In this paper, on the basis of the analysis of the current situation of the mine floor flood and the consultation system study, the overall design and structure, specially, the mechanism of many kinds of method for ma...In this paper, on the basis of the analysis of the current situation of the mine floor flood and the consultation system study, the overall design and structure, specially, the mechanism of many kinds of method for making a strategic decision and reasoning of the system of prevention and control of mine floor flood are introduced. The applied examples are given at last.展开更多
Academic journals,consulting firms,and mainstream media have often published“predictions”about the future develop-ment of medical and health care.These publications often emphasize the potential of cutting-edge scie...Academic journals,consulting firms,and mainstream media have often published“predictions”about the future develop-ment of medical and health care.These publications often emphasize the potential of cutting-edge scientific or technical breakthroughs.Health Care Science looks at the problem from another perspective.We focus on how these changes enter the health system,how they operate in the real world,and how they reshape the organization and governance of medical services.At the beginning of 2026,we envision the following three major shifts that will reshape healthcare.展开更多
Aimed at the deficiency of the mechanism of management and consultation, an idea of an internet-based Virtual Diagnosis Center （VDC） for machine fault is proposed, and the key elements of remote consultation are abs...Aimed at the deficiency of the mechanism of management and consultation, an idea of an internet-based Virtual Diagnosis Center （VDC） for machine fault is proposed, and the key elements of remote consultation are abstracted. Around the key elements, the construct scheme and cooperative mechanism among experts of VDC are designed. According to the diagnosed object, the context knowledge of a fault machine, fault cases and ActiveX-based analysis tools are integrated into a multimedia consultation environment in VDC to enhance the efficiency of expert consultation. Simultaneously, the technique of push subscription in a SQL Server is utilized to collect machine condition data in an enter- prise machine condition database, which ensures the security of the database. The VDC system in Xi＇an Jiaotong University has been applied to remote diagnosis of a blower in Wuhan Iron and Steel Corporation and the system construction reasonableness and the running stability are verified.展开更多
BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neu...BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.展开更多
The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations ...The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.展开更多
BACKGROUND Not all neuropsychiatric(NP)manifestations in patients with systemic lupus erythematosus(SLE)are secondary to lupus.The clarification of the cause of NP symptoms influences therapeutic strategies for SLE.AI...BACKGROUND Not all neuropsychiatric(NP)manifestations in patients with systemic lupus erythematosus(SLE)are secondary to lupus.The clarification of the cause of NP symptoms influences therapeutic strategies for SLE.AIM To understand the attribution of psychiatric manifestations in a cohort of Chinese patients with SLE.METHODS This retrospective single-center study analyzed 160 inpatient medical records.Clinical diagnosis,which is considered the gold standard,was used to divide the subjects into a psychiatric SLE(PSLE)group(G1)and a secondary psychiatric symptoms group(G2).Clinical features were compared between these two groups.The sensitivity and specificity of the Italian attribution model were explored.RESULTS A total of 171 psychiatric syndromes were recorded in 138 patients,including 87 cases of acute confusional state,40 cases of cognitive dysfunction,18 cases of psychosis,and 13 cases each of depressive disorder and mania or hypomania.A total of 141(82.5%)syndromes were attributed to SLE.In contrast to G2 patients,G1 patients had higher SLE Disease Activity Index-2000 scores(21 vs 12,P=0.001),a lower prevalence of anti-beta-2-glycoprotein 1 antibodies(8.6%vs 25.9%,P=0.036),and a higher prevalence of anti-ribosomal ribonucleoprotein particle(rRNP)antibodies(39.0%vs 22.2%,P=0.045).The Italian attribution model exhibited a sensitivity of 95.0%and a specificity of 70.0%when the threshold value was set at 7.CONCLUSION Patients with PSLE exhibited increased disease activity.There is a correlation between PSLE and anti-rRNP antibodies.The Italian model effectively assesses multiple psychiatric manifestations in Chinese SLE patients who present with NP symptoms.展开更多
As Internet becomes largely used in the AEC (architecture, engineering andconstruction) industry, the main focus is in the area of information and project management. In thedynamic engineering consulting, less has bee...As Internet becomes largely used in the AEC (architecture, engineering andconstruction) industry, the main focus is in the area of information and project management. In thedynamic engineering consulting, less has been done so far. This research tries to find thepossibility and potential of the Internet application in design and consulting for the AEC industryby proposing a working model in specific area, steel construction. Several issues have beendiscussed: defining and formatting the typical procedure and character of the steel constructionconsulting, behavior approach based on activities among partners, and the model organization.展开更多
As spring draws near,virtually everything is being renewed.During this year’s two sessions(the fourth session of the 14th National People’s Congress[NPC]and the fourth session of the 14th National Committee of the C...As spring draws near,virtually everything is being renewed.During this year’s two sessions(the fourth session of the 14th National People’s Congress[NPC]and the fourth session of the 14th National Committee of the Chinese People’s Political Consultative Conference[CPPCC]),deputies to the 14th NPC and members of the 14th CPPCC National Committee,from all regions of the country,and various segments of society,gathered in Beijing,in March.展开更多
The fourth session of the 14th National People’s Congress(NPC)and the fourth session of the 14th National Committee of the Chinese People’s Political Consultative Conference concluded in Beijing on 12 March and 11 M...The fourth session of the 14th National People’s Congress(NPC)and the fourth session of the 14th National Committee of the Chinese People’s Political Consultative Conference concluded in Beijing on 12 March and 11 March,respectively,making a series of notable achievements.One of the most prominent among them was the adoption of the 15th Five-Year Plan on the final day of the NPC session.展开更多
The annual meetings of the 14th National People’s Congress(NPC)and the 14th National Committee of the Chinese People’s Political Consultative Conference(CPPCC),known as the Two Sessions,were held in Beijing in March...The annual meetings of the 14th National People’s Congress(NPC)and the 14th National Committee of the Chinese People’s Political Consultative Conference(CPPCC),known as the Two Sessions,were held in Beijing in March.Thousands of NPC deputies and CPPCC National Committee members from different regions and walks of life discussed national policies,economic plans and developmental goals.展开更多
Objectives The in-hosptial palliative care consultation(PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perc...Objectives The in-hosptial palliative care consultation(PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital.Methods In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team, and 37 consultations were completed in 2016. A questionnaire was designed for physicians in terms of its benefits to patients,their family as well as the primary care team. Physicians who applied for consultation in 2016 formally(requested from the department other than the Geriatrics) and informally(by rotating residents and unemployed visiting doctors in geriatric department) were invited to participate in the survey by scanning a two dimentional code on social networking platform.Results There were 103 physicians participated in the survey, including primary care physicians from the department of Internal Medicine(n=8), Gynaecology(n=16) and Surgery(n=13), rotating residents(n=30), visiting doctors(n=16) in Geriatric department, and PCC team members(n=20). 94.0% of the non-PCC physicians agreed that PCC relieved the suffering of patients; 89.2% thought PCC improved the quality of patients' life; there were 91.6%, 95.2%, 90.4% physicians who felt it relieved the anxiety of patients, of family members and of care providers, respectively. There were 96.4% physicians who felt it could ease the tension in physician-patient relationship; 97.6% felt it lower the risk for medical negligence, and 96.4% of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation. More primary-team physician agree "PCC service helps the physicians better understand palliative care" than PCC members(97.6% vs. 80%, P<0.05), while both were interested in learning more on palliative medicine(100% vs. 96.4%, P>0.05).Conclusion Palliative care consultation service in a general hospital is efficacious and acclaimed.The primary care physicians and the PCC members hold positive attitudes to the benefits that the PCC services bring to patients, family members, and physicians themselves. PCC for terminal patients in a general hospital may serve as a good modle for promotion of palliative care in China.展开更多
In consultative committee for space data systems(CCSDS)file delivery protocol(CFDP)recommendation of reliable transmission,there are no detail transmission procedure and delay calculation of prompted negative acknowle...In consultative committee for space data systems(CCSDS)file delivery protocol(CFDP)recommendation of reliable transmission,there are no detail transmission procedure and delay calculation of prompted negative acknowledge and asynchronous negative acknowledge models.CFDP is designed to provide data and storage management,story and forward,custody transfer and reliable end-to-end delivery over deep space characterized by huge latency,intermittent link,asymmetric bandwidth and big bit error rate(BER).Four reliable transmission models are analyzed and an expected file-delivery time is calculated with different trans-mission rates,numbers and sizes of packet data units,BERs and frequencies of external events,etc.By comparison of four CFDP models,the requirement of BER for typical missions in deep space is obtained and rules of choosing CFDP models under different uplink state informations are given,which provides references for protocol models selection,utilization and modification.展开更多
Objectives: To describe the communication behaviors of patients and physicians and patient par-ticipation in communication about treatment decision-making during consultation visits for local-ized prostate cancer (LPC...Objectives: To describe the communication behaviors of patients and physicians and patient par-ticipation in communication about treatment decision-making during consultation visits for local-ized prostate cancer (LPCa). Methods: This is a secondary analysis of data from 52 men enrolled in the usual care control group of a randomized trial that focused on decision-making for newly diagnosed men with LPCa. We analyzed the patient-physician communication using the transcribed audio-recordings of real-time treatment consultations and a researcher-developed coding tool, including codes for communication behaviors (information giving, seeking, and clarifying/ verifying) and contents of clinical consultations (health histories, survival/mortality, treatment options, treatment impact, and treatment preferences). After qualitative content analysis, we categorized patient participation in communication about treatment-related clinical content, including “none” (content not discussed);“low” (patient listening only);“moderate” (patient providing information or asking questions);and “high” (patient providing information and asking questions). Results: Physicians mainly provided information during treatment decision consultations and patients frequently were not active participants in communication. The participation of patients with low and moderate cancer risk typically was: 1) “moderate and high” in discussing health histories;2) “low” in discussing survival/mortality;3) “low and moderate” in discussing treatment options;4) “none and low” in discussing treatment impacts;and 5) “low” in discussing treatment preferences. Conclusions: Findings suggest opportunities for increasing patient participation in communication about treatment decision-making for LPCa during clinical consultations.展开更多
The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this re...The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.展开更多
Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework ...Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.展开更多
Since the 1970s, Chinese seismologists have started to conduct the Annual Consultation on the Likelihood of Coming Earthquakes in the Next Year. This approach has unique scientific and practical merits either as an ac...Since the 1970s, Chinese seismologists have started to conduct the Annual Consultation on the Likelihood of Coming Earthquakes in the Next Year. This approach has unique scientific and practical merits either as an active response to the social needs in the situation that earthquake prediction research meets many difficulties, or as a real forward prediction test persistently conducted for 1/3 century. It is a pity that such an approach has not been well-known by international seismological community, and the scientific merits of such an endeavor is sometimes regrettably underestimated.展开更多
ERP(enterprise resource planning) is a huge and com pl ex system engineering which costs a great lot of fund and manpower. It is a refo rm in the enterprise management mode, management idea and management method whi c...ERP(enterprise resource planning) is a huge and com pl ex system engineering which costs a great lot of fund and manpower. It is a refo rm in the enterprise management mode, management idea and management method whi ch needs mass fund import, with long period, full of risk, hard to perform and can’t show its effects at once. The essence of the enterprise performing in ERP system is to run a "management engineering", which involves integration of opera tion process. The integration will touch business culture, enterprise system,m eans of operation and the department’s regulatioins amongst the operation conten ts, rights and responsibilities. Totally, the ERP system is the rebuilding of ma ngagement idea, method and means, which needs the common acquaintance from the t op management to the whole stuff.Meantime, it requires a perfect tactic to perfo rm an ERP system. We must confirm a cut-in spot as the right space to start bas ed on the enterprise requirement and the application environment. And to choose a right space decides that the application of ERP system is successful or not. S o, we must make it clear to build which subsystem first, to take the right seque nce for performing all kinds of function modules and the final integrated functi ons . All this prepared work for the implement of ERP system and the management, the recombination and optimization of enterprise management operation flow, ite m management and harmonization, ERP educational training and so on can not be pe rformed well without management consultancy. The effective management consultan cy can lead then implement of ERP system to shorten the executive cycle, to quik en the realization of effect and to harmonize the relationship to the client ent erprises so that to ensure the successful perform of ERP.展开更多
To improve the efficiency and precision of our pharmacy consultation services,we adopted a"1+X"model based on the PDCA(Plan-Do-Check-Act)cycle.In the initial analysis,we identified factors contributing to su...To improve the efficiency and precision of our pharmacy consultation services,we adopted a"1+X"model based on the PDCA(Plan-Do-Check-Act)cycle.In the initial analysis,we identified factors contributing to suboptimal consultation efficiency.Our approach included a thorough examination of our pharmacy consultation system,encompassing personnel training,consultation promotion,and the refinement of the consultation process.A standardized pharmacy consultation model was devised and continually refined,with a primary focus on infectious diseases.Subsequently,the model expanded to include various medical specialties,fostering multi-disciplinary participation.Since the implementation of the"1+X"pharmacy consultation model,spanning from 2017 to 2022,consultation numbers exhibited a consistent annual growth exceeding 50%.In 2022 alone,5044 pharmaceutical consultations were conducted,encompassing 3007 standard consultations and 96 expanded consultations across diverse departments such as neurosurgery and neurology.The adoption rate of consultation recommendations reached 89.2%,while the effectiveness of consultation treatments stood at an impressive 76.4%.This success underscored the impact of the"1+X"pharmacy consultation model on enhancing consultation outcomes.Collectively,our model,rooted in the PDCA cycle,not only served as a practical blueprint for pharmacy consultation systems in medical institutions but also provided valuable insights and a robust framework for the professional development and training of clinical pharmacists.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</str...<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. </span><b><span style="font-family:Verdana;">Materials</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the in</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">i</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">tial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). </span><b><span style="font-family:Verdana;">Results</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The delays (median, IIQ) were: (5.1 months;IIQ: 1.7 - 12.4), (25 days;IIQ: 10 - 67), (27 days;IIQ: 13 - 63), (2.2 months;IIQ: 1.2 - 5.8) and (9.9 months;IIQ: 4.4 - 17.6) respectiv</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">ly for consultation, diagnosis, treatment, health system and overall delays. The risks associated with a delay in initial consultation of greater than 3 months were (OR;95% CI): unschooled patients (2.01;1.66 - 2.40);monthly income below the minimum wage (2.70;1.81 - 5.96);unemployment (2.14;1.02 - 3.24) and absence of a family history of cancer (2.44;1.66 - 6.10). The main reasons for a late first consultation were: ignorance (60.2%), financial challenges (17.6%) and a preference for alternative treatment (11.1%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The consultation, diagnosis and treatment delays for breast cancer are very often long in our setting than those reported in developed countries. Both patients’ and institutional factors are demonstrated. There is a need to increase public awareness </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">on</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> the value of early diagnosis of breast cancer. Also, health system should be improved to enable early diagnosis and treatment of this affection.</span></span></span>展开更多
The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy ...The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy process(AHP)was used to determine the index weight.A total of 19 experts were included,all with intermediate or higher professional titles.The positive coefficients of experts in the two rounds of consultation were all 100%.The judgment basis of experts is 0.895,the degree of familiarity is 0.842,and the coefficient of authority is 0.868.The Kendall harmony coefficients of the first,second,and third-level indicators were 0.381,0.383,and 0.320,respectively.The expert coordination degree was tested by x^(2) test,the P values were all less than 0.05,indicating that the degree of expert coordination was well.After two rounds of letter inquiry,an evaluation index system of core competence of HCPs with professional accomplishment,theoretical knowledge,basic skills,professional skills,and professional development ability as the main framework was formed,including 5 first-level indicators,18 second-level indicators,and 62 third-level indicators.Based on the Delphi and AHP methods,the index system of HCPs'core competence established has high authority and scientificity,to provide the theoretical basis for the standardized training and comprehensive evaluation of HCPs.展开更多
文摘In this paper, on the basis of the analysis of the current situation of the mine floor flood and the consultation system study, the overall design and structure, specially, the mechanism of many kinds of method for making a strategic decision and reasoning of the system of prevention and control of mine floor flood are introduced. The applied examples are given at last.
文摘Academic journals,consulting firms,and mainstream media have often published“predictions”about the future develop-ment of medical and health care.These publications often emphasize the potential of cutting-edge scientific or technical breakthroughs.Health Care Science looks at the problem from another perspective.We focus on how these changes enter the health system,how they operate in the real world,and how they reshape the organization and governance of medical services.At the beginning of 2026,we envision the following three major shifts that will reshape healthcare.
基金This paper is sponsored by National Tenth 5-year R&D Project under Contract No2001BA204B05
文摘Aimed at the deficiency of the mechanism of management and consultation, an idea of an internet-based Virtual Diagnosis Center （VDC） for machine fault is proposed, and the key elements of remote consultation are abstracted. Around the key elements, the construct scheme and cooperative mechanism among experts of VDC are designed. According to the diagnosed object, the context knowledge of a fault machine, fault cases and ActiveX-based analysis tools are integrated into a multimedia consultation environment in VDC to enhance the efficiency of expert consultation. Simultaneously, the technique of push subscription in a SQL Server is utilized to collect machine condition data in an enter- prise machine condition database, which ensures the security of the database. The VDC system in Xi＇an Jiaotong University has been applied to remote diagnosis of a blower in Wuhan Iron and Steel Corporation and the system construction reasonableness and the running stability are verified.
基金Supported by STI2030-Major Projects,No.2021ZD0202001Capital Funds for Health Improvement and Research,No.CFH 2022-2-4012.
文摘BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.
文摘The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.
基金Supported by STI2030-Major Projects,No.2021ZD0202001National Natural Science Foundation of China,No.T2341003Capital Funds for Health Improvement and Research,No.CFH 2022-2-4012.
文摘BACKGROUND Not all neuropsychiatric(NP)manifestations in patients with systemic lupus erythematosus(SLE)are secondary to lupus.The clarification of the cause of NP symptoms influences therapeutic strategies for SLE.AIM To understand the attribution of psychiatric manifestations in a cohort of Chinese patients with SLE.METHODS This retrospective single-center study analyzed 160 inpatient medical records.Clinical diagnosis,which is considered the gold standard,was used to divide the subjects into a psychiatric SLE(PSLE)group(G1)and a secondary psychiatric symptoms group(G2).Clinical features were compared between these two groups.The sensitivity and specificity of the Italian attribution model were explored.RESULTS A total of 171 psychiatric syndromes were recorded in 138 patients,including 87 cases of acute confusional state,40 cases of cognitive dysfunction,18 cases of psychosis,and 13 cases each of depressive disorder and mania or hypomania.A total of 141(82.5%)syndromes were attributed to SLE.In contrast to G2 patients,G1 patients had higher SLE Disease Activity Index-2000 scores(21 vs 12,P=0.001),a lower prevalence of anti-beta-2-glycoprotein 1 antibodies(8.6%vs 25.9%,P=0.036),and a higher prevalence of anti-ribosomal ribonucleoprotein particle(rRNP)antibodies(39.0%vs 22.2%,P=0.045).The Italian attribution model exhibited a sensitivity of 95.0%and a specificity of 70.0%when the threshold value was set at 7.CONCLUSION Patients with PSLE exhibited increased disease activity.There is a correlation between PSLE and anti-rRNP antibodies.The Italian model effectively assesses multiple psychiatric manifestations in Chinese SLE patients who present with NP symptoms.
文摘As Internet becomes largely used in the AEC (architecture, engineering andconstruction) industry, the main focus is in the area of information and project management. In thedynamic engineering consulting, less has been done so far. This research tries to find thepossibility and potential of the Internet application in design and consulting for the AEC industryby proposing a working model in specific area, steel construction. Several issues have beendiscussed: defining and formatting the typical procedure and character of the steel constructionconsulting, behavior approach based on activities among partners, and the model organization.
文摘As spring draws near,virtually everything is being renewed.During this year’s two sessions(the fourth session of the 14th National People’s Congress[NPC]and the fourth session of the 14th National Committee of the Chinese People’s Political Consultative Conference[CPPCC]),deputies to the 14th NPC and members of the 14th CPPCC National Committee,from all regions of the country,and various segments of society,gathered in Beijing,in March.
文摘The fourth session of the 14th National People’s Congress(NPC)and the fourth session of the 14th National Committee of the Chinese People’s Political Consultative Conference concluded in Beijing on 12 March and 11 March,respectively,making a series of notable achievements.One of the most prominent among them was the adoption of the 15th Five-Year Plan on the final day of the NPC session.
文摘The annual meetings of the 14th National People’s Congress(NPC)and the 14th National Committee of the Chinese People’s Political Consultative Conference(CPPCC),known as the Two Sessions,were held in Beijing in March.Thousands of NPC deputies and CPPCC National Committee members from different regions and walks of life discussed national policies,economic plans and developmental goals.
基金supported by the Educational Reform Project of Peking Union Medical College(2015zlgc012)~~
文摘Objectives The in-hosptial palliative care consultation(PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital.Methods In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team, and 37 consultations were completed in 2016. A questionnaire was designed for physicians in terms of its benefits to patients,their family as well as the primary care team. Physicians who applied for consultation in 2016 formally(requested from the department other than the Geriatrics) and informally(by rotating residents and unemployed visiting doctors in geriatric department) were invited to participate in the survey by scanning a two dimentional code on social networking platform.Results There were 103 physicians participated in the survey, including primary care physicians from the department of Internal Medicine(n=8), Gynaecology(n=16) and Surgery(n=13), rotating residents(n=30), visiting doctors(n=16) in Geriatric department, and PCC team members(n=20). 94.0% of the non-PCC physicians agreed that PCC relieved the suffering of patients; 89.2% thought PCC improved the quality of patients' life; there were 91.6%, 95.2%, 90.4% physicians who felt it relieved the anxiety of patients, of family members and of care providers, respectively. There were 96.4% physicians who felt it could ease the tension in physician-patient relationship; 97.6% felt it lower the risk for medical negligence, and 96.4% of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation. More primary-team physician agree "PCC service helps the physicians better understand palliative care" than PCC members(97.6% vs. 80%, P<0.05), while both were interested in learning more on palliative medicine(100% vs. 96.4%, P>0.05).Conclusion Palliative care consultation service in a general hospital is efficacious and acclaimed.The primary care physicians and the PCC members hold positive attitudes to the benefits that the PCC services bring to patients, family members, and physicians themselves. PCC for terminal patients in a general hospital may serve as a good modle for promotion of palliative care in China.
基金supported by the National Natural Science Fandation of China (60672089,60772075)
文摘In consultative committee for space data systems(CCSDS)file delivery protocol(CFDP)recommendation of reliable transmission,there are no detail transmission procedure and delay calculation of prompted negative acknowledge and asynchronous negative acknowledge models.CFDP is designed to provide data and storage management,story and forward,custody transfer and reliable end-to-end delivery over deep space characterized by huge latency,intermittent link,asymmetric bandwidth and big bit error rate(BER).Four reliable transmission models are analyzed and an expected file-delivery time is calculated with different trans-mission rates,numbers and sizes of packet data units,BERs and frequencies of external events,etc.By comparison of four CFDP models,the requirement of BER for typical missions in deep space is obtained and rules of choosing CFDP models under different uplink state informations are given,which provides references for protocol models selection,utilization and modification.
文摘Objectives: To describe the communication behaviors of patients and physicians and patient par-ticipation in communication about treatment decision-making during consultation visits for local-ized prostate cancer (LPCa). Methods: This is a secondary analysis of data from 52 men enrolled in the usual care control group of a randomized trial that focused on decision-making for newly diagnosed men with LPCa. We analyzed the patient-physician communication using the transcribed audio-recordings of real-time treatment consultations and a researcher-developed coding tool, including codes for communication behaviors (information giving, seeking, and clarifying/ verifying) and contents of clinical consultations (health histories, survival/mortality, treatment options, treatment impact, and treatment preferences). After qualitative content analysis, we categorized patient participation in communication about treatment-related clinical content, including “none” (content not discussed);“low” (patient listening only);“moderate” (patient providing information or asking questions);and “high” (patient providing information and asking questions). Results: Physicians mainly provided information during treatment decision consultations and patients frequently were not active participants in communication. The participation of patients with low and moderate cancer risk typically was: 1) “moderate and high” in discussing health histories;2) “low” in discussing survival/mortality;3) “low and moderate” in discussing treatment options;4) “none and low” in discussing treatment impacts;and 5) “low” in discussing treatment preferences. Conclusions: Findings suggest opportunities for increasing patient participation in communication about treatment decision-making for LPCa during clinical consultations.
文摘The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.
文摘Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.
文摘Since the 1970s, Chinese seismologists have started to conduct the Annual Consultation on the Likelihood of Coming Earthquakes in the Next Year. This approach has unique scientific and practical merits either as an active response to the social needs in the situation that earthquake prediction research meets many difficulties, or as a real forward prediction test persistently conducted for 1/3 century. It is a pity that such an approach has not been well-known by international seismological community, and the scientific merits of such an endeavor is sometimes regrettably underestimated.
文摘ERP(enterprise resource planning) is a huge and com pl ex system engineering which costs a great lot of fund and manpower. It is a refo rm in the enterprise management mode, management idea and management method whi ch needs mass fund import, with long period, full of risk, hard to perform and can’t show its effects at once. The essence of the enterprise performing in ERP system is to run a "management engineering", which involves integration of opera tion process. The integration will touch business culture, enterprise system,m eans of operation and the department’s regulatioins amongst the operation conten ts, rights and responsibilities. Totally, the ERP system is the rebuilding of ma ngagement idea, method and means, which needs the common acquaintance from the t op management to the whole stuff.Meantime, it requires a perfect tactic to perfo rm an ERP system. We must confirm a cut-in spot as the right space to start bas ed on the enterprise requirement and the application environment. And to choose a right space decides that the application of ERP system is successful or not. S o, we must make it clear to build which subsystem first, to take the right seque nce for performing all kinds of function modules and the final integrated functi ons . All this prepared work for the implement of ERP system and the management, the recombination and optimization of enterprise management operation flow, ite m management and harmonization, ERP educational training and so on can not be pe rformed well without management consultancy. The effective management consultan cy can lead then implement of ERP system to shorten the executive cycle, to quik en the realization of effect and to harmonize the relationship to the client ent erprises so that to ensure the successful perform of ERP.
基金Jiangxi Provincial Hospital Pharmacy Special Research Fund Project(Grant No.2024-ZXYJ02)Jiangxi Provincial Department of Education Project(Grant No.200227)。
文摘To improve the efficiency and precision of our pharmacy consultation services,we adopted a"1+X"model based on the PDCA(Plan-Do-Check-Act)cycle.In the initial analysis,we identified factors contributing to suboptimal consultation efficiency.Our approach included a thorough examination of our pharmacy consultation system,encompassing personnel training,consultation promotion,and the refinement of the consultation process.A standardized pharmacy consultation model was devised and continually refined,with a primary focus on infectious diseases.Subsequently,the model expanded to include various medical specialties,fostering multi-disciplinary participation.Since the implementation of the"1+X"pharmacy consultation model,spanning from 2017 to 2022,consultation numbers exhibited a consistent annual growth exceeding 50%.In 2022 alone,5044 pharmaceutical consultations were conducted,encompassing 3007 standard consultations and 96 expanded consultations across diverse departments such as neurosurgery and neurology.The adoption rate of consultation recommendations reached 89.2%,while the effectiveness of consultation treatments stood at an impressive 76.4%.This success underscored the impact of the"1+X"pharmacy consultation model on enhancing consultation outcomes.Collectively,our model,rooted in the PDCA cycle,not only served as a practical blueprint for pharmacy consultation systems in medical institutions but also provided valuable insights and a robust framework for the professional development and training of clinical pharmacists.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. </span><b><span style="font-family:Verdana;">Materials</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the in</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">i</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">tial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). </span><b><span style="font-family:Verdana;">Results</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The delays (median, IIQ) were: (5.1 months;IIQ: 1.7 - 12.4), (25 days;IIQ: 10 - 67), (27 days;IIQ: 13 - 63), (2.2 months;IIQ: 1.2 - 5.8) and (9.9 months;IIQ: 4.4 - 17.6) respectiv</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">ly for consultation, diagnosis, treatment, health system and overall delays. The risks associated with a delay in initial consultation of greater than 3 months were (OR;95% CI): unschooled patients (2.01;1.66 - 2.40);monthly income below the minimum wage (2.70;1.81 - 5.96);unemployment (2.14;1.02 - 3.24) and absence of a family history of cancer (2.44;1.66 - 6.10). The main reasons for a late first consultation were: ignorance (60.2%), financial challenges (17.6%) and a preference for alternative treatment (11.1%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The consultation, diagnosis and treatment delays for breast cancer are very often long in our setting than those reported in developed countries. Both patients’ and institutional factors are demonstrated. There is a need to increase public awareness </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">on</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> the value of early diagnosis of breast cancer. Also, health system should be improved to enable early diagnosis and treatment of this affection.</span></span></span>
文摘The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy process(AHP)was used to determine the index weight.A total of 19 experts were included,all with intermediate or higher professional titles.The positive coefficients of experts in the two rounds of consultation were all 100%.The judgment basis of experts is 0.895,the degree of familiarity is 0.842,and the coefficient of authority is 0.868.The Kendall harmony coefficients of the first,second,and third-level indicators were 0.381,0.383,and 0.320,respectively.The expert coordination degree was tested by x^(2) test,the P values were all less than 0.05,indicating that the degree of expert coordination was well.After two rounds of letter inquiry,an evaluation index system of core competence of HCPs with professional accomplishment,theoretical knowledge,basic skills,professional skills,and professional development ability as the main framework was formed,including 5 first-level indicators,18 second-level indicators,and 62 third-level indicators.Based on the Delphi and AHP methods,the index system of HCPs'core competence established has high authority and scientificity,to provide the theoretical basis for the standardized training and comprehensive evaluation of HCPs.
