Evaluation index system of medical quality in clinical departments under the high-quality development of public hospitals / 现代医院

Objective To establish an evaluation index system that can be used for medical quality assessment in clini-cal departments.Methods Based on literature analysis and key informant interview,the Delphi method was used to analyze the-importance and operability of the evaluation index system of medical quality in clinical departments.Results A clinical depart-ment medical quality assessment and evaluation system was established,consisting of 3 primary indicators,14 secondary indica-tors,and 24 tertiary indicators.Conclusion By building a medical quality assessment and evaluation index system in clinical departments,a simple,standardized,and highly operational management model is established for medical institutions to carry out medical quality management.It is conducive to directing clinical departments to focus on medical quality management,improving their medical quality awareness and management level,and promoting the high-quality development of public hospitals.

Relationship of VKORC1 and CYP2C9 gene polymorphism and warfarin in patients with non-valvular atrial fibrillation / 实用医学杂志

Objective To evaluate the guidance value of VKORC1 and CYP2C9 gene polymorphism on clinical application of warfarin in patients with non-valvular atrial fibrillation (NVAF). Methods A total of 290 cases of patients with NVAF were identified and their baseline data , initial dose of warfarin and base INR measurement results were recorded, then the follow-up was conducted. The initial administration of warfarin to INR standard time for the first time, total amount of warfarin and the average daily amount were recorded. All participants′ venous blood was extracted for VKORC1 and CYP2C9 gene polymorphism test. Results VKORC1 AG/GG genotype patients had longer INR standard time and higer amount of warfarin than patients with AA (103.38 ± 65.29)g vs. (53.26 ± 24.02)g, P < 0.05. Patients with type CYP2C9 gene mutation had shortest INR standard time(9.10 ± 2.01)d vs. (13.07 ± 4.28)d, P < 0.05. and lowest administration amount of warfarin (28.80 ± 17.35)g vs. (55.45 ± 23.67)g, P < 0.05. Conclusion There exist significant differences of first adminstration amount of warfarin in patients with NVAF to INR standards. Warfarin dose for VKORC1 AA genotype patients is lower than that for GG/AG type; there is short INR standard time and less adminstration amount of warfarin for CYP2C9 genotypes AC/CC patients.