Objective The therapeutic effect for hemorrhage from esophageal varices(EV)with conservation,surgical intervention,EVL(esophageal variceal ligation)or TIPSS(transvenous intrahepatic portal systemic shunt)were compared.Methods The clinical materials of 72 patients with bleeding from EV were retrospectively reviewed. Results With octreotide(n=23) the rates of hemostasis within 48 hours and hospital mortality maintained 78.3 and 8.7 percent respectively.Rebleeding occurred within 7 days in 3/18 cases(16.7％ ) and within 150 days in 6/18 cases(33.3％ ),resulting in death in 4/18 instances;with emergency surgery death encountered in 4 out of 13 cases(30.8％ ),while with elective operation no death could be traced,7.7 percent of the series with octreotide rebled within 1 year and 19.2 percent did so after 2 years;after EVL(n=8) the varices reduced obviously or eliminated in 75 percent without rebleeding and death in follow-up period of 1～ 33 months;EV disappeared or ameliorated immediately following TIPSS in 9 out of 10 successful cases,yet the rebleeding rate attained 30 and 80 percent within 1 and 5 years respectively.The stent was proved afterwards stenosed or obstructed by ultrasonography.Encephalopathy ensued in 40 percent of the cases with 6 deaths in 61 months. Conclusion It was assumed that octreotide exerted affimative effect in the control of acute bleeding,particularly indicated for patients who were too weak to have endoscopy in 24 hours after admission,however bleeding often recurred following the use;elective surgery might reduce the early rebleeding rate and prolong the interval of rebleeding;EVL was capable of eradicating EV with simplicity;TIPSS had poor long-term effect.

ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.
Hospital Administration/legislation & jurisprudence ; Hospital Administration/*standards ; Hospitals, Public/legislation & jurisprudence ; Hospitals, Public/*standards ; Management Audit/*standards ; Quality Assurance, Health Care/*organization & administration ; Quality Control ; Total Quality Management/methods ; Total Quality Management/*standards

The health check up flow of digital hospital can be consulted with the assembly line of industry factory. Because they have the following same features: highly specialized workstation, closeness and continuance, rhythm, balanced production, continuous production. The essential prerequisites are as the follows: The inspecting items and methods should be stable; advanced product mix and stable production design; standardized raw material, consumption, procedure, inspection method; there are lots of request for health inspection; the customers move at the least unit; the space arrangement should be reasonable; the time arrangement should be proportion. With the computer net, the digital inspection can achieves the raw material controlling accurately. The basis of check up line concerns about equipment, net and software, data collection, and personnel. The group technology is used in the health inspection flow design of the digital hospital in the field of items customers and zone redivided. The digital assembly linemic health inspect has the following stages: member registering, notice, check in, arrange order, time control, report, feedback and analysis. The assembly linemic has following advantages: increasing the productivity, the space utility, satisfaction of customer, fund returning, lowering the cost and ensuring the quality.
Computer Communication Networks ; *Delivery of Health Care ; *Hospital Administration/economics ; *Hospital Information Systems/organization & administration ; Preventive Health Services/economics ; Preventive Health Services/organization & administration

Objective To investigate clinical and pathological features of lupus erythematosus profundus (LEP)of the scalp in children.Methods A retrospective study was carried out on 5 children with LEP.The clinical and histopathological features,treatment and prognosis of LEP were analyzed.Results The 5 children with LEP included 2 boys and 3 girls with a median age at onset of 5 months (range,2-38 months) and a median clinical course of 15 months (range,4-72 months).Clinically,the patients presented with arc-shaped or circular purple atrophic plaques on the scalp complicated by alopecia.The occipitalia and tempora were the most commonly involved sites.Antinuclear antibodies (ANA) and extractable nuclear antigens (ENAs) were negative in all the patients.Main histopathological changes were hyaline degeneration of the fat,mucin deposition and local aggregation of lymphocytes in fat lobules.Of the 5 patients,2 were treated with oral prednisone (1.5-2 mg/kg/day),1 with oral hydroxychloroquine (5 mg/kg/day),1 with oral prednisone (1.5 mg/kg/day) combined with hydroxychloroquine (5 mg/kg/day),and another 1 with topical halometasone cream and 0.03％ tacrolimus ointment.Lesions were remissed after 2-3 months of treatment,and subsided with growth of new hairs after 6 months.No recurrence was observed during a 1.5-year follow-up.Conclusion Prednisone and hydroxychloroquine are markedly effective for LEP,and pediatric patients with LEP may be treated by topical highpotency glucocorticoids and calcineurin inhibitors.

Objective To investigate the expression of PCNA in gastric cancer and its relationship with telomerase activity of peritoneal washings and peritoneal dissemination, and to compare the efficacy of telomerase activity and cytology of peritoneal washings for prediction of peritoneal metastasis of gastric cancer. Methods Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed to measure the telomerase activity of peritoneal washings collected from 60 patients with gastric cancer. Exfoliate cytologic analysis of the corresponding samples was used for comparison.Expression of PCNA was measured with immunohistochemical staining.Their relationship with clinicopathologic features were evaluated. Results The positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was 41.7%,which well related to serosal invasion, histology types, depth of infiltration and peritoneal metastasis of gastric cancer. The positive rate of telomerase activity increased with the increased depth of infiltration and serosal involvement areas (P

AIM: To explore the role of intestinal lymphatic pathway in MODS pathogenesis by two-hit in rats. METHODS: Mesenteric lymph was diverted by ligating mesenteric lymph duct, and the MODS model was established by two-hit method. 45 Wistar rats were divided into three groups: mesenteric lymph duct ligation group, non-ligation group and sham group. All rats facilitated blood withdrawal for serum sample at pre-experiment and after 24 h. Then organs including kidney, liver, lung, heart and intestine were collected for preparing homogenate. The tumor necrosis factor-alpha (TNF?), nitric oxide (NO), malondialdehyde (MDA) and superoxide dismutase (SOD) were determined. RESULTS: It showed that the MODS model was established successfully. After two-hit, the TNF?, NO 2 -/NO 3 -, NOS, iNOS and MDA in serum of non-ligation group were significantly increased than that in pre-experiment and sham group, and SOD was significantly lower ( P

Objective To explore the mechanism of mesenteric lymph duct ligation relieving hepatic injury in rats by two-hit of hemorrhage and LPS.Methods Forty-five Wistar rats were divided into three groups: ligation group,non-ligation group and sham group,and the two-hit model was established by hemorrhage and LPS,mesenteric lymph was blocked by ligating mesenteric lymph duct in ligation group.After 24 hours of operation,took out the liver for pathological section,and the hepatocellular apoptosis rate was determined by method of TUNEL,the expression of BCL-2 and BAX protein was determined by immunohistochemical test.At the same time,taking out liver for homogenate of 10 percent,the activity of MPO and ATPase and the contents of TNF-? and IL-6 were determined in hepatic homogenate.Results After two-hit,the hepatocellular apoptosis rate and expression of BAX protein in non-ligation group were significantly increased as compared with sham group and ligation group,and expression of BCL-2 protein was significantly lower.The contents of MPO,TNF-? and IL-6 in hepatic homogenate of non-ligation group were significantly increased than that of sham group,and the activity of ATPase in hepatic homogenate was significantly lower.But the ATPase in hepatic homogenate of ligation group were significantlyincreased and MPO,TNF-? and IL-6 in hepatic homogenate of ligation group were significantly lower as compared with non-ligation group.Conclusion The mechanism of mesenteric lymph duct ligation relieving hepatic injury of rats was related to the mesenteric lymph blockage reduces the TNF-? and IL-6 and improves the expression of BCL-2 protein and the activity of ATPase in liver.

AIM:To observe the effects of normal mesenteric lymph (NML) on the lung, heart and liver inju-ries and the phosphorylation levels of p 38 mitogen-activated protein kinase ( MAPK) , extracellular signal-regulated kinase (ERK) 1/2 and c-Jun N-terminal kinase (JNK) in the mice with endotoxic shock (ES).METHODS: The NML was drained form health male BALB/c mice for the intervention of ES after the removal of cellular constituent .Lipopolysaccha-ride (LPS, 35 mg/kg) was intraperitoneally injected into the mice for the establishment of ES model .After 60 min of LPS injection, the administration of NML (1/15 of whole blood volume) was performed through the femoral artery in NML +ES group.Meanwhile, the mean arterial pressure (MAP) was monitored during the experiment .At 6 h after intraperitoneal in-jection of LPS or the corresponding time point , blood samples were harvested from the heart through apical centesis for de-termination of the biochemical indexes to reflect myocardial and hepatocyte injuries .Simultaneously , the lung , heart and liver tissue specimens from a fixed location were harvested for the observation of histomorphology and the measurement of phosphorylation levels of p38 MAPK, ERK1/2 and JNK.RESULTS:Compared with sham shock (SS) group, MAP in ES group and NML+ES group remarkably decreased at multiple time points after intraperitoneal injection of LPS .However, MAP in NML+ES group at 80 min, 90 min, 190 min, 210 min, 240 min, 250 min, 340 min, 350 min, and 360 min were significantly increased compared with ES group .There were normal structures in the lung , liver and myocardium of the mice in SS group, while the morphological damages of these tissues appeared in ES group .Meanwhile, the damages were attenuated in the mice of NML +ES group.The activities of AST , ALT and CK-MB in the plasma in ES group were remark-ably higher than those in SS group .The CK-MB activity in NML+ES group was also increased compared with SS group , and the activities of AST and LDH-1 were lower than those in ES group .At 6 h after LPS injection , the phosphorylation levels of p38 MAPK, ERK1/2 and JNK in the lung tissues were remarkably increased .Meanwhile , no statistical difference of these indexes between the myocardial and hepatic tissues was observed .NML intervention decreased the phosphorylation levels of p38 MAPK in the lung tissues , and p38 MAPK, ERK1/2 and JNK in the myocardial tissues .CONCLUSION:The NML administration alleviates multi-organ injuries and reduces the phosphorylation level of p 38 MAPK in the lung tis-sues in the mice subjected to ES .

AIM: To observe the effects of shock lymph on apoptosis relative gene expressions of pulmonary micro-vascular endothelial cells(PMVECs),and explore its mechanism.METHODS: The model of severe hemorrhagic shock was established by maintaining the blood pressure of rats in the condition of sepsis,mesentery lymph and shock portal vein blood was taken out.As control,mesentery lymph,portal vein blood of normal rats was taken out.The primary PMVECs of passages 3 were treated by different treatment factors,respectively.The apoptosis rate was analyzed by flow cytometry,and the expressions of relative genes of apoptosis such as fas,fas L,bcl-2 and bax were detected by RT-PCR.RESULTS: The apoptosis rate of PMVECs was 9.86%?3.24% after exposed to shock lymph at the final concentration of 4% for 4 hours and significantly higher than that in control(P

In order to meet the needs of national clinical medical education strategy, to train medical students’ability of analyzing and solving problems, it is imminent to carry out the reform on comprehensive experiment in basic medi-cal teaching.During the practice, the basic medical college of Hebei North University tried to integrate functional ex-periment and morphological experiment, and had some experience to share with medical education colleagues.