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护患沟通的研究现状和进展

疼痛关爱在膝关节周围骨肉瘤患者术后护理中的应用

目的　探讨疼痛关爱对膝关节周围骨肉瘤关节置换患者的影响。 方法　将2010年3月－2012年6月收治的30例行膝关节置换术术后患者，随机分成对照组和试验组各15例，对照组采用常规止痛方法，而试验组采用疼痛关爱护理，观察比较两种护理方法的效果。 结果　试验组患者术后疼痛级别下降，住院治疗时间少于对照组，两组各项指标比较差异有统计学意义（P＜0.05），疼痛关爱护理效果较好。 结论　实施疼痛关爱护理，可缓解患者疼痛，缩短平均住院日，值得临床推广。

Construction of mdr1 Expression Vector and Detection of Its Expression in HepG2 Cells

【Abstract】ObjectiveTo construct an mdr1 expression vector and detect its expression in HepG2 cells in vitro. MethodsThe 4.5-kb mdr1 cDNA was obtained from the plasmid pHaMDR1 cloned into the PCIneo mammalian expression vector, which was later transferred into human hepatocarcinoma cell line HepG2 by liposome. Then the HepG2 cells resisting G418 were clustered and proliferated，and the specific fragment of mdr1 cDNA, mRNA and the Pgp in these HepG2 cells were detected by means of PCR, RT-PCR and FCM respectively. ResultsThe mdr1 expression vector was constructed successfully，and the stable multidrug resistance(MDR) hepatocarcinoma cell line （HepG2/mdr1） was developed as well. The outcome of PCR analysis showed that the specific fragment of mdr1 cDNA could be found in HepG2/mdr1 cells, but not in the nontransfection HepG2 cells. Furthermore,the content of the specific fragment of mdr1 mRNA and the expression of P-gp in HepG2/mdr1 cells were (59.7±7.9)% and (12.5±5.45)% respectively, the corresponding value in HepG2 cells were (16.9±3.2)% and (4.63±2.59)% respectively. The difference was statistically significant (P＜0.05). ConclusionIt is praticable to develop MDR hepatocarcinoma cell line by transferring mdr1 cDNA into HepG2 cells, which is useful in the research of MDR mechanism.

膝关节周围骨肉瘤保肢术后患者生存质量调查分析

目的　评估膝关节周围骨肉瘤患者保肢技术应用后的生存质量，进一步完善此技术的临床实践。 方法　选取2009年8月－2011年1月行膝关节恶性肿瘤切除后人工肿瘤膝关节置换保肢术及截肢术患者作为研究对象，共纳入29例患者，按照术式不同分为保肢组20例，截肢组9例。于术后6个月用国际普遍认可的生活质量评定量表SF-36进行随访。 结果　患者均成功获得随访，随访时间术后6个月，无死亡。2例发生肺部转移，27例无瘤生存。保肢组在生理、社会功能，生理、情感职能，精神健康、活力、身体疼痛、总体健康等8个维度的得分值均高于截肢组（P＜0.05）；两组患者在健康变化的得分值比较差异无统计学意义（P＞0.05）。 结论　行膝关节周围骨肉瘤保肢术患者与行截肢术患者相比，可获得更为满意的生存质量。

Building a multi-level and multi-disciplinary medical service supply chain model of difficult, complex and severe diseases medical consortium based on the whole life cycle

In response to the current situation of regional medical and health hierarchical diagnosis and treatment services and the existing problems in the continuity of medical services, this article applies supply chain management methods, system collaboration theory, and service ecosystem concepts to treat medical consortia as an organic whole. Based on the quality and efficiency of disease management in the whole life cycle of patients with difficult, complex and severe diseases, a multi-level and multi-disciplinary medical service supply chain model of difficult, complex and severe disease medical consortium is constructed with four core elements: patient flow, service flow, technology flow and information flow. This article provides a certain reference for the implementation of regional hierarchical diagnosis and treatment and the formulation of relevant policies in China from the perspective of theoretical research.

Application and practice of multi-disciplinary team service model in West China Hospital of Sichuan University

Multi-disciplinary team (MDT) is a leading diagnosis and treatment model widely respected in modern international medical field, which plays an important role in clarifying disease diagnosis, determining treatment direction, and reducing patient time and labor cost. In recent years, China has issued relevant policies to encourage hospitals to vigorously develop MDT. West China Hospital of Sichuan University established a MDT clinic in 2013. Through continuous innovation and bold breakthrough in terms of experience accumulation, clinical resource integration, disciplinary collaboration and other aspects, the hospital breaks the barriers of MDT, timely helps complex severe diseases patients to solve the diagnosis and treatment needs, provides patients with the best personalized treatment plan, and continuously improves the medical experience of patients. Therefore, this article introduces and summarizes the implementation process and experience of MDT outpatient clinic in West China Hospital of Sichuan University.