Innovative practice of " two hearts and four wings" in the construction of safe hospital / 中华医院管理杂志

The construction of safe hospital is the foundation of high-quality development of the hospital, and innovation provides power for the construction of safe hospital from the perspective of high-quality development. Taking Zhejiang Provincial People′s Hospital as an example, the authors introduced the innovation construction path of safe hospital in detail, and put forward the construction strategy of safe hospital with " two hearts" (patient-centered, employee-centered)and " four wings" (multimedia doctor-patient communication, Wulin aunt medical studio, integrated operation safety inspection, third-party medical liability insurance). Through the combination of basic safety management and innovative practice, the hospital vigorously promoted the culture of " two hearts" , and established an efficient collaborative information management system, so as to form replicable and promotable practical experience and promote the development of safe hospital.

Practice of applying multimedia technology in doctor-patient communication before diagnosis and treatment / 中华医院管理杂志

The existing doctor-patient communication pattern often falls prey to insufficient informed consent and even medical disputes. In the patient centered perspective, Zhejiang Provincial People′s Hospital explored a new communication mode centering on patients. Based on diagnosis-related groups catalogues and high-frequency surgeries catalogues of the departments, multimedia technology was called into play to produce dubbed PPTs and videos that were easy to understand, standardized and homogeneous, which were embedded into medical records system. Following observation of the PPT or video, patients could directly sign an informed consent on the computer. This practice not only deepens patient′s understanding and achieves homogeneous level of the communication, but also elevates doctor′s work efficiency, contributing to building a harmonious doctor-patient relationship.

Relationship of Posterior Capsular Opacification and Capsular Bend Type Investigation Based on Swept-source Optical Coherence Tomography.

Purpose: To investigate the relationship between capsular bend type and posterior capsule opacification (PCO) at a three-dimensional (3D) level using high-speed swept-source optical coherence tomography (SS-OCT).Methods: This was a retrospective study. A total of 99 eyes that underwent standard cataract surgery with phacoemulsification 2 years ago were analyzed. Standard SS-OCT radial scanning was performed in all eyes and the obtained photos were used for morphological observations of the capsular bend-IOL complex, the adhesion of posterior capsule to the IOL optic, and the position of the anterior capsulorhexis. Digital retroillumination photographs were taken of the posterior capsule of each eye to evaluate PCO (scoring and area).Results: In terms of the PCO score and area, there was no statistical difference between eyes with complete and incomplete adhesion of posterior capsule to IOL (both P > .05), whereas the partial overlap group showed a statistical difference greater than the total overlap group (P < .05). There were two types of capsular bends, completed adhesion (CA) and incomplete adhesion (IA). IA was divided into funnel adhesion (IA-F), parallel adhesion (IA-P), and detached adhesion (IA-D). The incomplete adhesion index (IAI) varied between eyes and ranged from 0 to 1. The PCO score and area in the high IAI group (higher than 0.50) were significantly greater than the low IAI group (< 0.50) (P < .05). In addition, the PCO score and area were significantly higher in the cohort with at least one IA-D capsular bend in six districts to the group that did not have IA-D capsular bend (P < .05).Conclusions: Complete or incomplete adhesion of the posterior capsule to the IOL optic may not be necessary for the development of PCO. Our study suggests that capsular bend type may be used as an index to predict PCO.

Three-Dimensional Morphology Study of Capsule in Pseudophakic Eyes with High-Speed Swept-Source Optical Coherence Tomography.

PURPOSE: To study the capsule morphology in pseudophakic eyes on the three-dimensional level using high-speed swept-source optical coherence tomography (SSOCT). METHODS: This study collected patients with age-related cataract and divided them into two groups according to the anterior capsule and intraocular lens (IOL) optic relationship: total anterior capsule overlap (360°, Group-T) and partial anterior capsule overlap (<360°, Group-P). One standard SSOCT radial scanning was performed in all eyes at 1 day, 1 week, 1 month, and 3 months postoperatively. RESULTS: Thirty-two eyes from 25 patients were enrolled in the Group-T and 17 eyes from 13 patients in the Group-P. No eyes achieved complete adhesion between IOL optic and posterior capsule at 1 day after the surgery. However, the rate of complete adhesion was low (15/49, 30.6%) even at 3 months postoperatively and there was no statistically difference between Group-T and Group-P (21.9% vs. 47.1%, P > 0.05). At 1 day, 1 week, 1 month, and 3 months after the surgery, the capsule bend index (CBI) in the Group-T was 0.02 ± 0.09, 1.35 ± 1.48, 3.60 ± 0.54, and 3.88 ± 0.19, respectively. CBI rises linearly during the first month and the rise goes stable relatively with the great reduction of standard deviation in the following 2 months (All P < 0.05). The anterior capsule opening area and diameter were both reduced in the first month, and then they both became stable. CONCLUSIONS: With square-edge IOL, posterior capsule opacification risk is still high in most eyes at 3 months postoperatively for the complete adhesion of posterior capsule and IOL was only achieved in 30.6% eyes. IOL-in-bag may be driven by the significant capsule bag changes especially in the first month postoperatively.

The perioperative nursing of patients underwent percutaneous microwave or radiofrequency ablation liver partition and portal vein embolization for planned hepatectomy / 中华护理杂志

This article summarized perioperative nursing experience of 6 patients underwent percutaneous microwave or radiofrequency ablation liver partition and portal vein embolization for planned hepatectomy(PALPP).The key points of nursing included:psychological counseling applied throughout the perioperative treatment;personalized preoperative biliary drainage;nursing intervention targeting at Enhanced Recovery After Surgery(ERAS);complication-directed prevention and nursing after microwave or radiofrequency ablation,portal vein embolization,and radical hepatectomy.All 6 patients were recovered and discharged successfully.

An analysis of risk factors for brucellosis in employees working in the sheep market in Tongxiang of Zhejiang Province, 2010-2015 / 中华地方病学杂志

Objective To understand the epidemiological characteristics of brucellosis among risk population and analysis risk factors, and to provide a reference basis for prevention and treatment of brucellosis. Methods Retrospective survey method was used to collect information on brucellosis and epidemiologically confirmed cases in Tongxiang City from 2010 to 2015. The employees gender, age, occupation, job seniority, contact area, contact history to abortion cub and with or without protection measures were analyzed by single factor and multiple factors analysis, calculate odds ratio (OR) and 95%confidence interval (CI). Results Totally 1 450 people were investigated and 43 were confirmed positive (2.97%),new cases were 37 with joint pain 86.49% (32/37), low temperature 81.08%(30/37), and weak 62.16%(23/37) as the main body symptoms. Most people were infected in the summer season, accounted for 8.07%(18/223); female cases were relatively higher, accounted for 5.38% (12/223);people younger than 30 years old had the highest positive rate 24.14%(7/29);people working in the processing of animal products had the highest positive rate 6.42%(12/187). The employees gender, age, the types of work, the job seniority, the district distribution and the season were all related to the prevalence of the disease (all P< 0.05) analyzed by Chi-square test and Fisher's exact probability method. By single factor analysis, gender (male, OR =0.397, 95%CI:0.178-0.884), age (31-60 years old, OR = 0.254, 95%CI:0.081-0.796), and types of work (processing personnel, OR =3.211, 95%CI: 1.424 - 7.238) and contacting young animal (OR = 3.544, 95%CI: 1.729 - 7.264), practitioners operating tool (OR=0.231, 95%CI:0.070-0.766) were related to the prevalence of the disease;by multiple factors analysis, contacting young animal (OR=5.198, 95%CI:2.078-13.000) was a risk factor for brucellosis abortion, and practitioners operating tools (OR = 0.161, 95%CI: 0.045 - 0.577) were brucellosis protective factors such as wearing gloves . Conclusion We suggest to strengthen health education and health promotion in professional key populations, do a good job in the epidemic monitoring and promote occupational protection awareness, and decrease the infection of brucellosis.

Investigation and analysis of brucellosis infection in non-occupational population in Tongxiang City of Zhejiang Province / 中华地方病学杂志

Objective To analyze the cases of brucellosis in non-occupational population in Tongxiang City of Zhejiang Province,and to provide a scientific basis for making strategies in brucellosis prevention and control.Methods Rose bengal plate agglutination test (RBPT) and serum tube agglutination test (SAT) were used to detect brucellosis in the general population who were closely contacted with cases in non-occupational groups and who had brucellosis-related symptoms.If the pathogen result was positive,Brandt strain type identification should be done to analyze the reasons for non-occupational population who infected with brucellosis.Results A total of 7 cases of brucellosis were detected in the non-occupational groups,which accounted for 14.58％ of the total number of cases (7/48).Misdiagnosis was common,seasonal incidence was not obvious,transmission route and population infected were diverse.Conclusion The incidence rate of brucellosis is an upward trend,public brucellosis prevention knowledge should be strengthened,and training in diagnostic and treating skills for medical professionals should be provided.

A investigation of epidemic outbreak of brucellosis in Tongxiang City of Zhejiang Province / 中华地方病学杂志

Objective To investigate the epidemiological characteristics of Brucella aggregation of disease outbreaks, and explore the causes and possible routes of transmission in Tongxiang City for proposing prevention and control measures.Methods A case investigation was done to the first case of bovine brucellosis, while search of new case was carried out in the population.Epidemiological survey was carried out in accordance with the case study form from Chinese Center for Disease Control and Prevention that developed the unified form, at the same time, survey of risk factors were carried out.According to the principle of informed consent, blood samples were collected, brucellosis rose bengal plate agglutination test (RBPT) and tube agglutination test (SAT) were used, and positive specimens were identified by Brucella culture.Brucellosis diagnosis was based on Brucellosis Diagnostic Criteria (WS 269-2007).Results The first case was a male Fifty-six years old wine salesman from the farmers market.Serum of the patient was (+) in RBPT test, and 1 : 400 (++) in SAT test.Cattle Brucella was check out by blood culture.Totally 66 human serum samples from the case search in key groups were tested, three people were detected seropositive but Brucella culture result was negative.Three cases were determined latent infection who had contacted beef sales staff.Conclusions The survey has shown that it is possible to get infected through contact with respiratory, skin, mucous membranes of Brucella infected beef or contaminated environment.Epidemic form should be concerned of non-professional personnel who are infected with different isoforms of brucellosis.The training of clinicians should be strengthened to improve their diagnosis and treatment technology.Health education should also be carried out to raise awareness of key population of disease prevention.

The new evidence of nucleolar ultrastructural dynamic change: fibrillar centre (FC) fusion in G1 phase and regeneration in S phase.

In higher eukaryotes ribosome production starts at the end of mitosis, increases during G1, is maximal in G2 (Sirri et al., 2000) and stops during prophase (Gébrane-Younès et al., 1997). But the mechanism of the change is still uncovered. Especially in the actively growing mammalian somatic cells usually contain one or several giant fibrillar centres (GFCs) with many tiny fibrillar centre (FCs) (Koberna et al., 2002; Raska et al., 2004; Casafont et al., 2007). The process how the giant fibrillar centre (GFC) and the many tiny fibrillar centres (FCs) were formed is unknown. The present results showed there were processes of FCs fusion in G1 phase and FCs regeneration in S phase respectively in the nucleoli of A 375 cells. A few FCs fused each other in late G1 phase when the process of nucleoli fusion was completed. In S phase, a lot of tiny FCs were regenerated from the periphery of GFC, separated and scattered into nucleolar matrix in late S phase and early G2 phase. The GFC was found to be coexisted with numerous tiny FCs in the nucleolus in G2 phase. The present study provided a new evidence of nucleolar dynamic change during interphase: fibrillar centre (FC) was not to be a stable state subunit of nucleolar compartment but a highly dynamic process that may be the bases of nucleolar morphological architecture organization and its function taking place.

Application of interest teaching method in the teaching of human parasitology / 中华医学教育探索杂志

Interest teaching method aims to inspire students' initiative and inquiry in learning.In the teaching process,we used some teaching methods including class lead-in,relevant extracurricular books and websites,scene representation,lectures on special content and arrangements of the review writing.It is important to maintain students' motivate and interest in learning human parasitology,therefore,we should no longer make students passively accept but the initiatively make inquiry learning.

Analysis of non-government awards on medical technology achievements in China / 中华医院管理杂志

A deep analysis of the present 26 non-government awards on medical technology achievements was made to probe into setbacks in access to such awards.The findings include lack of independence due to the semi-official nature,tight budget caused by limited funding sources,variety of award sizes due to lack of levels,less corporate involvement to result in less sponsors,and lack of international awards due to unsatisfactory international awareness.The authors recommend such optimal paths as laws and regulations to regulate such awards to be hosted by legal persons,incentives for more enterprises participation to make the awards a public highlight among enterprises,control over the size and types of such awards for better branding,and greater efforts in international collaboration to make international awards.

Determination of serum sFas and sFasL in the clinical research before and after treatment of uterine cervix cancer / 中国医师进修杂志

Objective To investigate the role of sFas and sFasL in the development and progression of uterine cervix cancer(UCC)and the clinical significance of detecting them.Method Serum sFas and sFasL levels of 30 UCC patients were detected by enzyme-linked immunosobent assay (ELISA) before and after treatment (operation or chemotherapy),at the same time serum sFas and sFasL levels of 20 healthy volunteers were also detected by ELISA.Results Serum sFas and sFasL levels of UCC patients[(8.60±0.27),(2.96±0.65)μg/L] were obviously higher than those of healthy volunteers[(6.27±0.25),(0.21±0.05)μg/L],there was statistical significance (P＜0.05).Serum sFas and sFasL levels of those who had operations decreased obviously 2 weeks after the operation,serum sFas and sFasL levels of those who had chemotherapy 3 weeks later increased,there was statistical significance when compared before and after treatment (P＜0.05).Conclusions sFas and sFasL may play important roles in the development and progression of UCC,detection of serum sFas and sFasL levels may conduce to observe the changes of pathogenetic condition.

Exploration of opening the relevant medical microbiology elective course / 中华医学教育探索杂志

In order to stimulate students to interest in study,broaden their horizons,and strengthen their scientific literacy,the writers opeed the elective course of medical microbiology---《plague and the movie》.During this teaching process the writers explored the setting of the elective course,and summarized the experience and the existing problems of the process and prospect the teaching work of the future.