Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Urate oxidase (Uox) plays a pivotal role in uric acid (UA) degradation, and it has been applied in controlling serum UA level in clinical treatment of hyperuricemia (HUA). However, because Uox is a heterogenous protein to the human body, the immune rejections typically occur after intravenous administration, which greatly hampers the application of Uox-based agents. In this study, we used Lactococcus lactis NZ9000, a food-grade bacterium, as a host to express exogenous Uox genes, to generate the Uox-expressing engineered strains to treat HUA. Aspergillus flavus-derived Uox (aUox) and the "resurrected" human-derived Uox (hUox) were cloned into vector and expressed in NZ9000, to generate engineered strains, respectively. The engineered NZ9000 strains were confirmed to express Uox and showed UA-lowering activity in a time-dependent manner in vitro. Next, in an HUA mice model established by oral gavage of yeast paste, the UA levels were increased by 85.4% and 106.2% at day 7 and day 14. By contrast, in mice fed with NZ9000-aUox, the UA levels were increased by 39.5% and 48.3% while in mice fed with NZ9000-hUox were increased by 57.0% and 82.9%, suggesting a UA-lowering activity of both engineered strains. Furthermore, compared with allopurinol, the first-line agent for HUA treatment, mice fed with NZ9000-aUox exhibited comparable liver safety but better kidney safety than allopurinol, indicating that the use of engineered NZ9000 strains not only alleviated kidney injury caused by HUA, but could also avoided the risk of kidney injury elicited by using allopurinol. Collectively, our study offers an effective and safe therapeutic approach for HUA long-term treatment and controlling.
Animals ; Lactococcus lactis/metabolism* ; Urate Oxidase/genetics* ; Mice ; Uric Acid/blood* ; Hyperuricemia ; Humans ; Administration, Oral ; Aspergillus flavus/genetics* ; Male

OBJECTIVE To investigate the treatment plan for az treonam-resistant metallo- β-lactamase（MBL）-producing Enterobacteriaceae infection in pediatric solid organ transplant recipients. METHODS The clinical data of aztreonam-resistant MBL-producing Klebsiella pneumoniae caused intra-abdominal infection of an infant after liver transplantation were retrospectively analyzed. Abdominal infection occurred after operation. The pathogenic bacterium was MBL-producing K. pneumoniae . The drug sensitivity results showed that the infant was resistant to aztreonam. Based on the results of sensitivity test ，polymyxin B combined with tigecycline were selected as initial regimen. The treatment effect was poor ，with recurrent disease and shock spots. The clinical pharmacist assisted the clinician to formulate treatment regimen of ceftazidime avibactam 0.5 g，q8 h combined with aztreonam 0.18 g，q6 h. Relevant domestic and foreign literature were reviewed ，and the treatment plan of MBL-producing Enterobacteriaceae infection after solid organ transplantation was summarized. RESULTS & CONCLUSIONS The infant was finally cured and discharged with ceftazidime avibatan combined and aztreonam. Several foreign literature reported that ceftazidime avibactam combined with aztreonam could effectively treat the infection caused by aztreonam-resistant MBL-producing Enterobacteriaceae infection in patients with organ transplantation. It is expected to be an effective treatment for aztreonam-resistant MBL-producing Enterobacteriaceae infection in pediatric solid organ transplant recipients.

Cirrhotic portal hypertension can lead to serious complications including esophageal variceal bleeding. Hepatic venous pressure gradient (HVPG) and upper gastrointestinal endoscopy can be used to evaluate the severity of portal hypertension and predict the risk of bleeding. However, both methods are invasive, which limits their clinical practice. Therefore, noninvasive techniques for the evaluation of portal hypertension will have certain advantages in clinical practice. This article introduces the noninvasive methods for the measurement of spleen stiffness, including transient elastography, acoustic radiation force impulse, real-time tissue elastography, and magnetic resonance elastography, as well as the value of these methods in evaluation of portal hypertension and influencing factors. It is pointed out that the difference in the diagnostic efficiency of spleen stiffness measured by these methods in portal hypertension needs to be verified by further studies.

Hepatitis C virus (HCV)infection is one of the most common causes of chronic hepatitis,liver cirrhosis,and hepatocellular car-cinoma.MicroRNAs (miRNAs),a class of small,non -coding RNA,are involved in a variety of physiological and pathological processes in human bodies.The mechanism by which miRNAs regulate HCV replication is described,and the effects of liver -specific microRNA -122 antagonists on hepatitis C antiviral therapy are discussed.Our study indicates that miRNAs play an important regulatory role in HCV ex-pression.Targeting miRNAs may be a potential therapeutic approach for treating HCV infection,but further studies are still in need.

BACKGROUND:With the improvement of hemodialysis technology, the long-term survival rate of maintenance hemodialysis patients has been increased continual y. Nowadays, how to improve the quality of life in maintenance hemodialysis patients has been aroused widespread concern, and gradual y become the reliable indicator for comprehensive evaluation of the effect of hemodialysis. OBJECTIVE: To evaluate the effect of individualized intervention and col ective intervention on quality of life in maintenance hemodialysis patients. METHODS:Eighty maintenance hemodialysis patients, who had accepted more than 3 months of dialysis, were randomly divided into two groups (40 cases in the experimental group and 40 patients in the control group). Al the patients in the control group received 6 weeks of individualized intervention according to the pre-established schedule based on the hemodialysis routine care. Patients in the experimental group also have a period of six weeks of col ective intervention according to the pre-established weekly schedule based on the hemodialysis routine care. The quality of life of the patients was evaluated with MOS 36-item short form health survey and kidney disease quality of life short form before and after intervention. RESULTS AND CONCLUSION:After the intervention, both of the experimental group and the control group achieved significantly greater improvement than before in MOS 36-item short form health survey and kidney disease quality of life short form (P<0.01). The physical impact, overal health, emotional state, emotional impact, social function and energy of MOS 36-item short form health survey in the patients of the experimental group were higher than those of the control group after intervention (P<0.01);and the social quality, sleep, social support and patient satisfaction of kidney disease quality of life short form in the experimental group were higher than those in the control group (P<0.01). The results show that both individualized intervention and the col ective intervention based on the individualized intervention are effective in improving quality of life in maintenance hemodialysis patients and the col ective intervention can better improve the quality of life from physical, psychological and social aspects.

[Objective]This paper aimed at discussing the application of pulse in the clinical through the analysis of medical cases by Wang Mengying. [Methods]Revisited the theory and practice of pulse in the medical cases of Wang Mengying and discussed Wang's experience in the clinical application of pulse in the diagnosis and treatment of diseases such as protration syndrome and cholera.[Results]The pulse is better than the other three in the diagnosis of patients with etiology and pathogenesis.Pulse can reflect the situation of patients ’etiology and pathogenesis.The process of disease can be plumbed through pulse diagnosis. [Conclusion] Ancient doctor attached great importance to the pulse,it can guide our clinical practice better through the study of pulse in modern clinical work.

Objective To investigate the status quo of quality of life and family environment of children and adolescents with diabetes, also to explore the relationship between family environment and the quality of life, so as to give some support for family nursing. Methods A total of 58 diabetic children and adolescents were asked to complete Pediatric Quality of Life Inventory,meanwhile their parents were asked to complete the family environment scale, relativity of life quality of diabetic children and adolescents with family environment was analyzed. Results The physical function, school function, psychosocial health and total quality of life of diabetic children and adolescents' were lower than healthy children; family conflicts and control were higher than normal, while knowledge was lower than normal. Their quality of life was positively correlated with family knowledge and control, family control and success contributed a lot to life quality. Conclusions The health professionals should improve the communication between children and parents, sharing the diabetes responsibility, reduce the family conflict, in order to manage diabetes effectively and improve the quality of life.

Poly (3-hydroxybutyrate-co-3-hydroxyhexanoate, PHBHHx) has superior mechanical and biocompatibility that may enable it to meet cardiovascular tissue engineering applications. We developed hybrid materials based on decellularized xenogenic vascular scaffolds that were coated with PHBHHx to investigate the intravascular biocompatibility. The hybrid patches were implanted in the rabbit abdominal aorta (hybrid patch, n = 12). Only decellularized xenogenic vascular scaffolds were implanted without coating as control (uncoated patch, n = 12). The patches were explanted and examined histologically, and biochemically at 1, 4 and 12 weeks after the surgery. The hybrid patches maintained original shapes, covered by confluent layer of cells and had less calcification than uncoated control. The results indicated that PHBHHx coating reduced calcification, promoted the repopulation of hybrid patch with recipients cells. In conclusion, PHBHHx showed remarkable intravascular biocompatibility and would benefit endothelization which would be a useful candidate for lumen of cardiovascular tissue engineering.
3-Hydroxybutyric Acid ; chemistry ; Animals ; Aorta, Abdominal ; surgery ; Caproates ; chemistry ; Cell Adhesion ; Coated Materials, Biocompatible ; chemistry ; pharmacology ; Goats ; Humans ; Implants, Experimental ; Pulmonary Artery ; cytology ; drug effects ; Rabbits ; Surface Properties ; Tissue Engineering ; Tissue Scaffolds