ObjectiveTo investigate the efficacy of Quality Control Circles (QCC) in reducing the emergency application times of maintenance hemodialysis. MethodsIn December, 2012, the quality circle was formed by eight nurses and a physician, through brainstorming. The group finally selected "Reducing emergency maintenance dialysis times" as the theme. With the help of questionnaire, interview, and comparative study, we analyzed the emergency situation of maintenance hemodialysis patients, and regulate and implement related policies. ResultsBy QCC practices, the times of hemodialysis declined from 11.7 to 5.3 cases per month, which exceeded our expectations largely. As to the circle members, their problem-solving skills, responsibility, communication skills, self-confidence, motivation and QCC techniques were also improved. ConclusionQCC can not only reduce the times of maintenance dialysis, but also improve the team cohesion, harmony and quality management capabilities.
ObjectiveTo systematically review the effectiveness and safety of GLP-1 receptor agonists versus DPP-4 inhibitors for type 2 diabetes mellitus (T2DM). MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 4, 2013), WanFang Data, CBM and CNKI were searched electronically for randomized controlled trials (RCTs) about GLP-1 receptor agonists versus DPP-4 inhibitors for T2DM up to April 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2.5 software. ResultsA total of 4 RCTs was included. The results of meta-analysis showed that:compared with DPP-4 inhibitors, GLP-1 receptor agonists were more effective in reducing levels of glycated hemoglobin (MD=-0.46, 95%CI-0.57 to-0.35, P < 0.000 01), fasting blood glucose (MD=-1.13, 95%CI-1.39 to-0.88, P < 0.000 01), and weight (MD=-1.59, 95%CI-1.99 to-1.19, P < 0.000 01). In addition, T2DM patients taking GLP-1 receptor agonists had significantly higher achievement rates of glycosylated haemoglobin ( < 7% and≤6.5%), and higher incidences of nausea (OR=4.31, 95%CI 2.87 to 6.47, P < 0.000 01) and diarrhea (OR=2.11, 95%CI 1.40 to 3.18, P=0.000 4). ConclusionGLP-1 receptor agonists are superior to DPP-4 inhibitors in controlling T2DM patients' levels of blood glucose and reducing weight, but it has more gastrointestinal adverse reaction.
ObjectiveTo systematically review the effects of adherence therapy in improving medication adherence and clinical outcomes in psychosis patients. MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2015), EBSCO, CBM, CNKI, VIP, and WanFang Data from inception to Oct. 2015, to collect randomized controlled trials (RCTs) about adherence therapy for patients with psychosis. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 13 RCTs involving 1 244 patients were included. The results of metaanalysis showed that adherence therapy could improve attitude towards medication adherence (MD=3.12, 95%CI 1.26 to 4.98, P=0.001), behavioral adherence (SMD=0.54, 95%CI 0.21 to 0.88, P=0.001), function (SMD=0.42, 95%CI 0.28 to 0.56, P=0.000 01) and insight of diseases (SMD=0.34, 95%CI 0.15 to 0.54, P=0.000 7) in patients with psychosis. But regarding psychotic symptoms, hospital stay, medical costs and adverse drug reactions, adherence therapy did not show benefit (all P values >0.05). ConclusionCurrent evidence shows that adherence therapy could improve medication adherence, function and insight towards diseases in patients with psychosis. Due to the limited quantity and quality of included studies, more large-scale, multi-center, and high quality RCTs are needed to verify the above conclusion.
ObjectiveTo explore the comprehensive hospital administrative management system for urban and rural cooperation in the process of medical reform. MethodsBy reviewing literature and interviewing directors of the administrative departments and hospital medical staff, we gradually established and improved the administrative management system for urban and rural hospital counterpart support. ResultsBetween 2010 and 2013, 123 medical workers were dispatched to support eight county-level hospitals, after which the comprehensive capacity, and technology and quality control in those hospitals were largely improved. Till the end of 2013, two of those hospitals were promoted to be grade-three class-B comprehensive hospitals; two were promoted as grade-two class-A comprehensive hospitals; three passed the reassessment to be grade-two class-A comprehensive hospitals; and another three county-level medical centers were promoted to be city-level key disciplines. ConclusionThe comprehensive administrative management system improves the management level of grass-roots hospitals at the county level; promotes the social public welfare of tertiary public hospital counterpart support; facilitates the process of medical system reform at the county level; establishes a series of administrative management modes such as unified support, personnel management, assessment standards and evaluation system; and promotes the sustainability of long-term counterpart support system.