OBJECTIVE To analyze the factors influencing patient satisfaction in the outpatient pharmacy of tertiary maternity and child specialist hospitals in Chongqing， and provide a reference for improving the pharmaceutical management capability of tertiary maternity and child specialist hospitals and enhancing patients’ medical experience. METHODS Utilizing KANO model， a questionnaire was developed and data were analyzed. Key influencing factors were identified through the categorization of requirement attributes， Better values， Worse values， and two-dimensional matrix analysis. The impact of these categorized demand factors on overall satisfaction was further validated through Structural Equation Modeling （SEM）. RESULTS Cronbach’s α coefficient for the survey questionnaire was 0.855， exceeding the acceptable threshold of 0.7； Bartlett test for sphericality yielded a value of 5 538.56 with P＜0.01， indicating good reliability and validity of the survey results. Through the KANO model’s factor selection process， the top four key factors influencing patient satisfaction in outpatient pharmacies were determined to be： medication pick-up time （r＝0.45）， pharmacist service attitude （r＝0.45）， rational medication consultation （r＝0.41）， self-service calling system （r＝0.40）， all of which were subsequently validated through SEM. CONCLUSIONS The four factors of medication pick-up time， self-service calling system， pharmacist service attitude， and rational medication consultation significantly influence patient satisfaction in the outpatient pharmacies of tertiary maternity and child hospitals in Chongqing.

Objective To evaluate the influence of the wearing position of dosimeters outside lead aprons on effective dose estimation for interventional radiology workers, analyze the differences between single and double dosimeter methods in effective dose estimation, and provide a reference for the personal dose monitoring of interventional radiology workers. Methods This study employed a combined approach of on-site monitoring and Monte Carlo simulation to evaluate the impact of the wearing position of dosimeters outside lead aprons on effective dose estimation, as well as the differences between effective doses measured using single and double dosimeters. Interventional radiology workers wore dosimeters at three positions: the neck outside the lead collar, the left chest outside the lead apron, and inside the lead apron. Effective doses were estimated using the single and double dosimeter methods specified in GBZ 128-2019 Specifications for individual monitoring of occupational external exposure, and the impact of different wearing positions on the estimation results was compared. Geant4 Monte Carlo simulations were used to model dose distributions at the neck outside the lead collar and at the left chest outside the lead apron for operators performing cardiovascular interventions under tube voltages of 70, 80, 90, and 100 kVp and exposure angles of posteroanterior (PA), anteroposterior (AP), and left anterior oblique 45° (LAO45°) positions. The study assessed the impact of dosimeter wearing position on effective dose estimation. Results Monte Carlo simulations demonstrated that neck doses consistently exceeded left chest doses across different tube voltages and exposure angles, with neck-to-chest dose ratios of 0.80-0.90. Under identical tube voltage conditions, AP showed the highest doses, followed by LAO45°, and PA demonstrated the lowest doses. The single and double dosimeter methods exhibited consistent patterns in effective dose estimation. Single dosimeter method generally yielded higher effective doses with relative deviations of 9.9% to 83%, though these deviations decreased under high tube voltages. Field monitoring data indicated that most interventional radiology workers maintained relative deviations between single and double dosimeter calculations below 6%, with neck-to-chest dose ratios of 0.95-1.1. The estimation patterns remained consistent across both methods, though single dosimeter method showed slightly higher results. Conclusion Under PA, AP, or LAO45°, the doses at the neck consistently exceeded those at the left chest. Therefore, when wearing lead protective equipment, the dosimeter should be properly positioned at the neck outside the lead collar to accurately reflect the radiation doses of surgeons. Some interventional radiology workers improperly positioned the dosimeter (intended at the neck outside the lead collar) at the left chest outside the lead apron, and this may result in an underestimation of the effective dose.

Objective To observe the application effect of protease combined with quadruple therapy in the remedial treatment of Helicobacter pylori (Hp) eradication failure. Methods A total of 100 patients with Hp infection who failed in initial treatment were selected as the study objects, and were divided into control group (50 cases) and observation group (50 cases), and two groups received a course of treatment for 14 days. The control group was given esomeprazole enteric-coated tablets, amoxicillin capsules, furazolidone tablets and colloidal bismuth pectin capsules. The observation group was given streptomycin granule and sodium bicarbonate powder on the basis of the control group. Hp eradication rates were calculated for intention to treat (ITT) analysis and per protocol (PP) analysis. The symptoms and adverse drug reactions before and after treatment were recorded in two groups. Results In the control group, 18 cases were successfully eradicated, the eradication rate by ITT analysis was 36%, and the eradication rate by PP analysis was 36%. In the observation group, 37 patients had negative ¹⁴C breath test results, with an eradication rate of 74% by ITT analysis and 74% by TT analysis. There was statistical significance in the eradication rate between the two groups (P < 0.05). There was no significant difference in compliance between the two groups (P>0.05). The improvement of abdominal pain symptoms before and after eradication was statistically significant between the two groups (P < 0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion The remedial treatment regimen of streptomycin combined with quadruple therapy can improve the eradication rate of Hp infection patients whose initial eradication failed.

Wumeiwan are recorded in the Jueyin chapter of Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）， and many doctors in the past dynasties believed that they had the effects of calming intestinal ascarid by warming Zang organs. The clinical application was limited. Since KE Qin， a doctor in the Qing dynasty， proposed that Wumeiwan were the primary prescription against Jueyin diseases， Wumeiwan have been valued by doctors， and their clinical application has also been expanded. The syndrome indicated for Wumeiwan is attributed， not only to the ascarid internal harassment， but to the abnormal Qi movement of wind and wood in Jueyin and the dysfunction of Yin and Yang. According to the functions of six meridians based on the theory of "open-close axis" in Huangdi's Internal Classic （《黄帝内经》） and the original texts of Treatise on Cold Damage and Miscellaneous Diseases， Yinshu refers to Jueyin. Wumeiwan， the primary prescription against Jueyin diseases， have the function of connecting Yin and Yang， and they can treat diseases caused by Qi disturbance of Jueyin and cold and heat in complexity. Sharing the same resource， the Secrets for Auxiliary Cultivation Life： The Essential Method of Using Herbal Medicine for the Differential Treatment of the Five Zang Organs （《辅行诀五脏用药法要》） and Treatise on Cold Damage and Miscellaneous Diseases both consult Models of the Classic of Decoction （《汤液经方》）. The formulation rules of tonic/purgative and collapse-saving prescriptions in Secrets for Auxiliary Cultivation Life follow the recorded "Tang Ye Jing Fa Tu" （an image revealing the compatibility principles of Chinese herbal drugs） and are closely related to the five elements theory. By exploring the formulation rules in "Tang Ye Jing Fa Tu" and the five elements of drugs， this study analyzed Wumeiwan and proved that Wumeiwan mainly acted on the liver， spleen， and heart. According to the Five Zang-organs Storing Spirit theory from Huangdi's Internal Classic， the above three organs are closely related to emotional adjustment. Therefore， the treatment of emotional disorders caused by qi disturbance of Jueyin and cold and heat in complexity with Wumeiwan is supported by evidence. At the end of this article， the reports on the treatment of emotional disorders with Wumeiwan in recent years were listed and reviewed. This article provides new ideas for the clinical application of Wumeiwan in the treatment of emotional disorders and expands the application range.

Mammography has played an essential role in the screening and treatment of breast cancer. However, the application of X-rays will also increase the risks of breast cancer while improving its detection rate. Moreover, the risks will increase with an increase in the radiation dose. Since the glandular tissue in breasts is sensitive to radiation, the evaluation of the average glandular dose (AGD) in mammography has attracted considerable international attention. Compared to relatively mature dosimetric studies on traditional two-dimension mammography and digital breast tomosynthesis, the method for the dose evaluation of the new cone beam CT for breasts are still subjected to research. This paper reviews and explores the current status of studies on the assessment method and relevant influencing factors of AGD under different types of mammography equipment.

Objective To establish a method to characterize the size and density of the female breast based on three-dimensional images of breast cone-beam computed tomography (CBCT), and describe the breast characteristics of women in a region of China, and to explore its value in dosimetric assessment for breast CBCT examinees. Methods We retrospectively surveyed the breast CBCT images of 203 women in a grade A tertiary hospital in a southwestern city of China from January 2021 to March 2023. The effective diameter of the breast at the chest-wall (D_eff), chest wall-to-nipple length (CNL), the effective diameter of the breast at half of CNL (D_h/2), breast volume (BV), glandular volume (GV), and volumetric breast density (VBD) were measured using the specific tools of the Koning Imaging Viewer system. The differences between groups were assessed using the Kruskal-Wallis H test. The correlation between variables was assessed using the Spearman’s correlation coefficient. Results The median values of D_eff, D_h/2, CNL, BV, GV, and VBD of the surveyed population were 11.9 cm, 8.3 cm, 6.5 cm, 327.7 cm³, 47.0 cm³, and 15.4%, respectively. GV and VBD had significant negative correlations with age. D_eff, D_h/2, CNL, and BV were significantly negatively correlated with VBD. Conclusion We established a quantitative method to analyze female breast characteristics based on three-dimensional breast CBCT images, and preliminarily characterized the female breast in a region of China, which can provide methodological support for the investigation of female breast characteristics in various regions of China in the future.

Objective To preliminarily compare ⁶LiF-⁷LiF and CR39 in individual neutron dose monitoring, and to provide a reference for improving individual neutron dose monitoring. Methods According to the GBZ 128-2019, 26 radiation workers from 7 institutions received individual neutron dose monitoring with ⁶LiF-⁷LiF and CR39 at the same time. The monitoring results were analyzed. Results For most of the workers, the personal neutron dose equivalent H_p(10) was less than the minimum detectable level. The results with the two monitoring methods differed in 6 of 26 workers. Conclusion Both ⁶LiF-⁷LiF and CR39 monitoring methods can be used for individual neutron dose monitoring for radiation workers, but the difference between ⁶LiF-⁷LiF and CR39 (in threshold energy, energy response, etc.) should be considered so that different types of radiation workers receive appropriate individual neutron dose monitoring.

With the extensive use of neutron sources in industry, medicine, and scientific research, the number of people exposed to neutron has been increasing, which highlights the importance of personal neutron dose monitoring in the field of radiation protection. In the past decades, researchers have developed and improved a variety of techniques and methods for personal neutron dose monitoring. This paper focuses on the problems and research progress of track dosimeters (solid-state nuclear track dosimeters and fluorescent nuclear track dosimeters), luminescent dosimeters (thermoluminescent dosimeters and optically stimulated luminescent dosimeters), and bubble dosimeters in personal neutron dose monitoring.

Objective To compare the surgical results of cholesteatoma of external auditory canal under the otoscope and the microscope.Methods Clinical data of 44 patients with cholesteatoma from January 2015 to December 2019 were analyzed retrospectively.According to the operation mode,the patients were divided into observation group and control group.The cholesteatoma in the observation group was cleaned under the otoscope,and the cholesteatoma in the control group was cleaned under the microscope.The clinical effects of the two groups were compared.Results The patients in both groups were cured and their hearing was improved in different degrees.Compared with the control group,the difference of speech frequency hearing threshold between the observation group and the control group was statistically significant(t = 19.71,t = 13.41,P＜0.05).The operation time of the observation group was short than that of the control group,and the local discomfort of the observation group was lighter than that of the control group after operation,which was statistically significant(t =-3.68,t =-2.44,P＜0.05).All the patients were followed up for 6 months with dry ears and no recurrence.Conclusion Endoscopic treatment of cholesteatoma of external auditory canal is simple and effective,which is worthy of clinical application.

Objective:To summarize and analyze the results of the individual dose intercomparison in which province-level health institutions participating, and explore the role of ability intercomparison in improving the detection capabilities of province-level health institutions.Methods:From 2009 to 2022, the results obtained by the province-level CDCs and occupational prevention and control institutions in the individual dose intercomparison countrywide for time periods of 2009—2020 and 2021—2022 were summarized. The intercomparison results were analyzed and compared for three regions of east, central and west China divided according to the method from China Health Statistics Yearbook 2022.Results:A total of 24 province-level CDCs and 14 occupational prevention and control institutions countrywide participated in the ability intercomparison from 2009—2022 for 13 times. Number of participating institutions increased from 26 in 2009 to 37 in 2022. The qualified rates of the intercomparison results among the province-level health institutions in the three regions were maintained at higher than 85% for 37 times and 100% for 28 times. The pass rate and excellent rate of the three regions were higher than the overall level at whole country level (2009-2020) and national level (2021-2022) in the same period for 9 and 5 times, respectively. The excellent rate of province-level health institutions in central region were higher than that of the other two regions in 9 intercomparisons.Conclusions:With the improvement of the intercomparison standard, the province-level health institutions in various regions have maintained a relatively stable and high detection capability. The ability intercomparison effectively improve the detection ability and the quality control of the province-level health organizations. Many province-level agencies have listed the ability intercomparison as the regular work.