医院图书馆与创建现代化医院

1 现代化医院的主要内容 2001年3月,作为加快江苏省卫生事业发展和现代化医院建设的一项重要部署和战略步骤,江苏省卫生厅明确提出,"十五"期间要把建设基本现代化医院作为医院工作的总体目标,并制定出具体的<江苏省基本现代化医院试行标准>.江苏省医院工作会议提出:"十五"期间,江苏省医院建设的"重头戏"是实现基本现代化,到2005年全省部分二、三级医院要达到基本现代化医院的标准,到2010年大部分二、三级医院要达到基本现代化.通过实施"医院现代化工程",力争出现一批综合水平较高,在全国有一定知名度的二、三级医院,满足人民群众日益增长的医疗保健需求.     

突出"以人为本"创建基本现代化医院

南京医科大学第一附属医院,在落实江苏省卫生厅提出的建设基本现代化医院工作中,以科学发展观指导创建基本现代化医院,突出"以人为本",努力探索人性化服务的新模式.对外以病人为中心,努力从人性化角度开展服务,围绕"服务、技术、环境"三满意开展工作不断提高病人的满意度;对内以员工为本,为其工作和发展创造良好条件,帮助其实现人生价值,以调动工作积极性.     

创建基本现代化医院的实践与探索

基本现代化医院的提出体现了时代的要求,是卫生事业与经济社会协调发展的必然要求,是为"两个率先"服务的必然选择,是促进医院发展的有力抓手.基本现代化医院的内涵体现了时代的先进性,现代化的核心是先进性,把先进性的要求规范化,把规范的内容标准化、指标化.基本现代化医院的创建促进了医院的全面的进步.     

以评促建努力提升医院管理水平

医院等级评审可以推动医疗机构加强内涵建设。经多方论证,江苏省建湖县第二人民医院于2010年启动创建二级中西医结合医院工作,遵循中西结合、中西医并重,围绕建设基本现代化中西结合医院的宏伟目标,主要从紧扣区域规划、抓好队伍建设、更新员工理念和提升医院发展内涵等4个方面着手做好创建工作,实现医院管理的持续改进。通过创建,医院员工的精神面貌、工作激情发生显著的变化,医院的医疗质量、患者的安全得到更好的保证,医院管理等方面收到的明显效果。     

创建医院文明提供优质服务

坚持把发展作为第一要务,坚持科学发展观,不断增强医院的综合实力,促进医院可持续发展,是创建医院文明的物质基础.本文以加强思想道德建设为主题,以为病人提供优质服务为目标,把创建"文明医院"与开展"优质服务年"活动结合起来,调动医务工作者爱岗敬业的工作热情,促进医院主动创建的积极性.     

加强职业道德建设推进医院基本现代化进程

2002年,省卫生厅将我院列为首批创建基本现代化医院试点单位。作为具有基本现代化水平的医院,优美的环境、精湛的技术、先进的设备固然重要,但同时也需要有良好的职业道德。为此,4年多来,我们一直积极探索医院职业道德建设的新路子,以此推进医院基本现代化进程。1充分认识职业道德建设的重要性1.1从贯彻“三个代表”重要思想的高度来认识职业道德建设。医院联系千家万户,涉及生老病死,与每个人的切身利益密切相关,因而也是社会主义精神文明建设的一个窗口。广大人民群众正是通过我们的行风、我们的工作,来看党风和社会风气的。可以说,医院的…     

新形势下加强公立医院党支部规范化建设的思考

加强公立医院党支部规范化建设,是新形势下落实全面从严治党向基层延伸、纵深发展的必然要求,对进一步增强党支部凝聚力、创造力和战斗力,推进公立医院各项工作健康发展,实现党建工作与医院发展同频共振、互动共赢具有重要意义。针对目前公立医院党支部规范化建设中存在的问题和达标创建工作实施步骤进行探讨,围绕"基本组织、基本队伍、基本活动、基本制度和基本保障"党支部规范化建设5要素提出建设举措,为公立医院加强党支部规范化建设工作提供借鉴与参考。     

加强职业道德建设推进医院基本现代化进程

2002年，省卫生厅将我院列为首批创建基本现代化医院试点单位。作为具有基本现代化水平的医院，优美的环境、精湛的技术、先进的设备固然重要，但同时也需要有良好的职业道德。为此，4年多来，我们一直积极探索医院职业道德建设的新路子，以此推进医院基本现代化进程。     

坚持改革与发展阔步迈向现代化

近年来医院坚持"以病人为中心、以社会满意为目标",坚持"把质量视为医院的生命、把医德和人才视为医院的本钱、把信誉视为医院的效益",在全省率先实施了人事与分配制度改革,真正建立起有责任、有竞争、有激励、有约束、有活力的运行机制,为病人提供了优质、高效、安全、价廉、方便的服务,深入地开展创建基本现代化医院工作,取得了很好的社会效益和经济效益.     

浅谈医院工会女职工工作的创新

医院工会女职工工作是医院党组织、职能部门联系女工群众的桥梁和纽带,在两个文明建设中有着非常重要的地位和作用.我院工会女职工工作在医院党委的正确领导下,组织不断健全,制度不断完善,开展了"创建女职工文明示范岗"、"巾帼文明示范岗"等一系列活动,积极参与医院的文化建设,为卫生事业的改革与发展做出了不可磨灭的贡献.     

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.