In order to improve doctor patient relationship and communications, the system of doctor patient communications was implemented in an all round way. First, the contents of the system were defined. Then the ways of implementing the system were fixed: improving training and changing service concepts; bringing doctor patient communications into line with quality management; making use of special survey forms for the system, and mastering a variety of communications skills. In addition, necessary organization, personnel, and regulations were put in place to guarantee the success of the system. Consequently, implementation of the system brought about pretty tangible results.

OBJECTIVE: To establish a HPLC method for the determination of plasma level of cefuroxime in experimental dogs. METHODS: 1. 0mL plasma samples were taken from experimental dogs at different time after intravenous injection of cefuroxime sodium 50mg? kg-1. Following pretreatment, the samples were subjected to determination on XDB-C18 chromatographic column. The mobile phase consisted of CH3CN-1‰ ( NH4) 2SO4 ( 12∶ 88) with a flow rate of 1. 0mL? min-1. The detection wavelength was 273nm and the column temperature was 25℃ . The quantification was performed by external standard method. RESULTS: Good linear relationship was achieved when the detection concentration of cefuroxime was within the range of 0. 5～ 250? g? ml-1( r=0. 999 5) . The average recovery of cefuroxime was 97. 76～ 116. 00% ( RSD

Objective To review the blood gas analysis of H7N9 flu patients for better understanding the characteristics and prognosis of the emerging disease.Methods A retrospective review was conducted for the 15 H7N9 influenza patients,whose blood gas profile was tested with a Radiometer 80 Blood Gas Analyzerin our hospital.The profile of blood gas analysis was compared between the 12 surviving patients and the 3 deaths in terms of their outcomes.Results The 3 patients who died of H7N9 influenza averaged 83 years old.The partial pressure of oxygen was <8 kPa in 9 of the 12 surviving patients,which meet the diagnostic criteria of type I respiratory failure.Their partial pressure of oxygen all recovered to normal (11 .033 ± 2.335 kPa,reference range 10-14 kPa)on discharge.The pH value of peripheral arterial bloold averaged 7.335 (range 7.39-7.54)on adission for the 3 patients who died of H7N9 influenza.The worst average pH value was 7.233 (range 7.32-7.35), which was significantly different from the values of the surviving patients.Conclusions Elderly patients are susceptible to H7N9 influenza infection and subsequent respiratory failure.Old age was associated with higher mortality.The partial pressure of ox-ygen is not significantly associated with patient outcomes.Appropriate active treatment may recover the blood gas profile to normal regardless of the initial values.If decreasing peripheral arterial bloold pH value is highly suggestive of poor prognosis, comprehensive measures should be taken to keep acid-base balance,including assisted ventilation to correct hypoxemia.

To guarantee the basic quality of nursing service, many countries have carried out the licensure examinations for registered nurses, which are used not only to evaluate the quality of nursing education but also to guide the development of education. This paper reviewed the process of the establishment of the systems, and outlined the features of the examinations in content design, organization and implementation, improvement and development trends in both China and America in order to improve ours.

At present,transjugular intrahepatic portosystemic shunt (TIPS) is an effective procedure widely used in the clinical treatment of portal hypertension.The blood stream in the portal vein can be directly shunted into the hepatic vein through the inserted stent,which helps to reduce portal vein pressure.TIPS provides treatment opportunities for the patients with advanced portal hypertension complicated by intractable ascites and gastroesophageal variceal bleeding and those who are waiting for transplantation or cannot tolerate surgery.The key to success of TIPS is to maintain stent patency after placement,and therefore,post-TIPS monitoring is of vital importance.As a noninvasive,cheap,practical,and repeatable procedure,ultrasound has an important value in post-TIPS monitoring.This article summarizes the role of color Doppler and contrast-enhanced ultrasound in evaluating stent function after TIPS.

Objective To assess the feasibility of secondary check by LinaTech TiGRT treatment planning systems.Methods Choosing the Linatech TiGRT treatment planning system,researched and developed by Linatech company,as the third-party check tools.First,using Linatech TPS for recomputing treatment plans for geometrical phantoms designed in TG-119 and patients.after computation,compared the point dose with the measured data of phantoms (Using chameber No.2571 to measure point dose) and original plans.Using PTW verisoft with a criteria of 3% dose difference and 5 mm distance to agreement to assess the dose distribution on center level.After then,you can assess the accuracy of treatment plans.Results Tiny volume changes were found in ROI,especially in small size phantoms orcuspidal regions.For comparing measured data with recomputed plans and original plans,the dose data were found basically identical in TG-119 phantoms.And for patients,the differences between recomputed plans and AAA original plans or AXB original plans were smaller in breast cancer,but they were even bigger innasopharynx cancer,all patient cases showed a gamma passing rate more than 90%.The gamma passing rate of AAA original plans and AXB original plans were 95.6% and 97.53% for breast cancer,and 94.67% and 96.83% for nasopharynx cancer.Conclusions The method of utilizing the LinaTech TiGRT treatment planning system as a third-party check tools to assess the accuracy of plans is feasible,and the validation process is convenient,but some functions still need to improve and the scope of differences still need more patient cases to determine.

Objective: To improve the low relief fund utilization rate, make the city minimal assurance relief patients enjoy double Medicaid assistance account and agricultural insurance or Medicare reimbursement policy. Methods: Based on the actual work, and actively explore, innovation, in the Oracle database platform, the transformation of His in outpatient service charge settlement system, establishing patient account data, through a patient's unique index related agricultural insurance or Medicare patient file information. Results:The outpatient service charge settlement system enabled for tailored low mental patients. Conclusion:the patients fully enjoy minimal assurance relief assistance account and agricultural insurance or Medicare reimbursement policy ofdouble Medicaid, andfirst diagnosis and treatment forbusiness conducted a preliminary exploration.

Autoimmune Diseases ; Humans ; Laryngeal Diseases ; Sarcoidosis ; Vocal Cords ; pathology

Objective To investigate the frequencies of genotype and allele distribution of IL-12A gene single nucleo?tide polymorphisms (SNP) rs568408 and IL-12B gene SNP rs3212227 in Zhuang populations in Guangxi, and to compare the distribution of IL-12A and IL-12B polymorphisms among different races. Methods The IL-12A SNP rs568408 and IL-12B SNP rs3212227 were detected by SNaPshot SNP genotyping technique in 165 Zhuang people in Guangxi, frequen?cies of genotype and allele of IL-12A gene rs568408 and IL-12B rs3212227 polymorphisms were analyzed in Zhuang popu?lations compared with the other four populations(HapMap-HCB, HapMap-JPT, HapMap-YRI, HapMap-TSI)from Hap?Map database. Results There were polimorphisms of IL-12A and IL-12B gene in Zhuang populations in Guangxi. The fre?quencies of allele and genotype distribution of IL-12A gene rs568408 polymorphisms were not significantly differenct com?pared with HapMap-HCB, HapMap-JPT and HapMap-TSI(P>0.05), but were significantly different compared with Hap?Map-YRI(P<0.01);The frequencies of allele and genotype distribution of IL-12B rs3212227 polymorphisms were not sig?nificantly differenct compared with HapMap-HCB and HapMap-JPT(P>0.05), but were significantly different compared with HapMap-YRI and HapMap-TSI(P<0.01). Conclusion There are significant differences in the frequencies of allele and genotype distribution of IL-12A gene rs568408 and IL-12B gene rs3212227 between Zhuang populations and other eth?nic populations, and this variation might contribute to a variety of clinical manifestation and morbidity of some IL-12 related diseases.

Objective To investigate the effect of continuous renal replacement therapy ( CRRT) on the reg-ulation of Treg/Th17 in patients with severe sepsis,and related inflammatory factors IL-6,IL-17,IL-10,and TNF-α.Methods 60 patients with severe sepsis were randomly divided into two groups,30 cases in each group.The control group received conventional treatment,and the observation group was treated with CRRT on the basis of the control group.Flow cytometry was used to detect the levels of Tregs and Th17 cells,and IL-6,IL-10,IL-17 and TNF-αwere detected by ELISA method.At the same time,the APACHEII score,ICU length of hospital stay were observed and recorded.Results After treatment,APACHE Ⅱscore,ICU length of hospital of the observation group were lower than the control group,there were statistically significant differences(t=4.258,t=4.518,all P<0.05). The expression levels of Th17,Treg and Tregs/Th17 in the observation group were significantly lower than the control group,the differences were statistically significant (t=5.872,4.267,4.285,all P<0.05).The expression levels of IL-6,IL-17,TNF-αin the observation group decreased more significantly than the control group,the differences were statistically significant (t=5.829,5.257,5.983,all P<0.05).But the expression level of IL-10 in the two groups had no obvious change[(35.26 ±18.63) pg/mL vs (35.52 ±20.09) pg/mL,t=2.164,P>0.05].Conclusion CRRT can not only remove the inflammatory mediators of abnormal expression,improve the function of T cells,but also can maintain the balance between Th17 and Treg,improve the immune disorders,and improve the prognosis of sepsis.