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.

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.

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.

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 .

Injectable lipid emulsions have been routinely used in patients since 1960s as a nutritional supplement for patients requiring parenteral nutrition. In recent years, lipid injectable emulsions have been extensively studied as a kind of novel drug carrier, also the quality problems of the lipid emulsion attract more and more attentions gradually. Large diameter tail of injectable lipid emulsions as a significant quality control indicator should pay more attention. Regarding to the defect of detecting large diameter tail of lipid injectable emulsions in our country, the purpose of this article is to summarize the techniques of detecting large diameter tail, illustrate the impacts of large lipid droplet on the quality of lipid injectable emulsions, emphasize the importance of detecting large diameter tail in lipid emulsions and provide guidance for researching and developing lipid emulsions in domestic market.

OBJECTIVE: To observe the efficacy of modified acupotome combined with blocking therapy in patients with carpal tunnel syndrome (CTS). METHODS: Fifty-five patients with CTS were divided into three groups, which were modified acupotome group including 26 CTS patients with 28 lesions treated by modified acupotome combined with blocking therapy, traditional acupotome group including 14 CTS patients with 16 lesions treated by traditional acupotome combined with blocking therapy, and blocking therapy group including 15 CTS patients with 15 lesions only treated by local blocking. The treatment outcome and one-year recurrence rate were observed. RESULTS: The response rate and one-year recurrence rate after operation in the modified acupotome group were 85.7% (24/28) and 20.8% (5/24) respectively, which had no significant differences as compared with 81.3% (13/16) and 38.5% (5/13) in the traditional acupotome group. The response rate and one-year recurrence rate after operation in the above two groups were both improved significantly as compared with those in the blocking therapy group which were 46.7% (7/15) and 85.7% (6/7) respectively. There were no acupotome-related adverse effects and injuries observed in the modified acupotome group. CONCLUSION: The modified acupotome is a considerable treatment method for CTS with respect to its simple manipulation and high effectiveness.

Fatty acid synthase (FAS) catalyses the reaction between acetyl-CoA and malonyl-CoA to produce fatty acids. It is one of the most important enzyme in lipid biosynthesis. FAS of the oleaginous yeast Rhodosporidium toruloides has two acyl carrier protein (ACP) domains and a distinct subunit composition compared with FASs of other species. As ACP is a protein cofactor crucial for fatty acid chain elongation, more ACPs in the FAS may facilitate the reaction. To study the biochemical and structural properties of this novel FAS from R. toruloides, plasmids were constructed and transformed into Escherichia coli BL21 (DE3). The strain ZWE06 harboring plasmids pET22b-FAS1 and pET24b-FAS2 could co-overexpress the two subunits. The recombinant FAS was purified by sequentially using ammonium sulphate precipitation, sucrose density gradient centrifugation and anion exchange chromatography. The specific activity of the recombinant FAS was 548 mU/mg. The purified complex would be used to study enzyme kinetics and protein structure of FAS, and heterogeneous expression and purification will facilitate revealing the mechanism of this novel FAS with double ACPs.
Acyl Carrier Protein ; Basidiomycota ; enzymology ; Chromatography ; Escherichia coli ; metabolism ; Fatty Acid Synthases ; biosynthesis ; genetics ; Fatty Acids ; biosynthesis ; Plasmids ; Recombinant Proteins ; biosynthesis ; genetics

Bicyclol with benzyl alcohol structure, is a poorly water-soluble drug, used for the treatment of chronic hepatitis B. To increase the drug solubility and oral bioavailability, a Bicyclol-phospholipid complex was studied on its preparation, formation mechanism, and the influence on drug physicochemical properties and oral absorption. The complex was prepared by a solvent evaporation method. The optimal formulation was selected by orthogonal experimental design, and a reasonable evaluating method of the complexation rate was established. Various methods, such as differential scanning calorimetry (DSC), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and 31P nuclear magnetic resonance (31P-NMR), were used to explore the phase state and formation mechanism of the complex. The solubility of drug in complex was investigated in water/n-octanol. Preliminary study of its absorption and liver tissue distribution in rats was also carried out. The results showed that Bicyclol and phosphatidylcholine can be complexed entirely in the molar ratio 1 : 2. Bicyclol was dispersed in phospholipids as amorphous state. They were combined by intermolecular hydrogen bond due to charge transfer effect which occurred between the two polarities of the double bond between phosphorus and oxygen (P=O) of phosphatidylcholine and benzalcohol group of Bicyclol. The solubility of the complex compared to the active pharmaceutical ingredient (API) was effectively enhanced 5.75 times in water and 7.72 times in n-octanol, separately. In addition, drug concentrations were also enhanced 43 times in plasma and 13 times in liver with one hour after administering the complex to rats via oral gavage. All of these indicated that Bicyclol with benzalcohol group can interact with phospholipids to form complex, improving drug's physicochemical properties, thus further increasing its absorption and target tissue distribution. This study also provided theoretical reference for the research of other benzalcohol derivatives complexed with phospholipids.

Objective To study the clinical characteristics,diagnosis,treatment and prognostic factors of patients with postradiation nasopharyngeal necrosis(PRNN) in nasopharyngeal carcinoma(NPC).Methods Sixty patients with PRNN were studied retrospectively,50 males and 10 females,age ranging from 30-70 years of (median 51.5 years). All patients were treated with endoscopic debridement and systemic or local anti-inflammatory treatment. Kruskal-Wallis H test was used to assess the interval time between irradiation completion and necrosis onset and related factors of treatment outcome.Multivariate Cox proportional hazards regression survival analysis was performed to analyze risk factors.Results The latent period between the last irradiation and the onset of the symptom ranged from 1 to 156 months,with a median of 5 months.The median interval time was 7.0 months in 1 course group and 4.5 months in ≥ 2 courses group ( x2 =5.527,P =0.031 ),and 7.5 months in T2 group and 5.0 months in ≥T3 group ( X2 =4.330,P =O.037 ),respectively.Forty-one patients of them had nasopharyngeal infection,and the difference in curative effect between infection group and non-infection group was sigmficantly(x 2 =14.775,P ＜ 0.001 ).Symptoms were alleviated in all patients after endoscopic debridement and systemic or local anti-inflammatory treatment.Follow-up for all patients ranged from 2 to 46 months (median 12.5 months).Seven patients with internal carotid artery exposure died of sudden nasopharyngeal massive bleeding and fifteen patients died of tumor or systemic exhaustion; five cases were lost,and the rest were all in survival. Inter carotid artery erosion was an independent prognostic risk factor according to multivariate Cox proportional hazards regression survival analysis ( P ＜ 0.05 ). Conclusions Endoscopic debridement is effective in treating irradiation-related nasopharyngeal necrosis. The occurrence of nasopharyngeal necrosis is related to infection,irradiation dose and course,and T stage.Internal carotid artery erosion is a severe situation and also an independent prognostic factor for the patients.The most common causes of death were nasopharyngeal bleeding and systemic exhaustion.

Objective:To explore the pathogenesis, diagnosis and treatment of pneumocystis jirovecii pneumoniae (PJP) after renal transplantation.Methods:A total of 20 PJP patients were selected from January 2018 to January 2020. The major symptoms included fever, chest tightness, dyspnea and cough with minimal sputum. Chest computed tomography (CT), laboratory tests and metagenomic next-generation sequencing (mNGS) of bronchoscopic pulmonary alveolar perfusion fluid (BALF) were performed. They received cotrimoxazole (SMZ: 18.75-25 mg/kg + TMP: 3.75-5 mg/kg q6 h) and basic regimen of caspofungin (50-70 mg/d) for 14-21 days. At the same time, bacterial, fungal or viral infections were treated, immunosuppressants were tapered or discontinued, supportive therapy and methylprednisolone, immunoglobulin and continuous renal replacement therapy (CRRT) were provided. Chest CT examination was performed for 5-7 days to evaluate the therapeutic effect and clinical data were retrospectively analyzed.Results:Among them, fever was predominant in 13 cases with an average body temperature of (38.8±0.68) ℃ while chest tightness and dyspnea occurred in 7 cases. Fourteen patients presented hypoxemia, 13 received non-invasive ventilator assisted breathing, 1 received mechanical ventilation via endotracheal intubation and the remainders received mask oxygen therapy. Seventeen patients were cured and discharged from hospital for 12~90 days. Three patients died of respiratory and circulatory failures due to deteriorating pulmonary infection. And 19 patients had elevated renal function initially and basically normalized around 2 weeks.Conclusions:PJP is one of the most serious complications after renal transplantation. Timely diagnosis and targeted treatment are essential. And mNGS examination plays a crucial role in the diagnosis of PJP. The basic anti-infective scheme of compound sulfamethoxazole plus carbophennet is efficacious. At the same time, appropriate tapering or discontinuation of immunosuppressants, supportive therapy and assisted respiration are also important.