摘要:目的:优化药品单剂量调剂,加强信息化管理,优化操作流程。 方法:采用东华软件:住院药房管理系统(DTCISIP)和住院药品调剂系统(DTCISID) 实施。结果:东华软件成功实现了我院4300病床的药品单剂量调剂及各部门管理联网,优化了操作系统及流程,且系统运行稳定。结论:东华软件进行药品单剂量调剂,加强了药品的出入管理,优化了药品单剂量调剂的操作流程。Abstract: Objective: To improve united dose dispension, enhance the utilization of information technology in management of united dose dispension and optimize clinical human resource. Methods: DONG HUA software, which included DTCISIP system(system for management of medicine for inpatients) and DTCISID system(system for dispension of medicine for in-patients), was used to carry out united dose dispension. Results: United dose dispension of 4300 beds were easy to achieve by using DONG HUA software. The system worked smoothly and received lots of praise. Conclusion: The management of medicine is enhanced and clinical human resource is optimized by using DONG HUA software to carry out united dose dispension
Sudden cardiac arrest is one of the critical clinical syndromes in emergency situations. A cardiopulmonary resuscitation (CPR) is a necessary curing means for those patients with sudden cardiac arrest. In order to simulate effectively the hemodynamic effects of human under AEI-CPR, which is active compression-decompression CPR coupled with enhanced external counter-pulsation and inspiratory impedance threshold valve, and research physiological parameters of each part of lower limbs in more detail, a CPR simulation model established by Babbs was refined. The part of lower limbs was divided into iliac, thigh and calf, which had 15 physiological parameters. Then, these 15 physiological parameters based on genetic algorithm were optimized, and ideal simulation results were obtained finally.
Objective To analyze the risk factors of type 2 diabetes mellitus and establish BP neural network model for screening of type 2 diabetes mellitus based on particle swarm optimization (PSO) algorithm. Methods Inpatients with type 2 diabetes mellitus in the Department of Endocrinology of the Affiliated Hospital of Guangdong Medical University and the Second Affiliated Hospital of Guangdong Medical University between July 2021 and August 2022 were selected as the case group and healthy people in the Health Management Center of the Affiliated Hospital of Guangdong Medical University as the control group. Basic information and physical and laboratory examination indicators were collected for comparative analysis. PSO-BP neural network model, BP neural network model and logistic regression models were established using MATLAB R2021b software and the optimal screening model of type 2 diabetes mellitus was selected. Based on the optimal model, the mean impact value algorithm was used to screen the risk factors of type 2 diabetes mellitus. Results A total of 1 053 patients were included in the case group and 914 healthy peoples in the control group. Except for type of salt, family history of comorbidities, body mass index, total cholesterol, low density lipoprotein cholesterol and staple food intake (P>0.05), the other indexes showed significant differences between the two groups. The performance of the PSO-BP neural network model outperformed the BP neural network model and the logistic regression model. Based on PSO-BP neural network model, the mean impact value algorithm showed that the risk factors for type 2 diabetes mellitus were fasting blood glucose , heart rate, age , waist-arm ratio and marital status , and the protective factors for type 2 diabetes mellitus were high density lipoprotein cholestero, vegetable intake, residence, education level, fruit intake and meat intake. Conclusions There are many influencing factors of type 2 diabetes mellitus. Focus should be placed on high-risk groups and regular disease screening should be carried out to reduce the risk of type 2 diabetes. The screening model of PSO-BP neural network performs the best, and it can be extended to the early screening and diagnosis of other diseases in the future.
Stress distribution of denture is an important criterion to evaluate the reasonableness of technological parameters, and the bite force derived from the antagonist is the critical load condition for the calculation of stress distribution. In order to improve the accuracy of stress distribution as much as possible, all-ceramic crown of the mandibular first molar with centric occlusion was taken as the research object, and a bite force loading method reflecting the actual occlusal situation was adopted. Firstly, raster scanning and three dimensional reconstruction of the occlusal surface of molars in the standard dental model were carried out. Meanwhile, the surface modeling of the bonding surface was carried out according to the preparation process. Secondly, the parametric occlusal analysis program was developed with the help of OFA function library, and the genetic algorithm was used to optimize the mandibular centric position. Finally, both the optimized case of the mesh model based on the results of occlusal optimization and the referenced case according to the cusp-fossa contact characteristics were designed. The stress distribution was analyzed and compared by using Abaqus software. The results showed that the genetic algorithm was suitable for solving the occlusal optimization problem. Compared with the reference case, the optimized case had smaller maximum stress and more uniform stress distribution characteristics. The proposed method further improves the stress accuracy of the prosthesis in the finite element model. Also, it provides a new idea for stress analysis of other joints in human body.
It is the main method for amplifying the specific gene to use the nucleic acid amplification system to accomplish polymerase chain reaction (PCR). The temperature retard between heat source and sample exists in the heating and cooling progresses of most nucleic acid amplification system. The retard would result in the problem that the sample would take a long time to reach the set temperature and the problem would reduce the speed of integrate reaction. Non-specific products would be created in the process of amplification when the sample cannot reach the set temperature within a certainly time and the amplified efficiency would be reduced. A miniaturization nucleic acid amplification system heated by air was designed in this study according to the principle of air-heated nucleic acid amplification system and the characteristics of the PCR instrument Smart-cycler. The heat transfer process was analyzed and the heat transfer time was calculated. The actual temperature was measured in real time, and the temperature curves were fitted. The heating time was chosen by analysis results and data fitting and the air temperature was changed, while the sample temperature was recorded. The retard between sample and air was optimized by choosing the best curve of sample temperature. The temperature retard between sample and air was reduced sharply and the required time of integrate progress is shortened to 50%. We confirmed from the amplification experiment of Listeria monocytogenes that the improved system could complete 3 cycles within 4 minutes, and the amplification effect was good. The amplification speed and effect could be improved effectively by optimizing the delay between sample and air.
Objective To explore the application effect of process optimization in perioperative venous access management. Methods A total of 205 general surgery patients in the Operating Room of Cheng Du Shang Jin Nan Fu Hospital, West China Hospital of Sichuan University from April to May 2018 were selected as the control group, and 205 general surgery patients from June to August 2018 were selected as the observation group. The traditional management process was used in the control group, and the process optimization management was performed in the observation group. The establishment of venous access and related complications between the two groups of patients, as well as the satisfaction of patients and staff before and after the process optimization were compared. Results There was no significant difference in gender, age, education level, operation type, anesthesia method, operation duration, or intraoperative intravenous infusion channels between the two groups of patients (P>0.05). There was no statistically significant difference in gender, age, educational background, job title, job nature, or working years of the staff participating in the satisfaction survey before and after the process optimization (P>0.05). The rate of repetitive venous puncture (15.61% vs. 58.05%) and the idelness ratio of the intraoperative indwelling needle approach (10.73% vs. 52.20%) in the observation group were lower than those of the control group, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the incidence of tube blockage, detubation, or phlebitis/exudation between the two groups (P>0.05). After process optimization, patient satisfaction (22.91±3.43 vs. 17.44±4.90) and staff satisfaction (28.17±2.56 vs. 20.65±3.71) were higher than before optimization, and the differences were statistically significant (P<0.05). Conclusions The process optimization of venous access management for perioperative patients can effectively reduce the rate of venous repeated venipuncture and the idelness ratio of the intraoperative indwelling needle approach, reduce invasive operations on patients, reduce the ineffective work of nurses, avoid the waste of medical resources such as manpower and materials, and improve the satisfaction of patients and staff. It is worthy of promotion and application.
Objective To evaluate the effect of optimizing the management measures of cataract ambulatory surgery. Methods The patients who underwent cataract phacoemulsification combined with intraocular lens implantation in the Ambulatory Surgery Center of East District of Beijing Tongren Hospital affiliated to Capital Medical University were selected. Patients between January and December 2021 (after the optimization of ambulatory surgery process) were included, and patients between January and December 2020 (before the optimization of ambulatory surgery process) were included as control. The three factors of age, gender and surgical eye type were used as predictive variables for propensity score matching. The proportion of patients who completed the surgery according to the scheduled time, the proportion of eye drops used according to the doctor’s instructions and the number of hospital visits before and after the optimization of the ambulatory surgery process were compared with the patients who successfully matched. Results A total of 28306 patients were included, including 13284 before and 15022 after process optimization. There were 13467 males and 14839 females, with a median age of 70 (60, 78) years. There was no statistically significant difference in the age of patients before the process optimization (P>0.05), but there was statistically significant difference in gender and surgical eye (P<0.05). After the propensity score matching, a total of 12932 pairs of patients were matched successfully. After the propensity score matching, there was no statistically significant difference between the two groups in age, gender and surgical eye (P>0.05). After the process optimization, the proportion of patients who completed surgery on schedule (98.8% vs. 93.3%) and used eyedrops according to the doctor’s instructions (97.4% vs. 93.0%) were higher than that before the process optimization, and the proportion of patients who came to hospital more than 3 times (0.7% vs. 1.9%) was lower than that before the process optimization (P<0.05). Conclusion The optimized ambulatory surgery process can help patients complete the surgery according to the scheduled time and use eye medication according to the doctor’s instructions, and can reduce the number of patients coming to the hospital.
Objective To refine the technique of portal inflow occlusion and parenchymal transection for laparoscopic hepatectomy in the porcine model. Methods Ten pigs were used. The portal inflow complete or selective occlusion was carried out with portal triad clamping or dissection and division of the left portal pedicle. The sequential laparoscopic local hepatectomy, left lateral lobectomy, and left medial lobectomy were performed without portal inflow occlusion. Parenchymal transection was performed with harmonic scalpel, LigaSure, microwave dissector, bipolar electrocautery, surgical clips, and endoscopic stapler. The efficacy and safety of different techniques in laparoscopic parenchymal transection of the liver were compared. Results The ischemic liver was darken with complete or selective portal triad clamping. The ischemic demarcation line between left and right lobe was obvious with the dissection and division of the left portal pedicle. There was an applicable scope of each hepatic parenchymal transection apparatus. The optimal combination of different techniques could increase efficacy and reduce hemorrhage in laparoscopic parenchymal transection of the liver. Conclusion Technical refinements of portal inflow occlusion and parenchymal transection in porcine models could provide evidences to clinical appliance of laparoscopic anatomic major hepatectomy.
Diabetic retinopathy (DR) is one of the main cause of severe visual impairment in diabetic patients. Most of the existing treatments are aimed at patients with intermediate and advanced stages of vision impairment, and are invasive treatments with limited effects. Therefore, it is urgent for non-invasive new therapies and new targets to prevent the risk of DR or delay the progress of DR. Early optimization of metabolic therapies, which are strict control of blood glucose, blood pressure and blood lipid in the early stage of diabetes, may prevent or improve potential and reversible microangiopathy, however, there is still a lack of comprehensive and effective drug targeted therapy and unified clinical application standards. Therefore, this study summarizes the application of new hypoglycemic drugs and some antihypertensive and lipid-lowering drugs in the prevention and treatment of DR in recent years, in order to provide some reference for the clinical early prevention and treatment of this disease.
Feature extraction is a very crucial step in P300-based brain-computer interface (BCI) and independent component analysis (ICA) is a suitable P300 feature extraction method. But at present the convergence performance of the general ICA iteration methods are not very satisfactory. In this paper, a method based on quantum particle swarm optimizer (QPSO) algorithm and ICA technique is put forward for P300 extraction. In this method, quantum computing is used to impel ICA iteration to globally converge faster. It achieved the purpose of extracting P300 rapidly and efficiently. The method was tested on two public datasets of BCI Competition Ⅱ and Ⅲ, and a simple linear classifier was employed to classify the extracted P300 features. The recognition accuracy reached 94.4% with 15 times averaged. The results showed that the proposed method could extract P300 rapidly and the extraction effect did not reduce. It provides an experimental basis for further study of real-time BCI system.