ABSTRACT
Clinical expertise, patient preference, and the best evidence are the three elements of evidence-based medicine. Based on high-level and high-quality evidence, qualitative and quantitative analysis of the prescribing decisions of physicians is beneficial to improving clinical efficacy. A mature methodological system is available for the retrieval, analysis, summary, evaluation, and recommendation of the evidence, but there are still few studies on physicians' prescribing decisions. How to analyze the trend of physicians' prescribing decisions based on the priority ranking in addition and subtraction of prescriptions? Analytic hierarchy process(AHP) is a method for decision making, which arranges the elements of the decision problem into overall goal, criteria, and operational sub-criteria, and uses the matrix eigenvector method to solve the problem. This study aims to analyze the priority of physicians' prescribing decisions for diabetes mellitus with deficiency of both Qi and Yin based on AHP. To be specific, a database of diabetes mellitus cases with deficiency of both Qi and Yin was established and AHP was used to yield the priority ranking of Chinese patent medicine prescriptions in specific clinical scenarios. In the selected cases of diabetes mellitus with deficiency of both Qi and Yin, Xiaoke Pills was the best prescription for the treatment of type 2 diabetes mellitus(deficiency of both Qi and Yin)(normalized=0.388), followed by Liuwei Dihuang Pills(normalized=0.269), Qishen Capsules(normalized=0.230), and Shengmai Injection(normalized=0.113). According to the analysis the available data, for type 2 diabetes mellitus(deficiency of both Qi and Yin), Xiaoke Pills was the most effective prescription in specific scenarios. When the physicians' prescribing decisions are consistent with the evidence, quantitative analysis of physicians' cognition will boost the evidence-based medical decision-making. However, the research results are also affected by the quality of literature, evidence level and priority, which are thus have some limitations. It is recommended that further small data research based on individual cases be carried out to lay a evidence-based basis for the clinical decision-making of type 2 diabetes mellitus.
Subject(s)
Humans , Analytic Hierarchy Process , China , Diabetes Mellitus, Type 2/drug therapy , Drug Prescriptions , Medicine, Chinese Traditional , Nonprescription Drugs/therapeutic use , Qi , Syndrome , Yin Deficiency/drug therapyABSTRACT
Flame-retardant coatings have drawn much attention in recent years. In this study, an inorganic sodium silicate-based intumescent flame-resistance coating with an excellent flameproof properties is developed by mainly utilizing sodium silicate as the ceramizable binder, via hydrolysis and self-condensation reaction. Fly ash, metakaoline, and wollastonite behave as supplement cementing materials. Major formulation encompasses the combination of the ammonium polyphosphate and pentaerythritol as the flame-retardant additives, and aluminum hydroxide or expandable graphite as the intumescence-improving filler agents. Expandable graphite was found to play an important role in the eventual performance of flame-resistance testing. The results showed that solid interaction forces can be formed between metakaoline and sodium silicate, resulting in a similar material to geopolymer with excellent physical properties. After high-temperature flame testing, a densely complex protective layer of carbon-char created on top of the robust silicon dioxide networks offers notable flame resistance. An optimal ratio in this inorganic intumescent coating contains sodium silicate-metakaoline (weight ratio = 9:1)-ammonium polyphosphate and pentaerythritol, aluminum hydroxide (3, 3, 10 wt.%)-expandable graphite (1 wt.%), which can create 4.7 times higher expansion ratio compared with neat sodium silicate matrix. The results of flame testing demonstrate only 387.1 °C and 506.3 °C on the back surface of steel substrate after one and three hours flaming (>1000 °C) on the other surface, respectively, which could meet the requirements according to the level of fire rating.