Objective: To explore the drug concentration detection of antipsychotic drugs in the treatment of schizophrenia and other psychiatric diseases.Methods: Collecting the research results of relevant references in recent years, and summarizing the development and existing problems of the detection of psychotropic drugs in recent years from the perspective of drug detection methods, multidisciplinary integration, and interdisciplinary cooperation, so as to provide a reference for the follow-up monitoring of antipsychotic drugs.Results: It was found that the individual differences in pharmacokinetics of these drugs were large, and the side effects and toxic reactions were not easily distinguished from the aggravation of the symptoms of the disease itself.Conclusion: Through the analysis of the collected literature, we can understand the research progress of antipsychotic drug concentration monitoring, and provide strong evidence for the realization of clinical individualized precise treatment.

目的 构建医养结合型养老机构服务质量评价指标体系,为规范、提升我国医养结合型养老机构的服务质量提供参考.方法 通过文献查阅、半结构访谈、专家咨询初拟医养结合型养老机构服务质量评价指标,采用德尔菲法进行4轮函询,确定医养结合型养老机构服务质量评价指标体系.结果 构建了包含3个一级指标、12个二级指标、52个三级指标的医养结合型养老机构服务质量评价指标体系;专家权威系数为0.889,4轮专家协调系数为0.117～0.190(P<0.001).结论 构建的医养结合型养老机构服务质量评价指标体系内容较为全面、具有科学性,为提升和评价医养结合型养老机构的服务质量水平提供了参考.

目的:调查四川省医养结合型养老机构老年人服务需求属性及特征差异,为医养结合型养老机构实现对老年人服务需求满足的"靶向精准"提供参考.方法:采用便利抽样抽取成都市、攀枝花市、泸州市、自贡市27家医养结合型养老机构内773名老年人为调查对象,采用一般资料调查表,自制《医养结合型养老机构老年人服务需求Kano属性问卷》进行问卷调查.结果:在改进Kano模型划分下,医养结合型养老机构老年人在整体层面对47项养老服务具有一定的需求;64项服务中有30项|DSI|≥0.5,33项SI＞|DSI|;重要度矩阵划分结果显示,11项服务划分在第一象限,归属于期望属性,26项服务划分在第二象限,归属于魅力属性,10项服务划分在第三象限,归属于无差异型属性;17项服务划分在第四象限,归属于必备属性.结论:医养结合型养老机构老年人的养老服务需求整体上呈现出"高依赖性"和"高期待性"倾向,据此提出,医养结合型养老机构在持续保障必备型需求服务,稳步提供期望型需求服务,努力丰富魅力型需求服务,客观分析无差异型需求服务的同时还应该采取"必备型需求(M)＞期望型需求(O)＞魅力型需求(A)＞无差异型需求(Ⅰ)"的需求满足策略.

ObjectiveTo investigate the attributes and influencing factors of service demand for the elderly in medical⁃nursing combined institutions in Sichuan province，so as to provide reference for the "targeted precision" of the elderly service needs of the medical⁃nursing combined institutions.MethodsTotally 773 elderly people who lived in 27 medical⁃nursing combined institutions in Chengdu，Panzhihua，Luzhou and Zigong from February 2019 to June 2019，were selected by convenient sampling.Questionaire investigation was carried out by using the general information questionnaire，Barthel Index（BI），the short⁃form of the UCLA Loneliness Scale（ULS⁃8），Lubben Social Network Scale（LSNS） and self⁃made Kano attribute questionnaire on the service demand of the elderly in medical⁃nursing combined institutions.ResultsThe elderly had a certain demand for 55 services at the overall level，including 22 must⁃be quality（M），7 one⁃dimensional quality（O） and 26 attractive quality（A）.Multiple linear stepwise regression analysis showed that self⁃care ability level，age，monthly institutional care costs，monthly income，functional comorbidity index，number of children，education level，loneliness，household registration location，and marital status were the main influencing factors of the service demand of the elderly in medical⁃nursing combined institutions（P<0.05）.ConclusionThe elderly in medical-nursing combined institutions were characterized by old age，disease，disability，loneliness and poor social support.The overall demand for the elderly care services showed a tendency of "high dependence" and "high expectation".Pension institutions should pay attention to the division of characteristic groups of the elderly and meet their different needs，in order to formulate a flexible service menu of "basic security" + "individual choice".

Aim and objective To establish an index system for the evaluation of undergraduate nursing student innovation ability. Background An index system for evaluation of undergraduate nursing student innovation ability has not been established. Design A three-round Delphi survey sought opinions from experts about the index system for evaluation of undergraduate nursing student innovation ability. Methods A Delphi survey was used for the study of 19 experts from nursing education, clinical nursing and health management. The consistency of consultation results formed the basis for determining the rounds of consultation. With the importance of consulting experts in the last round, we established the judgement matrix using yaahp7.5 software and the analytic hierarchy process and determined the weight coefficient of each index. A modified recommendation for the Conducting and Reporting of Delphi studies (CREDES) was used to guide this study. Results Nineteen experts from 10 nursing colleges and nine third-level first-class hospitals in seven domestic provinces/municipalities were included in this study. The index system was divided into primary, secondary and tertiary levels. Consensus was reached on three primary indicators ('spirit', 'ability' and 'achievement'), nine secondary indicators and 28 tertiary indicators. Conclusions A unified and hierarchical quality assessment index framework for nursing undergraduate creative ability was established. The framework should be further tested and improved in practice. Relevance to clinical practice Nursing students are the main force behind clinical nursing in the future. An innovative approach to skill acquisition and application could enhance the student nurse experience. The innovative ability of nursing students is important for identification of education strategies that be implemented to better support those individuals. Furthermore, the construction of the index system is helpful for evaluation of the innovation ability of nursing students that are required to better meet the needs of clinical nursing work in the future.

Background . WeChat is the most widely and frequently used mobile social media in China and has profoundly integrated into the daily life of many Chinese people. A variety of medicine-related information may be found on WeChat. As users of WeChat, doctors often access health-related information and even provide a variety of medical services or participate in various types of mobile communication with patients. Objective . This study is the first attempt to quantitatively explore the approaches by doctors of acquiring medical knowledge using Internet resources especially social media such as WeChat to access knowledge. Methods . A self-administered questionnaire was designed, distributed, collected, and analyzed utilizing the online survey tool Sojump. WeChat was adopted to randomly release the questionnaires using snowball sampling and collect the results after a certain amount of time. Results . 292 valid questionnaires out of 314 questionnaires by clinical doctors were analyzed. Regarding the current status of accessing medical knowledge among doctors, more than 60% of the doctors regularly used the Internet to search for medical knowledge, 19.86% used WeChat as a channel to acquire medical knowledge, and only 23.97% were satisfied with acquiring medical knowledge through the Internet. Regarding the frequency of WeChat usage, nearly 40% of the doctors accessed WeChat more than 20 times per day and over 70% used WeChat for over half an hour every day. Regarding the status of accessing medical knowledge through WeChat, nearly half (47.26%) of the doctors stated that they often read professional medical articles on WeChat and the most common channel is friends’ moment sharing and public account subscriptions, with selection rates of 59.93% and 60.27%, respectively. The most desirable mode of acquiring medical knowledge through WeChat was the following: “professional medical knowledge from peers, with a reminder.” Conclusion . WeChat has become a nonnegligible means of acquiring medical knowledge for busy Chinese physicians in a mobile environment. Further evaluation and improvement of the quality of medical knowledge on WeChat are needed. The recommendation of individualized articles through social media may become another contributing factor for doctors to acquire medical knowledge effectively and efficiently.

目的 探讨奥美拉唑所致药物不良反应(ADR)的规律及特点,为临床合理用药提供参考.方法 以“omeprazole”、“adverse effect”为主题词,检索1990～2017年Pubmed、Embase外文数据库中有关奥美拉唑致ADR的病例报告,并对患者相关情况进行统计分析.结果 共收集奥美拉唑致ADR病例245例,ADR多发生在40 ～59岁和60 ～79岁年龄段,给药2～10d及＞30 d ADR好发,以消化系统、血液系统、内分泌与生殖系统及神经肌肉系统的临床表现多见.结论 奥美拉唑所致ADR临床表现复杂,其发生与多种因素有关,应引起临床高度重视.

The aim of this study was to develop nifedipine (NF) hollow microspheres as a controlled-release preparation and evaluate in vitro. The formulation and technology was optimized using three factors three-level orthogonal experimental design with the in vitro release as marker. The optimal formulation was composed of ethyl cellulose ethocel (EC):polyvinyl pyrrolidone (PVP):NF (0.9:0.12:0.12, w/w) based on the orthogonal experiment. The hollow microspheres containing NF were spherical in shape with well-proportioned particle size. Floating ratios of these microspheres were more than 98% in release medium for 24 h. Furthermore, the release behavior of the hollow microspheres showed a zero order approximate dynamic model and could be expressed by the following equation: Q = 0.0325t + 0.138, r = 0.9993. The similarity factor (f(2)) values of three batches of NF hollow microspheres were 60.75, 61.51 and 60.84, respectively, ranged from 50 to 100, in comparison with commercially available NF controlled-release tablets (Adalat (R)). In Ritger-Peppas equation, the values of the release exponent n were 0.478 and 0.772, respectively, ranged from 0.45 to 0.89. NF loaded hollow microspheres with hydrophilic polymers PVP and hydrophobic polymers EC were successfully prepared in this study and were an effective controlled-sustained release particle carrier for gastric floating-type controlled-release delivery systems. The in vitro release behavior of NF hollow microspheres was almost similar to that of Adalat (R), indicating that drug was released by the combination of diffusion and erosion mechanisms. We believe further study may provide a new preparation of multi-unit oral controlled release system for NF.

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

Background and Aims: Bleeding is the most common adverse event after endoscopic submucosal dissection (ESD). Although several studies have reported on the use of antithrombotic agents and post-ESD bleeding, many issues remain controversial. We conducted a meta-analysis and systematic review to evaluate the effects of antithrombotic therapy on post-ESD bleeding. Methods: The published literature was searched on online databases, and all studies were included up to January 2017. Standard forms were used to extract data by 2 independent reviewers. The Newcastle-Ottawa Scale score was used to assess the quality of studies. The pooled odds ratio (OR) was computed for the effect of antithrombotic agents. Publication bias was assessed by funnel plots. Heterogeneity was assessed by the Cochran Q test and I-2 statistic. Results: Sixteen retrospective articles were included. Regardless of discontinuation (OR, 1.66; 95% confidence interval [CI], 1.15-2.39; P = .007) or continuation (OR, 8.39; 95% CI, 4.64-15.17; P <.00001), antithrombotic therapy was significantly associated with post-ESD bleeding, particularly for delayed bleeding (OR, 2.66; 95% CI, 1.42-4.98; P = .002). The bleeding rate was higher in the discontinued multiple antithrombotics group (OR, 5.17; 95% CI, 3.138.54; P <.00001) than in the discontinued a single antithrombotic group (OR, 2.23; 95% CI, 1.29-3.85; P= .004) and single antiplatelet group (OR, 2.08; 95% CI, 0.93-4.63; P = .07). In the subgroup analysis, resuming antithrombotics within 1 week (OR, 2.46; 95% CI, 1.54-3.93; P = .0002) and using heparin replacement (OR, 4.20; 95% CI, 1.94-9.09; P = .0003) significantly increased post-ESD bleeding risk. Continued use of low-dose aspirin (OR, 1.22; 95% CI, 0.178.61; P = .84) did not significantly increase the bleeding risk. Conclusions: Antithrombotic therapy is a risk factor for post-ESD bleeding, especially for delayed bleeding. Using multiple antithrombotic drugs, resuming antithrombotics within 1 week, and heparin replacement were significantly associated with post-ESD bleeding; but continuous low-dose aspirin was not. However, much larger prospective studies are required.

Background: China launched its second health reform in 2010 with considerable investments in medical informatics (MI). However, to the best of our knowledge, research on the outcomes of this ambitious undertaking has been limited.Objective: Our aim was to understand the development of MI and the state of continuing education in China and the United States from the perspective of conferences.Methods: We conducted a quantitative and qualitative analysis of four MI conferences in China and two in the United States: China Medical Information Association Annual Symposium (CMIAAS), China Hospital Information Network Annual Conference (CHINC), China Health Information Technology Exchange Annual Conference (CHITEC), China Annual Proceeding of Medical Informatics (CPMI) versus the American Medical Informatics Association (AMIA) and Healthcare Information and Management Systems Society (HIMSS). The scale, composition, and regional distribution of attendees, topics, and research fields for each conference were summarized and compared.Results: CMIAAS and CPMI are mainstream academic conferences, while CHINC and CHITEC are industry conferences in China. Compared to HIMSS 2016, the meeting duration of CHITEC was 3 versus 5 days, the number of conference sessions was 132 versus 950+, the number of attendees was 5000 versus 40,000+, the number of vendors was 152 versus 1400+, the number of subforums was 12 versus 230, the number of preconference education symposiums and workshops was 0 versus 12, and the duration of preconference educational symposiums and workshops was 0 versus 1 day. Compared to AMIA, the meeting duration of Chinese CMIAAS was 2 versus 5 days, the number of conference sessions was 42 versus 110, the number of attendees was 200 versus 2500+, the number of vendors was 5 versus 75+, and the number of subforums was 4 versus 10. The number of preconference tutorials and working groups was 0 versus 29, and the duration of tutorials and working group was 0 versus 1.5 days.Conclusions: Given the size of the Chinese economy and the substantial investment in MI, the output in terms of conferences remains low. The impact of conferences on continuing education to professionals is not significant. Chinese researchers and professionals should approach MI with greater rigor, including validated research methods, formal training, and effective continuing education, in order to utilize knowledge gained by other countries and to expand collaboration.

Objective To investigate and analyzethe quality of life among the elderly and its influencing factors Aba Tibetan and Qiang area,and provide scientific reference for improving the quality of life among elderly people in the re-gion and raising the level of health status.Methods A self-designed questionnaire and WHO Quality of Life Brief Scale (QOL-BREF)were employed to conduct a household survey among 272 elderly people in Aba Tibetan and Qiang Autono-mous Prefecture.T test,variance analysis and linear regression analysis were made by using SPSS 19.0 statistical software. Results In general,the dimensions of quality of life among the elderly in Aba Tibetan and Qiang area and compared the norm in China were all in low level except the environmental field.The highest score was (60.75 ±12.92)points in the field of physiology,followed by psychological field (59.44 ±12.40),environment field (58.56 ±11.28)and the lowest score in the field of social relation domain was (53.25 ±11.64)points.Conclusion Quality of life among the elderly in Aba Tibetan and Qiang area is in low level,which is affected by many factors.Among them,ethnic,cultural level,living style and income level are the main factors.

Background: As the world's second-largest economy, China has launched health reforms for the second time and invested significant funding in medical informatics (MI) since 2010; however, few studies have been conducted on the outcomes of this ambitious cause.Objective: This study analyzed the features of major MI meetings held in China and compared them with similar MI conferences in the United States, aiming at informing researchers on the outcomes of MI in China and the U.S. from the professional conference perspective and encouraging greater international cooperation for the advancement of the field of medical informatics in China and, ultimately, the promotion of China's health reform.Methods: Qualitative and quantitative analyses of four MI meetings in China (i.e., CMIAAS, CHINC, CHITEC, and CPMI) and two in the U.S. (i.e., AMIA and HIMSS) were conducted.Furthermore, the size, constituent parts and regional allocation of participants, topics, and fields of research for each meeting were determined and compared.Results: From 1985 to 2016, approximately 45,000 individuals attended the CMIAAS and CPMI (academic), CHINC and CHITEC (industry), resulting in 5,085 documented articles.In contrast, in 2015, 38,000 and 3,700 individuals, respectively, attended the American HIMSS (industry) and AMIA (academic) conferences and published 1,926 papers in the latter.Compared to those of HIMSS in 2015, the meeting duration of Chinese industry CHITEC was 3 vs. 5 days, number of vendors was 100 vs. 1500+, number of sub-forums was 10 vs. 250; While compared to those of AMIA, the meeting duration of Chinese CMIAAS was 2 vs. 8 days, number of vendors was 5 vs. 65+, number of sub-forums was 4 vs. 26.HIMSS and AMIA were more open, international, and comprehensive in comparison to the aforementioned Chinese conferences. Conclusions:The current MI in China can be characterized as "hot in industry application, and cold in academic research."Taking into consideration the economic scale together with the huge investment in MI, conference yield and attendee diversity are still low in China.This study demonstrates an urgent

Background As the world’s second-largest economy, China has launched health reforms for the second time and invested significant funding in medical informatics (MI) since 2010; however, few studies have been conducted on the outcomes of this ambitious cause. Objective This study analyzed the features of major MI meetings held in China and compared them with similar MI conferences in the United States, aiming at informing researchers on the outcomes of MI in China and the US from the professional conference perspective and encouraging greater international cooperation for the advancement of the field of medical informatics in China and, ultimately, the promotion of China’s health reform. Methods Qualitative and quantitative analyses of four MI meetings in China (i.e., CMIAAS, CHINC, CHITEC, and CPMI) and two in the US (i.e., AMIA and HIMSS) were conducted. Furthermore, the size, constituent parts and regional allocation of participants, topics, and fields of research for each meeting were determined and compared. Results From 1985 to 2016, approximately 45,000 individuals attended the CMIAAS and CPMI (academic), CHINC and CHITEC (industry), resulting in 5,085 documented articles. In contrast, in 2015, 38,000 and 3,700 individuals, respectively, attended the American HIMSS (industry) and AMIA (academic) conferences and published 1,926 papers in the latter. Compared to those of HIMSS in 2015, the meeting duration of Chinese industry CHITEC was 3 vs. 5 days, the number of vendors was 100 vs. 1,500+, the number of sub-forums was 10 vs. 250; while compared to those of AMIA, the meeting duration of Chinese CMIAAS was 2 vs. 8 days, the number of vendors was 5 vs. 65+, the number of sub-forums was 4 vs. 26. HIMSS and AMIA were more open, international, and comprehensive in comparison to the aforementioned Chinese conferences. Conclusions The current MI in China can be characterized as “hot in industry application, and cold in academic research.” Taking into consideration the economic scale together with the huge investment in MI, conference yield and attendee diversity are still low in China. This study demonstrates an urgent necessity to elevate the medical informatics discipline in China and to expand research fields in order to maintain pace with the development of medical informatics in the US and other countries.

OBJECTIVE:To prepare nifedipine (NF) hollow controlled-release microspheres and evaluate the quality. METH-ODS:Solvent diffusion volatilization method was used to prepare microspheres,using comprehensive scores of cumulative release in 2,12,24 h(Q2 h,Q12 h,Q24 h)as indexes,orthogonal test was designed to screen the carrier material ethyl cellulose(EC),poly-vinyl pyrrolidone(PVP)and main drug NF amounts;appearance,particle size distribution,drug loading,floating and cumulative release of the microspheres prepared by optimal formulation were evaluated and compared of in vitro release behavior with imported preparation of Nifedipine controlled-release tablets (Adalat?). RESULTS:The optimal formulation was as follow as NF 3.00 g, PVP 1.60 g,EC 15.65 g. Prepared NF hollow controlled-release microspheres were spherical in shape with particle size distribution of 24-40 mesh and drug loading of 8.66%;24 h floating rate in release medium was 97.93%,Q2 h,Q12 h,Q24 h were 20.49%, 52.90%,91.00%(RSD<10%,n=3). Compared with the imported preparation,similarity factor f2 values of cumulative release were higher than 50,showing in vitro drug-release was consistent with the zero-order kinetic equation (r=0.9993);n of Rit-ger-Peppas equation (r=0.9807) was 0.478. CONCLUSIONS:Prepare NF hollow controlled-release microspheres show similar drug-release behavior with the imported preparation,the drug is released by the combination of diffusion and erosion.

This paper studies the quality guarantee system of master's degree theses from a new perspective by introducing the basic ideas of system theory and cybernetics.Then it proposes a systematic guarantee system of medicine master's degree theses,which integrates standard system,organizational system,institutional system,evaluation system,monitoring system and cultural system.The system is implemented through normalized management,evaluation,control and education.

Objective To describe the main job stressors and to show the relationship between job stressors and the level of burnout among aged-care nurses. Methods Ninety-eight aged-care nurses were investigated by Questionnaire of Stressors of Aged-care Nurses and Questionnaire of Burnout of Aged-care Nurses. Results The level of job stress was moderate with an average score of 2.63±0.25. The level of burnout was moderate as well with emotional exhaustion score of 24.91±5.38, depersonalization score 12.00± 4.18 and no-accomplishment score 21.04±5.75. The top three resources of job stress were as followed: overworked, low salary and no promotion, non-cooperation of the aged and nursing risk. The top job stressors had positive correlation with the emotional exhaustion and no-accomplishment (P<0.05). Conclusion The important reasons of job burnout of the aged-care nurses are overworked, low salary and without promotion, non-cooperation of the aged and nursing risk. More aged-care nurses, the improvement of the salary and the career promotion, scientific management will contribute to decreasing the level of job stress and relieving the level of burnout of aged-care nurses.

Objective To describe the construction of the old-care nurses in Luzhou city and the level of burnout and the influencing factors among the old-care nurses. Methods: 156 old-care nurses in Luzhou city were investigated through questionnaires. Results:Old-care nurses were female-dominated(64.1%)with an average age of 41.67±10.891 years, and an average employment time of 4.22±3.258 years, Most of those nurses had the education level of joural high school and 56.4% of older-care nurse's monthly income is below 1 500 RMB. 61.5% of the older-care nurses had moderate burnout, and the lever of burnout were higher in the following groups the male, aged from 41 to 50 years, unmarried, with elementary education level, monthly income below 1 000 RMB, and the front nurses. Conclusion: Job burnout of the old-care nurses should be paid much attention and some measures should be taken to prevent and relieve this feeling.

The paper summarizes the relationship between teaching fine management and the the quality of talent cultivation improvement.The key to the educational work is not only the aim of“What kind of talent training”,but the process of systematic management of“How to cultivate talents”.Therefore,it is an important topic for medical educators to apply the delicacy management ideas and strategies to promote the quality of talent training.