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ObjectiveAs a new mode and format of health care service, Internet hospital has created a convenient and efficient medical treatment channel for patients and promoted more access to high-quality medical resources. In order to better identify patients′ service demands of Internet hospitals and thus meet people′s diversified health needs, refined classification management of service demands of Internet hospitals is implemented by KANO model, so as to promote the improvement of service quality of Internet hospitals and enhance patient satisfaction as well.MethodsBased on the analysis ideas of KANO model, 300 patients were randomly selected from the social pharmacy of an Internet hospital for questionnaire survey and service demand survey.ResultsIn the KANO requirement attribute classification of Internet hospital service items, there were 6 items belonging to charm attribute, 10 items belonging to expectation attribute and 5 items belonging to necessity attribute. Service items corresponding to expected attributes and necessary attributes account for more than 70% of Internet hospital services.ConclusionThe application of KANO model to the service demand survey of Internet hospitals can effectively improve the service management level of Internet hospitals, and the continuous improvement of service quality of Internet hospitals requires regular monitoring of service demand changes.
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The introduction of artificial intelligence into the medical field is also facing social ethical challenges while promoting changes in the field of health services. To realize the healthy development of medical artificial intelligence, we must consider the ethical issues inherent in the application of artificial intelligence technology in medical services. The article analyzes the ethical issues brought about by medical artificial intelligence from the aspects of security, doctor’s principal status, doctor-patient relationship, and fair benefit. By implementing special supervision, clarifying the principal status of doctors, and strengthening ethical protocols, the application of artificial intelligence in medical services will be guided to promote artificial intelligence to better improve the service capabilities and quality of healthcare system.
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This paper analyses the Methods of selecting the cultivation direction of hospital′s dominant disciplines and points out that hospitals should analyse the development environment Objective ly, design the discipline distribution scientifically, and harbor the construction thoughts multi-dimensionally. Based on the practical experience of Nanjing General Hospital, this paper expounds vital Methods to develop preponderant disciplines, proposes that "fusion" and "differentiation" are the developing trend and regards the three major factors-leading talents, strong team, and major projects, as the critical points to prompt the cultivation of preponderant discipline. Lastly, the paper further discusses the implementation of cultivation through strengthening the platform construction, enhancing exchange and cooperation, focusing on achievement transformation and highlighting technical features.
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Objective Ambulatory surgery(AS),with its simple procedures and efficient utilization of resources,is an ef-fective means of improving medical efficiency.The aim of this study was to improve the daily procedures of AS by analyzing the perform-ance and results of knee arthroscopy-assisted AS. Methods This study included 188 cases of knee arthroscopic surgery performed from March to August 2017,97 of them treated in the Ambulatory Surgery Center(group A)and the other 91 in the conventional ward (group B). We compared the average hospital stay,hospitalization expenses,and postoperative complications between the two groups of patients. Results Compared with group B,group A showed a significantly shorter hospital stay([95.0±41.3]vs[25.5±0.8]h, P<0.05)and lower hospitalization expenses([28 699.6±11331.1]vs[22231.7±7152.2]RMB,P<0.05). No statistically significant difference was observed in the incidence rate of postoperative complications at 1 and 3 days after surgery,1 case of bleeding in group A and 1 case of leg swelling in group B. Conclusion Ambulatory surgery in our hospital needs to be further improved on the basis of accelerated rehabilitation surgery as the core concept,precision medicine as the approach,and individualized treatment as the goal.
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Objective The proportion of multiple drugs and the irrational use of drugs increased significantly in the elderly patients (over 80 years). This study aimed to investigate the occurrence of potentially inappropriate medication (PIM) and analyzed the possible reasons related to PIM in elderly patients. Methods In this study,918 cases from Cadre Ward I of Research Center for Geriatrics of Nanjing General Hospital of Nanjing Military Region were selected from January to December in 2016. According to the Beers Criteria (Version 2015),we evaluated PIM in four subtypes,type 1 that is not related to the state of disease in elderly patients, type 2 that is related to the state of disease in elderly patients,type 3 which should be used carefully,and type 4 which is the inappropriate combination of non-anti-infective Drugs. The PIM influence factors were analyzed by logistic regression analysis. Results There are 521 cases (56.75%) of type 1 PIM. The first 3 drugs are Short and medium acting benzodiazepams,PPI and long acting benzodiazepams. There are 206 cases (22.4%) of type 2 PIM. The first 2 drugs are drugs associated with insomnia (oral hyperemia, stimulants, theo-phylline and caffeine) and drugs associated with dementia or cognitive impairment (anti-cholinergic drugs and H2 receptor antago-nists). There are 834 cases (90.85%) of type 3 PIM,which should be used carefully and 45 cases(4.90%) of type 4 PIM.45 cases (4.90%) of non-anti-infective drugs should be avoid or reduced as much as possible in consideration of renal function. The number of combined drug use(OR=5.331,95% CI:3.549-8.009),the age(OR=1.171,95% CI:1.093-1.249),the Chalson's comorbidity index (OR=1.964,95% CI:1.477-2.450) are risk factors of PIM. Conclusion The incidence of potentially inappropriate use of drugs is high among the elderly patients. Reducing the number of combined drugs is an important measure to avoid the occurrence of PIM in elderly patients.
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<p><b>OBJECTIVE</b>To investigate the protective effect of L-carnitine (LC) combined with sildenafil on the reproductive endocrine function of male rats with diabetes mellitus (DM).</p><p><b>METHODS</b>A total of 40 male SD rats were randomly divided into five groups, group A taken as normal controls, and groups B, C, D and E made into DM models by injection of streptozotocin at 65 mg/kg. Then the rats in groups A and B were treated with normal saline, C with sildenafil at 5 mg per kg per d, D with LC at 300 mg per kg per d, and E with sildenafil at 5 mg per kg per d plus LC at 300 mg per kg per d, all via gastric gavage for 6 weeks, followed by determination of the levels of testosterone (T), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the serum of the rats.</p><p><b>RESULTS</b>After 6 weeks of treatment, the T, FSH and LH levels were (25.25 +/- 2.67) nmol/L, (5.78 +/- 0.61) IU/L and (625.21 +/- 43.45) ng/L in group A, (9.63 +/- 1.71) nmol/L, (1.98 +/- 0.42) IU/L and (479.89 +/- 27.62) ng/L in group B, (18.98 +/- 3.07) nmol/L, (5.08 +/- 0.33) IU/L and (586.57 +/- 31.72) ng/L in group C, (16.18 +/- 2.65) nmol/L, (4.63 +/- 0.30) IU/L and (540.78 +/- 25.52) ng/L in group D, and (23.65 +/- 2.66) nmol/L, (5.59 +/- 0.48) IU/L and (621.53 +/- 36. 40) ng/L in group E. The three parameters were significantly lower in B than in the other four groups (P < 0.01), and so were they in C and D than in A and E (P < 0.05), but showed no significant differences either between C and D (P > 0. 05) or between A and E (P > 0.05).</p><p><b>CONCLUSION</b>Six-week medication of either sildenafil or LC alone could increase the levels of T, FSH and LH in the serum of DM rats, but the combination of the two had an even more obvious increasing effect, which indicates a still better protective effect on the reproductive endocrine function of diabetic male rats.</p>