医院文化重在内涵建设

医院文化是由医院主体和客体两部分组成,同时医院文化又分为医院硬文化和医院软文化两大方面.医院硬文化的主体是物,软文化主体是人.本文讨论的医院文化是指医院软文化.医院文化内涵建设主要包括医院的理念、价值观、品牌等方面的培育与构建,是医院文化建设的首要问题.     

引入CI系统制定医院文化建设战略

医院文化是医院员工普遍认同并自觉遵循的理念与行为方式的总和.医院文化建设是一个长期的过程,要想取得成功,必须制定一个科学的医院文化建设战略.一般来说,医院文化建设战略包括确定医院文化建设战略模式、划分医院文化建设阶段、制定医院文化建设的中期和短期计划、选择医院文化建设的具体策略等方面.     

新媒体时代利用微电影形式推动医院宣传工作的初探

医院文化是医院平稳、有序、良好运作和发展的源动力,医院文化建设是医院可持续发展的重要组成部分.宣传工作又是强化医院文化建设的重要手段,因此医院应该扩大宣传途径,做好医院宣传工作.微电影是如今网络技术的高速发展和人民对文化传播方式的提高的产物.并在互联网技术和多媒体技术的支持下,不断被广大群众所认识和接受.微电影运用在医院宣传和文化建设上,能够充分体现医院的文化理念、文化内涵,充分调动职工的参与度和积极性,使医院的文化发展呈现出新的活力.     

提升医院文化凝聚力探讨

医院文化是员工集体认同的价值观,是医院理念创新的基础,是医院精神的升华,是内部员工之间的“粘合剂”.医院文化建设必须以社会主义核心价值体系为指导,建立高尚优秀的医院文化、构建共性大文化、构建管理创新文化、构建自身的特色文化、构筑共同双赢文化、构建美好环境文化.     

构建医院服务文化打造医院服务品牌

医院文化是继企业文化之后,近几年在我国出现的一个新概念,开展医院文化建设是医院经营管理科学发展的必然.其对内起着导向、凝聚和规范作用,对外提升医院品牌.有学者说过:医院与医院之间,相似的是物质和技术,不同的是人才和文化.医院文化之间的竞争已成为医疗市场竞争的核心力.医院文化是医院在医疗活动和管理实践中产生的物质和精神财富的总和,他涵盖了医院在管理、服务、质量、制度建设等方面的内容.近几年来,我院以提高服务品质为宗旨,以强化医院服务文化为载体的管理着手,将无形的文化内涵、渗透到有形的服务工作中,打造了医疗服务品牌,在激烈的市场竞争中,赢得了市场.     

论医院文化建设的意义

医院文化是医院物质文化和精神文化的总和,包括物态文化、制度文化和文化心态三个层面.建设医院文化对于促进医院改革、发展和管理等具有重要的意义.在医院文化建设中,医院领导者要有文化头脑,善于从文化角度去观察和认识问题,运用文化手段去做好医院各项工作,这是搞好医院文化建设的关键.     

浅析医院文化建设中的几个关系问题

医院文化建设是医院建设发展的重要内容,认识和处理好医院文化建设中的几个关系问题,在医院文化建设的实践中具有重要的意义.医院的文化建设与制度建设既有区别又相互影响,二者既有区别,又是一体两面,制度是文化的载体,有形的制度中渗透着文化,无形的文化通过有形的制度载体得以表现,制度与文化永远是并存的,制度永远不可能代替文化的作用,文化也不能替代制度管理.理念是医院文化建设的灵魂,也是医院运营的指导思想,对提升医院核心竞争力有着决定性的意义,以构建和谐医院为目的 的医院文化建设应首先加强医院理念文化建设,着力培育几个理念:人本理念、诚信理念、忠诚理念和团队精神理念.医院品牌是医院文化的外在表现,建设医院品牌离不开医院文化.要建立起医院整体利益至高无上的信念,医院管理者应有"在对外服务上以患者和保健对象为中心,在对内管理上以职工为中心"的意识,用医院文化铸造人性化服务品牌,用医院文化铸造医疗质量品牌,用医院文化铸造医疗科技领先品牌,用医院文化铸造"以人为本"的管理文化品牌.     

浅谈医院文化建设

医院文化是整个社会文化系统一个重要的有机组成部分,是民族文化和现代意识相结合的产物,它既有社会文化的共性,又具有鲜明的医院特色.医院文化建设,其目的就是要着力打造先进的医院文化.建设先进的医院文化是新世纪、新阶段社会对卫生行业提出的新要求,是卫生行业精神文明建设的重要内容,是卫生行业贯彻"三个代表"重要思想、构建和谐社会的具体体现.因此,医院文化建设的好坏不仅影响医患之间的关系、医者之间的关系,还直接影响医院的社会效益和经济效益.那么,如何加强医院文化建设,笔者认为应从以下几个方面着手.     

医院文化建设与政治思想工作结合初探

医院文化是医院的灵魂,是医院生存的基础和精神支柱.医院文化与思想政治工作关系密切,思想政治工作对医院文化建设起指导作用,可促进医院文化健康发展,而医院文化则在一定意义上拓展了思想政治工作的内容、方法和渠道.     

新形势下医院党的建设与文化建设的关系研究综述

医院文化是社会主义文化的重要组成部分,医院文化强院应提上各级医院的发展战略和党的建设的议事日程.医院文化建设应成为医院党的建设和医院发展的战略,研究医院党建与文化建设的关系是医院战略发展的需要.目前医院党建与文化建设研究多为相对独立的研究,或偶有相关性讨论,但缺乏全面关联性的研究.医院党建与文化建设的关联性、同质性因素有待深入探讨,要以“文化建党”和“党建文化”理念深入探讨医院党建与文化建设的规律和良性互动,以促进医院全面持续科学发展.     

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.