Objective:To investigate and analyze the current status of patient satisfaction and the influencing factors at private hospitals in Guizhou Province,and thus to provide a scientific basis for the management of medical service at private hospitals.Methods:The satisfaction scores were statistically described and analyzed by the factor analysis and multiple linear regression analysis.Results:The overall satisfaction score of patients was (3.87 ± 0.85),of which the satisfaction of medical technology,drug price,inspection fee,and medical facilities was lower.The factor analysis showed that satisfaction of patients at private hospitals could be classified into the environment,the quality of service,medical expense,and service flow.Multivariate linear regression results showed that its standardized partial regression coefficient by the parameter descending order followed as medical expense,the environment,the quality of service,and then service flow.Conclusions:Private hospitals should set up a fair medical expenditure mechanism,improve the environment and quality of medical services,and optimize service flow in order to improve patient satisfaction.

Aim To establish and evaluate the simple and effective animal model of rheumatoid arthritis in SD rats induced by heat-killed mycobacterium tuberculosis H37Ra(Mtb).Methods SD rats were immunized s.c.at the base of the tail with Mtb(1 mg/rat) in mineral oil,and then body weight,blood routine,clinical signs of arthritis were observed regularly.And also hind paw volume in SD rats with AA was tested.Meanwhile,T-lymphocyte subset was determined by flow cytometry in peripheral blood,the level of TNF-?in serum and IL-1 and IL-6 and vascular endothe-lial growth factor(VEGF) in joint tissue were tested by ELISA.The ankle pathological change and radiographic evidence of the hind paws of SD rats were observed to evaluate the AA model effects and availability in SD rats.Results When compared with normal control rats,the total number of white blood cells,platelets and monocytes in peripheral blood and ratio of CD4/CD8 was markedly raised after immunization with Mtb.But body weight of model rats was significantly low from day 14 to 28 after injection of Mtb.The inflammatory arthritic lesions such as edema and erythema in the paws appeared after 9～10 d.The peak of inflammation was 14～16 d.The level of TNF-?in serum and IL-1,IL-6 and VEGF in joint tissue was significantly higher in SD rats with Mtb than that in normal control rats at d 28.The histopathological examination revealed cellular infiltration,synovial and cartilage hyperplasia in ankle joints of SD rats.Conclusions The model induced by Mtb in SD rats is more similar in clinical characterization of rheumatoid arthritis in human being.It is a more efficient and simpler manipulative procedure for screening of new anti-arthritis drugs and experimental studying of anti-rheumatoid arthritis.

ObjectiveTo investigate whether early goal-directed therapy (EGDT) could improve the mortality rate in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed, Cochrane Library, Embase data, Wanfang data, and CNKI from January 1980 to May 2015. Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT), clinical controlled trial (CCT), case-control studies, cohort studies with complete data, which endpoints were the short-term mortality [in-hospital, intensive care unit (ICU) or 28-day] and long-term mortality (60-day, 90-day or 1 year). RevMan 5.2 software was used for Meta analysis of effect of EGDT on mortality rate in patients with severe sepsis or septic shock, and funnel plot was drawn to evaluate the quality of enrolled literature.Results There were 12 studies meeting inclusive criteria including 5 528 patients, 4 RCTs, 3 case-control studies, 4 cohort studies, and 1 quasi-experimental research. It was shown by Meta analysis that EGDT was associated with significant decrease in the short-term mortality [relative risk (RR) = 0.72, 95% confidence interval (95%CI) = 0.64-0.80,P< 0.000 01], but not associated with decrease of long-term mortality (RR = 0.99, 95%CI = 0.92-1.06,P = 0.81). The funnel plot showed that there was no publication bias. EGDT was recommended as grade C.Conclusions EGDT was associated with significant improvement in short-term mortality but not with long-term mortality in patients with severe sepsis or septic shock. Grade C was recommended by our study.

Object To develop a high-performance capillary electrophoresis method to determine ferulic acid concentrations in serum of rats treated with Buyang Huanwu Decoction (BHD). Methods Capillary zone electrophoresis was applied for ferulic acid assay, quantitative determination was based on internal standard and detection was carried on by direct UV. The electrolyte buffer was composed of 25 mmol/L borax-methanol (85∶15). Capillary electrophoresis was performed using a 52 cm (30 cm to detector)?50 ?m fused-silica capillary tube. Separation voltage was 20 kV, sampling time was 3 s, detection wavelength was 320 nm, and the temperature was 30 ℃. Results Ferulic acid was successfully separated within 6 min, the recoveries were 97.2% in serum and 103.28% in BHD, respectively. RSD were 3.73% and 0.91% (n=3), respectively. Conclusion This method can supply reference for the determination of ferulic acid in serum samples and BHD.

A strain ph 16 , that could effectively degrade phenol,was isolated from sewer sludge of printing and dyeing plant. The preliminary identification sugg ested that the strain belongs to Micrococcus sp. The strain could resist to phenol up to 1.5 g/L. The efficient biodegradation of phenol occurred when th e strain was cultured in the medium (pH 7.0) containing 1.0 g/L phenol under 35℃, wh er e the highest degradation rate reach 99.6% after 36 hours. This strain, when t re ated with some heavy metal ions such as Hg +、Co 2+ and Ag 2+ , showe d the significant inhibition of phenol degradation by 74.2%～100%. The kinetic s of phenol degradation during culture of the strain was also explored.

Objective To discuss the clinical outcomes of old fracture-dislocation of proximal interphalangeal joint treated with a self-made distraction external fixator which consists of 3 pins and rubbers.Methods From March 2005 to August 2011,8 cases of old fracture-dislocation of proximal interphalangeal joint treated with a pins-rubber distraction external fixator were retrospectively reviewed.There were 6 males and 2 females,aged from 17 to 58 years,averaged 23.2 years.The middle finger was involved in 5 cases and ring finger was involved in 3 cases.The right hand was affected in six patients,and the left hand was affectd in two patients.The mechanism of injury was sports injury in 6 cases,traffic injuries in 1,and sprain in 1.All of the cases were closed injury.The mean time from injury to surgery was 58 d (range,45-90 d).According to Schenck classification of the proximal interphalangeal joint fracture-dislocation,there were 4 cases of type Ⅰ,3 of type Ⅱ,I of type Ⅲ.Based on the Michigan Hand Outcomes Questionnaire (MHQ) for subjective hand function score,the average preoperative score was 56; the range of motion of proximal interphalangeal joint was 0°.Grip strength was 60％-80％ of the contralateral hand.Results The follow-up lasted 6-51 months,with a mean period of 20.5 months.Solid bone healing was eventually achieved in all patients.The average healing period was 3 months (range,2-5 months).The mean normalized MHQ score was 88 (range,84-92).Grip strength was 85％-100％ of the contralateral hand.Extension of proximal interphalangeal joint was -10°-0° (average,-5°).Flexion angle was 75°-100° (average,89.4°).Postoperative complications included slight joint space narrowing (2 cases),joint incongruity (＜ 1 mm) (2 cases) and fusiform arthrocele (2 cases).No infection,pin loosening,and pin breakage was encounted.Conclusion A pins-rubber distraction external fixator is a minimally invasive,reliable and effective treatment for old fracture-dislocation of proximal interphalangeal joint.

Objective To investigate the epidemiological and clinical characteristics, risk factors, outcome and prevention strategy of very low birth weight infant (VLBWI) with nosocomial infection in neonatal intensive care unit (NICU). Methods The VLBWIs whose birth weight were less than 1500 g and hospital stays were more than 48 hours in NICU of Peking University Third Hospital from January 1, 1998 to December 31, 2008 were selected in this study. They were divided into nosocomial infection group and non-infection group. The clinical features and outcomes of nosocomial infection were summarized and the risk factors of which were analyzed with Logistic regression. Results There were 158 VLBWIs who fit for the criteria of our study during the eleven years, the mean birth weight was (1263.8± 155.5) g and the mean gestational age was (30.4±2.1) weeks. There were 70 times and 56 cases suffered from nosocomial infections. The incidence of nosocomial infection was 35.4% and hospital stay-related incidence was 14.4‰. Among 70 times of infections, there were 40(57.1%) pneumonia, 22(31.4%) septicemia, 4(5.8%) thrush, 1(1.4%)conjunctivitis, 1 ( 1.4%) upper respiratory tract infection and 2 (2.9%) unknown site infections.Forty-one strains of bacteria were isolated from 121 specimens, among which gram-negative bacillus accounted for 56.1% and gram-positive cocci for 46.3%. The duration of hospital stay of VLBWIs with nosocomial infection was significantly longer than that without [(43.7±15.5) d vs (26.3±14.4) d] (t = -7.058, P＜0.01). The fatality rate of VLBWIs with and without nosocomial infection was 3.6% (2/56) and 3.9% (4/102), and there was no significant difference (x2 = 0.012,P＞0.05). Logistic regression showed that mechanical ventilation (OR = 3.388, 95% CI: 1.656-6.932, P=0.001) and parenteral nutrition (OR= 7.054, 95%CI: 2.005-24.813, P=0.002) were risk factors of nosocomial infection. Conclusions The incidence of nosocomial infection in VLBWIs in NICU is high. Mechanical ventilation and parenteral nutrition should be avoided and the duration of invasive operation and treatment should be shortened as much as possible to minimize the chances of nosocomial infection in VLBWIs.

In this paper, we describe a study on visualization of SW atlases. Firstly, data structures in axial, coronal and sagittal directions are generated by SW atlases' raw data after pre-processing. Secondly, we produce 3D SW atlases through setting gray intensity and spaces between slices. Thirdly, we integrate the atlas into the neurosurgery navigation system and realize the visualization of SW atlases. Finally, we realize brain anatomy structures labeling and real-time display in neurosurgery navigation system.
Anatomy, Artistic ; Brain Mapping ; Humans ; Neuronavigation ; methods ; Neurosurgery ; methods

OBJECTIVETo study the medium and long term effects of perfusion of bone marrow stromal stem cells through optional artery for the treatment of non-traumatic femoral head avascular necrosis.

METHODSFrom January 2000 to December 2004,62 cases(78 hips) with non-traumatic femoral head necrosis accepted optional artery marrow stromal stem cells infusion treatment and had complete follow-up data, including 43 hips of 35 males and 35 hips of 27 females with an average age of 36.3 years old (22 to 54). According to preoperative imaging data, 16 hips were ARCO I stage, 52 hips were II stage, 10 hips were III a stage. Harris score was 64.94 +/- 8.12 preoperatively. Postoperative Harris score at the last follow-up, imaging changes,DSA vascular changes were analysis.

RESULTSThe patients were followed up for 9 to 13 years (means 11 years). By the end of the follow-up, a total of 18 hips got artificial joint replacement, 10 hips of preoperative ARCO I, II period got artificial hip joint replacement, 8 hips of IIIa period got hip artificial joint replacement. Harris score was 71.21 +/- 0.19 at the end of the follow-up, it was obviously enhanced compared with preoperative. DSA showed blood vessels of supply the femoral head increased thickening.

CONCLUSIONPerfusion of bone marrow stromal stem cells through optional artery can effective treat non-traumatic femoral head necrosis of ARCO I, II period, it can make the femoral circumflex artery and its branches increased thickening.

Adult ; Angiography, Digital Subtraction ; Arthroplasty, Replacement, Hip ; Female ; Femur Head Necrosis ; therapy ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Middle Aged

Objective:To investigate the effects of high thoracic epidural anesthesia (HTEA) on the cerebral blood flow (CBF) and hippocampal apoptosis-related proteins Bcl-2 and Bax during global cerebral ischemia and reperfusion (GCI) in rats.Methods:Fifteen-minute global ischemia was established by 4-vessel occlusion and epidural catheterization was performed through T4-5 intervertebral spaces in adult male Wistar rats.According to the different drugs infused into the epidural space,the rats were randomly divided into four groups:Sham group (0.9 ％ NaC1),Sham-HTEA group (0.25 ％ bupivacaine),GCI group (global cerebral ischemia,0.9 ％ NaC1) and HTEA group (global cerebral ischemia,0.25 ％ bupivacaine).And 0.25 ％bupivacaine or 0.9 ％ saline (20 μL·h-1) was infused continuously to the thoracic epidural space from 15 minutes before ischemia to 24 hours after reperfusion.Mean arterial pressure (MAP),heart rate (HR) and cerebral blood flow (CBF) were determined until 2 hours after reperfusion,and the hippocampal Bcl-2 and Bax proteins at 24 hours after reperfusion were examined by Western-blot.Results:Compared with the GCI group,HTEA group has no significant difference on MAP and HR during ischemia and 2 hours after reperfusion,andcompared with the Sham group,MAP in GCI group increased in ischemia 0 min and decreased in reperfusion 0 min.The CBF in HTEA group was significantly lower than that in GCI group (123.1％± 35.2％ vs 177.5％± 32.4％,P＜0.01) in reperfusion 10 min,and higher than that in GCI group during the hypoperfusion of 60 to 120 minutes after reperfusion (P＜0.05),and the ratio of Bax/Bcl-2 in hippocampus was significantly decreased in HTEA group 24 hours after reperfusion (P＜0.01).Conclusions:Continuous HTEA infusion of 0.25 ％ bupivacaine 20 μL ·h-1 could maintain the hemodynamic stability,and improve the CBF of hypoperfusion period in rats,as well as reduce the ratio of Bax/Bcl-2 at 24 hours after reperfusion.