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 .

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.

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.

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 .

During the management of Crohn's disease,there are some special situations that may be encountered by the clinicians,such as postoperative recurrence,fistulating disease in CD,pediatric CD,pregnancy,psychosomatics,and extra-intestinal manifestations.In this review,we concerned the progress in these fields in recent years.

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.

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.

Ultrasonography has grown rapidly and gained widespread acceptance in various fields.It has become a favored diagnostic imaging tool for its non-invasive,non-ionizing radiation,fast,convenient and portable.This article described briefly the application of ultrasound in vascular and its related diseases.

OBJECTIVE:To compare the cost of Xiangdan injection and Danshen chuanxiongqin injection in the treatment of unstable angina pectoris of coronary heart disease,and to provide reference for rational and economic drug selection. METHODS:42 inpatients with unstable angina pectoris of coronary heart disease were divided into Xiangdan injection group(group A,20 cas-es) and Danshen chuanxiongqin injection group (group B,22 cases). Two groups were given conventional symptomatic treatment according to the specific clinical situation;on this basis,group A was given Xiangdan injection 20 ml intravenously,qd;group B was given Danshen chuanxiongqin injection 10 ml intravenously,qd,for 14 d. Clinical efficacy and the occurrence of ADR were compared between 2 groups,and cost-minimization analysis was conducted. RESULTS:After treatment,total effective rate of group A and B was 95.00% and 95.45%,without statistical significance(P>0.05);there was also no statistical significance in the incidence of ADR (P>0.05). The costs of 2 groups were equal in addition to the cost of drugs. According to cost-minimization analysis,the drug cost of group A was 77.28 yuan and total cost was 705.88 yuan;the drug cost of group B was 1 310.40 yuan and total cost was 1 939.00 yuan;the drug cost and total cost of group A were far more less than that of group B,with statistical significance(P<0.05). The results of sensitivity analysis were consistent with it. CONCLUSIONS:The cost of Xiangdan injection is lower and more economical than that of Danshen chuanxiongqin injection in the treatment of unstable angina pectoris of coronary heart disease.

Objective To compare the efficacy of different doses of esomeprazole based quadruple therapy on Helicobacter pylori(H.pylori) eradication in Uygur population, and to study the relationship between H.pylori eradication and dyspepsia symptoms in H.pylori caused gastritis.Methods From August 2015 to May 2016, Uygur patients diagnosed with H.pylori positive superficial gastritis in Xinjiang Uygur Autonomous Region Kashgar Prefecture were recruited.According to random number table, patients were divided into single-dose group, standard-dose group and high-dose group.In single-dose group patients received esomeprazole 40 mg, once per day;in standard-dose group patients received esomeprazole 20 mg, twice per day;and in high-dose group patients received esomeprazole 40 mg, twice per day;besides esomeprazole the treatment of three groups were all combination of amoxicillin, clarithromycin and bismuth, magnesium compound granules.The treatment course of all three groups was 14 days.The H.pylori eradication rate, clinical efficacy, symptom score and adverse drug reaction were compared.The H.pylori eradication rate was evaluated with intention to treat analysis (ITT) and per-protocol sets (PP).Chi square test, t test and one-way analysis of vaiance were used for statistical comparison.Results A total of 248 patients were enrolled,82 cases in single-dose group, 83 cases in standard-dose group and 83 cases in high-dose group.There were five, five and six cases lose to follow-up or dropped out respectively in single-dose, standard-dose and high-dose group.The results of ITT analysis showed that the eradication rates of H.pylori in single-dose group, standard-dose group and high-dose group were 62.2%(51/82),77.1%(64/83) and 89.2%(74/83),respectively;the differences between each two groups were statistically significant (x2=4.34,16.33 and 4.30, all P<0.05).The results of PP analysis showed that H.pylori eradication rates of single-dose group, standard-dose group and high dose group were 66.2%(51/77),82.1%(64/78) and 96.1%(74/77),respectively;the differences between each two groups were statistically significant (x2=5.06, 22.47 and 7.84, all P<0.05).After four weeks of eradication therapy, the total dyspepsia symptom scores of single-dose group, standard-dose group and high dose group were all significantly lower than those before treatment (52.3±27.1 vs 99.4±44.1, 38.2±25.4 vs 101.0±48.9 and 28.8±16.1 vs 99.9±46.6), and the differences were statistically significant(t=5.88, 8.79 and 9.11, all P<0.01).After treatment, the total dyspepsia symptom scores of standard-dose group and high-dose group were both lower than that of single-dose group, and the differences were statistically significant (t=2.78 and 2.91, both P<0.01).The score of upper abdominal pain, epigastric burning, abdominal distention and symptom total score of high-dose group were all lower than those of standard dose group (4.8±3.9 vs 8.1±3.5, 3.1±2.5 vs 5.8±4.1, 7.9±6.8 vs 10.5±9.6 and 28.8±16.1 vs 38.2±25.4), and the differences were statistically significant (t=1.52,1.08,1.23 and 1.96, all P<0.01).After four weeks of treatment, the total efficacy rates of single-dose, standard-dose and high-dose group were 45.5%(35/77), 74.4%(58/78) and 87.0%(67/77),respectively.There were statistically significant differences between each two groups of three groups (x2=13.49, 29.73 and 3.98, all P<0.05).The incidences of adverse drug reaction of single-dose, standard-dose and high-dose group were 6.5%(5/77), 7.7%(6/78) and 7.8%(6/77),respectively;there was no statistically significant difference among the three groups (all P>0.05).Conclusions High dose of esomeprazole based quadruple therapy can increase the eradication rate of H.pylori in Uygur population, and H.pylori eradication therapy can significantly improve the dyspepsia symptoms of H.pylori caused gastritis in Uygur.High dose of esomeprazole may improve the clinical efficacy of H.pylori caused gastritis with dyspeptic symptoms in Uygur with safety.