Outpatient traffic analysis and management study of the hospital / 中华医院管理杂志

Objective To investigate the pattern of outpatients traffic,orchestra service resources,and optimize service provision,for a harmonized outpatient service.Methods A baseline survey was made at the outpatient department in 30 days(six hours per day,7:00-11:00,and 13:00-15:00).On such basis,data of the hospital's HIS system within the last five years were called into play for statistics analysis and simulation test,for the purpose of shift scheduling and resources allocation optimization.Results This study discovered each January-February as the valley of clinic visits and each July-August as the peak.52-week data analysis of a year found that the days of daily registrations between 4000-5000 are up to 163 days,those over 5000 are up to 86 days,of which Mondays with over 5000 registrations are up to 35 days.Each Monday is found to be a peak of outpatient visits,with significant drop during Saturdays and Sundays; daily registrations peak between 7:00-10:00 in the morning,while the traffic rises again during 13:00-14:00 in the afternoon,yet up to 26 ％of the morning peak only.Conclusion Statistics analysis of the outpatient service and emergency service at the outpatient department can help identify their patterns of operations,for effective improvement of service provision,alleviation of peak hour workload,shorten patient waiting time and better patient satisfaction.

The application of the single cell fluid in detecting HER-2 gene or protein / 中国基层医药

ObjectiveUsing the single cell fluid to establish a kind of practical experimental method,to detect the HER-2 gene and protein of breast cancer,and to provide reliable basis for pathology diagnosis.MethodsThe single cell fluid of breast cancer was preparaed by Medimachine system.Sucking a little of the single cell fluid spreaded on the slide and to be examined by immunohistochemistry using antibodies to HER-2 and fluorescence in situ hybridization.ResultsThe cell membrane of breast cancer was positive for HER-2 by immunohistochemistry according to American society of clinical oncology of American pathologists guideline recommendations for HER-2 testing in breast cancer and the HER-2 gene of the single cell amplified obviously by fluorescence in situ hybridization which the ratio of the average of HER-2 and the average of CEP17 exceeded 2.2.ConclusionThe single cell fluid could be used as positive control when we detected the HER-2 gene or protein of breast cancer,which guaranteed the correction of the results of the sample to be detected.

TREATMENT OF TOTAL AVULSION THE WHOLE HAND WITH DIGITAL NERVES PRESERVATION AND UPPER ABDOMINAL BAG-SHAPED SKIN FLAP / 解放军医学杂志

The treatment of total avulsion of the hand is somewhat difficult and the result usually not satisfactory. Four cases of such patients were treated from 1983 to 1987. After routine debridement, digital nerves and its surrounding adipose tissue were preserved. An "S" shape skin flap was designed an raised in the contralateral upper abdominal quadrant to cover the injured hand like a bag, so that both sides of the hand were covered. The donor area (12cm2) was directly sutured. Nerve endings might grow into the flaps because of the preservation of digital nerves. Three patients were followed-up for 2 to 6 years, the injured hands regained good pain sensation as well as stereognostic and temperatuer sensations. The function of the hand is satisfactory, but the flap looked bulky and multiple plastic operations were necessary to seperate the fingers.