1.Establishing a harmonious doctor-patient relationship based on common values
Journal of Medical Postgraduates 2014;(4):405-407
Doctor-patient relationship is a special relationship between people in special circumstances during a special peri -od, which is directly related to the harmony and stability of society as well as people's quality of life.Values are the fundamental views of people, including the understanding of the nature , composition and standards of values .Doctors and patients are consistent in goals , interests and ideals , having the same objectives to overcome diseases , promote health , and prolong lives .They are essentially unified in values.However, there are some inharmonious phenomena in the relationship between doctors and patients .Efforts should be made to improve the present doctor-patient relationship by the whole society besides doctors and patients , aiming to establish a harmonious doctor-patient relationship of mutual respect , mutual trust , mutual tolerance and mutual cooperation on the basis of common values .
2.Medical model and perspectives for hospital development
Shuqiang XU ; Tieshan ZHANG ; Peng HAN
Chinese Journal of Hospital Administration 2013;(6):426-429
Medical model is the product of medical practice and crystallization of the essence of medicine and insights of life based on human being's fights against diseases for ages.Medical practice and medical model change fundamentally with the changing needs of human.being for health,having undergone for example from biomedical model to biopsychosocial(BPS)model.Thanks to perspectives of Epistemology and practice theory,the medical model is nourishing itself with BPS theories and methodologies for sustainable development,helping human being to better understand health and life multi-dimensionally.In such a model,individual hospitals will shift from focusing on disease care to provision of wholesome and sustained health services,while hospital systems will shift from coordination to resources reallocation and vertical integration.Thus the hospitals will gain new perspectives and broader horizon for development in the future.
3.Protective effects of erythropoietin by epidural injection on neurocyte apoptosis and relative proteins after spinal cord injury in rats
Shuqiang CHEN ; Youjia XU ; Chen YU
Orthopedic Journal of China 2006;0(18):-
[Objective]To investigate the protective effects of rhEPO on neuromotor function and apoptosis of neural cell,after it was peritoneally injected at different time in rats with traumatic spinal cord injury(SCI).[Method]A total of 48 adult male Sprague-Dawley rats weighting 270 ?10 g were randomly divided into four groups.Rats in normal group(n=6)and sham group(n=6)underwent laminectomy producure only.In control group,rats(n=18)received normal saline epidurally at 1,6 and 24 hours after injury.Treatment group(n=18)received 5000 iu/kg body weight of recombinant humane erythropoietin administered epidurally at 1,6 and 24 hours after injury.SCI was induced with 70g/cm impact according to the improved Allen method.Behavioral evaluation of the rats was made 48 hours after trauma using the Basso,Beattie,and Bresnahan(BBB)scoring system and Rivlin's tiltboard experiment.Injured spinal cord tissue cell apoptosis was examined by the terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end abeling(TUNEL)reaction at 48 hour.Fasl and Caspase-3 expression was determined by immunohistochemical analysis at 48 hours after injury.The results were observed by light microscope and analyzed by SPSS statistics software.[Result]Compared to the control group,neuromotor function was significantly improved at 1,6,and 24 hours after injury in the experiment group.The indexes of neural cell decreased significantly(P
4.Practice and insight for self-assessment in hospital accreditation
Jinghong DING ; Shuqiang XU ; Li ZHAO ; Xin ZHANG
Chinese Journal of Hospital Administration 2012;(11):808-810
The paper covered the self-assessment practices of the hospital in the new round of accreditation.These include principles of Promoting hospital development and reform,and Balancing accreditation and development,Emphasizing Quality,Safety,Service,Management,and Performance,Centering on patients,and Focusing on Quality of Care and Medical Care Performance.The hospital adopted such means as enhancing hospital internal development,building the hospital-department twotier management responsibility system,upgrading quality of care and safety,and promoting sustainable development.The self-assessment has improved and tested the construction of quality control system of the hospital,while a better system further supports the accreditation of the hospital on the other hand.
5.Effects of Acute Exhausted Exercise on the Myocardial HSP70 and Plasma ANP of Rats in a High Temperature Environment
Aiping LI ; Shuqiang CUI ; Jincheng XU ; Qi GAO ; Jiexiu ZHAO
Chinese Journal of Sports Medicine 2010;(2):188-191
Objective To investigate the effect of acute exhausted exercise in high temperature environment on the expression of myocardial HSP70 and plasma ANP level of in rats. Methods Forty eight male Sprague-Dawley rats was randomly and equally assigned to the following six groups:control group(C),exercise group(E),one-hour heat exposure group (H), heat exposure and exercise group (HE), exercise and 24 hours after exercise group(E'),heat exposure and 24 hours after exercise(HE'). Each group consisted of 8 rats. Rats in E,HE,E' and HE' ran on a treadmill until exhaustion, while rats in H and H' were exposed in a high temperature environment (33℃ ,50%RH) for one hour. Rats in C,E,HE and H were killed immediately after exercise or heat exposure. Rats in HE' and E' were killed 24 hours after exercise. Samples from myocardium and serum were collected for determining HSP70,ANP and CK-MB. Results(1) HSP70 levels in groups E and E' are significantly higher than that in group C(P<0.05 and P<0.01,respectively),and the level in group HE' is significantly higher than that in groups H and E'(P<0.01 );The HSP70 level in group H is significantly higher than that in group C. (2) The ANP and CK-MB levels in group E are Significantly higher than that in group C.and in group HE is higher than in group H (P<0.05);The HSP70 levels in group E' and HE' significantly decrease comparing to that in groups E and HE (P<0.01). Conclusions(1)Both heat exposure and exercise can induce the increased expression of myocardial HSP70 in rats and the peak expression is seen 24 hours after exercise. The increased expression of HSP70 may have protective effects on the heat-induced myocardial injury. (2) The increased ANP levels in plasma immediately after exhausted exercise improves the blood circulation in myocardium and hints the potential possibility of myocardial damage. However,the high temperature environment does not strengthen the increase of plasma ANP level that caused by exhaustive exercise.
6.Establishment of doctor-oriented j ob evaluation factor system for general hospitals and survey analyses on its reliability and validity
Yang WANG ; Dan ZHANG ; Shuqiang XU ; Tieshan ZHANG
Journal of Jilin University(Medicine Edition) 2014;(6):1308-1313
Objective To investigate the highly-recognized job evaluation factors among the doctors from tertiary general hospitals and to establish a doctor-oriented job evaluation factor system for general hospitals followed with the reliability and validity analyses.Methods A questionnaire about the highly-recognized 23 job evaluation factors was launched among 791 doctors by the stratified sampling from six tertiary general hospitals in Beijing,and the factors were from a job evaluation model of tertiary general hospitals.Initial factor solutions were obtained by the principal components analysis of all evaluation factors and the main factors whose eigenvalues were over one were extracted as evaluation dimensions. Factor loadings were attained through Varimax and the factor whose factor loading was lower than 0.5 was eliminated.A reliability analysis by calculating Cronbachαcoefficient and a validity analysis with structural equation modeling were sequentially conducted on the job evaluation factor system.Results A doctor-oriented job evaluation factor system for general hospitals including 22 factors subject to 3 dimensions was established while the factor of job relevance was removed. The internal consistency coefficients of the dimensions were greater than 0.8 according to the calculation of Cronbachα, which showed a nice reliability. Several main indexes for evaluating the model fitting were all close to 0.9,which indicated a fair structural validity. Conclusion A doctor-oriented job evaluation factor system for general hospitals is established with fair reliability and validity,which could provide more references to the job evaluation of the doctors in tertiary general hospitals.
7.Evaluation of the application of medical humanities care at three clinical departments of the hospital
Peng HAN ; Xiaoyun CHEN ; Tieshan ZHANG ; Zhongguang YU ; Shuqiang XU
Chinese Journal of Hospital Administration 2014;30(4):310-313
By means of literature review,expert interviews and experts sorting,the authors identified three approaches of medical humanities care,and applied them to three clinical departments of top ten incidence of medical disputes of the hospital in 2012.These departments have similar number of beds,and covered both internal medicine and surgery departments.The purposes of the study are to evaluate the effects of medical humanities care measures in clinical departments,and to make relevant thoughts and suggestions.
8.A Qualitative Research of Medical Humane Care in Improving Doctor-patient Relationship
Peng HAN ; Xiaoyun CHEN ; Tieshan ZHANG ; Zhongguang YU ; Shuqiang XU
Chinese Medical Ethics 2014;(2):284-287
Using the method of semi -structure interviews to pre-interview 6 experts and officially interview10 experts , then the record of the interview was compiled into the paper .Using the grounded theory method to encode material of the interview , a summary was made for each case base on data collation and analysis .This paper ana-lyzed the humanities concern the connotation of the application in the construction of a harmonious doctor -patient relationship and the specific measures .On the basis of the application of humanistic care in the construction of a harmonious doctor -patient relationship , significance and limitation is discussed .
9.Preventive effct of Aprotinin and TNF-α antibody on postoperative abdominal adhesion in mice
Yanling YANG ; Hualiang CAO ; Xiaoping XU ; Shuqiang YUE
Chinese Journal of Rehabilitation Theory and Practice 2003;9(3):189-190
ObjectiveTo study the effect of aprotinin and tumor necrosis factor alpha(TNF-α) antibody on preventing postoperative abdominal adhesion in mice.Methods96 BALB/c mice were randomly divided into 4 groups:normal saline group(n=24),aprotinin group(n=24),TNF-α antibody group(n=24),and aprotinin combined with TNF-α antibody group(n=24).After an identical peritoneal injury operation,all mice were treated intraperitoneally with normal saline , aprotinin,TNF-α antibody and aprotinin combined with TNF-α respectively at the time of abdominal closure .The mice were killed 20 days after operation,the abdominal incisions and the development of intraabdominal adhesions were observed.Adhesion score was based on an overall assessment of the extent,location,and type of adhesions .ResultsAprotinin combined with TNF-α antibody group showed significantly lower adhesion score and 2-3 grade adhesion(advanced significant adhesion) rate was lower than that of other groups(P<0.01).Conclusions The intraperitoneal administration of aprotinin and TNF-α antibody can inhibit postoperative adhesion formation.
10.Treatment of Alzheimer disease: an evidence-based review
Jungfang CHI ; Jianzhao NIU ; Shuqiang XU ; Jian LI ; Jifeng WANG ; Jianping LIU
Journal of Integrative Medicine 2007;5(3):247-54
OBJECTIVE: The purpose of this research was mainly two-fold: first, to get an understanding of current researches conducted on Alzheimer disease in China; second, to systematically evaluate and compare Alzheimer's treatment delivered by traditional Chinese medicine (TCM) and Western medicine. METHODS: Two steps were employed in this research. They were data collection and cleaning, followed by systemic review and qualitative analysis. The data were selected from the following two databases: CNKI (http://www.cnki.net) and Wanfang Data (http://www.wanfangdata.com.cn). Inclusion criteria were: (1) Chinese literature; (2) Published between year 1994 and year 2004; (3) Using TCM as treatment and Western medicine as control; (4) Similar research purposes and methodology; (5) Subjects were diagnosed as Alzheimer disease. Descriptive analysis, homogeneity test, meta analysis, sensitivity analysis and subgroup analysis were performed in the second step. RESULTS: Supposing all qualified studies were of high quality, we got the following conclusion: the advantage of TCM was losing because of the newly-developed acetylcholinesterase inhibitors came in market. Moreover, the studies conducted after year 2002 were more homogeneous in comparison with those conducted in early years. Those studies using mini-mental status examination (MMSE) as outcome measurement were also more homogeneous than non-MMSE measurement groups. Combined odds ratio in comparative studies was 1.5 fold higher than that in experimental studies. Regarding to different outcome measurement, those studies using TCM assessment profile were 2.58(4.79/1.86) fold higher than those using MMSE as outcome measurement. CONCLUSIONS: After systemic literature search, we found that only 40 out of 2,403 studies met our inclusion criteria. Moreover, those qualified studies were of low quality. Therefore, the external validity of this study would be compromised. The solution to this would be to improve study quality by strengthening study design and carefully select more homogeneous subjects in terms of syndrome differentiation, by so doing, the results of meta analysis will be more convincing and easily recognized by international society.