预约挂号平台出票客户端的设计与应用

目的 为预约挂号患者提供出票服务,分流挂号窗口排队人群。方法 设计预约挂号出票客户端,自助服务与人工服务相结合,合理规划业务流程。结果 预约挂号患者不需在挂号窗口排队,可为预约挂号患者提供24小时多地点自助出票服务,同时实现医院对预约挂号第三方支付的财务监管。结论 预约挂号出票客户端极大地方便了患者及医院,具有较好的可行性。     

北京某医院2007 —2008年急诊患者就诊及付费行为模式分析

目的 分析急诊患者就诊及付费行为模式。方法 定义内急诊就诊流程,计算急诊挂号人次数分布情况等。结果 医院急诊量大,患者缴费次数多。结论 预交金付费模式是改变传统就诊模式、优化医疗服务流程、减少患者排队拥堵现象的可行措施。     

北京某三甲医院预约挂号满意度及影响因素调查

目的 改进医院预约挂号服务工作,完善预约挂号流程,进一步满足患者需求。方法 以2011年6月对通过网络、电话预约挂号的方式成功挂号的患者为调查对象,采用问卷调查方法,由经过培训的调查员进行调查,采用Epidata3.0软件进行数据录入,采用SPSS13.0进行统计分析。结果 对网络、电话预约挂号不满意的有57.4%,不满意的原因主要集中在取号环节上,80%多的患者是通过媒体和医院的宣传知道预约挂号的,但外地患者不足10%。结论 医院试行的网络、电话预约挂号方式具有一定的现实可行性,但是在取号环节及宣传预约挂号的方面,具有一定的欠缺,需要进一步完善和优化。     

医院门诊自助服务系统使用率的多因素分析

目的 探索医院门诊一站式自助服务系统在不同干预措施下的使用情况和使用患者的反馈。方法 2015年1—12月通过对门诊进行未干预、3种单独干预各1月、两种较强联合干预和全线干预后,计算自助服务系统的使用人次和使用人次占比,之后对患者进行问卷随访,比较患者的满意度、机器正常运行率和节省的时间。结果 在入口处设置醒目标识提示自助服务系统,多途径宣传一站式服务并且在自助机旁配备充足的指导人员的自助服务系统使用率相对最高。结论 自助服务系统使用率的提升不仅需要多途径、多层次,还需要门诊管理者在必要的时机进行适当的策略调整以取得有效模式来配合门诊运转。

     

门诊患者医疗服务感受度影响因素研究

??????? 目的 了解门诊患者对就医服务感受度影响因素,以期提高患者满意度。 方法 现场问卷调查法、专家访谈法。 结果 患者在门诊过程中最为关注的就诊流程、等候时间、就医环境、医德医风四个因素,非常看重医护人员服务规范,服务流程便捷流畅。病情不同患者对等候时间要求不同,对医院熟悉程度与就诊环境感受度不同。结论 在门诊服务中为患者提供便捷流畅、规范化的服务,同时应注重患者的不同服务需求。     

“互联网+”背景下医院挂号缴费模式的机遇与挑战

随着“互联网+”的推广及普遍应用,基于互联网的信息技术在医疗服务行业迅速发展。网络预约挂号和移动支付等挂号缴费新模式的推行为解决医院“三长一短”的问题带来了新的契机。通过对“互联网+”背景下医院在挂号、缴费等方面的现状研究,提出了新模式下可能存在的问题及改进建议。

     

专家门诊预约挂号影响因素分析

??????? 目的 初步探讨影响专家预约挂号率的原因及相应对策。方法 以SPSS 13.0软件分析2012年4月—2013年1月专家门诊情况与预约挂号率的关系。结果 不同门诊时间（季度、周别、午别）、不同专科、不同专家、不同门诊级别以及挂号率与号源使用率对我院专家门诊预约挂号率均有影响。结论 影响专家门诊预约挂号率的因素是多方面的，需采取综合措施，加强医院核心竞争力才是根本。     

某三甲医院医疗服务质量患者感知要素调查

目的 以医用“SERVQUAL理论为基础,根据医院实际重新设计了”SERVQUAL模型‘（服务质量差距模型“各条目,对与”SERVQUAL模型“ 在医疗服务质量评价中的应用进行探讨。方法 以北京市某医院117名患者及48位医务人员为对象,采用问卷调查的方法,测算患者对医院服务质量的SQ值（患者对于医疗服务的期望程度与实际感受程度之差）及医务人员的服务自我评价。结果 患者对医院服务质量的SQ值呈现了其在对医院医疗服务的感知与期望间有较大的差距,并通过医患之间的数据对比阐明医务人员所提供的服务质量与患者所感受的服务质量间同样存在差异。结论 SERVQUAL模型是一种从患者角度评价服务质量的方法,可以结合患者对于医疗服务的期望和实际感受,科学地了解患者对医疗服务的满意程度,并据此发现医疗服务中的薄弱环节。     

Photoinhibition in the Antarctic moss Grimmia antarctici Card when exposed to cycles of freezing and thawing

Freezing and thawing of the endemic moss species Grimmia antarctici Card, caused photoinhibition. When snow cover was removed from moss in the field, resulting in exposure to fluctuating temperatures and light conditions, photoinhibition, measured as a reduction in the ratio of variable to maximum chlorophyll a fluorescence (F_v/F_m), was observed. The extent of photoinhibition was highly variable and appeared to be reversible during periods of warmer temperatures. A series of controlled laboratory studies found that the light conditions that prevail between freezing and thawing events influenced the recovery from photoinhibition observed during freezing and thawing, with low light conditions facilitating the greatest rates of recovery. After four cycles of freezing and thawing, recovery from photoinhibition in hydrated moss was achieved within 12 h of transfer to 5°C and 15 μmol quanta m^?2 s^?1. These results favour the hypothesis that photoinhibition observed during freezing represents a protective process involving the down-regulation of photo-system II when photosynthetic carbon assimilation is limited by low temperatures.     

The role of Card9 overexpression in peripheral blood mononuclear cells from patients with aseptic acute pancreatitis

Activated mononuclear cells are an early event in the course of severe acute pancreatitis (SAP). To date, the molecular mechanism triggering peripheral blood mononuclear cells (PBMCs) is poorly understood. The aim of this paper was to determine the potential role of Card9 in SAP. We collected data from 72 subjects between January 2013 and June 2014. Subsequently, PBMCs were isolated on day 1, 3 and 5 of pancreatitis. Immunofluorescence staining, quantitative real‐time PCR, Western blotting, immunoprecipitation and ELISA were used to determine the role of Card9 in SAP. Microbial culture showed that SAP patients at the early period did not develop any bacteria and fungi infection. Card9 expression in SAP patients was higher than that in mild acute pancreatitis and volunteer healthy controls, up to the peak on day 1. The monocyte‐derived cytokines interleukin (IL)‐17, IL‐1β, IL‐6 and tumour necrosis factor‐α mediated by the induction of Card9 markedly increased in SAP patients compared with the control group. Furthermore, the inducible formation of Card9‐Bcl10 complex was found in PBMCs, which may be involved in nuclear factor kappa B (NF‐κB) and p38 activation in SAP. Receiver operating characteristic curve indicated that Card9 levels had a high sensitivity of 87.5% and specificity of 67.7%, showing the close correlation with SAP patients. Card9 overexpression was firstly found in aseptic SAP, which may be played an important role in NF‐κB and p38 activation in PBMCs. It also provided the new insights into therapeutic interventions by targeting monocytes activation in SAP patients.     

基于RAPD数据探讨中华蓑藓(Macromitrium cavaleriei Card.& Thér.)形态变异的遗传基础

中华蓑藓(Macromitrium cavaleriei Card.&;Thér.)的形态变异强烈,为了解形态变异是否具有遗传学背景,本研究以采自浙南凤阳山、浙中金华北山、浙西北的天目山和江西庐山4个种群的中华蓑藓为材料,运用随机扩增多态性DNA(RAPD)探讨了中华蓑藓的遗传多样性。从100条随机引物中筛选出了15条有效引物,利用它们共获得183个条带,其中多态性条带占79.69%,中华蓑藓各种群间的Dice遗传距离为0.0732~0.1514。POPGENE32软件分析得到种的Nei基因多样性指数(H)为0.3378,Shannon指数(I)为0.5126,遗传分化系数(G_st)为0.1670;基因流(N_m)为2.4947;种群内遗传多样性指数为0.4055,占种群总的遗传多样性的79.11%,反映出研究区域内的中华蓑藓遗传变异大多数存在于种群内,中华蓑藓形态变异并没有多少遗传背景,很可能是生态环境因素引起的可塑性变异。聚类分析表明,中华蓑藓种群遗传距离与地理距离之间无直接相关关系,遗传多样性水平与物种特性和所处不同群落有关。虽然4个种群内的形态变异丰富,但是属于同一物种的范围。     

Punch Card Programmable Microfluidics

Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive. Combining the idea of punch card programming with arbitrary fluid control, here we describe a self-contained, hand-crank powered, multiplex and robust programmable microfluidic platform. A paper tape encodes information as a series of punched holes. A mechanical reader/actuator reads these paper tapes and correspondingly executes operations onto a microfluidic chip coupled to the platform in a plug-and-play fashion. Enabled by the complexity of codes that can be represented by a series of holes in punched paper tapes, we demonstrate independent control of 15 on-chip pumps with enhanced mixing, normally-closed valves and a novel on-demand impact-based droplet generator. We demonstrate robustness of operation by encoding a string of characters representing the word “PUNCHCARD MICROFLUIDICS” using the droplet generator. Multiplexing is demonstrated by implementing an example colorimetric water quality assays for pH, ammonia, nitrite and nitrate content in different water samples. With its portable and robust design, low cost and ease-of-use, we envision punch card programmable microfluidics will bring complex control of microfluidic chips into field-based applications in low-resource settings and in the hands of children around the world.     

“数据解读卡”文献阅读法在医学研究生文献阅读能力培养中的作用

阅读文献可以促进学生了解科学发现的过程,有利于提高学生解读实验数据的能力,培养科学研究兴趣,是基础医学教学过程中必不可少的环节。因此,有必要探索一些引导和训练学生高效阅读文献的方法。该研究旨在通过“数据解读卡”文献阅读法来引导和规范医学研究生阅读文献的过程,通过分析学生在文献文本和图片上阅读时间分配的动态变化、测试学生文献解读技能和实验设计能力以及调查学生满意度来评价“数据解读卡”文献阅读法在培养和提高医学研究生解读实验数据的能力中的作用。结果表明,“数据解读卡”文献阅读法能明显提高图片相对阅读时间,从第1周20％左右逐步提高到第12周45％左右;学生解读实验数据能力得分从第1周0分左右提高到第6N3分和第12周4分左右;平均86％左右的学生认为有利于提高文献阅读的效率和有助于论文写作。该研究结果表明,“数据解读卡”文献阅读法可以规范和训练研究生阅读文献的能力,是提高学生阅读文献效率的有效途径。