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find Author "李德华" 12 results
  • 优化门诊服务流程 提高患者满意度

    目的 总结优化门诊环境与流程、提高门诊服务能力的方法与经验。 方法 2011年初通过改造和优化门诊环境及服务流程,强化服务意识,提高护理人员业务素质等方法,着力解决门诊服务中存在的相关问题,并以调查问卷方式对优化前后的效果进行比较评价。 结果 优化后,门诊就诊环境大为改善,服务流程得以改进,服务能力有所扩展,患者的就医满意度比2010年上升了14.84%,意见投诉则下降68.42%。 结论 合理的就诊流程及人性化主动服务,可以改善门诊患者的就医感受并提高患者满意度。

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  • JCI安全目标管理在降低产科护理不良事件中的应用

    【摘要】通过分析产科护理不良事件发生的原因,以JCI基线评估为契机,按JCI安全目标管理要求制定相应的政策,并严格落实到位。提高了产科护理质量,降低了产科护理差错的发生率,保障了孕产妇及新生儿的医疗、护理安全。

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • JCI医院评审标准在改进医务人员沟通中的应用

    【摘要】 介绍JCI医院评审标准对医务人员之间的沟通要求及应用方法,总结其在产科中的实践经验,JCI医院评审标准能降低或避免医务人员之间因沟通障碍造成的医疗纠纷及医疗缺陷,为有效改进医务人员之间的沟通效果提供实践方法。

    Release date:2016-09-08 09:52 Export PDF Favorites Scan
  • Investigation and analysis of humanistic care on improving the experience of inpatients

    Objective To understand the effect and influencing factors of humanistic care on improving the experience of inpatients. Methods Patients were collected from a third grade class A women’s and children’s hospital in June 2015 and June 2016, and their satisfaction was investigated by a third party. The service items of Inpatients Satisfaction Item Score Table in 2015 were analyzed. Appropriate intervention measures were taken to low-score items, such as humanistic knowledge training to all medical staff, improvement health guidelines, implementation of recycling process, carrying out high quality nursing interventions, and so on. The patients satisfaction survey results in 2016 were compared with those of 2015. Results In 2016, the total satisfaction rate (89.94%), and the average score of items ranked the top three (94.64±0.14), including the level of medical technology, medical ethics and the overall evaluation of doctor’s professional ehtics, medical communication and service attitude, were higher than those of 2015 (85.25, 90.86±1.53). The average score of items ranked the last three (89.25±9.21), including hospital ward, hospital environment (clean, quiet and safe), hospital meals and room service, and hospital food quality, was higher than that of 2015 (78.64±2.40). However, compared with the same period in the last year, the rank of hospital environment fell by two places. Conclusions Hardware conditions like physical environment have an important impact on the experience of hospital patients. However,  humanistic care is the key factor to improve the patients’ inpatient experience and satisfaction.

    Release date:2017-08-22 11:25 Export PDF Favorites Scan
  • Kano模型调查结果分析对改进门诊服务的指导意义

    目的 利用 Kano 模型在医院门诊服务调查中的结果来改进门诊服务。 方法 设计 Kano 模型门诊服务需求调查问卷,于 2016 年 8 月对某三级甲等专科医院门诊患者进行调查,问卷包括医疗环境、医疗便利程度、服务水平、医疗质量、医疗费用、尊重患者权益 6 个维度,共 26 项指标,分别用喜欢、理应如此、无所谓、能忍受、不喜欢 5 个选项评定相关质量的属性占比,并将属性得分最高者确定为该项质量属性,运用 Kano 模型结果对门诊服务情况进行分析,以改进服务。 结果 26 项门诊服务项目中有 17 项为必备质量属性,9 项为期望质量属性,无魅力质量属性项目。门诊患者对门诊服务项目的满意度评价为 0.41~0.58,无超过 0.6 接近 1 的项目;重要度评价为 0.58~0.85。 结论 该院门诊服务基本达到患者满意的程度,但缺乏魅力属性要素。该调查结果为管理者提供了如何改善门诊服务的参考。

    Release date:2017-09-22 03:44 Export PDF Favorites Scan
  • Construction of Recombinant Adenovirus Vectors Carrying Antisense Matrix Metalloproteinase-2

    【Abstract】Objective To construct a recombinant adenoviral vector carrying antisense matrix metalloproteinase2 (MMP2) for use in the gene therapy to inhibit the invasiveness and migratory capacity of hepatocellular carcinoma (HCC) cell line HepG2 in vitro and in vivo models. Methods Total RNA was extracted from HCC, and then a 500 bp fragment at the 5′ end of human MMP2 cDNA was synthesized by polymerase chain reaction (PCR) and was reversely inserted into the multiclone site (MCS) of the shuttle plasmid pAdTrack-CMV,with the resultant plasmid and the backbone plasmid pAdEasy-1,the homologous recombination took place in the E.coli BJ5183 and the recombinant adenoviral plasmid carrying the antisense MMP2 gene was constructed and generated. The adenoviruses(Ad-MMP2AS) were packaged and amplified in the HEK 293 cells.Then the viral titer was checked by GFP. Results The recombinant adenovirus vector carrying antisense MMP2 was constructed successfully, the b green fluorescence was observed in HEK 293 cells under a fluorescence microscopy. The viral titer was 1×108/ml. Conclusion The recombinant adenovirus Ad-MMP2AS constructed by us could introduce the antisense MMP2 into HepG2 effectively,which would provide experimental basis for reversing the overexpression of MMP2 in HCC and for inhibiting the invasiveness and migratory capacity of HepG2 in vitro and in vivo models.

    Release date:2016-08-28 04:44 Export PDF Favorites Scan
  • 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.

    Release date:2016-09-08 11:54 Export PDF Favorites Scan
  • 妇科化学治疗患者经外周静脉置入中心静脉导管并发症原因分析

    目的 探讨妇科行化学治疗(化疗)患者经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)并发症的影响因素。 方法 收集 2015 年 6 月—2016 年 6 月接受化疗并需要置入 PICC 的妇科肿瘤患者。观察患者并发症、拔管原因、导管头端位置、穿刺次数、置管部位、置管时间及拔管时间。 结果 920 例患者成功接受 PICC 置管,其中随访中死亡 25 例,失访 83 例。104 例患者因并发症而提前拔管,其 PICC 留置时间中位数为 62 d,并发症以静脉炎[41.35%(43/104)]和血栓形成[25.96%(27/104)] 最常见。左上肢置管[12.68%(53/418)]与右上肢置管[12.94%(51/394)]的并发症发生率比较差异无统计学意义(χ2=0.013,P>0.05),肘前窝静脉置管[12.95%(72/556)] 与上臂静脉置管[12.50%(32/256)] 的并发症发生率比较差异无统计学意义(χ2=0.032,P>0.05)。导管头端位于非上腔静脉者[28.57%(8/28)] 较位于上腔静脉者[12.24%(96/784)] 并发症发生率更高,多次(≥2次)穿刺者[30.19%(16/53)] 较 1 次穿刺成功者[11.59%(88/759)] 并发症发生率更高,差异均有统计学意义(χ2=5.074、15.338,P<0.05)。 结论 妇科化疗患者 PICC 置管后并发症较常见。但 PICC 仍是一种较安全、经济、能家庭护理的静脉通路。

    Release date:2017-09-22 03:44 Export PDF Favorites Scan
  • Construction of the Recombinant Adenovirus Carrying Antisense Multidrug ResistanceAssociated Protein and the Study of Its Application

    ObjectiveTo construct the recombinant adenovirus vector carrying antisense multidrug resistanceassociated protein (MRP) and transfect the human drugresistant hepatocellular carcinoma cell line(SMMC7721/ADM). MethodsThe fragment of MRP gene encoding 5′region was cloned reversely into the shuttle plasmid pAdTrackCMV, with the resultant plasmid and the backbone plasmid pAdEasy1,the homologous recombination took place in the bacteria and the recombinant adenoviral plasmid was generated. The adenoviruses were packaged and amplified in 293 cells. Then the cell line of SMMC7721/ADM was transfected with the resultant adenoviruses.ResultsThe recombinant adenovirus vector carrying antisense MRP was constructed successfully. The viral titer was 2.5×109 efu/ml, and more than 90% SMMC7721/ADM cells could be transfected when the multiplicity of infection(MOI) was 100. ConclusionThe recombinant adenovirus vector constructed by us could introduce the antisense MRP into the human drugresistant hepatocellular cell line effectively, which would provide experimental basis for the mechanisms and reversal methods of the multidrug resistance in human hepatocellular carcinoma.

    Release date:2016-08-28 04:48 Export PDF Favorites Scan
  • Zinc Finger Protein A20 Promotes Regeneration of Small-for-Sized Liver Allograft and Suppresses Rejection in Rats

    Objective  To examine the effect of zinc finger protein A20 on regeneration of small-for-sized liver allograft, graft rejection and recipient rat survival time. Methods Small-for-sized liver transplantation with 30% partial liver allograft was performed by using a b-rejection combination rat model of DA (RT1a) to Lewis (RT1l) rats. The rats were grouped into rAdEasy-A20 treatment group (A20 group), the control empty Ad vector rAdEasy treatment group (rAdEasy group) and PS control treatment group (PS group). Ex vivo gene transfer in donor liver graft was performed through portal vein infusion. Animals were assessed for survival days, expression of A20 in liver graft, liver graft regeneration, hepatocyte apoptosis, graft rejection, NF-κB activation and ICAM-1 mRNA expression in liver graft sinusoidal endothelial cells (LSECs), number of liver graft infiltrating mononuclear cells (LIMCs) and the subproportion of NK/NKT cells, and serum IFN-γ level. Results Survival day of A20 group rats was prominently longer than that of PS group rats and rAdEasy group rats (P=0.001 8), whereas survival day of rAdEasy group rats was remarkably shorter than that of PS group rats (P=0.001 8). Regeneration of the small-for-sized liver allograft was markedly augmented by A20, BrdU labelling index of hepatocyte on postoperative day 4 was significantly increased in the A20 group compared with the PS group and rAdEasy group (P<0.01). Hepatocyte apoptosis on postoperative day 4 was significantly inhibited by A20 (P<0.01). On postoperative day 4, histologic examination revealed a mild rejection in the A20 group but a more severe rejection in the PS and rAdEasy groups. NF-κB activity and ICAM-1 mRNA expression in LSECs on postoperative day 1 were notably suppressed by A20 overexpression. Flow cytometry analysis showed a marked downregulation of LIMCs number by A20, including more prominent decrease in the subproportion of NK/NKT cells on postoperative day 1 and 4, respectively (P<0.05). Serum IFN-γ level on postoperative day 4 was also significantly suppressed by A20 overexpression (P<0.05). Conclusion These data suggest that A20 could effectively promote small-for-sized liver allograft regeneration, suppresses rejection and prolong survival days of recipient rats. These effects of A20 could be related to an inhibition of LSECs activation, suppression of infiltration of LIMCs and the subpopulations such as NK cells and NKT cells into liver graft, and inhibition of hepatocyte apoptosis.

    Release date:2016-09-08 11:47 Export PDF Favorites Scan
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