Background: Ankylosing spondylitis (AS) is a common chronic progressive rheumatic disease. The aim of this study was to explore factors influencing abnormal bone mineral density (BMD) in young and middle-aged patients with AS. Methods: From July 2014 to August 2018, hospitalized patients with AS and health examinees in the health examination center of our clinics, ranging in age from 20 to 50 years, were monitored. The BMD of the lumbar spine and femoral neck of AS patients and those of a healthy control group were measured using dual-energy X-ray absorption. The BMDs of AS patients were compared with respect to age, course of disease, iritis, smoking habits, sex, height, weight, body mass index (BMI), medication use, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet volume, platelet count, uric acid (UA), alkaline phosphatase (AKP), and calcium ion levels. Single-nucleotide polymorphisms (SNPs) related to BMD were screened using genome-wide association analysis. Results: There was no statistical difference in the proportion of abnormal bone masses between the different body parts. The BMD of all bones in AS patients was lower than that in healthy controls ( P < 0.05). Additionally, BMD was correlated with serum calcium and CRP in AS patients ( P < 0.05), but not with age, platelet volume, platelet count, ESR, UA, AKP, height, weight, and BMI. The incidence of abnormal bone mass in AS patients was correlated with sex ( P < 0.05), but not with medication use, iritis, or smoking. BMD of the lumbar spine in AS patients did not correlate linearly with the course of the disease, but BMD of the femoral neck correlated linearly with the course of the disease ( P < 0.05). BMD was correlated with multiple SNPs in patients with AS. Lumbar BMD was correlated with rs7025373 and rs7848078. Femoral head BMD was correlated with 3:102157365, 3:102157417, rs1252202, rs1681355, rs3891857, rs7842614, and rs9870734, suggesting that genetic factors play a role in BMD in patients with AS. Conclusions: The proportion of abnormal bone mass in AS patients was higher than that in healthy individuals of the same age. The factors related to BMD in patients with AS are gender, CRP, and blood calcium. The BMD of the femoral neck of AS patients decreases with the course of the disease, but BMD of the lumbar spine is not related to the course of the disease. BMD in AS patients is associated with multiple SNPs.

Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in surgical antimicrobial prophylaxis (SAP) remains unknown. This study aimed to implement QCC interventions to improve the appropriateness of SAP. Methods: A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied. Results:The appropriateness of antibiotic prophylaxis before (January to December 2020) and after (January to December 2021) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The overall SAP appropriateness was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P<0.01). A significant improvement (P<0.05) was also determined for each category: selection (from 78.82% to 96.06%), duration (from 90.15% to 96.46%), indication (from 94.09% to 97.64%), timing of first dose (from 96.55% to 99.21%), antimicrobial usage (from 96.8% to 99.41%), redosing of antimicrobial (from 96.55% to 99.21%). Conclusion: Implementation of a QCC program can optimize the use of antibiotics and improve the appropriateness of SAP and is of practical importance to their standardization.

Administration of surgical antimicrobial prophylaxis (SAP) is considered one of the most effective measures to reduce the incidence of surgical site infection (SSI) after various surgical procedures. Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in SAP remains unknown. Our present study utilized the QCC activity to improve the appropriate administration of SAP. A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied. The appropriateness of SAP before (July to December 2018) and after (January to June 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The appropriate rate of SAP was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P༜0.01). A significant improvement (P༜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antimicrobial usage (from 96.8 to 99.41%), re-dosing of antimicrobial (from 96.55 to 99.21%). The appropriate application of SAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial misuse and overuse.

Background: Appropriate implementation of perioperative antimicrobial prophylaxis in surgery is considered an effective measure to prevent the incidence of surgical site infection and the emergence of antimicrobial-resistant bacteria. To reduce the emergence of antimicrobial-resistant bacteria, there is a need to improve the correct implementation of PAP. Methods: A QCC activity team was established to grasp the current situation of PAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The appropriateness of PAP before (July to December 2018) and after (April to September 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese perioperative antimicrobial prophylaxis guidelines. Results: The appropriate rate of PAP was significantly improved from 68.72% (n=406) before QCC to 93.7% (n=508) post QCC implementation (P＜0.01). A significant improvement (P＜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antibiotic usage (from 96.8 to 99.41%), re-dosing of antibiotic (from 96.55 to 99.21%). Conclusions: The appropriate application of PAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial-resistant bacteria and the development of medical quality improvement activities.

The present study aimed to exam the effect of quality control circle (QCC) activities on promoting the appropriate implementation of preoperative antibiotic prophylaxis in clean surgery. A QCC activity team was established to grasp the current situation of PAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The appropriateness of PAP before (July to December 2018) and after (April to September 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese perioperative antimicrobial prophylaxis guidelines. The appropriate rate of PAP was significantly improved from 68.72% (n=406) before QCC to 93.7% (n=508) post QCC implementation (P＜0.01). A significant improvement (P＜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antibiotic usage (from 96.8 to 99.41%), re-dosing of antibiotic (from 96.55 to 99.21%). The appropriate application of PAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial-resistant bacteria and the development of medical quality improvement activities.