An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, collecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessing medical services quality.

Objective To review the experience of surgical management for caustic esophageal stricture and discuss the surgical techniques of transverse colon interposition for esophageal replacement. Methods 106 patients with caustic esophageal stricture were treated surgically. 32 patients underwent colon interposition with colonphargageal anastomosis and others received colon interposition with a cerrical anastomosis. The ascending branch of the left artery of the transverse colon was preserved as the supporting vessel of the interpositioned colon. Results There was no postoperative death. The leakage of cervical anastomosis was observed in 12 patients, anastomosis stenosis in 8 patients, and tracheotomy was performed in 3 patients. All patients were perfectly recovered by the treatment. Conclusion Transverse colon interposition for esophageal reconstruction is an optimal approach in the treatment of caustic esophageal stricture.

Objective To evaluate the value of video-assisted thoracic surgery(VATS)for penetrating thoracoabdominal injuries.Methods Under general anaesthesia and double-lumen tracheal intubation,VATS was carried out to examine patients with chest injuries.Those who had mild injuries received VATS combined with mini-incision surgery.Electrocoagulation or suturing was employed to control intraoperative bleeding,and then blood clots were removed.Injured diaphragm muscles were repaired,and organs with hemorrhage or ruptures were sutured or resected.The seriously injured cases underwent open surgery and intra-abdominal exploration instead.Results A total of 18 patients received the operations.Among them,15 patients underwent VATS combined with mini-incision surgery(repair of the diaphragm was performed on 15,controlling intercostal arterial bleeding on 8,repair of the lung on 2,wedge resection of the lung on 2,and coagulated hemothorax removal on 2),the other 3 were converted to open surgery for repairing the diaphragm(3),heart(1),or esophagus(1),or lobectomy(2).Abdominal surgery via the thorax were performed on 13 cases,including repair of the liver in 1,lienectomy in 1,gastrorrhaphy in 1,repair of diaphragmatic hernia in 3,and intra-abdominal exploration in 7.Five patients received open surgery(pancreatic neoplasty in 1,repair of the liver in 1,lienectomy in 1,gastrorrhaphy in 2,and repair of the caul and mesenterium in 3).One patient who had multi-organ penetrating injuries died of hemorrhagic shock,circulatory failure,and DIC after open thoracic and abdominal surgeries.The mean operation time in this series was(125?44)minutes(ranged from 45 to 220),and the mean blood loss was(1089?582)ml(500 to 10 000 ml).Twenty-four hours after the operation,the mean volume of chest drainage was(234?75)ml(100 to 350 ml)in the first 24 hours after the operation.The chest drainage tube was withdrawn 2.5(2 to 5)days postoperation.The patients expelled gas in 1 to 4 days(mean,2 days).Totally,12 patients were followed up for 3 to 12 months(mean,6 months),during which none of them had trauma-related complications.Conclusion VATS combined with mini-incision surgery is safe and effective for patients with thoracoabdominal injuries,if the cases were carefully selected.

Background and purpose:Pterostilbene is a natural antioxidant, whose role in retinoblastoma remains unclear. The aim of this study is to probe the effects of pterostilbene on the proliferation, apoptosis and autophagy in retinoblastoma WERI-Rb-1 cell lines.Methods:Cell counting kit-8 (CCK-8) assays were used to analyze the effects of pterostilbene on the proliferation of WERI-Rb-1 cells. Apoptosis rate was determined by Annexin V/PI. Autophagic vacuoles were observed by acridine orange staining. LC3 and P62 protein expressions were determined using Western blot.Results:Pterostilbene significantly inhibited the proliferation of WERI-Rb-1 cells (P<0.01). The cell viability were (93.02±0.47)%, (55.10±2.04)% and (30.33±1.45)% after WERI-Rb-1 cells were treated with 25, 50 and 100 μmol/L pterostilbene for 24 h, and the cell viability were (88.38±3.70)%, (53.37±1.17)%, (29.60±1.05)% after WERI-Rb-1 cells were treated with 50 μmol/L pterostilbene for 12, 24 and 48 h. Pterostilbene induced cell apoptosis (P<0.01), the apoptosis rates of control group, 24 h treated group and 48 h treated group were (4.08±0.79)%, (13.44±2.12)% and (23.49±2.01)%. Pterostilbene induced autophagy of WERI-Rb-1 cells, increased LC3 expression, downregulated P62 expression and increased the number of autophagic vacuoles in WERI-Rb-1 cells (P<0.01). 3-MA and Beclin1 were able to rescue pterostilbene-induced cell death (P<0.01). After 3-MA was used to blunt autophagosome formation, the apoptosis rate markedly decreased in 3-MA+pterostilbene-treated cells compared with cells treated with pterostilbene alone [(12.97±2.09)%vs (8.35±1.11)%], and after siRNA was used to knockdown Beclin1, the apoptosis rate had the same change [(13.80±2.19)%vs (9.62±0.52)%].Conclusion:Pterostilbene can inhibit the proliferation of WERI-Rb-1 cells and induce cell apoptosis via autophagy activation.

Objective To evaluate the value of multislice spiral computed tomography angiography (MSCTA) in differential diagnosis between epithelial ovarian carcinoma (EOC) and borderline epithelial ovarian tumor (BOT).Methods The MSCTA images of 39 EOC patients and 23 BOT patients confirmed by surgical pathology were reviewed retrospectively.Main characteristics of tumor vessels were analyzed: the number of feeding arteries, the existence of dilated draining veins, whether the tumor vessels were tortuous, whether the distribution of tumor vessels were disturbed, and whether there were accompanying microaneurysms or arteriovenous malformations (AVMs).Results Two or more feeding arteries of the EOCs and BOTs were 89.7% (35/39) and 8.7% (2/23), respectively.Dilated draining veins were observed in 87.2% (34/39) of the EOCs and 4.3% (1/23) of the BOTs.The tortuosity of tumor vessels was observed in 97.4% (38/39) of the EOCs and 13.0% (3/23) of the BOTs.79.5% (31/39) of the EOCs and 8.7% (2/23) of the BOTs were complicated by microaneurysms, and 74.4% (29/39) of the EOCs and 4.3% (1/23) of the BOTs were complicated by AVMs.The characteristics of tumor vessels were significantly different between the two groups (P<0.01), with relatively high sensitivity and specificity.Conclusion MSCTA can better show the distribution, number and pattern of tumor vessels and is of great value in differential diagnosis between EOC and BOT.

OBJECTIVE:To improve the monitoring and reporting system of adverse drug use(ADR)in medical organiza?tions.METHODS:The current situation of monitoring and reporting system of ADR in medical organizations were analyzed.RESULTS&CONCLUSION:In our country the running of the ADR monitoring and reporting system is left to be improved and optimized.

Objective A novel Active Pharmaceutical Ingredient (API) pituitrin efficacy component content analysis method was explored, and the method is conformed to the requirements of the pharmaceutical production enterprise testing standard. Methods The reverse phase high performance liquid chromatography (RP-HPLC) was performed on a Zorbax Eclipse XDB-C18(250mm×4.6mm, 5 μm) (P/N 993967-902/ 5063-6600) Column, the column temperature was 25℃, the wavelength of detector was set at 220 nm, flow rate was 1.2 mL/min, 50% Acetonitrile- 0.13mol/L sodium dihydrogen phosphate aqueous solution was used as mobile phase for gradient elution. 20 μL sample solution was injected in each perform. Results The content of oxytocin and vasopressin as pituitrin efficacy components were analyzed by this method with advantage of simple and easy operation, good reliability and high precision. Different biological extraction technology process A and B was used on pituitrin injection production, the content of medicinal ingredients in the product: oxytocin and vasopressin is slightly different, but concentration level is different, which process B concentration is higher than that of A. Conclusion In this study, an effective determination the levels of oxytocin and vasopressin in pituitrin API method was established for a pharmaceutical production enterprise, can provide API pituitrin purification process control. Relevant technical information can be provided in the above, which worked on the biological API pituitrin research and development.

Objective To investigate the forearm flap personalized design method and the curative effect in repairing maxillofacial defects.Methods From March,2011 to September,2015,16 cases with oral maxillofacial tumor and facial tissue defect were treated.There were 8 males and 8 females with an age range of 41-70 years (mean,54 years).According to the shape and size of the defect after tumor resection in each patient,the forearm flap was designed to repair the defect.The effectiveness was evaluated after operation by observing the survival of the forearm flap transplantation,the patient's facial appearance,the functions of speech,swallowing.Results The incision healed by first intention in this group,16 cases of forearm flap survived.All cases were followed-up 8-36 months without tumor recurrence.The functions of speech,swallowing were basically normal.The facial appearance was satisfactory.The patients were satisfied with their appearance and functional recovery after operation.Conclusion Take personal way of forearm flap design according to maxillofacial soft tissue defect,can restore the maximum facial appearance and function of patients,improve the quality of life of patients after surgery to repair,can obtain satisfactory results.

This paper is aimed to establish the method of fingerprint analysis of chemical constituents by reversed-phase ultra-performance liquid chromatography (UPLC) for the quality control of the roots and rhizomes of Panax ginseng (Ginseng Radix et Rhizoma). The method was performed on a ACQUITY UPLC BEH C18 (50 mm x 2.1 mm ID, 1.7 microm) with a mixed mobile phase of water and acetonitrile in a gradient mode. The flow rate was 0.3 mL x min(-1) and the wavelength of measurement was 203 nm. Eleven batches of the Ginseng Radix et Rhizoma were determined. The UPLC chromatographic fingerprints of chemical constituents were established from the eleven batches of the Ginseng Radix et Rhizoma and showed fifteen characteristic common peaks, among which fifteen peaks were recognized and nine compounds (ginsenosides Rg1, Re, Rf, Rg2, Rb1, Rc, Rb2, Rb3 and Rd) were determined by comparison with chromatographic behaviors and UV spectra of the authentic compounds. The eleven batches of samples were classified as two clusters by hierarchical clustering analysis (HCA) and principle component analysis (PCA), and six samples were confirmed to establish the mutual model. The quality was assessed by similarity evaluation system for chromatographic fingerprint of TCM (2004B Version). The convenient and high specific method can be used to identify and evaluate the quality of the Ginseng Radix et Rhizoma.

Objective To investigate the diagnosis value of a new tumor marker CK18-3A9 in gastric cancer patients. Methods The serum level of CK18-3A9 in 350 gastric cancer patients, 150 gastritis patients and 500 healthy controls was detected with chemoluminescence, the diagnosis efficacy between the serum CK18-3A9 and CA72-4 was compared. Results The sensitivity, specificity of CK18-3A9 were 46.29 % and 96.92 %, but the sensitivity, specificity of CA72-4 were 26.00 % and 93.23 %, respectively. The differences were significant (P ＜0.001). Conclusion The serum level of CK18-3A9 maybe a new auxiliary diagnosis marker for gastric cancer.