Objective To explore the application of Plan-Do-Check-Act(PDCA)cycle management to continuously im-prove the service quality of outpatient pharmacy and enhance patient satisfaction.Methods To address the problem of long wait-ing time for patients in outpatient pharmacy,we applied PDCA cycle to investigate the factors affecting patients'waiting time in the process of medicine collection,analyze the current situation,determine the expected goals,formulate the service quality im-provement plan of outpatient pharmacy,implement the improvement plan,follow up and supervise,and summarize and analyse the problems regularly until it was solved.Results After implementing the PDCA cycle in the management,the service quality of outpatient pharmacy was improved,the waiting time was significantly shortened and the satisfaction of medical treatment was in-creased.Conclusion The application of PDCA cycle method is effective in improving the service quality of outpatient pharmacy.Therefore,it is recommended for broader implementation.

With the widespread application of diving technology, the safety of long-term diving has become a research focus. Research on the chronic health effects of long-term diving on divers mainly focuses on the respiratory system, circulatory system, nervous system, skeletal system, urinary system, as well as psychological health and sleep. Long-term diving can lead to increased lung capacity, thickening of nasal mucosa, myocardial hypertrophy, changes in heart rhythm, and hearing loss in divers. The impact of long-term diving on health is influenced by diving exposure index such as diving mode, maximum diving depth, underwater stay time, diving frequency, and number of dives, as well as individual factors such as years of diving experience, age, and medical history of divers. However, research on the effects of diving on health are inconsistent, and the potential mechanisms of health damage are unclear. Future large-scale research should be conducted under strict experimental conditions and with standardized inclusion criteria for subjects. Establishing a scientific and systematic assessment method for decompression is crucial for studying the chronic health effects of divers and enhancing understanding of relevant mechanisms to promote the development of diving industry and sport.

Objective:Three-dimensional simulation modeling technology was used to conduct three-dimensional reconstruction, classification and measurement for the anatomic structures of colorectal canal, tumor and key blood vessels in patients with rectal cancer before operation. And the accuracy of the data and information obtained for the prediction of anastomotic tension, important types of vascular variant, positioning of anatomical landmarks, etc. in laparoscopic-assisted radical resection of rectal cancer, and the guiding effect of operation was evaluated.Methods:The clinical data of 50 patients with laparoscopic-assisted radical resection of rectal cancer treated in the General Surgery Department, Beijing Ditan Hospital Capital Medical University from January 2019 to February 2021 were analyzed retrospectively, including 31 males and 19 females, aged from 42 to 83 years old, with an average age of (62.72 ±15.21) years. The patients were divided into two groups according to whether the patients underwent three-dimensional simulation reconstruction before operation. The patients who underwent abdomen pelvic enhancement CT and further three-dimensional reconstruction before surgery were taken as reconstruction group ( n=24), and the patients who were only routinely performed abdomen pelvic enhancement CT before operation were taken as control group ( n=26). For the patients in the reconstruction group, the CT images were modeled by Mimics software before operation, and the key data such as the length of colorectal and tumor, the correlation length of rigid structure of pelvic wall, the length of inferior mesenteric artery (IMA) from the bifurcation point of left and right arteria iliaca communis, the type and proportion of IMA variation, the length of left colonic artery (LCA) from the beginning of IMA and the distance between LCA and IMV were measured, and the consistency correlation coefficient (CCC) was analyzed with the actual data obtained during operation. And then the accuracy of three-dimensional simulation modeling technology for surgical guidance was evaluated. MedCalc 19.0 software was used for statistical analysis. Results:In the reconstruction group, regarding the data of each dimension of the model (intestinal tract, pelvic cavity, blood vessels) and the corresponding structural measurements during the operation, the consistent correlation coefficient (CCC) evaluation was more than 0.9. One case was predicted to have free splenic flexure of colon and one case actually had free splenic flexure of colon. The prediction accuracy was 100%. The IMA variants in the reconstruction group were divided into 4 types, all of which were verified by operation. Compared with the control group, the operation time ( P=0.011) and the location time (IMA, P=0.043; LCA, P=0.007; IMV, P=0.034) of each vessel in the reconstruction group were shorter, and the amount of intraoperative blood loss was less ( P=0.017). Conclusion:The application of three-dimensional simulation modeling technology before operation is helpful for the operator to accurately predict the intraoperative anastomotic tension, the type of IMA variation and the related diameter length, based on which the accurate operation plan can be made to guide the operation.

Objective:To study the impact of anticoagulant therapy starting at different platelet levels on the incidences of portal vein thrombosis (PVT) after splenectomy and devascularization.Methods:From January 2014 to January 2017, 125 patients with liver cirrhosis and portal hypertension underwent splenectomy and pericardial devascularization in Beijing Ditan Hospital, Capital Medical University. All patients routinely received anticoagulant therapy. There were 85 patients who had a platelet count greater than >100×10 9/L (the study group) and 40 patients who had a platelet count greater than >300×10 9/L (the control group). The incidence of PVT was compared between the two groups. Results:A total of 125 patients were included in the study, including 91 males and 34 females, aged 20-59 years. Age, gender, preoperative platelet level, preoperative splenic vein and portal vein width, preoperative coagulation function, preoperative liver function (Child classification), preoperative esophageal and gastric varices, operation time, preoperative bleeding time, preoperative venous blood flow velocity, coagulation function 1 week and 2 weeks after operation between the two groups were not significantly different (all P>0.05). Of 125 patients undergoing splenectomy and pericardial devascularization, PVT was not found in all patients before operation. The incidence of PVT was 39.2% (49/125) within one month after operation. Among the 85 patients in the study group, 28 patients developed PVT, and the incidence of thrombosis was 32.9% (28/85). In the control group, 21 patients developed PVT, and the thrombosis rate was 52.5% (21/40). The difference was significant (χ 2=4.366, P=0.037). After anticoagulant therapy, the incidence of bleeding in the study group was 4.7% (4/85), and that in the control group was 5.0% (2/40), the difference was no significant ( P>0.05). Conclusion:Early anticoagulation (platelet >100×10 9/L) does not increase the risk of postoperative bleeding, but can reduce the incidence of PVT.

Objective:To study factors influencing postoperative pancreatic fistula rates with a view to prevent postoperation pancreatic fistula from happening.Methods:This is a retrospective study on 281 patients who underwent distal pancreatectomy at the First Affiliated Hospital of China Medical University from March 2011 to April 2018. There were 89 males and 192 females, with the age of (51.01±13.65) years. Univariate and multivariate logistic regression analyses were used to analyze the following factors on the occurrence of pancreatic fistula after operation: gender, age, body mass index(BMI), tumor characteristics, preoperative fasting blood glucose, blood biochemistry, liver function and surgical indications.Results:Of the 281 patients who underwent distal pancreatectomy in this study, 245 (87.2%) did not develop pancreatic fistula / biochemical leakage, while 36(12.8%) patients developed clinically significant pancreatic fistula (B/C grade). Univariate analysis showed the factors which affected the incidence of pancreatic fistula after surgery to include: BMI, preoperative fasting blood glucose, and whether the main pancreatic duct was ligated (all P<0.05). Multivariate logistic regression analysis showed that the independent factors affecting pancreatic fistula incidence after surgery were BMI≥25 kg/m 2 ( OR=2.354, 95% CI: 1.137-4.873, P<0.05), and main pancreatic duct was not ligated ( OR=4.067, 95% CI: 1.191-13.885, P<0.05). Conclusions:A high BMI increased the risk of postoperative pancreatic fistula, while ligation of main pancreatic duct during surgery reduced the risk.

The coronavirus disease 2019 (COVID-19) was confirmed by nucleic acid test in 15 juvenile patients aged 4-17 years in Hangzhou Xixi Hospital from January 24 to February 10, 2020. The clinical data and the initial chest high resolution CT (HRCT) findings were retrospectively analyzed.Among 15 cases, 8 patients with a mean age of (6.5±2.3) years (4-11 year) had normal HRCT manifestations (mild disease), while 7 patients with a mean age of (11.9±3.0) years (7-17 years) showed abnormal manifestations (moderate disease). In the 7 moderate cases the CT findings included local thickening of bronchial wall in 2 cases, single lesion in 1 case, bilateral pulmonary lesions in 4 cases. There were total 11 lesions, 6 of which were ground glass and slightly high-density nodules, 5 of which were speckled ground glass and 2 with a little consolidation. There were 10 subpleural lesions, including 7 in the lower lobe of the two lungs, and 1 non-subpleural lesion; the thickened local bronchioles were observed in 3 cases. None of them had hilum and mediastinal lymph node enlargement or pleural effusion.

Objective: To evaluate the clinical effect of Jinghua Weikang capsule in treating peptic ulcer with intermingled heat and cold syndrome. Methods: From January 2016 to December 2018, 90 patients of peptic ulcer with intermingled heat and cold syndrome in Changzhou Hospital of Traditional Chinese Medicine were divided into two groups by the random digital table method, with 45 cases in each group.The control group was treated with rabeprazole capsule, and the observation group were treated with rabeprazole capsule and Jinghua Weikang capsule.The gastroscopic performance, the main individual symptoms and TCM syndrome between the two groups were compared. Results: The gastroscopic performance[42 cases(93.3%) were clinical cured, 1 case(2.2%) was significantly improved, 1 case(2.2%) was improved], TCM syndrome effect[38 cases(84.4%) were clinical cured, 4 cases(8.9%) were significantly improved, 2 cases(4.4%) were improved] in the observation group were significantly better than those in the control group[the gastroscopic performance: 35 cases(77.8%) were clinical cured, 5 cases(11.1%) were significantly improved, 3 cases(6.7%) were improved], TCM syndrome effect: 28 cases(62.2%) were clinical cured, 6 cases(13.3%) were significantly improved, 8 cases(17.8%) were improved](Z=-2.040, -2.463, all P<0.05). The improvement of TCM symptoms of epigastric pain which could be relieved by warmth and pressure, dry mouth with bitter taste, cool limbs were significantly better than those in the control group(χ²=6.154, 6.056, 7.174, all P<0.05). Conclusion Jinghua Weikang capsule can accelerate the repair of gastric mucous of patients with intermingled heat and cold syndrome, improve clinical syndrome, especially these symptoms: stomacha which can be relieved by warmth and pressure, dry mouth with bitter taste, cool limbs.

Hair loss is a common problem encountered by both male and female in social life. A variety of systemic diseases, skin diseases, trauma, etc. can lead to hair loss, but androgenetic alopecia is its main cause. Hair loss can cause a series of influences, such as affecting one's self-esteem and emotional health. Healthy and beautiful hair is very important for a person's external image, and the external image can affect a person's work and life to some extent. Hair transplantation surgery has gradually evolved, and its surgical effect is remarkable. However, hair transplantation technology is still not perfect and still faces many challenges, including the supply of hair, the survival rate of the hair, the length of the operation and the concealment of marks after the operation. In this paper, the current status of hair transplant surgery and some important challenges and possible solutions were discussed.

Objective:To explore ways and methods for public mental health intervention during the COVID-19 epidemic.Methods:A comprehensive literature review was conducted. Mental healthcare publicity materials posted by over 100 Chinese hospitals in multiple media (till February 24, 2020) were also systematically collected and analyzed.Results:Firstly, anxiety and fear were the most common mental health problems among people during the epidemic. Secondly, to achieve better outcomes, mental health intervention should be provided according to the type of service clients. Thirdly, new media can facilitate the transmission of mental healthcare knowledge, but the limitation is that it can not approach older adults who have limited access to new media. It is therefore essential to strengthen the mental health knowledge transmission to older adults.Conclusions:Mental health intervention is effective when it is provided according to the type of service clients during the COVID-19 epidemic.