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Objective:To analyze the nursing efficiency of clinical departments in general hospitals under the background of medical insurance payment reform, and to explore the methods of rational allocation of resources and improvement of service efficiency.Methods:The relevant data of Qingdao Municipal Hospital from January to December 2020 were selected. The nursing efficiency of 20 clinical departments in the hospital was evaluated by data envelopment analysis (DEA) and Malmquist index. The input indexes were the number of nurses, the number of hours, the number of open beds. The output indicators were number of discharges, average length of stay, and case mix index.Results:In 2020, the average comprehensive efficiency, pure technical efficiency and scale efficiency of 20 clinical departments in the hospital were 0.845, 0.913 and 0.923, respectively.The total factor production efficiency index of the hospital from February to April, from May to September and from October to November were all greater than 1, but the total factor production efficiency index from January to December was less than 1. There were 5 departments with total factor production efficiency index greater than 1.Conclusions:The comprehensive nursing efficiency of clinical departments needs to be improved, and diagnosis related groups (DRG) poses a more severe challenge to the efficiency management of internal medicine nursing. The COVID-19 epidemic has a great impact on the efficiency of nursing services.It is feasible to evaluate the nursing efficiency with DEA model and DRG related indicators.Combined with the disease characteristics and nursing work characteristics of patients admitted to the department, the deep causes should be explored, comprehensive measures should be taken to improve nursing efficiency, precise nursing service transformation based on the reform of medical insurance payment mode should be explored, Internet + nursing service should be promoted, and the improvement of nursing resource efficiency under the status of normal epidemic prevention and control should be paid attention to.
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Objective:To identify human infection with Brucella suis, analyze its biological and molecular characteristics, and to provide basis for prevention and control of brucellosis. Methods:Brucella suis strains were isolated from the body of the first case of human Brucella suis infection in Jiangsu Province. Serum agglutination test was used for serotyping. The specific gene bcsp-31 of Brucella was detected by PCR. AMOS-PCR was used to identify IS-711. The species and biotypes were identified by multiplex PCR. The wboA gene products were sequenced and phylogenetic tree was constructed. Multilocus sequence analysis (MLSA) was used for molecular typing, and cluster analysis was performed with reference strains. Results:The strain was confirmed to be Brucella suis biotype 3 by serum agglutination test and PCR. After sequencing the wboA gene, cluster analysis of the reference sequence showed that the wboA gene was closest to the biotype 3 strain Brucella suis str. 686 (CP007719). MLSA was typed into ST17(1-6-4-1-5-3-5-2-4). Conclusions:Brucella suis biotype 3 is reported in Jiangsu Province for the first time. The MLSA type is ST17. In the future, the prevention and control of human brucellosis should be carried out. We should actively cooperate with the animal husbandry and veterinary department to increase the quarantine, immunization and other control measures.
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Objective To investigate the relationship between MRI signal,pathological changes and neurological function after sciatic nerve injury in rabbits.Methods Twenty New Zealand white rabbits were randomly and evenly divided into 5 groups,and the right sciatic nerve crush models were established.T2 fat suppression fast recovery spin echo (T2 fs FRFSE) sequence scanning was performed 3 days,7 days,2 weeks,3 weeks and 4 weeks after injury,and TE was set as 30,60 and 90 ms,respectively.Signal intensity ratio (SIR) and relative signal intensity (△S) of proximal and distal part of injured nerve and control side nerve were measured.The relationship between SIR,△S,pathology and rabbit lower limb nerve function were analyzed.Results In the distal part of injured nerve,SIR and △S increased 3-7 days after injury,pathological results showed vacuolar degeneration,and basic toe function lost was found.SIR and △S reached the peak 2 weeks after injury,with most serious disintegration of myelin and toe function disable.SIR,△S and toe function disable gradually recovered,and the nerve regenerated at 3-4 weeks after injury.The injure display rate of T2 fs FRFSE images with TE=90 and 60 ms,SIR of both distal and proximal part of injured nerve were higher than those on images with TE=30 ms (all P＜0.05).Conclusion SIR and △S changes on T2 fs FRFSE imaging can be used to predict rabbit nerve injury.
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Objective To study the MR performances of finger joints with health subjects and rheumatoid arthritis (RA)patients,and to detect the imaging quality of a custom-made finger coil.Methods Finger coil,extremity coil,flexible surface coil and 3 inch surface coil were used to scan the self-made water phantom with similar T2 WI sequence,then the signal to noise ratio (SNR)on single image was measured for the comparison.The middle finger specimen (1 finger)was used for the research,5 healthy volunteers (8 fingers)and 18 RA patients (22 fingers)were also scanned.Results The SNR of finger coil was over 1.5 times higher than that of the 3 inch surface coil and 4 times higher than that of the extremity coil and flexible surface coil.For the 22 fingers with confirmed RA,synovitis was found in 1 7,joint effusion in 10,bone marrow edema in 5,bone erosion in 7 and tenosynovitis in 6.Conclusion The finger coil has higher SNR.
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Objective To investigate the effect of MR imaging in rats with series coil. Methods MR scanning was performed on the self-made aqueous solution phantom with the series coil and other three coils respectively, using the same FRFSE- XL pulse sequence. SNR of the same image was obtained in the same position slice for all four coils. Twelve SD rats were divided into three model groups and one normal group. FRFSE-XL FSPGR and Probe-SI pulse sequence were respectively used to show the brain injury,1H-MRS, spinal cord injury (SCI) and abdomen with series coils. Results The SNR of series coil (39. 7)was over six times higher than the SNR of knee joint coil (6. 41 ), which was the best in other three coils.Grey matter and white matte; the brain structure and hematomas were clearly depicted in the rats'brain on T1WI and T2WI. From the second week after injection of 6-OHDA into the rats brain, the ratio of NAA/Cr decreased (before injection 1.24 ,two weeks after injection 0. 781 ). The spinal cord and the configuration of the white matter were clearly showed on T2WI image, and the location and degree of SCI in the rat thoracic spinal cord were also well defined on T2 WI image. The pulse sequence of FSPGR T1 WI was used for rat abdomen scanning. The scan time was only eight seconds. It is helpful to overcome the breathing movement effect and show the structure of rat abdomen. Conclusion It provided a good means for the rat MR in vivo to make use of 3.0T MR combined with series coils.
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Objective To control the quality of Shujin Jiegu tablets by determining the content of dracorhodin in the preparation by HPLC.Method With dracorhodin as index,the content of dracorhodin in the preparation was determined by HPLC.Results Dracorhodin showed a good linear relationship in the range of 1.53～7.66 ?g,r =0.999 9.The average recovery was 98.64%,RSD=1.12%.Conclusion This method is simple,rapid,repeatable,and applicable to the quality control of the preparation.
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The parallel imaging technology of MRI is the latest technique emerging in the last few years, which is based on the phased array coil. SMASH procedure operates by simultaneously acquiring linear combination signals with different spatial sensitivities from the phased array coils to reduce the phase encoding and shorten the imaging time. SENSE procedure operates by increasing the pace when sampling is performed in k-space, which proves a speedup by reducing the number of encoding steps. When the phased array coil designed, such problems have to be taken into account as resonant frequency, impedance match, mutual impedance and et al.