ABSTRACT
Patient satisfaction is one of the core indicators to measure the service quality of medical institutions. To this end, a multi-campus public hospital in Shanghai constructed a management system of patient satisfaction evaluation. Since 2021, its call center has conducted a full coverage satisfaction assessment for discharged patients from its three campuses and collected dissatisfaction information feedback. The hospital organized relevant clinical departments and functional departments to fully communicate with the dissatisfied patients according to the feedback information, followed by a joint rectification. The hospital regularly conducts in-depth analysis of all complaints for timely discovery of common problems in different campuses for continuous improvement. This practice can provide reference for multi-campus hospitals to promote homogeneous management, to improve management efficiency, service quality and patient satisfaction.
ABSTRACT
Myasthenia gravis(MG)is a B cell-mediated,T cell-dependent,complements-involved autoimmune disease.Ocular myasthenia gravis(OMG)is a typical MG,with its symptoms limited to the extraocular muscles.The occurrence and development of a variety of autoimmune diseases including OMG are closely associated with the imbalanced expression of follicular regulatory T cells(Tfr cells).Therefore,Tfr cells may be a new research topic for OMG.
Subject(s)
Humans , Complement System Proteins , Myasthenia Gravis , Oculomotor Muscles , T-Lymphocytes, RegulatoryABSTRACT
Objective To evaluate the safety,feasibility of the application of "four-quadrant" tumor target-artery positioning in "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy.Methods A retrospective study was conducted on 25 patients who underwent retroperitoneal laparoscopic partial nephrectomy from November 2016 to March 2017 by single surgeon.There were 15 males and 10 females with a mean age of (52.6 ± 11.9) years old.The mean diameter of the tumor was (3.8 ± 0.5) cm.The mean R.E.N.A.L.score was (9.0±1.3).The mean GFR of the operation side was (49.2±11.4) ml/(min · 1.73 m2) before the operation.All 25 patients underwent 3 Dimentional CT for the reconstruction of their renal models.The tumor target-artery was located in "four-quadrant" system,which based on the boundary between tumor and renal parenchyma.Perioperative outcomes including the estimated blood loss (EBL),operation time,complications and oncological outcomes were carefully collected and analyzed.Results Of all the 25 patients,21 patients underwent "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy,the mean operation time was (106.1 ± 18.8) min,the mean EBL was (162.2 ±68.0) ml with no transfusion case.4 patients converted to conventional retroperitoneal laparoscopic partial nephrectomy,the operation time was 110-140 min,the EBL was 350-500 ml and the warm-ischemia time was 12-20 min respectively.The pathological outcome shows renal cell carcinoma in 24 patients and papillary renal cell carcinoma in 1 patient with all negative margins.The mean GFR of the operation side was (45.1 ± 10.2) ml/(min · 1.73 m2) after three months of the surgery and shows no statistical difference (P =0.268).Conclusion The application of the "four-quadrant" tumor target-artery positioning in " zeroischemia" retroperitoneal laparoscopic partial nephrectomy is a safety and feasible method in terms of accurate location of the target-artery,better postoperative renal function,low EBL and reasonable oncological outcomes.
ABSTRACT
Objective To investigate the changes of brain function in moderate and high myopia patients using fractional amplitude of low frequency fluctuation (fALFF),and discuss the correlation between brain function changes and clinical data of patients with myopia.Methods Totally 21 moderate and high myopia patients (myopia group),and 21 healthy volunteers (normal control group) who were matched with myopia patients in age and gender,were selected to take rs-fMRI examination.The difference of fALFF of brain functional activity in patients with myopia and normal controls was compared,and the correlation between the changes of fALFF and clinical data of patients with myopia was analyzed,Results Compared with normal control group,the fALFF values of myopia group in the region of the left inferior frontal gyrus,putamen and right inferior frontal gyrus,putamen and insula were significantly lower (all P ＜ 0.05,AlphaSim corrected).However,in bilateral cingulate gyrus,bilateral anterior cingulate gyrus,left postcentral gyrus,left superior parietal lobule and region,fALFF values were increased (all P ＜ 0.05,AlphaSim corrected).Conclusion Patients with myopia are accompanied by abnormal neuronal activity in many brain areas,which may reflect the dysfunction of language understanding and attention control in myopic patients.
ABSTRACT
Objective To identify the independent risk factors of surgical site infections (SSIs) for patients with cholelithiasis after biliary tract surgery.Methods 712 patients were enrolled from April 2010 to April 2015 in this study and their clinical data were retrospectively analyzed.There were 106 patients who developed SSIs.The risk factors of SSIs and their three subtypes (superficial incisional SSIs,deep incisional SSIs,and organ/space SSIs) were analyzed.The total hospitalization cost,length of hospitalization and patients who stayed over 30 days in hospital were compared between the group of patients with and without SSIs.Results Univariate analysis showed that SSIs were associated with diabetes,emergency operation,bile duct re-exploration,hepatectomy,positive bile bacteria culture,porta hepatis clamping,Ⅱ-Ⅳ grades of cholelithiasis,ASA Grade 3,BMI ＞ 30,hepatic function Grade B and protein level ＜ 30 g/L on hospital admission (all P ＜ 0.05).The results also indicated that superficial incisional SSIs,deep incisional SSIs and organ/space SSIs were correlated with emergency operation,bile duct re-exploration,hepatectomy,operation time,porta hepatis clamping,smoking,ASA score and protein level on hospital admission (all P ＜ 0.05).The total hospitalization expense,length of hospital stay and the number of patients hospitalized for over 30 days in the SSIs Group were significantly more than the non-SSIs Group (all P ＜ 0.05).Bile duct re-exploration,hepatectomy,positive bile bacteria culture and Ⅱ-Ⅳ grades of cholelithiasis were independent risk factors of SSIs on multivariate unconditional logistical regression analysis (all P ＜ 0.05).Conclusions Multiple factors in the perioperative period were involved in SSIs after bile duct surgery.Bile duct te-exploration,hepatectomy,positive bile bacteria culture and Ⅱ-Ⅳ grades of cholelithiasis were independent risk factors of SSIs.
ABSTRACT
A literature review of the criteria for discharge after the day ambulatory surgery includes four aspects, which are the importance and significance, the scoring system, the physical and mental exam, and the risk factors for delayed discharge. The results are the basis for the further research.
ABSTRACT
BACKGROUND:Artificial cornea titanium scaffold has a higher complication rate in clinical usage; therefore, to seek a kind of artificial corneal scaffold with high biocompatibility is a hot spot. OBJECTIVE:To explore the biocompatibility of the artificial cornea titanium scaffold with hydroxyapatite surface modification. METHODS: Twenty-seven New Zealand white rabbits were enroled to make alkali burn models of the right cornea and then randomized into three groups: in experimental group, artificial cornea titanium scaffold with hydroxyapatite surface modification was implanted into the right eye; in control group, artificial cornea titanium scaffold was implanted into the right eye; in blank group, no scaffold was implanted into the right eye. At 2, 4, 16 weeks after implantation, the right corneas were taken out for pathological observation and scanning electron microscope observation. RESULTS AND CONCLUSION:At 16 weeks after implantation, there was no difference in the number of inflammatory cels and fibroblasts among the three groups. Over time, in the experimental group, the corneal tissues, fibrous tissues and adhered extracelular matrices were increased gradualy. In addition, the experimental group had more adherent corneal tissues, extracelular matrices and better tissue healing than the control and blank groups. These findings indicate that the artificial cornea titanium scaffold with hydroxyapatite surface modification had good biocompatibility that can effectively promote proliferation of corneal cels and corneal vascularization.
ABSTRACT
Objective To investigate the perioperative nursing experience for patients with mayer rokitansky kuster hauser (MRKH).Methods We conducted multidisciplinary care to a MRKH patient,including personalize psychological support,bowel preparation,two surgical nursing convergence and vaginal mold care during hospitalization.Results The patient discharged after clinical symptoms remission,the patient sexual life was satisfaction,no complications were found in the six months follow-up.Conclusion The key of operation success is good coordination and cooperation of multiple departments,close observation and effective nursing in the perioperation period.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinicopathological features, treatment and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC).</p><p><b>METHODS</b>The clinicopathological data of eleven patients of pathologically confirmed renal MTSCC were reviewed retrospectively. Among the 11 patients, there were 4 males and 7 females with a mean age of 51.6 years (range, 24 to 81 years). Two patients presented with hematuria, one presented with lumbago and others were asymptomatic.</p><p><b>RESULTS</b>The renal MTSCC was of hypovascular tumor in enhanced CT scan. Seven cases were treated with radical nephrectomy, and the other four with partial nephrectomy. The mean diameter of tumors was 4.4 cm. The TNM stages were as follows: pT1aN0M0 in 6, pT1bN0M0 in 3, pT2N0M0 in 2 cases. Histological examination of the tumors showed that they consisted of spindle cells arranged in tubular and trabecular patterns embedded in a myxoid stroma. No recurrence or metastasis was observed during the follow-up (median 41 months).</p><p><b>CONCLUSIONS</b>MTSCC is a rare low-grade renal epithelial carcinoma with a relatively good prognosis. Preoperative CT scan is partly helpful for diagnosis and guiding decision making. Nephron-sparing surgery is recommended in most cases, especially in patients with small tumors.</p>
Subject(s)
Female , Humans , Male , Adenocarcinoma, Mucinous , Carcinoma , Carcinoma, Renal Cell , Diagnosis , Kidney , Kidney Neoplasms , Diagnosis , Neoplasm Recurrence, Local , Nephrectomy , Prognosis , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
With the indepth studies of molecular mechanisms of renal cell carcinoma ( RCC),people have made great progress in the targeted therapy drugs which targeted at vascular endothelial growth factor (VEGF) and their receptors,which dramatically improve the treatment outcome for patients with advanced or metastatic RCC.However,recent clinical trails show that the targeted therapy drugs may cause adverse events,such as hypertension,bone marrow toxicity,pneumonitis and so on.It is important to manage the adverse events promptly not only to improve the therapeutic efficacy but also to improve the quality of life for patients with RCC.
ABSTRACT
Objective To assess the prognosis of patients with bladder neck (BN) involvement in radical prostatectomy specimens and compare it with patients with seminal vesicle invasion (SVI).Methods From January 2002 to December 2008,42 patients with prostate carcinoma who underwent radical prostatectomy were analyzed retrospectively.The mean age was 70.3 years (range 59-78 years).The patients were divided into two groups according to 2002 TNM system:pT4a group (bladder neck invasion) with 17 cases and pT3b group (unilateral or bilateral seminal vesicle invasion)with 25 cases.Postoperative outpatients were followed-up on a regular basis,two consecutive postoperative serums PSA greater than 0.2 μg/L defined as a biochemical recurrence.The postoperative follow-up to the time of biochemical recurrence or follow up to the deadline without biochemical recurrence were defined as biochemical recurrence free survival time.Results All patients were followed up for 50-122 months.The patients with BN involvement 17.6％ (3/17) had biochemical recurrence,whereas seminal vesicle invasion 24.0％ (6/25),there was no statistical significance between the two groups (P＞0.05).Conclusions Postoperative adjuvant therapies can improve the biochemical recurrence free survival.In this study,the prognosis of pT4a and pT3b group is similar.A conceivable down-staging of BN involvement in the TNM staging system should be considered.
ABSTRACT
Pirh2 (p53-induced protein with a Ring-H2 domain),one of the ubiquitin-protein E3 ligases,can promote p53 degradation via ubiquitin-proteasome pathway,and repress the biological functions of p53.Researchers have found that the Pirh2 is overexpressed in many cancers,which suggests Pirh2 is probably correlated with tumorigenesis and cancer development,and it may become a promising cancer therapeutic target.
ABSTRACT
Advances in cryo-electron microscopy (Cryo-EM) and single-particle reconstruction have led to increasingly high resolutions of macromolecular three-dimensional reconstruction. However, for keeping up the continuing improvements in resolution, it is necessary to increase the number of particles included in performing reconstructions. Manual selection of particles, even assisted by computer, is a bottleneck of single-particle reconstruction. Cryo-EM image has low signal-to-noise ratio and low contrast, which leads to difficulty in particle picking. Various approaches have been developed to address the problem of automatic particle. This paper describes the application of template-based method, edge based method, feature-based method, neural network, DoG-based and simulated annealing approach in particle picking. The characteristics of various approaches are discussed, and the future development is presented.
Subject(s)
Animals , Humans , Electronic Data Processing , Cryoelectron Microscopy , Methods , Image Processing, Computer-Assisted , Methods , Imaging, Three-Dimensional , Macromolecular Substances , Molecular Conformation , Particle Size , Ribosomes , ChemistryABSTRACT
Objective To explore the value of strain rate imaging (SRI) technology in the diagnosis of hypertension patient with re-gional left ventricular early diastolic dysfunction. Methods 50 essential hypertension patients were divided into hypertension Group Ⅰ and Group Ⅱ, including 31 patients with normal left ventricular and 19 patients with left ventricular hypertrophy. 25 healthy people were used as the control group. SRI was done in the six different basal myocardial segments and the parameters of SRI were compared with that of Doppler tissue imaging (DTI) and pulse Doppler (PW). Results In the hypertension group, SRe of the six different basal myocardial segments was lower than that in the control group (P<0.05), but (SRa) of hypertension group was higher (P<0.05). SRe was negatively correlated with the patients'illness development (r=-0.89, P<0.05), but SRa was positively correlated (r=0.97, P<0.05). And the SRe/SRa<1 detection rate of Group Ⅱ was higher than that in Group Ⅰ, and the ratio in the control group was lowest(P<0.05). Total detection rate of SRI (88%) was higher than Em/Am <1 of DTI (79.67%) and E/A < 1 of PW(60%), and these changes were more obvious in Group Ⅰ. SRI was higher than DTT and PW (P<0.05). Conclusion Compared with traditional technology and methods, SRI could pro-vide more accurate diagnoses to hypertension patient with regional left ventricular early diastolic dysfunction.
ABSTRACT
Segmentation of cryo-electron micrograph (Cryo-EM) image is crucial to identification of macromolecular particles. In this paper, the features of Cryo-EM image are discussed and a new automatic segmentation algorithm for Cryo-EM image based on wavelet transformation and difference of Gaussian (DoG) is also provided. This method uses wavelet decomposition to do the multi-resolution analysis, which can depress noise and enhance contrast. After DoG image is segmented by using OTSU method, main edges are selected by the combination of gray and grads information. Experiment results show that the algorithm has good result.
ABSTRACT
The purpose of this study was to determine the effects of piperazinyl estrone, a new estrogen derivative, on bone turnover, bone mass and uterine weight in female aged rats. Thirty-two Sprague-Dawley female rats at the age of 22 months were treated with vehicle or with piperazinyl estrone (P-E) at 0.5, 1 and 2 mg/kg/day, subcutaneous injection for 1 month. At the time of death, the uterine weight was measured and bone histomorphometric analysis of proximal tibial metaphyses (PTM) was performed in undecalcified sections. Compared with control, bone mass was increased in P-E groups. Dynamic data showed that bone resorption were decreased, but bone formation was not declined and bone mass was increased significantly in P-E (1 mg/kg day) group. There was no significant change in uterine weight. The findings of this study show that piperazinyl estrone at dosage of 1 mg/kg/d is most efficacious in preventing the bone losses in aged rats and has no side effect on uterus.
Subject(s)
Animals , Female , Rats , Aging , Estrone , Pharmacology , Osteogenesis , Osteoporosis , Rats, Sprague-Dawley , UterusABSTRACT
BACKGROUND: Alienation is derived from dissimilation in philosophy.It is practically defined as the subjective state of individuals who develop negative feelings such as social isolation, uncontrollable and meaningless sense, oppression, and self-alienation because they are alien to others, the.society, nature and themselves, and even feel controlled.OBJECTIVE: To investigate alienation from psychological perspective,aiming to construct and verify the theoretical hypothesis of alienation,thereby working out alienation scale for adolescent students.DESIGN: Cross-sectional investigation.SETTING:National Key Research Center of Basic Psychology and National Key Liberal Arts of Southwest Normal University.PARTICIPANTS: The investigation was carried out from March to June 2000. The method of cohort stratified random sampling was adopted and the questionnaire was administered to adolescent students in Chongqing City and Lanzhou City. Inclusion criteria: volunteer students of grade one in junior high school to grade four in colleges. Exclusion criteria: Those who had incomplete data or had differences of more than 6 points in the total scores for three matched lie-testing questions in the questionnaire. A total of 1502 pieces of questionnaire were collected (including 1 066 questionnaires used for exploratory factor analysis and 436 questionnaires for verifying factor analysis); the age of the students covered the whole range of adolescence, and the boy-to-girl ratio in each grade was matched.METHODS:We combined literature analysis, investigation research and interview. The details are as follows: First, theoretical hypothesis was put forward based on literature analysis; then related variances were collected through interviews and open questionnaires, which were compared with the items in scales used home and abroad at present so as to work out predicting questions for adolescence alienation questionnaire. Finally, 52 items were screened out and used to construct the preliminary questionnaire. The formal alienation scale was made after standardized designation of behavioral variances, and verified for alienation analysis in adolescent students.MAIN OUTCOME MEASURES: Behavioral apparent variances were collected based on interviews and open questionnaires, and used as psychological potential variances after statistical processing.RESULTS:Data of 1502 pieces of questionnaire were analyzed.① The correlation coefficient of each item in the scale was over 0.35. ② The correlation coefficient of each item with the dimension was over 0.30, with statistical significance(P ＜ 0.01). ③ The reliability coefficient of each item was over 0.39 with great significance(P ＜ 0.01). ④ Alienation was displayed in three dimensions: social alienation, interpersonal alienation and surrounding alienation, which were associated with the correspondingdimensions of related scales (P ＜ 0.05-0.01). ⑤Alienation could be divided into 9 levels: sense of meaninglessness, sense of self alienation, isolation, nature alienation, parent alienation, environmental alienation, sense of uncontrollability and social alienation. Parameters that accorded with the theoretical hypothesis and used for verifying analysis were proved rational.Based on the analysis of the 9 first-rank factors, second-rank structural model of 3 unrelated factors were obtained using main component analysis and the maximum variance cross rotation with the optimal coefficients of simulated parameters of: X2/df=4.87;GFI=0.94;A GFI=0.90;RMR=0.0S;NFI=0.93;NNFI=0.92;CFI=0.95;IFI=0.95.CONCLUSION: Alienation scale has been proved to be reliable and valid. It can be used to assess alienation in adolescent students and has potential value of application in healthy psychological development and psychological education.