ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.
Hospital Administration/legislation & jurisprudence ; Hospital Administration/*standards ; Hospitals, Public/legislation & jurisprudence ; Hospitals, Public/*standards ; Management Audit/*standards ; Quality Assurance, Health Care/*organization & administration ; Quality Control ; Total Quality Management/methods ; Total Quality Management/*standards

The health check up flow of digital hospital can be consulted with the assembly line of industry factory. Because they have the following same features: highly specialized workstation, closeness and continuance, rhythm, balanced production, continuous production. The essential prerequisites are as the follows: The inspecting items and methods should be stable; advanced product mix and stable production design; standardized raw material, consumption, procedure, inspection method; there are lots of request for health inspection; the customers move at the least unit; the space arrangement should be reasonable; the time arrangement should be proportion. With the computer net, the digital inspection can achieves the raw material controlling accurately. The basis of check up line concerns about equipment, net and software, data collection, and personnel. The group technology is used in the health inspection flow design of the digital hospital in the field of items customers and zone redivided. The digital assembly linemic health inspect has the following stages: member registering, notice, check in, arrange order, time control, report, feedback and analysis. The assembly linemic has following advantages: increasing the productivity, the space utility, satisfaction of customer, fund returning, lowering the cost and ensuring the quality.
Computer Communication Networks ; *Delivery of Health Care ; *Hospital Administration/economics ; *Hospital Information Systems/organization & administration ; Preventive Health Services/economics ; Preventive Health Services/organization & administration

Mesangial proliferation is a basic pathologic process of many kidney diseases,mesangial proliferative glomerulonephritis(MsPGN) is the common pathological type.The pathogenesis of MsPGN still remains unclear.Recently,cytokines of fractalkine,interleukin and TGF-β gradually become hotspot in the pathogenesis of MsPGN.Studies shows that a variety of cytokines play an important roles in the development of MsPGN and the mechanism has been gradually clarified.Certain progress has been made in treatment,and more profound understanding of mycophenolate mofetil has been received,the treatment of the MsPGN as manifestations with refractory nephrotic syndrome has been achieved good effect.This review is based on the recent years of the primary non-IgA MsPGN progress.

Objective To study the significance of Wnt5a gene expression in gastric carcinoma (GC). Methods The Wnt5a mRNA expressions in SGC7901 cell line and normal gastric mucosa GES-1 cell line were detected by RT-PCR. The Wnt5a protein expressions in 60 GC and 30 matched tumor-adjacent normal tissue samples were examined by immunohistochemistry using the streptavidin-peroxidase method.χ2 test was used to analyze Wnt5a expression on the clinical pathologic features of gastric carcinoma. Results Both Wnt5a mRNA and Wnt5a protein were significantly higher in SGC7901 cells than those in GES-1 cells. The positive rate of Wnt5a protein expression was also significantly higher in GC than that in tumor-adjacent normal tissue (P < 0.05). Positive expression of Wnt5a was associated with higher degree of regional lymph node metastasis and the later TNM stage (P < 0.05). Conclusion Higher expression of Wnt5a seems to promote invasion and metastasis of gastric cancer, and Wnt5a might play an oncogene-like role in the development of gastric carcinoma.

Background:The clinical presentation of eosinophilic gastroenteritis( EG)is nonspecific and has not received much concern by physicians and pathologists. The diagnosis of EG was delayed in many cases. Aims:To explore the clinical features of EG. Methods:The clinical,laboratory,endoscopic and radiologic features and treatment in patients who were diagnosed as EG from October 2011 to September 2013 in Zhongshan Hospital, Fudan University were analyzed retrospectively. Results:Median age of 10 EG patients was 41. 9 years. Four patients had a history of allergy or asthma. The time from onset to diagnose was 25 days on average. The most common symptoms were abdominal pain with bloating, diarrhea or vomiting. Eight patients had hypereosinophilia. Abdominal CT revealed uniform edema or stratified thickness of intestinal wall or ascites in 7 patients. Endoscopy revealed erythema,edema and erosion in antrum,duodenum or jejunum in 6 patients. All cases were confirmed as having eosinophilic infiltration by mucosal biopsy or examination of ascites. Seven patients were successfully treated with corticosteroid. One patients experienced relapse after discontinuing corticosteroids during following up. Conclusions:EG may be more common than previously recognized and should be considered in the differential diagnosis of unexplained abdominal pain with peripheral eosinophilia or uniform edema or stratified thickness of intestinal wall. Multiple biopsies in multiple sites including descending duodenum and pathological examination for finding eosinophil infiltration are the keys to confirm the diagnosis. Corticosteroids are effective in relieving symptoms and improving eosinophilia.

Objective To evaluate the value of multi-slice CT(MSCT)classification in the assessment of the hilar cholangiocarcinoma resectahility.Methods Thirty patients with surgically and histopathologically proved hilar cholangiocarcinomas who underwent preoperative MSCT and were diagnosed correctly were included in present study.Transverse images and reconstructed MPR images were reviewed for Bismuth-Corlette classification and morphological classification of hilar cholangiocarcinoma.Thcn MSCT classification was compared with findings of surgery and histopathology.Curative resectabilty of different types according to Bismuth-Corlette classification and morphological classification were analyzed with chi-square test.Results In 30 cases,the numbers of Type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ according to BismuthCorlette classification were 1,3,4,5 and 17.Seventeen patients underwent curative resections,among which 1,2,1,4 and 9 belonged to Type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ respectively.However,there was no significant difference in curative resectability among different types of Bismuth-Corlette classification(X2=0.9875.P＞0.05).In present study,the accuracy of MSCT in Bismuth-Corlette classification reached 86.7%(26/30).The numbers of periducatal infiltrating,mass forming and intraductal growing type were 13,13 and 4,while 6,8 and 3 cases of each type underwent curative resections.There was no significant difference in curative resectability among different types of morphological classification(X2=1.2583,P＞0.05).The accuracy of MSCT in morphological classification was 100%(30/30)in this study group.Conclusion MSCT can make accurate diagnosis of Bismuth-Corlette classification and morphological classification.which is helpful in preoperative respectability assessment of hilar cholangiocarcinoma.

Objective To develop an intelligent assist order system for parenteral nutrition and embed it into hospital information system,so as to facilitate rational prescription of parenteral nutrition.Methods Comprehensive database,knowledge base and control system of parenteral nutrition orders were set up based on production rule.An intelligent assist order system for parenteral nutrition was designed and developed.Individual energy demand of patients were calculated automatically and compared with doctors' orders of parenteral nutrition.Cation concentration was calculated automatically and controlled for the stability of all-in-one parenteral nutrition admixture.Results This system achieved successful and fast calculation of individual energy demand,over-standard warning of total energy,the ratios of carbohydrates to lipids and non-protein calories to nitrogen,ion concentration,and liquid volume.It also controlled the cation concentration,thus avoiding demulsification.Conclusions The intelligent assist order system for parenteral nutrition can solve the problems of energy calculation and ensure the stability of all-in-one parenteral nutrition admixture.As a result,it can improve the utilization of parenteral nutrition in hospital.

Objective To establish experimental vascular dementia rat model and evaluate gait behavior . Methods Vascular dementia rat model induced by bilateral carotid artery ligation methods , 50 days for real-time gait behavioral training and testing after surgery .Results Compared with the sham group , Experimental vascular dementia model rats had 19 gait indicators appeared significantly statistical difference , Animal model gait abnormal behavior is mainly reflected in the forelimb step width increased (P <0.05), each foot walk cycle extension (P <0.05), Each foot stance time increased (P <0.05, P <0.01), and the swing time shortened (P <0.05), Homologous coupling shortened (P<0.05), each foot average footprint area and average intensity increased (P <0.05, P <0.01).Conclusion Experimental rat model of vascular dementia in real time gait abnormal behavior and seen in patients with clinical symptoms similar, can provide a reference model for the establishment and judgment .

Breast cancer stem cells (CSCs) are the main causes leading to the failure of treatment of breast cancer and play important roles in the progression of breast cancer and drug resistance, which are closely related to the therapeutic resistance of radiotherapy and chemotherapy, and endocrine therapy.The metastatic potential and therapeutic resistance of CSCs are associated with epithelial mesenchymal transition and Hedgehog, Wnt, interleukin-6/signal transduction and tanscriptional activation factor 3, transforming growth factor-β and other signaling pathways.While some of the targeted drugs targeting these signaling pathways are undergoing clinical transformation, which is expected to provide new approach for the clinical treatment of breast cancer.

To explore the status of HER-2 gene amplification and protein expression in Chinese esophageal squamous cell carcinoma patients and its relationship with the clinicopathological parameters.Methods The HER-2 gene amplification was detected by FISH and protein expression by IHC in 96 patients with esophageal squamous cell carcinoma that would be followed up for 3 years.Results Three cases presented with 3 +,15 cases with 2 +,11 cases with 1 +,and 67 with negative by HER-2 immunohistochemical staining;2 of 3 cases presented with HER-2 amplification in in 3 +,1 case presented with over 6 HER-2 copy numbers.HER-2 amplification and HER-2 overexpression had significant correlation (P ＜ 0.000 1).HER2 amplification or overexpression was associated with clinicopathological parameters,such as,carcinomas without necrosis (P =0.012) and lower stage (P =0.040).There was better DFS or OS trend in patients with HER-2 overexpression or amplification,but the significant difference did not reached.Conclusion This research has demonstrated the correspondence between gene amplification and protein overexpression of HER-2 in ESCC.HER-2 gene overexpression or amplification is a potential better predictive parameter in ESCC,but needs further study.