Up to present,the research of the early-warning system for the risk of the medical quality has been carried out both at home and abroad.The majority of these researches aimed at providing theoretical guidance for the scientific decision-making of local health departments.In order to construct quality of medical care evaluation indicators system.On the bases of intelligence research,drawing on a series of internationally recognized quality of medical care evaluation system.The majority of these researches aimed at providing theoretical guidance for the scientific decision-making of local health departments.However,the hospital-related research is very limited.Therefore,hospitals were selected as objects in this study.33 experts from 6 three"A" hospitals were selected.And by using a series of internationally recognized quality health care system as a source of reference and focusing on process control and standardizing of management,the early-warning system for the risk of the medical quality has been constructed based on the combination of theory and practice.At the same time,Delphi method was used to verify the results repeatedly to form a set of early-warning system for the risk of the medical quality which is objective,scientific and approved by experts.

Composition of invention patent application is important for obtaining patent right and maintaining the right stability. According to the features of TCM invention patent application and common problems in examination, this article summarized several key points for effective application composition, including composing background technology objectively, highlighting technical problems, reasonable layout of technical pian, working in contact with technical effects, and clarifying technical terms. It expounded each point with relevant typical cases, with a purpose to provide references for applicants and agents of TCM invention patent application.

BCR/ABL negative classical myeloproliferative neoplasms including three diseases,namely polycythemia veta,essential thrombocythemia and primary myelofibrosis.Progresses have been made in the study of these dieases in children following the development of that in adult,especially the research of molecular pathogenesis.Differences exist in clinical and molecular characteristics between children and adult BCR/ABL negative classical myeloproliferative neoplasms.There are specific characteristics in the diagnoses and treatment of childhood myeloproliferative neoplasms.This paper reviews the characteristics of childhood BCR/ABL negative classical myeloproliferative neoplasms in clinical and molecular features,diagnoses and treatment.

Objective To discuss the clinical application and features of coronary artery bypass grafting(CABG) through left intercostal thoracotomy approach. Methods A total of 36 cases of CABG were performed through left intercostal thoracotomy approach from September 1996 to August 2005 in this hospital.The patients fell into four categories: ①single vessel disease in the left anterior descending artery(LAD);②re-operation of CABG with a patent LIMA(left internal mammary artery)-LAD bypass;③severe calcified ascending aorta;and ④concurrent other procedures that required left thoracotomy.There were 26 cases of single vessel disease,3 cases of double vessel disease,and 7 cases of triple vessel disease.Five cases had a history of percutaneous coronary interventions(PCIs) and 6 cases had a history of CABGs.The left ventricular ejection fraction was 0.562?0.107. Results Off pump CABG with 1~4 distal anastomosis was successfully accomplished in all the 36 cases,with an operation time of 190.4?44.1 min.Concurrent procedures included 2 cases of transmyocardial laser revascularization(TMLR),1 case of lung cancer resection,and 1 case of esophageal cancer resection.There was no in-hospital mortality.Two fatal cases were seen in long-term follow-up observations.Recurrent angina developed in 2 cases 1 year after operation,and was cured with a PCI in 1 case and with a re-operation of CABG in 1 case. Conclusions The left intercostal thoracotomy is a safe and feasible approach for CABG surgery in patients with some special types of coronary heart disease.The procedure can be performed under beating heart.

Objective To report the experience of first 100 cases of off-pump coronary artery bypass(OPCAB) grafting by a training cardiac surgeon,and to discuss the feasibility of the training method.Methods The trainee,who had no previous experience of coronary surgery,received an OPCAB training program under the guidance by a director who had completed more than 2000 cases OPCAB.After 28 months of training,the trainee began to be an independent operator.The data of the first consecutive 100 cases of OPCAB by the trainee(Training Group) were collected for comparison with the director's 100 cases of OPCAB surgery(Control Group).Results There were 5 cases of conversion to on-pump surgery in the Training Group.The number of distal anastmosis in the Training Group(2.9?0.6) was smaller than that in the Control Group(3.5?0.7)(t=-6.508,P=0.001).Compared with the Control Group,there were less circumflex grafts(67/100 vs 88/100;?~2=12.645,P=0.000) and sequential grafts(3/100 vs 27/100;?~2=22.588,P=0.000) in the Training Group.There was no significant difference in mortality between the Training Group(3%,3 cases) and the Control Group(1%,1 case)(?~2=0.255,P=0.614).No significant difference was observed between the two groups in other postoperative severe complications.Conclusions The first 100 cases of OPCAB surgery performed by the trainee give favorable results,indicating a stable transition from training period to independent performance.It also testifies the feasibility of this training program.

Fluoropyrimidines are still the basic agents for adjuvant chemotherapy of colon cancer,a regimen containing 5-FU/LV/oxaliplatin (FOLFOX or FLOX) is the new standard for adjuvant settings,and FU/LV alone (Mayo,Roswell Park or LV5FU2) or single agent of capecitabine should be a choice of treatment for some particular patients; irinotecan should not be used for the adjuvant setting of colon cancer,because currently there is no evidence to show additional survival benefi t with addition of irinotecan to the adjuvant treatment,but increased risk of chemotherapy-related toxicity. Stage Ⅲ colon cancer is the main and defi nite indication for adjuvant chemotherapy,while adjuvant chemotherapy should not be routinely considered for stage Ⅱ colon cancer,except those with high risk factors including T4 tumor,obstruction,perforation,poor differentiation,invasion to nerve or vessels,and less than 12 examined lymph nodes. The age should not exclude the adjuvant chemotherapy if there is an adequate performance status. Adjuvant chemotherapy should be started within 8 weeks after surgery,and the current optimal duration for adjuvant chemotherapy of colon cancer should be six months.

BACKGROUND: Macromolecules modified gold nanoparticles can be used in therapeutics, diagnostics, and other aspects, but most reports mainly focuses on the preparation of protein, DNA and small molecules of sugar modified gold nanoparticles, and the research on polysaccharide modified gold nanoparticles is superficial. OBJECTIVE: To prepare heparin-modified gold nanoparticles, studying their particle size and ultraviolet absorption spectra, and to determine the optimum reaction condition. DESIGN, TIME AND SETTING: The comparative observation of the experiment was performed at the Biotechnology Pharmaceutical Laboratory of School of Chemical Engineering in Wuhan University of Technology from April 2007 to September 2008. MATERIALS: Gold nanoparticles were prepared and preserved at 4 ℃. METHODS: Heparin with an aldehyde group (HEP-CHO) as reducing end was prepared by nitrous acid degradation method. HEP-CHO was further reacted with dimethyl sulfoxide solution containing 0.05 mL and 0.5 mL glacial acetic acid to synthesize heparin with thiol-group (HEP-SH) through reductive amination reaction. Heparin was then orientated immobilized in four bottles of dimethyl sulfoxide solution containing 0.5 mL glacial acetic acid by adding the thiol-group of HEP-SH and sodium cyanoborohydride for 2, 4, 6, and 24 hours. The obtained products were added in gold nanoparticle solution, and the heparin was fixed on the surface of gold nanoparticles by Au-S bonds. MAIN OUTCOME MEASURES: ① Maximum ultraviolet absorbance of gold nanoparticles before and after heparin modified; ② Average grain size of gold nanoparticles and heparin-modified gold nanoparticles. RESULTS: Gold nanoparticles with good particle size were prepared by using a rate of sodium citrate to chloroauric acid was 6:1 (mol/mol). The reductive amination reaction yield was higher when the more acetic acid was added to the solvent. The products were increased within 6 hours and 24 hours, but the difference was not significant. The average grain size and maximum ultraviolet absorbance of gold nanoparticles were 10 nm and 522 nm, and those of heparin-modified gold nanoparticles were 20 nm and 529 nm. CONCLUSION: Heparin-modified gold nanoparticles with good particle size are prepared, and the size can effect on the maximum ultraviolet absorbance. The optimum reaction condition for heparin immobilization is using a rate of dimethyl sulfoxide to acetic acid is 8:1 (mol/mol) as solvent of heparin, and the reaction time is 6 hours.

Fungus infection of the patients with chronic prostatitis was studied and the applied value of modified Sabourand's liquid medium in fungus culture explored. The causative fungus in expressed prospapic secrepion (EPS) of chronic prostatitis patients were examined by improved Sabouraud's liquid medium and Sabouraud's glucose agar medium. The fungus species were identified. The results showed that in 1138 cases positive for fungus，the specimens of 95 cases (8.35 %) were cultured in the improved Sabouraud's liquid medium and those of 30 cases (2.64 %) in Sabouraud's glucose agar medium. In the 95 cases，63 strains were Candida albicans (63.3 %)，15 Candida tropicalis (15.8 %)，and 17 other Candida (17.9 %). It was concluded that: (1) The relationship between chronic prostatitis and fungus infection can not be ignored. The attention should be paid to the possibility of fungus infection for those with chronic postatitis who were treated with long-time antibiotics but the curative effects were not satisfactory;(2) In Candidal prostatitis，Candida albicans was a common causative fungus;(3) Application of the improved Sabouraud's liquid medium could increase the positive rate of Candida.

Objective:To evaluate the visual outcomes of cataract surgery in patients with retinitis pigmentosa (RP).Methods:A serial case-observational study was conducted.One hundred and eleven eyes of 67 patients with RP and cataract who received phacoemulsification with posterior chamber intraocular lens implantation in Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong from January 2011 to December 2015 were included.Best corrected visual acuity (BCVA) was examined using standard visual chart before and after surgery and converted to logarithm of the minimal angle of resolution (LogMAR) units.Optical coherence tomography was employed to examine the retinas in 19 eyes before surgery and the eyes were graded into gradeⅠ, Ⅱ and Ⅲ according to the integrity of inner segment ellipsoid zone (ISe).The correlation between the grading of ISe and postoperative BCVA was analyzed.This study complied with the Declaration of Helsinki, and study protocol was approved by an Ethics Committee of Joint Shantou International Eye Center (No.EC20170310(2)-P03).Written informed consent was obtained from each patient before operation.Results:The vision was improved in 82 eyes (73.9%) and not obviously changed in 29 eyes (26.1%) after surgery.The median BCVA was improved from preoperative 0.82 (0.60, 1.40) LogMAR to postoperative 0.40 (0.22, 0.70) LogMAR, showing a significant difference between pre-operation and post-operation ( Z=-8.76, P<0.01).The proportion of eyes with BCVA more than 0.52 LogMAR was significantly reduced from preoperative 79.3% (88/111) to postoperative 38.7% (43/111), and the proportion of eyes with BCVA more than 1.3 LogMAR was significantly reduced from preoperative 28.8% (32/111) to postoperative 4.5% (5/111) ( χ2=37.711, 23.643; both at P<0.01).A positive correlation was found between the grading of ISe integrity and postoperative BCVA( rS=0.959, P<0.01). Conclusions:Phacoemulsification with posterior chamber IOL implantation can improve the BCVA of RP patients.The integrity of the ISe can predict the postoperative BCVA in RP patients with cataract.

AIM To study the protection of 6,7 dimethexycoumarin on hypoxic animals. METHODS The effect of 6,7 dimethexycoumarin on survival time and survival rate of mice subjected to hypobaric, normobaric and chemical hypoxia were observed and the oxygen consumption of isolated tissues were measured. RESULTS 6,7 dimethexycoumarin obviously prolonged the survival time and promoted the survival rate of hypoxic mice, increased the mouth opening time of isolated mice and reduced the oxygen consumption of isolated cardiac muscle of mice. This contributes to exploring the mechanism of antiradiation and poison reducing of 6,7 dimethexycoumarin. CONCLUSION 6,7 dimethexycoumarin shows remarkable effect on tolerance to hypoxia in mice.