目的 总结阻塞性睡眠呼吸暂停低通气综合征患者手术配合经验。 方法 对2006年1月－2011年11月259例阻塞性睡眠呼吸暂停低通气综合征患者实施改良腭咽成形术的临床资料及护理措施进行回顾性分析。 结果 259例患者顺利完成手术，未发生呼吸道梗阻及大出血。随访4~9年，治愈158例( 61.0%) ，显效73 例(28.2%)，有效28例( 10.8%)。 结论 针对性的围手术期护理有助于保留悬雍垂改良腭咽成形术的顺利进行，减少手术后并发症，提高治疗效果。
Objective To investigate the effects of the recombinanthuman bone morphogenetic protein 2 (rhBMP-2) and/or the osteogenic agents on proliferation and expression of the osteoblast phenotype differentiation of the SD rat mesenchymal stem cells（MSCs）. Methods The rat MSCs were cultured in vitro and were randomly divided into the experimental groups(Groups A-I) and the control group. In the experimental group, MSCs were induced by rhBMP2 in different doses (10, 50, 100 and 200 μg/L) in Groups BE, the osteogenic agent alone (Group A) and by the combined use of rhBMP-2 ［in different doses (10,50, 100 and 200 μg/L)］ and the osteogenic agent in Groups F-I. The MTT colorimetric assay was used to evaluate the proliferation, and the activities of alkaline phosphatase (ALP) and osteocalcin (OC) were observed at 3, 6, 9, 12 days, respectively. Results The inverted phase contrast microscopy showed that MSCs by primary culture for 12 hours were adhibited, with a fusiform shape at 48 hours. At 4 days they were polygonal or atractoid, and were spread gyrately or radiately at 6 days. At 10 days, they were spread at the bottom of the bottle.The statistical analysis showed that the expression of the osteoblast phenotype differentiation of MSCs could be induced in the experimental groups. The proliferation of MSCs could be enhanced in a dosedependent manner in GroupsB-E. The expression of the osteoblast phenotype differentiation, which was tested by the activities of ALP and OC, was significantly higher in Groups F-I than in Groups A-E. Conclusion The combined use of rhBMP-2 and the osteogenic agents can enhance the MSC proliferation and induce an expressionand maintenance of the osteoblast phenotype differentiation of the rat MSCs.
Objective To optimize the environment of outpatient clinics in large hospitals, facilitate the patients’ visits and improve the comprehensive management level. Methods From September to November 2015, 2 hospitals in each part of a provincial city (middle, east, west, north and south), a total of 10 hospitals were chosed by convenient sampling method. The forms, types and distribution of outpatient navigation service system were investigated and analyzed by using a self-designed questionnaire. Results There were a total of 14 forms of counseling-guide services in the 10 hospitals. Just 1 hospital provided all the 14 forms of counseling-guide services, and 2 hospitals provided 13 forms of counseling-guide services, which were relatively complete. While the other 7 large hospitals provided only 4 to 6 forms of counseling-guide services, which were relatively simple. Conclusion Qualified outpatient navigation service system can help patients to receive more effective treatment, optimize the environment, highlighting the modern hospital humanistic service and the concept of intelligent service and scientific management.
Objective To verify the reliability and validity of a self-developed satisfaction evaluation questionnaire for outpatient department employees in public hospitals, and to provide suitable tools for conducting such surveys. Methods Two anonymous surveys were conducted on all employees of the Outpatient Department of West China Hospital of Sichuan University in July 2019 and November 2021, respectively. Questionnaire items were screened using methods such as item distribution, coefficient of variation, and decision value, and the reliability and validity of the questionnaire were evaluated using Spearman-Brown coefficient and Cronbach’s α coefficient, exploratory factor analysis, and confirmatory factor analysis. Results The final questionnaire retained 14 items, which could be divided into two dimensions: work conditions and interpersonal environment, and the overall fit index of structural equation model model were as follows: χ2/ν=6.957, standardized root mean square residual was 0.061, root mean square error of approximation was 0.147, goodness-of-fit index was 0.796, adjusted goodness-of-fit index was 0.719, normed fit index was 0.849, relative fit index as 0.819, incremental fit index was 0.868, Tucker-Lewis Index was 0.841, comparative fit index was 0.867. The combined reliability of the two factors in the questionnaire was 0.94 and 0.91, respectively. The average variance extraction was 0.67 and 0.76, respectively, and the square root of the average variance extraction was 0.82 and 0.87, both of which were greater than the correlation coefficient of 0.71 between the two factors. The Spearman-Brown coefficient of the final questionnaire was 0.913, and the Cronbach’s α coefficients for the overall and two dimensions were 0.953, 0.937, and 0.910, respectively. Conclusion The reliability and validity of the satisfaction evaluation questionnaire for outpatient department employees in public hospitals are good and can be applied to practical surveys.
ObjectiveTo study the method of rapid and accurate measurement of body temperature in dense population during the coronavirus disease 2019 pandemic.MethodsFrom January 27th to February 8th, 2020, subjects were respectively measured with two kinds of non-contact infrared thermometers (blue thermometer and red one) to measure the temperature of forehead, neck, and inner side of forearm under the conditions of 4–6℃ (n=152), 7–10℃ (n=103), and 11–25℃ (n=209), while the temperature of axillary was measured with mercury thermometer under the same conditions. Taking the mercury thermometer temperature as the gold standard, the measurement results with non-contact infrared thermometers were compared.ResultsAt 7–10℃, there was no statistical difference among the forehead temperatures measured by the two non-contact infrared thermometers and the axillary temperature (P>0.05); there was no difference among the temperature measured by blue thermometer on forehead, neck, and inner side of forearm (P>0.05); no difference was found between the temperature measured by the red thermometer on forehead and inner side of forearm (P>0.05), while there was statistical difference between the temperatures measured by the red thermometer on forehead and neck (P<0.05). Under the environment of 11−25℃, there was no statistical difference among the forehead temperatures measured by the two infrared thermometers and the axillary temperature (P>0.05); the difference between the temperatures of forehead and inner side of forearm measured by the blue thermometer was statistically significant (P<0.05), while no difference appeared between the forehead and neck temperatures measured by the blue thermometer (P>0.05); there was no statistical difference among the temperatures of three body regions mentioned above measured by the red thermometer (P>0.05). According to the manual, the allowable fluctuation range of the blue thermometer was 0.3℃, and that of the red one was 0.2℃. The mean differences in measured values between different measured sites of the two products were within the allowable fluctuation range. Therefore, the differences had no clinical significance in the environment of 7–25℃. Under the environment of 4–6℃, the detection rate of blue thermometer was 2.2% and that of the red one was 19.1%.ConclusionsThere is no clinical difference between the temperature measured by mercury thermometer and the temperature measured by temperature guns at 7–10 or 11–25℃, so temperature guns can be widely used. In order to maintain the maximum distance between the measuring and the measured persons and reduce the infection risk, it is recommended to choose the inner forearm for temperature measurement. Under the environment of ambient temperature 4–6℃, the detection rate of non-contact electronic temperature gun is low, requiring taking thermal measures for the instrument.