Objective To understand the satisfaction degree of partial function outsourcing in a certain hospital of Xiaogan.Methods Through a questionnaire survey , SPSS20.0 was used to do statistical analysis .Results The satisfaction survey of outsourcing staff , the overall satisfaction rate was 9..7%, 96.5%after outsourcing .Investigation on medical quali-ty and patient satisfaction before and after the outsourcing and the outsourcing were 76.7%, after the outsourcing of 90.2%. Outsourcing personnel own happiness survey , assist doctors to job satisfaction was 91.0%, and on pay satisfaction was 82.5%, and turnover rate was 37.1%; Auxiliary nurses on the job satisfaction was 94.2%, and on pay satisfaction was 91.5%, and turnover rate was 29.4%.Conclusion Description of the survey , public hospitals under the limited re-sources, only to keep and develop the most competitive advantage of core resources , will be part of the non core outsourcing , which is adapt to the new management mode of market economy .It is the hospital to reduce costs , improve performance , to enhance the core competitiveness and enhance their adaptability to the environment , and all has the important practical signif-icance.

Objective To understand the current situation of endoscope disinfection and sterilization quality of the medicalinstitutions in Guangzhou , and provide evidence for improvement of disinfection surveillance and nosocomial infection control management in the area .Methods The field survey and sampling examination were used to monitor the cleaning and disinfection effect of endoscopes in the medical institutions in 3 years.Results The cleaning and disinfection management of endoscopes in the medical institutions of Guangzhou was nearly eligible .In 3 years, a total of 106 samples were examined continually .The average eligible rate of cleaning and disinfection effect of endoscopes was 90.0%.The eligible rates in 2012-2014 were 95.6%, 85.2%, 85.3%respectively, and the difference was not significant (χ2 =2.960, P>0.05); Among the different types of endoscopes , the qualified rates of the disinfection of the enteroscopes and the gastroscopes lumen were 83.3%, 92.1%respectively.The difference between the two was not significant;Using integrated endoscopic wash -infec-tion center and the use of four or five channel slot method for cleaning disinfection , qualified rate difference has no statistical significance (P>0.05);Both the concrntration of the disinfectants and the hygienic puality were pualified .Conclusion We should strengthen the disinfection supervision and monitoring and give some technical advices for medical institutions to improve the ability to prevent and control hospital infection .

Objective To investigate the application of extended nursing in patients with esophageal carcinoma . Methods 70 cases of patients with esophageal cancer from March 2015 to June 2016 in our hospital as the research object , according to the different nursing methods , 70 patients were randomly divided into control group and observation group , and the control group was given routine nursing , the observation group based on routine on the increase of nursing continuing nurs -ing care, nursing intervention after 6 months, compared two groups of patients with clinical effect .Results The patients in the observation group were better than the control group on health knowledge ;The complication rate of observation group was 34.3%, and the control group and the complication rate was 80%.The complication rate of the observation group was less than the control group;The observation group self care ability is better than the control group;The observation group satisfac-tion 94.3%;The control group satisfaction 65.7%, and the nursing satisfaction in the observation group are better than the control group;Two groups had significant differences , with statistical significance (P<0.05).Conclusion The continuous nursing intervention can effectively improve patients with esophageal carcinoma after discharge of quality of life , improve the self nursing ability of patients , reduce the incidence of complications , improve nursing satisfaction , which is conducive to the rehabilitation of patients , and is worthy of clinical application .

Objective Explore the clinical value of ultrasonography in the diagnosis of skeletal muscle injury in the Achilles tendon .Methods Select visit from March 2016 to March 2017 period in orthopedic hospital 56 patients with Achil-les tendon injury , using a random number table group , the experimental group using diagnostic ultrasound skeletal muscles of the control group using diagnostic methods MIR , and ultimately by surgery as a diagnostic criteria between the two groups of patients with the diagnosis .Results Diagnostic accuracy rate of the experimental group were 96.42%.Skeletal muscle ul-trasound display achilles tendon rupture 12 patients , 6 patients with chronic Achilles tendon hyperplasia , swelling of the A-chilles tendon 6 patients, the diagnostic accuracy of the control group were 92.86%.Skeletal muscle ultrasound display A-chilles tendon rupture in 10 patients, 8 patients with chronic Achilles tendon hyperplasia , swelling of the Achilles tendon 3 patients.The results between the two groups of patients was statistically significant , that is P<0.05.Conclusion Ultra-sound in the diagnosis of skeletal muscle tendon injury in a significant clinical effect , but also has an affordable price , easy to operate and less damage to human advantage .It should be introduced .

Through surveying the hospital′s operation situation and management process of the simple clinic , and outpatient quantity in January to March 2016, we discussed and analyzed the problem of the simple clinic when working , then promoted service process reengineering , so as to the hospital′s simple clinic come into being scientific , reasonable , system management model .

Objective To explore after brainstem stroke patients with dysphagia by modified balloon dilation of the clinical effect of treatment and before and after the treatment in patients with pharyngeal function change by swallowing angiog -raphy digital analysis method for analysis and evaluation .Methods 60 patients with dysphagia after collection of brainstem stroke in our hospital were randomly divided into two groups .Control group (30 cases) underwent routine dysphagia rehabili-tation training in the treatment , and the observation group of 30 cases in the control group on the basis of the treatment added with balloon dilatation for treatment .Comparative analysis of pharyngeal contraction rate ( PCR) and pharyngeal contraction time between two groups before and after treatment were assessed by swallowing and digital measurement .Results There was no significant differences in PCR between two groups of patients before treatment ( P>0.05 ) .Compared with before treat-ment, the two groups of patients after treatment with different food PCR were significantly improved , and the difference was statistically significant (P<0.05).The improvement degree of the observation group was more significant than the control group (P<0.05).There was no significant difference between the two groups of patients before treatment (P>0.05).Com-pared with before treatment and after treatment in two groups of patients with different swallowing food pharyngeal contraction duration were significantly improved , and the difference is statistically significant ( P<0.05 ) and to improve the degree of the observation group compared with the control group is more significant ( P<0.05 ) .Conclusion The digital analysis technology of swallowing angiography can effectively evaluate the changes of pharyngeal function in patients with dysphagia af -ter stroke.It is worth to be further popularized .

Objective The curative effect comparison of circumcision suture surgery and surgery foreskin cerclage ring.Methods Selection in our department from July 2013 to October 2016 were selected from children with phimosis or re-dundant prepuce in children with a total of 562 cases as the research object , randomly divided into control group (182 cases) and observation group (380 cases).The observation group using disposable circumcision suture treatment , the control group using prepuce ring resection in the treatment of patients , observe the operation effect , two postoperative pain and complica-tions.Results The observation group operation success rate ( 100%) was significantly higher than the control group (94.09%), observation group operation time , intraoperative bleeding volume , postoperative 24h pain scores were signifi-cantly less than the control group , the adverse reaction rate of observation group ( 6.32%) was significantly lower than the control group (11.54%),the differences between groups were significantly P<0.05.Conclusion Ircumcision surgery su-ture is better than that of ring foreskin cerclage surgery , more safe and reliable .

Objective To investigate efficient examination for early diagnosis of otitis meida woth effusion in pre-school children.Methods 169 cases (338 ears) with otitis media effusion in preschool children in our clinic were analyzed . All the data were analyzed retrospectively .All the pediatric patients complained symptoms related to rhinosinusitis and pediat-ric snoring while they had not been found hearing impairment .All the pediatric patients were diagnosed due to the history , special physical examination and acoustic impedance .And all the patients were divided into 3 groups:group 1 with rhinosi-nusitis, group 2 with pediatric snoring , and group 3 with rhinosinusitis and pediatric snoring .The incidence rates of otitis media with effusion were analyzed among the three groups and control group .Results The incidence rates for group1, group 2, group 3 and contrl group were 55.96%、48.08%、63.24%、11.19%respectively.According toχ2 test, there were signif-icant difference between group 3 and control group ( P<0.001 ) , respectively .But there was no difference among the three experimental groups(P>0.05).Conclusion Preschool children are high -risk population, which are attacked by otitis media with effusion .The primary factors include rhinosinusitis and pediatric snoring .Detailed history , careful special physi-cal examination and acoustic impedance are most useful for diagnosis .All the parents , kindergareners and physicians should pay attention to early symptoms , otherwise early diagnosis and early treatment will be missed .

Objective To observe the clinical efficacy of improved Gudaofang at different concentrations for the treatment of soft tissue damage so as to determine its optimal concentration.Methods 150 patients with open soft tissue damage treated in our hospital from June 2014 to June 2016 were randomly divided into treatment Group A (n=40) and Group B (n=40), Group C(n=30)and control Group D (n=40).Group A, Group B and Group C were treated with 10%, 20%, 30% of improved Gudaofang respectively, while the control Group D was treated with 75% of alcohol.Its clinical efficacy was evaluated by tenderness score and swelling degree.Results Compared with post-treatment, different concentrations of improved Gudaofang significantly reduced the tenderness score and swelling degree (P<0.05).The total effective rate of Group A, Group B, Group C were 92.5%, 97.5% and 97.5%, respectively, were significantly better than the control Group D with 77.5% (P<0.05).Conclusion Different concentrations of improved Gudaofang has a certain clinical efficacy on treating open soft tissue damage.20% concentration of improved Gudaofang has the best cost-effective and is optimal drug concentration.

Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.