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1.
Chinese Critical Care Medicine ; (12): 1126-1128, 2021.
Article in Chinese | WPRIM | ID: wpr-909465

ABSTRACT

Objective:To envaluate the effect of public cardiopulmonary resuscitation (CPR) training in Ningnan Mountain area.Methods:Using the method of convenient sampling, 775 people in Ningnan Mountain area were investigated about CPR and first aid knowledge by questionnaire from January to December 2019. The awareness rate of CPR, operation score, and operation qualification rate of the public before and after CPR training in the primary trauma treatment (PTC) mode were observed.Results:After PTC training, the public's CPR knowledge score, operation score and operation qualification rate, in terms of first aid telephone, consciousness judgment method, identification of respiratory arrest, artificial respiration implementation method, effective CPR indication and extrathoracic cardiac compression position were significantly improved [first aid telephone score: 82.68±8.54 vs. 60.25±10.38, consciousness judgment method score: 79.46±10.82 vs. 58.35±9.26, identification of respiratory arrest score: 80.85±9.64 vs. 59.26±11.45, artificial respiration implementation method score: 81.54±9.48 vs. 56.47±10.54, extrathoracic cardiac compression site score: 80.35±10.48 vs. 59.56±9.85, effective indication of CPR score: 81.02±9.45 vs. 58.21±8.69, operation assessment score: 60.25±10.45 vs. 50.38±9.68, operation assessment qualified rate: 60.39% (468/775) vs. 12.13% (94/775), all P < 0.05]. Conclusion:PTC mode is helpful to improve the effect of public CPR training, which is worthy of clinical promotion.

2.
Article in Chinese | WPRIM | ID: wpr-907980

ABSTRACT

Objective:To investigate the diagnostic value of rapid on-site evaluation (ROSE) technique in the mucosal biopsy under respiratory endoscopy in children with active tuberculosis.Methods:Clinical data of 40 patients with active tuberculosis diagnosed in Department of Respiratory Intervention, Qilu Children′s Hospital, Shandong University from June 2017 to January 2020 were retrospectively analyzed.Results:(1) There were 33 cases of tracheobronchial tuberculosis and 7 cases of tuberculous pleurisy in the 40 cases, among them 9 cases were difficult to diagnose.(2)Among 33 cases of tracheobronchial tuberculosis, 24 cases (72.7%) of caseous necrosis breaking into the lumen, and 9 cases (27.3%) of mucosal swelling and external pressure.Cytological ROSE (C-ROSE) showed granuloma, epithelioid cells and lymphocytic infiltration with all bronchial mucosal biopsies.Different positives results of microbiological ROSE (M-ROSE) in different biopsy parts: positive results were found 6 times at caseous necrosis (13.6%, 6/44 times), 4 times at granulation hyperplasia (12.5%, 4/32 times), 2 times at hyperemia and edema (22.2%, 2/18 times), 0 time at yellow-white necrosis, and 54 times at the junction between lesions and normal mucosa (81.8%, 54/66 times). The mucosal pathology showed granuloma, exudation and necrosis, including 22 cases with tuberculous granuloma, 5 cases with characteristic tuberculous nodules, and 11 cases with positive acid-fast staining.(3)Seven cases of tuberculous pleurisy, serious pleural adhesion, pleural hyperemia and edema were observed under thoracoscopy.After clearing the adhesive tape, scattered caseous miliary nodules were found in pleura in 4 cases with a difficult clinical diagnosis.The C-ROSE of smear on thoracoscopic biopsy were characterized by necrotic and histopathic cell, with multinucleated giant cells, but granuloma was rare.M-ROSE in different parts: 8 times positive for millet nodules (80.0%), 0 time positive for adhesion band, 2 times positive for congestion oedema (14.3%); biopsy pathology showed granuloma and necrosis, with 3 cases characteristic tuberculosis nodules and 2 cases positive for anti-acid staining.(4)Pathogenic microorganisms were detected in 19 children using next generation sequencing (NGS) and Mycobacterium tuberculosis/Rifampicin resistance real-time nucleic acid amplification detection technology (Xpert MTB/RIF), including 7 positive for NGS (36.8%), 8 positive (42.1%) and 5 positive for both NGS and Xpert MTB/RIF (26.3%).Conclusions:Respiratory endoscopy combined with ROSE technique has important clinical significance in early diagnosis of active tuberculosis in children, and it is worth of promotion and applying.

3.
Article in Chinese | WPRIM | ID: wpr-907945

ABSTRACT

Objective:To explore the case characteristics, treatment and prevention measures of cardiac thrombus in children caused by Mycoplasma pneumoniae infection, so as to improve the clinicians′ understanding of the disease.Methods:The clinical data of 10 children with cardiac thrombus caused by Mycoplasma pneumoniae infection treated in Department of Respiratory Intervention, Jinan Children′s Hospital from November 2015 to January 2020 were retrospectively analyzed, including datum of cases, laboratory results, imaging data and follow-up results.Results:A total of 10 children (7 males and 3 females) were included with the median age of 6.5 years old, and all had fever for more than 1 week.The plasma D-dimer (D-D) of 9 children was significantly increased, and the C-reactive protein (CRP) of 6 children was increased.After anti-infection treatment, the absorption of pneumonia with atelectasis was better than before.The embolus disappeared after operation in 1 case, and the remaining 9 cases received anticoagulant therapy, among which 7 cases received Heparin anticoagulant therapy alone: cardiac embolus disappeared during hospitalization in 2 cases, disappeared after 2 weeks of oral administration of Dipyridamole outside the hospital in 1 case, and the other 4 cases received Heparin anticoagulant therapy alone during hospitalization with poor effect, embolus disappeared in 2 cases 4 and 5 months after discharge respectively, and 2 cases were not reexamined due to personal reasons; the embolus disappeared 2 months after discharge in 2 cases who were changed to low-molecular weight Heparin + Warfarin anticoagulant therapy after failing to respond to Heparin anticoagulant therapy.All the 10 cases showed no symptoms of tachypnea or chest pain during telephone follow-up.Conclusions:Children with long fever time and significantly elevated CRP and D-D are more likely to form thrombus.Anticoagulant therapy is effective after thrombosis, and surgical thrombectomy can be performed in children who have failed to respond to anticoagulant therapy or worry about complications caused by dropped embolus.

4.
Article in Chinese | WPRIM | ID: wpr-906527

ABSTRACT

Objective:To review and summarize the current research status of traditional Chinese medicine(TCM) for the treatment of chronic atrophic gastritis(CAG),provide references and hints for relevant studies,and contribute to the further understanding of TCM and the application of TCM in the treatment of CAG with scientific evidence. Method:The PubMed and Web of Science databases were searched for relevant literature on the treatment of CAG with TCM from their establishment to August 31,2020. Eligible randomized controlled trials (RCTs) and animal studies were included according to the inclusion and exclusion criteria,and then the information of the included studies was extracted,summarized,and organized for further analysis. Result:A total of 4 RCTs and 21 animal studies (including 13 papers on compound studies,3 papers on single herb studies,and 5 papers on monomer studies) about TCM treatment for CAG were included in this study. RCTs showed that TCM could work well in improving the pathological state of gastric mucosa and clinical symptoms in patients. However,there were problems of low study quality,and non-uniform diagnostic criteria for gastric mucosal pathology and clinical efficiency evaluation. Animal experiments mainly focused on the study of drug mechanism exploration,and their results showed that TCM treatment of CAG was characterized by multi-target action. However,the animal experiments also had some problems such as inconsistence of CAG animal model establishment,positive drug selection,drug intervention methods as well as intervention cycles among different experiments. Conclusion:The efficacy of TCM in the treatment of CAG has gradually gained global recognition,but there is still a need for further standardization and unification of research methods. In the future,high-quality clinical trials and standardized animal experiments are still needed to conduct in-depth studies on the time for intervention,intervention methods,active ingredients and mechanisms of TCM,so as to make contributions to the full understanding and application of TCM in the treatment of CAG.

5.
Article in Chinese | WPRIM | ID: wpr-906475

ABSTRACT

Qingxin Lianzi Yin (QXLZY), as an ancient classical formula for clearing the heart and nourishing the Yin, was composed of nine herbs (Scutellariae Radix, Ophiopogonis Radix, Lycii Cortex, Plantaginis Semen, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle, Nelumbinis Semen, Poria, Astragali Radix and Ginseng Radix et Rhizoma), coming from Prescriptions of the Bureau of Taiping People's Welfare Pharmacy. It could clear away the heart-fire, promote the interaction of the heart and kidney, replenish Qi and Yin, and stop strangury-turbidity. It was used to treat gonorrhea of urination, seminal emission, restlessness, wasting-thirst and so on. At present, the usage and dosage of QXLZY and its addition and subtraction are different in clinical practice. Most of the studies just focus on its clinical efficacy, and there is few review literature reflecting its historical evolution. Based on this, this paper systematically clarified the historical evolution, composition, preparation, interpretation, function, and modern clinical application of QXLZY. This work has been explained the historical evolution of QXLZY, and found that it was wildly used in modern clinical, especially suitable for the treatment of chronic urinary system diseases. At the same time, QXLZY also had significant therapeutic effects on neurasthenia, stomatitis, diabetic nephropathy and other aspects. Through the comprehensive analysis of ancient and modern literature, this work explores the true connotation of QXLZY from the perspective of traditional Chinese medicine theory, which can point out the direction of the clinical application and positioning of this famous classical formula after it comes into the market, and also can provide reference basis for its subsequent in-depth research and development.

6.
Article in Chinese | WPRIM | ID: wpr-906005

ABSTRACT

Gegen Qinliantang, a classic traditional Chinese medicine(TCM) compound, has been verified in modern research to possess various pharmacological effects such as anti-inflammation,anti-oxidative stress,protecting intestinal mucosal barrier, and regulating intestinal flora and immune response. Ulcerative colitis (UC) is a chronic idiopathic inflammatory disease involving the colorectal mucosa, which mainly results from genetic susceptibility, intestinal mucosal barrier damage, abnormal immune response, intestinal flora disturbance, and bile acid metabolism disorders. By reviewing the literature published in recent years, this paper sorted out the relevant pathways and mechanisms involved in the treatment of UC by Gegen Qinliantang to provide ideas for further clinical and basic research. This literature review uncovered that Gegen Qinliantang exerted the therapeutic effects against UC mainly via interleukin-6(IL-6)/Janus tyrosine kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3) signaling pathway, Toll like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB) signaling pathway,Notch signaling pathway, and matrix metalloproteinase-9(MMP-9)/p38 mitogen-activated protein kinase(p38 MAPK) signaling pathway. Gegen Qinliantang regulates the intercellular molecular transmission in multiple pathways to protect the intestinal mucosal barrier, adjust the immune response and anti-oxidative stress, and relieve UC, demonstrating the multi-target, multi-mechanism, and multi-pathway advantages of TCM compounds.

7.
Journal of Medical Biomechanics ; (6): E129-E135, 2021.
Article in Chinese | WPRIM | ID: wpr-904376

ABSTRACT

Objective To study the characteristics of neural adaptation for resistance training of maximum voluntary contraction (MVC) of muscles at different joint angles. Methods Thirty healthy male college students were randomly divided into 3 groups, and each group was subjected to MVC isometric contraction resistance training at elbow joint angles of 45°, 90°, and 135°. Surface electromyography (sEMG) signals of the biceps brachii were measured before and after training, and the root mean square (RMS) and median frequency (MF) of the sEMG signals were also analyzed. ResultsThere were significant differences in normalized RMS of sEMG for the biceps brachii before and after training at 45°, 90°, and 135° elbow joints. Comparison of the RMS between different angles after training showed that 45° was significantly different from 90° and 135°. There were no significant differences between 90° and 135°. After training, no significant differences were found in normalized MF at all angles. Conclusions The RMS of sEMG shows angle-specific changes, while the MF of sEMG does not have angle-specific changes. When the biceps brachii is at the middle and large elbow joint angles, the neural adaptation effect produced by isometric resistance training is better.

8.
Article in Chinese | WPRIM | ID: wpr-922723

ABSTRACT

A questionnaire was used to investigate the emergency training needs of novel coronavirus pneumonia of disease prevention and control institutions in provinces, deputy provincial level regions and cities specifically designated in the state plan, and the effect evaluation of emergency training activities conducted by Chinese Center for Disease Control and Prevention (China CDC). The results showed that 67.4% of 47 disease prevention and control institutions (31/46) believed that the emergency training at the initial stage of the epidemic should be conducted as soon as possible, and the form of network training should be given priority. The training should focus on the urgently needed technologies such as epidemiological investigation, formulation and response of prevention and control strategies, laboratory testing, etc. The teaching materials should highlight pertinence and practicability and be presented in the form of electronic video. The average satisfaction score of the video training conducted by China CDC was (8.81±1.125) and the score of audio-video courseware was (8.97±0.893). The needs analysis and evaluation of novel coronavirus pneumonia prevention and control in disease prevention and control institutions could provide reference for the follow-up training and improve the emergency training management.


Subject(s)
COVID-19 , China/epidemiology , Humans , Pneumonia/prevention & control , SARS-CoV-2 , Surveys and Questionnaires
9.
Article in Chinese | WPRIM | ID: wpr-921782

ABSTRACT

As a classic prescription for promoting blood circulation to remove blood stasis, Xuefu Zhuyu Decoction(XFZYD) is widely used in clinical practice and has notable curative effect. Based on the key targets of activating blood circulation, this study identified the active components of XFZYD to reveal the material basis. The components of XFZYD were collected from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). The molecular docking models were built for the blood-activating targets obtained from the previous study with the components of XFZYD. The top five active components with measurability for each target were selected as the potential blood-activating components in the prescription. The efficacy of the prescription can embody key pharmacological and high-content components. In this study, anti-platelet aggregation activity was used to characterize the effect of activating blood, and the in vivo experiments were conducted to verify the accuracy of the active components. A total of 210 chemical components of XFZYD were screened out from TCMSP and docked with the key targets with the function of activating blood. Ligustrazine, acteoside, naringin, etc. were selected as the potential active components for activating blood in XFZYD. The anti-platelet aggregation activity of the combination of Chuanxiong Rhizoma, Rehmanniae Radix, Aurantii Fructus, Glycyrrhizae Radix et Rhizoma, and Carthami Flos was 9.82%±5.11%. Compared with that in the control group, the platelet aggregation induced by adenosine diphosphate(ADP) was significantly inhibited in the test group(P<0.01), which verified the accuracy of the active components. This study can guide the research on the material basis of XFZYD and provide insights into the development and utilization of the classical prescription.


Subject(s)
Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Molecular Docking Simulation , Rhizome
10.
Article in Chinese | WPRIM | ID: wpr-912790

ABSTRACT

Objective:To understand the practice of humanistic care and social worker voluntary service in public hospitals in China.Methods:From January to March 2021, 38 typical cases concerning " medical social worker and volunteer system" and " building a harmonious doctor-patient relationship through humanistic service" were collected by relying on the evaluation of China Healthcare Improvement Initiative. By means of statistics on the frequency of the subject words in the cases, hotspots of these hospitals in " paying attention to medical humanistic care and promoting social work voluntary service" were identified.Results:By classifying the keywords of the 38 cases, the hotspots mainly focused on strengthening the construction and management of social work volunteer platform and team, providing convenient and high-quality services, integrating humanistic care into diagnosis and treatment services, and building characteristic brand projects.Conclusions:The concept of humanistic care should be integrated into the hospital culture construction, the standardized and institutionalized development of humanistic care and volunteer work in the hospital should be promoted. Supporting measures should be introduced to promote the professional and stable development of talent team, and the routine service system should be established based on the needs assessment of both doctors and patients.

11.
Article in Chinese | WPRIM | ID: wpr-912789

ABSTRACT

Objective:To analyze the practice and experience of " patient-centered, popularizing multi-disciplinary team(MDT) mode" in medical institutions, and to put forward reasonable suggestions and opinions for medical institutions to further improve and popularize MDT mode.Methods:Based on the evaluation of China Healthcare Improvement Initiative, 40 typical cases of MDT in medical institutions were collected, and descriptive analysis and textual analysis were carried out on the cases.Results:There were more specialized hospitals carrying out MDT, the application scope of MDT services was constantly expanding, and the management system and diagnosis and treatment process were constantly optimized.Conclusions:The mode of MDT in China is in the stage of exploration and development. In the promotion process, it is necessary to give full play to the role of information means, establish scientific and reasonable cost measurement and charge standard, and improve the enthusiasm of medical institutions and medical personnel to participate in MDT.

12.
Article in Chinese | WPRIM | ID: wpr-912787

ABSTRACT

Objective:To understand the changes in the practice environment from the perspective of doctors in 136 tertiary public hospitals, and to provide evidence for formulating strategies and measures to improve the practice environment of doctors.Methods:The data was collected from five rounds of China Healthcare Improvement Evaluation Survey from December 2015 to March 2021. The sample size was 17 945, 19 774, 20 786, 23 289, and 22 836, with a total of 104 630. The self-designed questionnaire on four dimensions of doctor-patient relationship, workload, administrative logistics support and professional identity was performed.Results:From the 1st to the 5th survey, the approval ratio of " the administrative and logistics department of this hospital is highly efficient" showed the characteristics of " U-shaped distribution" , and the approval ratio of " approve or encourage children to continue to engage in medical work" increased from 13.38% to 23.91%.From the 2nd to the 5th survey, the percentage of doctors who experienced doctor-patient disputes dropped from 28.96% to 23.20%, and the percentage of doctors agreeing that the relationship between doctors and patients in this hospital was improving continued to increase from 33.20% to 60.45%.From the 3rd to the 5th survey, the proportion of doctors experiencing medical troubles dropped from 15.10% to 14.19%, and the recognition rate of " the cafeteria of this hospital provided medical staff with nutritious and delicious meals" increased from 36.25% to 47.52%, and the approval proportion of " my current work load is heavy" dropped from 61.55% to 45.24%. The results of the 5th survey showed that there were significant differences in the approval ratios of each dimension in different genders, job titles and hospital types( P<0.001). Conclusions:From the perspective of doctor-patient relationship, workload, administrative logistics support, and professional identity, the improvement of doctors′ practice environment is still insufficient. Hospital administrators should continue to focus on the improvement of the doctor-patient relationship, and take necessary measures to reduce doctors′ workload and improve doctors′ professional identity.

13.
Article in Chinese | WPRIM | ID: wpr-912786

ABSTRACT

Objective:To analyze the salary level, change trend and salary satisfaction of nurses in tertiary public hospitals in China.Methods:The data was derived from three round third-party evaluation of the China Healthcare Improvement Initiative at 136 tertiary public hospitals from December 2017 to January 2018, March 2019 and January to March 2021. The self-reported salary, expected salary and salary satisfaction rate of nurses were analyzed.Results:The sample sizes of the three evaluations were 27 575, 27 568 and 25 197, representing the salary situation in 2017, 2018 and 2020 respectively. In 2017, 2018 and 2020, the actual average annual salary of nurses was 81 600 yuan, 100 000 yuan and 110 000 yuan respectively, the expected average annual salary was 140 000 yuan, 160 000 yuan and 160 000 yuan respectively, and the ratio of expected salary to actual salary was 1.72, 1.60 and 1.45 respectively. In 2017, 2018 and 2020, the proportion of nurses satisfied with their current income was 34.0%, 33.7% and 43.6% respectively. In 2020, nurses in the eastern region, other specialized hospitals, senior professional titles and graduate degrees had highest annual salary.Conclusions:The salary level and satisfaction rate of nurses in tertiary public hospitals in China show a slow growth trend, and the gap between actual salary and expected salary is gradually narrowing.

14.
Article in Chinese | WPRIM | ID: wpr-912785

ABSTRACT

Objective:To analyze the current level and dynamic change of the salary and income satisfaction rate of doctors in Chinese tertiary public hospitals in recent years.Methods:In January 2018, March 2019 and March 2021, the project team of " the third party evaluation of the China Healthcare Improvement Initiative" conducted a questionnaire survey among doctors of 136 tertiary public hospitals in 31 provinces. The first-line clinicians were investigated by stratified sampling method. The salary level and satisfaction of doctors were investigated by questionnaire. Chi square test was used for comparison between groups.Results:The sample size of the three surveys was 20 786, 23 289 and 22 836 respectively. The median value of doctors′ actual income after tax in 2017, 2018 and 2020 was 100 800 yuan, 120 000 yuan, 150 000 yuan respectively, and the median expected annual income after tax was 196 000 yuan, 250 000 yuan and 250 000 yuan. The proportion of doctors satisfied with the current income was 16.5%, 17.8% and 26.9% respectively. The salary and satisfaction rate of doctors had an upward trend, but the overall level was still low.Conclusions:In recent years, the salary of doctors in tertiary public hospitals in China has been improved to a certain extent, but on the whole, it is at a low level, and there is still much room for improvement. In the future, the government needs to improve the hospital salary system and increase the salary of doctors continuously, especially needs to pay attention to the doctors with high education level and intermediate titles.

15.
Article in Chinese | WPRIM | ID: wpr-912784

ABSTRACT

Objective:To investigate the patient satisfaction at tertiary cancer hospitals in China, and explore its determinants.Methods:Based on the fifth third-party evaluation of China Healthcare Improvement Initiative, an inpatient satisfaction survey was conducted from January 2021 to March 2021 in 33 tertiary cancer hospitals in China. Inpatient satisfaction was analyzed, and Chi-square test and binary multivariate logistic regression were run, using the level of overall inpatient satisfaction as a dependent variable.Results:A total of 5 417 inpatients in tertiary cancer hospitals was recruited with 49.8% men. The inpatient at the age of 35-59 accounted for 56.0%, and they were 52.8±13.9 years old. The level of overall inpatient satisfaction was 98.90%. The inpatient satisfaction rates of meal service, waiting time for admission and psychological counseling service provided by hospital were relatively poor, which were 78.75%, 92.40% and 94.11%, respectively. The regression showed that level of overall inpatient satisfaction in the central and western regions(compared with eastern area), with urban and rural residents basic medical insurance or other type(compared with urban employee basic medical insurance), of breast cancer patients(compared with other disease), with unsured postoperative metastasis(compared with non-postoperative metastasis), with low self-rated health score(compared with the score of between 81 and 100)was lower.Conclusions:The inpatients in tertiary cancer hospitals in China is highly satisfied with the care provided. In the future, more attention should be paid to the dimension of lower patient satisfaction, such as diet and psychological counseling.

16.
Article in Chinese | WPRIM | ID: wpr-912783

ABSTRACT

Objective:To analyze the status quo, trend and influencing factors of patient satisfaction in tertiary maternity and child hospitals in China.Methods:Based on the survey results of five round third-party evaluations of the China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on the satisfaction index in tertiary maternity and child hospitals, and the influencing factors of satisfaction were analyzed based on the results of the fifth evaluation.Results:Compared with the first round, the overall patient satisfaction in tertiary maternity and child hospitals in the fifth round was improved(inpatient: from 95.7% to 98.0%; outpatient: from 87.8% to 94.9%). Outpatient satisfaction varied significantly among gender, hospitals of different types, education level, types of treatment, medical insurance and doctors′ titles( P<0.05). Outpatient satisfaction in local hospitals was 1.502 times higher than that in hospitals under the National Health Commission. The satisfaction of referrals was 0.259 times lower than that of patients who were admitted directly. Inpatient satisfaction varied significantly among department, hospitals of different regions, household registration type and whether the admission was delayed due to the COVID-19 epidemic( P<0.05). The satisfaction of inpatients in medical ward and surgical ward was respectively 0.202 and 0.298 times lower than that of inpatients in pediatric ward. Inpatient satisfaction at the central regions was 3.311 times higher than that at the eastern regions. Conclusions:The overall patient satisfaction in tertiary maternity and child hospitals in China is improving. In the future, we should pay more attention to the hospital environment, humanistic care and other non-medical service dimensions with low satisfaction, so as to further improve the medical experience of patients in maternity and child hospitals.

17.
Article in Chinese | WPRIM | ID: wpr-912780

ABSTRACT

Objective:To explore the change trend of patients′ recognition of the medical reform effect and medical staff′s occupation and its relationship with medical experience, since the implementation of the China Healthcare Improvement Initiative(CHII), so as to provide reference for exploring the breakthrough point of consolidating the reform effect.Methods:Four indicators of the third-party assessment of patients were selected, which were " I think the medical reform has benefited patients" , " I think the doctor-patient relationship is improving in the past three years" , " I think medical personnel deserve social respect and recognition" , and " I am willing to let my children join the medical profession" . Descriptive and trend analysis were carried out on the survey results, and correlation analysis was carried out between the survey results and patients′ medical experience.Results:Compared with the baseline evaluation results(76.9% and 69.9%for outpatients, 87.3% and 85.6%for inpatients), the patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship in the fifth evaluation(86.2% and 89.1%for outpatients, 91.4% and 92.6%for inpatients)were significantly improved. The proportion of patients who thought the medical staff was worthy of respect and willing to let their children work in the hospital in the fifth evaluation(97.4%, 79.1%for outpatients, 98.7%, 85.1%for inpatients)were higher than the baseline evaluation results(92.3%, 71.0%for outpatients, 98.1%, 81.6%for inpatients). The above indicators were positively correlated with the patient′s medical experience.Conclusions:Since the implementation of CHII, patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship has been continuously improved, and patients′ respect and recognition of professional identity of medical personnel is at a high level and continues to improve. Improving medical experience has a positive effect on the improvement of patients′ sense of medical reform.

18.
Article in Chinese | WPRIM | ID: wpr-912778

ABSTRACT

Objective:To assess the progress and impact of the China Healthcare Improvement Initiative(CHII) from 2015 to 2020, which aimed at improving patients healthcare experiences.Methods:Five rounds of evaluation surveys were conducted from December 2015 to March 2021 among 136-214 tertiary public hospitals. Structured questionnaires to measure hospital actions and performance, satisfaction of patients and medical staff were designed, and the data were collected by the national and provincial survey teams via onsite inspection, face-to-face/telephone interviews and self-administered cellphone APPs respectively. After data cleaning, the results of five round evaluations were analyzed and compared.Results:The sampled hospitals demonstrated high participation rate in the CHII, and their overall performance turned out to be satisfactory. And the patient healthcare experiences consistently improved over the period of CHII. In contrast to the high satisfaction rate with clinical quality of the sampled hospitals, patients were less satisfied with the non-clinical services such as food and supporting services. The job satisfaction of doctors and nurses experienced mild improvements, while the problems of heavy workload, low salary, and poor health were not effectively solved yet.Conclusions:The implementation of CHII from 2015 to 2020 has played a significant role in promoting patient-centered service models in hospitals, but continuous inputs and coordinated efforts are still required in the future. The improvement of non-clinical services still needs to be addressed to further enhance patient satisfaction. The job satisfaction and well-being of doctors and nurses remain at low level, and effective measures need to be taken to maintain the stability of the medical staff.

19.
Article in Chinese | WPRIM | ID: wpr-888190

ABSTRACT

As one of the most commonly diagnosed cancers in the world, female breast cancer is induced by the high level of estrogen. Saussureae Involucratae Herba(SIH), a gynecological medicinal, regulates estrogen-induced diseases. However, the therapeutic effect of SIH on breast cancer has not been reported. Therefore, this study aims to explore the potential efficacy of SIH on breast cancer based on in vitro experiment and network pharmacology. The inhibitory effect of SIH water extract on proliferation and migration of breast cancer MDA-MB-231 cells was examined. The result demonstrated SIH water extract significantly suppressed the proliferation of breast cancer cells(IC_(50)=6.47 mg·mL~(-1)) and also restricted the migration. A total of 39 components of SIH were retrieved from traditional Chinese medicine database(TCMD) and 160 targets of SIH were screened by target fishing with the PharmaDB database. The Online Mendelian Inheritance in Man(OMIM) was used to establish a 1 001-targets data set of breast cancer. Based on the overlaps(45) of targets between SIH and breast cancer, a protein-protein interaction(PPI) network was built to analyze the interactions among these targets with STRING platform and Cytoscape. Finally, through topology and GO and KEGG analysis, 8 targets, 101 pathways and 85 biological processes were found to involve the treatment of breast cancer by SIH. SIH may exert the anti-breast cancer effect by regulating cell cycle, inhibiting proliferation, migration and adhesion of cancer cells, and modulating estrogen receptor. This study clarified the mechanism of SIH in treating breast cancer, which lays a foundation for the further development of SIH.


Subject(s)
Breast Neoplasms/genetics , Databases, Genetic , Drugs, Chinese Herbal , Female , Humans , Medicine, Chinese Traditional
20.
Article in Chinese | WPRIM | ID: wpr-888123

ABSTRACT

The traditional Chinese medicines(TCM) for activating blood circulation and the TCM for regulating Qi are often used in combination in clinical practice. However, their mechanisms are still unclear. The activity spectrum of targets can fuse the active components, targets and intensity of action, which provides support for the discussion of efficacy targets. The chemical components of common TCM sets for activating blood circulation and regulating Qi, as well as the negative sets not for activating blood circulation and re-gulating Qi were obtained from the database of TCM. By the similarity analysis of chemical components in TCM for activating blood circulation and DrugBank database, the predicted targets of chemical components in TCM for activating blood circulation were obtained, and the similarity value of the two was taken as the activity value of the active components and predicted targets. Then, the component-target activity value was weighted. The activity values of herb acting on the same target were fused to construct activity spectra of targets of the herbs for activating blood circulation, herbs for regulating Qi and negative herbs. The targets whose activity values of activating blood circulation and regulating Qi were higher than those of negative herbs were selected as potential targets of efficacy. Protein-protein interaction networks were constructed for topological, GO and KEGG enrichment analysis to determine the key targets of efficacy of activating blood circulation and regulating Qi. The component-target activity information collected from DrugBank database contained 4 499 compounds, 627 targets and 11 295 action relationships. The activating blood function protein-protein interaction network contained 206 nodes and 1 728 edges, while the regulating Qi function protein-protein interaction network contained 230 nodes and 986 edges. The enrichment analysis of topology, GO and KEGG showed that TCM for activating blood circulation mainly exerted its anti-inflammatory, neuroprotective and angiogenic effects on signaling cascade pathway mediated by VEGF/VEGFR2, ERK signaling pathway, calcium signaling pathway and PI3 K-AKT signaling pathway, and the key targets included mitogen activated protein kinases 3(MAPK3), proto-oncogene tyrosine-protein kinase Src(SRC), mitogen activated protein kinases 1(MAPK1), epidermal growth factor receptor(EGFR), phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha isoform(PIK3 CA), peroxisome proliferators-activated receptor gamma(PPARG), nitric oxide synthase 3(NOS3), prostaglandin G/H synthetase 2(PTGS2), matrix metalloproteinase-9(MMP9), and vascular endothelial growth factor A(VEGFA). TCM for regulating Qi mainly exerted anti-inflammatory and neuroprotective effects by acting on MAPK signaling pathway and PI3 K-AKT signaling pathway, and the key targets included mitogen activated protein kinases 8(MAPK8), SRC, mitogen activated protein kinases 14(MAPK14), and RAC-alpha serine/threonine-protein kinase(AKT1), mitogen activated protein kinases 3(MAPK3). Based on the activity spectrum of targets, the targets of the TCM for activating blood and the targets of the TCM for regulating Qi were analyzed to provide reference for the study of efficacy targets of TCM, and also provide some scientific basis for clinical application.


Subject(s)
Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Protein Interaction Maps , Qi , Vascular Endothelial Growth Factor A
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