A study of PDCA Cycle in managing hospital medical complaints may introduce such a cycle into the medical complaints control system of a hospital, effectively handling the medical complaints process. Since 2006 when the cycle was introduced into the hospital for medical complaints control, such complaints have been cut back significantly by the end of 2009. Furthermore, such complaints are under control from the start, and prevented from growing into medical disputes, effectively improving quality of care. Such a cycle can effectively avoid medical complaints, enhance medical safety, and build a harmonious doctor-patient relationship.

Objective To report our experience on closure of patent arterial duct using Hem-o-lok polymer ligating clip under a direct vision.Methods From May 2001 to May 2007,84 patients with cast patent arterial duct were treated with Hem-o-lok polymer ligating clips.Under a direct vision,the clips were placed to close the patent arterial duct through a small left subaxillary incision.Results The mean operation time was 42 minutes(ranged from 30 to 60).No intraoperative bleeding occurred in this series.After the operation,heart murmur disappeared in all the patients and none of them died.They were followed up for 2 to 50 months(mean 28 months),during which no residual shunting or recanalization occurred.Conclusion It is microinvasive and safe to close patent arterial duct by using Hem-o-lok polymer ligating clip.

Objective To study the method, advantage and shortcoming of mini-laparoscopic treatment for indirect inguinal hemia in children. Methods 136 cases with indirect inguinal hernia(right:75cases,left:44 cases,bilateral:17 cases) had been treated by high ligation with mini-laparoscopy. Results The mean operation time was 10 mmin for unilateral hernia and 23 mmin for bilateral hernia. Among 119 cases with unilateral hernia,38 cases had been found with contralateral latent hernia. The mean of postoperative inhospital stay were about 1 ～ 2 day(s). All patients had been followed-up for 3 ～ 12 months,there were only 2 cases recurrence found but no complications was detected.Conclusion Mini-laparoscopic high ligation for indirect inguinal hernia in children is a single, safe, satisfactory, effective,and minimally invasive surgical method.

OBJECTIVE:To provide reference for the application of antibiotics based on susceptibility test.METHODS:The problems appeared in the use of antibiotics based on susceptibility test in clinical pharmacy were analyzed and summarized.RESULTS & CONCLUSION:The antibiotics should be used rationally based on susceptibility test so as to improve the rational use of antibiotics.

Objective:To study the effects of the overexpression of hsa-miR-202 on the proliferation and molecular mechanism of lung cancer A549 cells. Methods:A sequence of hsa-miR-202 with ppG/miR/eGFP/Blasitidin pasmid was directionally connected and a eukaryotic expression vector pmiR-202 of the target hsa-miR-202 gene was constructed. pmiR-202 was transtected to A549 cell with Lipofectamine 2000. The WST assay was used to detect the cell proliferation rate, and RT-PCR was used to detect the relative gene expression levels. Western blot analysis was used to detect the IL-10 protein expression levels. The interaction between miR-202 and IL-10 was examined using a luciferase reporter assay. Results:The design from the DNA sequencing results shows that a eukaryot-ic expression vector of miR-202 was successfully constructed. The proliferation inhibition rates of A549 cells by Pmir-202 were 12%, 38%, and 52%. The differences in the treatment group compared with the blank control and negative control groups were statistically significant. The RT-PCR results showed that the relative expression levels of miR-202 increased after transfection with pmiR-202. Over-expression of miR-202 can downregulate the relative gene and protein expression levels of IL-10, and the relative levels were 25%and 0.75, respectively. Compared with the blank control and the negative control groups, the difference was statistically significant (P<0.05). The fluorescent activity was reduced when transfection was performed with miR-202 mimics, and IL-10-3'UTR plasmid was cloned. Conclusion: pmiR-202 effectively inhibited the proliferation of A549 cells and exhibited a time-effect relationship with miR-202 by targeted combination with IL-10 3'UTR to downregulate IL-10 expression in A549 cells.

OBJECTIVE:To investigate the clinical efficacy and safety of recombinant human epidermal growth factor(rhEGF) combined with lipoic acid in the treatment of diabetic foot. METHODS:A total of 68 patients with diabetic foot were randomly divid-ed into observation group and control group with 34 cases in each group. Both groups were given conventional therapy and Lipolic acid injection 0.6 ml added into Sodium chloride injection 250 ml. ivgtt(protecting form light),qd;observation group was additionally giv-en rhEGF for external use 1 ml and vaseline on the wounds,gauze dressing,qd. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,ulcer area,the expression of Bcl-2 and Bax were compared between 2 groups as well as the occurrence of ADR. RESULTS:The total effective rate of observation group(94.1%)was significantly higher than that of control group(67.6%),with statistical sig-nificance (P<0.05). Before treatment,there was no statistical significance in ulcer area,the levels of Bcl-2 and Bax between 2 groups(P>0.05). After treatment,ulcer area decreased significantly, the level of Bcl-2 increased significantly in 2 groups,while the level of Bax decreased significantly;the improvement of observation group was more significant than that of control group,with statis-tical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLU-SIONS:rhEGF combined with lipoic acid is effective for diabetic foot with good safety.

Quality of care is key to medical safety which has a close bearing on patients’life and health,and on the branding and efficiency of the hospital.Medical safety is one of the key indicators of the overall performance appraisal of the hospital.This novel type of nurse-physician collaboration,abandoning the traditional model of health care,is a new integrated model of health care which improves the overall quality of care,enhances medical safety and patient satisfaction.This paper described in detail the implementation methods and steps of the collaboration,the progress of such a collaboration and its contribution to medical safety are also discussed.

This article sumarized a practise-based study of the hospital regarding the management of its medical activities.By means of priotizing medical safety in pre-job and on-the-job eduation,and regular trainings in this regard,a systemized medical safety education ssytem is put in place among medical staff of different types and levels.This achieved the purpose of higher awaress of medical safety in medical practice,and downsized medical complaints significantly.

Objective To explore and investigate effective solutions of some issues in the self-development of large-scale compre-hensive hospital ,such as the innovation concept of hospital management ,strengthening the organization and management agencies , improving management efficiency and promoting the establishment of systematized management .Methods Starting from concept innovation ,theory innovation and method innovation of hospital management ,comprehensive applied the advanced concept of hospi-tal management and scientific management methods into the quality of medical care .Results Continuously strengthen the hospital medical quality and safety ,and form hospital-specific quality management system .Conclusion Through innovating the concept ,the-ory and methods of hospital management ,we can effectively promote continuous improving quality of medical care in comprehensive hospital and improve continually core competitiveness of hospital .

OBJECTIVE:To investigate the relationship of drug utilization index(DUI)of antibiotics with therapeutic efficacy of patients with acute exacorbation of chronic obstructive pulmonary disease(AECOPD). METHODS:By the method of drug utili-zation evaluation,inpatients with AECOPD in our hospital during 2013-2015 were selected as the research object. Diagnosis and treatment information prescribing information of patients were collected,and inpatients only receiving one kinds of antibiotics dur-ing hospitalization stay were selected to evaluate the relationship of therapeutic efficacy with rehospitalization indexes. RESULTS:A total of 2155 AECOPD patients were enrolled in the study. Among antibiotics with DDDs>500,antibiotics with DUI close to 1.0 was cefotiam hydrochloride for injection,and that with DUI far higher than 1.0 was Cefodizime sodium for injection,while that with DUI much less than 1.0 was Piperacillin sodium and sulbactam sodium for injection. There was statistical significance in therapeutic efficacy between Cefotian hydrochloride for injection and Piperacillin sodium and sulbaactam for injection (P<0.05);rehospitalization had no statistical significance(P>0.05). There was no statistical significance in therapentic efficacy or rehospital-ization between cefotiam hydrochloride for injection and cefodizimes sodium for injection(P>0.05). CONCLUSIONS:DUI is as-sociated with therapeutic efficacy,but the rationality of antibiotics can not be simple judged according to the distance between DUI and 1.0. A variety of confounding and bias factors should be integrated to avoid misreading and misjudgment.