Quality of care is key to medical safety which has a close bearing on patients’life and health,and on the branding and efficiency of the hospital.Medical safety is one of the key indicators of the overall performance appraisal of the hospital.This novel type of nurse-physician collaboration,abandoning the traditional model of health care,is a new integrated model of health care which improves the overall quality of care,enhances medical safety and patient satisfaction.This paper described in detail the implementation methods and steps of the collaboration,the progress of such a collaboration and its contribution to medical safety are also discussed.

Objective To understand how about the female consumers know the skin conditions of themselves and which they concern by a comprehensive questionnaire. Methods Three hundred and twenty-eight healthy volunteers in Shanghai were involved in this study. They were divided into 5 age groups equally. The questionnaire included the skin conditions, i.e. skin moisture, sebum, whiteness, redness, xanthochromia, homogeneity, spots, fine line, wrinkle, elasticity, angiotelectasis,pore, sagging, smoothness, gloss, roughness, scales and sensitivity. Each condition was divided into 10 grades to assess the skin conditions of the face (exposed site), upper arm (non-exposed site) and the perfect skin status. SPSS11.5 software was used to analyze the correlations of the skin conditions with ages. Results The skin concerns were difference in the 5 groups. Skin aging of sagging, wrinkle, spots and fine line became prominent from group C (35 to 40 years old). The correlations between the skin concerns of facial moisture, sebum, whiteness, homogeneity, spots, wrinkle, fine line, elasticity, sagging, sensitivity, upper arm sebum, spots, elasticity, angiotelectasis, sagging and roughness with ages were very significant (P＜0.01). Conclusion The changes of the volunteers'concerns about sebum, pore, sagging, elasticity, fine line and wrinkle with age in different age group are consistent with the quantitative measurement results from the oversea studies.

Objective To summarize the experience and the insufficiency of Nanjing Drum Tower Hospital on patent management,and find out the problemsand countermeasures for the management.Methods The authorized patents during 2003-2014 of Nanjing Drum Tower Hospital were analyzed statistically,and the date was overall analyzed combined withthe number,type,content,maintenance and transfer of patent and inventors' educational background,title and subject;and results are further analyzed;Results Patent grant increased significantly more than the invention patent in recent years.In terms of patent types,most patents are utility model patents,and conversion rate of patent outcome is very low.Conclusions Suggestions are proposed to improve hospital patent management:strengthening the guidance of the management of patent policy;promoting patent work;enhancing the professional quality of patent managers;optimizing the patent management processe andstrengthening the patent examination and data analysis;strengthening strategic cooperation among intellectual property management department,patent agency and biological pharmaceutical enterprises.

Objective To explore and investigate effective solutions of some issues in the self-development of large-scale compre-hensive hospital ,such as the innovation concept of hospital management ,strengthening the organization and management agencies , improving management efficiency and promoting the establishment of systematized management .Methods Starting from concept innovation ,theory innovation and method innovation of hospital management ,comprehensive applied the advanced concept of hospi-tal management and scientific management methods into the quality of medical care .Results Continuously strengthen the hospital medical quality and safety ,and form hospital-specific quality management system .Conclusion Through innovating the concept ,the-ory and methods of hospital management ,we can effectively promote continuous improving quality of medical care in comprehensive hospital and improve continually core competitiveness of hospital .

This article sumarized a practise-based study of the hospital regarding the management of its medical activities.By means of priotizing medical safety in pre-job and on-the-job eduation,and regular trainings in this regard,a systemized medical safety education ssytem is put in place among medical staff of different types and levels.This achieved the purpose of higher awaress of medical safety in medical practice,and downsized medical complaints significantly.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

As the importance of clinical risks management grows hospital management,reducing hospital medical errors for patients safety has become a key quality management process.Failure Mode and effect analysis( FMEA) is a proactive technique for error detection and reduction.In this paper,based on a brief review of it's history of development,described in detail the implementation method and steps of FMEA,mainly introducing the research progress for using FMEA in reducing hospital medical errors.

Objective To evaluate the expression of molecular markers in prostate cancer and to clarify the significance of these markers as prognostic indicators for androgen deprivation therapy. Methods A series of 116 prostate cancer patients under androgen deprivation therapy as a single treatment was reviewed. Expression levels of 7 proteins, including androgen receptor(AR),E-cadherin, Chromogranin A(CgA) , Ki-67, Survivin, EZH2 and hepsin, were measured by immunohistochemical staining. Results Of the 7 molecules. Ki67,EZH2 and Survivin expression were significantly associated with several conventional prognostic factors. Univariate analysis identified clinical stage, Glea-son scores,pretreatment serum PSA level, Ki-67 and Survivin expression as significant predictors for prostate-specific antigen (PSA) progression after endocrine therapy. Of these significant factors, Survivin expression, clinical stage and Gleason scores appeared to be independently related to PSA progression after endocrine therapy by multivariate analysis. Furthermore, there were significant differences in PSA progression-free survival according to positive numbers of these three independent risk factors. Conclusion Survivin could be a useful independent prognostic factor in prostate cancer with endocrine therapy, besides clinical stage and Gleason score.

Objective Through investigating the current situation of scientific research in medicine graduate students, we can provide scientific basis for training postgraduates effectively and reference for graduate education reform. Methods A total of 243 medicine graduate students in Drum Tower Hospital were surveyed and asked to complete the designed questionnaires which included general situation, the objective to study, the situation of participation projects, the management of student, and achievements. Results 33.74％ (82) of students' purpose was confusion, 51.44％ of (125) graduate students engaged in clinical and basic research, the scientific research graduate students and doctoral students participated in the tutor research project more than the professional type graduate students and Postgraduate student (P<0.05). There were significant differences in the number of SCI related papers published by the postgraduates who differ in their ways of training and in different degrees (P<0.05). Conclusion Graduate students are an important part of high-level talents in China. They are the successors of future scientific research. The effectiveness of training postgraduates' scientific research ability will directly affect the future scientific research level of the country. So we should strengthen the cultivation of graduate students' scientific research accomplishment, construct a scientific training model, set up scientific training mode and supervision mech-anism, in order to promote the research level of medical graduate students.

Objective To retrospectively investigate the disease spectrum of inpatients aged over 65 year and cost constitution in Sichuan Provincial People's Hospital from 2010 to 2014,so as to provide baseline data for further study.Methods The inpatients'disease spectrum and costs were collected from hospital information system.The diseases were classified according to the International Classification of Diseases(ICD-10).The data were analyzed using SPSS 18.0 software.Results The total number of old inpatients was 111,935,and male (55.2 ％) was more than female (44.8 ％).The average age was (74.5 ±6.8)years.The top four systematic diseases of primary diagnosis were circulatory system disease (21.0 ％),respiratory system disease (13.7 ％),digestive system disease (12.7％)and neoplasms (12.1％).The total number of male inpatients was more than the female inpatients.The average cost per capita was increased from (￥)18,778.1 yuan to (￥)23,391.9 yuan since 2010.The proportion of all costs accounted for by drugs in elderly inpatients was decreased from 45.5％ to 38.9％ since 2010.Nosocomial infection was decreased from 3.19％ to 0.16％ since 2010.Conclusions The number of elderly inpatients are more in male than in female in Sichuan Provincial People's Hospital from 2010 to 2014.The most common systematic disease is circulatory system diseases,and followed by respiratory system diseases,digestive system diseases and neoplasms.The proportion of all expenditures accounted for by drugs was declined in five years,while the average cost per capita is increased.