Command of the JCI standards and lessons learnt from practice and experience in JCI accreditation preparation,can help identify the gap between the hospitals and JCI standards.These standards can also guide the clinical pathway system,pharmacy intravenous admixture services system and medical business intelligence system.The information system built under such guidance not only makes an effective solution to existing problems,but also proves innovative.All these pave the way for successful JCI accreditation.

Objective: To further optimize the hospital inspection process, shorten the patient waiting time of examination and improve the overall utilization of medical equipment. Methods:HIS and PACS to realize the information system integration by using hospital information platform, and then develop a set of medical equipment reservation system. The doctor workstation through the system could real-time help patient appoint check items, and eliminate patients to check the front desk or reservation center reservation registration steps. Results:The successful application of medical equipment reservation system not only optimize hospital inspection process, shorten the patient waiting in line inspection time, but also increase the utilization rate of MR equipment by 35%. Conclusion: The use of medical equipment reservation system saves the patient queuing registration, waiting for the examination of the time, and improve the utilization rate of hospital medical equipment, create economic benefits for the hospital and brought widespread popularity and reputation for the hospital.

Objective:To investigate the metabolism changes in corpus striatum of hemiparkinsonian monkeys after chronic high frequency stimulation in subthalamic nucleus (STN) by SPECT and PET imaging. Methods: Two hemiparkinsonian monkeys, induced by unilateral internal carotid artery infusion of 1-methyl-4-phenyl-1,2,3,6-tetrahydropy-rindine (MPTP), were implanted with stimulation electrodes in STN of lesioned side according to stereotaxic atlas of the monkey brain. SPECT and PET examination were performed before and 1, 3 months after stimulation. Results: PD symptoms of monkeys, including rigidity, bradykinesia and gait abnormality, were significantly improved. SPECT imaging indicated that dopamine transporter (DAT) binding to corpus striatum in stimulated side increased and D 2 receptor (D 2 R) decreased to the level of unlesioned side after stimulating. PET imaging showed that right corpus striatum had lower density than left corpus striatum before stimulation. One month after chronic high frequency stimulation, bilateral corpus striatum had low density, but the right was slightly higher than that of the left;3 months after stimulation the right was obviously higher than the left . Conclusion: The symptoms of hemiparkinsonian monkeys can be obviously improved by STN deep brain stimulation(DBS). The increased DAT binding and glucose metabolism of corpus striatum in stimulated side and the decreased D 2 R binding after stimulation suggest that the activity of striatal dopaminergic system may be promoted by STN DBS.

Objective:This study aimed to clarify the correlation of SPRY4-IT1 expression with the clinicopathological character-istics and prognosis of patients with esophageal squamous cell carcinoma (ESCC), as well as the role of SPRY4-IT1 in promoting ES-CC cell growth. Methods:Quantitative real-time polymerase chain reaction for SPRY4-IT1 expression was performed on 50 paired can-cerous and adjacent non-cancerous esophageal specimens. Small interfering RNA was used to suppress SPRY4-IT1 expression to fur-ther explore its role in tumor progression. Cell viability was tested in vitro by MTT assay (OD=490 nm), and cell apoptosis and cell cy-cle were investigated by flow cytometry. Results:We found markedly elevated SPRY4-IT1 expression in cancerous tissues compared with adjacent non-cancerous tissues (90%, P<0.01). Relative SPRY4-IT1 expression levels were correlated with some clinicopathologi-cal characteristics, such as tumor size (χ2=5.333, P=0.021), elevated TNM (2009) stage classi fi cation (χ2=5.556, P=0.018), and de-creased overall survival rates (χ2=5.296, P=0.021). SPRY4-IT1 expression level was not correlated with patient age, gender, smoking status, or alcohol consumption (all P>0.05). Further experiments showed that SPRY4-IT1 expression levels were significantly higher in three ESCC cell lines than in the normal human esophageal epithelial cell line Het-1A. In vitro assays of the ESCC cell line KYSE30 demonstrated that knockdown of SPRY4-IT1 expression by small interfering RNA reduced cell growth, mediated cell cycle arrest at the G0-G1 phase, and promoted cell apoptosis (all P<0.01). Conclusion:SPRY4-IT1 was overexpressed in ESCC tissues and ESCC cell lines and promoted the growth of ESCC cells. The dysregulated expression of long non-coding RNA SPRY4-IT1 may play an important role in the process of ESCC development and may be developed as a useful biomarker for the diagnosis and prognosis of ESCC.

Objective To evaluate the safety and efficacy of 125I radioactive seeds implantation combined with postoperative chemotherapy as a treatment option for thoracic advanced esophageal squamous cell carcinoma(ESCC). Methods A prospective cohort study was carried out between 2000and 2005. According to preoperative CT staging criteria,298 patients in phase Ⅱ-Ⅲ of ESCC, who had were admitted to Oncology Center Surgery of Nanjing First Hospital Affiliated to Nanjing Medical University and Thoracic Surgery of YanCheng Oncology Hospital, were randomly divided into three groups: intraoperative 125I seeds implantation combined with postoperative chemotherapy (group A, 98cases), postoperative chemoradiotherapy (group B, 100 cases) and surgery alone (group C, 100cases). All patients received radical resection of esophageal cancer. According to pTNM staging criteria after operation, 233 patients in phase Ⅱb-Ⅲ of ESCC were finally enrolled in the study (78 in group A, 75 in group B, and 80 in group C). With 0. 5 m Ci of single seed, total activity of 5-11 mCi and matched peripheral dose in 60-70 Gy, 10-22 125I seeds were implanted into the target of patients in group A under direct vision in accordance with treatment planning system. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X-ray imaging. The postoperative complications were observed. The local recurrence of the cancer was demonstrated using CT scan. The survival rate of patients was followed up for 1-,3-,5- and 10 years. Results The satisfied quality assessment of 125I seeds was observed. There was no displacement or loss of seed. The local recurrence in group A, B and C was 11. 5%, 13. 3% and 38. 8%, respectively, with statistical significance (P ＜ 0. 05). There was no significant difference among three groups with respect to complications and 1-year survival (P＞0. 05). However, the overall survival rate 3-, 5- and 10-years was 64.8%,37. 7% and 25. 1% in group A respectively; 63.3%, 36.9% and 24.9% in group Brespectively; 43. 6i%, 25.0%, and 12.6% in group C, respectively (all P＜0. 05). The 3-,5- and 10-year progression free survival rates were 63.5 %, 37.4 % and 15.1% in group A respectively; 62.5 %,36.6% and 14. 4% in group B respectively; 42.5%, 25.6% and 6.2% in group C respectively (all P＜0. 05). Conclusions It is a safe, effective and simple method for intraoperative 125I seeds implantation combined with postoperative chemotherapy in treatment of advanced ESCC, which may reduce the local recurrence and improve survival rates in patients with ESCC.

Objective To evaluate the strategies and effect of surgical treatment for concomitant abdominal aortic aneurysm (AAA) and colorectal cancer (CRC). Methods Literatures on concomitant AAA and CRC published from January 1988 to December 2008 were retrieved from Pubmed, Sciencedirect, Ovid, CBMdisc, CNKI and et al, and correlated indexes were extracted for analysis. Differences among the groups were analyzed using the t test, chi-square test and fisher's exact test. Results A total of 367 cases of concomitant AAA and CRC treated by operation were retrieved. The length of operation delay of patients who received radical resection of CRC first was (115 ± 21 )days, which was significantly longer than (42 ± 8 )days of patients who received open abdominal aortic aneurysm repair (OAAR) first (t = 18. 9, P <0.05). The 30-day complication rate and accumulative length of hospital stay of patients who received one-stage radical resection of CRC + OAAR were 10.5% ( 12/114 )and (23 ±6) days, and 26.0% (47/181) and ( 16 ±4)days of patients who received two-stage radical resection of CRC + OAAR, with a significant difference ( χ2 = 10.42, t = 12. 01, P <0.05 ). The accumulative length of hospital stay of patients who received radical resection of CRC + endovascular aneurysm repair (EVAR) was (12 ±4) days, which was significantly shorter than that of patients who received radical resection of CRC + OAAR [ ( 19 ±5 ) days ] ( t = 9.48, P < 0. 05 ). The 4-year survival rate of patients who received two-stage radical resection of CRC + OAAR was 43.5% (27/62), which was significantly lower than that of patients who received two-stage radical resection of CRC + EVAR [69.2% (18/26) ] or one-stage radical resection of CRC + OAAR [73.7%(14/19) ] (χ2 =4.83, 5.28, P<0.05). Conclusions If the diameter of AAA is under 5 cm, radical resection of CRC should be firstly carried out; but if the diameter of AAA is above 5 cm, OAAR should be firstly carried out to prevent the rapture of tumors. One-stage surgery is better than two-stage surgery if patients could tolerate it.

Objective To establish a rabbit model of radiation-induced skeletal muscle injury in order to study the ultrastructural pathological changes and underlying mechanism.Methods 28 New Zealand rabbits were randomly divided into 2 groups with 16 rabbits in experimental group and 12 rabbits in control group.The experimental rabbits were irradiated on hip with a single dose of 80 Gy of 9 MeV electrons from a linear accelerator.1 month and 6 months after irradiation the pathological changes were respectively observed under light microscope and electron microscope.Results One month after irradiation,the morphologic changes including degeneration,necrosis of muscle cells,and hemorrhage between the muscle cells were observed under light microscope and the swelling of myofibrillae,blurring of light and shade band,vacuolar degeneration of mitochondria and amorphous areas of necrosis were observed under electron microscope.Six months after irradiation,the morphologic changes of nucleolus chips,fibrous connective tissue,thickening of vascular wall and vascular congestion between the muscle cells and the amorphous areas of necrosis in the experimental group were much more serious than those of 1 month after irradiation.In addition,the myofilaments were lost in degeneration areas and the sarcomere became shorten.Observation with electron microscope showed that the mitochondrial size and its morphological changes were varied and the amounts of collagen between myofibrillaes were increased 6 months after irradiation.Conclusions A rabbit model of high-dose irradiated skeleton muscle injury was successfully established with a single dose of 80 Gy of 9 MeV electrons from a linear accelerator.The degeneration and necrosis of muscle cells may be promoted by mitochondrial and vascular injury,degeneration of vessel and nerve fiber.

Objective To investigate the short-term efficacy and security of combined treatment of iodine-125 seeds and transeathether arterial chemoembolization in liver neoplasms. Methods Transcathether arterial chemoembolization underwent in experimental group (28 cases) with liver neoplasm. The treatment plan was formulated with treatment planning system and a median of 25 seeds per patient (range, 15--40 seeds) were implanted under CT or B ultrasound guidance in 2 weeks after the procedure. Transcathether arterial ehemoembolizafion underwent after the implanted regularity. Blood routine and liver function were detected before and after the procedure. X ray check and abdomen CT scan were performed each 2 months. Control group (32 cases) were treated with transcathether arterial chemoembolization alone. Analysis of variance and Chi-square test were used for statistics. Results All seeds were released to the target places successfully and no seed was found to be lost or migrated in experimental group. Transient elevation of the serum ALT and AST but recovered in 2 week. WBC, Hb, IgA and IgG were showed no significant changes. The severe complication was not found in those eases. The responsive rate of tumor was 75.0% (21/28), 37.5% (12/32) in experimental group and control group, respectively(X2 = 8.485,P = 0.004). The survival rate of 6 months was 92.9% (26/28), 75.0% (24/32) in experimental group and control group, respectively(X2=2.263,P=0.132). The surviral rate of 12 months was 72.0% (18/25), 43.3% (13/30) in experimental group and control group, respectively (X2 = 4.556, P=0.033). Conclusion It is simple, feasible, safe and short-termly effective for liver neoplasms in treatment combined iodine-125 seeds implantation with transcathether arterial chemoembolization.

Objective To explore expression and significance of growth differentiation factor (GDF)-15 in pituitary adenomas.Methods A total of 100 tissue samples of patients with pituitary adenomas were selected and divided into invasive pituitary adenomas group (n =63) and non-pituitary adenomas group (n =37) according to aggressive condition,and 50 healthy people were selected as control group.The expression of GDF-15 was compared among the three groups,and the correlation between GDF-15 and the invasiveness of pituitary adenomas was analyzed.Results The level of GDF-15 in patients with prolactin secreting pituitary adenomas and growth hormone adenomas was significantly higher than that of patients with non-functional pituitary adenomas (P ＜ 0.05).The level of GDF-15 in the invasive pituitary adenomas group was significantly higher than the non-invasive group and the control group (P ＜ 0.05).The correlation analysis showed that there was a positive correlation between GDF-15 and invasive pituitary adenomas (r =0.328,P =0.001).Conclusion In patients with pituitary adenomas,the expression of GDF-15 is higher,and there is a correlation between the GDF-15 level and the invasiveness of pituitary adenomas.

Objective To explore expression and significance of growth differentiation factor (GDF)-15 in pituitary adenomas.Methods A total of 100 tissue samples of patients with pituitary adenomas were selected and divided into invasive pituitary adenomas group (n =63) and non-pituitary adenomas group (n =37) according to aggressive condition,and 50 healthy people were selected as control group.The expression of GDF-15 was compared among the three groups,and the correlation between GDF-15 and the invasiveness of pituitary adenomas was analyzed.Results The level of GDF-15 in patients with prolactin secreting pituitary adenomas and growth hormone adenomas was significantly higher than that of patients with non-functional pituitary adenomas (P ＜ 0.05).The level of GDF-15 in the invasive pituitary adenomas group was significantly higher than the non-invasive group and the control group (P ＜ 0.05).The correlation analysis showed that there was a positive correlation between GDF-15 and invasive pituitary adenomas (r =0.328,P =0.001).Conclusion In patients with pituitary adenomas,the expression of GDF-15 is higher,and there is a correlation between the GDF-15 level and the invasiveness of pituitary adenomas.