The three-level quality management organization system established in the hospital required both the hospital and department indicators to be submitted to quality management and patient safety committee and they will be approved after discussion .The quality manager of each department need to report the monitoring data monthly , and the leaders can directly consult the monitoring data in real time by logging in quality management system .When the abnormal data or adverse trend are found , the management and relevant departments will analyze the reasons , and the relevant departments will draw up and implement the plan to continuously improve the medical quality .

Primary aldosteronism is a common cause of secondary hypertension.Laparoscopic surgery has become the golden standard for treatment of primary aldosteronism since the first laparoscopic adrenalectomy was performed in 1992.Adrenal-sparing surgery was recommended in surgical treatment for aldosterone-producing adenoma.This article reviews the factors influencing the improvement of postoperative blood pressure,and introduces the indications of the surgical treatment in patients with idiopathic hyperaldosteronism.

According to laws and regulations , rules and relevant standards , combined with the actual condition of our hospital, to develop the hospital management policies of covering the whole process of medical care , and to update in time, which is the basis of ensuring the quality of medical care .Our hospital standardized the management of the policies , designed a unified process from the formulation , review, approval, issuance, revision, abolishment of the hospital management poli-cies, and supervised and implemented effectively , in order to achieve the sustainable development of hospital management policies standardly , integrally , dynamically .

Objective To study the influece of probucol on high-sensitivity C-reactive protein(hs-CRP) and bone morphogenetic protein-7 (BMP-7) in serum of patients with diabetic nephropathy.Methods 124 patients with diabetic nephropathy were randomly divided into two groups,the control group (n =62 cases) and the observation group(n =62 cases).The patients of the control group were treated through the conventional treatment.However,the patients of the observation group were treated by probucol on the basis of conventional treatment.They were treated for eight weeks.The 24-hour urinary protein,hs-CRP and BMP-7 were detected before and after treatment.Results The 24-hour urinary proteins were decreased in both two groups after treatment (t =6.161,5.23,P ＜ 0.01).There was significant difference between two groups(t =5.35,P ＜ 0.05).The hs-CRP and BMP-7 were improved after treatment (t =10.50,5.54,all P ＜ 0.05),while those of the observation group were more significantly improved than those of the control group(t =10.28,4.36,all P＜0.05).Conclusion Probucol could improve the conditions of diabetic nephropathy which was through improving hs-CRP and BMP-7.

Objective To investigate the causes and influencing factors of dead on arrival (DOA) in children.Methods The clinic data from 66 children with DOA admitted in the emergency department of Hunan Children's Hospital from Jan 2010 to Apr 2012 were analyzed retrospectively.Results All of the 66 cases had cardiac respiratory arrest when admission.Fourteen cases had arrest for 10 minutes,12 cases for 30 minutes to an hour,40 cases had no details.Forty-four (68.2％) cases were carried by parents,22(31.8％)cases were transferred by medical professionals.The main causes of DOA were severe pneumonia with respiratory failure and (or) heart failure,intracranial infection,neonatal diseases.All cases were taken to resuscitation room by triage immediately.Tracheal intubations were completed in 48 cases and intravenous access with injection of epinephrine and other resuscitative drugs were established in all cases,but all cases were dead due to breathing and heartbeat stopped for a long time.Conclusion DOA is one of the important reasons for pediatric high-risk.The key of reduction of DOA incidence and improvement of survival rate is to improve pediatric emergency medical service system,strengthen the health education for the parents,to carry out training and establish homogenization service in emergency ICU.

Objective To investigate the correlation between urinary calculi and upper urinary tract infections.Methods Twenty-six patients underwent lithiasis in upper urinary tract accompanied with infectious symptoms were enrolled in this study (test group).Blood culture was obtained in peak temperature before lithotrity,urine sample was obtained for bacterial culture.Thirty patients with calculi in upper urinary react accompanied no infectious symptoms in the same period were enrolled in control group.Calculi were pestled for bacterial culture and analyzed the components after the calculi were removed.Results In test group,the positive of blood,urine,calculi culture were 4,23,18 patients.The prominent component of calculi was hexahydrate magnesium ammonium phosphate.Bacteria in 13 positive urine sample had the same property with the calculi samples which came from the same cases.In control group,the positive of urine,calculi culture were 4,4 patients.The prominent component of calculi were calcium oxalate calculi and uricite calculi.The morbidity of upper urinary tract infections in test group was significantly higher than that in control group [69.2％(18/26) vs.13.3％(4/30)] (P ＜ 0.05).The coincidence of urine culture and calculi culture in test group was significantly higher than that in control group [72.2％(13/18) vs.25.0％(1/4)](P＜0.05).Conclusions Infectious calculi can easily result in upper urinary tract infections.Hexahydrate magnesium ammonium phosphate can make the prominent component in infectious calculi.

Apathy is a common neuropsychiatric complication after stroke,the identification of apathy after stroke and its related factors and providing an effective intervention on it may contribute to the rehabilitation in patients with stroke.This article reviews the incidence of apathy after stroke,pathophysiological mechanisms,diagnostic evaluation and treatment.

This paper introduces the relationship between glutamate transporter, glutamate/cysteine transporter and neurotoxicity induced by glutamate. Under pathologic conditions, glutamate transporters release glutamate to activate glutamate receptors, and inhibit the uptake of glutamate/cysteine transporters, which induces downstream changes. Among these changes oxygen derived free radidicals affects the function of glutamate transporter and enhances the neurotoxicity of glutamate. All these can lead to neurocyte death. Glutamate transporters release glutamate to inhibit the uptake of glutamate/cysteine transpoter and activate glutamate receptor. The inhibition of glutamate/cysteine transpoter affects the function of glutamate transporter. Two transporters interaction and the downstream changes lead to neurocytes death.

Objective To observe the curative effect of surgical treatment for eyelid basal cell carcinoma. Design Retrospective case series. Participants 33 cases with eyelid basal cell carcinoma. Methods 33 cases with eyelid basal cell carcinoma treated with surgery, standard excision in 17 case and Mohs micro excision in 16 cases were analyzed, postoperative appearance and function of re- eonstruetiiv eyelid, reeurence rate and survival rate were observed by follow-up survey. Main Outcome Measures Postoperative ap- pearance, function of reconstruetiiv eyelid, recurence rate and survival rate. Results After 6 month ~ 5 years follow-up survey with an average of 2.5 years, 28 of 29 cases obtained normal eyelid appearance, 1 case with lower eyelid gentle ectropium. 11 cases showed hy- perpigmentation in skin-grafting area in early stage, and became normal in half a year. Eyelid function of 29 cases were normal. Tumour relapse was seen in one case 2 years after standard resection,the cure rate was 94.12%. No tumor relapse was seen in group of mohs micro resection, the cure rate was 100%. Within five years postoperation, there was no death case caused by basal cell carcinoma re- lapse, except one dying from myocardial infarction and another dying of eerebrovaseular disease. Conclusions Operational excision is an effective approach for eyelid basal cell carcinoma. The effect of mohs micro resection is better than the one of standard resection. With dissociate skin grafting, fluctuate tarsal transmigration and dissociate skin grafting, eyelid appearance and function recover well.

Objective: To explore the effect of mast cell before or after stimulation of antigen (?IgE HRP).Methods: To observe the shape and calculate the percent of histamine releasing of mast cell used the staindiing method of DAB add neutral red.Results: The tendency of the degranulation of mast cell was declined obviously after adding HUOXIANG ZHENGQI ORAL LIQUOR. Conclusion: HUOXIANG ZHENGQI ORAL LIQUOR can prevent and treat type Ⅰ hyperresponsiveness.