Effects of 0.15% Ropivacaine Alone and Combination with Sufentanil on Epidural Labor Analgesia and Adverse Reactions

To compare the effects of 0.15% ropivacaine alone and combination with sufentanil on epidural labor analgesia and adverse reactions. Methods: A total of 297 eligible primiparae were randomly divided into group A (n=149, 0.15% ropivacaine + sufentanil) and group B (n=148, 0.15% ropivacaine). Visual analogue scale (VAS) scores before analgesia and 20 min after epidural medication, and maximum VAS score during labor were observed. The times of patient-controlled analgesia (PCA) pump pressing and remedial analgesia, dosage of analgesic drugs, modified Bromage score, satisfaction degree, duration of labor, mode of delivery, 1-min and 5-min Apgar scores of newborns, adverse reactions during analgesia, and fever during labor were recorded. Results: VAS score 20 min after epidural medication and maximum score during labor were significantly lower in both groups than those before labor analgesia (P<0.05), but the two groups had similar scores (P>0.05). The two groups had similar times of PCA pump pressing and remedial analgesia, dosage of analgesic drugs, modified Bromage score and satisfaction degree (P>0.05). They had similar duration of labor, mode of delivery and 1-min and 5-min Apgar scores of newborns (P>0.05). There were 13 cases (8.72%) and 0 cases of pruritus in group A and B, respectively (P<0.05). They had similar incidence rates of nausea and vomiting, urinary retention and fever during labor (P>0.05). Conclusions: The epidural labor analgesia effect of 0.15% ropivacaine is comparable to that of 0.15% ropivacaine + 0.05 ng/mL sufentanil for primiparae, but the incidence rate of pruritus plummets when ropivacaine is used alone.

Evaluation and Analysis of the Satisfaction Degree of the Intelligent Outpatient Clinic of Tianjin 3A Grade Hospitals Based on the KANO Model

Objective — Based on the Kano model, we investigated the outpatients' satisfactions with the functions of the intelligent outpatient clinic of 3A Grade hospital in Tianjin, to improve the function of the intelligent outpatient clinic. Methods — Based on the Kano model, a questionnaire was designed to investigate the satisfaction and expectation of Tianjin outpatients with the use of intelligent outpatient clinic. A survey was conducted on 384 outpatients to determine the functions of the intelligent outpatient clinic. Results — Among the 14 intelligent outpatient service, 11 (79%) are attractive quality, 3 (21%) are one-dimensional quality, and there are no must-be quality. In the quadrant diagram, there are 3 requirements in the dominant area and 11 requirements in the retention area. There are three high satisfying attributes: convenience of multifunctional payment method, convenience of reservation registration and security of multiple payment methods. There is an unsatisfying function: the information pushed by WeChat platform. Conclusion — The intelligent outpatient clinic function has been satisfied by most patients, but it hasn’t been fully popularized. It is necessary to improve the payment security, the order waiting and other attractive quality, to optimize the medical experience of the intelligent clinic and improve patients' satisfaction.

Efficacy of management of associated dysfunctions on rotator cuff and long head of the biceps: systematic review

Background The important functional role the rotator cuff (RC) and biceps play in the shoulder, the close anatomical relationship between them and the high incidence of injuries require an appropriate multidisciplinary therapeutic approach after a rigorous assessment. The objective is to identify and analyze surgical interventions, whether or not followed by a postsurgical one, of associated dysfunctions on the RC and long head of the biceps (LHB) and their effectiveness in improving shoulder functionality. Methods A systematic review based on PRISMA protocol was conducted using PubMed, Web of Science, PEDro, Scopus, CINAHL, and Dialnet until 22 April 2021. The main inclusion criteria were as follows: randomized clinical trials including subjects diagnosed with RC and LHB lesions who had surgical and/not post-surgical treatments. The methodological quality of trials was evaluated by the PEDro scale. Data were shown in 3 pre-established tables: (1)sample data, diagnostic methods, dysfunctions and injury frequency, interventions, outcome measures and results; (2)significance and effectiveness of interventions; and (3)comparison of the effectiveness of interventions. Results Eleven studies were selected. The methodological quality of ten of them was assessed as good and one excellent (PEDro scale). All articles had surgical treatments and ten had postoperative management. All trials used arthroscopy and two open surgery too. Single-row, double-row and transosseous repair were used for RC lesions, while SLAP repair, tenotomy, and tenodesis were applied to LHB injuries. Measured parameters were functionality, pain, Popeye’s sign, strength, range of motion, satisfaction degree, biceps cramping, and quality of life. All approaches in general, surgical plus postsurgical, were always effective to the parameters measured in each study. Seven trials compared tenotomy and tenodesis: four of them obtained statistically significant differences in favor of tenodesis in Popeye’s sign, cramping, satisfaction degree, and/or forearm supination strength; and one, in favor of tenotomy in cramping. All studies measured functionality using functional assessment scales. The most widely used was the Constant Score. Conclusions Surgical plus post-surgical interventions in associated dysfunctions on RC and LHB were effective. Tenodesis obtained better results than tenotomy in Popeye’s sign, satisfaction, and forearm supination strength. However, there was no difference regarding biceps cramping.

Multi objective optimization model and algorithm of logistics service transaction matching on blockchain platform

The logistics service transaction matching of the blockchain platform is an important part of the transaction. Firstly, the evaluation index system of the logistics service transaction satisfaction degree in the blockchain platform is constructed. According to the evaluation index of the logistics service users and providers, the actual situation of the logistics service transaction and the principle of maximizing the satisfaction degree of the logistics service users and providers, we set the expectation range of both sides and do data standardization, design the calculation method of satisfaction information amount for different expectation data types, build a multi-objective optimization model for logistics service transaction matching on blockchain platform, and seek the matching solution that makes all service users and providers the most satisfaction. Considering the large amount of data in blockchain, the concurrent design of NSGA-II algorithm based on Hadoop is carried out. Through the calculation of the example, in the matching of multi-objective optimization model of logistics service transaction matching on the blockchain platform, when the users and providers of logistics service are more satisfied about the indicators with each other, and then it gets more satisfactory matching results.

Decision-Making Models Based on Satisfaction Degree with Incomplete Hesitant Fuzzy Preference Relation

To address the situation where the incomplete hesitant fuzzy preference relation (IHFPR) is necessary, this paper develops decision-making models based on decision makers’ satisfaction degree with IHFPR. First, the consistency measures from the perspectives of additive and multiplicative consistent IHFPR are defined based on the relationships between the IHPFRs and their corresponding priority weight vector, respectively. Second, two decision-making models are developed in view of the proposed additive and multiplicative consistency measures. The main characteristic of the constructed model sarethey taking into account the decision makers’ satisfaction degree. The objective functions of the models are developed by maximizing the parameter of satisfaction degree. Third, a square programming model is developed to obtain the decision makers’ weights byutilizing the optimal priority weight vectors information, the solution of the model is obtained by solving the partial derivatives ofLagrange function.Finally, a procedure for multi-criteria decision-making (MCDM) problems with IHFPRs is given, and an illustrative example in conjunction with comparative analysis is used to demonstrate the proposed models are feasible and efficiency for practical MCDM problems.

Patient Satisfaction in Shanghai Hospitals: A Large Sample, Multi-Center, Cross-Sectional Study

The objective of this paper is to study patients’ satisfaction degree with the hospital, environment, medical service and staff in several hospitals in Shanghai. With the questionnaire survey method, two-dimensional code is set up in every department to investigate satisfaction degree of patients. The research data input, collection and analysis are used the tools of Excel and SPSS19.0. A total of 6144 questionnaires were obtained. Analysis of objective data shows that patients’ satisfaction degree with every department is 4.41 (3.05–4.92). And subjective data analysis shows that patients’ satisfaction degree with facial faculties, surgery, internal medicine, outpatient department, infusion room, general practice, emergency treatment, pharmacy department, neurology, rehabilitation department, traditional Chinese medicine department, pediatrics, obstetrics and gynecology department, health service station and the others is as follows: 0.75, 0.28, 0.22, [Formula: see text]0.09, 0.32, 1.00, [Formula: see text]0.12, [Formula: see text]0.14, 0.63, 1.00, 0.60, [Formula: see text]0.09, 0.33, 1.00, 0.14. And patients’ satisfaction degree with service, environmental, convenience, medicine, order, administrative management, logistic service and time is as follows: 0.84, 0.91, 0.17, 0.91, [Formula: see text]0.16, 0.01, [Formula: see text]0.46, [Formula: see text]0.49. The difference of patients’ satisfaction degree between each department is related to patients’ special status, especially when treat is difficult and disease is severe. Because of different links with patients’ need, these factors have different influences on patients’ emotional tendencies. Hospitals should enhance patients’ satisfaction degree by optimizing resource allocation and department order, reducing waiting time, increasing visiting time, improving administration, attaching importance to logistics and intensifying infrastructure construction.