1.Patient experience based key indicators for quality of care
Chinese Journal of Hospital Administration 2013;29(4):291-295
Objective To establish patient-experience based key indicators for quality of care.Methods Literature review,collection of proven surveys on patient experience and satisfaction,study of China's conditions,with demonstrations by experts team.Results A framework was built for patientexperience based key indicators on quality of care.Level-1 indicators within the framework are tangibility,reliability,responsiveness,assurance,care and continuity.There are 28 level-2 indicators and 83level-3 indicators.Conclusion Such key indicators are highly practical as the basis for developing the scale of patient experience.
2.An evaluation scale of medical services quality based on "patients' experience".
Chang-Jun, TIAN ; Yue, TIAN ; Liang, ZHANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(2):289-97
An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, collecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessing medical services quality.
3.Preliminary observations of differentially expressed genes in cholangiocarcinoma
Zhigang TIAN ; Zhi XU ; Liang ZHANG
Chinese Journal of Minimally Invasive Surgery 2001;0(05):-
Objective To analyze differentially expressed genes between hilar and distal cholangiocarcinoma and to clarify the molecular mechanism of tumorigenesis. Methods Gene-expression profiles of 3 samples of hilar cholangiocarcinoma and 4 samples of distal cholangiocarcinoma were analyzed using oligo microarray containing 21 329 genes. The differentially expressed genes between the two groups were analyzed using the Significance Analysis of Microarrays (SAM) in order to get the specifically differentially expressed genes. The gene expression presence was verified by real-time PCR (RT-PCR). Results A total of 725 genes of cholangiocarcinoma was regulated significantly compared to normal bile duct. Of them, 244 genes were upregulated and 399 genes were downregualted in both groups; on the other hand, 82 gene expressions between hilar and distal cholangiocarcinoma had significant differences (ratio ≥ 2.0 or ≤ 0.5). The SAM analysis showed that 40 genes, including AREG, EPHA2, SPP1, PACE4, and so on, were identified as differentially regulated between the two groups (q=0). Conclusions These data are helpful for a better understanding of the tumorigenesis of cholangiocarcinoma and contribute to the development of diagnostic and therapeutic strategies. The gene expressions between hilar and distal cholangiocarcinoma are significantly different, which suggests that the two tumors have different molecular mechanisms of tumorigenesis.
4.Distant metastases to maxillary sinus from an unknown lung adenocarcinoma: a cases report.
Wenqing LIANG ; Qianqian LI ; Tian ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2016;30(1):74-75
A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.
Adenocarcinoma
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diagnosis
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pathology
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Adenocarcinoma of Lung
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Bone Neoplasms
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secondary
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Humans
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Lung Neoplasms
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diagnosis
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pathology
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Male
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Maxillary Sinus
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pathology
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Middle Aged
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Nose Neoplasms
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secondary
5.Ethical Discussion in the Extraction of Teeth
Liang ZHAO ; Liping CAI ; Linkun ZHANG ; Jiangang TIAN ; Jianwei ZHANG
Chinese Medical Ethics 1994;0(06):-
Extraction of teeth is the most basic and widely used operation of oral and maxillofacial surgery. According to characteristics of extraction of teeth, the author views medical ethics principles which in the diagnoses and treatments process from the aspect of medical ethics, they are,①Doctors must intensify their own quality and self - cultivations and establish the idea of " People First ". ②Doctors must carry on the overall and systematic inspection, make the plan of diagnoses and treatments synthetically toimplement the idea of " People First ". ③Doctors should pay attention to interact with patient, meet different patients' demands and create the harmonious medical environment.
6.Chondrogenic differentiation of mouse bone marrow mesenchymal stem cells induced by cartilage-derived morphogenetic protein-2 in vitro.
Hongtao, TIAN ; Shuhua, YANG ; Liang, XU ; Yukun, ZHANG ; Weihua, XU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2007;27(4):429-32
To study the cartilage differentiation of mouse mesenchymal stem cells (MSCs) induced by cartilage-derived morphogenetic proteins-2 in vitro, the MSCs were isolated from mouse bone marrow and cultured in vitro. The cells in passage 3 were induced into chondrogenic differentiation with different concentrations of recombinant human cartilage-derived morphogenetic proteins-2 (0, 10, 20, 50 and 100 ng/mL). After 14 days of induction, morphology of cells was observed under phase-contrast microscope. Collagen II mRNA and protein were examined with RT-PCR, Western blotting and immunocytochemistry respectively and the sulfate glycosaminoglycan was measured by Alcian blue staining. RT-PCR showed that CDMP-2 could promote expression of collagen II mRNA in an dose-dependant manner, especially at the concentration of 50 ng/mL and 100 ng/mL. Immunocytochemistry and Western blotting revealed a similar change. Alcian blue staining exhibited deposition of typical cartilage extracellular matrix. Our results suggest that mouse bone marrow mesenchymal stem cells can differentiate into chondrogenic phonotype with the induction of CDMP-2 in vitro, which provides a basis for further research on the role of CDMP-2 in chondrogenesis.
Bone Marrow Cells/*cytology
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Bone Morphogenetic Proteins/*pharmacology
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Cell Differentiation/*drug effects
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Cells, Cultured
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Chondrocytes/*cytology
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Chondrogenesis/drug effects
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Chondrogenesis/physiology
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Mesenchymal Stem Cells/*cytology
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Recombinant Proteins/pharmacology
7.Analysis of intraocular lens power calculation for cataract patients with high myopia and posterior scleral staphyloma
Jing, SUN ; Si-tuo, LIANG ; Fang, TIAN ; Hong, ZHANG
Chinese Journal of Experimental Ophthalmology 2013;(6):578-581
Background The accurate calculation of intraocular lens (IOL) power is essential for attaining the desired refractive outcome after cataract surgery,especially for patients with high myopia and posterior scleral staphyloma.Objective This study was to evaluate the clinical feasibility of IOL Master compared with contact A-scan in cataract patients with high myopia and posterior scleral staphyloma,then compare the accuracy of different IOL power calculation formulas.Methods This was a prospective case control clinical research.Fourty-one eyes with age-related cataract of 28 patients underwent phacoemulsification with monofocal foldable IOL implantation in Tianjin Medical University Eye Hospital were involved,who were all high myopia with posterior scleral staphyloma.Preoperative measurement was measured with IOL Master as well as with contact A-scan and manual keratometry.IOL power was calculated according to the SRK-Ⅱ,SRK-T,Haigis,Hoffer Q,Holladay 1 formulas.The refractive outcome was followed-up 3 months after operation.Results The difference was significant between the 2 methods in axial length (AL) and anterior chamber depth (ACD) measurement (P =0.005,0.000) ; In corneal curvature measurement,there was no significant difference between them (P =0.398).When mean absolute refractive error (MAE) was divided by ±1.00 D,The SRK/T and Haigis formula performed better than other formulas measured by IOL Master;The Holladay 1,Hoffer Q and Haigis formula performed better than other formulas measured by contact A-scan combined with manual keratometry,respectively.Conclusions For cataract patients with high myopia and posterior scleral staphyloma,SRK/T and Haigis formula were recommended when employing IOL Master; whereas when using contact A-scan combined with manual keratometry,we prefer Holladay 1,Hoffer Q or Haigis formula.
8.Protective Effects of Insulin-glucose on Myocardium in Patients Receiving Combined Cardiac Valve Re-placement under Cardiopulmonary Bypass
Jianhua QIN ; Xuerong ZHANG ; Qingjun MA ; Liang HE ; Yongfang TIAN
China Pharmacy 2017;28(21):2915-2918
OBJECTIVE:To investigate the protective effects of insulin-glucose on myocardium in patients receiving cardiac valve replacement under cardiopulmonary bypass. METHODS:Totally 120 patients receiving combined cardiac valve replacement under cardiopulmonary bypass were divided into control group and observation group according to random number table,with 60 cases in each group. All patients were given routine operation. Control group was given Thomas cardioplegia and oxygenated blood with a ratio of 1:4(V:V)to protect myocardium at 4 ℃. Besides that,the observation group was additionally given Insulin injec-tion 10 IU/L and Glucose injection 10 g/L added into Thomas cardioplegia at 4 ℃ to protect myocardium. The levels of plasma brain natriuretic peptide(BNP)and cardiac troponinⅠ(cTnⅠ)before anesthesia induction(T0),at the end of cardiopulmonary by-pass(T1),12 h(T2),24 h(T3),48 h(T4),and 72 h(T5)after surgery,the rate of recovery of automatic heartbeat after opening aor-ta,the application of vasoactive agent(dopamine)at T1 and the occurrence of postoperative complications were observed and com-pared between 2 groups. RESULTS:At T0,there was no statistical significance in the levels of plasma BNP and cTnⅠ between 2 groups(P>0.05). The levels of plasma BNP and cTnⅠin 2 groups at T1-5 were significantly higher than T0,with statistical signifi-cance(P<0.05);the levels of cTnⅠ began to decrease at T4 and cTnⅠbegan to decrease at T5. However,the levels of BNP and cTnⅠwere significantly lower in observation group than in control group at T1-5,with statistical significance(P<0.05). After open-ing aorta,there was no statistical significance in the rate of recovery of automatic heartbeat between 2 groups(P>0.05). The dos-age of dopamine (at T1) and the incidence of complications in observation group were statistically lower than control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during or after surgery. CONCLUSIONS:Insulin-glucose can alleviate myocardial damage, reduce the dosage of vasoactive agent and the incidence of postoperative complications in pa-tients receiving combined cardiac valve replacement under cardiopulmonary bypass with significant protective effect on myocardium with good safety.
9.A clinical study of trazodone replacement treatment on benzodiazepine drugs dependence in senile patient
Liqun XIAO ; Peng LIAN ; Wangxin ZHANG ; Tian LIANG ; Ruilan ZHOU
Chinese Journal of Behavioral Medicine and Brain Science 2012;21(3):253-254
Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment while the other factor scores were not significantly changed.Trazodone wes effective without severe side effects and dependence.The study group showed significantly lower scores in learning,calculation,the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive function than after treatmemt (P < 0.05 ).Conclusion Trazodone is an ideal medicine to senile insomnia.
10.Efficacy of 125Ⅰ seed implantation as an adjunctive therapy for extrahepatic metastasis of primary hepatocellular carcinoma
Liang ZHANG ; Weijun FAN ; Ligang WANG ; Tian TANG
Chinese Journal of Radiology 2009;43(8):844-848
egrated interventional and minimally invasive therapy could improve the life and survival and it is an effective adjunctive therapy for primary hepatocellular carcinoma with metastasis outside the liver.