Ethical Reflections on the Implementation of Broad Consent in Chinese Medical Institutions / 中国医学伦理学

Taking the occurrence and development of general consent as the research object, this paper compared the differences between the ethical characteristics of broad consent and informed consent of specific research through the analysis of the content revision process of broad consent in the U.S. Broad Rules, and tried to explore the feasibility of implementing broad consent in Chinese medical institutions.

Epidemiology of allergic rhinitis in children in grassland of Inner mongolia / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region.@*Methods@#A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis.@*Results@#A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ2=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ2=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ2=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area.@*Conclusions@#The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.

Evaluation on the management effectiveness of performance management for administrative departments at public hospitals / 中华医院管理杂志

Objective@#To evaluate the implementation effectiveness of performance management for administrative departments.@*Methods@#By means of questionnaires, the authors made a comparative analysis of the performance perception of service recipients of these departments before and after the implementation of the scheme, and the change of external performance appraisal results of the case hospital was analyzed through third-party evaluation. Then face to face interviews were used to conduct performance communication with the management staff.@*Results@#Questionnaire results showed that the satisfaction of those served by these administrative departments for their work improvement and work results was generally elevated, scoring 4.31 for their satisfaction elevation(higher than 3.0 of the neutral attitude). A third party external performance appraisal indicated a capability enhancement as shown by the hospital in the appraisal indicators by the hospital′s authorities, scoring 91.52 in 2018 as compared to 82.34 in 2016. In-depth interviews exhibited that the ranking of the total scoring of performance appraisal of these departments was more in line with the staff′s psychological feelings. These departments also agreed with the appraisal system, the algorithm of performance scoring and the appraisal results.@*Conclusions@#The performance management of these departments of the hospital had achieved the goal of effective implementation and elementarily improved the efficiency of the hospital′s internal management.

Empirical research on the performance appraisal model and implementation framework for administrative departments at public hospitals / 中华医院管理杂志

Efficient measurement of administrative departments at public hospitals is key to performance appraisal for such units. The authors analyzed the current situation and problems of performance management of such departments of public hospitals, and made case studies for the formulating and implementing process of the performance appraisal system.Furthermore, they probed into appraisal methods for these departments and presented a performance appraisal model of " expectation-response" . Combined with the practice of the case hospitals, the authors recommended an annual personalized evaluation indicator system. Based on analysis of the operation process of the case hospitals from 2016 to 2018, namely theory study-practical exploration-experience summary-program readjustment for further practice. These efforts studied the implementation framework of performance management for these departments, summarized the by-stage practice experiences of the appraisal from the " basic version" to " specialized version" . Thus the paper provided references for their performance management of these hospitals.

Evaluation on the management effectiveness of performance management for administrative departments at public hospitals / 中华医院管理杂志

Objective To evaluate the implementation effectiveness of performance management for administrative departments.Methods By means of questionnaires,the authors made a comparative analysis of the performance perception of service recipients of these departments before and after the implementation of the scheme,and the change of external performance appraisal results of the case hospital was analyzed through third-party evaluation.Then face to face interviews were used to conduct performance communication with the management staff.Results Questionnaire results showed that the satisfaction of those served by these administrative departments for their work improvement and work results was generally elevated,scoring 4.31 for their satisfaction elevation (higher than 3.0 of the neutral attitude).A third party external performance appraisal indicated a capability enhancement as shown by the hospital in the appraisal indicators by the hospital's authorities,scoring 91.52 in 2018 as compared to 82.34 in 2016.In-depth interviews exhibited that the ranking of the total scoring of performance appraisal of these departments was more in line with the staff's psychological feelings.These departments also agreed with the appraisal system,the algorithm of performance scoring and the appraisal results.Conclusions The performance management of these departments of the hospital had achieved the goal of effective implementation and elementarily improved the efficiency of the hospital's internal management.

Empirical research on the performance appraisal model and implementation framework for administrative departments at public hospitals / 中华医院管理杂志

Efficient measurement of administrative departments at public hospitals is key to performance appraisal for such units.The authors analyzed the current situation and problems of performance management of such departments of public hospitals,and made case studies for the formulating and implementing process of the performance appraisal system.Furthermore,they probed into appraisal methods for these departments and presented a performance appraisal model of " expectation-response".Combined with the practice of the case hospitals,the authors recommended an annual personalized evaluation indicator system.Based on analysis of the operation process of the case hospitals from 2016 to 2018,namely theory study-practical exploration-experience summary-program readjustment for further practice.These efforts studied the implementation framework of performance management for these departments,summarized the bystage practice experiences of the appraisal from the "basic version" to "specialized version".Thus the paper provided references for their performance management of these hospitals.

Survey of medical staff cognition of the control and treatment of venous thromboembolism at seven general hospitals in Beijing: analysis and countermeasures / 中华医院管理杂志

Objective To investigate the cognition of medical staff on the control and treatment of venous thromboembolism ( VTE) at the municipal general hospitals in Beijing, for due countermeasures. Methods Customized questionnaires were used to survey the medical staff at 7 general hospitals in Beijing. The data so acquired were divided into approval items and disapproval items to calculate the ratio of approval items, while the comparison between those of different specialties and academic titles was subject to logistic regression analysis. Results 2 496 valid questionnaires were recovered, and the results showed that over 95% of them recognized the necessity of the VTE control and treatment work in the hospital, yet they need to improve their professional knowledge in this regard. There were differences in the cognition level among different specialties, and the higher the professional title, the better the recognition. Top three concerns for VTE work were increased workload, increased hospitalization expenses and extended hospital stay in turn. Top three difficulties in the work were patient′s compliance, coordination of auxiliary departments, and doctors′ cognition and involvement. Conclusions Cognition of VTE needs to be enhanced, and it is imperative to improve the VTE control and treatment system, carrying out the work in a scientific, standardized and economic manner.

Practice and reflection of objective assessment of subjective indexes in medical graduate scholarship evaluation / 中华医学教育探索杂志

In the evaluation of medical postgraduate scholarship, objective method is adopted to evaluate subjective indicators. According to the specific practices for experts and the views of students to establish a set of subjective and objective indicators combined with the evaluation index system, objective indicators including research ability, academic achievement, various school activities, subjective indicators such as ethics, communication and coordination ability, innovation ability etc. To evaluate the subjective index according to the analysis, the inherent requirements of subjective index application case scenario simulation and peer evaluation and other objective methods, we aim to eliminate the scholarship evaluation process of subjective indicators "passing" or "useless" phenomenon, more fair and equitable selection of truly outstanding students.

Expression and role of survivin in laryngeal squamous cell carcinoma and laryngeal papilloma in adults / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of Survivin in laryngeal squamous cell carcinoma (LSCC) and laryngeal papilloma in adults and its significance in carcinogenesis and development of the LSCC.@*METHOD@#The expressions of Survivin protein were detected by immunohistochemistry technique in 46 cases of LSCC, 24 cases of adjacent nontumorous laryngeal epithelium, 20 cases of laryngeal papilloma and 16 cases of normal laryngeal epithelium.@*RESULT@#The positive rates of Survivin protein expression in laryngeal carcinoma, adjacent nontumorous laryngeal epithelium and laryngeal papilloma were 71.74% (33/46), 33.33% (8/24)and 40.00% (8/20) respectively. There was no expression in normal laryngeal epithelium. The positive rate of Survivin protein expression in laryngeal carcinoma was significantly higher than that in the adjacent nontumorous laryngeal epithelium, laryngeal papilloma and normal laryngeal epithelium. But there was no statistically significant correlations between Survivin protein expression and the clinicopathological characteristics of tumor site, T-stage, pathological grading, UICC-stage and lymph node metastasis (P > 0.05). Expression of Survivin protein in 3 cases in laryngeal papilloma group which turned into laryngeal carcinoma later were all positive.@*CONCLUSION@#There was overexpression of Survivin in the laryngeal carcinoma. The expression of Survivin might play an important role in the carcinogenesis of LSCC and might be an early event during laryngeal carcinogenesis. It could be a diagnostic marker for evaluating the malignant potential of laryngeal papilloma in adults.

Vidian canal as a landmark to endoscopic nasal skull base surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyze whether the vidian canal can be served as a landmark to endoscopic nasal skull base surgery and provide clinical reference by imaging and anatomical methods. METHODS Twenty three cadaveric heads were scanned through axial and coronal high resolution CT to observe the vidian canal and its relationship with around structures.Three cadaveric heads, in which arteries were injected with latex,were dissected by endoscopic transnasal or transmaxillary to pterygopalatine fossa and cavernous sinus approaches.RESULTS 1.The course and shape of vidian canal and its relationship with around structures can be clearly detected through high resolution CT.All the vidian canals were on the same level or below the internal carotid canal.2.Anatomic study corresponded to the results of imaging.Vidian content pointed to the anterior genu of internal carotid artery constantly.The vidian canal and foramen rotundum can serve as a surgical corridor.CONCLUSION As the landmark, vidian canal plays an important role in the endoscopic nasal skull base surgery.Being a bony canal,it can be detected through high resolution CT easily and clearly.

Isolated sphenoid sinus inflammatory disease / 中国耳鼻咽喉头颈外科

OBJECTIVE To add to the current bodyof knowledge on isolated sphenoid sinus inflammatorydisease in order to promote early diagnosis and prompttreatment to prevent critical complications. METHODS A retrospective analysis was performed on 23 clinical cases of isolated sphenoid sinus inflammatory disease. The clinical features,radiological features,treatment and follow-up results were reviewed in the light of relevant literature. RESULTS The most common symptoms of the disease were headache and visual disturbance. All patients were treated by endoscopic sinus surgery and followed-up for 6-14 months. No recurrence was observed. CONCLUSION Diagnosis of isolated sphenoid sinus inflammatory disease at its early stages is difficult to ascertain because of the non-specificity of its symptoms. The widespread use of nasal endoscopy and CT examination makes early pre-operative diagnoses possible. Managing sphenoid sinus inflammatory disease with functional endoscopic sinus surgery is the preferred method of treatment.