OBJECTIVE To address the management challenges encountered by inpatient pharmacy of our hospital in undertaking “internet-based medicine delivery” （IMD） services， and to improve service efficiency and medication safety. METHODS SWOT analysis method was applied to systematically examine both internal and external factors， formulate comprehensive management strategies， and restructure the service processes. Process optimization included： establishing a closed-loop process for dispensing and returning drugs based on the drug traceability codes； unifying the drug inventory of the inpatient pharmacy with that of IMD， optimizing the management of storage locations； improving the inventory management function of the hospital information system， and adjusting the inventory counting plan and shift scheduling rules. The indicators of the inpatient pharmacy， including inventory structure， dispensing efficiency， inventory checks accuracy rate， the rationality rate of prescription， and consistency rate of human-machine review， were compared before and after the implementation of the strategies to evaluate the implementation effects. RESULTS After implementation， the structure of the drug inventory was significantly optimized. The proportion of drugs approaching their expiration dates decreased by 35.55%， the proportion of unsold drugs decreased by 64.52%， and the proportion of drugs that had been accumulated for more than 4 weeks decreased by 33.26%. The speed of prescription dispensing increased by 34.92%， and the daily drug requisition time was shortened by 62.03%. The accuracy rate of inventory checks rose from 86.33% to 90.33%， while the rationality rate of prescriptions and the consistency rate of human-machine review rose from 86.00% and 89.33% to 95.00% and 97.00% respectively. Furthermore， the launch of the drug traceability system reduced external dispensing errors from 4 to 1. CONCLUSIONS The comprehensive management strategy based on SWOT analysis can effectively improve the quality of drug management in the inpatient pharmacy and the operational efficiency of IMD， ensuring timely and safe medication for patients.

Objective To investigate the expression level of fibroblast activation protein(FAP)in esophageal squamous cell carcinoma(ESCC)and its prognostic implications,and to further explore the role of FAP expression in cancer-associated fibro-blasts(CAFs)in driving the malignant progression of ESCC.Methods The expression levels of FAP in tumor and adjacent tis-sues of 31 types of tumors were assessed by utilizing the TCGA database,followed by an analysis of its influence on the progno-sis of ESCC.Fresh tumor and normal tissue samples were acquired from ESCC patients in high-incidence regions for extracting and purifying primary CAFs and normal fibroblasts(NFs).Phenotypic identification and functional analyses were conducted via qRT-PCR,Western blot,and immunofluorescence.Supernatants from NFs,CAFs,and CAFs treated with the FAP inhibitor(FAPi)were collected to establish an in vitro co-culture model with KYSE150 cells.The impact of differential FAP expression levels on the malignant progression of KYSE150 cells,encompassing proliferation,invasion,and migration were assessed by u-sing EdU assay,CCK-8 assay,colony formation assay,Transwell assay,and scratch assay.The in vivo expression of FAP in CAFs was detected in a subcutaneous tumor model of esophageal cancer in mice to elucidate its role in the malignant progression of ESCC.Results In 10 types of malignant tumors,including ESCC,the expression of FAP was markedly elevated in tumor tissues compared to adjacent non-tumorous tissues.Moreover,elevated FAP expression in ESCC was associated with a poor prognosis and may serve as an independent prognostic risk factor for ESCC patients.Primary CAFs and NFs were effectively isolated from ESCC tumor and adjacent tissues,and their phenotypic characteristics were precisely characterized.The results of co-culture experiments indicated that,in comparison to NFs and untreated cells,CAFs with elevated FAP expression markedly enhanced the proliferation,invasion,and migration of KYSE150 cells.Conversely,FAPi treatment significantly suppressed these malignant behaviors.In vivo experiments had demonstra-ted that the deactivation treatment of FAPi and CAFs exerted a significant inhibitory effect on tumor growth in tumor-bearing mice.Conclusion In ESCC,the high expression of FAP is positively correlated with the activation of CAFs and the poor prognosis of patients,thereby promoting the malignant progression of the tumor.

Objective To investigate the expression level of fibroblast activation protein(FAP)in esophageal squamous cell carcinoma(ESCC)and its prognostic implications,and to further explore the role of FAP expression in cancer-associated fibro-blasts(CAFs)in driving the malignant progression of ESCC.Methods The expression levels of FAP in tumor and adjacent tis-sues of 31 types of tumors were assessed by utilizing the TCGA database,followed by an analysis of its influence on the progno-sis of ESCC.Fresh tumor and normal tissue samples were acquired from ESCC patients in high-incidence regions for extracting and purifying primary CAFs and normal fibroblasts(NFs).Phenotypic identification and functional analyses were conducted via qRT-PCR,Western blot,and immunofluorescence.Supernatants from NFs,CAFs,and CAFs treated with the FAP inhibitor(FAPi)were collected to establish an in vitro co-culture model with KYSE150 cells.The impact of differential FAP expression levels on the malignant progression of KYSE150 cells,encompassing proliferation,invasion,and migration were assessed by u-sing EdU assay,CCK-8 assay,colony formation assay,Transwell assay,and scratch assay.The in vivo expression of FAP in CAFs was detected in a subcutaneous tumor model of esophageal cancer in mice to elucidate its role in the malignant progression of ESCC.Results In 10 types of malignant tumors,including ESCC,the expression of FAP was markedly elevated in tumor tissues compared to adjacent non-tumorous tissues.Moreover,elevated FAP expression in ESCC was associated with a poor prognosis and may serve as an independent prognostic risk factor for ESCC patients.Primary CAFs and NFs were effectively isolated from ESCC tumor and adjacent tissues,and their phenotypic characteristics were precisely characterized.The results of co-culture experiments indicated that,in comparison to NFs and untreated cells,CAFs with elevated FAP expression markedly enhanced the proliferation,invasion,and migration of KYSE150 cells.Conversely,FAPi treatment significantly suppressed these malignant behaviors.In vivo experiments had demonstra-ted that the deactivation treatment of FAPi and CAFs exerted a significant inhibitory effect on tumor growth in tumor-bearing mice.Conclusion In ESCC,the high expression of FAP is positively correlated with the activation of CAFs and the poor prognosis of patients,thereby promoting the malignant progression of the tumor.

Objective:To explore the current situation of maternal childbirth readiness and analyze its influencing factors, providing a basis for improving maternal childbirth readiness.Methods:From March to July 2023, convenience sampling was used to select 355 pregnant women who visited Obstetrics Clinic in three Class Ⅲ Grade A hospitals in Chengde City, Hebei Province as participants. Participants were surveyed using the self-designed General Information Questionnaire, Childbirth Readiness Scale, Perceived Social Support Scale, Family APGAR Index, and Childbirth Self-efficacy Inventory 32. LASSO regression and random forest importance ranking were used to select characteristic variables, and multiple linear regression was combined to enhance interpretability, so as to explore the important factors affecting maternal childbirth readiness.Results:The total score of the Childbirth Readiness Scale for 355 pregnant women was (74.41±7.09), and the mean score of each item was (4.13±0.39). The random forest algorithm showed that when the lambda (λ) value was 0.167 7, the error was minimized, and the corresponding number of influencing factors was six. The top six independent variables in importance ranking were perceived social support, childbirth self-efficacy, gestational week, primiparous status, participation in maternity school, and place of residence. Multiple linear regression analysis showed that perceived social support, childbirth self-efficacy, whether primigravida, gestational week, and participation in maternity school were important influencing factors of maternal childbirth readiness ( P<0.05) . Conclusions:The childbirth readiness of pregnant women is above the middle level. Medical and nursing staff can start with factors that affect the childbirth readiness of pregnant women, adopt personalized nursing measures for pregnant women with different characteristics, and encourage family members to provide sufficient family support to improve the readiness of pregnant women for childbirth.

Objective:To explore the current situation of maternal childbirth readiness and analyze its influencing factors, providing a basis for improving maternal childbirth readiness.Methods:From March to July 2023, convenience sampling was used to select 355 pregnant women who visited Obstetrics Clinic in three Class Ⅲ Grade A hospitals in Chengde City, Hebei Province as participants. Participants were surveyed using the self-designed General Information Questionnaire, Childbirth Readiness Scale, Perceived Social Support Scale, Family APGAR Index, and Childbirth Self-efficacy Inventory 32. LASSO regression and random forest importance ranking were used to select characteristic variables, and multiple linear regression was combined to enhance interpretability, so as to explore the important factors affecting maternal childbirth readiness.Results:The total score of the Childbirth Readiness Scale for 355 pregnant women was (74.41±7.09), and the mean score of each item was (4.13±0.39). The random forest algorithm showed that when the lambda (λ) value was 0.167 7, the error was minimized, and the corresponding number of influencing factors was six. The top six independent variables in importance ranking were perceived social support, childbirth self-efficacy, gestational week, primiparous status, participation in maternity school, and place of residence. Multiple linear regression analysis showed that perceived social support, childbirth self-efficacy, whether primigravida, gestational week, and participation in maternity school were important influencing factors of maternal childbirth readiness ( P<0.05) . Conclusions:The childbirth readiness of pregnant women is above the middle level. Medical and nursing staff can start with factors that affect the childbirth readiness of pregnant women, adopt personalized nursing measures for pregnant women with different characteristics, and encourage family members to provide sufficient family support to improve the readiness of pregnant women for childbirth.

Objective:To observe any effect of supplementing conventional rehabilitation training with repeated transcranial magnetic stimulation (rTMS) in the treatment of lumbar disc herniation (LDH).Methods:Seventy-two LDH patients were randomly divided into an rTMS group ( n=24), a training group ( n=24), and a combined group ( n=24). The rTMS group received 2Hz rTMS at an intensity of 80% resting motor threshold with a total of 1000 pulses, the training group was given Mackenzie therapy and lumbar core muscle stability training, while the combined group was provided with both. Each group was treated once a day, 6 times a week for 8 weeks. The participants rated their pain using a visual analog scale (VAS), and the Oswestry dysfunction index (ODI) was also used to evaluate the degree of pain and dysfunction in all three groups before and right after the treatment, as well as 8 weeks later. After the treatment, its therapeutic effect was evaluated using the improved Macnab standard. Each patient was followed up for 12 months and any recurrence was recorded. Results:Before treatment there was no significant difference in average VAS ratings or ODI scores among the three groups. Afterward, pain and dysfunction were relieved significantly in all three groups. Compared with the rTMS group, the average VAS rating in the training group was significantly higher and the average ODI score was significantly lower after the treatment and during the follow-up. Moreover, the average VAS rating and ODI score of the combined group were significantly lower than those in the other two groups after the treatment and during follow-up. The total effectiveness rate in the rTMS group was assessed as 62.5% compared with 95.8% in the training group and 100% in the combined group-a significant difference for the rTMS group. Follow-up showed that the recurrence rates of the rTMS group, training group and combined group were 37.5%, 25% and 8.3%, respectively-a significant difference in the case of the combined group.Conclusion:rTMS combined with rehabilitation training can relieve pain, improve lumbar function and reduce the recurrence of LDH.