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【Objective:】 To understand the current status and problems of the doctor-patient relationship under the family doctor contract service system through the investigation on residents contracted by community family doctors, and to provide reference for constructing harmonious doctor-patient relationship and promoting the healthy operation of the family doctor contract service system. 【Methods:】 A questionnaire survey was conducted on 1 655 residents of a certain university community in Xi’an from January to February 2023 who completed family doctor contract services in 2022. Through the general situation of signed residents, the willingness of signed family doctors, and the satisfaction and opinions with signed family doctors’ services, this paper investigated the current status of the doctor-patient relationship and proposed corresponding improvement strategies. 【Results:】 A total of 856 residents(52.68%) were willing to sign the contract, 322 residents(19.82%) were unwilling to sign the contract, 397 residents(24.43%) expressed indifference, and 50 residents(3.07%) abstained from signing the contract. There was no statistical difference in service satisfaction between residents of different genders(P=0.292). The satisfaction of working staff aged 40-60(72.33%) was higher than that of retirees aged over 60(61.05%, P<0.001). The satisfaction of those with bachelor’s degree or above(58.23%) was higher than that of those with bachelor’s degree below(51.77%, P=0.008). The satisfaction of individuals living alone(70.21%) was significantly higher than that of non-solitary individuals(54.35%, P<0.001). The overall satisfaction score of contracted residents with contracted services was(4.48±0.14) points, including 4.31 points for satisfaction with service methods, 4.47 points for satisfaction with service attitudes, 4.52 points for satisfaction with service content, and 4.60 points for satisfaction with service effectiveness. 【Conclusion:】 Most community residents have a positive attitude towards family doctor contract services. Improving service satisfaction and strengthening doctor-patient communication are feasible ways to improve grassroots doctor-patient relationships and promote the operation of the family doctor contract service system.
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Objective To investigate the application value of case-based learning (CBL) combined with teaching rounds in the standardized training of residents in department of hematology. Methods A total of 124 residents who received standardized training in department of hematology from August 2015 to July 2018 were selected and randomly divided into experimental group and control group. The residents in the experimental group received the teaching method of CBL combined with teaching rounds, while those in the control group received traditional teaching rounds. The two groups were compared in terms of department examination scores and teaching quality. Results Compared with the control group, the experimental group had significantly higher scores of the department examinations of hematological theoretical knowledge and case analysis (P<0.05). The residents in the experimental group thought that the new teaching method of CBL combined with teaching rounds could stimulate their interest in learning hematological diseases, improve self-study abilities , help them to combine theoretical knowledge with clinical practice , enhance their knowledge of hematological diseases, and cultivate their clinical thinking ability. Conclusion CBL combined with teaching rounds has achieved good results in standardized training of residents in department of hematology, and thus it holds promise for application in standardized training of other specialties in internal medicine.
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Objective To discuss action of microelement Se in serum and milk of gestational diabetes melli-tus parturient.Methods The serum and milk samples were collected from 50 gestational diabetes mellitus parturient and 50 healthy parturient.The selenium contents were detected by radioimmunoassay.Results The serum Se content in gestational diabetes mellitus parturient was obviously lower than that in healthy parturient(t =2.128,P 0.05).Conclusion Selenium deficiency persisted in gestational diabetes mellitus parturient.But Selenium defi-ciency did not exist in milk of gestational diabetes mellitus parturient.So encouraging breastfeeding,elevating selenium containing food intake,and supplement the selenium preparation properly maybe prevent and delay type 2 diabetes in gestational diabetes mellitus parturient.
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Objective To analyze the problem existing in the process of health records informatization con-struction and explore solution on the basis of situation of health record informatization in Yanta district of Xi'an city. And to provide bases for acceleration of residents'health records informatization construction in Xi'an.Methods Send 10 investigators to study and investigate the hospital information management system of 10 full-time public universities in Yanta district.Results There were a total of 25 711 faculties in 10 full-time public universities and 19 809 facul-ties had established electronic files,the filing rate was 77.04% A.On the whole,it seemed that the teaching staff in the filing rate(78.91%)was higher than that of the retired workers filing rate(73.78%),the two groups had statisti-cally significant difference(χ2 =88.164,P <0.05)B.Conclusion Xi'an Yanta district university faculty of electron-ic health records has exceeded the national average level,but there are still many problems need to be improved.We should strengthen government investment,the establishment of the region's unified information management standards, increase publicity and education efforts,and actively create the region's resource information sharing platform.
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Objective To investigate the clinical significance of peripheral blood parameters including immature reticulocyte fraction (IRF) in monitoring the hematopoietic recovery of patients with acute myeloid leukemia aftcr receiving consolidation chemotherapy with high dose cytarabine (HDAC).Methods The peripheral blood parameters,including absolute neutrophil (ANC) and platelet (Plt) counts as well as IRF,were measured by Sysmex XE-2100 automated hematology analyzer before and after consolidation chemotherapy with HDAC in 30 patients with acute myeloid leukemia.These peripheral blood parameters were further statistically analyzed and compared.Results Following consolidation chemotherapy,the median time to recovery for ANC,Plt and IRF was (9.2±2.5) days,(11.3±3.7) days and (5.0±2.6) days,respectively.In comparison with ANC and Plt recovery,IRF showed significantly early recovery (P ＜ 0.05).Additionally,ANC raised preceding Plt recovery (P ＜ 0.05).However,the median recovery time of ANC,Plt and IRF showed little difference among these patients further subgrouped according to FAB and risk based classification (P ＞ 0.05).Conclusion IRF is an early indicator for the hematopoietic recovery of patients with acute myeloid leukemia following consolidation chemotherapy with HDAC,which could provide important clinical information to evaluate therapeutic efficacy.
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Objective To investigate the response of multiple myeloma (MM) cells to 8-chloroadenosine 3',5'-monophosphate (8-Cl-cAMP) and the impact of arsenic trioxide (As2O3) on the above reaction.Methods MM-derived cell lines RPMI8226 and U266 were used as in vitro models.Cell apoptosis was evaluated according to cellular morphology and DNA content measured by flow cytometry.Meanwhile,rhodamine 123 (Rh123) staining and flow cytometry assay were used to detect the changes of mitochondrial transmembrane potentials (△ψm) in MM cells before and after the treatment.The synergic effects of 8-Cl-cAMP and As2O3 were evaluated by King' s formula.Results The 8-Cl-cAMP could induce growth inhibition of RPMI8226 and U266 cells in dose and time-related manners.The 8-Cl-cAMP could trigger apoptosis and △ψm collapse in MM cells through cellular morphology and flow cytometry analysis.As2O3 accelerated 8-Cl-cAMP-mediated apoptosis of RPMI8226 cells,but there were few synergic effects observed.Conclusion 8-Cl-cAMP could induce cell proliferation inhibition and apoptosis in MM cells.Mitochondria may be one of targets in 8-Cl-cAMP-mediated apoptosis.Furthermore,As2O3 catalyzes 8-Cl-cAMP-induced apoptosis.