The authors probed into the application and feasibility of DRGs in improving the efficiency and quality of hospital medical services,in order to establish a lean management mode based on DRGs.DRGs are seen as different from other means of management,with such evaluation of medical services being more comparable and operable,and the evaluation results more trustworthy.Application of such practice can obviously improve the efficiency and quality of medical services,making it widely applicable to hospital′s lean management.

Objective To investigate the clinical features of acute pancreatitis during pregnancy,including etiology,clinical manifestation,treatment and prognosis,in order to provided the clinical experience to prevent and treat the acute pancreatitis.Methods Retrospective analyse the clinical information of 11 patients with acute pancreatitis during pregnancy in the People's Hospital Affiliated to Peking University from January 1990 to December 2012.Results The age rage of patients was 25-34 years old.Of them,mild acute pancreatitis(MAP) was 5 cases (45.5％),while severe acute pancreatitis (SAP) were 6 cases (54.5％).Pathogenic data showed that 2 cases (18.2％) were biliary pancreatitis,7 cases (63.6％) were with hyperlipidemia,1 case(9.1％) was gallstone pancreatitis with hyperlipidemia,and 1 case (9.1％) did not find a clear cause.Five cases occurred during second trimester(45.5％),and 6 cases occurred during third trimester (54.5％) as well as no maternal death was seen.Four cases of fetal delivery were at term (36.4％),5 cases of premature delivery(45.4％),2 cases of death (18.2％),and all born infants were alive.Conclusion Acute pancreatitis during pregnancy mainly relates to biliary diseases and hyperlipidemia,and mostly occurred during third trimester.Acute pancreatitis during pregnancy can lead to premature birth,still birth.Early diagnosis and therapy are important for acute pancreatitis during pregnancy.

Objective To search for a scientific and feasible system for performance appraisal of hospital management staff, and enhance the level of hospital management. Methods The 360-degree evaluation and improved performance report evaluation are called into play to examine such staff. Examiners include the superiors, peers (heads of clinical and technical departments and those of administrative departments), inferiors and others (representatives of the faculty congress and staff congress). Results Outcomes of the two evaluation methods found 8 of the top ten as overlapping, and 8 of the bottom ten as overlapping as well. 80% overlapping between the two prove the results as highly similar, and a relativity analysis found the general results of the two methods as highly consistent. Conclusion United applic of the two methods can effectively examine the management staff and improve their management capabilities.

Objective To investigate the application and feasibility of the single bed work efficiency in the evaluation of hospital beds efficiency,to establish the hospital beds efficiency evaluation model,in order to provide the basis for scientific and effective utilization and evaluation of beds.Methods Proposing the concept of single bed work efficiency,establishing a new evaluation model of bed efficiency,and analyzing the utilization of hospital beds in 2015.Results Single bed work efficiency is supenor to other indexes in evaluating the Utilization efficiency of hospital beds,and the new bed efficiency evaluation model is more objective and accurate.Conclusion The evaluation model of hospital beds utilization efficiency based on the single bed work efficiency is more comparable and operable,which can be widely used in hos pital delicacy management.

Objective To compare the efficacy in radical cure of H.Pylori (Hp) by different proton pump inhibitor (PPI)-based treatment regimens.Methods One thousand two hundred and three H.Pyloriinfected patients diagnosed by both endoscopic pathology and a rapid urease test were enrolled in this study.Reviewed 13 C-urea breath test at the end of Hp eradication treatment for more than 4 weeks,and retrospective analyzed the different effect of Hp eradication regimens.All patients were given treatment regimens,which including PPI (esomeprazole azole,bella,esomeprazole,pantoprazole omeprazole,2 times/d) plus antimicrobial for 7,10,14 d.According to antimicrobial,patients were divided into A,B,C,D,E group.Patientss in group A(421 cases) were given amoxicillin 1.0 g,2 times/d,clarithromycin 0.5 g,2 times/d;In group B (49cases) were given amoxicillin 1.0 g,2 times/d,levofloxacin 0.2 g,2 times/d;In group C(69 cases) were given amoxicillin 1.0 g,2 times/d,metronidazole 0.4 g,2 times/d;In group D(559 cases) were given clarithromycin 0.5 g/d,2 times/d,levofloxacin 0.2 g,2 times/d and in group E(105 cases) were clarithromycin 0.5 g,2times/d,metronidazole 0.4 g,2 times/d.Bismuth were colloidal bismuth pectin 200 mg,2 times/d.Results The radical cure rate of Hp was 84.04％ (453/539) in the group treated by regimens with Amoxicillin,and significant higher than that of without Amoxicillin (69.12％ (459/664),x2 =36.104,P =0.000),and the radical cure rate of Hp was 14.92％.The Hp radical cure rate of quadruple therapy was 76.85％ (767/998),while triple therapy was 70.73％ (145/205).However,no significant difference between these two regimens was found(x2 =3.476,P =0.062).The Hp radical cure rates of 14-,10-and 7-day course therapies were 84.28％ (134/159),75.79％ (579/764),71.07％ (199/280) respectively,and there was significant different among the three groups (x2 =9.644,P =0.008).There was significant increases trend in the 14-day therapy group comparing to 10-and 7-day regimen groups (x2 =5.399,11.719,P =0.020,0.001 respectively),while no significant difference was shown between the 10-and 7-day therapy groups(x2 =2.398,P =0.121).The radical cure rates were 84.80％ (357/421),81.63％ (40/49),81.16％ (56/69),69.95％ (391/559),64.76％(68/105) respectively in A,B,C,D and E groups,and there was significant difference among the groups (x2 =37.999,P =0.000).Conclusion Radical cure therapy of Hp should be PPI-based.A 14-day triple or quadruple treatment regimen with combination of Amoxicillin and clarithromycin is suggested as a first-line therapy.It is worth to clinically popularize such regimens in the light of the superior efficacy.

Objective To learn the current anesthesiologists deployment at the hospital,and to figure out how to measure anesthesiologists deployment.Methods Existing data and expert consultation were used to obtain various indicators,and the current anesthesiologists deployment was analyzed,calculating with the formula the needed number of anesthesiologists.Results Despite the rising demand and resource utilization,anesthesiologists were found in obvious shortage at the hospital.The number of anesthesiologists needed was calculated as 101.4,with a vacancy of 11.4.Conclusion The national health authorities were recommended to revise the standard of anesthesiologists deployment at hospitals.

Objective To explore the current status of job satisfaction of clinical medical staff and factors that influence the job satisfaction,and to put forward coping strategies and suggestions for improving the job satisfaction of clinical medical staff,so as to maintain workforce stability.Methods The paper will investigate the job satisfaction of clinical medical staff by sending questionnaires to all doctors and nurses working in a hospital,and use descriptive analysis and T test statistic method to analyze the current status of job satisfaction of questionnaire receivers as well as different dimensions of job satisfaction among different population groups.Results More than 85％ of questionnaire receivers think that the job they are doing is at higher risk.Over 80％ feel stressed out by their jobs.Less than 35％ are satisfied with their occupations,social status,working status,job security,and promotion opportunities.Less than 15％ feel respected by their jobs.Conclusions Generally,questionnaire receivers' job satisfaction is low.Heavy workload and poor quality of life are leading factors that contribute to their low job satisfaction.In this sense,we should adopt various measures to give attention to these key population groups.

Objective The association between Helicobacter pylori(H.pylori) infection and allergic diseases was controversial.The aim of this study was to investigate the association between H.pylori infection and allergic diseases.Methods A questionnaire survey regarding the general health condition and allergic diseases was carried out in patients who had taken gastroscopy at People's Hospital of Peking University from September 2015 to April 2016.H.pylori infection was detected by the H.pylori antibody,rapid urease test and gastric mucosa pathology.Results There were 1 034 patients were enrolled in this study.The rate of H.pylori infection was 20.5%(212/1 034).The frequencies of contact dermatitis,urticaria,food/drug allergy,allergic rhinitis,bronchial asthma were 6.9%(71/1 034),15.5%(160/1 034),18.0%(186/1 034),20.8%(215/1 034) and 3.4%(35/1 034),respectively.The rate of the food/drug allergy was significantly lower in the H.pylori-positive group than in the H.pylori-negative group(11.8 %(25/212) vs.19.6%(161/822),χ2=6.940,P=0.008).The risk of food/drug allergy in H.pylori-positive group was 0.611(95% CI:0.386-0.966,P=0.035) in the multivariate analysis.When the patients were divided into age-dependent groups,the rate of the food/drug allergy was significantly lower in the H.pylori-positive group than in the H.pylori-negative group(10.9 %(11/101) vs.20.6%(101/490),χ2=5.152,P=0.023) in those patients ≥50 years old.There were not statistically significant differences on contact dermatitis,urticaria,eczema,asthma and allergic rhinitis between helicobacter pylori positive group and negative group(P>0.05).Conclusion H.pylori infection may be a protective factor in food/drug allergy and the protective effect enhanced by infection time.

Objective To investigate the clinical significance of gastric cracks by investigating the relationship between stomach cracks under gastroscopy and H.pylori infection as well as its pathological manifestation,in order to improve the detection rate of H.pylori.Methods Gastroscopy patients were enrolled as our subjects excluding those with tumors,major diseases and under 18 years old.Mucosal biopsies were obtained from the lesser curvature of antrum and the greater curvature of body in each patient,then by HE staining,pathological and HP examination.The information including the pathological diagnosis,HP antibody,rapid urease test,endoscopic diagnosis and endoscopic gastric body cracking phenomenon were collected from all patient.H.pylori positivity was defined as a patient who showed two or more positive results in the Rapid Urea's Test,pathohistological examination and H.pylori antibody detection.Results (1) 437 patients with gastroscopy were included between December 2009 and December 2011,among whom 210 were male and 227 were female.There were 32 cases with gastric ulcer,59 cases with duodenal ulcer,51 cases with duodenitis,62 cases with reflux esophagitis,and 276 cases with chronic gastritis.(2) H.pylori distribution in stoma of all patients:160 of 437 patients(36.61％) are H.pylori positive,of which 68.75％ (110/160) was found H.pylori positive in both of gastric antrum and body,25.63％ (41/160) was H.pylori positive only in antrum,and 3.13％ (5/160) was H.pylori positive only in the body of stomach.(3)Relationship between the presence of cracks in gastric body and H.pylori infection:the H.pylori positivity was 62.58％ (97/155) and 22.34％ (63/282) respectively in the group with or without the presence of cracks in body.Cracks in gastric body examined by gastroscopy was related to H.pylori infection(x2 =69.788,P =0.000).(4) Relationship between the presence of cracks in gastric body and patho-histology:the presence of cracks in gastric body was related with severity of gastric inflammation by Wilcoxon rank sum test (P ＜ 0.0001),while there was no relationship between gastric body cracks and atrophy,intestinal metaplasia and atypical hyperplasia(P ＞ 0.05).(5) Relationship between the presence of cracks in gastric body and diseases:the presence of cracks in body was related with duodenitis,bile reflux under gastroscopy while there was no difference among in gastric body and gastric ulcer,esophagitis and chronic gastritis in terms of cracking appearance (P ＞ 0.05).Conclusion Our finding showed that cracking appearance in the gastric body is related with severity of inflammation in gastric mucosa bile reflux and duodenitis,suggesting that it can be one of the gastroscopic manifestations of more severe gastritis.

Objective To investigate the effectiveness of the comprehensive quantitative　assessment system in the review of senior clinical titles so as to set up a comprehensive appraisal　system for clinicians.Methods A retrospective analysis was made to compare the objective parameters　for performance appraisal of the applicants for senior titles before and after the adoption of the　comprehensive quantitative assessment system,namely,between 2003 to 2006 and 2007 to 2010.Results The parameters were improved in aspects of clinical practice,education and research.And　the average age of applicants was lowered.Conclusion The new assessment system works well for　clinician appraisal,and produces a positive guiding effect of the senior title review on hospital　development.Suggestions are also made to solve the existing problems and to improve the system.