Objective To find out about patients needs, better deliver patient oriented care, and enhance patients satisfaction towards the service. Methods An investigation by questionnaire was made into 552 randomly selected outpatients with regard to the factors influencing patients selection of hospitals when seeking medical service and the needs of outpatients when waiting to see the doctors. Results Among the major factors influencing patients selection of hospitals when seeking medical service are the medical expertise of doctors and patients confidence in them. Spread of knowledge about health, constant notice to patients waiting of how things are going, introduction to specialists, and provision of signs indicating the service process are areas of service that patients waiting to see the doctors hope to get or see improved. Conclusion Enhancing the medical expertise and the overall quality of the medical staff, intensifying the awareness of quality service and standardizing medical behavior are among the major steps that hospitals can take to deliver patient oriented service.

ObjectivesTo explore the clinical significant for change o f serum enzyme with ACVD.MethodsThe serum enzyme of 150 cases wi th ACVD were investigated.ResultsThe serum enzyme of 150 cases with ACVD were significantly higher than that of the control group (P

Objective To investigate the occupational musculoskeletal injury of nurses in a thirdgrade and A-level general hospital in Zhengzhou,and analyze the relationship between occupational musculoskeletal injury and presenteeism.Methods 460 nurses were surveyed with questionnaires by convenience sampling,including nurses' demographic data,Nordic Standardized Questionnaires and Work Limitations Questionnaire.Results The annual incidence rate of OMSI in nursing staff was 82.38％.The parts of body which had high annual incidence rate of nurses' OMSI were lower back,neck and shoulder.The rates of presenteeism for no OMSI,one part OMSI and two or more parts OMSI were 35.14％,52.60％ and 59.68％.The scores of work efficiency decrease were (2.02±1.26),(4.67±2.53),(7.31±3.42).Conclusions Nurses' occupational musculoskeletal injury can result in presenteeism.The more serious occupational musculoskeletal injury is,the higher incidence rate of presenteeism,the more critical the presenteeism is.

Objective To analyze the sequences of two component signaling system PhoP/PhoQ encoding genes of Pseudomonas aeruginosa strains sensitive or resistant to aminoglycoside antibiotics and to determine the correlation between the PhoQ/PhoP and the resistance. Methods The segments of entire pimQ and phoP genes of P. aeruginosa were obtained by PCR and then sequenced after T-A cloning. Two prokaryotic expression systems of phoQ and phoP genes were constructed and the target recombinant expres-sion products rPhoQ and rPhoP were extracted by Ni-NTA chromatography. Rabbits were intracutaneoualy immunized with rPhoQ and rPhoP to obtain antisera and double immunodiffusion test was used to detect the titers of antisera. The phoQ genes of aminloglycoside antibiotics-resistant P. aeruginosa strains were knocked out by using Red recombination system, and phoQ mutants were identified by PCR plus sequencing and Western blot assay. Tube dilution method was applied to determine MIC values of wild and mutant strains of P. aeruginosa to four different aminoglycoside antibiotics. Results In comparison with the corresponding sequences in GenBank, the similarities of nueleotide and putative amino acid sequences of the cloned phop and phoQ genes were 98.7%-99.6% and 98.7%-100% , and 98.4%-99.8% and 99.1%-100%, respec-tively. Both rPhoQ and rPhoP were successfully expressed using pET-42a and E. coil BL21 DE3 system, and their rabbit antisera with 1 : 4 and 1 : 8 double immunodiffusion titers were also obtained. The deletion of phoQ genes and absence of the products in the two phoQ mutants were confirmed by PCR, sequencing and West-ern blot assay. MIC values of the four different aminoglycoside antibiotics to the two mutants were 1/512-1/2048 as those of their wild strains. Conclusion PboQ/PhoP is a sequence conserved two component sig-naling system of P. aeruginosa, and this system mediates resistance of the microbe to aminoglycoside antibiotics.

Objective To evaluate anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol in patients undergoing short surgery. Methods Fifty ASA Ⅰ or Ⅱ patients who scheduled for elective surgery under general anesthesia were enrolled in study. The anesthesia was induced with intravenous injection of midazolam 0.03 mg/kg and sevoflurane inhalation. Induction of anesthesia was started with 6% sevoflurane and fresh gas flow rate of 6 L/min. The inspired concentration of sevoflurane was reduced to 2% as soon as eyelash reflexes of these patients were abolished. At the same time, remifentanil 2 μg/kg was injected slowly over 1 min,and 30 s later,patients were mechanically ventilated after tracheal intubation. 2% sevoflurane was kept inhaling, and remifentanil and propofol were kept pumping for anesthesia maintenance. The mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO_2) and bispectral index (BIS)were recorded before administration,at the time of the disappearance of eyelash reflex, immediately before tracheal intubation,and immediately after tracheal intubation. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was also recorded. And conscious recovery, spontaneous breathing recovery,the endotracheal extubafion time and OAAS score were recorded. Results All patients were successfully intubated at the first attempt. The satisfactory intubation conditions were found in 82% (41/50) of cases. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was (73 ± 12) s. MAP,heart rate and SpO_2 remained stable and BIS was maintained at 45-55 before and after tracheal intubation, and all patients were quick recovery. Conclusion The anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol without muscle relaxant in patients undergoing short surgery is smooth, safe and reliable.

Objective To systematically analyze and assess the risk of venous thromboembolism in the patients with rheuma‐toid arthritis(RA) .Methods The related literatures on the venous thromboembolism occurrence in the patients with RA published at home and abroad were performed the electronic retrieval .The obtained data were analyzed by adopting the RevMan5 .1 software . The data unable to merge were analyzed by adopting the descriptive analysis method .Results A total of 10 related papers were in‐cluded .The 3 indicators of venous thromboembolism occurrence rate ,deep vein thrombosis occurrence rate and pulmonary thrombo‐embolism occurrence rate were performed the meta analysis .The RR and 95% CI of the occurrence rates of venous thromboembo‐lism ,deep vein thrombosis and pulmonary thromboembolism were 2 .00(1 .71 ,2 .33) ,2 .31(1 .84 ,2 .90) ,2 .25(2 .23 ,2 .28) respec‐tively .Conclusion The risk degree of venous thromboembolism occurrence in the RA patients is higher than that in the non‐RA pa‐tients .

Objective To evaluate the efficacy of transarterial embolization(TAE) for intraperitoneal hemorrhage due to spontaneous rupture in hepato-cellular carcinoma(HCC).Methods 50 cases with ruptured HCC were divided into 4 groups according to the type of their previous treatment:group A,TAE followed by elective hepatectomy 12;Group B,TAE alone 12;Group C,emergency operation 13;Group D,medical conservative management.Results Celiac arterio-graphy done before the present treatment showed extravasation of contrast material in 6(25%) of the 24 patients in group A and B,and hypervascular tumor was observed in the rest.The hemostasis success rate of group A,B and C were 100%,which were much higher than that of group D(40%)(P

Objective To detect the effect of chitosan gel on rectal injury which was induced by acetic acid. Methods 36 rats were anesthetized, 4% acetic acid swab was placed into the rectum (3 cm in depth for 1 min) to establish rectum injury model. These rats were divided into model control group, positive control group and drug group with 12 rats each group randomly. Chitosan gel was given to the drug group through anus with the dose of 1 575 mg·kg-1 , and hemorrhoid cream (1 575 mg·kg-1 ) was administered in the positive control group for 6 successive days. At 30 min, 1, 4, 6 day( s) after administration, 3 rats of each group were sacrificed, and were dissected, rectal injury and rectal pathology morphology changing of each group at different time points of administration were compared through visual observation. Results At 30 min, 1, 4, and 6 day(s) after administrating chitosan gel, score of rectum mucosa injury in dury group was lower than those in model control and positive control group. Pathological changes ( including epithelial tissue necrosis, mesenchyme hyperemia, hemorrhage, edema, gland injury, infiltration of inflammatory cells) were significantly slighter in drug group than in model control group and positive control group. Those lesions were restored faster in drug group than in model control group and positive control group, and there was no obvious scar. Conclusion Chitosan gel can obviously alleviate the rectal injury caused by 4% acetic acid and has therapeutic effect.

OBJECTIVE To study characteristics of changing T lymphocytes in epidemic hemorrhagic fever(EHF) patients during acute phase and find out the pathogenesis,in order to elevate the level of early diagnosis.METHODS The anticoagulant blood from 30 cases of EHF patients and 50 normal healthy blood donors was collected.T lymphocyte subsets were detected by flow cytometry.RESULTS Compared with those of normal persons,CD4+ T cell counts of EHF patients decreased,CD8+T cell and double CD4+CD8+ cell(double positive cells,DP cell) counts of EHF patients increased obviously,and 25 cases of EHF in recovery stage returned to normal.And in comparison with HIV,CMV and EBV patients,DP cell counts of EHF patients increased obviously.CONCLUSIONS T lymphocytes of EHF decrease obviously but could be resumed,detection of amounts of lymphocyte subsets and CD4+CD8+ cells can provide an early diagnosis method to EHF.

Objective To establish a reproducible rat model of acute rectal mucosal injury induced by acetic acid. Methods Fifteen healthy Sprague-Dawley rats were randomly divided into the control group (3 rats) and experimental group (12 rats).Acute rectal mucosal injury was induced by 4%acetic acid using a cotton swab inserted into the rat rec-tum for 1 min to a depth of 3 cm.The morphological characteristics were analyzed by the naked eye and histology at 0.5 h and 1, 4, and 6 days after acetic acid intervention.Results All rats survived 6-day study period.The successful rate of model establishment was 100%.From 0.5 h to 1st day after acetic acid intervention, the gross morphology of recta showed congestion, edema and ulcer to ulcer complicated with hemorrhage.The histology showed necrosis and hemorrhage of the epithelial tissue of the mucosa to complete and extensive necrosis of the mucosa.The glandular structure showed partial to complete loss.The submucosa showed edema to edema complicated with hemorrhage and congestion.The interstitial tissues showed vasodilatation and congestion to inflammatory cell invasion.From 4 to 6 days after acetic acid intervention, the rectal mucosal changes were obviously improved.Epithelial and glandular regeneration and inflammatory granulation occurred, but not fully recovered, some edema and redness, partial lack of glands were still present.Conclusions 4%acetic acid for 1 min can be used to successfully induce rat model of acute rectal mucosal injury.This procedure is easy to operate, with a high success rate,reproducible, and the alterations are lasting more than 6 days.This animal model is very suitable for rapid screening of topical drugs for the treatment for rectal mucosal injury.