Objective: This study aims to investigate the positive practice environments evaluation of doctors in public hospital and provide suggestions for Chinese health care reform from the perspective of health service providers.Methods: Using self-designed questionnaire, a national cross-sectional survey was performed in 77 public hospitals across seven provinces/ metropolis, involving a total of 3564 doctors.Positive practice environment includes organizational management and doctor-patient two-dimension relationships.Results: The doctor''s mean score of positive practice environment evaluation was 18.02±4.86 (out of 40).Doctors had a higher evaluation (score) of organizational management than doctor-patient relationship.In the organizational management dimension, the personal advice got the lowest scores(2.24±1.04);and in doctor-patient relations, evasion of medical risk got the lowest scores(1.59±0.81).There was a difference in the positive practice scores of physicians in different regions, and the scores of doctors from the western China were the lowest (P<0.001.Doctors from western medicine hospitals had lower evaluation of positive practice environments than ones from Chinese Traditional Medicine hospitals(P=0.002.Conclusion: As per the analysis conducted in this investigation, the current medical practice environment of doctors in China is not a promising one.Doctor-patient relationship is worse than organizational management.Hospitals should adopt a participatory decision-making model in management and establish a broadband performance based compensation to motivate junior doctors.Besides, government should establish reasonable compensation incentive mechanism, with the aim of promoting doctor-patient trust.

Objective To introduce a new management for ulcerative colitis. Methods There were eighteen patients underwent inferior mesenteric artery drug infusion who suffered from ulcerative colitis and cannot be cured by internal medicine. We observed the clinical symptoms and laboratory test results at the most resent follow up. Results All the patients’symptoms such as bellyache ,phrexia, abdominal distension were disappeared after interventional therapy. Diarrhea in seventeen patients was stopped. Fifteen patients who had blood stool were be cured. Erythrocyte and leucocyte were no longer be seen with stool laboratory test after drug infusion.Conclusion Inferior mesenteric artery drug infusion is another positively efficacy way for ulcerative colitis.

OBJECTIVETo investigate the therapeutic effect of glucocorticoids on the acute pulmonary edema in rats induced by nitrogen dioxide (NO₂).

METHODSThirty SD female rats were randomly equally divided into 5 groups: normal control group, NO₂ exposed group, high-, middle- and low-dose of glucocorticoids treated group (6 rats per group). 6 rats in the normal control group were exposed to room air for 30 min, and the other rats to NO₂. 18 rats in the glucocorticoids group were treated with different doses of dexamethasone (6.0, 3.0, 1.0 mg/kg), while the rats in the NO₂ poisoning group were treated with normal saline (2.5 mg/kg). The lung wet/dry (W/D) weight ratio was calculated, and plasma atrial natriuretic peptide (ANP) levels, superoxide dismutase (SOD) activity from whole blood, plasma interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-α (TNF-α) and Interferon-γ (IFN-γ) were detected by enzyme-linked immunosorbent assay (ELISA).

RESULTSThe lung W/D ratios were increased significantly in glucocorticoids treated group and NO₂-exposed group compared with normal control group (P < 0.05), while they were significantly reduced in glucocorticoids treated group as compared with NO₂-exposed group (P < 0.05). SOD activity in whole blood in glucocorticoids treated group and NO₂-exposed group was significantly lower than that of normal control group (P < 0.05), while it was no significant difference between that of glucocorticoids treated group and NO₂-exposed group (P > 0.05). Plasma ANP was significantly increased in NO₂-exposed group compared with normal control group (P < 0.05), while it was significantly decreased in glucocorticoids treated group compared with NO₂-exposed group (P > 0.05). Plasma TNF-α of high-, middle- and low-dose of glucocorticoids treated group [(27.04 ± 8.19), (40.10 ± 9.09), (39.76 ± 9.60) pg/ml] was decreased significantly as compared with NO₂-exposed group (68.55 ± 27.84 pg/ml) (P < 0.05). Plasma IL-6 in high- and middle-dose of glucocorticoids treated group [(15.97 ± 6.18), (19.69 ± 5.52) pg/ml] was significantly decreased as compared to NO₂-exposed group [(29.29 ± 9.31) pg/ml] (P < 0.05). Plasma IL-10 in high-, middle- and low-dose of glucocorticoids treated group [(23.24 ± 5.14), (27.78 ± 8.17), (33.29 ± 10.42) pg/ml] was significantly reduced compared with NO₂-exposed group [(44.38 ± 9.19) pg/ml] (P < 0.05). Plasma IFN-γ in high- and middle-dose of glucocorticoids treated group [(7.21 ± 4.55), (19.23 ± 4.35) pg/ml] was reduced compared with NO₂-exposed group [(30.83 ± 6.82) pg/ml] (P < 0.05).

CONCLUSIONHigh-, middle-, low-dose glucocorticoids all can improve the permeability of alveolar wall and capillary, and have nonspecific anti-inflammatory effects. The therapeutic effects on pulmonary edema are significant. High and middle dose of glucocorticoids treated group are more useful for decreased inflammatory factors.

Animals ; Disease Models, Animal ; Female ; Glucocorticoids ; therapeutic use ; Nitrogen Dioxide ; toxicity ; Pulmonary Edema ; chemically induced ; drug therapy ; Rats ; Rats, Sprague-Dawley

Adolescent ; Adult ; Benzene ; poisoning ; Female ; Humans ; Male ; Occupational Exposure ; Thrombocytopenia ; chemically induced ; immunology

Objective To explore the characteristics of the flow velocity waveform of superior vena cana (SVC) in a rat model with chronic monocrotaline-induced pulmonary hypertension by echocardiography.Methods The chronic pulmonary hypertension model was developed by monocrotaline solution (60 mg/kg) injection into the abdominal cavity in 32 SD rats.Eight rats with the placebo injected served as controls.An examination of the flow velocity waveform of SVC was performed by Doppler echocardiography via supraclavicular fossa before and 28-day after the injection.The pulmonary arterial systolic pressure was measured by pressure-guided micro-catheter 28-day after the injection both in the control and the pulmonary hypertension model group.Results Chronic monocrotaline-induced pulmonary hypertension was successfully developed in 29 rats.The flow velocity waveform of SVC showed that the ratio of the maximum reverse peak flow velocity due to atrial contraction (VAR) to the maximum systolic peak flow velocity (Vs) and VAR increased dramatically 28-day after the monocrotaline solution injection in both sides of SVC (P ＜0.01), while only the Vs of the right SVC significantly decreased (P ＜0.05).Conclusions The changes of VAR/Vs ratio and VAR in rat model with chronic monocrotaline-induced pulmonary hypertension suggested that the changes of flow velocity waveform of SVC have indicating features in reflecting pulmonary hypertension.

AIM: To evaluate the clinical results of capsular tension ring (CTR) implantation in phacoemulsification for eyes with congenital lens subluxation.METHODS: This study comprised 18 patients (31 eyes) with congenital ectopia lentis.All patients received phacoemulsification with CTR and intraocular lens (IOL) implantation.Visual acuity before and after surgery were examined.IOL decentration were measured with Image-Pro Plus image processing software.The complications were also recorded preoperatively and postoperatively.RESULTS: Uncorrected vision of all eyes increased after surgery, and all cases had different degree of IOL decentration after surgery.Two eyes received CTR scleral fixation 3mo after surgery because the IOL decentration aggravated during the follow-up period.CONCLUSION: Phacoemulsification with CTR and IOL implantation is effective and safe for congenital lens subluxation.The implantation of CTR increase the stability of the capsular bag, improve the safety of surgery, and maintain the right position of IOL.CTR scleral fixation is a effective supplement for progressive cases.

Objective:To investigate the accuracy of bony resection and component size planning of total knee arthroplasty (TKA) assisted with a novel designed patient-specific instrumentation (PSI).Methods:Thirty-eight TKAs assisted with a novel designed PSI of thirty-five patients from March 2018 to April 2019 were retrospectively analyzed. There were 11 males (10 knees) and 27 females (25 knees), aged 67.7±6.9 years (range 49-81 years). Intraoperative bone resection thicknesses at medial distal femur (MDF), lateral distal femur (LDF), medial posterior femur (MPF), lateral posterior femur (LPF), anterior femur (AF), medial tibial (MT), lateral tibial (LT) were measured with vernier caliper and compared with the preoperative planned bone resections as a primary outcome. The femur and tribal component sizes used intraoperatively were recorded and compared the preoperative planning.Results:The difference of thickness was -0.1±1.6 mm at MDF, -0.5±1.6 mm at LDF, 0.8±1.7 mm at MPF, 0.0±1.7 mm at LPF, 0.0±1.4 mm at AF, -0.3±1.4 mm at MT and 0.3±1.5 mm at LT. The ratio of differences <2 mm and <3mm were 87.8% and 93.94% at MDF, 87.8% and 93.94% at LDF, 71.3% and 85.71% at MPF, 77.14% and 91.43% at LPF, 88.46% and 100% at AF, 85.29% and 97.06% at MT, 83.78% and 94.59% at LT. 89.47% of femoral components were the same size with preoperative planning, 10.53% femoral components were within 0.5 size compared to the preoperative planning, no femoral components were over 0.5 size compared to the preoperative planning; 36.84% of tibial components were the same size with preoperative planning, 60.53% tibial components were within 0.5 size compared to the preoperative planning, 2.63% tibial components were within 1 size compared to the preoperative planning, notibial components were over 1 size compared to the preoperative planning.Conclusion:TKA assisted with a novel designed PSI shows good accuracy with bone resection and component size planning. The procedure of TKA could be simplified with this technique.

Objective To evaluate the clinical effect of retrievable esophageal covered metal internal stent in treating patients with achalasia.Methods Under DSA guidance,peroral"Z-type"double horn covered metal internal stent implantation was performed in 16 patients with achalasia.Esophagography was carried out about 28 days after the procedure and the stent was retrieved.Results Of 16 cases,the stent fell off into the stomach two weeks after the operation in one.And the stent was successfully replaced after it was taken out.The placed stent was successfully retrieved in all cases 28 days after the treatment.No serious complications occurred.All the patients were followed up for 3 months to 3 years.During the follow-up period restenosis of the esophagus developed in two cases(at one and 1.5 years respectively),and the restenosis degree was relived after balloon dilation.Clinically,no esophageal symptoms,such as dysphagia,occurred in all patients.Conclusion As a simple and safe technique,the retrievable esophageal covered metal internal stent implantation is very effective with fewer complications for the treatment of achalasia.Moreover,the technique carries lower restenosis occurrence.

OBJECTIVETo observe the clinical effect of chronic fatigue syndrome (CFS) treated with moxibustion at Gaohuang (BL 43).

METHODSWith stratified block randomization, 72 patients accorded with inclusive criteria were divided into a moxibustion at Gaohuang (BL 43) group (moxibustion group) and an acupuncture group, 36 cases in each one. In the moxibustion group, Gaohuang (BL 43) was treated with big moxa cones as the main acupoint, 10 cones a time; Qihai (CV 6) and Zusanli (ST 36) were added with big moxa cones, 7 cones a time. In the acupuncture group, acupoints were the same as those in the moxibustion group, and twirling reinforcing method was used after qi arriving, 60 times one minute and 360° with range. In the two groups, 10-day treatment was made into one course and there were two days between courses. The treatment was given once a day for 3 courses. Changes of fatigue assessment index (FAI) before and after treatment and clinical effects were observed.

RESULTSThe total effective rate was 88.9% (32/36) in the moxibustion group, which was better than 72.2% (26/36) in the acupuncture group apparently (P < 0.05). After treatment in the two groups, FAI scores were obviously declined compared with those before treatment (both P < 0.01) and FAI score in the moxibustion group was apparently lower than that in the acupuncture group (P < 0.05).

CONCLUSIONMoxibustion at Gaohuang (BL 43) can improve the FAI score of patients with CFS and the clinical efficacy is definite.

Acupuncture Points ; Adult ; Fatigue Syndrome, Chronic ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Adolescent ; Cysts ; complications ; Headache ; etiology ; Humans ; Male ; Nasal Septum ; pathology ; Nose Diseases ; complications