In July 2024,the Diagnosis Related Groups(DRG)2.0 is released based on the Notice from the National Healthcare Security Administration on Issuing the DRG 2.0 and Deepening the Relevant Work.Compared with DRG 1.1,version 2.0 was established based on a wider range of suggestions regarding the Adjacent Diagnosis Related Groups(ADRG),Major Comorbidity or Complication(MCC),and Comorbidity or Complication(CC)from various institutions.A list of disease diagnoses and surgical operations that are not used as grouping rules was compiled,and grouping efficacy was further improved by upgrading the algorithms for MCC and CC with the help of AI.Meanwhile,it is necessary to pay more attention to the number of cases of ADRG,the better methods to list the MCC/CC,the suggestions of various doctors and continuously standardize the data and update the grouping scheme of DRG.

In July 2024,the Diagnosis Related Groups(DRG)2.0 is released based on the Notice from the National Healthcare Security Administration on Issuing the DRG 2.0 and Deepening the Relevant Work.Compared with DRG 1.1,version 2.0 was established based on a wider range of suggestions regarding the Adjacent Diagnosis Related Groups(ADRG),Major Comorbidity or Complication(MCC),and Comorbidity or Complication(CC)from various institutions.A list of disease diagnoses and surgical operations that are not used as grouping rules was compiled,and grouping efficacy was further improved by upgrading the algorithms for MCC and CC with the help of AI.Meanwhile,it is necessary to pay more attention to the number of cases of ADRG,the better methods to list the MCC/CC,the suggestions of various doctors and continuously standardize the data and update the grouping scheme of DRG.

OBJECTIVE To establish a comprehensive platform for regional pharmaceutical care among Jiangxi provincial pediatric alliance to realize the management of pediatric hierarchical diagnosis and treatment, and improve the quality of pharmaceutical care. METHODS A unified diagnosis and treatment information standard and a knowledge base of children's rational drug use rules were established among the medical institutions of Jiangxi provincial pediatric alliance. On this basis, the medical records and drug use information of patients in various medical institutions in the region were uploaded to the chain in a structured manner in real time, and a comprehensive platform for regional pharmaceutical care was built. RESULTS The comprehensive platform for regional pharmaceutical care built based on blockchain technology could share medical resources and information among medical institutions, realize rational drug use management, remote prescription review, individualized drug use guidance, popular science education, government supervision, etc., and improve the quality of pharmaceutical care. CONCLUSION The comprehensive platform for regional pharmaceutical care among Jiangxi provincial pediatric alliance can help allocate high-quality medical resources (drug safety knowledge base and pediatric pharmacists) for primary medical institutions. Further more, it lays the foundation for government supervision at the same time ensuring children’s medication safety, which has great practical significance.

Objective:To explore the challenges in the implementation of drug centralized volume-based procurement policies in hospitals and propose corresponding optimization suggestions.Methods:From August to December 2023, a purposive sampling was conducted to select 11 pharmaceutical experts from tertiary hospitals in China for Delphi method. The survey content included " policy recommendations for promoting the acceleration and expansion of national drug centralized procurement and retaining surplus medical insurance funds for centralized procurement" .Results:Survey participants gave feedback on a set of existing problems found in the implementation of drug centralized procurement policies and proposed corresponding optimization methods. Kendall′s W coefficient of the specialist consultation was 0.332( P<0.05), demonstrating good consistency and concentration of the expert opinions. Among the problems, the score of drug supply guarantee was the highest(mean value of importance was 4.45). At the same time, the recommendation of strengthening monitoring and early warning, coordination and dispatch, and effectively ensuring the supply of centralized drug procurement had the highest score and concentration(mean value of importance was 4.91, coefficient of variation was 0.06). Conclusions:Through Delphi method, this study revealed issues and optimization methods in the implementation of drug centralized procurement policies in hospitals. The findings could provide valuable insights for improvements in the pharmaceutical sector and future policy adjustments.

Objective:To develop an Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses and test its reliability and validity.Methods:Based on the theory of knowledge, attitude, and practice, a preliminary scale draft was formed through a literature review, three rounds of Delphi expert consultation, and a pre-survey. Using convenience sampling, 311 hemodialysis nurses were selected for a survey from December 2022 to February 2023 for item analysis, exploratory factor analysis and reliability testing. Another survey was conducted on 260 hemodialysis nurses from February to June 2023 for confirmatory factor analysis, convergent validity, and discriminant validity testing.Results:The Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses included three subscales and five dimensions, with a total of 33 items. The content validity index at the item level was 0.867 to 1.000, and the content validity index at the scale level was 0.992. After exploratory factor analysis, two, one, and two common factors were extracted from the knowledge, attitude, and practice subscales, with cumulative variance contribution rates of 70.114%, 75.192%, and 67.467%, respectively.Confirmatory:factor analysis showed that the model fitted well. The Cronbach's α coefficients of the three subscales were 0.929 to 0.943, the half reliability coefficients were 0.861 to 0.903, and the retest reliability coefficients were 0.824 to 0.874. Conclusions The Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses has good reliability and validity and can be used to evaluate the physical examination ability of hemodialysis nurses for arteriovenous fistula.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To investigate the ability and current situation of nursing undergraduates to use social media for health education, and analyze the impact of social media health education experience on the ability of nursing undergraduates to use social media, so as to provide reference information for the design of nursing undergraduates' health education courses in the future.Methods:Using the convenient sampling method,from May to September 2019, 147 nursing undergraduates from four medical colleges in Beijing were selected, and the general information questionnaire and the Chinese version of Social Media Competency Inventory were used for the questionnaire survey. Using the objective sampling method, the 20 nursing undergraduates were selected for semi-structured interview.Results:57.14%(84/147) of nursing undergraduates had used social media for health education at the undergraduate stage. Among the scores of all dimensions of social media ability, the scores of social media self-efficacy (4.42 points per item) and performance expectation (3.31 points per item) were higher. In the interview, nursing undergraduates believed that after college training, the ability of using publicity tools and making carriers, the ability of information selection and transmission, the ability of teamwork and other social media applications were improved.Conclusions:The current situation of applying social media to health education for nursing undergraduates needs to be further improved, and the ability of applying social media to health education has great room for improvement. Social media health education experience can effectively improve their abilities related to social media application.It is suggested that the relevant courses and training of applying social media to health education should be promoted in undergraduate nursing education in Colleges and universities.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective:To compare the effects of esketamine and opioids on postoperative cellular immune function in the patients undergoing laparoscopic gynecological surgery.Methods:Fifty patients, of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged 20-65 yr, with height 150-180 cm, weighing 50-80 kg, who underwent laparoscopic non-oncologic gynecological surgery with general anesthesia in the Second Hospital of Shanxi Medical University from September 2020 to February 2021, were divided into 2 groups using a random number table method: esketamine group (group K) and opioid analgesic group (group O), with 25 patients in each group.Anesthesia was induced as follows: esmketamine 0.25-0.50 mg/kg was intravenously injected in group K, sufentanil 0.2-0.4 μg/kg was intravenously injected in group O, and propofol 2 mg/kg and rocuronium 0.6-0.9 mg/kg were intravenously injected in two groups.Anesthesia was maintained as follows: esketamine was intravenously infused at 0.5 mg·kg -1·h -1 in group K, remifentanil was intravenously infused at 10-20 μg·kg -1·h -1 in group O, and propofol 4-10 mg·kg -1·h -1 was intravenously infused, and rocuronium 0.2-0.3 mg/kg was intermittently injected in two groups.Blood samples from elbow veins were collected before anesthesia induction (T 1) and immediately after extubation (T 2) for determination of T lymphocyte subsets (CD3 + , CD4 + , CD8 + , CD4 + CD25 + CD127 low) and NK cells and B lymphocyte (by flow cytometry) and serum interleukin-6 (IL-6) and IL-10 concentrations (by multiplexed fluorescent microsphere immunoassay). Routine blood tests were performed on preoperative day 1 and postoperative day 3, and neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were calculated. Results:Compared with group O, the percentages of CD3 + and CD4 + cells, ratio of CD4 + /CD8 + and percentage of NK cells were significantly increased, serum IL-6 concentrations were decreased, and serum IL-10 concentrations were increased after extubation, white blood cell, monocyte and neutrophil counts were increased, and lymphocyte count was decreased on postoperative day 3 ( P<0.05), and no significant change was found in neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in group K ( P>0.05). Conclusion:Compared with opioid analgesics, esketamine has less inhibition of postoperative cellular immune function in the patients undergoing laparoscopic gynecological surgery.