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Objective:Based on the current medical environment, to learn about cognition status of doctor-patient relationship among medical students and analyze causes of the tension between doctors and patients.Methods:Using the self-designed questionnaire "Clinical Medical Students' Cognition Survey on Occupational Status and Doctor-Patient Relationship", a cross-sectional survey was conducted on 527 medical students from 5-year and 7-year clinical program in Batch 2014 in a medical university in Heilongjiang Province. The survey mainly analyzed the causes of the tension between doctors and patients from the level of medical staff, patients and their families, hospitals and society. SPSS 22.0 was used for descriptive statistics and chi-square test.Results:The results showed that 93.7% of the medical students believed that the current doctor-patient relationship was not harmonious. There were cognitive differences among medical students in different gender ( P=0.029), first contact clinical grade ( P=0.003) and professional identity ( P<0.001). Conclusion:Medical students have a poor evaluation towards the current doctor-patient relationship. In order to construct harmonious doctor-patient relationship in the future, we can try to take measures such as carrying out relevant courses of doctor-patient communication, improving the medical students' communication skills and enhancing their professional identity.
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Objective@#To develop a nursing quality index system for patients with continuous renal replacement therapy (CRRT) in ICU.@*Methods@#Based on evidence-based analysis, semi-structured interview, Delphi method and AHP method were adopted to determine the nursing quality indicator and indicators′weight in CRRT.@*Results@#The index system consisted of 8 first-level indicators, 22 second-level indicators, and 51 third-level indicators. After two rounds expert advisory, the effective response rates were 100.0%, 93.3%; authority coefficients were 0.84, 0.86; coefficients of concordance for first-level, second-level, third-level indicators were 0.686, 0.359, 0.196 at first round, and those were 0.688, 0.454, 0.273 at second round, and P values were all less than 0.01.@*Conclusion@#The nursing quality index system are scientific, comprehensive and practical, which can be applied to guarantee the implementation of CRRT treatment and patient safety.
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Objective To investigate the biomechanical properties of human calcaneus by finite element method. Methods Through CT scanning, Mimics, Geomagic and other software, the finite element model of calcaneus was established. The stress distribution and displacement tendency of calcaneus under normal standing and external force were analyzed. Results Under normal standing, the calcaneal stress was uniformly distributed and small. Under external force, the entire calcaneus stress increased significantly, and the stress on calcaneocuboid articular surface also obviously increased. Conclusions The analysis of the stress and strain distribution on calcaneus in neutral position under different loading, and the investigation on biomechanical properties of calcaneus and mechanism of calcaneal fracture will provide theoretical basis for clinical treatment of calcaneal fractures.
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Objective To translate The Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) into Chinese,and assess its reliability and validity in Chinese hospitalized patients. Methods The original PURPOSE-T was translated into Chinese and back translated and modified for cultural adaptation according to guidelines.The reliability and validity of the Chinese version of PURPOSE-T were tested in 230 hospitalized patients. Results The Chinese version of PURPOSE-T consists of three parts and contains 25 entries. The inter-rater consistency Kappa coefficient was 0.798, the weighted Kappa coefficient was 0.843. The evaluation results were compared with binary variables with a Kappa coefficient of 0.745. The test-retest reliability Kappa coefficient and the weighted Kappa coefficient were 0.863 and 0.892. Two classified assessment Kappa coefficient was 0.857. The item content validity index ranged from 0.83 to 1.00, and the scale content validity index was 0.98. The phi correlation coefficient of PURPOSE-T and Braden scale was 0.781; the phi correlation coefficient of Waterlow Scale evaluation result was 0.777. The correlation coefficient between Chinese PURPOSE-T items and Braden scale items ranged from 0.605 to 0.877 (P<0.01), and the Waterlow Scale items ranged from 0.599 to 0.887 (P<0.01). Conclusions The Chinese version of PURPOSE-T appears to possess adequate validity, test-retest reliability and internal consistency. The newly translated Chinese version of PURPOSE-T may be used to assess the risk of pressure injury in inpatients in China.
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Objective To explore the research hotspots of critical care nursing in recent 5 years. Methods Based on PubMed, articles published during the last 5 years were retrieved using the MeSH termCritical Care Nursing. Bicomb 2.0 and SPSS 20.0 software were used to do word frequency analysis and co-word cluster analysis. Results A total of 826 articles were retrieved. With the top 42 keywords as high frequency keywords, 6 hotspots were extracted, including the allocation of critical care nurse staffing, attitudes and psychological experiences of people related to critical care nursing, competency of critical care nurses, evidence-based nursing practice, new techniques and methods of critical care nursing, and communication among critical care nurses, patients as well as patients′relatives. Conclusions Using co-word analysis, this study analyzed the hotspots of critical care nursing in recent 5 years. The results not only help researchers and clinical practitioners understand the current status of critical care nursing research, but also provide references for new developing studies and clinical practices.
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<p><b>BACKGROUND</b>Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis, and plays a key role in the pathogenesis of diabetic retinopathy (DR). This study was designed to identify the possible role of VEGF gene polymorphisms in the development of DR in type 2 diabetic patients in Chinese and clarify the relationship between VEGF serum levels and the risk of DR.</p><p><b>METHODS</b>This cross-sectional study included 1 040 Chinese subjects with type 2 diabetes mellitus. There were 372 patients diagnosed with DR in the case group and 668 patients without DR in the control group. DNA from each patient was analyzed for VEGF polymorphisms of -2578A/C (rs699947), -1154G/A (rs1570360), -460C/T (rs833061), +405C/G (rs2010963), and +936C/T (rs3025039) using MassARRAY compact analyzer. The VEGF serum levels were quantified by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>No evidence of association was observed between -2578 A/C (rs699947), +405C/G (rs2010963), +936C/T (rs3025039), and DR risk under stringent Bonferroni's correction. However, VEGF serum levels were significantly higher in DR patients than those of control group. The genetic variation of VEGF polymorphisms influenced VEGF serum levels; subjects carrying the VEGF -2578 C/C (rs699947) genotype had greater VEGF serum levels than those carrying the C/A genotype and VEGF serum levels were significantly higher in CC genotype of the +405C/G (rs2010963) compared with those of the other genotypes.</p><p><b>CONCLUSIONS</b>The data did not suggest significant association between the VEGF polymorphisms and DR risk under stringent Bonferroni's correction. However, our study indicated that DR patients have higher VEGF levels than diabetic patients without retinopathy, and -2578A/C (rs699947) and +405C/G (rs2010963) may be important factors in determining serum VEGF levels.</p>
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Aged , Female , Humans , Male , Asian People , Genetics , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Blood , Genetics , Polymorphism, Genetic , Vascular Endothelial Growth Factor A , Blood , GeneticsABSTRACT
Objective:To measure the salary satisfaction level of medical staff in county-level public hospitals and provide reference for the design of policy reforms. Method:Eight county-level public hospitals were investigated. All analyses were performed using SPSS 19. 0 via statistical description and binary logistic regression. Results: The total salary satisfaction of the medical staff was 48 . 8%, and the average score was 54 . 05 ± 18 . 04 . The welfare satis-faction is the lowest (38. 8%), and the average score is 7. 98 ± 3. 51. Logistic regression analysis shows that the ac-ademic degree, department category, working hours per week, acceptance of bribes, and officially budgeted posts are the main factors affecting overall compensation satisfaction. Conclusion:The overall salary satisfaction level of medi-cal staff in county-level public hospitals is very low, and the welfare satisfaction is the lowest. Establishing the rea-sonable level of compensation, the rise of compensation, and the welfare mechanism are feasible choices to improve salary satisfaction.
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<p><b>BACKGROUND</b>Numerous studies have investigated the association between adiponectin concentrations and diabetic retinopathy (DR) caused by type 2 diabetic mellitus. However, the results remain conflicting. We performed a meta-analysis to explore the relationship between adiponectin concentrations and risk of DR caused by type 2 diabetic mellitus from published articles.</p><p><b>METHODS</b>A published literature search was performed through the PubMed, Cochrane Library, EMBASE, Science Citation Index Expanded database, Chinese CNKI, and Chinese Wan Fang databases for articles published in English and Chinese. Pooled standardized mean differences (SMDs) and 95% confidence intervals (95% CIs) were calculated using random or fixed effects model. Heterogeneity between studies was assessed using the Cochrane Q test and I(2) statistics.</p><p><b>RESULTS</b>Nineteen studies with a total of 1 545 cases and 1 502 controls were retrieved. The original meta-analysis found a significant difference in the adiponectin concentrations between the DR and non-DR (NDR) groups. After excluding the high heterogeneity studies, the second meta-analysis also demonstrated the significant association (SMD (95% CI) = -0.62 (-0.80 to -0.44), P = 0.0001). According to the available data, there was statistical significance in the adiponectin concentrations considering non-proliferative DR (NPDR) versus NDR, PDR versus NPDR in Chinese populations with high heterogeneity.</p><p><b>CONCLUSION</b>Adiponectin concentrations are correlated with DR; however, the relationship between adiponectin concentrations and DR needs more in-depth investigations with larger sample sizes.</p>
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Adiponectin , Blood , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , BloodABSTRACT
Objective: To analyze the constitution of hospitalization expenses and provide evidence for controlling unreasonable increase of medical costs. Methods: To compare the medical expense constitution of cerebral infarction patients with and without medical insurance; interview the doctors, patients and the medical insurance managers of medical insurance, analyze the influencing factors of the expense through combining the result of interview and quantitative data. Results: The patients with medical insurance spent higher expense than their counterparts, the per capita cost of medical insurance increase by year. Through analyzing the constitution of hospitalization cost, medicine fee and examination cost are the major medical costs. Conclusion: The costs of patients with medical insurance have over-treatment problem, which could be controlled by changing payment method and strengthening management.