The paper analyzed the needs for care quality management in large general hospitals and progresses made in hospital quality management theories. In respect of care quality management in hospitals, authors hold that the key to care quality is comprehensive scientific management of hospitals, and it is necessary to put in place a long-term management of care quality in line with the development direction of hospital evaluation and by means of total quality management system, as well as enhanced quality management and quality culture building.

Objective To explore the clinical value of real-time shear wave elastography (SWE) in liver tissue stiffness of normal children.Methods Totally 243 normal children were examined by SWE.The data of liver stiffness measurement (LSM) were recorded and analyzed.The differences of LSM between different genders and hepatic segments were compared.According to the age,243 normal children were divided into pre-school group,school age group and adolescent group;and the differences of LSM between 3 groups were compared.The consistency was analyzed in different operators.Results The mean value of LSM in normal children was (4.21±0.70)kPa,and the 95％ confidence interval was (4.11,4.31)kPa.The success rate of segment S5 was higher than that of segment S4 (100％ [243/ 243] vs 79.83％ [194/243]),and the mean value of LSM in segment S5 was lower than that in segment S4 (P＜0.05).The mean value of LSM increased with age,and the boys' was a slightly higher than the girls',but there were no statistical differences between them (all P＞ 0.05).LSM had good consistency in different operators,the intraclass correlation coefficient was 0.92.Conclusion SWE could be an objective and quantitative assessment in liver stiffness of children.

Objective To investigate the diagnostic value of high frequency ultrasound combined with esophageal filling in neonates with congenital esophageal atresia.Methods Fifty-eight newborns who were suspected with congenital esophageal atresia underwent ultrasound,the surgical results considered as the gold standard,then the ultrasound features of the congenital esophageal atresia were summarized.ResultsSeven cases were the type Ⅰ of the congenital esophageal atresia,1 case belongs to type Ⅱ,40 cases were considered as type Ⅲ,4 cases were classified type Ⅳ and 6 cases were type Ⅴ,the diagnostic accuracy of ultrasound in congenital esophageal atresia was 96.55% and the classification accuracy was 89.65%.Conclusions High frequency ultrasound combined with esophageal filling has a high accuracy and can be used as a new diagnostic method in diagnosing neonates with congenital esophageal atresia,and it′s worthy of further research and promotion.

Objective To investigate the diagnostic value of high frequency color Doppler ultrasound combined with gastrointestinal filling in infants with duodenal obstruction . Methods One hundred infants who were suspected with duodenal obstruction underwent both gastrointestinal ultrasound and upper gastrointestinal tract ,put the surgical results as the ?gold standard ,the values of ultrasonic and upper gastrointestinal tract in the diagnosis of pediatric congenital duodenal obstruction were compared . Results The diagnostic accuracy of ultrasound and upper gastrointestinal tract in duodenal obstruction was 100%and 94% respectively ,the difference was statistically significant ( P = 0 .041) . The accuracy rate of obstruction location was 98 .04% and 84 .31% respectively , also was considered to denote statistical significance ( P = 0 .023 ) . The total diagnostic accuracy of congenital disorders caused by duodenal obstruction was 89% and 49% respectively ,and P = 0 .001 implies statistically significant difference . Conclusions There is a high diagnostic accuracy in high frequency ultrasound combined with gastrointestinal filling in children with congenital duodenal obstruction ,and the diagnosis of some diseases is better than that of the upper gastroenterography .

Wenchuan Earthquake in Sichuan Province caused heavy casualties in minutes beyond local medical capacity,and some of whom had to be transferred to medical institutions in other provinces and cities for rescue and further treatmenL This paper described the leadership and implementation of this large scale operation to transfer these casualties to other provinces and cities.With characteristics and experiences,this paper made an in-depth review on relevant issues for reference of long-distance transfer of casualties in batches in future.

Objective To compare the local control and survival rates of hyperfractionated radiotherapy plus concurrent chemotherapy with hyperfractionated radiotherapy alone in the treatment of stage Ⅲ-Ⅳ nasopharyngeal carcinoma (NPC).Methods Between December 1992 and December 1995, 150 NPC patients were randomized into hyperfractionated radiotherapy plus concurrent chemotherapy (R+C) and hyperfractionated radiotherapy alone (R alone) groups. Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R+C patients before and during the course of radiotherapy. Results The overall 5-year survival (OS), disease-free survival and distant metastasis-free survival rates were 57.3%, 55.9% and 55.9% . The 5-year survival rates of the R+C and R alone groups were 64.0% and 50.7%, with the difference statistically significant (P=0.037). One patient in the R+C group and 5 patients in the R alone group developed nasopharyngeal recurrence and the corresponding 5-year local control rates were 98.7% and 93.4%. The acute mucosal reaction in the R+C patients was severer than that of the R alone, but well tolerated and did not develop any severe complications. Conclusions Hyperfractionated radiotherapy plus concurrent chemotherapy can improve the local control and survival in patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma with well tolerated mucosal reactions. Chemotherapy gives greater benefit on the survival of stage Ⅳ patients.

Objective To investigate the protective effects of rhein lysinate ( RHL) on cardiac tissue damage in-duced by paraquat in experimental mice , and to clarify its mechanism .Methods In this study mice were assigned to the following three groups: control, paraquat model, and RHL-treated groups.The model of oxidative damage mice was established by intraperitoneal injection of paraquat .RHL-treated group was given RHL ( 50 mg/kg ) by gavage for one week before performing model .The other two groups were given equal volume of distilled water .For making model , paraquat was intraperitoneally injected in the paraquat model and RHL-treated group .The content of MDA was detected by thiobarbituric acid assay .The activities of SOD and GSH-Px were detected by biphenyl three phenolic autoxidation assay and NADPH coupling method respectivly .The pathological profile of cardiac tis-sue was observed by hematoxylin and eosin ( HE) staining and reactive oxygen species was observed by DCFH-DA staining .The change of proteins related to myocardial damage detected by Western blot .Results Compared with control group, the activities of SOD and GSH-Px decreased (P<0.05) and the content of MDA increased (P<0.05) in paraquat model group .However , these changes were attenuated byr RHL treatmen ( P<0.05 ) .The pathologi-cal examination indicated the structure of cardiac tissue was damaged and reactive oxygen species of cardiac tissue was increased after paraquat was given , however , these changes were attenuated after RHL treatmen .It was shown in western blot analysis that compared with control group , the expression of SIRT1 decreased, the acetylation of P53 and the expression of P 53 and P66 increased in paraquat-treated group .These changes were attenuated by RHL treatmen ( P<0.05 ) .Conclusions RHL may attenuate paraquat-induced cardiac injury in mice .

Objective To investigate the effect of Shensong Yangxin capsule on cardiac remodelling of myocardial infarction mouse model and the possible molecular mechanisms. Methods Adult male C57BL/6J mice were divided into sham operation group(n=10), model control group(n=20)and Shensong Yangxin group(n=20)according to random number table. Left anterior descending branch of coronary artery was ligated to establish myocardic infarction model in the model control group and Shensong Yangxin group. From the 2nd day after the surgery, Shensong Yangxin ( 400 mg . kg-1 ) was intragastrically administered, and the death rate of the mice was observed.Four weeks after the surgery, echocardiography was used to measure the cardiac function;myocardiac infarction area was detected by pathological staining;the expression levels of cardiac remodelling markers and extracellular matrix proteins were detected by RT-PCR. The possible molecular mechanisms were screened by Western blotting. Results As compared with the model control group, Shensong Yangxin significantly reduced the mortality after myocardial infarction in mice(P<0.05), as well as the myocardial infarct size(P<0.05).The mRNA expression levels of cardiac remodelling markers ANP, BNP, and β-MHC and the extracellular matrix proteins(collagenⅠ, collagen Ⅲ, CTGF, TGFβ) decreased significantly in the Shensong Yangxin group as compared with the model control group. Western blotting showed that Shensong Yangxin significantly decreased activation of smad3, and reduced expression level of smad4. Conclusion Shensong Yangxin attenuates cardiac remodelling after myocardial infarction and the mechanism may be related with blockage of smad signaling pathway.

Naturally existing Newcastle disease virus (NDV) can specifically execute oncolytic ability in clinical studies. Reports from clinical trials using NDV as oncolytic agents showed promise and warrant results in cancer therapy. In recent years, reverse genetics technology has been used widely in the studies of NDV virology. More recently, the technology was applied to optimize the oncolytic efficacy of NDV, for instance, modification of the F gene, and expression of GM-CSF, IFN-gamma, IL-2 or TNF-alpha. NDV is widely investigated in cancer therapy and will definitely offer a prosperous future for clinical cancer therapeutics. We reviewed the developments of cancer therapy by recombinant NDV using reverse genetics technology, as well as our own experience in this domain.
Animals ; Humans ; Neoplasms ; pathology ; therapy ; Newcastle disease virus ; genetics ; physiology ; Oncolytic Virotherapy ; methods ; Oncolytic Viruses ; genetics ; physiology ; Recombination, Genetic

Objective:To explore the relationship between blocking antibody and lymphocyte subsets in elderly patients (age≥35 years old) with recurrent spontaneous abortion(RSA).Methods:A retrospective case-control study was conducted on the patients with recurrent spontaneous abortion who met the inclusion criteria from October 2014 to September 2019 in the Reproductive Center of Women Health Center of Shanxi.They were divided into two groups according to their ages: 66 cases in RSA group and 334 cases in normal pregnant age group.The blocking antibody and lymphocyte subsets were detected by flow cytometry.Results:The negative rate of blocking antibody in elderly recurrent spontaneous abortion patients was 77.27% (51/66), which was not significantly different from that in normal gestational recurrent spontaneous abortion patients (83.53%(279/334)) ( P=0.221), but significantly higher than that in normal women (23.46%(42/179)) ( P=0.001). The blocking antibody′s blocking efficiency results showed that the CD3′s blocking efficiency of elderly recurrent spontaneous abortion patients (0.10 (-0.50, 0.60)) was significantly lower than that of normal women (0.60 (0.00, 1.30)), the difference was statistically( P=0.001). The CD8 blocking efficiency of elderly recurrent spontaneous abortion patients (0.00 (-0.60, 0.63)) was significantly lower than that of normal women (0.30 (0.00, 0.70)), the difference was statistically( P=0.016). Lymphocyte subsets showed that the CD8 + T cell ratio in elderly recurrent spontaneous abortion patients (26.93±7.25) was significantly lower than that in normal gestational recurrent spontaneous abortion patients (29.22±7.29), the difference was statistically significant ( P=0.020). The CD4 + /CD8 + ratio in elderly recurrent spontaneous abortion patients (1.64±0.99) was significantly higher than that in normal gestational age recurrent spontaneous abortion patients (1.37±0.50), the difference was statistically significant ( P=0.030). The ratio of natural killer cells in elderly recurrent spontaneous abortion patients (16.13±7.10) was significantly higher than that in normal women (14.04±2.35), the difference was statistically significant ( P=0.022), and higher than that in normal gestational age recurrent spontaneous abortion women (15.57±7.02). Conclusion:There were differences in lymphocyte subsets between elderly RSA patients and normal pregnant women, and the increase of natural killer cell ratio may be an important factor in the occurrence of RSA, especially in elderly RSA patients.