Objective To preliminarily describe the current situation of chronic disease drug continuity between community hospitals and the Affiliated Hospital of Qingdao University in the medical alliance,to explore the key points for further improving the connection between upper and lower-level hospitals in the medical alliance,and to improve the drug supply guarantee and the ability of pharmaceutical services of primary medical institutions.Methods The nine community hospitals within the medical alliance centered on the Affiliated Hospital of Qingdao University were taken as the research subjects to investigate the medication continuity between the community hospitals and the core hospital in terms of cardiovascular diseases,diabetes,and respiratory system diseases before and after the medical alliance.Results Before the integration of medical alliances,the drug linkage rate for cardiovascular diseases,diabetes,and respiratory system diseases in community hospitals and core hospitals was relatively low.After the integration of medical alliances,the average drug linkage rate for the three chronic diseases significantly increased,all exceeding 60%.At the same time,the drug catalog in community hospitals was streamlined,reducing the phenomenon of one drug having multiple specifications.There is a significant difference in the number of drug varieties provided by different community hospitals for the three chronic diseases.Conclusion The medical alliance with the Affiliated Hospital of Qingdao University as the core promotes the up-down linkage of drug treatment in community hospitals,simplifies the drug catalog of primary medical structure,and facilitates the treatment and prescription of chronic patients.

Objective:To explore the application effect of nurse-led navigation service in the economic toxicity management of prostate cancer patients, and to provide reference for the economic toxicity management of prostate cancer patients.Methods:By using the method of historical control study, 60 patients with prostate cancer admitted to Beijing Friendship Hospital, Capital Medical University were selected as the research subjects by convenience sampling from March to August 2023. According to the time sequence of admission, 30 patients admitted from March to May 2023 were included in the control group, and 30 patients admitted from June to August 2023 were included in the intervention group. The control group was given routine nursing, and the intervention group was given nurse-led navigation service. The patients were evaluated at admission, discharge and 3 months after discharge using the Comprehensive Scores for Financial Toxicity Based on the Patient-Reported Outcome Measures and the Compliance Behavior Questionnaire.Results:The age of the control group patients was ( 70.07 ± 5.76 ) years, and the age of the intervention group was ( 68.80 ± 7.22 ) years. The economic toxicity scores of the intervention group at discharge and 3 months after discharge were ( 35.13 ± 4.84 ) and ( 37.90 ± 4.89 ), respectively, which were higher than those of the control group ( 21.70 ± 2.52 ) and ( 21.33 ± 2.94 ), the differences were statistically significant ( t=-13.48, -15.89, both P<0.05 ). The complete compliance rate of the control group was 46.67 % (14/30), which was lower than 73.33% (22/30) of the intervention group, and the difference between the two groups was statistically significant ( χ2=4.44, P<0.05). Conclusions:Nurse-led navigation services can effectively monitor and evaluate the level of economic toxicity in patients with prostate cancer, reduce the degree of economic toxicity in patients with prostate cancer, help improve patients′ compliance behavior, and help patients cope with economic toxicity in a positive way.

Objective To preliminarily describe the current situation of chronic disease drug continuity between community hospitals and the Affiliated Hospital of Qingdao University in the medical alliance,to explore the key points for further improving the connection between upper and lower-level hospitals in the medical alliance,and to improve the drug supply guarantee and the ability of pharmaceutical services of primary medical institutions.Methods The nine community hospitals within the medical alliance centered on the Affiliated Hospital of Qingdao University were taken as the research subjects to investigate the medication continuity between the community hospitals and the core hospital in terms of cardiovascular diseases,diabetes,and respiratory system diseases before and after the medical alliance.Results Before the integration of medical alliances,the drug linkage rate for cardiovascular diseases,diabetes,and respiratory system diseases in community hospitals and core hospitals was relatively low.After the integration of medical alliances,the average drug linkage rate for the three chronic diseases significantly increased,all exceeding 60%.At the same time,the drug catalog in community hospitals was streamlined,reducing the phenomenon of one drug having multiple specifications.There is a significant difference in the number of drug varieties provided by different community hospitals for the three chronic diseases.Conclusion The medical alliance with the Affiliated Hospital of Qingdao University as the core promotes the up-down linkage of drug treatment in community hospitals,simplifies the drug catalog of primary medical structure,and facilitates the treatment and prescription of chronic patients.

Objective:To explore the application effect of nurse-led navigation service in the economic toxicity management of prostate cancer patients, and to provide reference for the economic toxicity management of prostate cancer patients.Methods:By using the method of historical control study, 60 patients with prostate cancer admitted to Beijing Friendship Hospital, Capital Medical University were selected as the research subjects by convenience sampling from March to August 2023. According to the time sequence of admission, 30 patients admitted from March to May 2023 were included in the control group, and 30 patients admitted from June to August 2023 were included in the intervention group. The control group was given routine nursing, and the intervention group was given nurse-led navigation service. The patients were evaluated at admission, discharge and 3 months after discharge using the Comprehensive Scores for Financial Toxicity Based on the Patient-Reported Outcome Measures and the Compliance Behavior Questionnaire.Results:The age of the control group patients was ( 70.07 ± 5.76 ) years, and the age of the intervention group was ( 68.80 ± 7.22 ) years. The economic toxicity scores of the intervention group at discharge and 3 months after discharge were ( 35.13 ± 4.84 ) and ( 37.90 ± 4.89 ), respectively, which were higher than those of the control group ( 21.70 ± 2.52 ) and ( 21.33 ± 2.94 ), the differences were statistically significant ( t=-13.48, -15.89, both P<0.05 ). The complete compliance rate of the control group was 46.67 % (14/30), which was lower than 73.33% (22/30) of the intervention group, and the difference between the two groups was statistically significant ( χ2=4.44, P<0.05). Conclusions:Nurse-led navigation services can effectively monitor and evaluate the level of economic toxicity in patients with prostate cancer, reduce the degree of economic toxicity in patients with prostate cancer, help improve patients′ compliance behavior, and help patients cope with economic toxicity in a positive way.

In recent years, driven by the support of national policies and societal needs for employments, talents in biology majors have been growing rapidly. To foster high-calibre biology talents for the society in the context of the "double world-class initiative" in higher education, this study analyzed the opinion of biology undergraduates in Huzhou University on employment and their professional recognition of biology majors. The aim of this study was to propose a high-quality employments-driven talent training mode for undergraduates in biology majors, so as to serve as a reference for the reform in training modes of other relevant majors.
Humans ; Universities ; Students ; Biology/education*

Objective To analyze the impact of canceling drug price markup policy on hospitalization expenses of urban public hospitals in Sichuan province and provide decision-making basis. Methods Data of hospitalization expenses of the top 50 diseases among inpatients discharged in 2016 and 2017 were collected, totaling 2 732 022 inpatient cases. Based on hospitalization expenses, these disease were divided into seven categories ( A-G) using dynamic clustering analysis, which represent respectively dominant diseases of different expense makeups, to compare such indicators as hospitalization expenses and composition ratios of these diseases before (2016) and after the reform (2017). Results The study found drastic changes among the medical expenses of different categories of dominant diseases. For example, per-hospitalization cost of categories E ( featuring high drug and examination expenses ) and G ( featuring balanced expenses distribution) diseases decreased since the reform, while the other categories rose instead. The proportion of drugs of different disease categories decreased to various extents. For example, category A ( high drug ratio of 5.60% ) and category E (5.15% ) diseases of which were found with the sharpest drop. Proportion of service expenses, on the other hand, rose to different extents. For example, the proportion of service expenses of all disease categories increased to varying degrees, among which category E (3.46% ), category F (3.37% ) and category D (3.36% ) accounted for the largest share of increase.Conclusions The reform is moving the cost structure of dominant diseases in Sichuan towards a rational level, yet with significant differences among disease categories. The authorities should target various categories to adjust their reimbursement policies, minimize financial burden on patients, strengthen their supervision on drug use and medical behavior, prevent such misbehaviors as the inducing demands and transferring drug markups.

Objective To explore the applicable conditions for using urine plutonium monitoring data to assess personal internal doses,in order to provide references for the occupational health management and the urine plutonium monitoring in nuclear sector.Methods Using some plutonium mixtures from DOE nuclear facilities,as an example,the urine plutonium levels were estimated through simulation calculation at 1 mSv effective dose arising from either acute or chronic inhalation of plutonium compounds,respectively.The results were compared with the typical detection limit of radiochemical separation and α-spectrometry.The feasibility of urine plutonium monitoring for dose assessment of internal radiation exposure was discussed.Results Only for type M plutonium compunds,1 mSv detection limit can be achieved using radiochemical separation and α-spectrometry within 10 d after inhalation.Conclusions Before the monitoring plan of urine plutonium is made,detection limits of monitoring method should be considered.Internal dose could be accessed using workplace air monitoring and working hours when necessary.

Objective To evaluate the performance of medical services of 18 tertiary hospitals in Sichuan province in 2016 based on DRGs, to identify objective methods to evaluate service quality and performance of medical institutions.Methods Based on the homepage data of inpatient medical records from 18 tertiary hospitals in Sichuan in 2016, using diagnosis-related groups as a risk-adjustment tool, the study evaluated the medical service quality and performance from three dimensions:medical ability,service efficiency and medical Quality.Results In the evaluation of medical service capacity, hospital I had the highest number of discharged cases and total weight(83 405 cases and 126 522.22),and hospital G had the lowest discharge cases and total weight(2 350 cases,2 797.12).The highest number of DRGs group was from hospital B(661 groups),and the lowest from hospital G(43 groups).The highest value of CMI was from hospital F(2.091),and the lowest from hospital D(0.953).Hospitals B,I and P had wide disease type range,while hospitals F, B and I had higher overall technical level than the other hospitals.Of the service efficiency evaluation,hospital E had the lowest time consumption index(0.740),and hospital P had the lowest expenditure index(1.073).Of the service quality evaluation,hospitals F and G had the lowest risk of mortality and the lower risk of mortality(0.00%,0.00%).Hospital I had the highest total score (100.0 points), and hospital G had the lowest total score(51.1 points).Conclusions DRGs based evaluation on medical service quality and performance of medical institutions can ensure reliability and scientific adequacy of evaluation.It may contribute to the continuous improvement of medical quality, and provide data support and decision reference for medical service supervision.

OBJECTIVETo analyze a child with facial abnormalities with combined cytogenetic and molecular techniques and delineate its clinical phenotype.

METHODSNeuropsychological profile of the child was analyzed. Color Doppler, CT and MRI were used for detecting the nodules in the body. Conventional peripheral blood karyotypes of the child and his parents were analyzed with G-banding. Array-comparative genomic hybridization (aCGH) was performed to detect minor structural chromosomal abnormalities.

RESULTSThe child had mental retardation, maxillofacial dysmorphism on the right side, and irregular solid nodules on the back. The karyotypes of the child and his parents were all normal, while aCGH has identified a de novo constitutive 1.2 Mb deletion at 17q11.2 in the child. The aCGH results of his parents were normal.

CONCLUSIONThe de novo 17q11.2 microdeletion probably underlies the facial abnormalities and neurofibromatosis in the patient.

Child, Preschool ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 17 ; genetics ; Comparative Genomic Hybridization ; Humans ; Intellectual Disability ; genetics ; Karyotyping ; Male ; Maxillofacial Abnormalities ; genetics ; Phenotype ; Smith-Magenis Syndrome ; genetics

Objective To explore methods to develop a hospital quality of care index system of county level hospitals based on the homepage of inpatient medical records and examine the validity of this system. Methods By means of literature review, homepage data and panel discussion, along with theories and statistical methods, indexes were identified. The dimensions and indices of the index system were pinpointed. Confirmatory factor analysis and normalization methods were combined to calculate the weights and scores of such indices. Scores were adjusted by Charlson comorbidity index ( CCI) with multi-regression method. The hospitals were ranked by adjusted scores in each dimension. The validity was evaluated by comparing the application results to universally acknowledged standards, such as hospital level and economic level of the geographic areas. Results An index system with 6 dimensions and 25 indices was developed, and the application results proved valid to some extent. The adjustment of CCI also proved effective. The 6 dimensions were correlated yet their directions were not consistent. Conclusions The methods and data used to develop the system have demonstrated strong operability and availability. The application results can reflect medical care quality in different aspects making it applicable among homogeneous hospitals. It is meaningful to assess dimensions respectively.