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Objective:To evaluate the current organizational capacity and maturity of private hospitals in China, in references improving their organizational capacity and promoting their sustainable development.Methods:The purposive sampling method was used from May to November 2019, and private hospitals of continuous operation for 5 years or above were selected for a questionnaire survey. Self-evaluation was made on the organization capacity of these hospitals in such 12 aspects as positioning, normalization, decision making, execution, supervision, marketing, coerciveness, risk exposure, innovation, learning capacity and leadership. Based on existing models, five levels of maturity models from low to high were established, namely that of business in difficulty, that of basic stable operation, that of stable development, that of expanding business, and that of independent branding.Factor analysis was used for structural efficiency analysis, the questionnaires were subject to a descriptive analysis, and a maturity scoring was obtained based on self-evaluation of organizational capacity.Results:A total of 45 non-public hospitals were investigated in this study, and 450 valid questionnaires were recovered. The factor analysis classified the organizational capacity into basic capacity, core capacity and development capacity. The organizational capability of the hospitals scored in average 4.14 points; the development capacity scoring(3.87 points) was lower than basic capacity(4.16 points) and core capacity(4.06 points). 80% of the private hospitals were in the basic stable stage or stable development stage.Conclusions:Private hospitals feature in general lower maturity, good basic capacity and core capacity, while they tend to have weak development capacity, not to mention innovation and construction of learning organizations.
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Objective:To investigate the changes of default network functional connectivity (FC) in resting state of patients with insomnia disorder (ID).Methods:Fifty-six patients with insomnia disorder and fifty healthy controls were recruited. All subjects were assessed with Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), Epworth sleepiness score (ESS) and Hamilton depression scale (HAMD-17). All subjects were scanned with resting state functional magnetic resonance imaging (rs-fMRI). SPM12 and CONN18b were used to preprocess rs-fMRI data on MATLAB (R2013b).The medial superior frontal gyrus was defined as the seed point, and the differences in the functional connection strength of the two groups of subjects were compared. Pearson correlation analysis was performed between the FC value of the brain area with statistical significance and scores of PSQI and ISI.Results:(1)FC analysis showed that compared with the control group, patients with ID had abnormal default mode network (DMN) connection, as follows: FC of left medial superior frontal gyrus and left central anterior gyrus (MNI: x, y, z=-30, -15, 51) and anterior cingulate gyrus (MNI: x, y, z=-6, 24, 36), FC of right medial forehead between the last gyrus and the left central anterior gyrus (MNI: x, y, z=-48, -6, 48), FC of left anterior cuneiform and the left central back (MNI: x, y, z=-54, -18, 54) and left superior occipital gyrus (MNI: x, y, z=-21, -69, 30), FC of right precuneus and left central posterior gyrus (MNI: x, y, z=-60, -21, 48) was enhanced. The FC of left anterior cuneiform lobe and the right middle frontal gyrus (MNI: x, y, z=42, 33, 42) and the right angular gyrus (MNI: x, y, z=54, -51, 45), FC of right precuneus and left inferior temporal gyrus (MNI: x, y, z=-51, -12, -42) was weakened. (2)With the left medial superior frontal gyrus as the seed point, FC values in anterior cingulate gyrus ( r=0.451, 0.338, both P<0.01) and left anterior central gyrus ( r=0.324, 0.402, both P<0.05) were positively correlated with PSQI and ISI scores. With the right precuneus as the seed point, FC value of left posterior central gyrus was positively correlated with PSQI( r=0.333, P=0.013) and ISI scores( r=0.418, P=0.008), while FC value of left inferior temporal gyrus was negatively correlated with PSQI( r=-0.662, P=0.001) and ISI scores( r=-0.402, P<0.01).With the left precuneus as the seed point, FC value of left superior occipital gyrus was positively correlated with PSQI( r=0.438, P=0.001) and ISI scores( r=0.495, P=0.011). Conclusion:Patients with ID may have changes in the functional connection of multiple networks. The decrease of FC in DMN may be one of the potential causes of insomnia. The increase in FC between DMN and the visuospatial attention network may be the core of the mechanism of damage to the brain function network of insomnia link.
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Objective@#To explore the effect of comprehensive functional exercise on re-intubation in hospitalized patients with critical muscle wasting.@*Methods@#A total of 92 patients with severe muscle atrophy who were treated in our hospital from January 2016 to 2018 were selected. According to the nursing method, the patients were divided into two groups, including 46 cases in the control group, routine muscle atrophy exercise, and 46 cases in the observation group. Comprehensive functional exercise was performed on the basis of the control group. The control group took regular muscle atrophy exercises, and the observation group took a comprehensive functional exercise on the basis of the control group. The reintubation rates at 48h, 72h, and 168h after extubation were compared between the two groups; the incidence of crisis, ventilator prevalence, occurrence rate, and off-line time were compared between the two groups; the health status of SF-36 was compared between the two groups.@*Results@#There were 0, 1, and 2 patients in the observation group at 48, 72, and 168h, and 5, 10, and 13 patients in the control group, respectively, with statistically significant differences (χ2=5.287, 8.364, 9.478, P < 0.05 or 0.01). The incidence rate of crisis, ventilator probability and complication rate were 8.70% (4/46), 4.35% (2/46) and 4.35% (2/46) in the observation group, and 23.91% (11/46), 30.23% (13/46) and 19.57% (9/46) in the control group, respectively. The difference was statistically significant (χ2=8.791, 9.478, 7.325, P < 0.05). The off-line time of the observation group was (107.22 ±10.98) h, and that of the control group (199.44 ±10.57) h, with statistically significant difference (t=2.413, P < 0.05). The SF-36 health status score of the observation group was respectively 36.12±10.44, 82.20±10.24, 40.43±16.14, 63.88±9.75, 82.06±10.11, and the control group was 26.68±17.66, 26.78±10.72, 42.18±8.79, and 68.92±9.65. The difference between the two groups was statistically significant (t=12.214-14.829, P<0.05).@*Conclusions@#Comprehensive functional exercise is beneficial to reduce the rate of intubation of patients with severe muscle atrophy, reduce the incidence of adverse events and improve the health of patients.
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Objective To explore the effect of comprehensive functional exercise on re-intubation in hospitalized patients with critical muscle wasting. Methods A total of 92 patients with severe muscle atrophy who were treated in our hospital from January 2016 to 2018 were selected. According to the nursing method, the patients were divided into two groups, including 46 cases in the control group, routine muscle atrophy exercise, and 46 cases in the observation group. Comprehensive functional exercise was performed on the basis of the control group. The control group took regular muscle atrophy exercises, and the observation group took a comprehensive functional exercise on the basis of the control group. The reintubation rates at 48h, 72h, and 168h after extubation were compared between the two groups; the incidence of crisis, ventilator prevalence, occurrence rate, and off-line time were compared between the two groups; the health status of SF-36 was compared between the two groups. Results There were 0, 1, and 2 patients in the observation group at 48, 72, and 168h, and 5, 10, and 13 patients in the control group, respectively, with statistically significant differences (χ2=5.287, 8.364, 9.478, P < 0.05 or 0.01). The incidence rate of crisis, ventilator probability and complication rate were 8.70% (4/46), 4.35% (2/46) and 4.35% (2/46) in the observation group, and 23.91% (11/46), 30.23% (13/46) and 19.57% (9/46) in the control group, respectively. The difference was statistically significant ( χ2=8.791, 9.478, 7.325, P<0.05). The off-line time of the observation group was (107.22 ±10.98) h, and that of the control group (199.44 ± 10.57) h, with statistically significant difference (t=2.413, P<0.05). The SF-36 health status score of the observation group was respectively 36.12±10.44, 82.20±10.24, 40.43±16.14, 63.88±9.75, 82.06±10.11, and the control group was 26.68 ± 17.66, 26.78 ± 10.72, 42.18 ± 8.79, and 68.92 ± 9.65. The difference between the two groups was statistically significant (t=12.214- 14.829, P＜0.05). Conclusions Comprehensive functional exercise is beneficial to reduce the rate of intubation of patients with severe muscle atrophy, reduce the incidence of adverse events and improve the health of patients.
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Objective:To investigate the characteristics of perceived stress and coping style and their relationship withsymptoms in college students with psychosis-risk syndrome (PRS).Methods:A two-stage screening process was conducted in 3160 college students.Participants were screened with 16-Item Version of the Prodromal Questionnaire (PQ-16).The students with scores of PQ-16 ≥9 were further interviewed with Structured Interview for Prodromal Syndromes (SIPS).Twenty-two individuals who met the criteria of PRS on SIPS were enrolled as the PRS group.The control group (n =22) were randomly selected from the participants with scores of PQ-16 ＜9 who were matched with age,gender and education level.Two groups were assessed with Chinese Perceived Stress Scale (CPSS),Trait Coping Style Questionnaire (TCSQ) and Self-rating depression scale (SDS) to measure subjective stress,coping style and depressive symptoms.Results:PRS group reported higher CPSS total scores [(34 ± 8)vs.(22 ± 8)] and negative coping styles scores [(35 ± 5)vs.(28 ± 7)],and lowerTCSQ positive coping styles scores [(31 ±6)vs.(37 ±4)] than the controls (Ps ＜0.05).The CPSS scores in PRS group were positively correlated with the scores of negative coping style (r =0.57,P ＜0.01),and the SDS scores were positively correlated with CPSS total scores and scores of negative coping style (r--0.86,0.66,Ps ＜ 0.01).There was no significant relation of psychosis-risk symptoms to scores of CPSS and TCSQ (P ＞0.05).Conclusion:It suggests that college students with PRS have a higher perceived stress and tend to use more negative coping style,which may be positively correlated with depression.
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Based on the analyses of the status of humanistic medicine education both at home and abroad, the article emphasized the need for the implement of medical humanities education with the whole process and multidisciplinary integration. In combination with practice, from the three modules of the ex-plicit curriculum, implicit curriculum and integrated curriculum, the author discussed the specific conno-tation of the whole course of medical humanities education. The article also summarized the main points of the course system in teaching practice from the aspects of training objectives, teaching staff construction, teaching methods improvement and innovation, and humanistic quality evaluation of medical students.
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Objective Research on the correlation of dyslipidemia of civil aviation pilots and the TCM constitution aimed to explore that how professional environmental affects the lipid metabolism and the constitution.MethodsMeasure the lipid statusand TCM constitution of 656 pilots, and 496 of them with dyslipidemia were studied. The sample were stratified according to the age and the types of dyslipidemia, including young and middle-aged groups, only abnormal total cholesterol metabolism (TC), only abnormal triglyceride metabolism (TG), and both abnormal cholesterol and triglycerides metabolism groups and then the differences in prevalence of traditional Chinese medicine in different groups were analyzed and discussed. ResultsThe prevalence of abnormal lipid metabolism was 75.61% in 656 pilots. The top three TCM constitutions among the pilot with dyslipidemia were phlegm dampness constitution (35.89%), dampness heat constitution (33.06%) and deficiency of Yang(20.97%). If age was not considered, the prevalence of TCM constitutions were not significantly different between the groups of only abnormal TC and TG (P>0.05), while the prevalence of Yang deficiency and dampness heat constitutions of only either TC or TG abnormal group were significantly higher than those of the group of both abnormal TC, TG (χ2 values were 6.793, 5.077, P<0.05). Take age as considered, TC metabolic abnormalities in youth group, the prevalence of damp heat constitution of the only TC abnormal group was higher than both TC, TG abnormal group (χ2=7.637,P<0.01); and the prevalence of Qi deficiency and Yang deficiency constitution of the only TG abnormal group were higher than both TC, TG abnormal group (χ2values were 6.139, 7.525,P<0.05). In the middle-aged group, the prevalences of Yang deficiency and Qi stagnation constitution of only TC abnormal group were higher than only TG abnormal group (χ2 values were 9.750, 3.922,P<0.05), and the prevalence of Yang deficiency of only TC abnormal group was higher than both TC, TG abnormal group (χ2=5.208,P<0.05). The prevalence of Yang deficiency of both TC, TG abnormal group was higher than only TG abnormal group (χ2= 4.489,P<0.05). Conclusions The result showed high prevalence of dyslipidemia in the population of civil aviation pilots. Age and lipid metabolism status could affect the types of TCM constitution. Damp-heat constitution was the common type of TCM constitution in the population of the young pilot, and Yang deficiency and Qi stagnation constitution were the common types in the population of middle-aged people whose lipid metabolism were disorder. The group of only abnormal TC influence on TCM constitution more than both abnormal TC and TG.
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Objective To explore the association between family function and self-esteem in college students.Methods Totally 2560 college students were sampled.They were assessed with the self-compiled questionnaire on family information,Rosenberg' s self-esteem scale (SES) and family assessment device (FAD).Results The students from only-child family (30.32±4.19) scored higher on SES than students with siblings (29.54±3.97).The students with experience of grandparents raising (29.84±4.19) scored lower on SES than students raised by parents (30.29±4.13).Students from harmonious family and with monthly incoming above 10000 Yuan scored higher on SES than other groups.All the differences were statistically significant (P＜0.01,P＜0.05).There was significant correlation between SES and all of the dimensions of FAD (r=-0.260-0.379,P=0.000).Multiple regression showed that such dimensions of FAD as role,communication,behavior control,problem solving and general functioning,as well as social economic status of the family played important role on self-esteem of the students(β=0.039-0.169,P＜0.01 orP＜0.05).Conclusion Family factors have significant impact on self-esteem of the college students,especially family role and communication which are important positive predictors on self-esteem of college students.
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Objective To investigate the effects of escitalopram (ESC)on the cognitive function,the expression of brain-derived neurotrophic factor (BDNF)in the hippocampus,the dendritic length and arborization and dendritic spines density of chronic cerebral ischemic rats.Methods Rats were randomly divided into sham-operation group,model group (permanent occlusion of bilateral common carotid arteries,2VO)and experimental group (treated with escitalopram at the dosage of 30 mg/kg·d).Rats were selected as study objects at week 1,2,4 and 8 after administration in each group.Their cognitive function was evaluated by the Morris water maze,the expression of BDNF protein was measured by Western blot,and dendritic morphology was studied by Golgi staining. Results In the Morris water maze test,the escape latency obviously extended in model group and experimental group compared with that in sham-operation group (P<0 .0 5 ),while the escape latency was shorter in experimental group than in model group (P<0.05).Compared with those in sham-operation group,the dendritic length and arborization and the density of dendritic spines in hippocampal CA1 significantly decreased in model group and experimental group (P<0 .0 5 ),while they increased significantly in experimental group compared with model group (P<0.05)by Golgi staining.Compared with sham-operation group,the expression of BDNF in the hippocampus of experimental group and model group significantly decreased (P<0 .0 5 ),but it increased significantly in experiment group compared with model group (P<0.05)by Western blot.Conclusion Escitalopram could significantly delay the progression of cognitive impairment induced by chronic cerebral ischemia in rats.The improvement of learning and memory may be related to the increased expression of BDNF.