A Survey on Current Activities and Issues of Pharmacists at Facilities Calculating Fees for the Implementation of Antimicrobial Stewardship in Ehime / 社会薬学

Although the fees for the implementation of antimicrobial stewardship (AS addition) were newly established in the 2018 revision of medical fees, more detailed activities and issues of pharmacists at facilities calculating AS addition have not been clarified so far. Therefore, to understand the current status of AS activities and problems, we conducted a questionnaire survey of facilities that calculate the additional fee for infection prevention measures 1 and investigated whether there are differences in AS activities between facilities where pharmacists are full-time employees and facilities where non-pharmacists are full-time employees. The results showed that the number of antimicrobial agents used by full-time pharmacists was larger than that by non-pharmacists. In addition, the frequency of AS was lower for non-full-time workers than for full-time workers, with most full-time workers performing AS every day, while non-full-time workers performing AS two to three days a week. In addition, non-full-time workers lacked human resources and work time, and did not have sufficient work materials. The survey revealed that AS activities’ current status and problems differ between full-time and non-full-time employees.

Status of snack behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To understand the current situation regarding snack food consumption among grade 4 and grade 5 primary school students in agricultural and pastoral areas of Qinghai Province, China, and to provide a scientific basis for nutrition education and intervention strategies.@*Methods@#Multistage stratified cluster random sampling was employed. The research included 969 fourth and fifth grade students were selected from 10 primary schools in four counties and districts of three cities in Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. The self report questionnaire method was used to investigate the current status regarding snack food consumption in this population.@*Results@#The proportion of students who consumed snack food at home, school and elsewhere were 98.2%, 88.5% and 75.4%, respectively. Male students reported a lower rate of snack consumption at school than female students ( χ 2=9.66). The fifth grade students reported a higher rate of snack consumption at home and other places than the fourth grade students ( χ 2=10.31, 6.77). The reported rate of snack consumption of students in the rural was higher than that in the county( χ 2=6.03,100.53, 24.77). The reported rate of snack consumption of boarding students at home was lower than that of non-boarding students ( χ 2=7.22), while the reported rate of snack consumption at school was higher than that of non-boarding students ( χ 2=9.04）（ P <0.01). The most popular snacks consumed at home included fruits and vegetables, cereals and nuts (76.9%, 67.2%, 63.7%), while the most popular snacks consumed at school were fruits and vegetables, cereals and candies (45.1%, 36.9%, 24.4%). The most popular snacks consumed in other settings included ice cream, candies and beverages(54.7%, 51.6%, 42.9%). The top three reasons for snacking were that snacks were regarded as delicious, healthy/nutritious and clean (76.9%, 65.5% and 59.0%, respectively).@*Conclusion@#Snacking is popular among students, although many snacks are unhealthy. Therefore, there is a need to improve food environments and nutrition education, so as to help students to choose healthy beverages and adopt healthy eating behaviors.

Analysis on the current situation of clinical blood fees exemption for blood donors and their family members in Henan / 中国输血杂志

【Objective】 To analyze the current situation of direct exemption of clinical blood fess for voluntary blood donors and their family members in Henan Province, in order to improve and fully implement the policy. 【Methods】 According to the policy on blood fees exemption issued by China and Henan Province in 2019,the data of hospitals in 18 prefecture-level cities in Henan from 2020 to 2021 were continuously collected from the system of clinical blood fees exemption,including the way of exemption,the number of people (times) of exemption,exemption amount, the proportion of blood fees exemption and the total exemption rate. The experience gained in the past two years after the implementation of the policy was summarized,and the existing problems and causes were analyzed. 【Results】 The rates of direct exemption of blood fees in Henan Province in 2020 and 2021 were 34.53% (8 709/25 221) and 71.68%(23 587/32 906) (P<0.05) ,respectively. In 2021, the direct exemption rate of blood fees in 18 cities was 6.20% (83/1 370) to 88.50% (1 332/1 505) [ (47.35±41.15)%],and increased month by month from 43.19% (1 183/2 507) in January to 83.15% (2 097/2 522) in August, then remained stable at a similar level to August from September to December, with 83.43% (2 744/3 289) in December as the highest for the year. 【Conclusion】 The implementation of the policy of blood fees exemption showed significant effectiveness, which has effectively promoted the development of voluntary blood donation in Henan. However, there is still room for improving the policy in some cities, which is expected to further increase the direct exemption rate of the city and the whole province.

Evaluation of the impact of clinical pathway on medical efficiency and medical expenses of patients with two rheumatoid immune disease based on DRG data / 中国医师杂志

Objective:To evaluate the effect of clinical pathway implementation on medical efficiency and medical expenses of patients with two common rheumatic immune diseases " rheumatoid arthritis" and " ankylosing spondylitis" diseases by using diagnosis related group (DRG) related indicators.Methods:The data of patients with two common rheumatic immune diseases " rheumatoid arthritis" and " ankylosing spondylitis" included in the clinical pathway management from January 2017 to December 2019 in the Department of Rheumatology and Immunology of Jinhua Hospital, Zhejiang University School of Medicine were carried out. The impact of clinical pathway implementation on the average hospital stay, average cost and average drug cost of patients with the two diseases were analyzed and compared , so as to evaluate the effect of the implementation of the clinical pathway.Results:From the implementation of clinical pathway in 2017 to 2019, the number of patients admitted and total medical specialty services in the two groups of " rheumatoid arthritis" and " ankylosing spondylitis" increased year by year ( P<0.01). The average length of stay, average cost and average drug cost of patients in the " rheumatoid arthritis" disease group decreased year by year, with statistically significant differences between groups (all P<0.01). The average length of stay in the ankylosing spondylitis group was shortened year by year, and the difference was statistically significant ( P<0.01). Compared with 2017, the average cost in 2018 decreased significantly, and the difference was statistically significant ( P<0.01). There was no significant difference in average cost between 2018 and 2019 ( P>0.05). The average cost in 2018 was significantly higher than that in 2017 ( P<0.05). After analyzing the causes and optimizing the clinical pathway, the average cost in 2019 was significantly lower than that in 2018 ( P<0.01). Conclusions:Through the implementation of clinical pathways and continuous optimization of pathway connotation during use, the diagnosis and treatment efficiency of patients with " rheumatoid arthritis" and " ankylosing spondylitis" can be significantly improved, and medical costs can be reduced, which is in line with the current medical reform needs.

Analysis of influencing factors of medical cost ratio of breast cancer cases treated with chemotherapy and molecular targeted therapy / 中华医院管理杂志

Objective:To understand the medical cost ratio and its influencing factors of breast cancer chemotherapy and molecular targeted therapy in a hospital, for reference for reasonable control of medical cost.Methods:The first page data of all breast cancer chemotherapy and molecular targeted therapy cases in a tertiary hospital from January to June 2021 were selected to extract the data of age, hospitalization expenses, hospitalization time, complications or complications. The influence of each index on the distribution of medical expense ratio was analyzed by single factor analysis and chi-square test was used for comparison between groups.Results:A total of 3 109 cases of chemotherapy and molecular targeted therapy for breast malignant tumors were included, of which very low-rate, low-rate, high-rate and very high-rate accounted for 7.04%(219 cases), 58.32%(1 813 cases), 30.81%(958 cases) and 3.83%(119 cases) respectively. In addition to the way of admission, there were significant differences in the distribution of medical cost rates under different ages, time consumption index, complications or concomitants, admission departments, treatment methods and medical insurance types( P<0.01). Conclusions:There were many factors affecting the medical cost rate of breast malignant tumors. Relevant departments should expand the pilot scope of DRG payment, promote the multi-disciplinary diagnosis and treatment mode of tumors, refine the DRG grouping scheme, to provide standardized and homogeneous diagnosis and treatment services for tumor patients, and reasonably control the excessive growth of medical costs.

Escuta clínica e o conto de fadas: relato de experiência no atendimento à criança institucionalizada / La escucha clínica y el cuento de hadas: relato de experiencia en el cuidado de niños institucionalizados / Clinical listening and the fairy tale: experience report in caring for institutionalized children / L'écoute clinique et le conte de fées: rapport d'expérience dans la prise en charge d'enfants institutionnalisés

A escuta clínica de crianças em contextos institucionais, como os serviços de acolhimento, tem suscitado debates no campo do Sistema Único de Assistência Social. Assim, o objetivo do presente estudo é relatar a experiência de atendimento à criança em acolhimento institucional. Reflete-se, pois, sobre a possibilidade da escuta clínica, a partir da utilização do conto de fadas como recurso terapêutico. Para tanto, apresenta-se fragmentos de um caso atendido, pela primeira autora, em uma instituição de acolhimento para crianças e adolescentes em um município do estado do Pará. Compreende-se que é possível a criação de espaços de falas, a partir de recursos favorecedores da expressão da criança (conto de fadas) em outros campos de atuação do psicólogo (acolhimento institucional), flexibilizando o enquadramento de atendimento na perspectiva da clínica psicanalítica e ampliada

La escucha clínica de los niños en contextos institucionales, como las guarderías, ha suscitado debates en el ámbito del Sistema Único de Asistencia Social. Así, el objetivo de este estudio es reportar la experiencia del cuidado de niños en instituciones de cuidado. Por tanto, reflexiona sobre la posibilidad de la escucha clínica, a partir del uso del cuento de hadas como recurso terapéutico. Por tanto, fragmentos de un caso atendido por el primer autor se presentan en un albergue para niños y adolescentes de un municipio del estado de Pará, favoreciendo la expresión del niño (cuento de hadas) en otros campos de trabajo del psicólogo (atención institucional), flexibilizando el encuadre del cuidado en la perspectiva de la clínica psicoanalítica y ampliada

The clinical listening of children in institutional contexts, such as childcare services, has raised debates in the field of the Unified Social Assistance System. Thus, the aim of this study is to report the experienceof caring for children in institutional care. Therefore, it reflects on the possibility of clinical listening, from the use of the fairy tale as a therapeutic resource. Therefore, fragments of a case attended by the first author are presented in a shelterfor children and adolescents in a municipality in the state of Pará. It's understood that it is possible to create spaces for speech, from resources that favor the child's expression (fairy tale) in other fields of activity of the psychologist (institutional care), making the framing of care in the perspective of psychoanalytic clinic and extended

L'écoute clinique des enfants dans des contextes institutionnels, tels que les services de garde d'enfants, a soulevé des débats dans le domaine du Système Unifié d'Assistance Sociale. Ainsi, le but de cette étude est de rapporter l'expérience de prise en charge d'enfants en institution. Dès lors, il réfléchit à la possibilité d'une écoute clinique, à partir de l'utilisation du conte de fées comme ressource thérapeutique. Par conséquent, des fragments d'un cas assisté par le premier auteur sont présentés dans un foyer pour enfants et adolescents dans une municipalité de l'État du Pará favorisant l'expression de l'enfant (conte de fées) dans d'autres domaines de travail du psychologue (soins institutionnels ), assouplir le cadrage des soins dans la perspective de la clinique psychanalytique et étendue

Public health emergencies in schools and economic loss in Luoyang from 2010 to 2019 / 中国学校卫生

Objective@#To analyze public health emergencies in schools and associated economic loss in Luoyang from 2010 to 2019, and to provide suggestions for developing evaluation mechanism for economic loss of public health emergencies in school settings.@*Methods@#Data of public health emergencies in schools during 2010-2019 in Luoyang was analyzed by descriptive epidemiological method; the integrity and logicality of the economic losses reports in emergencies were assessed; the overall economic losses of emergent events of public health in schools were evaluated.@*Results@#Among the 60 public health emergencies reported during 2010 to 2019 in Luoyang, 24 (40.00%) occurred in schools. Infectious diseases accounted for 91.67%(22). The peaks of public health emergencies were in May and December. Among the 24 public health emergencies, 50.00%(12) occurred in primary schools, with 386 (58.22%) cases. Nearly 75.00% (18/24) of public health emergencies in schools were reported, among them, reports with reasonable integrity accounted for 5.56% (1/18) and reports with logicality accounted for 38.89% (7/18). The highest integrity rate was found in disease prevention and control system (75.00%), while health supervision and law enforcement ranked the lowest (20.83%). According to the economic losses, the expense used for disease control and prevention was in front of the row(￥429 000), while the expense used for health supervision ranked at the bottom(￥20 800).@*Conclusion@#The reporting rate of economic losses of school public health emergencies in Luoyang is relatively high, but there is still a big gap in the integrality and logicality of the data. It is necessary to improve the standard of direct network reports of economic losses and to establish an effective evaluation mechanism for accurately responding to public health emergencies and evaluating economic losses.

Report on the Actual Condition of Homemade Pill Manufacturing / 日本東洋医学雑誌

A questionnaire survey was conducted on the actual state of manufacturing homemade pill preparations. Of the 14 facilities that responded, there were 4 pharmacies producing pills of only one type and 4 pharmacies producing more than 11 types. There were 7 facilities for handmade, manufacturing, 5 facilities for machinery manufacturing, and 2 facilities for handmade and/or machinery. The manufacturing process consists of about 9 steps, and it is possible to do it in 2-3 hours if considering just the time to make the pills, but it requires several days or more including preparation, machine cleaning, maintenance, etc. Based on the above, it seems that the current technical fees for pill manufacturing are extremely low.

Conduct responsible research to escape from predatory journals

@#Academics and researchers, willingly or unwillingly, continue to fall a “victim” to predatory journals. The entire cascade of moving forward in academia depends on one’s ability to publish papers - as many as possible and in the shortest possible time. Such a requirement for a “number” persuades an academician or a researcher to race for an increased number of papers rather than to ensure the quality of the papers they want to publish. Thanks, but no thanks to the predatory journals - for providing a comfortable avenue for those papers to get published. An effective way out could be to train the academics and create awareness among them to conduct research following the codes of responsible research. Policymakers may also need to consider adopting policies that will not force their academic and research staff to race against time and compromise the codes of responsible research.

Research updates of international strategies to control sugar-sweetened beverages consumption in children and adolescents / 中国学校卫生

Abstract@#Excessive intake of sugar-sweetened beverages among children and adolescents could increase the risks of adverse health outcomes, including dental caries and obesity. This study reviewed the consumption of sugar-sweetened beverages among children and adolescents in China and the international strategies to reduce the consumption of sugar-sweetened beverage. The aim of the study was to provide a reference for the introduction of relevant policies to control the intake of sugar-sweetened beverages in children and adolescents in China. In summary, measures including a tax on sugar-sweetened beverages, implementing front-of-pack labelling system, restricting marketing and publicity and education have been adopted to control the consumption of sugar-sweetened beverages in some countries, while public publicity and education have been adopted in China. It is suggested that comprehensive policies and measures should be adopted to control the intake of sugar-sweetened beverage among Chinese children.

Snack consumption and the influencing factors of students participation in the Nutrition Improvement Program for Rural Compulsory Education in 2019 / 中国学校卫生

Objective@#To evaluate snack consumption and the influencing factors associated with student participation in the Nutrition Improvement Program, and to provide a scientific basis for improving the program.@*Methods@#Among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns (i.e., school, company, and mix). This study randomly selected one or two classes from each grade, which ranged from grade 3 to grade 9. A questionnaire, which addressed snack consumption and choice, was distributed to 27 374 students.@*Results@#The findings revealed that 14.0% of students from poor rural areas in central and western regions consumed snacks two or more times per day, and 21.6% of students spent 3 yuan or more on snacks each day. The top three choices of snacks included fruit and vegetables (50.6%), biscuits and bread (50.1%), and puffed food (40.0%). Students who had mothers who worked outside the home, parents who worked outside the home, who consumed corporate meals, and who had access to a small shop on campus were more likely to consume snacks one or more times per day(OR=1.35，1.19，1.11，1.51，P<0.05).@*Conclusion@#The phenomenon of snack consumption among primary and middle school students from poor rural areas in central and western regions is common, and the selection of unhealthy snacks was identified as a problem. A health education system with comprehensive support and guidance from individuals, families, schools, and society should be established to guide students to opt for healthier snacks.

The Impact of Inflation on the Medical and Hospital Money Transfers of the Neurosurgical Procedures of the Brazilian Unified Healthcare System from 2008 to 2017

Introduction There are more than 1,500 hospital procedures included in the Brazilian Unified Healthcare System's (SUS, in the Portuguese acronym) table, which is the reference for service payment provided by establishments serving the public health network, and they are stagnant. The underfinancing of procedures is so dramatic that in some cases the amounts paid by the SUS are even lower than the taxes generated by the costs of the same procedures in Brazilian private hospitals. This article aims to compare the evolution of the compensation of neurosurgical procedures by calculating the percentile of the lag in the values transferred to both neurosurgeons and hospitals, according to the SUS table, establishing the ideal and real values according to the current inflation, in a retrospective 9-year comparison. Methodology This is an observational, comparative, retrospective study, based on the values of medical and hospital money transfers of 25 neurosurgical procedures in 2008, which were corrected according to the 2017 National Consumer Price Index (IPCA, in the Portuguese acronym). Results Through this study, from 2008 to 2017, the transfers of medical fees regarding neurosurgical techniques are almost completely outdated. As examples, we can mention: the external/subgaleal ventricular shunt, with a deficit of 43.6%; the electrode implant for brain stimulation, with - 41.67%; and decompressive craniotomy, with - 32.21% in relation to the corrected value. Only 4 of the 25 neurosurgeries present a value above that predicted by the IPCA, one of them being cerebral aneurysm embolization larger than 1.5 cm with a narrow neck (þ 8.0%). Regarding the money transfers to hospitals, all procedures are 43.6% lower than expected, since there was no readjustment in the amounts paid to the institutions in the analyzed period. For example, in 2008, for the transposition of the cubital nerve, R$ 267.30 were transferred, and the same amount was maintained in 2017; and, for the surgical treatment of compressive syndrome in osteofibrous tunnel at carpal level (R$ 145.18), the amount also remained fixed throughout these 9 years. Conclusion Because they did not follow the evolution of the economy, in 80% of the surgeries, the neurosurgeons did not have their economic demands met regarding the procedures performed through SUS. And the data became even more alarming when the money transfers to hospitals were evaluated, since there was no evolution in the money transfers for any of the neurosurgeries evaluated.

Psicoterapia: quanto custa a sessão? / Psychotherapy: how much should a session cost? / Psicoterapia: ¿cuanto cuesta la sesión? / Psychotherapy: how much should a session cost?

Esta pesquisa teve como objetivo conhecer as principais dificuldades enfrentadas pelos psicólogos no processo de estabelecimento dos seus honorários referente aos serviços de psicologia clínica na cidade de Caruaru/PE. Foi executada através de métodos qualitativos, sendo utilizada a entrevista semidirigida para coleta dos dados e na sistematização dos dados utilizamos a análise de conteúdo de Bardin. Participaram da pesquisa três psicólogas que residem e trabalham na cidade referida. Ficou evidente que as orientações sobre o estabelecimento dos honorários na prática clínica ou inexistiram ou foram inconsistentes; quando o assunto são as dificuldades enfrentadas ao estabelecer o valor da sessão percebemos certa ansiedade quando necessitam negociar o valor com o paciente devido à falta de instrução. Ao final, percebemos que as vivências práticas que facilitaram o manejo do dinheiro na relação, foram as trocas de experiência entre os colegas, a flexibilização do valor a partir da necessidade real do cliente e principalmente da forma de pagamento. Concluímos que se faz necessário sensibilizar as instituições de ensino de psicologia e seus professores para sistematizar discussões sobre o tema, apesar de compreendermos que não existe consenso sobre o assunto e que precisamos fomentar mais pesquisas nesta área para proporcionar um maior suporte teórico.

This research aimed to study the main difficulties faced by psychologists in the process of establishing their fees for clinical psychology services in the city of Caruaru / PE. It was performed using qualitative methods, using semi--directed interview for data collection and tabulation using Bardin content analysis. Three psychologists living and working in this city participated in the study. It became obvious that the guidelines on the establishment of fees in clinical practice either did not exist or were inconsistent when the subject faced difficulties in establishing the cost of the session. We perceived anxiety when negotiation with the patient was required and this was attributed to a lack of education. In the end, we realized that the practical experiences that facilitated the management of money in the relationship were the exchange of experience among colleagues, the flexibility needed due to client's financial issues and also payment format. We conclude that it is necessary to educate psychology teaching institutions and their teachers to systematize discussions about the subject although we understand that there is no consensus on the subject and we need to encourage more research in this area to provide greater theoretical support.

Esta investigación tuvo como objetivo conocer las principales dificultades enfrentadas por los psicólogos en el proceso de establecer sus honorarios rela-cionados con los servicios de psicología clínica en la ciudad de Caruaru / PE. Fue realizada a través de métodos cualitativos, siendo utilizada la entrevista semidirigida para la recolección de datos y en la sistematización de los datos se utilizó el análisis de contenido de Bardin. Participaron de la investigación tres psicólogas que residen y trabajan en la ciudad citada. Fue evidente que las orientaciones sobre el establecimiento de los honorarios en la practica clínica o no existieron o fueron inconsistente; cuando el asunto son las dificultades enfrentadas al establecer el valor de la sesión se notó cierta ansiedad cuando necesitan negociar el valor con el paciente debido a falta de instrucción. Al final, fue percibido que las vivencias practicas que facilitaron el manejo del dinero en la relación, fueron los intercambios de experiencia entre los colegas, la flexibilización del valor a partir de la necesidad real del cliente y principal-mente la forma de pagamento. Se concluyo que es necesario sensibilizar las instituciones de enseñanza de psicología y sus profesores para sistematizar discusiones sobre el tema, a pesar de comprender que no existe consenso sobre el asunto y que es necesario fomentar más investigaciones en esta área para proporcionar un soporte teórico mayor.

Discussion on Forensic Identification of the Rationality of Medical Expense / 法医学杂志

In cases on compensation for personal injury, the issue of medical expense compensation involves the vital interests of the compensation obligor, the injured party and the medical institution. The rationality of medical expenses is likely to be controversial, however, there is no unified standard and stipulation for the medical expense rationality identification in forensic clinical identification at present, therefore, in the practice of judicial expertise, expert opinions easily become confused, and the legitimate rights of the parties could be infringed, which affects the impartiality and authority of judicial expertise. This article starts with the concept of medical expense and the rationality of medical expense and the reasons for disputes over the rationality of medical expense, to put forward the basic principles that should be followed in the identification of rationality of medical expenses, for peer reference.

Estimated economic burden of disease of Norovirus gastroenteritis of schools in the Pearl River Delta Region / 中国学校卫生

Objective@#This study aims to estimate the economic burden of disease of outbreak of norovirus gastroenteritis in the Pearl River Delta Region, and provide scientific evidence for the government’s decision-making and control measures.@*Methods@#Using a unified questionnaire, a survey was conducted to the schools and students’ families which had suffered an outbreak of norovirus gastroenteritis in the Pearl River Delta Region from October 2017 to April 2018.@*Results@#The survey found that the mean total economic burden of sick students was 720.41(95%UI=640.45-804.63)RMB. The mean economic burden of sick students who were inpatient, outpatient and self-treatment were 1 712.75(95%UI=328.50-34 00.00), 213.70(95%UI=191.83-236.33) and 58.97(95%UI=43.00-77.69)RMB, respectively. The mean economic burden of transport, extra tutoring and cost of lost labor were 53.63(95%UI=43.98-63.58), 558.49(95%UI=381.40-774.01) and 695.62(95UI=630.25-767.29)RMB. The mean total economic burden of health students was 382.62(95%UI=343.29-424.45)RMB. The mean total economic burden of school was 49 264.53(95%UI=22 363.38-79 976.25)RMB. The total economic burden of disease increases as the level of outbreak increases. The larger the epidemic level, the proportion of sick students’ financial burden gradually decreased, 56.58%,23.27% and 10.93%.@*Conclusion@#The high economic burden of disease of norovirus gastroenteritis in the Pearl River Delta Region, respectively, indicating that relevant departments should strengthen the prevention, control and education in order to mitigate the disease economic burden.

Effect of partial rectal resection with transanal stapler in the treatment of rectum protrusion / 中国基层医药

Objective To investigate the clinical effect of transanal stapler partial rectal resection for rectocele.Methods From January 2012 to January 2018,90 patients with rectocele treated in Changzhi Traditional Chinese Medicine Hospital were divided into control group (45 cases) and observation group (45 cases) according to the operation method.The control group was treated with closed transrectal repair ,while the observation group was treated with partial rectal resection with anal stapler.The operative effect ,incidence of postoperative complications , recurrence rate,degree of pain after operation ,length of hospital stay and cost of treatment were compared between the two groups.Results The total effective rate of the two groups was 100.0%.The incidence of complications in the observation group was 2.2%(1／45),which was lower than that in the control group [17.8%(8／45)] (χ2 ＝4.444, P＝0.035).The recurrence rate in the observation group was 0(0／45),which was lower than that in the control group [13.3%(6／45)] (χ2 ＝4.464,P＝0.035).The hospitalization time in the observation group was shorter than that in the control group[(7.01 ±2.06)d vs.(11.31 ±2.42)d].Compared with the control group ,the treatment cost of the observation group was higher[(0.836 ±0.164)×104CNY vs.(0.605 ±0.136)×104CNY],and the post-operative pain score was lower [(4.24 ±1.33) vs.(6.45 ±1.17)] ( t＝9.076,7.273,8.369,all P＜0.001).Conclusion Transanal stapler partial rectal resection is effective in the treatment of rectocele , with less complications, lower recurrence rate and less pain after operation ,but the cost of treatment is higher.

Analysis of the effect of ABC classification on improving hospital drug management system / 中国基层医药

Objective To analyze the effect of ABC classification method on improving the drug management system of Urumqi Friendship Hospital.Methods The drug data of Urumqi Friendship Hospital from January 2017 to December 2017 were retrospectively analyzed.The in-hospital information system (HIS) was used to sort the annual consumption,and the antibacterial drugs were sorted by DDDS to analyze the data as control group .From January 2018 to December 2018,the drug data of Urumqi Friendship Hospital were retrospectively analyzed by the AIS analysis method in the hospital HIS system ,which were selected as research group.The effect of ABC analysis on the manage-ment of hospital drugs was analyzed ,and to compare the changes in drug management before and after the application of ABC analysis.Results Through the analysis of A ,B and C drugs,the total amount of 921 drugs were found to be 127.358 million CNY,including 122 kinds of A drugs (13.25%),the amount of 97.975 million CNY (79.93%);133 kinds of B drugs (14.44%),the amount of 18.56 million CNY (15.17%);666 kinds of C drugs (72.31%), the amount of 6.0016 million CNY (4.90%).Among the ABC classification results ,there were 24 kinds of cardiovas-cular system drugs in class A drugs ,and the highest percentage was 28.57%.There were 29 kinds of Chinese herbal medicines in class B drugs ,with a percentage of 23.33%.There were 52 kinds of oral drugs (42.62%),64 kinds of injections (52.46%),and 6 kinds of other drugs (4.92%),while 66 drugs (49.62%) were classified as B drugs. Species (44.36%) and 8 other drugs (6.02%).Among the ABC classification results ,the total amount of the top 20 drugs in class A drugs was 46 073 529.65 CNY,accounting for 47.11%of the A drugs,accounting for 37.65%of the total amount.Among them,the amount of clopidogrel tablets and atorvastatin calcium tablets was significantly larger . The inventory turnover index [(8.37 ±2.48)d] of the inventory management index of the research group after the ABC classification method was significantly higher than that of the control group [(6.22 ±3.61) d] ( t＝14.897, P＜0.05),and the monthly average inventory amount [(4.5 354 ±0.5 024)million CNY] was significantly higher than that in the control group [(3.9 963 ±0.7 538) million CNY] (t＝18.060,P＜0.05),the slow-moving rate [(4.24 ±1.31)%] and the stock-out rate [(8.73 ±3.14)%] were significantly lower than those in the control group [(5.11 ±0.82)%,(9.39 ±2.67)%] (t＝17.084,4.859,all P＜0.05).Conclusion The ABC classifica-tion method helps to improve the hospital drug management system ,can promote rational drug use ,dynamically manage drugs,ultimately reduce drug costs ,and rationally utilize limited drug resources.

Effect of partial rectal resection with transanal stapler in the treatment of rectum protrusion / 中国基层医药

Objective@#To investigate the clinical effect of transanal stapler partial rectal resection for rectocele.@*Methods@#From January 2012 to January 2018, 90 patients with rectocele treated in Changzhi Traditional Chinese Medicine Hospital were divided into control group (45 cases) and observation group (45 cases) according to the operation method.The control group was treated with closed transrectal repair, while the observation group was treated with partial rectal resection with anal stapler.The operative effect, incidence of postoperative complications, recurrence rate, degree of pain after operation, length of hospital stay and cost of treatment were compared between the two groups.@*Results@#The total effective rate of the two groups was 100.0%.The incidence of complications in the observation group was 2.2%(1/45), which was lower than that in the control group [17.8%(8/45)] (χ2=4.444, P=0.035). The recurrence rate in the observation group was 0(0/45), which was lower than that in the control group [13.3%(6/45)] (χ2=4.464, P=0.035). The hospitalization time in the observation group was shorter than that in the control group[(7.01±2.06)d vs.(11.31±2.42)d]. Compared with the control group, the treatment cost of the observation group was higher[(0.836±0.164)×104CNY vs.(0.605±0.136)×104CNY], and the post-operative pain score was lower[(4.24±1.33) vs.(6.45±1.17)](t=9.076, 7.273, 8.369, all P<0.001).@*Conclusion@#Transanal stapler partial rectal resection is effective in the treatment of rectocele, with less complications, lower recurrence rate and less pain after operation, but the cost of treatment is higher.

Analysis of the effect of ABC classification on improving hospital drug management system / 中国基层医药

Objective@#To analyze the effect of ABC classification method on improving the drug management system of Urumqi Friendship Hospital.@*Methods@#The drug data of Urumqi Friendship Hospital from January 2017 to December 2017 were retrospectively analyzed.The in-hospital information system (HIS) was used to sort the annual consumption, and the antibacterial drugs were sorted by DDDS to analyze the data as control group.From January 2018 to December 2018, the drug data of Urumqi Friendship Hospital were retrospectively analyzed by the AIS analysis method in the hospital HIS system, which were selected as research group.The effect of ABC analysis on the management of hospital drugs was analyzed, and to compare the changes in drug management before and after the application of ABC analysis.@*Results@#Through the analysis of A, B and C drugs, the total amount of 921 drugs were found to be 127.358 million CNY, including 122 kinds of A drugs (13.25%), the amount of 97.975 million CNY (79.93%); 133 kinds of B drugs (14.44%), the amount of 18.56 million CNY (15.17%); 666 kinds of C drugs (72.31%), the amount of 6.0016 million CNY (4.90%). Among the ABC classification results, there were 24 kinds of cardiovascular system drugs in class A drugs, and the highest percentage was 28.57%.There were 29 kinds of Chinese herbal medicines in class B drugs, with a percentage of 23.33%.There were 52 kinds of oral drugs (42.62%), 64 kinds of injections (52.46%), and 6 kinds of other drugs (4.92%), while 66 drugs (49.62%) were classified as B drugs.Species (44.36%) and 8 other drugs (6.02%). Among the ABC classification results, the total amount of the top 20 drugs in class A drugs was 46 073 529.65 CNY, accounting for 47.11% of the A drugs, accounting for 37.65% of the total amount.Among them, the amount of clopidogrel tablets and atorvastatin calcium tablets was significantly larger.The inventory turnover index [(8.37±2.48)d] of the inventory management index of the research group after the ABC classification method was significantly higher than that of the control group [(6.22±3.61)d] (t=14.897, P<0.05), and the monthly average inventory amount [(4.5 354±0.5 024)million CNY] was significantly higher than that in the control group [(3.9 963±0.7 538)million CNY] (t=18.060, P<0.05), the slow-moving rate [(4.24±1.31)%] and the stock-out rate [(8.73±3.14)%] were significantly lower than those in the control group [(5.11±0.82)%, (9.39±2.67)%] (t=17.084, 4.859, all P<0.05).@*Conclusion@#The ABC classification method helps to improve the hospital drug management system, can promote rational drug use, dynamically manage drugs, ultimately reduce drug costs, and rationally utilize limited drug resources.

Beverages consumption, sleep quality and depressive symptoms in Chinese university students: a latent variable mediation model / 中国学校卫生

Objective@#This study aimed to examine the mediating effects of sleep quality in the association between beverages consumption and depressive symptoms in Chinese university students, and to provide a theoretical reference for preventing and reducing depression symptoms.@*Methods@#This school-based cross-sectional survey was carried out among 4 624 university students from 2 universities in Anhui and Jiangxi provinces of China. The patient health questionnaire-9 items (PHQ-9) was used to assess depressive symptoms. The Pittsburgh sleep quality index（PSQI） was used to assess sleep quality, and a self-reported dietary frequency questionnaire was used to measure beverages consumption. The quantile regression model was used to association analysis, and the latent variable mediation model was used to analyze the mediation effect.@*Results@#The positive rates of mild, moderate, moderate to severe and severe depression in 4 624 university students were 31.4%, 7.5%, 4.1% and 2.0%, respectively. There was a significant association between the beverages consumption score, the PSQI score, and the PHQ-9 score( P <0.01). The higher the quantile of the beverage consumption and PSQI score, the greater the regression coefficient ( β ), and a significant dose-response relationship was observed( P <0.01). In the latent variable mediation model of beverages consumption associated with depressive symptoms in Chinese university students, the mediating effect value of sleep quality was 0.12, and the ratio of mediating effect to total effect was 71.3%.@*Conclusion@#Our study demonstrates that poor sleep quality partially mediates the association between beverages consumption and depressive symptoms in Chinese university students.