Quality management covers every corner of hospital services,which upholds full-process quality management,continuous quality improvement and smooth management with patients at the center.By means of building a 3-tier quality management framework at the hospital,development of quality management criteria,appraisal indicators and documentation and use of quality management tools,quality management defects were identified from a third-party perspective.This effort has significantly improved quality of care at the hospital,and elevated the management execution and general service quality of the hospital.

Objective: To evaluate the feasibility and efficiency of a low dose imaging protocol on reducing X-ray dose level in pediatric supraventricular tachycardia (SVT) ablation procedure. Method: Data were collected from 103 patients who underwent catheter ablation for SVT in Children′s Hospital of Fudan University from January 2014 to October 2016 in terms of body weight, body surface area (BSA), SVT types, accessory pathway location, fluoroscopy time and the radiation dose (including AIR KERMA and dose area product) in a case observational study.The fluoroscopy protocols were operated at 36 nGy/frame and 10 frames/s (Standard group, n=47) from January 2014 to September 2015, 36 nGy/frame and 10 frames/s with removal of the grid (Grid-out group, n=24) from October 2015 to April 2016, as well as 23 nGy/frame and 4.0-7.5 frames/s without the grid (Grid-out plus low dose group, n=32) from May 2016 to October 2016, respectively.Comparisons among groups were performed by independent-sample t-test or one-way analysis of variance for normally distributed continuous variables, and χ² test for categorical variables. Result: The average body weight, BSA, fluoroscopy time and AIR KERMA of the three groups was (34±14) kg, (1.14±0.33) m^2, (11±8) minutes and (12.97±12.43) mGy, respectively.No significant differences in body weight (F=2.551), BSA (F=2.359), SVT types (χ²=6.15), and accessory pathway location (χ²=3.438) were observed among these three groups (P>0.05). Images acquired by low dose protocol could provide enough information for procedures, and no complication occurred.The acute success rates were 100% in all of these three groups, and there was no significant difference in mean fluoroscopy time (F=0.004, P>0.05) among them.However, the radiation dose (AIR KERMA) in the Grid-out plus low dose group was much lower than that in the Standard group ((7.54±7.31) mGy vs. (16.25±12.08) mGy, F=6.112, P<0.01)). Conclusion The new strategy of combination of low dose fluoroscopy protocol with removal of grid markedly reduced radiation exposure to children undergoing supraventricular tachycardia ablation while maintaining procedural efficacy and safety.

OBJECTIVE To investigate the surgical efficacy and prognostic factors of patients with advanced nasal and sinuses malignancies,in order to provide more reference for surgical plan selection and prognosis evaluation.METHODS A total of 117 patients with advanced nasal and sinuses malignancies were retrospectively chosen in the period from January 2010 to January 2019 in our hospital.The clinical characteristics and follow-up survival data were analyzed,and the independent prognostic factors of advanced nasal and paranasal malignant tumors were evaluated by univariate and multivariate methods.RESULTS The progression free survival rate and overall survival rate were 48.71％and 62.39％,respectively.The median progression free survival time and overall survival time were 32.48 months and 39.80 months,respectively.Univariate and multivariate analysis showed that age,histopathological type,marginal status and whether adjuvant therapy was accepted were independent factors influencing progression free survival time and overall survival time after surgery for advanced nasal and sinus malignancies(P＜0.05).CONCLUSION The surgical efficacy of advanced nasal and sinusoidal malignancies is satisfactory and the clinical prognosis is related to age,marginal status and adjuvant therapy.