ABSTRACT
Objective To explore the cognition ,attitude and intention of seeking doctor on hierarchical diagnosis and treat-ment among the patients suffering from chronic diseases in Chongqing City .Methods A multistage stratified sampling method was adopted to investigate 1125 patients with chronic diseases extracted from 9 public hospitals as well as basic medical and health in-stitutions in 9 districts and counties of Chongqing City .Meanwhile ,the differences of intentions of seeking doctor and cognition situ-ation of hierarchical diagnosis and treatment were analyzed .Results The patients with chronic diseases in basic medical and health institutions were more likely to choose the basic medical and health institutions for seeking doctor than the patients treated in public hospitals ,the difference was statistically significant (χ2 = 190 .051 ,P<0 .01);31 .2% of the patients with chronic diseases never contacted the hierarchical diagnosis and treatment .The technical capabilities of basic medical and health institutions meeting treat-ment needs ,gradual improvement of medical condition and service level and trending to seeking doctor in basic medical and health institutions had statistical difference between the patients in public hospitals and patients in basic medical and health institutions (P<0 .01) .The aspects of understanding the current referral system between medical institutions and downward referral conducing the disease to obtain continuous long tern treatment had statistical difference between the patients in public hospitals and patients in basic medical and health institutions (P< 0 .01) .Conclusion In order to better carry out hierarchical diagnosis and treatment in Chongqing City ,it is necessary to perfect the supporting polices of hierarchical diagnosis and treatment for guiding the primary diag-nosis in the patients with chronic disease ,meanwhile establish an efficient dual referral mechanism and enlarge the propaganda of hi-erarchical diagnosis and treatment policy .
ABSTRACT
AIM: To evaluate the efficacy and safety on the radio-heating-chemotherapy in treatment of patients with malignant pleural effusion (MPE). METHODS: 60 patients of MPE were randomly devided into two groups, radio-chemotherapy group (treatment group) and chemotherapy group (control group). The drugs, according to the types of tumor cells, were select to take intravenous injection and pleural cavity administration. The patient’s pleural cavity was drained continuously by pleurocentesis. These treatments were made once two week lasting for 4-6 weeks with NS 30 ml+cisplatin 60 mg by perfusion of pleural cavity. After the perfusin of pleural cavity, radio-heating was performed 60-90 min, twice one week for 8-10 times in the treatment group. RESULTS: The response rate was 90% (CR+PR) in the treatment group, and 67% (CR+PR) in the control group. The rates were higher than those in the control group (P