Medical quality management is the core of hospital management.Concerning how to build the improving long-term mechanism of modem medical quality,the article is guided with the theory of modern medical quality management,and tested with the reform of medical quality management about one hospital.It puts forward 10 essential elements on how to construct the long-term mechanism on improving the medical quality,which is based on consulting all kinds of experts.Namely,“qualifications,responsibilities,complete path,reverence for life,reverence for integrity,reverence for rules,value on evaluation,value on case history,value on sum-up,value on teamwork”.Then it will take active effect on hospital workers and hospital managers in strengthening medical quality control,and improve the medical quality persistently.

Objective To explore the effect of minimally invasive transpedicular bone grafting additional ver -tebral pedicle screw fixation in the treatment of thoracolumbar fracture .Methods 60 patients with thoracolumbar fracture were randomly divided into the observation group and the control group ,30 cases in each group .The control group received traditional open inter vertebral four nail pedicle screw fixation combined with posterolateral bone graft fusion for treatment while the observation group was treated by minimally invasive transpedicular bone grafting addi -tional vertebral pedicle screw fixation ,to analyze the clinical effects .Results The imaging parameters of postopera-tion[the sagittal index(1.9 ±7.1)°,Cobb's angle(4.2 ±3.5)°,change of vertebral body height (90.2 ±6.5)%]in the observation group were significantly better than those of the control group (t=6.78,6.80,7.02,all P<0.05). The imaging parameters 3 months after operation[the sagittal index(4.9 ±3.2)°,Cobb's angle(7.0 ±2.7)°,change of vertebral body height (87.6 ±4.1)%] in the observation group were significantly better than those of the control group(t=6.78,6.80,7.02,all P<0.05).The operation time,incision length,bleeding volume,postoperative drain-age,postoperative hospital stay of the observation group were (141.9 ±14.2)min,(10.8 ±1.7)cm,(105.7 ±12.3)mL, (5.6 ±4.1)mL,(6.6 ±1.1)d,respectively,which were significantly better than those of the control group (t=7.72,7.89,5.68,all P<0.05).Conclusion Minimally invasive transpedicular bone grafting additional vertebral pedicle screw fixation has a significant effect in the treatment of thoracolumbar fractures ,which is safe and reliable .

Objective To evaluate the application of dynamic magnetic resonance imaging in the diagnosis of female stress urinary incontinence(SUI). Methods Dynamic magnetic resonance imaging(DMRI)were performed on 30 healthy female volunteers and 35 female SUI patients.DMRI of the pelvic floor at rest and OR maximal strain were performed by using sagittal T2-weighted fast gradient sequences.The distance of Urethra-vesical junction to the pubococcygeal line,the posterior vesicourethral angle and angle of inclination of the urethral axis were measured at rest and on maximal strain position.The t-value exact test were used to analyze the data. Results At rest the Urethravesical junction laid above pubococcygeal line on both control and SUI groups.Mean distance from the Urethra-vesical junction to pubococcygeal line at rest had no difference between the two groups.On straining,the mean Urethra-vesical junction descent distance in the SUI group(-0.9±1.1cm)was significantly higher than in control group(-0.14±0.3 cm),(P＜0.001).On straining,the mean angle of urethral inclination in the SUI group(65±37°)was significantly bigger than in control groups (17±21°),(P＜0.05).The posterior vesicourethral angle in the SUI groups(156±36°)was significantly bigger than in control groups(113±28°),(P＜0.05). Conclusion Dynamic magnetic resonance imaging is a non-invasive.easily applied method in the diagnosis of SUI.

Objective To analyze the spectrum of anus disease during the medical selection of flying cadets and com-pare the medical standard between US Air Force and Chinese Air Force in order to improve the system of medical selection. Methods The data on flying cadets of Chinese Air Force medical selection from 2012 to 2015 were retrospectively analyzed and these data were re-analyzed by medical standards for US Air Force flying cadets.Results Ninety students were elimi-nated because of anal disease,including 65 hemorrhoids,14 fistula and 11 fissure.The rate of disqualification from 2012 to 2015 was 48.28%, 33.33%, 31.37%, 39.69%and there was no significant statistical difference between each two years (x2 =2.6154,P=0.4548).There was statistically significant difference(P=0<0.05)in hemorrhoids standards between CAF and USAF,and significant difference in fistula and fissure standards.Conclusion Compared with Chinese medical se-lection standards,the US Air Force standards focus on whether the symptoms of disease have effect on air safety and effi-ciency.To improve our medical selection standards,we need to learn from foreign air forces and take our own conditions into account.

Objective To analyze the disease spectrum of abdominal external hernia during medical selection of flying cadets and compare the medical standards between US Air Force and Chinese PLA Air Force in order to improve the system of medical selection.Methods The data about abdominal external hernia among flying cadets during Chinese PLAAF medical selection between 2012 and 2015 were retrospectively analyzed and compared with the medical standards of the USAF flying cadets.Results Twenty-nine candidates were eliminated because of hernia,including 4 cases of hiatal hernia,3 cases of umbilical hernia and 22 cases of inguinal hernia.4.70% of the candidates were eliminated because of hernia disease.Empirical research showed difference in hernia standards between China and the USA.Conclusion Compared with Chinese medical selection standards,the USAF standards give more weight to whether the symptoms of disease impact air safety and efficiency.Our medical selection standards need to be improved by learning from foreign practices.

Objective:To explore the effects of health education on the knowledge and awareness of hypertension in primary and secondary school students.Methods:Twenty seven primary and secondary schools in Emin County of Xinjiang Uygur Autonomous Region were selected in 2014 as study sites; among which 24 schools were randomly assigned as the intervention group and 3 schools were assigned as control group. According to the education methods (classroom teaching, publicity manual, hypertension class reports and the combination of the three) and the frequency of education (1, 2, 3 times per semester), the intervention group were further randomly divided into 12 subgroups with 2 schools in each group. The intervention study was carried out for 3 years.Results:A total 13 402 students were involved in the study, and there were 11 333 students in the intervention group and 2 069 students in the control group. The awareness rates of hypertension concept [41.8% (4 738/11 333) vs. 24.6% (511/2 069), χ 2=154.86, P<0.01], the adverse consequences of hypertension [85.8% (9 735/11 333) vs. 75.4% (1 561/2 069),χ 2=25.80, P<0.01], the hypertension risk factors [84.3% (9 564/11 333) vs. 72.5%(1 501/2 069), χ 2=12.83, P<0.01), and the health behaviors after hypertension [84.9% (9 629/11 333) vs. 67.7%(1 402/2 069), χ 2=187.24, P<0.01] in intervention group were all significantly higher than those in control group. The stratified analysis showed that among students in elementary school, junior high school and high school, there were significant differences in the awareness rate of adverse consequences [94.4% (2 019/2 138) vs. 81.6% (3 829/4 690), 86.2% (3 887/4 505), χ 2=199.31, P<0.01], awareness rate of risk factor [86.8% (1 857/2 138) vs.86.1% (4 038/4 690), 81.4% (3 669/4 505) , χ 2=49.96, P<0.01); and awareness rate of correct behavior [89.9% (1 923/2 138) vs. 86.1% (4 037/4 690), 81.4% (3 669/4 505) χ 2=89.77, P<0.01]. Up to 95.9% (10 868/11 333) students in the intervention group liked the hypertension health education. Conclusion:Based on the school health education curriculum, the intervention measures of hypertension health education are effective, and the awareness rate of hypertension related knowledge among senior high school students is significantly improved.

Objective To develop a nomogram based on pulmonary nodules preoperative CT signs and 3D quantitative parameters for predicting mediastinal lymph node metastases in patients with clinical stage ⅠA lung adenocarcinoma.Methods The imaging data of 164 patients who underwent preoperative CT scan and systematic lymph node dissection were analyzed retrospectively.Commercially available AI software was used to extract 3D quantitative parameters of pulmonary nodules automatically,and CT signs of pulmonary nodules were analyzed.Logistic regression was used to explore the role of these parameters in predicting pathological nodal involvement.A nomogram prediction model was established,then discrimination and calibration of the model were evaluated.Results Among 164 enrolled patients,19(11.6％)were tested positive for mediastinal lymph node metastases at pathology review.The nomogram incorporated spiculation,lobulation,the largest cross-sectional area,and carcinoembryonic antigen(CEA).The model showed great discrimination and calibration,with a C-index of 0.942[95％confidence interval(CI)0.923-0.961].The predicted value of the model fitted well with the actual observed value on the calibration curve.Conclusion The nomogram prediction model based on preoperative CT signs,3D quantitative parameters,and CEA can estimate the probability of mediastinal lymph node metastases in clinical stage ⅠA lung adenocarcinoma.This model may help with clinical decision-making and individualized evaluation.

OBJECTIVE: To explore the regulatory effects of GABAergic neurons in the zona incerta (ZI) on sevoflurane and propofol anesthesia. METHODS: Forty-eight male C57BL/6J mice divided into 8 groups (n=6) were used in this study. In the study of sevoflurane anesthesia, chemogenetic experiment was performed in 2 groups of mice with injection of either adeno-associated virus carrying hM3Dq (hM3Dq group) or a virus carrying only mCherry (mCherry group). The optogenetic experiment was performed in another two groups of mice injected with an adeno-associated virus carrying ChR2 (ChR2 group) or GFP only (GFP group). The same experiments were also performed in mice for studying propofol anesthesia. Chemogenetics or optogenetics were used to induce the activation of GABAergic neurons in the ZI, and their regulatory effects on anesthesia induction and arousal with sevoflurane and propofol were observed; EEG monitoring was used to observe the changes in sevoflurane anesthesia maintenance after activation of the GABAergic neurons. RESULTS: In sevoflurane anesthesia, the induction time of anesthesia was significantly shorter in hM3Dq group than in mCherry group (P < 0.05), and also shorter in ChR2 group than in GFP group (P < 0.01), but no significant difference was found in the awakening time between the two groups in either chemogenetic or optogenetic tests. Similar results were observed in chemogenetic and optogenetic experiments with propofol (P < 0.05 or 0.01). Photogenetic activation of the GABAergic neurons in the ZI did not cause significant changes in EEG spectrum during sevoflurane anesthesia maintenance. CONCLUSION Activation of the GABAergic neurons in the ZI promotes anesthesia induction of sevoflurane and propofol but does not affect anesthesia maintenance or awakening.
Male ; Animals ; Mice ; Mice, Inbred C57BL ; Propofol/pharmacology* ; Sevoflurane/pharmacology* ; Zona Incerta ; Anesthesia, General ; GABAergic Neurons