Objective:In the view of research on outpatient service process of a compositive hospital,the advanced method and its effects to improve the outpatient service process by informational system were discussed.Methods:The outpatient informational system is closely related to the process rebuilding.Results:It is necessary to reunite the existing process by informational technology in order to dicease the units,shunt the peak,get rid of the stricture and improve the efficency.And more a new outpatient service process being convenient,quick,good,sufficient and with low-consume should be established. Conclusion:We must hang on the guildline of "based on humanity",and break off the traditional mode,achieve the advanced mode,improve the scientific management,ensure the service quality which based on informational technology.

ObjectiveTo evaluate the changes of hepatic blood perfusion in cirrhotic patients undergoing pericardial devascularization (PCDV).MethodsHepatic artery and portal vein perfusion of 22 pre- and post- PCDV cirrhotic patients were evaluated with rheohepatogram(RHG) and ultrasonography (USG).ResultsCompared with normal control, the hepatic artery, portal vein effective perfusion and total hepatic perfusion decreased on RHG 〔(0.053?0.011) vs. (0.031?0.009),(0.033?0.011) vs. (0.018?0.008),〔(7.7?3.0) vs. (3.5?1.7), all P

After serious-minded analyzing on the former service process,the manager of our hospital found the problems in the old construction and considered more reasonable design in the new service building.The patient-centered new outpatient building was aimed to meet patient's needs,improve service quality,allocate medical resource,innovate new pattern and optimize the work process.It will provide a bright future for the development of hospital.

Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.

Objective To investigate the level of human cytomegalovirus(HCMV)specific CD8+ T lymphoeytes in peripheral blood and the immune reaponae of HCMV reactivation after kidney transplantation.Methods Thirty-eight HCMV seropesitive HLA-A*0201 kidney transplant recipients(9 with HCMV infection and 29 without HCMV infection)and 54 healthy individuals were enrolled.The levels of total HCMV specific CD8+ T cells were measured using HLA-A2 pentamer folded with HCMV-peptide NLVPMVATV.The levels of IFN-γ secreting CD8+ T cells were measured by intracelluhr IEN-γ staining pulsed with the same peptide.Results The median levels of pentamer stained CD8+ T cells were 1.19%(0-19.42%),1.20%(0-18.40%)and 3.2%(0.51%-18.90%)in healthy group,negative HCMV group and positive HCMV group(H=5.34,P＞0.05),respectively.The median levels of IFN-γ secreting CD8+ T cells were 0.72%(0-0.70%),0.47%(0-5.61%)and 0.67%(0.07%-4.00%),respectively(H=0.58,P＞0.05).However,the mean proportions of IFN-γ secreting pentamer stained T cells relative to total HCMV specifc CIL were(60.18±19.16)%,(39.19±17.22)% and(20.02±13.26)%,respectively.There were significant differences among the groups(P＜0.01).Condusiorm There was no significant difference of levels of HCMV specific CD8+ T lymphocytes in peripheral blood between the kidney transplant recipients and healthy individuals.However,the proportion of HCMV-specific IFN-γ producing CD8+ T cells in pentamer stained cells was reduced in the kidney transplant recipients especially in those with active HCMV infection,which may contribute to the inability to control HCMV reactivation.

Through ethical analysis of the conflicts appearing in four special cases in the four steps of assisted reproductive technology implementations, this paper pointed out the measures to solve them in the perspective of le-gal protection, standardized management, ethical supervision, and self-regulation for making the research and ap-plication of assisted reproductive technology serve patients better and promoting the healthy development of assisted reproductive technology.

Through the doctor group, the questionnaire survey to understand what the doctor online habits situ-ation of network communication, doctors and patients, the effect of the real network environment for medical diag-nosis and treatment, news media under the network environment on the influence of the doctor and the doctor group about web development comprehensive view of the impact of the doctor-patient relationship.Points out that the current network environment brings to the doctor-patient relationship: the influence of the Internet become some doctors information update and the accumulated knowledge source, network has become an important platform inter-action some doctors and patients, doctors need to deal with an increasing number of network patients, the doctor-shave reactive shifts to the media negative reports.

The construction of harmonious doctor-patient relationship is an important project in social medicine .The influen-cing factors about doctor-patient relationship are analyzed from three aspects which are responsibility ethics , bottom-line ethics and clin-ic ethics.Based on the discussion , certain countermeasures are proposed to reconstruct harmonious doctor -patient relationship .

Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy ( NPWT) in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .

BACKGROUND:Tissue inhibitor of matrix metaloproteinase 1 (TIMP-1) is the corresponding antagonist of matrix metaloproteinase 13 (MMP-13), and their balance between expression and functional activity exerts an important role in the metabolic state of the extracelular matrix. During the development of osteoarthritis, however, TIMP-1 and MMP-13 expressions and their expression ratio show unclear changes in DH guinea pigs.
OBJECTIVE:To explore the expression levels of MMP-13 and TIMP-1 in DH guinea pigs with different ages, and to analyze the relationship between the ratio of MMP-13 to TIMP-1 and the age-dependent degenerative changes in the articular cartilage.
METHODS:Twenty-four female Dunkin Hartley guinea pigs were sacrificed at age of 2, 4, 8, 12 months separately, with six animals at each time point. The knee joints were colected and gross visual appearance of the articular cartilage was observed, then were decalcified and prepared for paraffin sections. VG staining and Mankin score were used to analyze the histological changes. Immunohistochemistry was conducted to assess the expression levels of MMP-13 and TIMP-1 in the cartilage. Integrated absorbance values were used as the quantitive analysis calculated by Image pro-Plus 6.0. Linear regression analysis was done to analysis the relationship between Mankin score and the ratio of MMP-13/TIMP-1. RESULTS AND CONCLUSION:Normal appearance in the articular cartilage was observed in 2-month-old DH guinea pigs, while degenerative changes in the articular cartilage were shown in 4-month-old animals, which became severer with age. Significant difference was found in Mankin score between any two groups (P < 0.05). The ratio of MMP-13 to TIMP-1 increased with age, and the ratio was positively correlated to the Mankin score (P < 0.05). Age-related articular cartilage degeneration occurred in Dunkin Hartley guinea pigs at 4 months of age, and devoloped with age, which is related with the imbanlance of the expression ratio of MMP-13 to TIMP-1.