Lean strategy for data mining and continuous improvement of Chinese pharmaceutical process: a case study of sporoderm-removal Ganoderma lucidum spore powder / 中国中药杂志

In the digital transformation of Chinese pharmaceutical industry, how to efficiently govern and analyze industrial data and excavate the valuable information contained therein to guide the production of drug products has always been a research hotspot and application difficulty. Generally, the Chinese pharmaceutical technique is relatively extensive, and the consistency of drug quality needs to be improved. To address this problem, we proposed an optimization method combining advanced calculation tools(e.g., Bayesian network, convolutional neural network, and Pareto multi-objective optimization algorithm) with lean six sigma tools(e.g., Shewhart control chart and process performance index) to dig deeply into historical industrial data and guide the continuous improvement of pharmaceutical processes. Further, we employed this strategy to optimize the manufacturing process of sporoderm-removal Ganoderma lucidum spore powder. After optimization, we preliminarily obtained the possible interval combination of critical parameters to ensure the P_(pk) values of the critical quality properties including moisture, fineness, crude polysaccharide, and total triterpenes of the sporoderm-removal G. lucidum spore powder to be no less than 1.33. The results indicate that the proposed strategy has an industrial application value.

Transplante cardíaco no Hospital das Clínicas da Universidade Federal de Minas Gerais: custo do paciente internado / Cardiac transplantation at the Hospital das Clínicas of the Federal University of Minas Gerais: inpatient cost

Este trabalho teve como objetivo identificar o custo do paciente internado para transplante cardíaco no Hospital das Clínicas da Universidade Federal de Minas Gerais nos anos de 2019 e 2020. Por meio da metodologia de custeio ABC e Diagrama de Pareto foram levantados os valores inerentes aos materiais, medicamentos e exames realizados pelos pacientes no período de internação em que ocorreram os transplantes. Também foram investigados os custos referentes ao tempo disponibilizado pela equipe cirúrgica e os custos relativos aos dias de internação em Unidade de Terapia Intensiva e Enfermaria. O método de pesquisa envolveu estudo de caso e pesquisa documental, especialmente prontuários físicos e eletrônicos dos pacientes, nos quais foram verificados os registros de dados clínicos. Os preços dos materiais, medicamentos e exames foram obtidos em bancos de dados utilizados pelo hospital como: Comprasnet, Banco de Preços, Painel de Preços e sistemas internos de gestão de compras. Os custos de internação foram levantados junto ao setor responsável pela apuração de custos do HC-UFMG, enquanto as informações utilizadas para cálculo do custo da equipe cirúrgica são provenientes do Portal da Transparência do Governo Federal e plano de cargos, carreiras e salários da Empresa Brasileira de Serviços Hospitalares e UFMG. Alcançado o objetivo foi produzido relatório situacional, que poderá ser utilizado pelas instituições de saúde como referência de pesquisa e negociação com os entes responsáveis pelo financiamento da saúde no Brasil, principalmente dos transplantes cardíacos. A pesquisa se mostrou relevante do ponto de vista clínico e de gestão, possibilitando uma visão sistêmica e integrada dos processos, à medida que amplia o conhecimento dos custos de uma importante linha de cuidado, além de contribuir com o redimensionamento de recursos e dar mais subsídios à tomada de decisão. Os resultados mostraram que no Hospital das Clínicas da UFMG o Custo do Transplante Cardíaco é de R$ 141.958,91.

This study aimed to identify the cost of patients hospitalized for heart transplantation at the Clinical Hospital of the Federal University of Minas Gerais in the years 2019 and 2020. Through the ABC costing methodology and Pareto's Diagram, the values inherent to the materials, drugs and diagnostic procedures to which the patients were submitted during the period of hospitalization for the transplant were raised. The costs related to the time made available by the surgical team and the costs related to the days of hospitalization in the Intensive Care Unit and ward were also investigated. The research method involved case study and documental research, especially physical and electronic patient records, in which clinical data records were verified. The prices of materials, medicines and exams were obtained from databases used by the hospital such as: Comprasnet, Price Bank, Price Panel and internal purchasing management systems. The hospitalization costs were collected from the sector responsible for calculating the costs of the HC-UFMG, while the information used to calculate the cost of the surgical team comes from the Federal Government's Transparency Portal and the and Empresa Brasileira de Serviços Hospitalares and UFMG's career and salary plan. Having achieved the objective, a situational report was produced, which can be used by health institutions as a reference for research and negotiation with the entities responsible for health financing in Brazil, especially heart transplants. The research proved to be relevant from a clinical and management point of view, enabling a systemic and integrated view of the processes, as it expands the knowledge of the costs of an important line of care, in addition to contributing to the resizing of resources and providing more subsidies to decision making. The results showed that at the Hospital das Clínicas da UFMG the cost of Heart Transplantation is R$ 141.958,91.

A method of lung puncture path planning based on multi-level constraint / 生物医学工程学杂志

Percutaneous pulmonary puncture guided by computed tomography (CT) is one of the most effective tools for obtaining lung tissue and diagnosing lung cancer. Path planning is an important procedure to avoid puncture complications and reduce patient pain and puncture mortality. In this work, a path planning method for lung puncture is proposed based on multi-level constraints. A digital model of the chest is firstly established using patient's CT image. A Fibonacci lattice sampling is secondly conducted on an ideal sphere centered on the tumor lesion in order to obtain a set of candidate paths. Finally, by considering clinical puncture guidelines, an optimal path can be obtained by a proposed multi-level constraint strategy, which is combined with oriented bounding box tree (OBBTree) algorithm and Pareto optimization algorithm. Results of simulation experiments demonstrated the effectiveness of the proposed method, which has good performance for avoiding physical and physiological barriers. Hence, the method could be used as an aid for physicians to select the puncture path.

Analysis on 158 detainees with adverse reactions due to anti-infective drugs / 药学实践杂志

Objective To analyze the characteristics and trends of adverse drug reactions (ADR) induced by anti-infective drugs in Shanghai Prison General Hospital and provide a guideline of rational drug use and pharmacovigilance for detainees. Methods The anti-infective drug induced ADR cases reported to the national ADR monitoring center in our hospital from January 2011 to October 2018 were collected. The primary and secondary factors of types, organs and (or) systems affected by anti-infective drugs that lead to ADR were studied with Pareto diagram. Results 158 ADR cases caused by anti-infective drugs were collected. 143 cases (90.51%) were male in 20-59 years old. Pareto diagram analysis showed that ADRs mainly involved eight kinds of anti-infective drugs (antituberculosis drugs, cephalosporins, sulfonamides, antiviral drugs, penicillin, aminoglycosides, fluoroquinolones and nitroimidazoles). ADRs mainly involved in hepatobiliary and blood system. Both topical and systemic reactions were reported. Abnormal liver function, liver injury, rash and allergic reaction were the most common. Conclusion Pareto diagram method reflected the "critical minority and minor majority" analysis on detainees with ADRs caused by anti-infective drug. It was recommended to focus on anti-tuberculosis drugs and cephalosporin drugs to reduce or avoid the occurrence of ADR.

Adherence to recommended intra-partum guidelines of high risk pregnancies: a study in North Bengal Medical College, Darjeeling district, West Bengal, India

Background: High risk pregnancies in intra-partum period are vulnerable, and if not appropriately attended, may roll on to maternal death or dreaded maternal near-miss cases. Despite the presence of a number of standard treatment guidelines designed to address most of the high risk conditions, their adherence and implementation continues to be uncommon. To assess the adherence to recommended guidelines during referral of high risk pregnancies in labour in mothers of the difficult terrains of eastern Himalaya. Methods: A descriptive epidemiological study with cross-sectional design was conducted among mothers with high risk pregnancies admitted in the labour ward, North Bengal Medical College Hospital, Darjeeling. 433 subjects were studied using complete enumeration technique. Results: Anaemia in pregnancy (22%), obstructed labour (19%), pre-term rupture of membranes (15%) and pregnancy induced hypertension (15%) were the high risk conditions identified. Referral linkage existed in most (70.7%) but no pre-referral treatment was given to 61.4% of the intra-partum mothers. Multivariate analysis shows mothers with age more than 35 years (AOR 4.97), bad obstetric history (AOR 2.40) & not attended by doctors (AOR 5.02) were found to be having more odds of missing the pre-referral treatment. About 86% of the gaps in pre-referral treatment were due to doctors not attending patients, lack of referral communication, not providing JSSK facilities and non-maintenance of Partograph as per Pareto analysis. Conclusions: Most of the non-adherence to standard treatment guidelines in high risk intra-partum mothers are related to health service delivery and can be ameliorated through proper administrative measures.

Application of Pareto Analysis in Studying DR High Fault Rate / 中国医疗器械杂志

OBJECTIVE@#To explore the effect of Pareto analysis on the investigation of DR (Digital Radiography) high fault rate.@*METHODS@#The quality control team was established to analyze the causes of DR high fault rate by using the fault statistics of eight DR in our hospital for nearly three years,and to formulate and implement countermeasures,then compare them with the data after rectification.@*RESULTS@#After three months of implementation,the number of DR faults in our hospital decreased from 130 times/quarter to 47 times/quarter,a year-on-year drop was 63.8%.Among them,the number of console faults decreased from 105 times/quarter to 25 times/quarter,a year-on-year drop was 76.2%,close to 80%.@*CONCLUSIONS@#Pareto analysis is effective in reducing DR fault rate and is worthy of being promoted to other medical devices.

Characteristics of death distribution of critical patients in a single emergency center in Beijing / 中国实用内科杂志

OBJECTIVE: To explore the characteristics of death distribution in emergency critical care patients and guide the distribution of emergency resources.METHODS: Clinical data of all patients who died in the emergency department of Peking University third hospital from 2013 to 2017 were collected.Age,gender composition and time of death were analyzed.Pareto diagram was used to analyze the composition of causes of death.RESULTS:(1)Elderly patients(≥60 years old)accounted for81.0% of the total number of deaths,and the age difference has statistically significant(P<0.05).(2)Pareto diagram analysis showed that respiratory diseases,sudden death,shock and nervous diseases were the main causes of death in critically ill patients.(3)Age was associated with respiratory diseases,cardiovascular diseases,shock,sudden death,nervous diseases and trauma(P<0.05).Gender was associated with respiratory diseases,sudden death and trauma(P<0.05).(4)50.8% the death cases occurred within 24 h after admission,the median time of sudden death patients is the shortest(1 h),followed by shock(24 h).The median time of death of malignant tumor was up to 5040 h.CONCLUSION: Elderly patients are the major death group in the emergency department.Respiratory,circulatory and neurological diseases are the common causes of death.And most patients die in the early stage of treatment.Therefore,it is necessary to reasonably allocate emergency medical resources according to the actual situation.

On the Pareto compliance of the averaged hausdorff distance as a performance indicator / Sobre la sujeción de Pareto para la distancia promedio de hausdorff como indicador de desempeño / Sobre a sujeição de Pareto para a distância média de hausdorff como indicador de desempenho

Abstract The averaged Hausdorff distance Δ p is an inframetric, recently introduced in evolutionary multiobjective optimization (EMO) as a tool to measure the optimality of finite size approximations to the Pareto front associated to a multiobjective optimization problem (MOP). Tools of this kind are called performance indicators, and their quality depends on the useful criteria they provide to evaluate the suitability of different candidate solutions to a given MOP. We present here a purely theoretical study of the compliance of the Δ p -indicator to the notion of Pareto optimality. Since Δ p is defined in terms of a modified version of other well-known indicators, namely the generational distance GDp , and the inverted generational distance IGDp , specific criteria for the Pareto compliance of each one of them is discussed in detail. In doing so, we review some previously available knowledge on the behavior of these indicators, correcting inaccuracies found in the literature, and establish new and more general results, including detailed proofs and examples of illustrative situations.

Resumen La distancia promedio de Hausdorff Δp es una inframétrica recientemente introducida en optimización multiobjetivo evolutiva (EMO) como una herramienta para medir la optimalidad de aproximaciones finitas al frente de Pareto asociado con un problema de optimización multiobjetivo (MOP). Presentamos aquí un estudio puramente teórico sobre la sujeción del indicador Δp a la noción de optimalidad de Pareto. Puesto que Δp está definida en términos de una versión modificada de otros indicadores bien conocidos como lo son la distancia generacional GD p y la distancia generacional invertida IGD p , discutimos en detalle criterios específicos para la sujeción de tipo Pareto de cada uno de ellos. Adicionalmente, presentamos una revisión del comportamiento previamente conocido de estos indicadores, corrigiendo imprecisiones que se encuentran en la literatura y establecemos resultados nuevos y más generales, incluyendo pruebas detalladas y ejemplos ilustrativos.

Resumo A distância média de Hausdorff Δp é uma inframétrica introduzida recentemente em otimização multiobjetivo evolucionária (EMO) como uma ferramenta para medir a otimalidade de aproximações finitas para o frente de Pareto associado com um problema de optimização multiobjetivo (MOP). Apresentamos aqui um estudo puramente teórico sobre a sujeição do indicador Δp à noção de otimalidade de Pareto. Desde Δp é definido em termos de uma versão modificada de outros indicadores bem conhecidos, tais como a distância geraçional GD p ∈ a distância geraçional invertida IGD p , discutimos em detalhes critérios específicos para a sujeição de Pareto de cada um deles. Além disso, apresentamos uma revisão do comportamento previamente conhecido desses indicadores, corrigindo imprecisões encontradas na literatura ∈ estabelecemos novos ∈ mais gerais resultados, incluindo testes detalhados ∈ exemplos ilustrativos.

Analysis on 2621 cases of adverse drug reaction reports by Fishbone and Pareto di ag ram / 药学实践杂志

Objective To analyze the regularity and characteristics of 2621 cases of adverse drug reaction (ADR) occur-ring in our hospital during 2013-2016 ,and to explore the factors and causes of ADRs ,so as to provide evidence for the contin-uous improvement of rational use of drugs .Methods 2621 cases of ADR reports were retrospectively analyzed by monitoring software to extract ADR report source ,patient age and sex ,related pharmaceutical dosage forms ,routes of administration , clinical characterization ,organ involvement and other information .The Pareto method was used to identify the main drugs that caused ADR and ADR factorial analysis was performed with Fishbone diagram .Results ADR mainly reported by physicians (2573 cases ,98 .17％ ) and pharmacists reported at least (3 cases ,0 .11％ );population aged >70 years accounted for the lar-gest proportion (570 cases ,21 .74％ );ADR mainly caused by intravenous infusion (1680 cases ,64 .10％ ) .The clinical mani-festations were gastrointestinal system lesions (717 cases ,24 .17％ ) .Pareto analysis showed that the main drug factors in-volved anti-infective drugs ,anti-neoplastic drugs ,Chinese medicine injections and parenteral nutrition drugs .Fishbone analysis showed that elderly patients ,intravenous administration ,incomplete monitoring and related drugs were the determining factors associated with ARDs .Conclusion The close attention should be paid to monitoring and guidance of special populations ,espe-cially the elderly ;reducing intravenous forms ,monitoring the main factors of medicines ,carrying out the individualized medica-tion monitoring ,strengthening clinical pharmacy ,in order to promote clinical rational use drug and reduce the occurrence of drug-induced diseases .

Analysis and Policy Suggestion of Hierarchical Diagnosis and Treatment System Based on Game Theory in China / 中国医院管理

Objective To discuss the dilemma of establishing the hierarchical diagnosis and treatment system in China and the relevant policy recommendations.Method Game theory and Pareto improvement theory can be used to analyze and promote the implementation of the hierarchical diagnosis and treatment system.Results The difficulty of grading diagnosis and treatment lies in the failure to achieve Pareto improvement,that is,patients and the government can save costs in the grading system,but doctors have not been given corresponding incentives,therefore,they are lack of enthusiasm for subsidence.Conclusion The hierarchical diagnosis and treatment system can save the government subsidies for health insurance and medical costs.If the doctor can get part of the costs,they will sink to the grassroots medical institutions,which can realize the Pareto improvement.The order of medical treatment and classification will be formed.

Analysis of the application of Pareto's law and PDCA principle in the teaching of ICU nursing / 中国实用护理杂志

Objective To observe and analyze the application of Pareto law and PDCA principle in ICU nursing teaching. Methods Totally 133 nursing interns in ICU from October 2015 to October 2016 were chosen as the control group adopting the routine nursing teaching method; 137 nursing interns from November 2016 to November 2017 were selected as the experimental group for whom Pareto law and PDCA principle were applied in ICU nursing teaching. The post-teaching theory, skill test scores, quality of nursing documents and satisfaction with teaching were compared between the two groups. Results As for the doctor's order list, body temperature list, nursing record sheet, repairable rate of nursing document defect, the test group accounted for 0.73％ (1/137), 0, 0.73％ (1/137) and 1.46％ (2/137) respectively, while those of the control group were respectively, 5.26％ (7/133), 4.51％ (6/13), 8.27％ (11/13), and 18.05％(24/133). The difference between the two groups was statistically significant (χ2=4.8235-39.3526, P<0.05 or <0.01)). In the experimental group, the scores of theoretical knowledge, professional operation, patient management and work attitude were as follows:(93.5±1.4), (94.9±1.1), (89.2±3.3) and (91.5±2.6);those of the control group were respectively (93.5 ± 1.4), (94.9 ± 1.1), (89.2 ± 3.3) and (91.5 ± 2.6). The difference was statistically significant (t=21.3228-26.9353, P<0.01). The satisfaction rate of the test group was 100.00％ (137/137), and that of the control group was 69.17％ (92/133). The difference was statistically significant (χ2=41.3671, P<0.01). Conclusion In ICU nursing teaching, the application of Pareto law and PDCA principle can effectively improve the test scores of theory and skill operation after nursing teaching, enhance the quality of nursing documents, improve the interest of nursing interns in learning, and raise the teaching satisfaction rate. Thus, the effect is ideal.

Estimation of the Optimal CA-CFAR Threshold Multiplier in Pareto Clutter with Known Parameters

The performance of the CA-CFAR processor is affected by certain clutter variations. Although problems caused by sudden clutter changes have already been corrected in multiple CFAR proposals, the influence of slow statistical variations in the background signal is often ignored. To solve this problem, the authors estimated the optimal CA-CFAR threshold multiplier values necessary to adapt the processor to the clutter slow statistical changes. The application of the results guarantees that the operational false alarm probability of the processor will only exhibit a small deviation from the value conceived in the design. The clutter was simulated with a Pareto distribution with a known fluctuating shape parameter according to recent papers that strongly suggest the use of this distribution. The current research completes an important step in the design of an adaptive detector that operates without a priori knowledge of the shape parameter In addition, the authors provide mathematical expressions that allow the direct application of the results in the design of radar detectors.

El desempeño del procesador CA-CFAR es afectado por ciertas variaciones del clutter Mientras que los problemas causados por los cambios repentinos del clutter han sido corregidos por múltiples propuestas CFAR, se ignora frecuentemente la influencia de las variaciones estadísticas lentas de la señal de fondo. Para resolver este problema, los autores estimaron los valores óptimos del multiplicador del umbral CA-CFAR necesarios para adaptar el procesador a los cambios estadísticos lentos, garantizando por tanto que la probabilidad de falsa alarma del detector exhibirá solamente una ligera desviación con respecto al valor concebido en el diseño. El clutter fue simulado con una distribución Pareto con parámetro de forma conocido de antemano, de acuerdo a publicaciones recientes que sugieren fuertemente el uso de esta distribución. La investigación actual completa un paso importante en el diseño de detectores adaptativos que operan sin el conocimiento a priori del parámetro de forma. Adicionalmente, los autores proporcionan expresiones matemáticas que permiten la aplicación directa de los resultados en el diseño de detectores de radar.

O desempenho do processador CA-CFAR está afectada por certas variações da desordem. Enquanto os problemas causados por mudanças bruscas de lixo foram corrigidos para múltiplas propostas CFAR, é muitas vezes ignorado a influ-ência de variações estatísticas lento do sinal de fundo. Para resolver esse problema, os autores estimaram os valores ideais do limiar necessário multiplicador CA-CFAR para adaptar o processador para retardar alterações estatísticas, garantizando, portanto, a probabilidade de falsa detector de alarme apenas um ligeiro desvio da valor concebido no design. A desordem foi simulado com um parâmetro de distribuição de Pareto conhecidos na maneira previamente, de acordo com publicações recentes que sugerem fortemente a utilização desta distribuição. A investigação actual complete um passo importante na concepção de detectores adaptativas que operam sem conhecimento a priori do parâmetro de forma. Addi-cionalmente, os autores fornecem expressões matemáticas que permitem a aplicação direta dos resultados do projeto de detectores de radar.

Pareto effect generated in use of full-text database / 中华医学图书情报杂志

The Pareto effect generated in use of journal articles covered in Wiley Online Library ( WOL) , a full-text database developed by China Pharmaceutical University, was analyzed, which showed that the number of WOL-covered source journals in ACIE, SSCI, A & HCI, the number of full-text journals that published SCI-covered papers of our university, the key and strong subjects of our university were the leading factors of Pareto effect gener-ated in use of WOL, studies on Pareto effect are thus of importance for the library in its development of literature resources, data information service and subject service.

The Communication Effect of Lawyer in Medical Dispute Litigation from View of Game Theory / 中国医学伦理学

This paper analyzed medical dispute litigation from the view of game theory.The adoption of mediation strategy for both hospital and patient was the Pareto optimal of this model.The adoption of court decision for both hospital and patient was the Nash equilibrium and its overall benefit was the Pareto suboptimal of this model.The communication of patient's lawyer can prompt the reconciliation between hospital and patient.On the one hand,it let the hospital realize the responsibilities they should bear,on the other hand let patients be willing to make concessions on the basis of the original claims,and finally made the two sides reach a reconciliation agreement,thus to make conflict between hospital and patient end in litigation and the overall benefits maximize.

Pareto Chart Analysis of Unreasonable Factors of Prescription in Outpatient and Emergency Departments of Our Hospital during 2013-2015 / 中国药房

OBJECTIVE:To investigate the current situation of unreasonable prescriptions in outpatient and emergency depart-ments of our hospital,and to provide reference for rational drug use in the clinic. METHODS:The evaluation of outpatient and emergency prescriptions in our hospital during 2013-2015 were summarized and analyzed. Irrational prescriptions were divided into 3 categories,involving 19 items. The main,secondary and general factors of irrational prescriptions were analyzed by Pareto chart. RESULTS:Among 19 types of irrational prescriptions,main factors included unsuitable drug selection,inappropriate usage and dosage,inappropriate drug combination,prescribing not in accordance with the antibiotics management regulations,incomplete di-agnosis. No indications of medication,drug dosage beyond the regulations ofthree urgent seven slowwere treated as the second-ary factors. Other 12 items were general factors. CONCLUSIONS:According to the main and secondary irrational drug use types, clinical pharmacists should carry out effective intervention and pharmaceutical care to improve the level of rational drug use and en-sure the safety of clinical drug use.

Statistics and Analysis of 20353 Cases of Pharmaceutical Consultations in a Hospital / 中国药房

OBJECTIVE:To provide reference for improving pharmaceutical consultations and the quality of pharmaceutical care. METHODS:The records of pharmaceutical consultations were collected from medication consultation center of Huilong-guan district in our hospital during Jan. 2014-Dec. 2016,and then summarized in terms of consultants composition,consultation form,consulting contents and drugs consulted,while Pareto Diagram was used to analyze the main and minor factors of consult-ing contents. RESULTS:The medication consultation center provided pharmaceutical consultations 20353 cases during 2014-2016. Main consultants were patients (20039 cases,98.5%). A total of 6307 persons were involved,mostly female (3646 persons,57.8%). Face to face was the most common consulting method (19440 cases,95.5%). There were 13 types of consulting contents,among which usage and dosage and guidance for special formulation use were the main factors,including 10392 cases (51.1%) and 3844 cases (18.9%). Among 20353 cases of pharmaceutical consultations,18874 cases of in-volved drugs,and involved 11 categories,mostly respiratory drugs (11756 cases,62.3%). CONCLUSIONS:Usage and dos-age and guidance for special formulation use are the main contents of pharmaceutical consultations in the hospital district. The services of pharmaceutical consultations for patients,physicians and nurses provided by pharmacists can solve the questions on medications,and can promote rational drug use in clinic.

Distribution of oral diseases in outpatient clinics:A Pareto analysis / 中华医学图书情报杂志

Objective To study the value of objective information transformation by analyzing oral diseases in outpa-tient department of our hospital and the diagnosis and treatment of oral diseases between expert clinic and outpatient clinic. Methods Oral diseases in over 50000 cases who visited the outpatient department of our hospital in 2015 were classified according to the ICD10 and analyzed by Pareto analysis. Results Dental carries, pulpitis, chronic periodontitis and dental crowding were the major diseases detected in outpatient department of our hospital, ac-counting for 80% of the total outpatients, and importance was thus attached to their treatment. Oral diseases re-ceived orthodontic therapy in expert clinic and received tooth implantation in outpatient clinic. Conclusion Hospi-tals should scientifically allocate their medical resources, strengthen the training of their young dentists, bring into full play of their limited medical resources according to the distribution of oral diseases in their outpatient depart-ments in order to meet the increasing demand of oral healthcare.

The empirical analysis of the professional content of secondary clinical treatment subjects and the DRGs rang / 中华医院管理杂志

Objective Taking the respiratory department of internal medicine as an example, to compare the coverage of clinical treatment of the MDC covered by DRGs of Beijing version with the professional services offered as secondary clinical treatment subjects in China.Methods Using the data from medical record home page from hospitals in Beijing above secondary level from 2012 to 2014 and both the DRGs defined in Pareto diagram statistical method and the DRGs proved by experts, for analysis and definition of the DRGs coverage involved by respiratory discipline of internal medicine.Results Respiratory discipline of internal medicine involved DRGs of 42 groups as found by the two methods.Conclusion The DRGs scope of secondary clinical departments in hospitals should be made based on both expert consultation and clinical data statistics method.

PARETO DIAGRAM ANALYSIS ON DISEASES SPECTRUM FROM 91,069 DISCHARGED PATIENTS / 现代医院

Objective To realize the fundamental conditions and variation trends of disease spectrum of Meizhou and its surrounding areas in order to investigate the focuses of diseases monitor and control .Methods Sta-tistic analysis was done on diseases of hospital in 2013 with Pareto Diagram .Results About twelve kinds of disea-ses, including circulatory diseases , tumor, digestive diseases , respiratory diseases and urinary diseases , accounted for the total number of 89.2%.Conclusion Characteristics of diseases spectrum in hospitals were analyzed , for which we can attach importance to disease prevention , optimize medical resource allocation , enhance key specialty construction and improve the level of diagnosis and treatment .

Pareto chart analysis of high-risk events in delivery room / 重庆医学

Objective To explore the composition of the high risk events in delivery room ,and then investigate the measure-ments improving the nursing quality .Methods Pareto principle was used to analyses the composition of high risk events in delivery room from January 2010 to June 2012 in a third-grade class-A hospital in Jiangsu province .Results Among all the high risk e-vents ,low satisfaction with nursing care took more than 80% proportion of the total events ,it was called the A events .The dysto-cia ,acute production ,bleeding ,umbilical cord prolapse ,etc cumulative constitute 91% -100% proportion(C events) .Conclusion Managers in delivery room must take measures to improve the paritys`satisfaction with the nursing care ,meanwhile ,other high risk events should also be solved .