口腔专科医院门诊患者满意度量表的探索与分析

目的 分析在口腔专科医院门诊就诊的患者满意度,探索患者满意度评价体系及满意度量表的建立方法.方法 选取2018年12月至2020年1月于大连市口腔医院门诊就诊的1200例患者作为研究对象,向其发放本院自制的患者满意度量表,通过定点匿名自填式问卷调查的方法了解就诊患者对门诊服务的满意度状况,然后使用相关分析法、临界比率值法,优化调整量表中的有关项目,分析在口腔专科医院门诊就诊的患者满意度.结果 共发放1200份调查问卷,其中有效问卷有1044份.相关分析表明,诊疗时间、医生态度、护士操作、候诊情况、诊疗说明、文明服务等监测指标与患者的总体满意度显著相关(P<0.05).根据得分结果将1044例患者为高分组(n=283)和低分组(n=761),两组患者16项监测指标中的满意度评分比较差异均有统计学意义(P<0.05).患者的总体满意度为81.32分;4个项目的项目满意度监测得分分别为诊疗环境81.12分,服务水平82.27分,便利程度56.47分,流程效率74.15分.结论 分析患者满意度状况后,对满意度量表进行科学、合理的调整,可提升该量表的效度及信度,同时还能从诊疗环境、服务水平、便利程度、流程效率等方面综合评估口腔专科医院门诊患者的满意度.     

广西柳州市柳北区社区卫生服务满意度调查

目的 调查柳州市柳北区社区卫生服务机构的满意度状况,为进一步提高社区卫生服务机构医疗服务质量提供依据.方法 用拦截法随机抽取12家社区卫生服务机构就诊后的病人或病儿家长371人进行问卷调查.结果 居民对卫生服务机构总体评价的满意度为72.77%,满意度较高的项目为服务态度、隐私尊重(均为80.32%)和解释交流(78.71%),满意度较低的项目有本次费用(70.08%)、价格合理(68.19%)和环境设备(63.16%).结论 应进一步加大投入,从多层面、多环节为患者考虑,改进工作,使社区卫生服务工作更完善.     

非口腔专业大学生口腔健康状况及习惯调查分析

目的:调查非口腔专业大学生口腔卫生状况和口腔卫生习惯,讨论防治办法,有目的的进行口腔健康卫生普及,为口腔健康保健工作提供信息支持.方法:采用检查及问卷调查形式,对283名大学生进行调查.结果:龋病患病率为35.7％,口腔溃疡患病率为4.95％,牙龈出血率为34.6％,牙石出现率为69.6％,牙本质敏感症患病率为13.4％,错颌畸形患病率为17.3％.结论:大学生口腔卫生情况不佳,口腔卫生习惯较差,口腔维护意识不强,需进行口腔卫生知识科普,随时观察大学生口腔卫生情况的变化.     

589例重庆市口腔门诊患者医疗服务满意度的调查研究

目的调查重庆市居民口腔门诊医疗服务满意度现状,为口腔医疗机构服务品质的评价与改善提供参考依据。方法对重庆市主城区各级口腔医疗机构,依据2009年各医院门诊挂号人次比例,经分层随机抽样,选取589例来自重庆市各级口腔医疗机构就诊的成年患者,参考狩野纪昭(Noriaki Kano,1984)的二维品质模式的问卷内容,采用李克特5级标度法,对其一般资料、口腔门诊医疗服务满意度进行问卷调查。结果被调查的589例患者中77.93%对口腔门诊医疗服务的总评价为满意,不满意的患者为1.70%;将教育程度和医疗费用支付方式与口腔门诊医疗服务总满意度做单向方差分析发现差异有统计学意义(P<0.05),其中小学或初中患者对口腔门诊医疗服务总满意度显著低于不识字、大专或大学及研究生患者,商业医疗保险者对口腔门诊医疗服务总满意度显著高于社会基本医疗保险和自费者。结论重庆市口腔门诊医疗服务满意度总体评价良好,仍有待进一步提高服务举措以满足其社会评价。     

北京市西城区社区卫生服务患者满意度影响因素研究

目的探讨影响北京市西城区居民对社区卫生服务满意度的因素。方法 2011年11月采取连续抽样的方法,对来社区卫生服务中心或站就诊的患者及偶遇社区居民进行现场问卷调查,调查内容包括一般人口学特征、医疗保障形式、就诊患者对社区卫生服务的满意度评价。结果患者对社区卫生服务的总体满意度为95.9%(940/980)。Logistic回归分析显示,就诊环境、医生业务水平、机构开诊时间、药品种类、地理位置设置、解释病情是影响患者满意度的因素(P<0.05)。结论西城区社区卫生服务居民对社区卫生服务的总体满意度较高,但仍需改进,有关部门管理者应从主要影响因素入手,采取积极有针对性的措施以促进当地社区卫生服务的可持续发展。     

全国社区卫生服务现状调查——社区卫生服务机构与医院就诊患者满意度比较

目的了解社区卫生服务机构与医院就诊患者的满意度。方法对社区卫生服务机构及医院就诊患者进行问卷调查。结果就诊者到医院就诊的主要目的是诊疗,而到社区卫生机构就诊的主要目的包括开药、体检及预防保健;在各项服务指标中,医院就诊者满意度最高和最低的分别是服务态度和服务价格;对社区卫生服务的评价在总体趋势上与医院相同,但具体项目的差别程度却明显不同,对社区卫生服务价格满意或很满意(60·00%)的比例几乎是医院服务的2倍(32·16%),而对服务项目的满意度却相差较小(68·39%和62·19%)。结论就诊者对社区卫生服务机构的总体满意度高于医院。应加强宣传,扩大社区卫生服务对社区居民的覆盖面;改革医疗服务价格体系,提高居民对社区卫生服务的经济可及性;努力建立医院服务与社区卫生服务优势互补的医疗卫生服务体系。     

云南省口腔医疗服务能力调查

［摘要］目的　了解云南省口腔医疗服务能力及状况，包括云南省口腔医疗机构的分布、口腔卫生人力资源分布状况、人均门诊费用、患者就诊率等情况．方法　采用问卷调查的方式，对云南省口腔医疗机构进行调查研究．结果　云南省2011年有口腔医疗机构1 045家，其中公立机构416家．昆明市口腔医疗机构305家，每千平方米口腔机构为14.2，口腔卫生人力指数为15，患者就诊率为14.19%，口腔疾病支出为139.9元/人，以上指标昆明市均居各州市首位．结论　云南省口腔医疗资源分布严重不均，口腔医疗服务能力参差不齐，需建立完善的口腔疾病诊疗质量控制体系，培养专科护士缓解口腔医疗资源紧张现状，大力推行四手操作，有效提高医疗服务质量．     

肿瘤专科医院门诊患者满意度调查分析

目的 通过对肿瘤专科医院门诊患者就诊满意度进行调查,了解患者对门诊就诊的评价情况,并分析服务缺陷和原因,以提高门诊服务质量和整体管理水平,提高患者就诊满意度.方法 2020年9月1-30日,四川省肿瘤医院于院内招集10名志愿者在门诊各区域开展门诊患者满意度调查工作,共调查400名门诊患者的满意度.结果 回收有效问卷391份,调查结果显示,患者对"就诊医生诊疗技术是否满意"评价得分最高(8.49分);对"就诊流程是否便利"评价得分最低(6.13分);调查过程中有253名患者提出意见和建议,共计407条.结论 根据门诊患者满意度结果,有针对性地加强各环节的管理,优化就诊流程,开展好岗位职能培训有利于提高肿瘤专科医院门诊总体服务质量和患者满意度.     

珠海市香洲区社区医疗服务满意度评价

目的评价群众对珠海市香洲区社区医疗服务的满意度.方法随机抽取香洲区4家社区卫生服务机构,对在这4家机构就诊的患者进行问卷调查,包括患者的一般情况和对社区卫生服务的满意程度.结果患者对社区医疗服务的总体满意度较高,对医生的态度最满意,但是对医疗设备和价格满意度比较低.结论香洲区的社区卫生服务机构应当适当增加设备,设法降低药品价格;另外政府应建立合理的补偿机制.     

社区卫生服务总体满意度影响因素分析

利用自行设计封闭式调查问卷,对4102名社区居民调查社区卫生服务服务项目的知晓和利用情况以及对就诊环境、服务态度、沟通内容、诊疗技术的满意度和总体满意度。使用多元逐步线性回归（R2=0．542,F=471．6140,P=0．000）分析总体满意度的影响因素,探讨改进工作的优先项目。提升总体满意度因素：①沟通内容、诊疗技术、服务态度和就诊环境满意度每提高10％,总体满意度分别增加2．44％、2．50％、2．47％和0．98％;②曾接受家庭病床、康复服务和慢病管理服务者分别增加2．33％、1．60％和0．85％;③知晓计划生育生殖健康服务者提高0．94％。降低总体满意度因素：①子女进行过预防接种者降低1．68％;②曾建立了健康档案者下降1．13％。提示要提高社区卫生服务满意度,应优先提高诊疗技术、沟通水平和服务态度,发展特色服务。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.