Quality of care and safety are the lifeline of hospital performance and hospital management.With reference to the KTQ hospital quality certification system of Germany,Tongji Hospital built platforms to supervise outpatient,emergency,inpatient,surgical operation,nursing, hospital-acquired infection,and pharmacy management.By the connection and reaction of both online and offline systems,Tongji Hospital has built a systematic,informationized and precise medical quality and safety system for large public hospitals,safeguarding quality of care and safety of patients.

Given the rapid progress in recent years,hospital ethics review remains a weak link.This study started from the nature and role of the hospital ethics committee to probe into setbacks found in hospital ethics review practice.Viewpoints in the paper covered the access system,review system,training system,and the conflicts of interest between researchers and subjects,in an effort to further improve the quality of ethic review,and to better protect the rights and interests of subjects.

Objective:To study the effect of Longman Ampelopsis grossedentata on the level of serum lipid. Methods:The exper-imental rats were given high-fat diet during the experiment. The rats were randomly divided into the model group, high dose group (37. 80 g·kg-1), medium dose group (12. 60 g·kg-1), low dose group (6. 30 g·kg-1) and lipid-lowering drug group (180 mg· kg-1 ) . All the groups were administrated continuously for 30 days, and the effect on body weight, serum TC, TG and HDL-C were measured. Results:Compared with that of the model group, the increase of body weight in the other groups was not significant ( P>0. 05), and all the rats had no obvious poisoning symptom. TC and TG were higher after the high-fat diet administration than those be-fore the experiment in the model group, and the differences were statistically significant (P<0. 05). After the 30-day treatment, the levels of TC and TG in the high-dose group were significantly decreased compared with those of the model group (P<0. 05). Conclu-sion:Longman Ampelopsis grossedentata shows assistant therapeutic effect on serum lipid.

Objective To establish a fluorescent polymerase chain reaction (PCR) method for rapid, sensitive and specific determination of -88/-123 polymorphisms in Myxovirus resistance protein A (MxA) gene promoter so as to provide molecular biology tool for optimized interferon-a treatment in chronic hepatitis B patients. Methods Hepatitis B virus (HBV) genotyping,serum HBV DNA level,and- 88/- 123 polymorphisms in MxA gene promoter of patients who had been treated with interferon-α were detected. The statistical analysis was done by using SPSS software to understand the relationship between MxA gene polymorphisms and interferon-α treatment. Afterwards, an optimal fluorescent PCR system was established to determine -88/-123 polymorphisms in MxA gene promoter. The sensitivity and the specificity of this system were confirmed by DNA sequencing. P-value of chi square test, odds ratios of regression analysis and 95% confidence intervals were employed. Results Patients with- 88 G/T and - 123 C/A in the interferon-stimulated response element in MxA gene promoter were interferon-α sensitive, while patients with - 88 GIG and - 123 C/C were not interferon-α sensitive. The coincidence rate of this system was 99.65% in comparison with DNA sequencing.Conclusion MxA gene polymorphisms could be rapidly and sensitively determined by this fluorescent PCR system.

Objective To investigate current status of narcotic analgesic use in patients with cancer pain in our hospital, in order to promote the rationalization of prescribing narcotic drugs and the rational use of analgesics. Methods A total of 400 narcotic prescriptions ( 100 of outpatients and 300 of inpatients ) in Tongji hospital were randomly selected from March to May in 2014.Basic index and consumption of anesthetic drugs, money consumption distribution on different tumor types, and unreasonable prescription were analyzed. Results The overall prevalence of irrational prescriptions was 11. 00%, with 13.00% from inpatient and 10. 33% from outpatient, respectively. Reasons for irrational prescriptions mainly included vague instructions on dosage and administration, incomplete clinical diagnosis, lack of pharmacist check and inappropriate dosage. In the basic indexes, proportions of reasonable prescription and drugs within the national formulary were higher in the inpatient than in the outpatient service.The average money consumption of outpatient prescription was significantly higher than that of inpatient prescription.Most types of diagnosis were lung cancer in outpatient and inpatient departments, and total cost of lung cancer drugs was the highest.Morphine hydrochloride of outpatient had the highest average consumption, followed by codeine phosphate of the outpatient and the inpatient, and oxycodone hydrochloride controlled-release tablets cost more in inpatient. Conclusion The narcotic analgesic used in our hospital is basically rational. Most doctors prescribe according to the guidelines, but standardized training of prescription for cancer patients with pain medication needs to be strengthened, and supervision of narcotic analgesic medication should be enhanced.

OBJECTIVETo investigate the pro-angiogenic effects of several multiple myeloma (MM) cell line culture supernatants on human bone marrow endothelial cell (HBMEC) proliferation, migration, and capillary formation, and the anti-angiogenic effects of thalidomide.

METHODSHBMEC was cultured in the presence of MM cell lines (IM9, XG1, U266 and MOLP-5) supernatants. Proliferation and migration of HBMEC were determined, capillary-like tubule formation of HBMEC was examined in fibrin and Matrigel. The inhibiting effect of thalidomide was investigated by adding it into myeloma cell line culture supernatants. Vascular endothelial growth factor (VEGF) was measured by ELISA.

RESULTS(1) MM cell lines culture supernatants promoted HBMEC proliferation and migration. (2) In fibrin and Matrigel, capillary-like tubule network formation promoted by the supernatants. (3) All of these effects could be inhibited by thalidomide. (4) This effect was not related to VEGF in the supernatants.

CONCLUSIONSMM cell line promote proliferation, migration and tubule formation by secreting VEGF or other several cytokines. Thalidomide can inhibit these effects.

Angiogenesis Inhibitors ; pharmacology ; Bone Marrow ; blood supply ; Cell Division ; drug effects ; Cell Movement ; drug effects ; Cells, Cultured ; Culture Media, Conditioned ; chemistry ; pharmacology ; Endothelial Growth Factors ; metabolism ; Endothelium, Vascular ; cytology ; drug effects ; physiology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Lymphokines ; metabolism ; Multiple Myeloma ; pathology ; secretion ; Neovascularization, Physiologic ; drug effects ; Thalidomide ; pharmacology ; Tumor Cells, Cultured ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

OBJECTIVETo investigate the potential effects of angiogenic process by secretory phospholipase A2 (sPLA2) inhibitor-HyPE (linking N-derivatized phosphatidyl-ethanolamine to hyaluronic acid) on human bone marrow endothelial cell line (HBME-1).

METHODSIn order to examine the suppressing effects of HyPE on HBME-1 proliferation, migration, and capillary-like tube formation, HBME-1 were activated hy angiogenic factor, specifically by basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), and oncostatin M (OSM) (at a final concentration of 25, 20, and 2.5 ng/mL, respectively), then HBME-1 proliferation, migration, and tube formation were studied in the absence or presence of HyPE. HBME-1 tube formation was specially analyzed in fibrin gel.

RESULTSHyPE effectively inhibited HBME-1 proliferation and migration as a dose-dependent manner, whatever HBME-1 were grown in the control culture medium or stimulated with b-FGF, VEGF, or OSM. In fibrin, the formations of HBME-1 derived tube-like structures were enhanced by all angiogenic factors, but these were strongly suppressed by HyPE.

CONCLUSIONSThe results support the involvement of sPLA2 in angiogenesis. It is proposed that sPLA2 inhibitor introduces a novel approach in the control of cancer development.

Bone Marrow Cells ; cytology ; Capillaries ; drug effects ; Cell Division ; drug effects ; Cell Movement ; drug effects ; Cells, Cultured ; Endothelial Cells ; cytology ; Enzyme Inhibitors ; pharmacology ; Fibroblast Growth Factor 2 ; antagonists & inhibitors ; Humans ; Hyaluronic Acid ; pharmacology ; Neovascularization, Pathologic ; pathology ; Oncostatin M ; Peptides ; antagonists & inhibitors ; Phosphatidylethanolamines ; pharmacology ; Phospholipases A ; antagonists & inhibitors ; Phospholipases A2 ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors

OBJECTIVETo investigate the frequency of p16 and p15 gene methylation in multiple myeloma (MM), and its relationship with bone marrow cell apoptosis and clinical outcome.

METHODSTwenty-two patients with MM were studied to detect p16 and p15 gene methylation. Methylation-specific polymerase chain reaction (MSP) was used to detect gene methylation, and terminal transferase-mediated dUTP nick end-labeling (TUNEL) was used to detect cell apoptosis.

RESULTSp16 and/or p15 gene methylatoin was detected in 10 of 22 patients (45.4%). There were 3 patients with p16 gene methylation, 9 patients with p15 gene methylation, and 2 patients with both genes methylation. The incidence of methylation of p15 gene was higher than that of p16 gene (P < 0.05). The patients with p16 and/or p15 gene methylation had a delayed cell apoptosis, poor response to chemotherapy, and a short over-all survival (OS).

CONCLUSIONThe methylation of p16 and/or p15 gene plays a key role in MM apoptosis pathogenesis. The patients with both p16 and p15 gene methylation had a poor prognosis.

Apoptosis ; Cell Cycle Proteins ; Cyclin-Dependent Kinase Inhibitor p15 ; Cyclin-Dependent Kinase Inhibitor p16 ; genetics ; DNA Methylation ; DNA, Neoplasm ; genetics ; Gene Silencing ; Genes, p16 ; Humans ; Multiple Myeloma ; genetics ; pathology ; Prognosis ; Transcription Factors ; genetics ; Tumor Suppressor Proteins

Objective To investigate the mechanism of improvement of gait behavior in PD rat models by low frequency electrical stimulation of pedunculopontine tegmental nucleus (PPTN) by optogenetics method. Methods (1) Twenty-four healthy adult male SD rats were randomly divided into a sham-operated group 1, a lesion group 1 and a photoactivation group (n=8); normal saline was injected into the right medial frontal tract (MFB) of the sham-operated group 1; 6-hydroxydopamine (6-OHDA) was injected into the lesion group 1 and photoactivation group to induce PD models; two weeks after modeling, injection of adeno-associated virus hsynapsin-ChR2-mcherry into the right PPTN of the three groups was performed, and the photoactivation group received blue-ray stimulation by implanting optical fibers into the PPTN at the same time. (2) Twenty-four healthy adult male SD rats were randomly divided into a sham-operated group 2, a lesion group 2 and a photoinhibition group (n=8);normal saline was injected into right MFB of the sham-operated group 2; 6-OHDA was injected into the lesion group 2 and photoinhibition group to induce PD models; two weeks after modeling, injection of adeno-associated virus hsynapsin-NpHR-mcherry into the right PPTN of the three groups was performed, and the photoinhibition group received yellow-ray stimulation by implanting optical fibers into the PPTN at the same time. (3) Three weeks after injection of adeno-associated virus, Catwalk gait analysis was used to assess the behavioral ability of rats in each group. Results (1) As compared with the sham-operated group 1, lesion group 1 had significantly increased front claw spacing and back front claw spacing, and significantly decreased stride length and pressure of damaged lateral and contralateral limbs, and significantly decreased swing speed of contralateral limb (P<0.05); as compared with those in the lesion group 1, the front claw spacing and back claw spacing were significantly shortened, and stride length and pressure of damaged lateral and contralateral limbs were statistically increased in the photoactivation group (P<0.05). (2) As compared with the sham-operated group 2, lesion group 2 had significantly increased front claw spacing and back front claw spacing, significantly decreased stride length of damaged lateral limb, and significantly decreased pressure and swing speed of damaged lateral and contralateral limbs (P<0.05); no significant differences were noted on the front claw spacing and back front claw spacing, pressure and swing speed of damaged lateral and contralateral limbs between lesion group 2 and photoinhibition group (P>0.05). Conclusion The mechanism of low frequency electrical stimulation of PPTN improving gait behavior of PD rat models is related to activation of PPTN neurons.

Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.