Objective To draw up a satisfaction rating scale utilized by outpatients in general hospitals,for the quality evaluation of the out-patient service.Methods Outpatients at four municipal general hospitals in Hangzhou City were as the subjects.The validity and reliability of the rating scale were estimated.Results The response rate to items was 98.82% ,and valid rate reached 96.8% ,the internal consistency coefficient was in the range of 0.76 to 0.87.The composition of the scale conforms well to the management practice,the relativity inside the factor was stronger than the relativity among the factors,which supported the contents validity.Factor analysis results demonstrated that both the factor loads and structures were consistent with the structures of the rating scale,which supported the structure validity.Conclusion All of validity indexes of the rating scale meet the requirements of psychometrics.This scale is practicable to estimate the satisfaction of outpatients to the service they received,and provides valuable evidence to estimate the quality of hospital therapeutic services.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

OBJECTIVE: To evaluate three therapeutic schemes for sudden deafness with cost-effectiveness analysis for guiding rational use of drugs. METHODS:Using pharmacoeconomic cost-effectiveness analysis to evaluate 61 patients with 62ears of sudden deafness treated by Salvia Miltiorrhiza(groups A), Salvia Miltiorrhiza and cerebroprotein hydrolysate(groups B) or cerebroprotein hydrolysate(groups C) . RESULTS: The effective rates of three groups were 73.9%, 75.0% and 80.0% respectively without significant difference among them(P ＞ 0.05) . The average drug costs for one patient in three groups were 617.89 yuan, 2 651.29 yuan and 2 647.99 yuan respectively. The costs for 1% increase of effective rate in three groups were 8.36 yuan, 35.35 yuan and 33.10 yuan respectively. CONCLUSION: Salvia Miltiorrhiza scheme is the most rational one for sudden deafness.

ObjectiveTo get to know the status of health statistics postgraduate teaching and requirements during the study, and provide a basis to improve medical statistics teaching. MethodsPostgraduate students of 2008 grade of Dalian Medical University were selected randomly and filled in the self-designed questionnaire. Results52.6％ of the students considered that medical statistics was more important than other courses. 72.6％ of the students thought that medical statistics was difficult. Up to 30％of the students couldn't master and apply superior statistical analysis technique. ConclusionThe results of the survey offered basis and direction for enhancing the teaching quality and improving teaching methods.

Hemophilia is a common pediatric hereditary bleeding disorder,including hemophilia A (FⅧ deficiency) and hemophilia B (FⅨ deficiency).Children with hemophilia tend to spontaneous bleeding or bleeding after minor injuries or surgery.In this review,we briefly discussed the preoperative diagnosis and classification of hemophilia,dynamic monitoring of FⅧ or FⅨ,dose of clotting factor and duration of treatment and some other perioperative issues when surgery is needed,to guide hemophilia children's surgery and postoperative rehabilitation.

Objective To investigate the effects of preconditioning with emulsified isoflurane(eISO)on inflammatory response to myocardial ischemia-reperfusion(I/R)injury in rats.Methods Forty SD rats of both sexes weighing 250-280 g were randomly allocated into 4 groups(n =10 each):groupⅠ sham operation(S);group Ⅱ myocardial I/R + normal saline(NS); group Ⅲ I/R + eISO and group Ⅳ I/R + 30％ intralipid(Ⅱ.)(vehicle for eISO).Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 180 min reperfusion.NS,30％ intralipid and elSO 2 ml/kg were infused iv over 30 min at 30 min before myocardial ischemia in groups Ⅱ,Ⅲ and Ⅳ respectively.The animals were killed at the end of 180 min repeffusion.Their hearts were removed for determination of infarct size and myocardial NF-κB p65 and ICAM-1 expression(by immuno-histochemistry)and plasma concentration of TNF-t(by radioimmunoassay).Results Myocardial I/R induced myocardial infarct and significantly increased plasina TNF-a concentration and myocardial ICAM-1 and NF-κB p65 expression in gro up Ⅱ,Ⅲ and Ⅳ as compared with'sham operation group (Ⅰ).Plasma TNF-a concentration and myocardial ICAM-1 and NF-kB p65 expression were significantly lower in group Ⅲ(eISO)than in group Ⅱ and Ⅳ.Conclusion Down-regulation of myocardial NF-kB and ICAM-1 expression and inhihition of inflammatoy response are involved in the mechanism by which preconditioning with iv elso protects against myocardial I/R injury.

ObjectiveTo explore the efficacy of large trauma craniotomy with bilateral frontal coronal incision in treating contusion and laceration of bilateral frontal lobes.MethodsThe clinical data of 68 patients with contusion and laceration of bilateral frontal lobes who were treated with bilateral decompressive craniectomy were analyzed retrospectively.There were 36 cases(observation group) treated with large trauma craniotomy with bilateral frontal coronal incision and 32 cases (control group) given bilateral decompressive craniectomy by stages.The prognosis of two groups were observed and compared.The prognosis was evaluated at 6 months after surgery by Glasgow outcome scale (GOS) score.ResultsThere were 23 cases (63.89％,23/36) who got good recovery,8 cases(22.22％,8/36) with poor prognosis and 5 dead cases (13.89％,5/36) in observation group.There were 11 cases (34.38％,11/32) who got good recovery,9 cases (28.12％,9/32) with poor prognosis and 12 dead cases (37.50％,12/32) in control group.The rate of good recovery and mortality between two groups had significant differences (P ＜ 0.05).ConclusionsThe large trauma craniotomy with bilateral frontal coronal incision can significantly relieve or ease intracranial hypertension of patients with contusion and laceration of bilateral frontal lobes.And it can improve the prognosis and decrease the mortality.

Objective:To observe effects of Cuttle-Bone on blood inorganic phosphorus and parathyroid hormone(PTH)in patients of uremia in hemodialysis.Methods:74 cases of uremia in hemodialysis were randomly divided into a control group,a cuttlefish bone treatment group and a calcium carbonate treatment group.The control group did not take any conjugation agent of phosphorus. The cuttlefish bone treatment group were treated with oral administration of cuttlefish bone powder 3.0g in each meal and the calcium carbonate treatment group with chewing calcium carbonate tablets 1.5g in each meal.They all were treated for 3 months. Results:After treatment,blood inorganic phosphorus and PTH decreased(P0.05),with less effect on blood calcium(P

Objective To investigate the relationship between the development of pancreatic cancer and inflammation, and the therapy strategy.Methods Related articles were reviewed.Results The pathogenesis of inflammation in pancreatic cancer development involves cytokines, NF ?B, COX 2, PPAR ?, DNA damage, gene changes,etc. Based on these mechanisms some medications are under developing.Conclusion Accumulative effects of pancreatic inflammation may lead to DNA changes, and even pancreatic cancer development. Medications aimed at suppressing pancreatic inflammation may help with prevention and treatment of pancreatic cancer.

Objective:To investigate the protective effect of resveratrol on lipopolysaccharide (LPS)-induced cell injury in human periodontal ligament cells(hPDLCs).Methods:hPDLCs were cultured and identified.The cultured hPDLCs were divided into 5 groups:control group and LPS(10 μg/ml) + RES(0/30,60 and 90 μmol/L respectively) groups.The cell proliferation was detected by MTI assay.The secretion of TNF-α and IL-6 of hPDLCs was detected by ELISA kit.The expression of TLR4/NF-κB mRNA and protein was determined by PCR and Western blot analyses,respectively.Results:The cultured cells were negative for cytokeratin and positive for vimentin staining.Compared with the control group,cell proliferation was decreased,the secretion of TNF-α/IL-6 levels and the expression of TLR4/NF-κB mRNA and protein were increased after treatment with LPS.Whereas,with 30-90 μmol/L resveratrol pretreatment,the proliferation ability of hPDLCs was enhanced(P ＜ 0.05),the secretion levels of TNF-α and IL-6 and the expression of TLR4/NF-κB mRNA and protein were reduced (P ＜ 0.01) in a dose-dependent manner.Conclusion:Resveratrol may attenuate LPSinduced cell injury by inhibiting TLR4/NF-κB pathway in hPDLCs.