The influences of medicine by the rapid development of economy are at least reflected on the following three as-pects: dramatically increasing awareness of health and medical demand of the majority and the serious “five long one short” phenome-non in outpatient clinic.This paper is based on the medical data of Nanfang Hospital.We analyzed the problems in the five links of appointed registration, visiting the doctors, taking examination and treatment, charging medical fees and medicine -claiming, putting forward four suggestions including updating concept for outpatients , emphasizing the application of information equipment and popular-ization of mobile device, such as WeChat guidance, in order to enhance the hospital networking mechanism , realize the synchronous transfer of information, introduce high-technology, and finally perfect the e-record of patients.

Objective To investigate the remote effects of epidermal growth factor(EGF)and early removal of eschar combined with skin grafting for the treatment of skin lesion produced by mustard gas.Methods A 3-year follow-up survey was condueted in 39 patients with skin lesion produced by mustard gas.The condition of healing was observed and evaluated.Results Good epithelial healing with pigmentation was observed in all the surveyed patients,and only in a few of them showed local recurrence of wound.Itching and paresthesia in the wounded parts were the main complaints.The sequelae remained unpredictable.Conclusion The early use of epidermal growth factor and early removal of eschar followed by skin grafting for the treatment of skin lesion produced by mustard gas may achieve satisfactory therapeutic effect.

Objective To analyze the status quo and influencing factors of patient safety culture among medical staffs in the hospitals of Shenzhen City to provided reference for its improvement and conduct the patient safety culture research by other medical institutions.Methods The Patient Safety Culture Questionnaire of Medical Institutions(PSCHO) was adopted to investigate on 1000 medical persons from February to May 2016.Results The total score of patient safety culture in medical staffs was (3.53±0.40) and,the difference among different categories of medical persons had no statistical significance (P＞ 0.05).The differences among the medical staffs with different working ages,communication frequency with patients,training times,concern frequency had statistical difference(P＜0.05).Conclusion The patient safety culture level in Shenzhen City is higher.However,the sense of blame and shame is one of the important factors impeding the promotion of the patient safety culture in hospitnl.Hospital should conduct the targeted improvement to the related factors affecting the patient safety culture from the aspects of organism,department and individual level.

Objective To compare the efficacy and safety of naphthoquine, artemisinine and a combination of the two drugs in the treatment of faciparum malaria. Methods Of 230 patients, 100 patients were treated with combined regime (Co-NQ), 100 patients were treated with naphthoquine (NQ) and 30 patients were treated with artemisinine (QHS). All patients were hospitalized for 7 days and followed up for 28 days. Results The mean fever clearance time for Co-NQ, NQ, and QHS was (17.5 ?12.3)h, (32.7?17.7)h and (18.1?9.7)h respectively; the mean parasite clearance time was (30.0?8. 8)h,(45.5?10.0)h and (29.1?6.0)h respectively; and the 28 days cure rate was 97.0% ,100.0% and 66.7% respectively. Conclusion The Co-NQ possesses benefits of both naphthoquine and artemisinine, acting rapidly, with a short course of only one dose and a high cure rate. The regime is well tolerated by patients.

Objective: To assess the expression of retinoic acid receptor beta 2 (RAR-β2) in breast tumor and to evaluate the relationship between RAR-β2 expression and tumorigenesis of breast cancer. Methods: Immu-nohistochemistry was used to detect the expression of RAR-β2 protein in specimens from 40 cases of breast cancer, 40 cases of atypical ductal hyperplasia, 40 cases of fibroadenoma and 20 cases of normal breast tissues. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the mRNA expression levels of RAR-β2 gene in 20 cases of breast cancer, 20 cases of atypical ductal hyperplasia, 20 cases of fibroadenoma, and 20 cases of normal breast tissues. Results: Immunohistochemical staining results revealed that the positive expression of RAR-β2 protein showed nuclear staining. The positive expression rate of RAR-β2 was 30% (12/40) in breast cancer, 17.5% (7/40) in atypical ductal hyperplasia, 87.5% (35/40)in fibroadenoma, and 95% (19/20) in normal breast tissues. The expression of RAR-β2 protein in breast cancer was significantly lower than that in normal breast tissues (X~2=26.30, P<0.001). The expression of RAR-β2 was not significantly different between atypical ductal hyperplasia and breast cancer (P>0.05). No correlation was found between the expression of RAR-β 2 protein and the tumor size, menopausal age, lymph node metastasis, clinical stage, histological grade, or protein expression of ER and PR in breast cancer tissues (P>0.05). Follow-up results showed that 3 out of 28 patients with negative RAR-β2 expression had visceral organ metastasis, but only one of the 12 RAR-β2 positive patients had osseous metastasis. RT-PCR analysis showed that the positive expression rate of RAR-β2 mRNA in breast cancer, atypical ductal hyperplasia, fibroadenoma and normal breast tissues was 25% (5/20), 35% (7/20), 85% (17/20) and 100% (20/20), respectively. The RAR-β2 mRNA expression rate in breast cancer was significantly lower than that in normal breast tissues (X~2=30.43, P<0.001). No significant difference in RAR-β2 mRNA expression was found between atypical ductal hyperplasia and breast cancer tissues (P>0.05). Conclusion: RAR-β2 gene may play a repressive role in the initiation of breast cancer, and the loss of the expression of RAR-β2 gene may be the initial step in breast carcinogenesis.

Objective To study tumor immune escape in a gastric carcinoma cell line expressing human indoleamine 2,3-dioxygenase(IDO).Methods Human IDO gene was cloned by RT-PCR and the vector for pIRES_2-EGFP-IDO was constructed.BGC-823 cells were transfected with the plasmid using eleetroporation.The integrated INDO genes were detected by RT-PCR and Western blot.The enzyme activity of IDO were measured.T cells from gastric cancer patients were cecuhured with BGC-823 transfected with IDO or added with 1-MT circumstance,T cell-mediated cytotoxicity and proliferation were detected.Results Higher level expression of IDO mRNA and IDO protein Was detected in tumor cells transfected with IDO gene.The level of kynurenic acid was higher in transfected cells compared with no-transfeeted group (4.84±0.11)mg/L vs.(1.83±0.10)mg/L,P=0.000.The cytotoxicity ratio of the IDO transfected group and transfected group with 1-MT circumstance (1-MT group) was lower than control group (P<0.05).The inhibition rate of transfected group with 1-MT group Was higher than control group(P<0.05).Conclusion Gastric cancer cell lines encoded with IDO inhibits T cell-mediated cytotoxicity and proliferation.

Objective To investigate the distribution of eosinphililic neurons ( ENs),reactive astrocytes ( RAs),and infarction after transient cerebal ischemia,and the time profile of pathomorphological changes.Methods Unilateral forebrain ischemia was induced in Mongolian gerbils by two 10 minutes unilateral common carotid artery occlusions with a 5 hours interval.Laser Doppler flowmetry was used to detect intra-ischemic anterior cortex blood flow.Animals were sacrificed at 24 hours,4 days,2 weeks,4 weeks,16 weeks and the brain were prepared for pathomorphological assay.Results Intra-ischemic laser Doppler flowmetry show significant ischemia during carotid artery occlusion:22.1％ ± 9.5％,26.3％ ± 4.9％,37.5％ ± 3.5％,F =67.219,P ＜ 0.01 ; the decrease was significantly greater in the anterior cortex.ENs appeared in middle and deep layers at 24 hours postischemia,and ENs area extend to all layers of cortex by 4 days.Large areas of high EN density ( ≥80/mm2) evolved to infarcts between 4 days and 4 weeks.Posterior cortex evolved to low EN area ( ＜ 80/mm2) without transformation into infarcts.RAs were consistently distributed in areas with ENs,and RA areas with high EN density were largely transformed into infarcts between 4 days and 4 weeks. Delayed astrocytic death took place in the RA areas with high EN density.Conclusion Density of ENs is an important indicator of delayed astrocytic death and infarction in postischemic tissue.

Objective To analyze and compare the differences in application of 24-hour dietary recall and dietary balance index (DBI) in dietary survey and evaluation of patients with type 2 diabetes mellitus,meanwhile investigate their nutrition status.Method This was a cross-sectional study.A total of 100 type 2 diabetes inpatients at the age of 19-59 were recruited from Shanghai Jiaotong University Affiliated Sixth People's Hospital from December 2013 to February 2014.They were surveyed and evaluated by 24-hour dietary recall and DBI respectively.Result The micronutrient intake in patients with type 2 diabetes was not sufficient.Compared with RNI,the intake of vitamin B1,B2,and calcium was less than 50％.The average of DBI lower bound score (DBI-LBS) of the 100 patients was 32.1±6.1,65％; the patients were in moderate or severe deficit of food intake.DBI higher bound score (DBI-HBS) was 4.4±2.8.No significant excess intake problem was found.Dietary quality distance was 36.4±6.9.Eighty-seven percent of them had a dietary patterns of mode B.Conclusion Dietary patterns in type 2 diabetes patients were not reasonable.Nutrition education and nutrition intervention for type 2 diabetes should be emphasized.The two methods can be used to evaluate dietary quality independently,but it would be better to evaluate the quality of the patients' diet using two dietary survey methods together.

Objective To study the multi-slice spiral CT anatomy of pulmonary veins.Methods After accomplishing the scanning of coronary CT angiography in 120 cases with multi-slice spiral CT,the volume rendering and multi-planner reconstruction based on the original transverse images were performed.The pulmonary veins style according to the number of pulmonary-atrium ostium,pulmonary vein,common ostium and additional pulmonary vein were classified.The difference of sex in presence of the common ostium and additional pulmonary vein was analyzed statistically.Results The incidence of the common ostium and additional pulmonary vein was 22.5% and 15.8%,respectively,there was no difference in sex.The pulmonary veins included 4 types:standard type(62.5%),common ostium type(21.7%),additional pulmonary vein type(15.0%),mixed variation type(0.8%).Conclusion Multi-slice spiral CT can accomplish the observation of pulmonary vein,which can provide anatomic informations for clinic.

Objective:To investigate whether interferon-gamma inducible protein-10(IP-10) and interferon-gamma(IFN-?) participated in the human cerebral ischemia injury.Methods:Twenty-one cerebral ischemia specimens, collected from patients died of cerebral infarction, were divided into three groups: less than 7 days, 7-14 days and 15-21 days according to the lasting time of cerebral infarction. The infiltrating of inflammatory cells were observed using HE stain as non-ischemic hemisphere was for controls. Expression of IP-10 and IFN-? in sections both postmortem ischemic hemisphere and non-ischemic hemisphere were detected using immunohistochemistry.Results:In the groups of less than 7 days and 7-14 days large quantity of inflammatory cells were infiltrated in ischemia tissue. Expression of IP-10 in three groups was elevated in the ischemic hemisphere compared with non-ischemic hemisphere(1.74-folds, 1.41-folds and 1.52-folds increases respectively, P0.05).Conclusion:These results showed IP-10 and IFN-? are expressed in human cerebral ischemia. It was suggested that IP-10 and IFN-? involve in cerebral ischemia injury. Moreover, it was also suggested that IP-10 participate in the repair for the later stage of cerebral ischemia injury.