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Objective To explore a model of day care fitting the local and regional characteristics to serve all the ethnic groups in Xinjiang, and analyze its performance. Methods Such indicators as the outpatient visits, discharges, average days of stay, and preoperative bed-occupying days of the hospital from 2010 to 2015 before the day-care mode was in place, were selected and compared against those since the mode in place from 2016 to 2018.Also compared were six typical diseases common for day surgery in day surgery wards sent from various departments, with non-day-surgery patients of the same period before.The comparison covered such indicators as nursing cost, laboratory examination cost, treatment cost, drug cost, consumables cost, drug cost ratio and average hospitalization cost between the two modes. The data were subject to statistical analysis using t test and χ2 test.Results Since day care mode in place, the average days of stay(8.93 days vs.7.72 days)and preoperative bed-occupying days(3.50 days vs.3.01 days) both decreased significantly, given the gradual growth of outpatients and discharges. Average hospitalization expenses of the six groups dropped significantly as well( P<0.05).Conclusions Day care mode can not only enhance the utilization of hospital beds to add to the income structure positively, but also significantly reduce the patients′hospitalization expenses, thus improving patient experience and satisfaction.
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Objective The "heuristic" teaching rounds were applied to cardiovascular diseases and we observed the application effect . Methods From January to March 2017, 56 resident physicians at internal medicine base in the First Affiliated Hospital of Xinjiang Medical University were randomly divided into the experimental group and the control group, with 28 people of each group. The experimental group mainly adopted heuristic teaching rounds, and the control group adopted conventional teaching rounds. Interview method was used to interview the instructors , resident physicians , doctors and nurses in preparation for teaching rounds, the implementation process, the expected goals and effects. 56 resident physicians evaluated the preparation, guidance process, guidance methods and outcomes of ward rounds. SPSS 19.0 was used for statistical analysis, and rank sum test was used for evaluation results. Results As to the familiarity of the instructor on the condition (82.15％vs. 30.86％), guiding the training of humanistic care (92.86％ vs. 39.29％), physical examination (96.43％ vs. 28.57％), analysis of auxiliary examination (85.71％vs. 35.71％), writing medical records (85.72％ vs. 14.29％), summarizing the characteristics of cases (78.57％vs. 35.71％), diagnosis and differential diagnosis (85.71％vs. 21.43％), treatment plan making (85.71％vs. 25.00％), question formulation (89.29％vs. 30.72％), explanation of difficult problems and new progress ( 78 . 57％ vs . 17 . 86％) , content summary ( 92 . 85％ vs . 28 . 58％) the experimental group was significantly higher than the control group. In the experimental group, the teaching rounds of communication (96.43％vs. 46.43％), history acquisition techniques (85.72％vs. 21.43％), examination techniques (92.86％vs. 28.57％), clinical thinking (92.86％ vs. 28.57％), learning interests (96.43％ vs. 25.00％) and efficiency (85.71％ vs. 14.28％), the understanding and memory of knowledge (85.72％ vs. 28.57％), the problem solving ability (89.29％ vs. 21.43％), improvement of team collaboration (67.86％ vs. 28.57％) were significantly higher than those in the control group (P<0.05). Conclusion The "heuristic" teaching rounds attached great importance to preparation before and after class, focusing on resident physicians' active participation and teamwork, integrating humanistic care and communication skills, giving full play to the resident physicians motivation so as to ensure their efficient learning.
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Objective To observe the characteristics of brain activation of multiple sclerosis (MS) patients and healthy controls at functional magnetic resonance imaging (fMRI) with olfactory stimulation,determine the locations of activation in areas of olfactory center and explore the MS olfactory related network.Methods Eighteen MS patients from the Affiliated Hospital of North Sichuan Medical College from February 2017 to March 2018 were enrolled as MS group,and 20 matched healthy adults during the same period served as controls.The Visual Analogue Scale was used to evaluate olfactory function in all subjects,the rest structure MRI was performed first,and volatile gases of lavender and rose solution were used to alternately stimulate olfactory during fMRI scanning.The brain activation was obtained by using matlab2013a and SPM8 softwares.The distribution and quantity of demyelination lesions were counted on T2 weighted image,and Spearman correlation analysis was done with SPSS 17.0 software package.Results The activated brain areas in the healthy control group included bilateral middle frontal gyrus,bilateral insula,bilateral supramarginal gyrus,bilateral orbitofrontal gyrus,right thalamus,right central anterior gyrus,bilateral cingulated gyrus,bilateral hippocampus,bilateral amygdala and bilateral superior frontal gyrus (t =2.11,P＜0.05).The activated brain areas in the MS group included right cerebellum,left insula,left superior temporal gyrus,right inferior frontal gyrus (t=2.19,P＜0.05).Compared with the control group,the MS group showed statistically significant decrease in activated values in right insula,right amygdala,right inferior frontal gyrus,right frontal middle gyrus,and the left supramarginal gyrus (t=2.04,P＜0.05).The distribution and number of demyelination lesions and major activation of brain regions with olfactory in the MS group demonstrated no significant correlation (r=-0.524,P=0.054).Conclusions Multiple brain areas involved in the olfactory processing and olfactory-related brain network existed.The activation of olfactory center had dominance in the right brain.The activation of the brain area in the MS group was significantly reduced,and the activation voxel and activation intensity were weakened.The olfactory-related brain network changed in MS patients.The distribution and number of demyelination lesions had no significant effect on the major activation of brain regions with olfactory stimulation.
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Parkinson's disease (PD) is one of the most common forms of neurodegenerative diseases and increases in incidence with aging.Low mortality and high disability rates bring huge economic and psychological burden to society and families.PD manifested as motor symptoms and non-motor symptoms.Recent studies have shown that non-motor symptoms,such as sensory disorder,are the significant symptoms in early stages of PD and influence quality of life of PD patients.This review focuses on the characteristics and electrophysiological changes of sensory disorders (olfactory,visual,auditory,vestibule function,pain,etc) in PD patients to provide help for the early diagnosis,disease monitoring and efficacy evaluation of PD.
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Objective To evaluate the effects of low blood sugar production index (LGI) combined with low blood sugar production burden (LGL) dietary intervention on blood glucose, oxidative stress and anthropometric indicators in type 2 diabetes mellitus. Methods A total of 150 cases of type 2 diabetes were randomly divided into two groups,maintain the original treatment plan of two groups,75 patients in the control group were given traditional food interchange method for dietary intervention;the experimental group of 75 patients, provide food education based on LGI+LGI food exchange method , the time period of 3 months. Fasting blood glucose (FPG)、2h postprandial blood glucose (2hPG), Glycated hemoglobin (HbAlc), Superoxide dismutase (SOD), Malondialdehyde (MDA), Vitamin C, Vitamin E, Body Mass Index (BMI), Waist circumference (WC) Upper arm muscle circumference (AMC), Triceps skin fold thickness (TSF) were observed before and after the intervention. Results There were no significant differences in blood glucose, oxidative stress and anthropometry between the two groups (P>0.05). After intervention, in the control group: FPG, 2hPG, HbAlc, SOD, MDA, Vitamin C, Vitamin E, BMI, WC, AMC, TSF were (10.27 ± 2.67) mmol/L, (11.51 ± 2.54) mmol/L, (8.78 ± 1.95)%, (322.73 ± 51.97) kU/L, (5.80 ± 1.76)μmol/L, (40.78±4.86)μmol/L, (19.33±4.79)μmol/L, (23.94±3.18) kg/m2, (89.57±10.23) cm, (24.10± 3.01) cm, (18.38 ± 3.79)mm respectively. In the experimental group: they were (8.76 ± 2.77) mmol/L, (10.63 ± 1.76) mmol/L, (7.96 ± 1.86)%, (357.29 ± 60.04) kU/L, (5.26 ± 1.33)μmol/L, (44.01 ± 7.06)μmol/L, (21.58 ± 5.25) μmol/L, (22.93 ± 2.75) kg/m2, (86.05 ± 10.79) cm, (22.75 ± 2.86) cm, (16.98 ± 4.48) mm respectively. There was significant difference between the two groups after intervention (t=2.049-3.769, all P < 0.05). In the experimental group, the improvement of blood sugar, oxidative stress and anthropometry was better than that of the control group (P < 0.05). Conclusions LGI combined with LGL diet intervention is better than the traditional method of food interchange, the blood glucose, oxidative stress and anthropometric indicators have improved, which can improve treatment efficacy in type 2 diabetes and easy for home self-management.