OBJECTIVE To explore the transformation of the dispensing and drug pickup process in traditional Chinese medicine pharmacy （TCM Pharmacy） in our hospital based on data-intelligence-driven， aiming to improve pharmacists’ work efficiency and patients’ drug pickup experience. METHODS Value stream mapping and journey mapping were used to systematically identify non-value-added links in pharmacists’ dispensing process and key pain points in patients’ drug pickup under the traditional process. An intelligent dispensing and drug pickup system for the TCM Pharmacy was developed based on the C# and Android television platforms， and a machine-learning model was adopted to predict patients’ drug pickup waiting time. A comprehensive evaluation was performed from three perspectives： system performance， prediction accuracy， and satisfaction of pharmacists and patients. RESULTS The system successfully streamlined non-value-added links such as “waiting for writing on the board” and “searching for drugs”， and realized multimodal dynamic prompts of dispensing status through auditory （number calling） and visual （television terminal） channels. The constructed model for predicting drug pickup waiting time exhibited good fitting degree and generalization ability （mean absolute error＝4.28 min， R 2 ＝0.882）. The comprehensive satisfaction scores of pharmacists and patients in the traditional mode were significantly increased from （70.99±1.74） and （73.58±1.98） to （90.02±1.30） and （88.61±2.08） in the new system， respectively （ P ＜0.01）. CONCLUSIONS The transformation of the intelligent drug dispensing and pickup system for TCM pharmacy based on data-intelligence-driven effectively improves the efficiency of pharmacists’ dispensing work， realizes process transparency and waiting time predictability， and significantly enhances patients’ drug pickup experience.

Objective To evaluate the impact of integrated medical and nursing care teaching ward rounds on the theo-retical knowledge learning and clinical operational skill training of primary-level medical staff.Methods A total of 90 clinical healthcare workers(39 physicians and 51 nurses)from our hospital between May and December2024 were randomly assigned to either a control group or an intervention group.The control group participated in traditional three-tier nursing teaching ward rounds,while the intervention group underwent integrated medical and nursing care teaching ward rounds.The two groups were compared in terms of improvements in theoretical knowledge,ward round operational skills,and core clinical competencies.Re-sults Both groups demonstrated improvements in theoretical knowledge and ward round operational skills after the intervention,with the intervention group showing significantly greater gains(P＜0.05).Additionally,scores related to physical fitness,emo-tional well-being,and cognitive function improved in both groups,with significantly higher improvements in the intervention group(P＜0.05).The Clinical Nursing Skills(CINS)scores—including judgment,early warning,anticipatory thinking,and overall clinical competence—also improved significantly in the intervention group compared to the control group(P＜0.05).Conclu-sion Integrated medical and nursing care teaching ward rounds significantly enhance theoretical knowledge,operational profi-ciency,and core clinical competencies among primary healthcare providers.This model fosters higher professional engagement and helps cultivate qualified primary-level medical personnel who are better equipped to meet real-world clinical demands.

Purpose To investigate the value of peritumoral expansion-based radiomics from tumor regions of interest(ROIs)for predicting epidermal growth factor receptor(EGFR)mutation status and to identify the optimal peritumoral expansion margin.Materials and Methods This retrospective study included 390 patients with pathologically confirmed non-small cell lung cancer(NSCLC)and definitive EGFR genotyping results from the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University(December 2021 to September 2023).Patients were randomly divided into training and validation sets(8∶2 ratio,310 vs.80 patients;CT slice thickness:5-7 mm).An additional independent test set of 100 patients undergoing thin-section CT(1-2 mm)was included to assess model generalizability across slice thicknesses.Clinical characteristics and CT semantic features were analyzed.After automated tumor segmentation with manual refinement,ROIs were sequentially expanded outward by 1,2,3,4 and 5 mm.A total of 2 264 radiomic features were extracted from each ROI.Feature selection using minimum redundancy maximum relevance and least absolute shrinkage and selection operator algorithms was performed in the training set to calculate radiomics scores.Logistic regression was used to develop prediction models.A combined model integrating optimal peritumoral radiomics score with clinical and CT features was established,with performance compared across models.Results Gender(χ2=24.922,P<0.001),smoking history(χ2=11.199,P=0.001),emphysema(χ2=40.802,P<0.001),and lymph node metastasis(χ2=5.674,P=0.017)were associated with EGFR mutation status.In the validation set,the area under the curve for the tumor ROI-based radiomics model was 0.676,while the five expansion models achieved area under the curve of 0.723,0.720,0.734,0.681,and 0.598,respectively.The combined model based on 3 mm expansion demonstrated superior performance to individual radiomics and clinical models,with area under the curve of 0.826,0.734,0.711 in the validation set,and 0.809,0.760,0.702 in the independent test set.Conclusion Peritumoral expansion-based CT radiomics demonstrates value for predicting EGFR mutations in NSCLC,with 3 mm identified as the optimal expansion margin.Integration with clinical information further enhances predictive accuracy.

Purpose To investigate the value of peritumoral expansion-based radiomics from tumor regions of interest(ROIs)for predicting epidermal growth factor receptor(EGFR)mutation status and to identify the optimal peritumoral expansion margin.Materials and Methods This retrospective study included 390 patients with pathologically confirmed non-small cell lung cancer(NSCLC)and definitive EGFR genotyping results from the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University(December 2021 to September 2023).Patients were randomly divided into training and validation sets(8∶2 ratio,310 vs.80 patients;CT slice thickness:5-7 mm).An additional independent test set of 100 patients undergoing thin-section CT(1-2 mm)was included to assess model generalizability across slice thicknesses.Clinical characteristics and CT semantic features were analyzed.After automated tumor segmentation with manual refinement,ROIs were sequentially expanded outward by 1,2,3,4 and 5 mm.A total of 2 264 radiomic features were extracted from each ROI.Feature selection using minimum redundancy maximum relevance and least absolute shrinkage and selection operator algorithms was performed in the training set to calculate radiomics scores.Logistic regression was used to develop prediction models.A combined model integrating optimal peritumoral radiomics score with clinical and CT features was established,with performance compared across models.Results Gender(χ2=24.922,P<0.001),smoking history(χ2=11.199,P=0.001),emphysema(χ2=40.802,P<0.001),and lymph node metastasis(χ2=5.674,P=0.017)were associated with EGFR mutation status.In the validation set,the area under the curve for the tumor ROI-based radiomics model was 0.676,while the five expansion models achieved area under the curve of 0.723,0.720,0.734,0.681,and 0.598,respectively.The combined model based on 3 mm expansion demonstrated superior performance to individual radiomics and clinical models,with area under the curve of 0.826,0.734,0.711 in the validation set,and 0.809,0.760,0.702 in the independent test set.Conclusion Peritumoral expansion-based CT radiomics demonstrates value for predicting EGFR mutations in NSCLC,with 3 mm identified as the optimal expansion margin.Integration with clinical information further enhances predictive accuracy.

Objective To investigate the correlation between early clinical outcomes following endoscopic surgery for unilateral lumbar disc herniation and variations in the cross-sectional area of the sciatic nerve.Methods Fifty-two patients(n=52)with unilateral lumbar disc herniation were recruited from June 2023 to June 2024 at the Pain Department of the First Affiliated Hospital of Nanchang University.The cross-sectional area(CSA)values of bilateral sciatic nerves were measured at the gluteal sciatic tuberosity-great femoral rotor level using ultrasound before and on the 4th day after surgery.The change in nerve cross-sectional area ΔCSA and sciatic nerve swelling rate(SR-SN)were calculated.Patient BMI(Body Mass Index),visual analog scale(VAS),Japanese Orthopaedic Association score(JOA),Oswestry Disability Index(ODI),and Treatment Improvement Rate(TIR)were collected preoperatively and on postoperative day 4.Changes in sciatic nerve cross-sectional area in unilateral lumbar disc herniation and its relationship to clinical outcomes were analyzed using the scoring scales as controls.Results Compared to the preoperative period,there was a significant decrease in VAS and ODI scores,as well as an increase in JOA score on the 4th postoperative day(P<0.01).Furthermore,surgical intervention led to substantial improve-ment in clinical outcomes for the patients.Prior to surgery,the CSA value of the affected side of the sciatic nerve was greater than that of the healthy side(P<0.01).Although CSA value decreased on the affected side after surgery,it remained higher than that of the healthy side(P<0.01).Additionally,there was a significant difference between SR-SN values on both sides with higher values observed on the affected side(P<0.01).Notably,△CSA on the affected side exhibited a negative correlation with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05);The SR-SN on the affected side exhibited a positive correlation with BMI and negative correlations with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05).However,no significant correlations were observed between △CSA,SR-SN,and ODI score on the affected side.(P>0.05).Conclusions In patients undergoing endoscopic surgery for lumbar disc herniation,a greater change in the cross-sectional area of the affected sciatic nerve before and after the operation is associated with more pronounced improvement in early symptoms.However,further investigation is required to explore the relationship between this change and recovery of both lumbar spine and lower limb function.

Objective To evaluate the impact of integrated medical and nursing care teaching ward rounds on the theo-retical knowledge learning and clinical operational skill training of primary-level medical staff.Methods A total of 90 clinical healthcare workers(39 physicians and 51 nurses)from our hospital between May and December2024 were randomly assigned to either a control group or an intervention group.The control group participated in traditional three-tier nursing teaching ward rounds,while the intervention group underwent integrated medical and nursing care teaching ward rounds.The two groups were compared in terms of improvements in theoretical knowledge,ward round operational skills,and core clinical competencies.Re-sults Both groups demonstrated improvements in theoretical knowledge and ward round operational skills after the intervention,with the intervention group showing significantly greater gains(P＜0.05).Additionally,scores related to physical fitness,emo-tional well-being,and cognitive function improved in both groups,with significantly higher improvements in the intervention group(P＜0.05).The Clinical Nursing Skills(CINS)scores—including judgment,early warning,anticipatory thinking,and overall clinical competence—also improved significantly in the intervention group compared to the control group(P＜0.05).Conclu-sion Integrated medical and nursing care teaching ward rounds significantly enhance theoretical knowledge,operational profi-ciency,and core clinical competencies among primary healthcare providers.This model fosters higher professional engagement and helps cultivate qualified primary-level medical personnel who are better equipped to meet real-world clinical demands.

Objective To investigate the correlation between early clinical outcomes following endoscopic surgery for unilateral lumbar disc herniation and variations in the cross-sectional area of the sciatic nerve.Methods Fifty-two patients(n=52)with unilateral lumbar disc herniation were recruited from June 2023 to June 2024 at the Pain Department of the First Affiliated Hospital of Nanchang University.The cross-sectional area(CSA)values of bilateral sciatic nerves were measured at the gluteal sciatic tuberosity-great femoral rotor level using ultrasound before and on the 4th day after surgery.The change in nerve cross-sectional area ΔCSA and sciatic nerve swelling rate(SR-SN)were calculated.Patient BMI(Body Mass Index),visual analog scale(VAS),Japanese Orthopaedic Association score(JOA),Oswestry Disability Index(ODI),and Treatment Improvement Rate(TIR)were collected preoperatively and on postoperative day 4.Changes in sciatic nerve cross-sectional area in unilateral lumbar disc herniation and its relationship to clinical outcomes were analyzed using the scoring scales as controls.Results Compared to the preoperative period,there was a significant decrease in VAS and ODI scores,as well as an increase in JOA score on the 4th postoperative day(P<0.01).Furthermore,surgical intervention led to substantial improve-ment in clinical outcomes for the patients.Prior to surgery,the CSA value of the affected side of the sciatic nerve was greater than that of the healthy side(P<0.01).Although CSA value decreased on the affected side after surgery,it remained higher than that of the healthy side(P<0.01).Additionally,there was a significant difference between SR-SN values on both sides with higher values observed on the affected side(P<0.01).Notably,△CSA on the affected side exhibited a negative correlation with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05);The SR-SN on the affected side exhibited a positive correlation with BMI and negative correlations with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05).However,no significant correlations were observed between △CSA,SR-SN,and ODI score on the affected side.(P>0.05).Conclusions In patients undergoing endoscopic surgery for lumbar disc herniation,a greater change in the cross-sectional area of the affected sciatic nerve before and after the operation is associated with more pronounced improvement in early symptoms.However,further investigation is required to explore the relationship between this change and recovery of both lumbar spine and lower limb function.

Objective:To construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited small vessel disease, manifesting as recurrent ischaemic events, migraine with aura and cognitive decline. Multiple sclerosis (MS) is an autoimmune disease characterized by white matter demyelination in the central nervous system, and positive oligoclonal band is an important diagnostic basis for this disease. There are many similarities between the two diseases in clinical manifestations and imaging, which are easy to cause misdiagnosis. A case of CADASIL confirmed by genetic testing more than 10 years after the initial diagnosis of MS with a positive oligoclonal band is reported. The analysis of this case is conducted to improve the new understanding of the inflammatory pathogenesis of CADASIL and increase the level of disease diagnosis and treatment.