In the scientific,systematic,practical and feasible principles,the quality control needs and management needs of health authorities and medical institutions were analyzed.The study probed into the real-time monitoring functions of existing hospital information systems and information products of IT technology firms,and the feasibility of setting up key monitoring points during medical service processes.685 real-time monitoring indicators have been set up for real-time monitoring of medical process quality.

The patients with stroke is often accompanied by malnutrition, its causes include eating less, increased catabolism, and intestinal dysfunction, etc. Malnutrition can not only aggravate the extent of brain damage in patients with stroke, but also increase the incidence of complications, and thus affecting the course and prognosis of stroke. Therefore, correct evaluation of the nutritional status in stroke patients, choosing the appropriate nutrient timing and nutritional support methods have important significance. Among a variety of nutritional assessment methods, the scored Patient-Generated Subjective Global Assessment can quickly identify malnutrition in stroke patients. Early enteral nutrition support, including oral nutritional supplements, nasogastric tube feeding and percutaneous endoscopic gastrostomy, can significantly improve the prognosis in stroke patients. Among them, nasogastric tube feeding is the first choice for nutritional support in stroke patients.

Adolescent ; Catheter Ablation ; methods ; Humans ; Male ; Pre-Excitation, Mahaim-Type ; Tachycardia, Atrioventricular Nodal Reentry ; surgery

Objective To study the effect of berberine on the lipid metabolism and the expression of ox-LDL,CD36 and PPAR? in the peritoneal macrophage(PM) and alveolar macrophage(AM) from the type 2 diabetic rats. Methods Sprague-Dauley rats were randomly divided into groups of normal control,high-fat diet,type 2 diabetes and berberine treatment.The levels of blood glucose,insulin and lipid were measured biochemically,the content of ox-LDL in macrophage and the protein expression of CD36 and PPAR? in macrophage were assayed by ELISA,the mRNA expression of CD36 and PPAR? in macrophage was disclosed by RT-PCR. Results Compared with the control group, the levels of glucose,insulin and total cholesterol (TC),triglycerides(TG),low density lipoprotein-cholesterol (LDL-C) in blood were increased significantly(P0.05). The content of ox-LDL,the protein and mRNA expressions of CD36 and PPAR? in PM and AM increased in type 2 diabetic group(P

Objective:To evaluate the efficacy of paroxetine on functional low fever. Methods:Using a randomized and placebo controlled trail, a total of 54 with functional low fever were randomized into paroxetine group and placebo group. In paroxetine group, 28 patients received oral paroxetine 1 tablet (20mg/tablet), one times a day for 8 weeks. There were 26 patients in the placebo. The criteria of assessing the therapeutic efficacy on functional low fever and Hamilton Depression Scale (HAMD; 17 items) were used to assess the therapeutic efficacy at the 4th and 8th weekend respectively.Results:After 8 weeks of treatment, the efficacy rate on functional low fever and antidepression were 78.6%, 82.1% in paroxetine group and 26.9%, 23.1% in the placebo group respectively. There was a significant difference between the two groups (P

OBJECTIVE:To observe the clinical efficacy and safety of Qingkailing injection combined with naloxone in the ad-juvant treatment of chronic obstructive pulmonary disease (COPD) with pulmonary encephalopathy. METHODS:80 COPD pa-tients with pulmonary encephalopathy were randomly divided into control group and observation group. Control group was treated with conventional treatment,including bi-level noninvasive positive pressure ventilation,conventional oxygen inhalation,anti-infec-tion,resolving sputum and relieving asthma,etc;based on the treatment of control group,observation group was additionally treat-ed with Qingkailing injection 40-60 ml by intravenous infusion,30-40 drops/min,qd+Naloxone hydrochloride injection 0.8 mg by intravenous infusion,and then Naloxone hydrochloride injection 2 mg by microinfusion pump for continuous 24 h. After 3 d,the clinic data was observed,including clinical efficacy,and pO2,pCO2,pH,CO,CI,GCS coma score before and after treatment,av-erage hospitalization time,endotracheal intubation rate and incidence of adverse reactions. RESULTS:The total effective rate in ob-servation group was significantly higher than control group,average hospitalization time and incidence of adverse reactions were significantly lower than control group(P<0.05). After treatment,pO2,pH and GCS scores in 2 groups were significantly higher than before,observation group was higher than control group,pCO2 was significantly lower than before,observation group was lower than control group(P<0.05). There were no significant differences in the CO and CI before and after treatment and endotra-cheal intubation rate between 2 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,Qingkailing injection combined with naloxone has good efficacy and safety in the adjuvant treatment of COPD with pulmonary encephalopathy.

The introduction of pertussis vaccines has greatly decreased the incidence of pertussis,but pertussis is still one of the most common epidemic diseases responsible for infant and child morbidity and mortality,and is perceived as a serious public health problem in many countries.The advent of acellular vaccines has constituted an important advance in the acceptance of the immunization and consequently the control of the disease.Acellular pertussis vaccines result in fewer adverse reactions compared with whole-cell pertussis vaccines,and the efficacy of acellular vaccines is similar to whole-cell pertussis vaccines.This review summarizes the characteristics of virulence factors of Bordetella pertussis.Acellular pertussis vaccines in term of efficacy,safety,and use are discussed emphatically.

Objective To explore the management therapy of pediatric rhabdomyosarcoma.Methods Retrospective analysis of treatment of 29 cases with rhabdomyoscroma from Oct.1998 to Jun.2006.Primary sites included 5 cases of neck,1 chest wall,2 abdominal wall,12 retroperitoneal pelvic cavity and 9 extremity.Pathologic types included embryonal type 19(65.5%),alveolar 8(27.6%),pleomorphic 2(6.9%).According to IRS staging system they were Ⅰstage(n=2),Ⅱstage(n=6),Ⅲstage(n=9)and Ⅳstage(n=12).Most tumors were large than 5 cm(n=26).Results Twenty-seven cases were followed up but 2 of the cases were lost,19 cases got complete remission(4 cases relapsed or died after stopping treatment for 3 months to 3 years and 1 case relapsed after giving up treatment for 3 months),4 cases got partial remission(3 cases relapsed after 6 months diagnosed),4 cases got no response(3 of which deteriorated or relapsed and 1 case surved with tumor).Fourteen cases had constant remission between 5-77 months,averaging 22.9 months with average guitting time of treatment 16.9 months.Conclusion Total tumor resection,chemotherapy and radiotherapy play an important role in management of pediatric rhabdomyosarcoma.

Objective To study the diagnosis and treatment of the model of multidisciplinary team treatment on hepatoblastoma in children.Methods Retrospective analysis of treatment and long term follow-up of 16 patients with hepatoblastoma(8 cases were boys,8 cases were girls;aged 3 months to 11 years old,average age was 2 years old) during Aug.1998 to Jan.2006 in Shanghai Children's Medical Center.Special in multidisciplinary team treatment,preoperative evaluate and operation.Results The morbility locum of 8 cases were in right liver lobe,8 cases were in left liver lobe.Fifteen cases of the clinical presentation were abdominal mass,1 case was peritonitis.According to International Society of Pediatric Oncology(SIOP) Pretext staging system,43.7%(7/16)cases were stage Ⅱ,43.7%(7/16)cases were stage Ⅲ,12.5%(2/16)cases were stage Ⅳ.In 7 cases of stage Ⅱ,6 cases were accepted tumor total resection,1 case was accepted emergency surgery because tumor was fracture.Patients were given ICE protocal.In 7 cases of stage Ⅲ,6 cases were able to undergo delayed tumor resection following open biopsy and subsequent treatment with chemotherapy 2-3 courses.One case gave up treatment because its had poor response to chemotherapy.In 2 cases of stage Ⅳ,1 case was received liver transplantation due to poor respond to chemotherapy.One case was not received any treatment.In 7 cases of stage Ⅱ,6 cases were alive,1 case died,3-year free survival rate was 100%(4/4).In 7 cases of stage Ⅲ,5 cased were alive,3-year free survival rate was 75%(3/4).Two cases of stage Ⅳ all died.Conclusions Surgery play a very important role in the treatment of hepatoblastoma in children.Chemotherapy has improved the resectability of the tumor.Multidisciplinary team treatment is an effective model for diagnosis and treatment on childhood hepatoblastoma.

Objective:To evaluate the effect of Candida albicans ( C. albicans) hyphae on autophagic flux in murine bone marrow-derived macrophages (BMDM) . Methods:BMDM were in vitro stimulated with C. albicans hyphae for 0.5, 4 and 12 hours, and the 0-hour group treated without hyphae served as a control. Western blot analysis was performed to detect the conversion of microtubule-associated protein 1 light chain 3 (LC3) -Ⅰto LC3-Ⅱ, and determine the expression of phosphorylated mechanistic target of rapamycin (p-mTOR) at each time point. Some BMDM were divided into several groups: control group receiving no treatment, hyphae group treated with C. albicans hyphae, lysosomal inhibitor groups treated with different lysosomal inhibitors, including E-64d (a cysteine proteinase inhibitor) + pepstatin (a pepsin inhibitor) , bafilomycin-A1 (BAF-A1) , ammonium chloride and chloroquine, and hyphae combined with lysosomal inhibitor groups treated with lysosomal inhibitors immediately followed by C. albicans hyphae. After 4- or 12-hour treatment, the effect of C. albicans hyphae on basal autophagic flux in murine BMDM was evaluated. Statistical analysis was carried out by using unpaired t test, factorial design analysis of variance and least significant difference- t test. Results:After 0.5-, 4- and 12-hour in vitro treatment with C. albicans hyphae, the conversion of LC3-Ⅰ to LC3-Ⅱ significantly increased in murine BMDM (1.254±0.118, 1.629±0.391, 1.598±0.379, respectively) compared with the 0-hour group (0.983±0.030; t=3.875, 2.856, 2.804, respectively, all P< 0.05) , while there was no significant difference in the protein expression of p-mTOR among the 0-, 0.5-, 4- and 12-hour groups. After 4- and 12-hour in vitro treatment with C. albicans hyphae combined with lysosomal inhibitors E-64d and pepstatin, the accumulation level of LC3-Ⅱ significantly increased in BMDM compared with those treated with E-64d and pepstatin alone ( t=3.691, 6.648, respectively, both P< 0.05) . Compared with the corresponding lysosomal inhibitor groups, the accumulation level of LC3-Ⅱsignificantly increased in BMDM treated with C. albicans hyphae combined with BAF-A1, ammonium chloride or chloroquine for 4 and 12 hours (all P< 0.05) . Conclusion:In vitro treatment with C. albicans hyphae can increase the conversion of LC3-Ⅰto LC3-Ⅱ in the basal autophagic flux in murine BMDM.