Abstract: Objective To study the expression of E-selectin on vascular endothelial cells of nude mice liver induced by esophageal carcinoma cells, in order to find out the function of E-selectin in the metastasis of esophageal carcinoma into the liver. Methods Twelve Balb/c nude mice aged from 6 to 8 weeks with their weight ranged between 20 and 25 grams were selected in our research. The mice were equally distributed into the experimental group and the control group(n=6). EC9706 cell solution (5×10.6/0.02 ml) were injected beneath the splenic capsule of the mice in the experimental group. One hour later, spleen was removed. For the mice in the control group, after laparotomy, phosphate buffer without EC 9706 was injected beneath the splenic capsule and spleen was also removed one hour after the injection. Eight hour later, we resected the liver of the nude mice, and expression of E-selectin on vascular endothelial cells of the liver was detected with reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC). Results In the experimental group, 8 hours after injection of EC9706 cells (5×10.6), the results of RT-PCR showed expression of E-selectin mRNA in the liver, and IHC showed a positive protein expression of E-selectin in the cytosol and membrane of hepatic sinus vessels.However, no E-selectin mRNA expression was found in the control group and IHC showed a negative protein expression of E-selectin. Conclusion Human esophageal carcinoma cell line EC9706 can induce balb/c mice liver vascular endothelial cell E-selectin expression, which shows that EC9706 may stay in the liver and form etastatic focus.
ObjectiveTo systematically review the current status of doctor-patient conflicts in China.MethodsWe searched CNKI and CSSCI databases to collect literatures about the doctor-patient conflicts from inception to April 23rd, 2017. The literatures were categorized by the published time, the high-frequency vocabulary, the citation frequency, the researching discipline, the researching facility, the quality of literature, the theme of literature and so on. The current research status of the doctor-patient conflicts was analyzed.ResultsA total of 226 literatures were included, in which 72 defined and classified the doctor-patient conflicts, 122 analyzed the causing reasons of doctor-patient conflicts, and 160 analyzed the governance paths of doctor-patient conflicts. The research disciplinary vision was limited to the policies, regulations and the medical education and so on, and the researches in psychology or economics disciplinary vision were insufficient. The medical and comprehensive universities were the main research units of the studies of the doctor-patient conflicts. The frequency and quality of the researches about doctor-patient conflicts were low.ConclusionThe classified studies of doctor-patient conflicts are insufficient, so the scientific and manageable classified criterions are needed in the further studies. Systematic studies in influential factors of doctor-patient conflicts are insufficient, so the occurring mechanisms of conflicts are needed to be done by systematical researches on patient-centered way. The studies of governance paths of doctor-patient conflicts are insufficient, so the strategies of classified and systematical management which according to the different conflicting forms and entire process of the conflict occurrence should be put forward.
ObjectiveTo investigate the application and effect of doctor-nurse collaboration model for patients undergoing day surgery of laparoscopic cholecystectomy. MethodsFrom April 2010 to October 2013, we established the day-case laparoscopic cholecystectomy rapid rehabilitation team by day-surgery ward nurses, anesthesiologists, and surgeons. Collaboration was practiced through preoperative health education for the 1 902 patients, perioperative nursing cooperation, postoperative early activity and feeding of the patients, and follow-up. ResultsAfter the operation, there were 8 cases of incision bleeding, 1 case of bile leakage, 8 cases of shoulder and back pain, and 12 cases of nausea and vomiting. All the patients' postoperitive complications were controlled after treatment. ConclusionThe doctor-nurse collaboration model can significantly ensure the medical quality and safety of day surgery and improve the patients' medical experience. All the Patients, hospital and society will benefit from the model.
Objective To investigate and assess the current status of communication between medical students and old patients so as to improve the communication skills of medical students. Methods A total of 90 medical students were surveyed by a questionnaire. Data analysis was performed with SPSS 13.0 software. Results Medical students have recognized the importance of communication with patients, but they rarely had active communication behaviors. In addition, their knowledge of communication skills was utterly inadequate. Conclusion It is necessary to strengthen the training of communication skills among medical students.
ObjectiveTo explore the effect of doctor-nurse-patient communication area established in the ward. MethodsBefore (July to September 2013) and three months after (October to December 2013) the establishment of doctor-nurse-patient communication area, 30 doctors, 30 nurses and 216 patients or their family members were respectively investigated by questionnaires and interviews, and the data were collected and compared by t test. ResultsThirty questionnaires for doctors, 30 for nurses and 216 for patients or their family members were issued before and after the establishment of doctor-nurse-patient communication area. The response rate for the questionnaires was 100%. After the implementation of doctor-nurse-patient communication area, the satisfaction of patients' family members, nurses' awareness of the patients' condition and implementation of health education were significantly higher than those before the implementation (P < 0.05). ConclusionThe doctor-nurse-patient communication area established in the surgical ward can promote the trust between the patients and medical staff, create a good atmosphere to understand the needs of patients, meet patients' demand as far as possible and improve communication ability of medical staff, which makes doctors, nurses and patients more satisfied.
Objective To provide scientific evidence for the establishment of medical specialist system in China by investigating the history, current situation, problems and countermeasures of medical specialties training at home and aboard. Method The principle and theroy of evidence-based medicine were adopted. The information before Dec. 31, 2003 of Pubmed, CBM, official website, some journals, most frequently used search engines and medical monograph were systematically reviewed. Included literatures were assessed and graded according to the pre-defined criterias. Results A total of 1 319 studies (1 298 in English, 21 in Chinese) were included, among which only 6 were related to the classification of medical specialties. Based on the information from official website of USA, Canada, UK, Singapore, Australia and China (including HK and Taiwan), it showed that China has the largest number of medical specialties, followed by that of USA. In China, the number of medical specialties has more than that of the disciplines in clinical field, which was followed by resident training programs. Some specialties were duplicate, or not international standardized. Conclusions The classification of medical specialties should be developed consecutively, which comprehensively considered the international trend, characteristics of doctor training and the current situation. Specialties whose training program are well-established and developed should initiate firstly. Others will be put into practice gradually after being fully exprienced.
ObjectiveTo evaluate the infiuence of doctor-nurse double check table applied before operation on the completion of preoperative preparation in gastrointestinal surgery department of class-three grade-one hospitals. MethodsA total of 647 selective operation patients from April to September 2013 in the Department of Gastrointestinal Surgery were divided into observation group (n=315) and control group (n=332) based on admission time. After training for medical staff, the check tables were filled, and relatively high frequency issues were followed up for quality tracking. The completion of preoperative preparation was compared between the two groups after operation. ResultsCompared with the control group, the completion of preoperative preparation and satisfaction of patients of the observation group were significantly higher and the operation delay was significantly lower (P<0.05). ConclusionPreoperative application of doctor-nurse double check table can significantly improve the completion rate of preoperative preparation, the operation delay phenomenon and satisfaction of patients, promote the communication between doctors and nurses, reduce the risk of operation, and ensure the safety of surgical patients.
ObjectiveTo study the status-quo of doctors' workload in China, analyze its influential factors, and to provide references for relevant policy-making. MethodsA multi-centre cross-sectional study was conducted. Clinical doctors who had worked for more than 6 months from 46 hospitals in 10 provinces were enrolled. The included doctors' workload was measured with working time per week and number of daily service patients. SPSS 20.0 software was used to analyze the data. ResultsA total of 1 537 doctors were included. The number of daily service outpatients and that of daily service inpatients per doctor were 22.17±20.95 person and 13.24±11.13 h, respectively. Working time per week were 54.06±10.76 h. The significant influential factors of the number of daily service outpatients were gender, employment relationship, hospital grade, age, professional title, and location; while those of the number of daily service inpatients were hospital grade, professional title, and location. Besides, type of department, hospital grade, doctor's age, education background and location were closely related to working time per week. ConclusionChinese doctors' workload is very heavy especially for long-time work. Hospitals and health departments should develop some target measures to reduce doctor's workload, so as to ensure medical safety.
【摘要】目的探讨新型医患沟通范式的临床价值。方法分析新型医患沟通范式的基本文书和临床应用效果。结果自2002年1月2009年12月,新型医患沟通范式应用于9800余例住院患者,无1起医疗事故发生。结论新型医患沟通范式从形式上和内容上对患者知情权进行了充分的保障,对构建和谐医患关系具有重大价值。【Abstract】Objective To explore the clinical value of new doctorpatient communication paradigms. Methods The primary documents and clinical application results of new doctorpatient communication paradigms were analyzed in our study. Results We applied the new doctorpatient communication paradigms to more than 9800 patients of inpatient from January 2001 to December 2009. No medical negligence was observed. Conclusion The new doctorpatient communication paradigms can ensure the patient’s right of informed consent in form and in content. Its value to construct harmony doctorpatient relationship is great.