 patients, there were 78 males, 75 females, aged (48.44 ± 7.76) years old. The expert positive coefficient of the three rounds of inquiry letters was all 100%, the expert authority coefficient was 0.936, 0.950 and 0.960 respectively, and the Kendall harmony coefficient was 0.490, 0.327 and 0.414 respectively (all P<0.01). The risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer included 14 items. The results of prediction efficiency analysis showed that the area under the receiver operating characteristic curve was 0.938 (95% CI 0.903-0.974, P<0.01). When the cut-off score was 56.2, the sensitivity, specificity and Youden index of the risk assessment tool were 0.926, 0.881 and 0.807, which had the best prediction efficiency. Conclusions:The risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer has high scientificity, predictive efficiency and practicability, and is suitable for the risk assessment for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer in China.

Objective:To understand the current situation of adolescent depression research in China and explore the research hotspots and development trends, so as to provide reference for adolescent depression related research.Methods:The literature related to adolescent depression in China National Knowledge Infrastructure was retrieved from the establishment of the database until February 25, 2023. CiteSpace software was used for visual analysis of the literature.Results:A total of 2 739 articles were included, and the number of published papers showed an increasing trend from 1980 to 2023. The author with the most articles was Zhang Wenxin and the institution with the largest number of publications was Chongqing Medical University. The research hotspots mainly focused on self-esteem, redundancy, social support, family environment, peer relationships and other aspects and research trends included parental conflict, peer relationships, self-injury, rumination and so on.Conclusions:The problem of adolescent depression has attracted widespread attention from scholars, and it is necessary to strengthen the communication and cooperation between authors and institutions in the future, carry out more interdisciplinary research, so as to provide more help for the intervention and treatment of adolescent depression.