OBJECTIVE To establish a scientific， systematic， multi-dimensional performance management system for pharmacy practice， so as to improve the efficiency and quality of pharmacy practice performance management in public hospitals. METHODS Based on the four dimensions of the balanced scorecard theory， finance， customer， internal process， learning and growth， reference indicators for pharmacy practice performance management were summarized. The Delphi method was used to screen indicators， and the analytic hierarchy process was applied to determine the weights of indicators. A pharmacy practice performance management system was then constructed. Based on this system， action plans were formulated and implemented. The effectiveness was evaluated from two aspects： customer reviews and changes in pharmacy practice outcomes. RESULTS A total of 28 reference indicators were summarized， and a performance management system for pharmacy practice was constructed， consisting of 4 primary indicators， 9 secondary indicators， and 20 tertiary indicators. Compared with action plans implementation before， the satisfaction of clinical departments was significantly improved， and 11 pharmacy practice performance management indicators were optimized after implementation. CONCLUSIONS A scientific and systematic performance management system for pharmacy practice has been successfully established， which can provide a reference for the innovation of hospital pharmacy practice management and the high quality development of pharmacy practice.

Objective To investigate the protective effect of dapagliflozin on kidney and the expression of AMP-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)signaling pathway in diabetic nephropathy(DN)rats.Methods A total of 40 SPF Wistar male rats were randomly divided into normal group,model group,low-dose group and high-dose group,with 10 rats in each group.After the DN model was successfully prepared,the rats in normal group were given normal diet + normal saline by gavage,the rats in model group was given high sugar and high fat feed + normal saline by gavage,the rats in low-dose group was given high sugar and high fat feed+1mg/(kg·d)of dapagliflozin by gavage,the rats in high-dose group was given high sugar and high fat feed+10mg/(kg·d)of dapagliflozin by gavage.Rats in each group were continuously gavaged for 12 weeks.Renal function indexes,renal pathological changes,p-AMPK and p-mTOR protein expression,collagen type Ⅰ(COL Ⅰ),collagen type Ⅳ(COL Ⅳ)and fibronectin(FN)of all groups were compared.Results Blood urea nitrogen(BUN),serum creatinine(SCr),24h urinary protein quantity,p-mTOR protein expression,COL Ⅰ,COL Ⅳ and FN levels of rats in model group,low-dose group and high-dose group were significantly higher than those in normal group,and p-AMPK protein expression was significantly lower than that of normal group(P<0.05).BUN,SCr,24h urinary protein quantity,p-mTOR protein expression,COL Ⅰ,COL Ⅳ and FN levels of rats in low-dose group and high-dose group were significantly lower than those in model group,while p-AMPK protein expression was significantly higher than that in model group(P<0.05).BUN,SCr,24h urinary protein quantity,p-mTOR protein expression,COL Ⅰ,COL Ⅳ and FN levels in high-dose group were significantly lower than those in low-dose group,and p-AMPK protein expression was significantly higher than that in low-dose group(P<0.05).Conclusion Dapagliflozin has a good kidney protection effect on DN rats,and its mechanism may be related to the regulation of AMPK/mTOR signaling pathway.

Objective To conduct a scoping review of studies on the use of virtual reality(VR)in cancer-related cognitive impairment(CRCI),and to generalize and summarize the current state of the art of VR use in CRCI.Methods The computerized retrieval of PubMed,Embase,Web of Science,the Cochrane Library,WanFang Data,CNKI and VIP databases was carried out.Studies were collected from the database establishment to July 2023.3 researchers independently screened the literature,extracted data,and evaluated the risk of bias in the included studies.Results A total of 9 studies were included.VR was used for CRCI assessment and intervention.The assessment included visual and auditory memory,executive function and verbal fluency.The intervention content involved common cognitive impairment dimensions of CRCI,including memory,executive ability,attention,information processing speed and language fluency.The intervention frequency ranged from 3 to 5 times/week,15 to 60 min/time,and the duration was 2 to 8 weeks.The intervention frequency and intensity were dynamically adjusted based on the patient performance,game type and complexity.VR has shown good validity and benefits in CRCI assessments and interventions,while improving patients'sleep quality and ability to perform daily living,with higher patient acceptance and no VR related adverse events being reported,but its role in improving mental health remains controversial.Conclusion VR shows good validity and benefits in CRCI assessment and intervention,and has good safety and high acceptance.In the future,it is still necessary to conduct large-sample,randomized controlled studies,attach importance to the role of patient needs in the formulation of VR cognitive intervention programs,and increase CRCI-related objective indicators to further verify the effect of VR intervention on CRCI.At the same time,longitudinal evaluation and follow-up programs may be considered to determine progressive changes in CRCI from VR interventions.

Humans ; Parkinson Disease/diagnosis* ; Machine Learning

Objective:To explore the association of induced abortion with subsequent stillbirth.Methods:The data collected from the National Free Pre-Pregnancy Health Examination Project in Yunnan Province between 2010 and 2017 were used in this analysis. Information on women's background characteristics, pregnant history, disease history, physical examination, etc. were recorded. After their pre-pregnancy health examination, women were routinely followed up and any pregnancies and pregnancy outcomes were recorded. By using SPSS20.0 and SAS9.4 software, we employed description analysis, Chi-square tests, stratified analysis and multivariate logistic regression for data analysis.Results:A total of 174 782 pregnancies were included in this analysis, and the total incidence rate of stillbirths was 0.64% (1119/174 782). The incidence rate of stillbirths in the group of women who had a previous history of induced abortion (exposed group) was 0.83% (333/40 216), which was significantly higher than 0.58% (786/134 566) in the non-induced abortion group (unexposed group). Results of unconditional multivariate logistic regression analysis demonstrated that, compared with unexposed group, the risk of stillbirth in exposed group was higher in those with 1 and 2 or more induced abortions ( OR=1.22, 95% CI=1.05-1.41; OR=1.33, 95% CI=1.08-1.64). The risk of stillbirth was significant lower in women who conceived in 2011-2016 than in 2010 ( OR=0.66, 95% CI=0.51-0.85). Mother's ethnicity, age, education level, parity and body mass index (BMI) before pregnancy were significantly associated with the risk of stillbirth. Women's occupation, previous histories of premature birth, stillbirth and natural abortion were not associated with subsequent stillbirth. Conclusion:Induced abortion is associated with an increase of the risk of subsequent stillbirth. Mother's ethnicity, age, education level, parity and BMI are significantly associated with the risk of stillbirth. Overweight and obesity before pregnancy increase the risk of stillbirth.

Objective:To explore the association of induced abortion with subsequent stillbirth.Methods:The data collected from the National Free Pre-Pregnancy Health Examination Project in Yunnan Province between 2010 and 2017 were used in this analysis. Information on women's background characteristics, pregnant history, disease history, physical examination, etc. were recorded. After their pre-pregnancy health examination, women were routinely followed up and any pregnancies and pregnancy outcomes were recorded. By using SPSS20.0 and SAS9.4 software, we employed description analysis, Chi-square tests, stratified analysis and multivariate logistic regression for data analysis.Results:A total of 174 782 pregnancies were included in this analysis, and the total incidence rate of stillbirths was 0.64% (1119/174 782). The incidence rate of stillbirths in the group of women who had a previous history of induced abortion (exposed group) was 0.83% (333/40 216), which was significantly higher than 0.58% (786/134 566) in the non-induced abortion group (unexposed group). Results of unconditional multivariate logistic regression analysis demonstrated that, compared with unexposed group, the risk of stillbirth in exposed group was higher in those with 1 and 2 or more induced abortions ( OR=1.22, 95% CI=1.05-1.41; OR=1.33, 95% CI=1.08-1.64). The risk of stillbirth was significant lower in women who conceived in 2011-2016 than in 2010 ( OR=0.66, 95% CI=0.51-0.85). Mother's ethnicity, age, education level, parity and body mass index (BMI) before pregnancy were significantly associated with the risk of stillbirth. Women's occupation, previous histories of premature birth, stillbirth and natural abortion were not associated with subsequent stillbirth. Conclusion:Induced abortion is associated with an increase of the risk of subsequent stillbirth. Mother's ethnicity, age, education level, parity and BMI are significantly associated with the risk of stillbirth. Overweight and obesity before pregnancy increase the risk of stillbirth.

Flood disaster is one of the most serious natural disasters in the world, and it could pose an inestimable impact on the affected people. Based on existing laws, regulations, and emergency manuals in China, extensive literature review, epidemiological and related protection evidence, and expert consultation, this study analyzed different health risk factors of flood disaster and proposed a multi-stage, multi-population, and multi-phase comprehensive protection measures for the public in the perspective of pre-event prevention, in-event intervention and post-event rescue strategy, which could provide a scientific basis for improving the level of public health protection against the flood disaster and corresponding health outcomes.

Objective To systematically evaluate maternal perinatal complications and neonatal outcomes after in vitro fertili zation and embryo transplantation(IVF-ET).Methods The computer retrieval was performed on the databases of PubMed,Cochrane library,EMbase,CNKI,Wanfang and Chinese biomedical literature database.The articles on the comparison between IVF and natural pregnancy were included.The RevMan5.3 software was adopted to conduct the meta analysis.Results Twenty-three articles conforming to the requirements were included,including 1 312 651 cases,among them 113 044 cases were IVF and 1 199 607 cases were naturalpregnancy.IVF mother's age was larger than that of natural pregnancy,while the gestational weeks were smaller than those of natural pregnancy,the newborn birth weight was lighter than that of natural pregnancy(P＜0.05);the probability of pregnancy-induced hypertension (PIH),placenta previa,postpartum hemorrhage and gestational diabetes mellitus (GDM) occurrence in IVF mother were higher than that of natural pregnancy (P＜0.05);the rate of multiple and cesarean section in IVF mothers were higher than that of natural pregnancy (P＜0.05);the occurrence rates of small for gestational age(SGA),low birth weight infants,stillbirth and premature in IVF were higher than those of natural pregnancy (P＜0.05).Conclusion The maternal perinatal complications in IVF are higher than those of natural pregnancy,and the birth outcomes in IVF are worse than those of natural pregnancy.

Objective To investigate the current status of job satisfaction,stressful events and self-efficacy among nurses in cancer hospital,and explore correlation among job satisfaction,stressful events and self-efficacy.Methods Totally 260 nurses from Zhejiang Cancer Hospital were inquired by Minnesota satisfaction questionnaire,inventory of stressful events,and general self-efficacy scale.Descriptive analysis and Pearson correlation analysis were adopted to analyze the data.Results A total of 260 questionnaires were given out,while 246 valid questionnaires returned,and the effective rate was 94.6％.The total average scores of job satisfaction,stressful events and self-efficacy were (3.41 ± 0.45),(117.72 ± 18.92) and (2.50 ± 0.44).There was a significant negative correlation between overall satisfaction and stressful event (r =-0.458,P＜0.001).However,satisfaction were positively correlated with self-efficacy (r =0.257,P =0.020).Conclusions Job satisfaction among nurses of cancer hospital is higher than data of previous studies,but the overall self-efficacy is still low,and most of them is in the middle-high stressful events.Managers can improve nurses' job satisfaction by reducing occupational stress and increasing self-efficacy.That might reduce dimission rate,and maintain the stability of care team.

Objective To study the clinical effect and application value of micro-plasma beam joint radiofrequency treatment for the striae of pregnancy.Methods 21 female patients with the striae of pregnancy were included in this study,treated from the July 2012 to March 2014,aged 25-37 years;and time of the striae was from 3 months to 7 years.Micro-plasma radiofrequency technology was used to treat the striae,with interval of 30 days each time for total seven months.The total effective rate,satisfaction,and the adverse reaction were evaluated after the treatment.Results 21 patients included grade 4 in 6 cases,grade 6 in 10 cases,grade 2 in 4 cases and grade 1 in 1 case;the total effective rate was 95.2％ (20/21).Satisfactory degree was for the level C in 6 cases,B in 14 cases,and A in 1 case,with total satisfactory rate of 95.2％ (20/21).Adverse reactions included mild pigmentation in 2 patients after scab skin falling off,and disappeared at the end of the treatment course.Conclusions Micro-plasma beam combined with radio frequency in treating the striae of pregnancy has clear curative effect and good clinical application value.