Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
The setting and adjustment of ventilator parameters need to rely on a large amount of clinical data and rich experience. This paper explored the problem of difficult decision-making of ventilator parameters due to the time-varying and sudden changes of clinical patient’s state, and proposed an expert knowledge-based strategies for ventilator parameter setting and stepless adaptive adjustment based on fuzzy control rule and neural network. Based on the method and the real-time physiological state of clinical patients, we generated a mechanical ventilation decision-making solution set with continuity and smoothness, and automatically provided explicit parameter adjustment suggestions to medical personnel. This method can solve the problems of low control precision and poor dynamic quality of the ventilator’s stepwise adjustment, handle multi-input control decision problems more rationally, and improve ventilation comfort for patients.
ObjectiveTo understand the cognition and mediation tendencies of health care workers in terms of third-party mediation for medical disputes, analyze the factors influencing the trust of both doctors and patients on third-party mediation, and propose suggestions on building third-party mediation mechanisms for medical disputes. MethodsBetween August and December 2012, we made the cognition questionnaire on third-party mediation for medical disputes based on the past medical literature, and the knowledge of doctor-patient relationship as well as third-party mediation agency's organizational structure (including locations and management authorities), staffing, mediation basis, validity sources and fund ensuring. We performed the random cluster sampling survey on all health care workers in five hospitals of different levels. The original data were put into the computer for statistical analysis by SPSS 18.0. ResultsThe knowledge of health care workers on third-party mediation was high. They believed that the best place for solving medical disputes should be the court or judicial administrative department, and the management authorities should be health administrative departments. In case of mediation failure, the majority of health care staff chose to continue to solve the dispute through legal channels. For the effectiveness of mediation conclusion, most health care workers tended to believe in the form of arbitration. They thought that mediators should have professional background of medicine and law; the majority of those surveyed doctors tended to accept forensic conclusions as a basis for mediation. For determining the compensation, doctors were in favor of Applicable Regulations for Medical Malpractice. Over 40% of medical staff believed that third-party mediation should be financed by government financial allocation, and more than half of the medical staff believed that it should be paid by the insurance company. ConclusionThird-party mediation should be set in and managed by the court or judicial and administrative departments. Mediator group should be formed by professionals of law and medical sciences. In the mediation process, it is recommended that the focus of controversy should be identified by forensic identification in order to form a clear division of responsibilities and high mediation efficiency. We recommend that the government introduce in financial allocations at all levels on the basis of medical liability insurance system, and force medical institutions to purchase medical liability insurance through the regulations of law, in order to provide funding support for the operation of third-party mediation organizations. Meanwhile, medical liability insurance companies should be operated under strict supervision to avoid their interference on the mediation work.
ObjectiveTo explore the expressions of glucose regulated protein (GRP) 78 and GRP94 in rectal adenocarcinoma and their clinical significances. MethodsIn 45 paraffin-embedded sections of rectal adenocarcinoma tissues and adjacent normal tissues, the expressions of GRP78 and GRP94 were examined by EnVisionTM. ResultsThe positive rates of GRP78 and GRP94 protein expression in the rectal adenocarcinoma tissues were 53.33% (24/45) and 53.33% (24/45), while those in the adjacent normal tissues were 13.33% (6/45) and 15.56% (7/45), respectively. There was a statistical significance of the expression of GRP78 or GRP94 between the tumor tissues and the adjacent normal tissues (all P < 0.001), and it was found that the positive expression rates were relevant to the extent of differentiation, Dukes stage, and lymph node metastasis of cancer (all P < 0.05), but not to the patient's sex, age, and size of tumor (all P > 0.05). And there was a statistical significance in Spearman method about the rate of positive expression between GRP78 and GRP94 (rs=0.464, P < 0.01). ConclusionGRP78 and GRP94 protein is highly expressed in rectal adenocarcinoma tissue, related to its metastasis and invasion, might be used as a useful indicator to judge the malignant degree.
Mitochondrial quality control includes mechanisms such as mitochondria-derived vesicles, fusion / fission and autophagy. These processes rely on the collaboration of a variety of key proteins in the inner and outer membranes of mitochondria to jointly regulate the morphological structure and functional integrity of mitochondria, repair mitochondrial damage, and maintain the homeostasis of their internal environment. The imbalance of mitochondrial quality control is associated with leukemia. Therefore, by exploring the mechanisms related to mitochondrial quality control of various leukemia cells and their interactions with immune cells and immune microenvironment, this article sought possible targets in the treatment of leukemia, providing new ideas for the immunotherapy of leukemia.
ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
ObjectiveTo understand the current situation of hospital infection management related to the hospital maternity ward, learn the risks of infection, discover problems existing in hospital infection management, and seek appropriate solutions for hospital infection. MethodsBetween January 2011 and December 2012, using uniform questionnaire for prospective survey and field interviews, we investigated the hospital infection situation in medical health care workers, pregnant women, and live newborns. ResultsA total of 2 225 questionnaires were retreated with a retreat rate of 100%. Hospital infection occurred in 23 cases, of which 15 cases were maternal infection (1.35%) and 8 cases were neonate infection (0.72%). Maternal infection was mainly focused on reproductive tract, surgery incision and urinary tract. Neonate infection was mainly focused on lower respiratory tract and skin. The management system of hospital infection in the maternity ward was basically strengthened, but the infection monitoring work was still not timely, and staff training in infection control knowledge was not in place. The overall environment, sterilization, disinfection and isolation should be strengthened, and there were also some other safety hazards. ConclusionThe management of infection in hospital maternity ward is the key to control the infection in maternity ward. The infection management seems perfect, but there are still some hidden dangers. The management system needs to be improved and the management should be implemented strictly according to the system, in order to avoid the occurrence of infection in maternity ward and ensure the safety of patients.
目的 调查四川省妇幼保健院医院感染发生情况及影响因素，以改进医院感染发病率监测方法与医院感染预防和控制措施。 方法 对2011年9月19日0：00～24：00所有住院患者进行调查，包括当日出院、转院、死亡的患者，但不包括新入院患者，使用全国医院感染监控网统一设计的调查表，采用床旁调查和查阅病历相结合，对调查结果进行统计分析。 结果 应调查住院患者112例，实际调查109例，实查率为97.3%；发生医院感染4例，现患率为3.7%。医院感染部位以呼吸道为主，抗菌药物使用率为64.2%。 结论 通过医院感染现患率调查，可以在短期内全面了解医院感染的现状，针对性的制定医院感染监控措施，预防和控制医院感染的发生。