ABSTRACT
Objective:To investigate the quality of rehabilitation medical service in tertiary general hospitals in Gansu Province. Methods:Stratified sampling was used to sample tertiary general hospitals in Gansu Province for on-site surveys in 2017. A quality evaluation index system was established in the view of medical service providers, including 17 indicators, based on Donabedian model and experts' opinions. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank-sum Ratio were applied to make a comprehensive evaluation on the overall service quality of the hospital rehabilitation medical service. Results:A total of 27 tertiary general hospitals were sampled, in 13 cities/prefectures of Gansu Province. For the structure quality, the compliance rate of the business operation area and the number of beds in the rehabilitation medicine department were 77.78% and 51.85% respectively; while the compliance rates of the physicians, therapists and nurses were all less than 50%. For the process and results quality, the compliance rates were all more than 85%. For the overall quality of rehabilitation medical service, five hospitals were classified as Good, located in Lanzhou, Tianshui and Jiayuguan; 18 hospitals were classified as Medium, located in Longnan, Longdong, Lanzhou and surround, Linxia and Hexi regions; four hospitals classified as Poor, located in Lanzhou and Tianshui. Conclusion:The overall quality of rehabilitation services in the tertiary general hospitals of Gansu Province needs to be improved, and the development of rehabilitation services is uneven in various regions. Comprehensive evaluation provides an important reference to promote the rational distribution of rehabilitation medical resources and improve the quality of rehabilitation medical services.
ABSTRACT
Patent foramen ovale (PFO) is a common congenital heart disease that can cause cryptogenic stroke through paradoxical embolization.For patients with PFO combined with cryptogenic stroke,whether anticoagulant therapy is superior to antiplatelet therapy in the prevention of recurrent stroke? And whether PFO closure can significantly reduce the risk of stroke recurrence compared with medical therapy alone? All those raised the clinical problems to be solved urgently.The advances in treatment of cryptogenic stroke associated with PFO are herewith summarized in present paper by reviewing randomized trials,meta-analyses and the guidelines or expert consensus about PFO and cryptogenic stroke.
ABSTRACT
Autophagy generally reside in eukaryote and is a highly conserved protein degradation pathway,which take part in the maintenance of cellular homeostasis as well as the growth of cells.The characterization of autophagy being reported over years has revealed that it involved in immune response,such as removal of intracellular bacteria,inflammatory cytokine secretion,antigen presentation,and lymphocyte development,and then involved in the pathogenesis of multiple sclerosis indirectly.So,in this review,we focus on the pathway ofautophagy and the role of which in the multiple sclerosis (MS) in order to further understand the important effect and potential therapeutic value of autophagy in MS.