This article analyses and describes the influencing mechanism of hospital alliance on quality of care from six aspects:product and technology,organizational structure,psychosocial climate, management,organizational culture,and competition in medical service market.In order to ensure and improve the medical quality,this study discusses that hospital alliance can not only ally in the form but also optimize the internal structure,strengthen the integration of organizational culture of the institutions, gradually form a social psychological climate of“Quality First”.In addition,the government′s regulation on the medical service market is also indispensable.

OBJECTIVE:To provide behavioral intervention strategies for the reduction of health risks involved in Chinese inhabitants' self-medication.METHODS:The health risks and the behavioral patterns involved in Chinese inhabitants' self-medication were analyzed.RESULTS &CONCLUSION:The self-medication behaviors of Chinese inhabitants can only be intervened through strengthening the health education,improving Chinese inhabitants' self-medication ability,standardizing the management of packaging and descriptions of OTC,promoting and enforcing GPP,launching consumer medication counseling services extensively,enhancing pharmacists' quality,reinforcing supervision and reporting of adverse drug reactions,etc.

One hundred and sixteen senile patients (older than 65 years) with chronic heart failure (CHF) were analyzed retrospectively in order to verify if old patients with CHF would benefit from long-term (one year) angiotension-converting enzyme inhibitor (ACEI) treatment. The frequency of drugs (including ACEI, digitalis and diuretic) used was stratified into four degrees accordingly. Development of the CHF was scored with regard to relapse rate and severity of this disease. Stepwise regression analysis was applied to explore the relationship between the scored outcome of CHF and the frequency of individual drug administration. A significant relationship of the scored outcome of CHF to the frequency of ACEI usage but not to digitalis nor to diuretics was found (partial coefficient of the correlation r = 0.42, P = 0.002). It was concluded that the long-term administration of ACEI improves the outcome of CHF in senile patients.
Angiotensin-Converting Enzyme Inhibitors/*administration & dosage ; Chronic Disease ; Heart Failure, Congestive/*drug therapy ; Heart Failure, Congestive/etiology ; Hypertension/complications ; Myocardial Ischemia/complications ; Retrospective Studies ; Treatment Outcome

Objective To investigate clinical features and extent of gastric, liver and pancreatic damage of primary Sjgren syndrome(pSS). Method Clinical data of 152 pSS patients with gastric,liver and pancreatic damage were analyzed.Results The occurence of chronic atrophic gastritis(CAG),the most commonly seen gastic involvment in pSS,was 77.8%.The atrophic leisions differed with patient's age.Compared with the control group, the atrophy and intestinal metaplasia of the pSS patients with CAG were milder(P

ObjectiveTo observe the changes of high sensitive serum C-reaction protein (hsCRP) in macrovascular disease with or without type 2 diabetes.MethodsThere were 3 groups population in our study:148 type 2 diabetic patients were divided into 2 subgroups:77 patients with macrovascular disease and 71 without macrovascular disease, 73 non-diabetic patients with macrovascular disease and 75 health controls. The concentration of serum hsCRP of all patients were determined by ELISA.ResultsThere was significant difference in concentration of serum hsCRP between type 2 diabetes with or without macrovascular disease groups, non-diabetes macrovascular disease group and control(P<0.01 or P<0.001). However, there was not significant difference between 2 diabetes groups and non- diabetic macrovascular disease group(P>0.05). There was no significant difference in hsCRP between type 2 diabetes with and without macrovascular disease (P>0.05).ConclusionThere may be a chronic inflammatory reaction in patients with type 2 diabetes or macrovascular disease. hsCRP might be a well forecasting factor of the occurrence and development of type 2 diabetes and atherosclerosis.

Objective To study the serum level of resistin and IL‐6 in the sepsis‐induced acute lung injury (ALI) in rats and to probe the relation of IL‐6 and resistin to ALI and its possible mechanism .Methods The forty‐five Wistar rats were randomly as‐signed to three groups ,a control group ,a sham group and a model group .ALI was induced by intravenous injective of LPS (10 mg/kg) and those animals were killed after 6 hours ,12 hours ,24 hours .The lung wet/dry weight ratio ,serum IL‐6 was detected by chemiluminescence and resistin levels were detected by ELISA .Results Compared with the control group and the sham group ,the lung wet/dry weight ratio ,lung pathologic tissue score ,the serum level of resistin and IL‐6 were increased(P<0 .05) .Positive cor‐relation was observed between resistin and IL‐6 in different time .Conclusion Resistin possibly participate the process of sepsis in‐duces ALI .

AIM:To explore the association between single nucleotide polymorphism in exon 33 (E33SNP) of thyroglobulin gene and Graves ’ disease ( GD) relapse after antithyroid drug ( ATD) withdrawal .METHODS:The healthy controls (232 cases) and GD patients with discontinued treatment (243 cases) were selected.According to the time of re-lapse, the GD patients were divided into A, B and C subgroups.The A group contained 77 cases of relapse within 1 year, B group contained 86 cases of relapse 1~2 years after treatment and C group contained 80 cases without recurrence within 2 years.The genotypes of E33SNP were identified by RT-PCR.The genotype ratio of thyroglobulin between control group and observation group was comparatively analyzed , and the levels of thyroid-stimulating hormone ( TSH) , free triiodothyro-nine (FT3), free thyroxine (FT4) and thyrotropin receptor antibody (TRAb), ophthalmopathy and goiter size in A , B and C subgroups in different genotype GD patients were investigated .Moreover , cumulative efficiency for patients with different genotypes in the observation group after ATD treatment within 2 years were analyzed .RESULTS:The genotype of E33SNP between observation group and control group had no significant difference , but a significant difference between A , B and C subgroups was observed (P<0.05).The levels of TSH, FT3 and FT4, and goiter size of the patients with different geno-types had no significant difference , while the TRAb levels and ophthalmopathy presented a significant difference ( P <0.05).In addition, the cumulative efficiency within 2 years for GD patients with E33SNP T/T, E33SNP T/C and E33SNP C/C genotypes was 61.8%, 42.6% and 21.3%, respectively, all with significant differences (P<0.05).CONCLU-SION:The GD patients with E33SNP C/C genotype have significantly higher TRAb level and ophthalmopathy rate than those in the patients with E33SNP C/T and E33SNP C/C genotypes, and are more likely to relapse after ATD treatment . The GD patients with E33SNP T/T genotype show a lower recurrence rate .Therefore, combination treatment or other treat-ment modalities may be more reasonable for the GD patients with E 33SNP C/C genotype.

Objective To observe the apeptosis in liver injury following limbs ischemia-reperfusion(IR) in rats and the protective effects of taurine.Methods The model of limbs ischemia-reperfusion injury was established.30 Wistar rats were randomized into 3 groups: control group,IR group and tanrine + reperfusion group (TR group) (n = 10 for each group).The levels of malondialdehyde (MDA) and xanthineoxidas (XOD), calcium and myeloper-oxidase (MPO) in the liver tissue were measured.DNA fragmentation was observed and analyzed by agarose gel e-lectrophoresis.Apoptosis was detected by TUNEL methods.The morphologic changes were observed with HE stai-ning.Results Compared with control group,the values of MDA, XOD, MPO, calcium in liver tissue were increased significantly in IR group (P<0.01), but the values of those in TR group were lower than in IR group (P<0.01).The percentage of apeptosis cell was higher in IR group than in control group(P<0.01).Compared with IR group, the percentage of apoptosis cell was lower in TR group (P<0.01).IR group presented DNA ladder pattern, while TR group showed no specific DNA ladder pattern in agarose gel electrophoresis.Conclusion Apoptosis participates in the liver injury after limb ischemia-reperfusion.Taurine can mitigate the liver injury and apoptosis after limb is-chemia-reperfusion injury in rats.

AIM: To investigate the application of phrenic nerve conduction time(PNCT) in the recovery of general anaesthesia. METHODS: Pdi (t) and PNCT were measured by cervical magnetic stimulation of phrenic nerves in 8 patients before and after the administration of muscle relaxant. RESULTS: Pdi (t) was reduced from (23.7?2.4) cmH 2O to (11.5?3.4) cmH 2O (reduction rate: 51.5%, P

Objective To observe BQ123 on lung tissue injury following ischemia-reperfusion of hind limbs in rats.Methods A total of 30 male SD rats were randomly divided into control,I-R,and BQ123 groups,with 10 rats in each group. After 4- hour of ischemia and 4-hour of reperfusion to the hind limbs, ET-1 was measured by radioimmunoassay, levels of myeloperoxidase (MPO) and malondialehyde (MDA) were examined by biochemical method,and the content of P-selectin was examined by ELISA. Immunohistochemical method was used to detect the expressions of Fas,Bcl-2 and Caspase-3 in lung tissues. Pulmonary apoptosis was examined by means of TdT-mediated dUTP nick end labeling ( TUNEL) . Results Compared with the control group,the levels of ET-1,MPO,MDA and P-selectin in lung tissues were all increased significantly in I-R group ( P<0. 01). The expressions of Fas,Bcl-2 and Caspase-3 were 0. 294±0. 003,0. 108±0. 005,and 0. 174±0. 003,significantly up-regulated in the I-R group. The apoptosis rate [(18. 83±2. 86)%] was significantly increased in the I-R group (P<0. 01). Compared with I-R group,the tissue contents of ET-1,MPO,MDA and P-selectin were significantly lowered in BQ123 group (P<0. 01). The expression levels of Fas (0. 115±0. 007) and Caspase-3 (0. 159±0. 006) were decreased,but the expression of Bcl-2 was increased (0. 128±0. 005). The apoptosis rate in BQ123 group was significantly lower [(10. 67±2. 16)%,P<0. 01].Conclusion BQ123 may have protective effects on lung tissue after limb ischemia-reperfusion in rats by means of improving neutrophil aggregation and reducing the expression of proteins related to cell apoptosis.