In order to improve doctor patient relationship and communications, the system of doctor patient communications was implemented in an all round way. First, the contents of the system were defined. Then the ways of implementing the system were fixed: improving training and changing service concepts; bringing doctor patient communications into line with quality management; making use of special survey forms for the system, and mastering a variety of communications skills. In addition, necessary organization, personnel, and regulations were put in place to guarantee the success of the system. Consequently, implementation of the system brought about pretty tangible results.

In the hospital administration,the establishment and the implementation of the strategic planning of the hospital occupies a very important position.This paper,combined with the actual situation of a children's hospital in Chongqing,describes the hospital rational use of three level management system of the hospital,office,department,in order to get the full investigation of the national macro policy,the development of the medical industry and the status of the hospital and other aspects,and then supports efficient workflow to complete the hospital strategic planning.This paper also focuses on the target implementation,program implementation and project implementation of three levels,in order to illustrate the process for the implementation of the strategy to provide a reference of.hospital strategic planning formulation and implementation.

Objective To discuss the effects and the possible mechanismof curcumin on pulmonary functions and expression of TGF-β1 and NF-κB in paraquat-induced pulmonary fibrosis of rats.Methods SPF Wistar rats were randomly (random number) divided into three groups:paraquat-poisoned group (PQ group,with PQ 50 mg/kg by gavage),Curcumin-treatment group (PC group after 30,with curcumin (200 mg/kg) by intraperitoneal injection),and Blank group (B group,with same volume of sterile saline at the same time).After 14 d,the lung function of rats was observed,and the expression of TGF-β1 and NF-κB protein were detected by immunohistochemistry.Results The survival rates of mice significant difference in the PC and PQ groups with (70.83％ vs.41.67％,P ＜0.05).Compared with the B group,lung function index (Te,PIF,PEF,EF50,TV,F) of PQ group significantly decreased (P ＜ 0.05,P ＜ 0.01).Compared with the PQ group,lung function index (Te,PEF,TV,F) of PC group significantly increased (P ＜ 0.05 or P ＜ 0.01).There are some expression of lung tissues of rats with TGF-β1,NF-κB in B group.Compared with B group,PQ group significantly enhanced (P ＜0.01or P ＜0.05).Compared with the PQ,PC group significantly decreased (P ＜ 0.01 or P ＜ 0.05).Conclusions Curcumin can relieve paraquat-induced pulmonary fibrosis by inhibiting the over expression of TGF-β1,NF-κB in lung tissue of rats.

Objective To observe the effects of curcumin on pulmonary fibrosis and functions on paraquat (PQ)-challenged rats, and investigate the possible mechanism. Methods 108 SPF Wistar rats were divided into three groups according to random number sheet: normal saline (NS) control group, PQ model group and curcumin-treatment group. The rats in each group were subdivided into three subgroups according to different time points (3, 7, 14 days), with 12 rats in each subgroup. PQ-challenged models were reproduced by intragastrical administration of PQ solution 50 mg/kg, and those in NS control group were given the equal volume of NS. After 30 minutes, the rats in curcumin-treatment group were given 200 mg/kg of curcumin by intraperitoneal injection, and those in NS control group and PQ model group were given the equal volume of NS. At 3, 7, 14 days, the tidal volume (VT) was examined, and the blood was drawn from femoral artery for blood gas analysis. Then the rats were sacrificed and the lung tissues were harvested, the hydroxyproline (Hyp) content was measured by alkaline hydrolysis; the expression of transforming growth factor-β1 (TGF-β1) was determined by immuno-histochemistry; the distribution and the change of the pulmonary collagen fiber were observed after Masson staining. Results After exposure to PQ, the VT and arterial partial pressure of oxygen (PaO2) were decreased gradually, and the levels of Hyp and TGF-β1 were increased gradually, reaching the trough or the peak at 14 days, which were significantly lower or higher than those in NS control group [14-day VT (mL):1.52±0.33 vs. 2.81±0.47, 14-day PaO2(kPa): 5.87±0.95 vs. 14.15±1.02, 14-day Hyp (μg/mg): 3.12±0.06 vs. 1.14±0.05, 14-day TGF-β1 (integral A value): 29.72±4.27 vs. 4.15±0.52, all P < 0.01]. After intervene of curcumin, the parameters were significantly improved as compared with those of PQ model group [14-day VT (mL): 2.34±0.19 vs. 1.52±0.33, 14-day PaO2(kPa): 10.23±1.01 vs. 5.87±0.95, 14-day Hyp (μg/mg): 2.31±0.04 vs. 3.12±0.06, 14-day TGF-β1 (integral A value): 15.46±2.89 vs. 29.72±4.27, all P < 0.01]. It was shown by Masson staining that in PQ model group, with the PQ-poisoned time prolonging, diffused pulmonary fibrosis and a large number of collagen deposition were observed gradually, and the most serious collagen deposition was observed at 14 days; after intervene of curcumin, pulmonary fibrosis was alleviated significantly at different time points as compared with the PQ model group. Conclusion Curcumin can enhance the pulmonary function by reducing the deposition of collagen fiber and inhabiting pulmonary fibrosis of PQ-poisoned rats.

Objective To observe the effects of curcumin on the lung collagen area and the expression of TNF-α,IL-6 and NE in paraquat-poisoning rats at different intervals,and discuss the possible mechanism of curcumin antagonizing paraquat poisoning.Methods A total of 108 SPF Wistar rats were divided into three groups (random number):blank group (B group) for control,paraquat poisonin group (PQ group) and curcumin-treatment group (PC group).The rats of PQ group and PC group were given paraquat (50 mg/kg) by gavage,and the rats of B group were given equal volume of sterile saline solution at the same time.Thirty minutes later,the rats of PC group were given curcumin (200 mg/kg) by intraperitoneal injection,and rats of B group and PC group were given equal volume of sterile saline solution instead.At 3 d,7 d and 14 d after modeling,the distribution and pathological changes of lung tissue and collagen fiber were observed by HE and Masson staining.The concentration of tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were detected by enzyme-immunoassay.The lung neutrophil elastase (NE)expression was observed by immuno-histochemical method.Result Compared with B group,PQ group had pulmonary alveolitis in different degrees at different intervals,and the most serious pulmonary alveolitis was observed at 7 d after modeling.Diffused pulmonary fibrosis of the lung tissue and a large area of collagen fiber deposition were observed especially at 14 d after modeling,as well as the expression of NE was observed obviously,especially at 14 d after modeling.The concentration of TNF-α,IL-6 in serum were significantly increased (P ＜ 0.05,P ＜ 0.01).Compared with PQ group,the pulmonary alveolitis and fibrosis obviously in PC group with obvious reduction in the expression of NE and significant descrease in the concentrations of TNF-o and IL-6 (P ＜ 0.05).Conclusion Inhabiting inflammatory factors to alleviate the seriousness of alveolar inflammation and pulmonary fibrosis might be one of the mechanism of treatment with curcumin for paraquat poisoning rats.