OBJECTIVE To provide references for medical institutions’ outpatient pharmacies to increase the scanning rate， scanning efficiency and scanning accuracy of drug traceability codes.METHODS A total of 4 157 unscanned traceability code records from the first two‑week period of June 2025 were selected from the outpatient pharmacy of our hospital. Pareto chart was adopted to analyze the reasons for unscanned codes， and the Objective-Rules-Training-Check-Culture （ORTCC） model was utilized to carry out fine management. The traceability code scanning rate， pharmacists’ work efficiency （number of prescriptions dispensed per pharmacist per hour， number of drug boxes dispensed per pharmacist per hour）， patients’ medication-waiting time and dispensing errors were compared among four periods： before scanning implementation （June 2024）， before management intervention （June 2025）， the first phase after management （September 2025）， and the second phase after management （December 2025）， so as to evaluate the management effects.RESULTS The traceability code scanning rates in the first phase and second phase after management were remarkably higher than those before management （ P ＜0.05）， and the scanning rate in the second phase after management was obviously higher than that in the first phase after management （ P ＜0.05）. Compared with the period before scanning implementation， the number of prescriptions dispensed per pharmacist per hour， the number of drug boxes dispensed per pharmacist per hour， decreased significantly and patients’ medication-waiting time prolonged markedly before management （ P ＜0.05）. In the second phase after management， both the number of prescriptions dispensed per pharmacist per hour and the number of drug boxes dispensed per pharmacist per hour increased significantly， and patients’ medication-waiting time shortened greatly in contrast with the status before management （ P ＜0.05）. Besides， no statistically significant differences were found in the number of drug boxes dispensed per pharmacist per hour and patients’ medication-waiting time between the second phase after management and the period before scanning implementation （ P ＞0.05）.After the implementation of traceability-code scanning management， dispensing errors presented a gradually declining trend in each stage.CONCLUSIONS The fine management system for outpatient drug traceability codes constructed based on Pareto chart and ORTCC model can improve the traceability code scanning rate and pharmacists’ work efficiency of outpatient pharmacies， and reduce drug dispensing errors.

Objective To explore the diagnostic value of magnetic resonance Fiesta sequence combined with MRCP for Mirizzi syndrome. Methods Retrospective analysis was carried out for 18 patients who received MR examination before surgery in our hospital from June 2010 to April 2014 and were diagnosed as Mirizzi syndrome by surgical pathology. Various signs of Mirizzi in Fiesta and MRCP were analyzed and compared with surgical results. Diagnostic accuracy was compared between the combined use of Fiesta and MRCP and the use of Fiesta or MRCP alone. Results Among 18 patients with Mirizzi, 15 were type Ⅰ and 3 were type II. Calculi in gallbladder neck or cystic duct could be seen in all the 18 patients, common bile duct under pressure could be seen in 16 patients and unclear Calot triangle structure could be seen in 11 patients. Accuracy of Fiesta combined with MRCP for the diagnosis of Mirizzi syndrome was sig-nificantly higher than that of Fiesta or MRCP alone, and the differences were statistically significant (P<0.05). It was highly consistent with the surgical results. Conclusion Fiesta combined with MRCP has relatively high value for pre-operative diagnosis of Mirizzi syndrome.

Objective To investigate the clinical value of coronary artery Z-scores on echocardiography in diagnosing coronary artery abnormalities. Methods The echocardiography results of 612 patients with Kawasaki disease (KD) at the acute and recovery phase were retrospectively studied. Coronary artery luminal diameters were converted to body-surface-area-adjusted Z-scores. According to coronary Z-scores classiifcation, all the subjects were divided to four groups:415 cases with no dilation (ND), 133 cases with small coronary artery abnormalities (SCAAs), 47 cases with large coronary artery abnormalities (LCAAs), and 17 cases with giant coronary artery abnormalities (GCAAs). Clinical features (gender, age, typical clinical manifestations, fever duration) and laboratory results (CRP, ESR, WBC, PLT) were compared among all the four groups. Coronary artery diameters and the Z-scores were compared between acute and convalescence phase. Results Along with the increase of coronary Z-score, fever duration was prolonged [ND group:(7.75±3.12) d, SCAAs group (8.50±4.12) d, LCAAs group: (8.57±3.58) d, GCAAs group: (11.88±4.33) d, F=22.375, P<0.05]. With coronary Z-score increasing, PLT also increased (F=22.029, P=0.000), and the highest PLT was observed in GCAAs group. There were no significant differences in the CRP, ESR and WBC among all the four groups (F=0.236, 1.116, 0.121, all P>0.05). No significant different coronary diameters were found in ND cases between recovery and acute phase [(2.24±0.34) mm vs (2.33±0.36) mm, t=1.926, P > 0.05]. But there were significant difference in the coronary Z-scores of ND patients between recovery and acute phase (0.41±0.82 vs 1.17±0.75, t=8.332, P < 0.05). The coronary Z-scores in SCAAs group (1.32±0.89 vs 3.40±0.62, t=11.073, P < 0.05), LCAAs group (3.12±2.27 vs 6.20±1.28, t=4.579, P<0.05) and GCAAs group (11.88±6.77 vs 20.4±9.70, t=3.480, P<0.05) at recovery phase were smaller than values at acute phase. Conclusions The KD coronary Z-scores are the body-surface-area-adjusted standard value, and not subject to the influence of children growth and development. Therefore, it may accurately evaluate the severity of coronary artery abnormalities and its recovery process. Accurate quantitative of the coronary artery luminal dimensions is important in KD clinical management and prognosis prediction.