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 .

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.

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 quality standard of Gegenbao Soft Capsule.Methods The qualitative identification of puerarin and daidzein was carried out by TLC,and the contents of puerarin and daidzein were determined by HPLC.Results Puerarin and daidzein could be identified by TLC with high specificity.The linearity was from 0.214 to 1.42 ? g for puerarin and from 0.033 to 0.221 ? g for daidzein by HPLC,and the average recovery was 101.5 % for puerarin and 96.6 % for daidzein with RSD 1.6 % and 1.8 % respectively(n=6).Conclusion This method is simple,accurate and reliable for the quality control of Gegenbao Soft Capsule.

Objective To explore the treatment of kala-azar with antimonial resistance in children. Method The clinical data of antimony resistant Kala Azar in a child was analyzed retrospectively, and the related literature were reviewed. Results A 2-year- and 5-month-old boy, suffered from fever, pancytopenia and hepatosplenomegaly. He was diagnosed with kala-azar by bone marrow examination, and improved after the treatment of adequate antimonial. Later, he relapsed twice and the treatment of adequate was effective.. This was the third relapse, and was considered as antimonial resistance. Liposomal amphotericin B (1 mg/kg on day 1, 2 mg/kg on day 2, 3mg/kg on day 3~7 and day 10, with accumulated dose of 21 mg/kg) was used and effective. The child improved and no relapse in one-year follow-up. Conclusion Liposomal amphotericin B can be used in the treatment of kala-azar with antimonial resistance in children.

Objective To investigate the factors of postoperative complications of elderly patients with gastric cancer. Methods One hundred and fifth elderly patients with gastric cancer were selected as our subjects,who were underwent surgical treatments in general surgery department Jiangsu Shengze Hospital from Jan. 2009 to Dec. 2012. The general informations including age,staging of gastric cancer,radical operation performed or not,resection combined with other organs and operation periods were recorded. Results There were no significant differences between postoperative complications patients in terms of age,staging of gastric cancer,radical operation performed or not,resection combined with other organs( χ2 = 3. 113,P = 0. 078,χ2= 0. 465,P = 0. 495,χ2 = 0. 518,P = 0. 472,χ2 = 0. 303,P = 0. 582). The cases with operation periods < 3 h in complication group and no complication group were 30(57. 9% )and 51(81. 0% ),and the operation periods> 3 h were 22(42. 3% )and 12(19. 1% )respectively,and the difference was significant( χ2 = 6. 326,P= 0. 012). Conclusion Operation period is the main influencing factor of the elderly patients with gastric cancer. Therefore,reducing operation period under ensuring operation quality is more efficiency to decrease the complication.

Objective To study the clinical effects of Dingchuan zhike decoction with ambroxol hydrochlo-ride on the patients with chronic obstructive pulmonary disease and pulmonary heart disease.Methods According to the random number table,the patients were divided into the observation group (70 cases)and the control group (73 cases).The patients were treated with ambroxol hydrochloride and Dingchuan zhike decoction in the observation group;the control group had a treatment with ambroxol hydrochloride.The lung function,sputum fluid inflammatory cytokines and clinical symptoms were compared between the two groups.Results When the two groups received treatment for 7 days,VC and FEV1 in the observation group were (2.45 ±0.38)L and (1.51 ±0.24)L,those in the control group were (1.94 ±0.38)L,(1.01 ±0.21)L,the patients′lung functions:FVC,VC,PEF,FEV1,and MVV% were improved in the observation group than those in the control group (t=10.64,15.87,12.14,10.22, 14.04,all P<0.05);After 14 days treatment,VC and FEV1 of patients in observation group were (2.83 ±0.35)L and (1.67 ±0.27)L,those in control group were (2.25 ±0.22)L,(1.21 ±0.23)L,the patients in the observation group were better than those in the control group on the lung functions:FVC,VC,PEF,FEV1 ,and MVV% (t =11.02,11.87,12.68,16.41,16.09,all P<0.05).The CRP of the observation group were (14.13 ±5.21)mg/L, (3.94 ±2.39)mg/L,after 7 and 14 days treatment respectively.And these in the control group were (20.99 ±9.77) mg/L,(9.94 ±8.22)mg/L.The PCT of the observation group were (0.31 ±0.24)μg/L,(0.27 ±0.09)μg/L. These in the control group were (0.51 ±0.21)μg/L,(0.31 ±0.18)μg/L.The levels of CRP and PCT on the obser-vation group′patients were better than those on the control group′patients after 7 days treatment (t=16.75,22.05, all P<0.05).When patients received 14 days therapy,the levels of CRP and PCT on the observation group′patients were better than those on the control group′patients (t=10.75,12.05,all P<0.05).The total effective rate was 86.30% in the control group and that of the observation group was 97.14 %.The total effective in the observation group was better than that in the control group.(χ2 =5.46,P<0.05).Conclusion The therapy of ambroxol hydro-chloride with Dingchuan zhike decoction is better than therapy of ambroxol hydrochloride alone.

Objective To observe the efficacy of drug treatment of coronary aneurysm complicated with embolism in Kawasaki disease (KD). Methods The clinical data of eight KD children with coronary aneurysm and embolism were retrospectively analyzed. Results Eight KD children (six males and two females) at age of 0.25-5.2 years (mean=2.89) ,were diagnosed with gigantic coronary artery aneurysms. The diameter of aneurysm was around 8.3-13.8mm. Thrombosis appeared from 19 days to five months after coronary aneurysms formation. The onset manifestations included sudden chest pain and myocardial infarction with symptoms of heart failure in one case, shock in one case and no symptom in six cases. The maximum diameter of the thrombus was 2.8 mm×15.4 mm in the shape of funicular. Four cases had thrombus in the right coronary artery, two cases in the left coronary artery, and two cases in both sides. The patients underwent anticoagulant therapy taking heparin, urokinase, warfarin, aspirin and dipyridamole. Anticoagulant therapy was successful in 7 cases and the thrombus was completely dissolved in 7 days to more than 4 months. One case had recurrent coronary thrombosis after 4 months. One case died in 12 hours after thrombolysis. Conclusions Coronary thrombosis usually appears in the half year after the onset of KD coronary aneurysm. Thrombolysis therapy takes long time in Kawasaki patients. Breaking off of thrombus are rarely seen.

Chickenpox is an acute and highly infectious respiratory disease commonly seen in children.Varicela－zoster often results from the activation of latent virus in chickenpox called varicella－zoster virus（VZV）or called human herpesvirus type 3. Primary infection of VZV may induce typical disease of various severity and most healthy children infected with VZV have mild symptoms and good prognosis.But VZV infection，if occurs in special population such as persons of immune inhibition treatment will induce serious consequence or even death and it is as same serious as in adults.A detailed illustration of molecular biology，epidemiology，laboratory diagnosis，treatment and preventive strategy of the VZV were given.