深化门诊预约诊疗服务新模式的探讨

实行预约诊疗安排表工作模式,把患者预约就诊与科室诊治工作直接相连,将预约诊疗从门诊挂号深化至门诊医生诊查、检查、治疗、取药等各服务科室。通过多条预约渠道,提供按序号或按约定时间预约就诊方式,供患者自由选择。同时,配有全程的预约、诊疗进程信息公示、自动短信提醒,患者能够随时了解各诊室的工作安排、就诊患者人数、诊治实施情况,有效引导患者分时段、错峰就诊。     

导诊服务台对患者咨询问题分析及对策

门诊作为医院的重要窗口,是对病人进行早期有效诊治的重要场所,是确保医疗和护理质量的首要环节,同时门诊也是各种病人高度集中的场所。门诊的环境嘈杂、拥挤,人流动性大,且以患者为主。由于患者有病痛,行动不便,环境不熟悉,对医疗工作程序不了解等原因,均会加重就诊过程中的不便和精神负担。因此做好导医工作,为患者提供咨询服务,方便患者就诊是门诊护理工作的重要环节之一。现就本院患者对导诊服务台所咨询的问题进行随机统计分析,并提出相应对策。     

国内医院预约挂号的现状和建议

随着国家医疗改革的不断深入,卫生部针对国内大部分综合性医院门诊挂号拥挤的现象和因此导致的众多问题,推出了预约挂号的新政。预约挂号实行以来减轻了门诊拥挤,提高了诊疗效率,方便了患者就诊,但在实际推广仍有不足,因此需要推广实名制挂号、构建统一预约挂号平台、加强信用建设、完善医院管理创新、试行社区预约转诊等,实现预约挂号的"人性化、精细化、信息化、社会化"。     

公立医院实施多学科诊疗模式的SWOT分析

多学科诊疗（multidisciplinary diagnosis and treatment，MDT）将医疗资源合理、有效地进行组合，有利于提高诊疗效率，提升医疗服务质量和患者满意度。本文以广东省人民医院为例，以SWOT方式论述门诊和住院病区实施MDT模式的实践效果，为其他医院开展此项工作提供参考。     

人性化视角下医院急诊科“一站式服务”的实施与优化

为满足就诊患者及家属对高质量医疗服务的需求,提高急诊科室的医疗服务质量,减少医患冲突的发生,为急诊病人争取更多的抢救时间。针对当前急诊科存在的问题,设计并实施基于人性化角度的“一站式服务”方式与措施。“一站式服务”不仅提高医疗服务质量和效率,同时也简化了诊疗流程,增强了医务人员的服务意识,提高了患者的满意度。     

大型综合医院门诊分层级就诊模式探讨

针对大型综合性医院门诊病人多、初诊患者多、外地病人多和优质医疗资源供需矛盾等现状,通过回顾性分析华西医院完善分层级就诊的历程,结合现场调研,实现了以门诊初诊病人为重点,对分层级就诊的服务理念、层级结构、服务项目和服务流程进行了创新,缓解病人看病难问题,有效满足了门诊初诊病人分层级就诊的需求。     

分诊护士在内科门诊应急事件处理中的作用

医院门诊具有就诊患者多、病种多、人流量大的特点.大多数内科门诊患者可择期就诊,但有部分患者家属不了解危重病人应该到急诊救治,而选择门诊就诊,从而也增加了门诊医疗和护理的风险.在门诊临床工作中,时有突发事件的发生,如果患者病情得不到及时有效处理,极可能引发医患纠纷.本文对医院门诊分诊护士抢救急危重病人应急处理进行总结,其临床经验供临床医务人员参考.     

我国医院门诊多专科协作诊疗模式现状分析

随着医学学科不断细分,我国各家医院门诊逐渐从以往大内科、大外科的“一对多”诊疗模式转为专病、专科的“一对一”诊疗模式。但是“一对一”诊疗模式有其自身局限性,无法解决疑难杂症就诊不同专科的问题、患者来回奔波的困境。多专科协作诊疗的“多对一”诊疗模式是目前国际上积极倡导的新模式,其能给患者提供更加全面性、更加针对性的诊疗,但又因其人力成本高、不固定性强等特点,较难提高服务能力。对我国医院门诊的多专科协作诊疗模式进行现状分析,总结实践经验,为我国多专科协作诊疗模式的今后发展提供依据。     

基于排队论的门诊挂号收费窗口的配置

在国内,总能看到各大医院门诊都排着长长的队,究其原因是因为门诊工作量大,而医疗资源相对有限,当现有的医疗资源无法满足源源不断到来的病患时,就会不可避免的出现排队现象,这其中反映最为突出的就是挂号缴费等待时间长。本文将选取襄阳市某中医医院的实例,应用排队论的数学模型,分析该院门诊收费挂号窗口配置的合理性,为医院科学管理提供理论依据和指导,从而达到缩短患者就诊时间,提高服务满意度的目标。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

Physiological characteristics of various species of strains of carboxydobacteria

Seven strains of aerobic carbon monoxide-oxidizing bacteria (carboxydebacteria) when growing on CO as sole source of carbon and energy had doubling times which ranged from 12–42 h. The activity profiles obtained after discontinuous sucrose density gradient centrifugation indicated that the CO-oxidizing enzymes are soluble and the hydrogenases are membrane-bound in all strains examined. The CO-oxidizing enzymes of Pseudomonas carboxydohydrogena, Pseudomonas carboxydoflava, Comamonas compransoris, and the so far unidentified strains OM2, OM3, and OM4 had a molecular weight of 230,000; that of Achromobacter carboxydus amounted to 170,000. The molecular weights of the CO-oxidizing and H₂-oxidizing enzymes turned out to be identical. The cell sonicates were shown to catalyze the oxidation of both CO and H₂ with methylene blue, thionine, phenazine methosulfate, toluylene blue, dichlorophenolindophenol, cytochrome c or ferricyanide as electron acceptors. Methyl viologen, benzyl viologen, FAD⁺, FMN⁺, and NAD(P)⁺ were not reduced. The spectrum of electron acceptors was identical for all strains tested. Neither free formate, hydrogen nor oxygen gas were involved in the CO-oxidation reaction. Methylene blue was reduced by CO at a 1:1 molar ratio. The results indicate that CO-oxidation by carboxydobacteria is catalyzed by identical or similar enzymes and that the reaction obeys the equation CO+H₂OCO₂+2H⁺+2e^- as previously shown for Pseudomonas carboxydovorans.Dedicated to Otto Kandler remembering almost three decades of enjoyable cooperation     

Modulation of allostery of pyruvate kinase by shifting of an ensemble of microstates

Since the introduction of the concepts of allostery about four decades ago, much advancement has been made in elucidating the structure-function correlation in allostery. However, there are still a number of issues that remain unresolved. In this review we used mammalian pyruvate kinase (PK) as a model system to understand the role of protein dynamics in modulating cooperativity. PK has a triosephosphate isomerase (TIM)(α/β)₈ barrel structural motif. PK is an ideal system to address basic questions regarding regulatory mechanisms about this common (α/β)₈ structural motif. The simplest model accounting for all of the solution thermodynamic and kinetic data on ligand-enzyme interactions involves two conformational states, inactive E^T and active E^R. These conformational states are represented by domain movements. Further studies provide the first evidence for a differential effect of ligand binding on the dynamics of the structural elements, not major secondary structural changes. These data are consistent with our model that allosteric regulation of PK is the consequence of perturbation of the distribution of an ensemble of states in which the inactive E^T and active E^R represent the two extreme end states. Sequence differences and ligands can modulate the distribution of states leading to alterations of functions. The future work includes: defining the network of functionally connected residues; elucidating the chemical principles governing the sequence differences which affect functions; and probing the nature of mutations on the stability of the secondary structural elements, which in turn modulate allostery.