With the opening of the medical service market and the rise of medical expenses, patients have started to pay more attention to the choice of medical service institutions. Patient satisfaction has become another key factor in competition besides quality and price. The paper mainly deals with the implication of the degree of customer satisfaction in medical services, the steps of measurement, and the immediate significance of studying the degree of customer satisfaction.

Objective To investigate effect of Murphy's law on the nursing safety management of the hemodialysis patients. Methods 4598 hemodialysis cases in a blood purification center of a first class grade A hospital from April to July in 2011 was assigned as pre-implementation group.Then Murphy's law was used in the nursing practice.In the following,another 5683 hemodialysis cases from November in 2011 to January in 2012 were assigned as post-implementation group.The incidence of nursing risks and hemodialysis equipment failures were compared between the two groups.Result The incidences of nursing risks and hemodialysis equipment failures in the post-implementation group were significantly lower than those of the pre-implementation group(P<0.05).Conclusions Murphy’s law is effective for the declines of nursing manipulative defects and hemodialysis equipment failures.Besides,the law can be good for the strengthened awareness of safety and enhanced consciousness of all staff participating in the safety management so as to ensure the safety and quality of hemodialysis.

Objective To examine supine fulcrum pressurized radiograph to predict spinal flexibility in adolescent idiopathic scoliosis (AIS). Methods 1. Empirical study: put two points (A and B) on one side of the plastic stick and one point on the other side ( C), pressurize on the plastic stick when point C is in the middle of A and B, and then measure the projection shifting of point A. Repeat the pressure test when the distance between A and C doubled. Analyze the effect of increasing distance on diminishing pressure. 2.Clinical study :45 patients ( 16 males and 29 females) underwent standing anteroposterior radiograph ,fulcrum lateral flexion radiograph, supine lateral flexion radiograph. The Cobb's angles were measured and the flexibility ratio was determined on preoperative fulcrum radiograph. Results (1) If the length of A and C was 25 cm, pressurize on point C, when pressure quantitative scale number located 1 scale and 2 scale of the rule, projection shifting of point A were 5 cm and 10 cm. If the length of A and C was 50 cm, pressurize on point C, when pressure quantitative scale number located 1 scale and 2 scale of the rule, projection shifting of point A were 8 cm and 15 cm. The longer the distance, the lesser the pressure force of plastics stick. (2)The Cobb angles and curve flexibility provided by fulcrum lateral flexion radiograph had significant difference from that provided by supine lateral flexion radiograph in male group and female group. Cobb angles of male group was 28. 6°± 4. 1 °, 16. 7°± 4. 6° respectively (t= 7. 438, P ＜ 0. 01 )and curve flexibility was 47. 6% ±8. 1% ,69. 4% ± 8. 5% respectively( t = 7. 438, P ＜ 0. 01 ). Cobb angles of female group was 24.5°± 2. 7°,12. 6°±2. 4° respectively(t = 17. 540,P ＜0. 01 )and curve flexibility was 53.4% ±5.2% ,76. 0% ±4. 7% respectively(t = 17. 54, P ＜ 0. 01 ). The flexibility of spinal main curve of female patients was obviously higher than male patients. Conclusions Supine fulcrum pressurized technique can make up for the insufficiency of supine lateral flexion technique, and provide a convenient, safe, precise and useful method for evaluation of spinal flexibility in AIS.

Objective To analyze the mammographic features and pathological characteristics among different molecular subtypes of breast cancer.Methods The results of 210 cases breast cancer identified by postoperative pathology were collected and classified to three groups;Luminal,HER-2(+)and TNBC(triple negative breast cancer)by molecular subtypes.Three groups'mammograph-ic features and pathological characteristics were compared.Results 210 cases included 147 Luminal cases,30 HER-2 (+)cases and 33 TNBC cases.There were statistically significant difference between tumor grading and lymph node metastasis (P <0.05).Three groups had statistically significant difference among mass number,mass margin and calcification incidence(P <0.05),and had no sta-tistically significant difference between mass size and shape(P >0.05).The mammographic features of Luminal molecules subtypes showed more mass with burr,HER-2(+)molecules subtypes showed no fixed features but more calcification incidence than other groups,TNBC molecules subtypes showed merely mass with clear margin and less calcification.Conclusion The mammographic fea-tures and pathological characteristics of different molecular subtypes of breast cancer are significant differences.

Objective To explore the association between interpregnancy weight change and the recurrence of gestational diabetes mellitus(GDM).Methods This study included women who had two delivery records and a history of GDM during their previous pregnancy at the Guangdong Women and Children Hospital between January 2017 and July 2022.Interpregnancy weight change was defined as the difference between the prepregnancy BMIs of two consecutive pregnancies.Interpregnancy weight change was categorized into four groups(＜-1,-1 to＜1,1 to＜3,≥3 kg/m2),with the-1 to＜1 kg/m2 group serving as the reference.Logistic regression analyses were used to assess the associations of interpregnancy weight changes with GDM recurrence and changes in glucose values during two consecutive pregnancies.Results Among 703 participants,326 individuals(46.4％)experienced GDM recurrence.Compared with the groups with an interpregnancy BMI change of-1 to＜1 kg/m2,the groups with a BMI change of 1 to＜3 or ≥3 presented an increased risk of GDM recurrence,with odds ratio(OR)[95％confi-dence intervals(CI)]of 2.16(1.52-3.08)and 2.56(1.44-4.56),respectively.The risk of GDM recurrence significantly in-creased with increasing interpregnancy weight gain(P for trend＜0.01).However,there was no significant association between a BMI change＜-1 kg/m2 and GDM recurrence,with an OR(95％CI)of 0.95(0.57-1.57).An increase of 1 kg/m2 in the in-terpregnancy BMI was associated with a higher risk of elevated fasting blood glucose and 1 h plasma glucose,with OR(95％C1)of 1.15(1.05-1.26)and 1.21(1.10-1.33),respectively.Conclusion Women with a history of GDM are at a high risk of GDM recurrence,and interpregnancy weight gain is associated with an increased risk of GDM recurrence.These findings under-score the importance of health education among women with a history of GDM who plan to conceive again and emphasize the im-portance of weight management in reducing the recurrence of GDM.

Objective To explore the feasibility of using short-latency somatosensory evoked potentials (SLSEP) to quantitate Deqi.Methods A randomized crossover controlled trial was carried out. Healthy subjects were enrolled and allocated to treatment (thick needle, deep insertion and manipulation for Deqi) and control (thin needle, shallow insertion and no manipulation without Deqi) groups. Somatosensory evoked potentials were recorded before, during and after acupuncture. Deqi was assessed using the score scale in the subjets. The effects of Deqi and no Deqi at point Sanyinjiao (SP 6) on the potentials were observed.Results The preliminary exploration of the feasibility by the trial test showed that the effect of Deqi on short-latency somatosensory evoked potentials had certain regularity. It was worthy to be observed.Conclusion The plan is feasible. The formal test can be conducted.

The effects of intramuscular or intracerebroventricular injection of penta-gastrin(PG) on the action potential amplitude (APA) of the myocardial cells and the heart rate(HR) were studied. The results were as follows:1 ) Injection of 10?g/10?l of PG into one of the lateral ventricles of the ratfailed to produce any effect on APA or HR. When the dosage of PG was doubled(20?g/10?l), then HR could be slowed down significantly (P

Objective By using infrared thermal imager (Flir-SC620), to observe the effect of needling Sanyinjiao (SP6) on the skin temperature at Guanyuan (CV4) and Sanyinjiao in patients with primary dysmenorrhea (PD) of cold and dampness stagnation pattern, and to explore the probability of using infrared thermal imaging for diagnosis and as an objective index for evaluating the action and needling qi of acupuncture. Method Thirty-six subjects were recruited and divided into four group, a health control group (group A), a control group of PD of cold and dampness stagnation pattern (group B), a needling-qi-expected group (group C) and a needling-qi-unexpected group (group D). Group A and B were not given acupuncture treatment, while group C and D were treated with acupuncture at bilateral Sanyinjiao with needles retained for 30 min, and the needling sensations were recorded. The infrared thermal imager was used to detect the skin temperature at Guanyuan and bilateral Sanyinjiao for 40 min for each group, and the temperature was recorded every 10 min. The temperature during different periods of time, 0-10 min, 20-20 min, 20-30 min, 30-40 min, 0-30 min, and 0-40 min were then calculated. In group C, those obtained the needling qi sensation were further grouped into C-1 and those didn’t obtain the sensation were into C-2; in group D, those obtained needling qi sensation were further grouped into D-1 and those didn’t obtain the sensation were into D-2. SPSS 17.0 was adopted for data processing, and the data were analyzed by using MANOVA of repeated measuring. Result Compared to group A (6 cases), the temperature at Guanyuan in group B (6 cases) was significantly decreased during 0-30 min and 0-40 min (P<0.05), the temperature at the left Sanyinjiao during 0-40 min in group B was significantly decreased (P<0.05), and the temperatures at bilateral Sanyinjiao during 30-40 min in group B significantly dropped (P<0.05). Compared to group B, the temperatures at Guanyuan during 0-30 min and 0-40 min in group C1 (12 cases) and group D1 (11 cases) were significantly increased (P<0.05), the temperature at left Sanyinjiao during 0-40 min in group D1 was significantly increased (P<0.05), and the temperatures at bilateral Sanyinjiao during 30-40 min in group D1 were significantly increased (P<0.05). There was no case in group C2 and only 1 case in group D2, hence, the data were not enough for analysis. Conclusion Decrease of the infrared temperature at Guanyuan and Sanyinjiao can be taken as one of the diagnostic criteria for dysmenorrhea of cold stagnation pattern. Increase of the infrared temperature at Guanyuan can be regarded as one of the objective evidences for the along-meridian transmission characteristic in needling Sanyinjiao.

Objective To analyze the variation types kaunene synthase-like (KSL) gene in Danshen (Salvia Root, Radix Salviae Miltiorrhizae) from different producing areas in China, and investigate primarily the influence of KSL gene polymorphism on enzyme-catalyzed reaction of its codases.Methods Specific primers were designed, and full-length KSL genes of Danshen from different producing areas (Henan, Shandong, Sichuan, Hubei, Shanxi, Neimonggu, Hebei) in China were homologously cloned.The variation types were compared and mutation samples were selected to establish a prokaryotic expression system and inducible expression in vitro.The enzyme-catalyzed products of KSL gene were detected by using gas chromatography-mass spectrometer (GS-MS) , and influence of KSL gene polymorphism of Danshen on protease catalytic efficiency was further analyzed.Results The full-length KSL gene was 1 788 bp, and there were totally 595 amino acid residues encoded.The sequencing results showed that there were polymorphisms in KSL gene of Danshen from different producing areas in China, which could cause synonymous and non-synonymous mutations.The catalytic efficiency of different genotypes of KSL was significantly different, which was the highest in Shanxi and the lowest in Inner Mongolia.The KSL gene containing A-type variation mutated at 1 047 bp in Danshen from4 producing areas including Shanxi, Hubei, Shandong, and Sichuan, and the catalytic efficiency of which was significantly higher than those containing no Atype variation in Danshen from4 producing areas including Henan, Hebei and Inner Mongolia.Conclusion KSL genes have gene polymorphisms indeed in Danshen from different producing areas.The non-synonymous mutations induced by polymorphisms can further lead to changes of amino acid sequences and finally resulting in difference in the catalytic efficiency of encoded enzymes.The polymorphisms of key enzyme genes in the synthesis pathway of tanshinones can be taken as a starting point to provide further reference for revealing the accumulation mechanism of tanshinones and breeding the excellent germplasm of Danshen.

From the time of Neijing (Internal Classic) and Nanjing (Classic of Medical Problems) till the end of Qing dynasty, the medical scholars of each dynasty had taken the recognition of deqi as the subject in the stud- ies. Through the historical analysis, the content of regulating deqi was further understood in relevant ancient liter- ature. By checking the ancient works of acupuncture in each dynasty till the end of Qing dynasty, in reference to the evidences in over 10 works, such as Zhenjiu Dacheng (Great Compendium of Acupuncture and Moxibustion) , Zhenjing Zhinan (Instruction of Acupuncture Canon), Zhenjiu Daquan, and in association with the academic views of acupuncture masters in modern time, it was discovered that the medical scholars after the time of Neijing and Nanjing had enriched the understandings of deqi, such as the connection of cold and heat reaction, radiation to the affected site, reinforcing and reducing purpose in qi regulation. The methods of deqi regulations had, been explored till the end of Qing dynasty since the time of Neijing and Nanjing and the understandings of it were vari- ous among scholars.
Acupuncture Therapy ; history ; methods ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Qi ; history ; Sensation