The influences of medicine by the rapid development of economy are at least reflected on the following three as-pects: dramatically increasing awareness of health and medical demand of the majority and the serious “five long one short” phenome-non in outpatient clinic.This paper is based on the medical data of Nanfang Hospital.We analyzed the problems in the five links of appointed registration, visiting the doctors, taking examination and treatment, charging medical fees and medicine -claiming, putting forward four suggestions including updating concept for outpatients , emphasizing the application of information equipment and popular-ization of mobile device, such as WeChat guidance, in order to enhance the hospital networking mechanism , realize the synchronous transfer of information, introduce high-technology, and finally perfect the e-record of patients.

Objective To analyze the status quo and influencing factors of patient safety culture among medical staffs in the hospitals of Shenzhen City to provided reference for its improvement and conduct the patient safety culture research by other medical institutions.Methods The Patient Safety Culture Questionnaire of Medical Institutions(PSCHO) was adopted to investigate on 1000 medical persons from February to May 2016.Results The total score of patient safety culture in medical staffs was (3.53±0.40) and,the difference among different categories of medical persons had no statistical significance (P＞ 0.05).The differences among the medical staffs with different working ages,communication frequency with patients,training times,concern frequency had statistical difference(P＜0.05).Conclusion The patient safety culture level in Shenzhen City is higher.However,the sense of blame and shame is one of the important factors impeding the promotion of the patient safety culture in hospitnl.Hospital should conduct the targeted improvement to the related factors affecting the patient safety culture from the aspects of organism,department and individual level.

Objective Big endothelin-1(big ET-1) is associated with the prognosis of various cardiovascular diseases. This study is to explore the predictive value of plasma big ET-1 level for long-term outcome after mitral valvuloplasty in patients with moderate to severe chronic ischemic mitral insufficiency .Methods A total of 142 consecutive patients with moderate to severe chronic ischemic mitral regurgitation who underwent coronary artery bypass grafting and mitral valvuloplasty were enrolled at our center from January 2009 to December 2015.The clinical baseline data were collected and recorded.All patients were followed up.The mortalities and major adverse cardiovascular and cerebrovascular events during the follow-up period were re-corded.Results A total of 142 patients were enrolled, with mean age of(59.4 ±8.3) years.During(51.9 ±22.6) months follow-up, 19 cases(13.4％) died and 35 cases(24.6％) had major adverse cardiovascular and cerebrovascular events.Uni-variate and multivariate Cox regression analysis showed that big ET-1 was an independent risk factor for all-cause mortality (HR=3.970, 95％CI:1.535-10.268) and major adverse cardiovascular and cerebrovascular events(HR=2.754, 95％CI:1.238-6.129).In addition, left ventricular ejection fraction, pulmonary hypertension and stroke history were independent risk factors for all-cause mortality , while left ventricular ejection fraction , stroke history were independent risk factors for major adverse cardiovascular and cerebrovascular events.Conclusion Long-term outcomes of simultaneous coronary artery bypass grafting and mitral valvuloplasty for moderate to severe ischemic mitral insufficiency are satisfactory and big ET-1 is an inde-pendent risk factor for long-term outcomes of these patients.