Objective To understand the satisfaction degree of partial function outsourcing in a certain hospital of Xiaogan.Methods Through a questionnaire survey , SPSS20.0 was used to do statistical analysis .Results The satisfaction survey of outsourcing staff , the overall satisfaction rate was 9..7%, 96.5%after outsourcing .Investigation on medical quali-ty and patient satisfaction before and after the outsourcing and the outsourcing were 76.7%, after the outsourcing of 90.2%. Outsourcing personnel own happiness survey , assist doctors to job satisfaction was 91.0%, and on pay satisfaction was 82.5%, and turnover rate was 37.1%; Auxiliary nurses on the job satisfaction was 94.2%, and on pay satisfaction was 91.5%, and turnover rate was 29.4%.Conclusion Description of the survey , public hospitals under the limited re-sources, only to keep and develop the most competitive advantage of core resources , will be part of the non core outsourcing , which is adapt to the new management mode of market economy .It is the hospital to reduce costs , improve performance , to enhance the core competitiveness and enhance their adaptability to the environment , and all has the important practical signif-icance.

Objective To explore the relationship of T2DM with xerophthalmia after cataract surgery.Methods Retrospective analysis was made on the clinical data of 137 cataract patients (176 eyes) from April,2016 to October,2016.The DM patients were chosen as the DM group (58 cases,71 eyes),and single cataract ones were chosen as the control group (79 cases,105 eyes).The clinical data and xerophthalmia index were compared between two groups.Results The age and sex constituent ratio of DM group and control group had no significant difference (all P ＞ 0.05).The postoperative MQ score,BUT,FL,SⅠt of DM group at 1 week,1 month and 3 months were significantly worse than those at preoperative 2 days (all P ＜ 0.01),but the indexes relieved with time prolong.The postoperative MQ score,FL,SⅠt of control group at 1 week,1 month were significantly worse than those at preoperative 2 days (P ＜ 0.01),the postoperative BUT and preoperative BUT had no significant difference (P ＞ 0.05),all of the postoperative index and preoperative index had no significant difference(all P ＞ 0.05).The postoperative MQ score,BUT,FL,SⅠt of DM group at 1 week,1 month and 3 months were significantly worse than those of the control group (all P ＜ 0.01).Conclusion The xerophthalmia after cataract surgery of T2DM patients are more seriously than normal cataract patients.

OBJECTIVETo explore the effect of early goal-directed therapy (EGDT) combined with Yiqi Fumai Lyophilized Powder (YFLP) on central venous-arterial carbon dioxide difference [P(cv-a)CO2] and central venous oxygen saturation (S(cv)O2) in patients with septic shock.

METHODSTotally 50 patients with septic shock were assigned to the control group and the treatment group according to random digit table, 25 cases in each group. Patients in the control group received treatment according to EGDT principle. Those in the treatment group were intravenously injected with YFLP (5.2 g adding in 500 mL normal saline) additionally. Changes of P(cv-a)CO2, S(cv)O2, lactic acid, central venous pressure (CVP), mean arterial pressure (MAP), and APACHE II score were observed in the two groups before and after treatment. The 6-h success rate and 28-day mortality were also observed.

RESULTSCompared with before treatment in the same group, lactic acid and APACHE II score decreased, levels of S(cv)O2, MAP, CVP increased in the two groups after treatment (P < 0.01). P(cv-a)CO2 decreased more obviously after treatment in the treatment group, and lower than that in the control group after treatment (P < 0. 05, P < 0. 01). The 6-h success rate was 48% (12/25) in the control group and 76% (19/25) in the treatment group (P < 0.05). The 28-day mortality was 36% (9/25) in the control group and 12% (3/25) in the treatment group (P < 0.05).

CONCLUSIONEGDT combined with YFLP could significantly elevate S(cv)O2, decrease P(cv-a)CO2 and mortality in patients with septic shock, and obviously improve the clinical effect.

APACHE ; Blood Pressure ; Carbon Dioxide ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lactic Acid ; blood ; Shock, Septic ; therapy

Objective To explore the affect of citalopram on Hamilton Depression Scale (HAMD) ,self rating Depression Scale (SDS) score ,high sensitive C reactive protein (hs‐CRP) ,heart rate variability (HRV) ,andrenin angiotensin systerm(RAS) levels of patients with coronary heart disease complicated with anxiety‐depression .Methods 160 cases of patients with coronary heart disease and anxiety depression in January 2012 to August 2014 were selected ,they were randomly divided into observation group and control group according to the list of number table methods ,the control group of 80 patients used routine treatment methods ,while 80 patients in observation group were added with citalopram on the basis of conventional therapy ,after 6 weeks of treatment ,the clinical efficacy and changes of the HAMD ,SDS score ,score ,and hs‐CRP ,heart rate variability ,and renin angiotensin levels of two groups were compared .Results (1)The total clinical effective rate of the observation group was 93 .75% ,significantly higher than 70 .0% of the control group ,the difference was statistically significant (χ2 =10 .21 ,P<0 .05);(2)HAMD score ,SDS score ,hs‐CRP of the observation group was significantly lower than that of the control group ,the difference was statistically signifi‐cant(t=12 .98 ,9 .43 ,11 .86 ,P<0 .05);(3)HRV of the study group was significantly higher than that in the control group ,there was a statistically significant difference (P<0 .05);(4)Angiotensin II of the observer group were (93 ± 26)ng/L ,Angiotensin Ⅱ of the control group were (37 ± 14)ng/L ,the difference was statistically significant (P<0 .05) .Conclusion Citalopram has a signifi‐cant efficacy in treatment of patients with coronary heart disease combined with anxiety‐depression ,which is safe and reliable that is worth clinical popularizing and applying .

Objective:To explore causes of complicated acute lung injury (ALI) after percutaneous coronary interven-tion (PCI) .Methods:According to blood gas analysis and chest imaging examination ,a total of 175 patients under-going PCI were divided into ALI group (n=62) and non-ALI group (n=113) .High performance liquid chromatog-raphy was used to measure plasma concentrations of epinephrine (E) and norepinephrine (NE) during perioperative period .Plasma levels of interleukin-6 (IL-6) and procalcitonin (PCT) and chest CT imaging changes were meas-ured .Fluorescent immunoassay was used to measure plasma level of brain natriuretic peptide (BNP) to assess impact of cardiac function on ALI .Results:Compared with non-ALI group on 1d after PCI ,there were significant rise in plasma levels of NE [ (2.51 ± 0.31) nmol/L vs .(6.91 ± 0.39) nmol/L] and E [ (1.23 ± 0.11) nmol/L vs .(6.03 ± 0.37) nmol/L] ,P<0.01 all;and significant rise in plasma levels of IL-6 [ (119.81 ± 17.23) pg/ml vs .(252.28 ± 34.23) pg/ml] ,PCT [ (0.88 ± 0.01) pg/ml vs .(4.99 ± 0.87) pg/ml] and BNP [ (927.82 ± 89.72) pg/ml vs . (3936.55 ± 131.78) pg/ml] in ALI group (P<0.01 all) .Chest CT indicated that lung tissue inflammation was seri-ous .Conclusion:In patients undergoing percutaneous coronary intervention ,complicated acute lung injury is related to hyperactive sympathetic activity ,postoperative inflammation and heart function status etc .

Aim The present study is designed to elucidate the protective effect of Polysaccharide from Spirulina Platensis(PSP) on dopaminergic neurons of MPTP-induced Parkinsons disease model in C57BL mice.Methods C57BL mice were divided into 5 groups:control group,MPTP group,PSP 200 mg?kg-1 plus MPTP group,PSP 400 mg?kg-1 plus MPTP group,and PSP 800 mg?kg-1 plus MPTP group.Immunohistochemistry assay,RT-PCR,and HPLC-ECD were used to detect the immunoreactivity of tyrosine hydroxylase(TH) and dopamine transporters(DAT),the expression of TH mRNA and DAT mRNA in substantia nigra(SN),the content of dopamine(DA) and its metabolites,i.e.3,4-dihydroxyphenyl acetic acid(DOPAC) and homovanilic acid(HVA) in striatum(Str).Results The result showed that,compared with control group,the TH and DAT immunoreactive stain in MPTP group was significantly decreased(P

[Objective] To observe the effect of spleen-stomach regulating herbal medicine in improving the nutritional status in dystrophic patients receiving maintenance hemodialysis. [ Methods ] Sixty-one dystrophic cases receiving maintenance hemodialysis were randomized into two groups. Group A ( n = 31) and group B ( n = 30) received the same symptomatic treatment and the same maintenance hemodialysis, and group A received spleen-stomach regulating herbal medicine additionally. For those in group A with spleen-stomach deficiency, Liujunzi Decoction was applied; for those with stagnation of phlegm, modified Huanglian Wendan Decoction was used. After treatment, the main symptoms and signs of dystrophy, triceps skin fold (TSF), and middle-arm muscle circumference (MAMC) were observed, as well as serum levels of total protein (TP), albumins (Alb) and transferrin (TRF), hemoglobin (HB), protein catabolic rate (nPCR) and SGA scoring for comprehensively nutritional evaluation. [Results] Compared with group B, symptoms and signs were much improved ( P

Objective To study the distributive characteristics of DC and the expressions of E-cadherin and ICAM-1 in muscosal immune mouse model,to discuss the regulative role for E-cadherin and ICAM-1 in the DC migration. Methods By the method of immunohistochemistry staining and light microscopy,we observed the distributive characteristics of DC in muscosal immune mouse model,analysed the expressions of E-cadherin and ICAM-1. Results The DC mainly distributed in mesenteric lymph node(MLN),Peyer's patch(PP),and GUT(stomach,jejunum and ileum) of muscosal immune mouse model.The number of DC was larger in the experiment group than that in control group.The expression of ICAM-1 was higher,but lower of E-cadherin in muscosal immune mouse model.The number and area density of experiment group were greater compared with that of control group.Conclusion The E-cadherin and ICAM-1 may play a critical role in DC migration.

Objective:To investigate the recent and forward effects of different operation patterns on recurrent calculus of intrahepatic duct.Methods:A analysis was made on previous history and operation patterns,distribution,effect and follow-up visit in 76 reoperation patients with recrudescent hepatolith between Jan,2000 and Feb,2008 in Affiliated Provincial Hospital of Anhui Medical University,retrospectively.The situation after operation was confirmed as the short-term curative effects and the follow-up results as long-term curative effects.Results:The average hospital stay was 10.4 days and the incidence rate of postoperative complications was 14.5%.The follow-up which lasted from 8 months to 8 years showed that the average recurernce rate was 38.2%.Besides,the rate of joint-type operation was lower than single-type operation (P