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.

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.

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 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.

As a guanine nucleotide dissociation stimulator (GDS) of Rho-like GTPases, T lymphoma invasion and metastasis inducing factor 1(Tiam 1)possesses such biological functions as regulating reconstruction of cytoskeletal structure and migratory potential of cells. Studies had shown that over-expression of Tiam 1 was able to induce invasion and metastasis of tumor cells, the molecular biological basis of which includes the interactions between Tiam 1 and trans-membrane system of cytoskeleton, adhesion molecules and extra-cellular matrix, the effect on proliferation and apoptosis of tumor cells exposed by Tiam 1, as well as the activities of Tiam 1 regulated by other invasion and meatstasis associated factors. Simultaneously, these experimental results suggested that much more work would be needed in Tiam 1 on the diversity of its activity regulation ,the specificity of its biological effect, the realationship among Tiam 1 with other invasion and metastasis associated factors, as well as their mechanisms of signal transduction.

The clinical data of 39 cases of idiopathic hyperaldosteronism (IHA) confirmed by operation were analyzed. The indications of operation consisted of (1) unable controlled the patients′ conditions by pharmacotherapy, (2) severe side effects due to high doses of medication and (3) difficulty in distinguishing between adenoma and nodule hyperplasia. The unilateral total adrenalectomy was suggested.

Superior vena cava syndrome(SVCS) is caused by malignant tumour, often showing tumour crisis. The prognosis is bad. It will endanger the life frequently if not cured in time. It is argued which is the preferred treatment on radiotherapy, chemotherapy, surgery or colligate therapy etc. Now we introduce briefly correlated study in the near future, pointting out the colligate therapy trend of SVCS.

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.