目的 探讨营销服务理论（8P）在体检信息系统建设中的应用与实践效果。 方法 借鉴8P理论与理念，以现代信息技术为手段,设计和构建以客户为中心的体检信息系统。 结果 体检信息系统的建立，优化了体检流程，提高了服务效率和报告质量，增加了客户满意度，取得良好的经济和社会效益，为健康体检工作的数字化、规范化管理奠定了良好的基础。 结论 加强体检中心的信息化系统建设，能全面提升中心的工作效率和服务质量,增强市场竞争力。
Abstract： Objective To evaluate the incidence and prognosis of postoperative acute kidney injury （AKI） in patients after cardiovascular surgery， and analyse the value of AKI criteria and classification using the Acute Kidney Injury Network （AKIN） definition to predict their in-hospital mortality. Methods A total of 1 056 adult patients undergoing cardiovascular surgery in Renji Hospital of School of Medicine， Shanghai Jiaotong University from Jan. 2004 to Jun. 2007 were included in this study. AKI criteria and classification under AKIN definition were used to evaluate the incidence and in-hospital mortality of AKI patients. Univariate and multivariate analyses were used to evaluate preoperative， intraoperative， and postoperative risk factors related to AKI. Results Among the 1 056 patients， 328 patients（31.06%） had AKI. In-hospital mortality of AKI patients was significantly higher than that of non-AKI patients （11.59% vs. 0.69%， P＜0.05）. Multivariate logistic regression analysis suggested that advanced age （OR=1.40 per decade）， preoperative hyperuricemia（OR=1.97）， preoperative left ventricular failure （OR=2.53）， combined CABG and valvular surgery （OR=2.79）， prolonged operation time （OR=1.43 per hour）， postoperative hypovolemia （OR=11.08） were independent risk factors of AKI after cardiovascular surgery. The area under the ROC curve of AKIN classification to predict in-hospital mortality was 0.865 （95% CI 0.801-0.929）. Conclusion Higher AKIN classification is related to higher in-hospital mortality after cardiovascular surgery. Advanced age， preoperative hyperuricemia， preoperative left ventricular failure， combined CABG and valvular surgery， prolonged operation time， postoperative hypovolemia are independent risk factors of AKI after cardiovascular surgery. AKIN classification can effectively predict in-hospital mortality in patients after cardiovascular surgery， which provides evidence to take effective preventive and interventive measures for high-risk patients as early as possible.
Simulations can mimic the environment that refers to the surgery operation to improve the technical skills of the trainees. In this paper, we designed a new cardiac surgery simulative training system. The isolated pig heart was selected as the heart model. A mechanical device was designed to achieve the beating of heart model. At the same time, adjusting frequencies of mechanical movement could change the rating of heartbeat. In order to validate the rationality of the system, 12 non-medical specialty students and 12 medical specialty students were divided into two groups, which consecutively accepted seven-days of training for off-pump coronary artery bypass grafting using the cardiac surgery simulative training system. The time for completing bypass grafting before and after training were recorded. And the bridging outcomes of each trainee were assessed by 3 surgery cardiac surgeons using the object structured assessments of technical skill (OSATS) criteria. After training, each trainee could finish the bypass suturing in a shorter time than before training, and the scores of each trainee assessed by OSATS criteria were also improved. The results showed that the cardiac surgery simulative training system had better training effect in improving the surgical techniques, operation skills and proficiency of surgical instruments of trainees.
ObjectiveTo explore the preparation method, physical and chemical properties, and biocompatibility of a conductive composite scaffold based on polypyrrole/silk fibroin (PPy/SF) fiber with " shell-core” structure, and to provide a preliminary research basis for the application in the field of tissue engineered neuroscience.Methods The conductive fibers with " shell-core” structure were prepared by three-dimensional printing combined with in-situ polymerization. PPy/SF fiber-based conductive composite scaffolds were formed by electrospinning. In addition, core-free PPy conductive fibers and SF electrospinning fibers were prepared. The stability, biomechanics, electrical conductivity, degradation performance, and biological activity of each material were tested to analyze the comprehensive properties of fiber-based conductive composite scaffolds.ResultsCompared with pure core-free PPy conductive fibers and SF electrospinning fibers, the PPy/SF fiber-based conductive composite scaffolds with " shell-core” structure could better maintain the stability performance, enhance the mechanical stretchability of the composite scaffolds, maintain long-term electrical activity, and improve the anti-degradation performance. At the same time, PPy/SF conductive composite scaffolds were suitable for NIH3T3 cells attachment, conducive to cell proliferation, and had good biological activity.ConclusionPPy/SF fiber-based conductive composite scaffolds meet the needs of conductivity, stability, and biological activity of artificial nerve grafts, and provide a new idea for the development of a new generation of high-performance and multi-functional composite materials.