Retrospective analysis of adverse drug reactions of bevacizumab biosimilar and original drug in our hospital / 中国药房

OBJECTIVE To analyze the occurrence of adverse drug reactions （ADR） between bevacizumab biosimilars and original drugs， and to provide data support for rational use of drugs in clinical. METHODS ADR reports of bevacizumab biosimilars and original drugs reported by Jiangsu Cancer Hospital from January to December 2022 were retrospectively analyzed. RESULTS A total of 6 818 patients were treated with bevacizumab， and 136 ADR patients were reported. The incidence of ADR caused by bevacizumab biosimilars was higher than original drugs （2.18% vs. 0.71%， P＝0.004）. In ADR reports， the main treatment plan was bevacizumab combined with other tumor drugs （129 patients）； 118 patients were cured and improved； there were 108 general reports and 28 serious reports； the main system/organ involved in ADR was the cardiovascular system； there were no statistical significance in the incidence rates of hypertension/blood pressure increase， leukocyte/platelet decrease， diarrhea and fever caused by bevacizumab biosimilars and original drugs. CONCLUSIONS The incidence of ADR related to bevacizumab biosimilars is significantly higher than that of the original drugs， but there is no significant difference in the clinical manifestation of ADR. Clinicians can use bevacizumab biosimilars or original drugs based on the willingness of patients and their families.

Inviabilidad de un régimen legal especial para la tenencia compartida de niños y niñas con discapacidad en el Perú / Unviability of a special legal regime for the shared custody of children with disabilities in Perú / Inviabilidade de um regime legal especial para a guarda compartilhada de meninos e meninas com incapacidade no Peru

En materia de Derecho de familia, la legislación peruana contempla la posibilidad de una tenencia compartida, regulada expresamente en el Código de los Niños y Adolescentes, sin establecer precisiones sobre las condiciones y formas de aplicación, lo que es similar en el Derecho comparado. Sustentado en principios bioéticos y jurídicos, en el presente artículo se analiza la posibilidad de generar una regulación especial para la tenencia compartida, enfocada en la necesidad de establecer criterios especiales que puedan tener en cuenta los jueces en los casos concretos que involucren a niños y niñas. Estos criterios deben partir de un modelo social dirigido a quebrar las barreras impuestas, dotando de las condiciones más adecuadas para un desarrollo integral y pleno. En esa línea de pensamiento, es fundamental el interés superior del niño, el compromiso de los progenitores y la implementación de ajustes razonables.

In terms of family law, Peruvian legislation contemplates the possibility of shared custody, expressly regulated in the Code of Children and Adolescents, without establishing details on the conditions and forms of application, which is similar in comparative law. Based on bioethical and legal principles, this article analyses the possibility of generating a special regulation for shared custody, focusing on the need to establish special criteria that judges can take into account in specific cases involving children. These criteria should be based on a social model aimed at breaking down the barriers imposed, providing the most appropriate conditions for an integral and full development. In this line of thought, the best interests of the child, the commitment of the parents and the implementation of reasonable accommodations are fundamental.

Em matéria de Direito de família, a legislação peruana contempla a possibilidade de uma guarda compartilhada, regulada expressamente no Código das Crianças e Adolescentes, sem estabelecer especificações sobre as condições e formas de aplicação, o que é similar no Direito comparado. Apoiado em princípios bioéticos e jurídicos, no presente artigo se analisa a possibilidade de gerar uma regulação especial para a guarda compartilhada, focada na necessidade de estabelecer critérios especiais que juízes possam ter em conta nos casos concretos que envolvem meninos e meninas. Esses critérios devem partir de um modelo social dirigido a quebrar as barreiras impostas, dotando as condições mais adequadas para um desenvolvimento integral e pleno. Nessa linha de pensamento, é fundamental o interesse superior da criança, o compromisso dos pais e a implementação de ajustes razoáveis.

Chinese expert guidance on overall application of lenvatinib in hepatocellular carcinoma / 中华消化外科杂志

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4,2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

A Workshop on Supporting Students with Developmental Disabilities 2023 / 医学教育

With the enactment of the amended Anti-Discrimination Act, which mandates the provision of reasonable accommodations, the urgent task for all health professional education institutions is to establish a support system for students with developmental disabilities. On the other hand, they are also required to fulfill their social accountability through quality assurance in education, such as the implementation of outcome-based education curriculum. In order to consider how to balance reasonable accommodations for students with developmental disabilities, quality assurance in education, and social accountability in undergraduate medical education, Professionalism Subcommittee held a workshop on April 22, 2023. The participants engaged in active discussions during the workshop.　Through a post-workshop survey, educational needs and challenges in supporting students with developmental disabilities were clarified, providing insights for future Subcommittee activities.

Discussion Points for Developing Support System for Inclusion of Healthcare Students with Disabilities / 医学教育

The number of students with disabilities is increasing in healthcare and other fields. However, support systems have yet to progress, and faculty and staff often find it difficult in the field. About 10% of medical students in the United States report that they have a disability, and reasonable accommodation is provided in didactic, lab, and clinical setting. The government and others have indicated support policies for students with disabilities, and a large-scale survey of healthcare providers with disabilities has been conducted, and the issues have been clarified. This section introduces specific examples of support and reasonable accommodation for students with disabilities overseas. It is thought that the training of students with disabilities and their employment will facilitate diversity among healthcare professionals and improve the quality of healthcare. There is an urgent need to understand the overall picture of healthcare students with disabilities in Japan and to develop support systems for their inclusion.

Rational use management standards of national key monitoring drug / 中国药房

At present， there is a lack of unified and standardized management for the rational use of national key monitoring drugs. According to the relevant requirements of the state， based on the relevant literature published at home and abroad in recent years and combined with the management practice of many medical institutions across the country on the national key monitoring drugs， in order to make the national key monitoring drugs more reasonable use and standardized management in medical institutions at all levels， the Clinical Pharmacy Branch of the Chinese Medical Association， the Pharmaceutical Epidemiology Special Committee of the Chinese Pharmaceutical Association and the Pharmaceutical Epidemiology Special Committee of the Sichuan Pharmaceutical Association organized experts to fully discuss， and to form this management standard. This standard mainly provides relevant opinions and suggestions on the basic principles of rational use of key monitoring drugs and the regulatory measures for key monitoring drugs， especially on how to strengthen the pharmaceutical management and use management of key monitoring drugs， further promoting the standardized use of key monitoring drugs.

Correlation analysis of lipid metabolism disorder of third trimester and retinopathy of prematurity in premature infants / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the correlation between lipid metabolism disorder and retinopathy of prematurity(ROP)of premature infants. <p>METHODS: A retrospective analysis was performed on the medical data of 48 premature infants mothers who were hospitalized and diagnosed with ROP in the Department of Neonatology, Children's Hospital of Soochow University from January 2017 to December 2018. Forty-eight hospitalized no-rop premature infants mothers were enrolled as the control group during the same period. The two groups were compared in terms of blood lipids and adiponectin level in the third trimester. Pearson correlation and Logistic regression analysis were used to analyze the correlation between adiponectin and blood lipids and risk factors of retinopathy in premature infants. <p>RESULTS: The total cholesterol, triglyceride, low-density lipoprotein and apolipoprotein B level in the observation group were all higher than those in the control group, while high-density lipoprotein, adiponectin and apolipoprotein A1 level were lower than those in the control group. In addition, Pearson correlation analysis showed correlation between adiponectin and blood lipid levels, while Logistic regression analysis showed increased of total cholesterol, triglycerides, low-density lipoprotein, and apolipoprotein B and decreased of high-density lipoprotein, and apolipoprotein A1 were risk factors for ROP.<p>CONCLUSION: Pearson test indicated positive correlation between lipid disorders of third trimester and retinopathy of premature infants, which may be related to adiponectin. In clinical work, we should focus on strengthening the guidance of maternal nutrition to reduce the incidence of ROP.

Artificial intelligence techniques applied to predict teams position of the brazilian football championship / Técnicas de inteligência artificial aplicadas para previsão da posição de times do campeonato brasileiro de futebol

ABSTRACT This study presents a classifier prediction in groups for the Brazilian Football Championship of both A and B leagues, from the results of the first half of each championship. With assertive predictions of the group where a team will end the championship, strategic planning can be performed in the squad, such as new hiring, specific training for athletes, and possible championships that the team will be entitled to participate in according to the group classification. In order to find the predictions, two techniques of artificial intelligence were applied: Multi-Layer Perceptron (MLP), which is a type of artificial neural network, and Support Vector Machine (SVM). Preliminary results show that the proposed methodology is very promising, with more than 40% successful cases with MLP and almost 50% with SVM. Moreover, results indicate that the methodology is able to make a reasonable prediction by missing one group of the true group at the end of the championship. The SVM technique was slightly better than MLP. A post-processing analysis of the SVM results was applied to the 2018 A league data from the Brazilian championship, resulting in 85% success indicator of groups.

RESUMO Este trabalho apresenta uma previsão de classificação em grupos para as equipes do campeonato brasileiro de futebol tanto da série A quanto da série B a partir dos resultados do primeiro turno de cada campeonato. Com previsões assertivas do grupo onde um time irá finalizar o campeonato, pode-se realizar um planejamento estratégico no elenco tal como novas contratações, treinos específicos dos atletas e possíveis campeonatos que o time terá direito de participar de acordo com o grupo em que se classificar. Para encontrar as previsões, aplicou-se as técnicas rede neural artificial Multi Layer Perceptron (MLP) e Support Vector Machine (SVM). Resultados preliminares indicam que a metodologia proposta é bastante promissora, acertando em mais de 40% dos casos com a MLP e quase 50% com o SVM. Além disso, os resultados indicam que a metodologia também é capaz de realizar uma boa previsão errando em um grupo do verdadeiro grupo ao final do campeonato. A técnica SVM se mostrou um pouco superior à MLP. Um pós processamento nos resultados do SVM é aplicado aos dados do ano de 2018 da série A do campeonato brasileiro, resultando em 85% de acertos dos grupos.

Study on Compatibility Rationality of Panlongqi Tablets in Treatment of Osteoarthritis Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To explore the compatibility of Panlongqi tablets in the treatment of osteoarthritis. Method:Network pharmacology was used to predict and screen the targets and pathways related to osteoarthritis of 59 compounds in Panlongqi tablets including activating blood circulation and removing stasis group（ACRG），expelling wind-damp group（EWDG）and tonifying liver and kidney group（TLKG）. Through data integration analysis, the characteristics and compatibility rules of this prescription in preventing and treating osteoarthritis were analyzed. Result:The 59 compounds can act on 70 osteoarthritis(OA) related targets, mainly involving inflammatory stimulation response, cell proliferation, cell metabolism, immune regulation and other related processes. Pathway enrichment analysis involved inflammatory response, cartilage degeneration, immune regulation, bone metabolism and other related pathways. Conclusion:The three drugs play different regulatory roles in the pathogenesis of OA, such as inflammation, chondrocyte apoptosis and metabolism, extracellular matrix degradation, and bone metabolism. Among them, promoting blood circulation and removing blood stasis were mainly related to anti-inflammatory and analgesia, the wind-dampening group was mainly involved in regulating immunity and inflammation, and the liver-kidney group was more related to bone metabolism and chondrocyte apoptosis.

Status and Rationality of Opioid Use in Lung Cancer Patients: A Single Center Retrospective Study / 中国肺癌杂志

BACKGROUND@#Cancer pain affect the physical activity, psychological state and quality of life seriously, and even shortened the survival time of patients. Rational and standard application of opioids could control cancer pain effectively. Since the high incidence of cancer pain in lung cancer patients, the status of opioids application should be analyzed to evaluate the rationality of analgesic application in lung cancer patients.@*METHODS@#The clinical data of 305 patients with lung cancer who were hospitalized in Department of Respiratory and Critical Care Medicine of Peking Union Medical College Hospital from June 2018 to June 2019 were analyzed retrospectively.@*RESULTS@#In the analysis of factors affecting the use of opioids in lung cancer patients, age and drug kinds were the main influencing factors. The proportion of male patients was higher than female. Moreover, male patients used more kinds of opioids and were mostly between 60 and 69 years old. The variety and structure of opioids used in lung cancer patients in our hospital met the requirements. Oxycodone hydrochloride prolonged-release tablet has the highest frequency of application, and defined daily cost (DDC) ranked the first with a serial number ratio of 1, which showed good synchronization. The quantity of morphine tablet and morphine injection were low, and the overall breakthrough cancer pain (BTcP) in lung cancer patients was well controlled. The overall application of opioids were reasonable (93.4%), and the unreasonable items mainly included the disposal of BTcP and the unreasonable frequency of opioids, as well as overdose.@*CONCLUSIONS@#The majority of patients with lung cancer who take opioids are male, and the cancer pain in elderly men are more difficult to control, which needs to pay more attention. The overall application of opioids in the patients with lung cancer pain in our hospital are reasonable, but there are still some problems to focus, such as the disposal of BTcP, the dosage of opioids and the medication of special groups.

Kilovoltage cone-beam computed tomography imaging dose estimation and optimization: Need of daily cone-beam computed tomography

Aim: The aim of the present study was to access the need of daily cone-beam computed tomography (CBCT) and the requirement of in-house protocols of image acquisition frequency to reduce unnecessary exposure to the patients undergoing radiotherapy treatment. Materials and Methods: The dose delivered during CBCT procedure (On-Board Imager, Trilogy, Varian medical system, Inc., Palo Alto, California) was assessed for pelvic and head and neck region. For dose estimation, cylindrical polymethyl methacrylate phantoms of 15 cm length, 16 cm, and 32 cm diameter were used to simulate the patient's head and neck and pelvic region thickness, respectively. More than 10 cm scatterer was added on either end of this phantom. Calibrated Ionization chamber DCT10 LEMO SN 1685 iba, dosimetry, Germany (10 cm active length) was used to measure the dose Index. The doses known as cone-beam dose index (CBDI100) were estimated for all the scanning protocols (kV and mAs setting) available on the machine. In this study, image acquisition frequency to correct the setup error was optimized. In-house protocol for image acquisition frequency during treatment has been suggested to reduce the dose. It was based on the principle of as low as reasonable achievable. Results: Optimized dose protocol observed was the “standard dose head” for which the CBDI100 was 2.43 mGy. Whereas for pelvic imaging, single protocol of 125 kV, 80 mA was available by which a dose of 7.61 mGy is likely to be received by the patient during scan. Maximum shift of 6 mm in lateral direction was observed to the patient of Pelvis region and 5 mm was observed in the longitudinal direction for the H and N patients. Angular shift measured in patient position was 3.8° and 3.1° for H and N and pelvic region, respectively. Conclusion: Three consecutive-day CBCT-imaging at the beginning of the treatment followed by once weekly CBCT and two-dimensional (2D) imaging in remaining days of treatment can be an optimized way of imaging for the patient having malignancy in the region of pelvic and abdomen. For H and N, once in a week, CBCT with standard dose head protocol, followed by 2D-imaging in remaining days can be an optimized way of imaging.

Basic Understanding of Support for Students Who Have Developmental Disorders at Medical Training Institutions / 医学教育

The Act for Eliminating Discrimination against Persons with Disabilities stipulates that medical training institutions need to offer the provision of Reasonable Accommodation to students with developmental disorders and/or related characteristics.　Reasonable Accommodation is the consideration to guarantee the rights of students with developmental disorders; thus, educational institutions have an obligation to provide this Reasonable Accommodation.　In this paper, we outlined specific support for students with developmental disabilities and related characteristics in medical training institutions from the aspects of “enrollment,” “university education,” and “employment.”　Essential ways to support students with developmental disorders and related characteristics include the presentation of clear criteria, mutual cooperation, and collaboration between faculty members and administrative staff, as well as understanding the basics of how to interact with such students.

Evaluation of central lymph node dissection for papillary thyroid carcinoma in cN0 T1/T2 / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the application of the central lymph node dissection (CLND) for papillary thyroid carcinoma (PTC) in cN0 T1/T2.@*Methods@#Retrospective analysis of 532 cases with PTC in cN0 T1/T2 who underwent CLND between October 2014 and September 2016 in the Department of Thyroid Surgery, the First Affiliated Hospital of the Kunming Medical University. The incidence of central lymph node (CLN) metastasis and risk factors were analyzed.@*Results@#CLN metastasis rates: 41.2% (42/102) in males vs 34.9% (150/430) in females, P=0.252; 33.9% (116/342) in single focal carcinoma vs 40.4% (74/183) in multifocal carcinoma, P=0.157; 44.0% (125/284) in patients with 45 years old or less vs 27.0% (67/248) in patients more than 45 years old, P=0.000; 30.3% (113/373) in microcarcinoma vs 50.9% (81/159) in non-microcarcinoma, P=0.000.In unilateral lesions, ipsilateral CLN metastasis was correlated with the tumor diameter (P=0.012), but not with the number of lesions (P=0.653). also contralateral CLN metastasis was correlated with the tumor diameter (P=0.000), but not with the number of lesions (P=0.815). For the left or right unilateral single focal lesion, the tumor diameter was not correlated with the metastasis of the posterior to right recurrent laryngeal nerve central lymph nodes (LN-prRLN-CLN) (P=0.652, P=0.088). But in bilateral multifocal carcinoma the tumor diameter was correlated with metastasis of LN-prRLN-CLN (P=0.039).@*Conclusions@#Prophylactic CLND is reasonable for PTC in cN0 T1/T2. A bilateral CLND should be conducted for patients with bilateral multi-focus cancer and unilateral or bilateral non-microcarcinoma, especially in patients more than 45 years old. For unilateral single focal microcarcinoma on the right, the content of CLND should be from laryngeal nerve on right center to posterior branche; for unilateral single focal microcarcinoma on the left side, the left CLND should be conducted. An ipsilateral CLND can be considered in patients with unilateral multifocal microcarcinoma, and generally a routine dissection of the LN-prRLN-CLN is not required, however for bilateral non-microcarcinoma and the the non-microcarcinoma on the right side, the LN-prRLN-CLN dissection should be conducted.

Practices of a hospital to control of medical expenses / 中华医院管理杂志

Measures have been taken by the hospital to control drug expense proportion and consumables expense proportion, in addition to such actions as ceiling pricing for individual diseases, clinical pathways and better incentive mechanisms. All these measures help to curb unreasonable growth of medical expenses, and ease patients' burden. The study proves that the goal of expense control set in the healthcare reform can be achieved by setting multiple control indexes, strengthening pharmaceutical affairs management, normalizing procedure of consumables circulation, reforming the compensation incentive mechanism, giving the best play of cost control role of medical insurance, and introducing new technologies or programs.

Pharmaceutical Care for One Patient with Phantom Limb Pain / 中国药师

The clinical pharmacist involved in the treatment of one case of phantom limb pain from the aspects of doctor's order reorganization,dose adjustment of analgesic drugs,pain score monitoring,ADR monitoring and medication education. And significant effects were shown in the drug use safety and the pain improvement in the patient. Therefore,the participation of clinical pharmacist in pain treatment can optimize analgesic effects,detect adverse drug reactions timely and thus obtain more benefits for patients.

Analysis of Hemostatic Drugs Used for Orchidopexy in Children during the Perioperative Period / 中国药师

Objective:To analyze the hemostatic drugs use for orchidopexy in children during the perioperative period to promote the rational use of hemostatic drugs for orchidopexy in children. Methods:The perioperative prophylactic use of hemostatic drugs for orchi-dopexy in 138 children from June 2015 to December 2016 was retrospectively analyzed. The difference of clinical data and outcome indica-tors were compared between hemostatic drugs group(drug group) and without hemostatic drugs group (control group),and the rational use of hemostatic drugs in the drug group was analyzed. Results:The operation time,amount of bleeding and the length of hospital stay showed no statistical differences between the groups during the perioperative period in our hospital. There were 44.9% of children under-going orchidopexy treated with hemostatic drugs,and the unreasonable rate was 51.6% in the drug group. Among them,35.5% of chil-dren were with too long medication time,11.3% of children were with unreasonable initial treatment time, and 4.8% of children were with single overdose. Conclusion:The perioperative hemostatic drugs use for orchidopexy in children still has several problems, inclu-ding excessive medication duration,inappropriate administration time and single overdose etc,and clinicians should pay attention to above situations.

Investigation and Analysis on the Drug-related Problems in Clinical Application of Antiepileptic Drugs in Hospitalized Patients of One Hospital / 中国药师

Objective:To discuss the causes and characteristics of drug-related problems(DRPs) of antiepileptic drugs by the in-vestigation of antiepileptic drugs' use in our hospital in order to provide reference for the rational clinical application of antiepileptic drugs. Methods:A retrospective analysis on 878 inpatients' records including antiepileptic drug application in our hospital from Janu-ary to December 2016 was carried out. The gender,age,etiology,application of antiepileptic drugs,usage,combination and adverse reactions were statistically analyzed in order to analyze the epidemiological characteristics of antiepileptic drugs in our hospital. At the same time,the necessity,safety and validity of the DRPs of antiepileptic drugs were studied by the international generic Spanish drug related research method(Granada-Ⅱclassification method). Results:Among the 878 cases,most were male patients(60.71%) and the proportion of patients over 50 years old was 69.02%. Patients with cerebrovascular diseases accounted for the most (323 cases, 36.79%),and 7 varieties of antiepileptic drugs were involved, and sodium valproate was with the largest proportion (489 cases, 51.75%). The DRPs were classified as DRP2(49 cases),DRP5(22 cases) and DRP6(8 cases). Conclusion:In view of the epi-demiological characteristics of antiepileptic drugs and DRPs specific issues in clinical applications, clinical pharmacists need to strengthen the intervention in DRPs of antiepileptic drugs in order to promote the safety and reasonability of clinical application.

Investigation of antibiotic use and a comparative analysis of therapeutic efficacy before and after intervention / 重庆医学

Objective To investigate the rationality of antibiotic use in Chongqing before and after intervention and its inter vention effect.Methods 16 200 cases,54 000 outpatient prescriptions and annual average antimicrobial consumption in 2011 from Chongqing sub network of Health and Family Planning Commission antibacterial drug monitoring network were selected as control group;48 600 cases,162 000 outpatient prescriptions and annual average antimicrobial consumption from 2012 to 2014 were selected as intervention group.The use rate of antimicrobial agents in outpatients,the intensity of antimicrobial use in hospitalized patients,the percentage of antimicrobial use in hospitalized patients,the average number of antimicrobial use in hospitalized patients,the combined use of antibiotics and other antimicrobial agents in hospitalized patients were retrospectively studies.Results Except for the utilization rate of antibiotics in the outpatients and the density of antimicrobial agents in hospitalized patients,the utilization rate of antibiotics in the hospitalized patients,the microbiology inspection rate of application of antibiotics in non surgical treatment (％),the average use days of antibiotics in the hospitalized patients(days) and the combination rate of antibiotics in the hospitalized patients from 2012 to 2014 (after intervention) had significant impact in comparison with 2011 (before intervention).Conclusion Through the clinical pharmacistes' participating in the intervention in reasonable use of antibiotics and a variety of powerful intervention measures,the rationality of antibiotic use is feasible.

Problems and suggestions on the use of cough and cold medicines containing ephedra alkaloids in children / 中华实用儿科临床杂志

With the mutual communication and penetration of traditional Chinese medicine and modem medicine,the combination of traditional Chinese and western medicine is common in clinical practice.However,since western-style doctor is usually lack of traditional Chinese medicine theory knowledge,many problems exist in the combination of Chinese and western medicine.The problem that Chinese medicine containing ephedra alkaloids in combination with western medicine in pediatric medicine is especially serious.Because of the complexity of the children's drugs,improper use of the ephedra alkaloids is prone to adverse reactions.A comprehensive analysis of drugs containing ephedra alkaloids existing in the pediatric clinical application is performed,and in order to provide guidance for clinical rational drug use.

Effect of quality control activities on improving compliance and rational diet of elderly patients with coronary heart disease / 中国基层医药

Objective To explore the effect of quality control activities in the treatment of elderly patients with coronary heart disease and the effect of reasonable diet.Methods From March 2015 to December 2016,the nursing group was divided into two groups:"protect heart circle",and 120 elderly patients with coronary heart disease were systematically managed.The patients were treated with compliance low and without reasonable diet reasons,to develop goals and strategies,the final application of goods tube circle activities to improve patients' compliance,improve the proportion of reasonable diet.Results After the quality control activities,the patients were investigated,the treatment compliance (75.00％) was significantly higher than before activity (48.33％),and the difference was statistically significant (x2 =19.43,P =0.00).After the event,the patients' food pass rate increased from 35.00％to 63.33％,the incidence rate of hyperlipidemia decreased from 70.00％ to 63.33％,the obesity rate decreased from 65.00％ to 55.00％,the food pass rate and quality control activities were significantly improved compared with before treatment (x2 =19.272,P =0.00).After the event of quality control activities,the total cardiovascular adverse events were reduced from 109 cases to 72 cases,and the difference was statistically significant (x2 =30.77,P =0.00).After the activities of the product tube,the self-growth of the health care workers [after the event (4.27 ± 0.80)points,before the event (2.45 ± 0.68)points],the activity participation [after the event (3.39 ± 0.52)points,before activity (1.34 ± 0.42) points],QCC technique [after the event (3.99 ± 0.54) points,before activity (1.35 ± 0.48) points],personal ability[after activity (4.14 ± 0.36) points,before activity (2.69 ± 0.32) points],team spirit [after activity (4.13 ±0.38)points,before activity (2.26 ± 0.28) points],and the communication skills and expression ability [after activity (4.29 ± 0.39) points,before activity (2.25 ± 0.38) points] had statistically significant differences compared with before activity (t =18.99,33.60,32.98,43.40,40.03,41.04,all P =0.000).Conclusion The development of quality control activities can improve patients' compliance and play a positive role in planning patients 'rational diet,thus laying a solid foundation for long-term treatment of coronary heart disease and improving team awareness and self-accreditation of medical staff.So quality control activity is worthy of promoting in the future clinical work.