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Objective To analyze the risk factors and predictors related to postoperative delirium(POD) in liver transplantation. Methods The clinical data of 232 liver transplant recipients were retrospectively analyzed. Recipients were assigned to POD group (n=60) and non-POD (n=172) group according to the presence of POD. The intra- and post-operative conditions were compared between the two groups of liver transplant recipients. The risk factors for occurrence of POD in liver transplant recipients were analyzed using multifactorial analysis. And the value of predicting the occurrence of POD in liver transplant recipients according to the risk factors were assessed. Results The incidence of POD in liver transplant recipients was 25.9%. The operation time and anhepatic phase in the POD group were longer than those in the non-POD group. Intraoperative infusion of erythrocyte, infusion of cryoprecipitate, and lactic acid level were higher than those in the non-POD group (all P < 0.05). The levels of postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time international normalized ratio (PT-INR), and plasma fibrinogen in the POD group were significantly higher than those in the non-POD group (all P < 0.05). Preoperative hepatic encephalopathy, elevated blood ammonia, high score of model for end-stage liver disease (MELD), elevated postoperative AST level and long intraoperative anhepatic phase were the independent risk factors for POD in liver transplant recipients (all P < 0.05). Preoperative elevated blood ammonia and high MELD score showed profound value in predicting the occurrence of POD in liver transplant recipients, with best cut-off values of 42.6 μmol/L and 18 points, sensitivity of 0.650 and 0.767 as well as specificity of 0.826 and 0.727, respectively. Conclusions The incidence of POD is high in liver transplant recipients. Preoperative hepatic encephalopathy, elevated blood ammonia, high MELD score, elevated postoperative AST level, and long intraoperative anhepatic phase are independent risk factors for liver transplant POD. Preoperative elevated blood ammonia and high MELD score are predictors of POD in transplant recipients.
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Objective@#To investigate the correlation between cord blood vitamin D level and recurrent respiratory tract infection in infants.@*Methods@#From August 2014 to July 2015, 298 neonates in the Second Hospital of Jiaxing were selected in this study.The serum levels of 25-hydroxyvitamin D[25(OH)D] were measured by enzyme-linked immunosorbent assay(ELISA) in umbilical cord blood of neonates.The incidence of respiratory tract infection in infants was followed up.@*Results@#There were 53.1%(158/298) newborns with vitamin D deficiency(deficiency group), 24.8%(74/298) neonates with inadequate vitamin D(inadequate group), 22.1%(66/298) infants with adequate vitamin D(adequate group). The incidence rates of recurrent respiratory infections in vitamin D deficiency group, inadequate group and adequate group were 29.7%(47/158), 17.6%(13/74), 10.6%(7/66), respectively.The incidence of recurrent respiratory tract infection among the three groups was statistically significantly different(χ2=11.114, P=0.01).@*Conclusion@#Vitamin D nutrition level of neonates has a significant correlation with infants with respiratory tract infection, especially lower respiratory tract infection.Therefore, it is necessary to pay attention to the supplement and detection of vitamin D during pregnancy, so as to reduce the incidence of infant respiratory diseases in the region.
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Objective To explore the impact of breast conservation surgery and modified radical mastectomy combined with intensity modulated radiation therapy respectively on the living quality and sexual life for patients with early-stage breast cancer.Methods From January 2011 to December 2016, 89 patients with breast cancer were admitted and divided into two groups according to different surgical methods.Patients in the conservation group (n=24) received breast conservation surgery combined with intensity modulated radiation therapy, while patients in the modified radical group (n=65) received breast radical surgery combined with intensity modulated radiation therapy.The quality of life and sexual satisfaction of patients were measured by questionnaire investigation.And the data were calculated by SPSS 16.0.Results Different surgical methods combined with radiotherapy affectted the score of living quality a lot.The average score was (87.500±7.940) points in the conservation group, while it was (65.350±8.490) points in the modified radical group, the difference was statistically significant (P<0.01).At the same time,the degree of self acceptance and sexual satisfaction in the conservation group after surgery was better than that in the modified radical group,and the difference was statistically significant (P<0.01).Conclusion Breast conservation surgery combined with intensity modulated radiation therapy for breast cancer patients could receive better quality of life and sexual satisfaction compared with modified radical mastectomy combined with intensity modulated radiation therapy.
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@#Objective To explore framework and measure of vocational psychological quality for postgraduate students majoring in med-ical sciences in China. Methods The framework of vocational psychological quality had been developed based on the grounded theory. A structured and standardized questionnaire had been developed via field test for 95 postgraduates and interviews with 24 experts. A total of 1142 postgraduates had been measured with the final questionnaire. Results The standardized questionnaire had been developed including 3 subscales from factor analysis, such as vocational cognition, vocational personality and vocational adaptation, with 13 factors and 62 items in total. The Cronbach'sαcoefficient was 0.902 for the whole questionnaire, and the split-half reliability was 0.747. The correlation coeffi-cients between subscales and whole questionnaire was 0.401 to 0.929. Conclusion Vocational cognition, vocational personality and vocation-al adaptation are the main constituents of the vocational psychological quality for postgraduates majoring in medical sciences. The question-naire is acceptable in content and structure validity and internal consistency reliability.
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Objective To study the occurrence,risk factors,and direct economic losses caused by healthcare-asso-ciated infection(HAI)in hemodialysis patients in a hospital.Methods 840 patients who underwent hemodialysis in this hospital from April 2012 to September 2014 were selected,incidence of HAI,related factors,and economic los-ses due to HAI were investigated.Results Among 840 hemodialysis patients,89 patients developed 104 times of HAI,HAI density was 4.27‰ . Multivariate regression analysis showed that young age and old age,combined mul-tiple diseases,long duration of hemodialysis,two or more intubation sites,prolonged intubation,long length of hospital stay were all risk factors for HAI(OR= 1.123-2.325);Fees for bed,consultation,examination,treat-ment,nursing,medicine,and others in HAI group were all significantly higher than non-infected group(H= 49.6-1 038.9,all P<0.01 ),difference in medicine fees was most significant.Conclusion Risk factors for HAI are young age and old age,combined multiple diseases,long duration of hemodialysis,two or more intubation sites, prolonged intubation,and long length of hospital stay,the occurrence of HAI can increase the economic burden of hemodialysis patients.
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Objective To investigate the effect of pidotimod granules combined with Yupingfeng granules in the treatment of children with recurrent respiratory infection.Methods A total of 124 patients in the treatment of children′s immunologic function with recurrent respiratory infection were taken into this research.124 patients were divided into OBG(63 patients)group and COG(61 patients)group according to random number table and treated with pidotimod granules and Yupingfeng granules.Statistics of children′s treatment in the two groups were collected and analyzed after research.Results In OBG group,there were 33 excellent cases,28 effective cases,2 void cases,and the treatment efficiency was 96.83%,which were better than those in COG group(χ2 =8.796,9.054,8.931,9.135, all P <0.05).In OBG group,the extinction time of fever,moist rale,expectoration and chest pain were significantly shorter than those in COG group(t =8.562,9.025,8.747,8.637,all P <0.05).The differences between the two groups after treatment in IMF were statistically significant (all P <0.05 ).Conclusion Pidotimod granules and Yupingfeng granules has perfect effect in the treatment of children′s immunologic function with recurrent respiratory infection,which is worthy of promotion.
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Objective To observe the effect of clinical first-aid skills training for community doctor. Methods Effect of systematic clinical first-aid skills training and traditional teaching methods were scored by the questionnaire survey in order to compare their difference. Results Through systematic clinical first-aid skills training, the score on contacting the actual work, improving the diagnosis and treatment, analyzing and problem-solving skills, enhancing learning initiative, participation, scientific learning method and self-learning ability, impro-ving clinical thinking, strengthening team spirit and humane education were significantly improved compared to that of the traditional teaching methods (P<0. 01). Conclusion The systematic clinical first-aid skills training is an effective way for community physicians.
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The difference in history of development, the curriculum and teaching content of medical humanities education have been compared and researched among the United States, Britain and China, and the questionnaire survey have been conducted to the students from HeBei Medical University, to find the disadvantages and willingness to reform in medical humanities education in China. Based on the successful experience on Medical Humanistic Education from foreign countries, suggestions were put forward such as increased emphasis on medical humanities education, reasonable arrangements for medical education curriculum, creating a good atmosphere on campus, making the medical education to match the social demand, and providing scientific basis for the development of medical humanities education.
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Objective To discuss some expectation on reform of classroom teaching method for eight-year program medical education, in order to provide a basis for the evaluation and reform of classroom teaching method. Methods Investigation that mainly included expectation on reform of classroom teaching method, classroom teaching method of most expected application, and ex-pected value of classroom teaching method was investigated and analyzed with self-made question-naire, to total 78 medical students (22 of Grade 2008, 20 of Grade 2009, 20 of Grade 2010, 16 of Grade 2011) of eight-year program who had completed the stage before medical education in the uni-versity, and related 32 teachers. Software of SPSS 20.0 was used to make statistical analysis. Results In the survey, 55.8% students and 78.1% teachers hoped to reform the current classroom teaching methods (χ2=4.782,P=0.029). 61%students and 90.6% teachers expected comprehensive application of diverse method(χ2=15.464,P=0.017), including instruction combined with writing on blackboard, teaching by multimedia, PBL, inversion-type class, independent learning, a lot of questions for exami-nation, and so on. The value expectation (>60%) of classroom teaching method was multivariate, in-cluding to stimulate students' interest in learning, to cultivate ability of finding and solving problems, conducive to understanding of knowledge and memory, conducive to comprehension and memory of knowledge, conducive to cultivation of learning method, able to improve ability of creativity and criti-cal thinking, conducive to strengthening interaction and communication of teachers and students, to improve the subject consciousness of student in classroom, helpful to cultivate the spirit of teamwork, to improve the efficiency of teaching, and able to make full use of information technology. Conclusions For the diversified value demand and the highly expectation on reform of current classroom teaching method, more attention should be paid to evaluation and guidance on reform of classroom teaching method for eight-year program medical education.
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Starting from the transformation of the management models of foreign affairs,we introduced the achievements made through expanding the functions of foreign affairs at a military medical university in terms of academic exchanges,research collaboration,and training of young intellectuals,which resulted in the improvement of scientific and technological strength.Further expansion of foreign affair functions was then discussed in aspects of establishing institutional mechanisms,improving the service platform and building a team of qualified foreign affair administrators.
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Based on the research standpoint of internal needs,innovative research and management practice,the paper revealed and deeply discussed the 20 drivers behind the full play of medical doctor students' innovative behavior through the use of the method of questionnaire,expert in-depth interviews.
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In recent years,medical colleges have generally accepted the higher education assessment(evaluation).How to put the good practices and experience we obtained during the educational assessment into the daily teaching management and achieve normalization of teaching evaluation is of great significance to continuously improving the teaching quality.It is the primary condition to establish the evaluation index system for evaluating clinical teaching quality by regular teaching assessment. In this paper,the author constructed a clinical teaching quality evaluation index system through systematic research and exploration.
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How to construct the human social science in military medical universities is a new task in the process of medical education development.This article explores the relevant problems from both theory and practice.
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Facing the new problems under the background of new era,with the establishment of the market economy of our country and the improvment of the medical health system,how to solve medical health problems,how to strengthen the modernization management of state-owned hospital,and how to improve their comprehensive strength become the focus of the health research.With the internal and external environment analysis and the strategic management theory,this paper puts forward the development strategy and the support system of the children's hospital of Chongqing Medical University.
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ObjectiveTo launch researches on the current status of college students' view on life values.MethodsCreating College Students' Views on Life questionnaires for 774 undergraduates in Kunming for further analyses on their views on life values.ResultsThere appeared an inclination of diversified notions among the college students in which the mainstream of thoughts appeared to be positive with a little inclination towards narrow-mindedness and bigotry.Values in the narrow life of the paranoid dimension between males and females were significantly different ( P ＜0.01 ).Urban students and rural students were significantly different ( P＜0.01 ).The only-children and the non-only-children were significantly different ( P＜0.01 ).Similar results are found amongst the students majoring arts,science,medical science or art and sports,esp.with a distinction in positive life values,love of life and parochial attitudes towards life values,P ＜ 0.05 or P ＜ 0.01 as noted.ConclusionVarious factors contribute to the loss of life values among college students,and we earnestly request encouraging solutions to the problems found in life education and steer them into the right course.
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The training model of high level Chinese Medicine Talents has been the focus of debate in Chinese Medicine over the years.Through reviewing the history of high level Chinese Medicine Talents training in China since 1949,we have summarized the characteristics and analyzed the deep level problems impacting the quality of talents training.The strategies which we have proposed in this study will have high significance not only in the theory but in a realistic sense.
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ObjectiveTo explore the effective way of first aid skill standard training in regional central hospital.Methods60 residents from different regional central hospitals were received aid skills training based on two ways:namely OSCE ( multi-station structured skills test ) which lay particular em phasis on skills and traditional face to face way; and were assessed by uniform standards.ResultsThe scores of residents who received OSCE training were significantly better than those which received traditional face to face training ( P＜0.05 ),including.ECG,cardiopulmonary resuscitation,endotracheal intubation and doctor examination.ConclusionFirst aid skills standard training used by OSCE approach in regional central hospital can improve their first aid skills and should be promoted.
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Objective To evaluate the sustainable innovative ability of science and technology (S &T) of four large general hospitals from three different regions of China(Chongqing, Shaanxi and Hunan) with an evaluation system. Method The data collected were processed with normalization method. The evaluation models were established and varied in design to reflect either the dynamic trends or the levels of innovative abilities in different hospitals. Results Hospital A, B and D took on an ascending trend in sustainable S & T ability for innovation, while hospital C showed a descending trend in recent years. Overall, hospital A and D had a stronger sustainable S & T ability for innovation than hospital B and C. Conclusion The eval-uation system established is able to reflect the levels and trends of sustainable S & T innovative ability of the selected hospitals, which is in accordance with the actual situations, and is therefore scientific and feasible.It could provide reference for hospital S & T administrators to make decisions and is favorable to the sustainable development of hospital's S & T innovative ability.
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Objectives To establish an evaluation index system for general hospital's sustainable innovation ability of science and technoloby and determine the index weight. Methods Firstly, the theory of scientific and technological innovation was discussed based on the systematic analysis of the related facts from the documents. Secondly, a set of targets was drafted with methods of work breakdown structure (WBS), classification and combination from references to many other studies of science and technology evaluation, and then revised by experts who are familiar with the subject. Thirdly, the weight of each target was decided through Analytical Hierarchy Process (AHP) and questionnaires. Results A systematic and comprehensive evaluation system of the general hospital's sustainable innovation ability of science and technology, comprised 3 first-level indicators, 15 second-level indicators and 37 third-level indicators, which were proved reliable by consistency check. The weights of each indicator were also defined. Conclusions The evaluation system comprises both qualitative and quantitative indicators. The indicators not only reflect the performance of a period, but also reflect the sustainability of large general hospitals' scientific and technological innovation ability. By using the scientific consultation, analysis and statistics, the evaluation system is proved to be valid and reliable.
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Up to present,the research of the early-warning system for the risk of the medical quality has been carried out both at home and abroad.The majority of these researches aimed at providing theoretical guidance for the scientific decision-making of local health departments.In order to construct quality of medical care evaluation indicators system.On the bases of intelligence research,drawing on a series of internationally recognized quality of medical care evaluation system.The majority of these researches aimed at providing theoretical guidance for the scientific decision-making of local health departments.However,the hospital-related research is very limited.Therefore,hospitals were selected as objects in this study.33 experts from 6 three"A" hospitals were selected.And by using a series of internationally recognized quality health care system as a source of reference and focusing on process control and standardizing of management,the early-warning system for the risk of the medical quality has been constructed based on the combination of theory and practice.At the same time,Delphi method was used to verify the results repeatedly to form a set of early-warning system for the risk of the medical quality which is objective,scientific and approved by experts.