基于熵权TOPSIS法的区域医院科技影响力评价研究

目的:开展区域医院科技影响力评价研究,助力我国区域医院科技创新体系建设。方法:以中国医院科技影响力评价体系为基础,通过专家咨询和访谈,形成更符合区域特色的区域科技影响力评价体系。采用熵权法并依赖数据本身的离散性得到指标权重,采集并处理深圳市50家医院科技影响力的评价指标数据,利用TOPSIS法计算得出其综合科技影响力。结果:确定了区域医院科技影响力评价指标体系,包括科技产出、学术影响和科技条件3个维度,共21个三级指标。不同医院的科技影响力明显不同,参评医院的国家级重点科研项目数量较少,国家级科研平台数量较少。结论:建议深圳市加强政府统一筹划,增加医院科技投入;促进高水平综合医院的全面发展,突出专科医院的特色;加强科研平台建设,为医院的科技发展奠定基础;建设富有创新意识和创新能力的科技队伍,优化利用区域医院科技资源,培育及提高区域科技竞争优势。     

我国三级医院科技影响力评价的实证研究

为评价已建立的我国三级医院科技影响力评价指标体系的实际应用,选取全国1130家三级医院,根据指标体系收集数据,经综合评价方法计算医院科技影响力水平,采用Kruskal-Wallis秩和检验分析其影响因素。结果表明不同等级、不同类型及不同地区的医院科技影响力均存在统计学差异(P<0.05)。该研究可为国家和各省份科研管理者制定和调整医院科研政策以及科研导向提供一定和依据。     

基于RBF神经网络的医院科技影响力评价模型构建

在文献调研的基础上基于德尔菲法建立医院科技影响力评价指标体系,根据专家经验和知识对60家医院的科技影响力进行排名。采用径向基函数神经网络方法,将50个医院作为训练样本,10个医院作为测试样本,构建出一套基于径向基函数的医院科技影响力的评价模型,实验结果表明该评价模型较好地拟合了专家的思维,可以使医院科技影响力评价真实有效。     

补充计量学及其在生物医学领域的应用

目的：建立完整、科学、可行的四川省医院科研信息采集、评价指标体系,对医院科技能力进行评价。方法：采用文献法、专家会议法、德尔菲法、问卷调查法及相关统计学方法建立信息评价体系,运用分层随机抽样的方法对四川省54家医院信息评价系统的信度与效度进行分析。结果：医院科技信息的采集评价指标,具有良好的信度与效度。结论：四川省医院科技信息采集、评价体系有很强的实用性、科学性和可操作性,弥补了国家和四川省目前使用的卫生统计报表中缺乏对医疗机构科研能力的统计指标和相应数据的采集空缺。     

医学院校图书馆向地方医院开展智库服务的评价指标设计

阐述设计评价指标的原则,采用参考文献法和专家咨询法,基于灰色理论设计医学院校图书馆向地方医院开展智库服务的评价指标,包括4个1级指标和20个2级指标,构建出一个相对科学的评价指标体系。     

公立医院绩效评价指标体系的研究

目的:构建科学、实用并且适合公立医院的绩效评价指标体系,为医院自我评价提供参考依据,也为卫生行政部门评价、检查医院提供参考指标.方法:采用文献法和专家咨询法(Delphi法)确定绩效评价指标体系并确定各级指标的权重.结果:确定公立医院绩效评价指标体系.指标体系分为3级,一级指标4个(效果、效率、效益、效用)、二级指标9个(医疗质量、创新能力、医疗效率、人员构架、收入情况、患者费用、医疗收益、服务质量、发展潜力)、三级指标33个(基础护理合格率、人均发表论文数、平均住院日等).结论:该评价指标体系较为合理全面,计算方法简单易行,既可以横向比较医院同期的各绩效水平,也可以纵向比较某医院不同时期的差别,因此具有很强的可操作性.     

公立医院编制外用工劳动关系评价指标体系的构建研究

目的:探讨建立准确、客观、可操作性较强的符合公立医院编制外用工的劳动关系评价指标体系,旨在为医院管理部门提供一套完整而科学有效的医院劳动关系评价体系。方法:通过Delphi法确定公立医院编制外用工劳动关系评价指标体系,并用层次分析法为指标体系赋权重。结果:确定了公立医院编制外用工劳动关系评价指标体系。指标体系分为两级,其中一级指标7个、二级指标指标33个。结论:建立的公立医院编制外用工劳动关系评价指标体系对了解公立医院劳动关系现状,促进医院健康可持续发展具有推动作用。     

我国医院网站质量评价现状及方法

通过相关文献调研和总结我国医院网站评价研究现状,系统梳理相关方法学研究成果,在分析医院网站受众及服务特点的基础上初步建立我国医院网站综合评价模型,包括3个1级指标、13个2级指标和52个3级指标.     

我国医院智能化评价指标体系构建研究

目的/意义 构建符合我国国情的医院智能化评价指标体系,为医院智能化程度量化评价提供参考,助力医院智能化建设有序发展。方法/过程 基于对现有医院信息化建设评价标准体系的梳理,运用德尔菲法和层次分析法,通过评价指标体系构建、函询专家选择、指标重要性评价与函询结果检验、评价指标权重确定4个环节,探讨医院智能化评价指标体系构建过程。结果/结论 构建包含3个一级指标、8个二级指标和33个三级指标的医院智能化评价指标体系,与现有智慧医院评价体系互补,可反映当前智能化医院建设基础与发展目标,对未来智慧医院建设具有一定适用性及引领性。     

基于科技信息大数据的科技人才科研综合能力评价及应用研究

在对科技人才科研综合能力分析的基础上,构建科技人才科研综合能力评价模型,设计基于科技信息大数据的评价指标体系,包括基本素养、科研产出影响力、科研管理能力、学术潜力和学术地位5个维度,研究其在人才引进工作中的应用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.