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Objective:To establish an evaluation index system of hospital culture construction led by Party building in public hospitals, and to explore the relationships among Party building, hospital culture and patient satisfaction, and explain the mediating effect of hospital culture between Party building and patient satisfaction.Methods:Literature review and two rounds of Delphi method were used to create an evaluation index system of hospital culture construction led by Party building in public hospitals. On such basis, a questionnaire was designed and 429 staff from 33 public hospitals in Shanghai were surveyed through April and June 2021. Cronbach α coefficient method and exploratory factor analysis were used to test the reliability and validity of the indexes, and the regression analysis method was used to verify the mediating effects. Results:Following two rounds of Delphi survey run by 14 experts, a performance evaluation index system for the hospital culture construction was constructed, comprising 5 level-1, 13 level-2 and 29 level-3 indexes. The Cronbach α coefficients of overall indexes and 5 level-1 indexes fell in the range of 0.860-0.901( P<0.01), and the retest reliability of overall index and 5 level-1 indexes fell between 0.91-0.93( P<0.01). Based on the exploratory factor analysis, all of the characteristic roots of the factors generated by orthogonal rotation were>1, and the total variance explained contribution rate was 56.84%, proving the good validity of the indexes. The effect of Party building on patient satisfaction was significant( β1=0.139, P<0.01), and that on hospital culture effect significant as well( β2=0.168, P<0.01), while that on patient satisfaction was also significant( β3=0.115, δ=0.448, P<0.01)with hospital culture effect introduced as the mediating effect. Conclusions:The evaluation index system of hospital culture construction led by Party building proves highly scientific and effective, and hospital culture plays to some extent a mediating role between Party building and patient satisfaction. This proves that Party building presents a significant transmission effect on patient satisfaction through hospital culture building. The study provides a reference for strengthening Party building and hospital culture construction and improving patient satisfaction in public hospitals.
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Objective:Under the guidance of " Opinions on Strengthening Party Construction in Public Hospitals" enacted by the Central Committee of the Communist Party of China, the performance evaluation index system for Party-committee secretaries has been released to reflect the overall leadership responsibility of Party committees at public hospitals.Methods:By means of literature review, policy learning and the preliminary work performance of Shanghai Hospital Development Center(SHDC), the framework of the target system was constructed. Three rounds of Delphi method were conducted to score 138 indicators based on eight aspects: result, objectivity, statistics, sensitivity, accessibility, quantifiability, importance and score-oriented. The final indicators were selected and statistically weighted. SPSS 20.0 software was used for descriptive statistical analysis, and Cronbach α evaluation coefficient method and Pearson correlation coefficient were also used to analyze the reliability and validity of indicators. Results:Following three rounds of Delphi research, 18 experts finally constructed a performance evaluation index system for Party committee secretaries that is composed of 4 level-1, 13 level-2 and 25 level-3 indexes. The new index system was used to simulate the scores of 14 hospitals, which was positively correlated with the survey results of third-party patient satisfaction( r=0.897, P<0.01), and was better than the original index system. Conclusions:The index system constructed in this study proves better quantitative objectivity and stronger operability. It has a good reliability and validity among the hospitals that belongs to SSHDC, and could be used for the evaluation of performance of Party-committee secretaries at public hospitals.
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<p><b>OBJECTIVE</b>To investigate the impact of staghorn stone branch number on outcomes of percutaneous nephrolithotomy (PNL).</p><p><b>METHODS</b>From January 2009 to January 2013, the 371 patients with staghorn stones who were referred to our hospital for PNL were considered for this study. All calculi were showed with CT 3-dimentional reconstruction (3-DR) imaging. The computerized database of the patients had been reviewed. Our exclusion criterion was patients with congenital renal anomalies, such as horse-shoe and ectopic kidneys. And borderline stones that branched to one major calyx only were also not included. From 3-DR images, the number of stone branching into minor renal calices was recorded. We made "3" as the branch breakdown between groups. And the patients were divided into four groups. The number of percutaneous tract, operative time, staged PNL, intra-operative blood loss, complications, stone clearance rate, and postoperative hospital day were compared.</p><p><b>RESULTS</b>The 371 patients (386 renal units) underwent PNL successfully, included 144 single-tract PNL, 242 multi-tract PNL, 97 staged PNL. The average operative time was (100 ± 50) minutes; the average intra-operative blood loss was (83 ± 67) ml. The stone clearance rate were 61.7% (3 days) and 79.5% (3 months). The postoperative hospital stay was (6.9 ± 3.4) days. A significantly higher ratio of multi-tract (χ(2) = 212.220, P < 0.01) and staged PNL (χ(2) = 49.679, P < 0.01), longer operative time (F = 4.652, P < 0.01) and postoperative hospital day (F = 2.067, P = 0.043) and lower rate of stone clearance (χ(2) = 10.691 and 47.369, P < 0.05) were found in PNL for calculi with stone branch number ≥ 5. There was no statistically meaningful difference among the 4 groups based on Clavien complication system (P = 0.460).</p><p><b>CONCLUSION</b>The possibility of multi-tract and staged PNL, lower rate of stone clearance and longer postoperative hospital day increase for staghorn calculi with stone branch number more than 5.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Kidney Calculi , Pathology , General Surgery , Length of Stay , Nephrostomy, Percutaneous , Operative Time , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To evaluate the effects of small interfering RNA(siRNA)against Ki67 gene on the proliferation and apoptosis of human renal carcinoma cell line 786-0 cells.Methods The human renal carcinoma 786-0 cells were treated with Ki67-siRNA(100 nmol/L).The mRNA expression of Ki67 was detected by RT-PCR.The protein expression of Ki67 was detected by Western blot and immunohisto- chemical technique,respectively.The proliferation of 786-0 cells was detected by MTT assay.The apoptosis of 786-0 cells was detected by TUNEL assay.Results RT-PCR and Western blot analysis showed that the Ki67 mRNA and Ki67 protein expression levels of the 786-0 cells treated with Ki67-siRNA were(37.6?1.9)% and(46.4?0.9)% ,respectively,which were significantly lower than those of controls [(97.3?0.9)% and(95.3?0.9)%,P＜0.01],The Ki67 positive expression rate of 786-0 cells treated with Ki67-siRNA by immunohistochemical technique was 52.5?2.3,which was significantly lower than that of controls(114.5?4.9 ,P＜0.01).The proliferation-inhibiting rate and apoptosis rate of the 786-0 cells trea- ted with Ki67-siRNA were( 63.6?1.6)% and(41.7?0.6)% ,respectively,which were significantly higher than those of controls [(2.8?0.2)% and(10.3?1.4)%,P＜0.01].Conclusions siRNA against Ki67 gene can inhibit the proliferation and induce the apoptosis by blocking Ki67 expression of hu- man renal carcinoma 786-0 cells.The inhibition of Ki67 expression by siRNA may be a promising approach in gene therapy for renal cancer.