The influences of medicine by the rapid development of economy are at least reflected on the following three as-pects: dramatically increasing awareness of health and medical demand of the majority and the serious “five long one short” phenome-non in outpatient clinic.This paper is based on the medical data of Nanfang Hospital.We analyzed the problems in the five links of appointed registration, visiting the doctors, taking examination and treatment, charging medical fees and medicine -claiming, putting forward four suggestions including updating concept for outpatients , emphasizing the application of information equipment and popular-ization of mobile device, such as WeChat guidance, in order to enhance the hospital networking mechanism , realize the synchronous transfer of information, introduce high-technology, and finally perfect the e-record of patients.

Objective To investigate the remote effects of epidermal growth factor(EGF)and early removal of eschar combined with skin grafting for the treatment of skin lesion produced by mustard gas.Methods A 3-year follow-up survey was condueted in 39 patients with skin lesion produced by mustard gas.The condition of healing was observed and evaluated.Results Good epithelial healing with pigmentation was observed in all the surveyed patients,and only in a few of them showed local recurrence of wound.Itching and paresthesia in the wounded parts were the main complaints.The sequelae remained unpredictable.Conclusion The early use of epidermal growth factor and early removal of eschar followed by skin grafting for the treatment of skin lesion produced by mustard gas may achieve satisfactory therapeutic effect.

Objective To compare the efficacy and safety of naphthoquine, artemisinine and a combination of the two drugs in the treatment of faciparum malaria. Methods Of 230 patients, 100 patients were treated with combined regime (Co-NQ), 100 patients were treated with naphthoquine (NQ) and 30 patients were treated with artemisinine (QHS). All patients were hospitalized for 7 days and followed up for 28 days. Results The mean fever clearance time for Co-NQ, NQ, and QHS was (17.5 ?12.3)h, (32.7?17.7)h and (18.1?9.7)h respectively; the mean parasite clearance time was (30.0?8. 8)h,(45.5?10.0)h and (29.1?6.0)h respectively; and the 28 days cure rate was 97.0% ,100.0% and 66.7% respectively. Conclusion The Co-NQ possesses benefits of both naphthoquine and artemisinine, acting rapidly, with a short course of only one dose and a high cure rate. The regime is well tolerated by patients.

Objective To analyze the status quo and influencing factors of patient safety culture among medical staffs in the hospitals of Shenzhen City to provided reference for its improvement and conduct the patient safety culture research by other medical institutions.Methods The Patient Safety Culture Questionnaire of Medical Institutions(PSCHO) was adopted to investigate on 1000 medical persons from February to May 2016.Results The total score of patient safety culture in medical staffs was (3.53±0.40) and,the difference among different categories of medical persons had no statistical significance (P＞ 0.05).The differences among the medical staffs with different working ages,communication frequency with patients,training times,concern frequency had statistical difference(P＜0.05).Conclusion The patient safety culture level in Shenzhen City is higher.However,the sense of blame and shame is one of the important factors impeding the promotion of the patient safety culture in hospitnl.Hospital should conduct the targeted improvement to the related factors affecting the patient safety culture from the aspects of organism,department and individual level.

Objective To investigate the distribution of eosinphililic neurons ( ENs),reactive astrocytes ( RAs),and infarction after transient cerebal ischemia,and the time profile of pathomorphological changes.Methods Unilateral forebrain ischemia was induced in Mongolian gerbils by two 10 minutes unilateral common carotid artery occlusions with a 5 hours interval.Laser Doppler flowmetry was used to detect intra-ischemic anterior cortex blood flow.Animals were sacrificed at 24 hours,4 days,2 weeks,4 weeks,16 weeks and the brain were prepared for pathomorphological assay.Results Intra-ischemic laser Doppler flowmetry show significant ischemia during carotid artery occlusion:22.1％ ± 9.5％,26.3％ ± 4.9％,37.5％ ± 3.5％,F =67.219,P ＜ 0.01 ; the decrease was significantly greater in the anterior cortex.ENs appeared in middle and deep layers at 24 hours postischemia,and ENs area extend to all layers of cortex by 4 days.Large areas of high EN density ( ≥80/mm2) evolved to infarcts between 4 days and 4 weeks.Posterior cortex evolved to low EN area ( ＜ 80/mm2) without transformation into infarcts.RAs were consistently distributed in areas with ENs,and RA areas with high EN density were largely transformed into infarcts between 4 days and 4 weeks. Delayed astrocytic death took place in the RA areas with high EN density.Conclusion Density of ENs is an important indicator of delayed astrocytic death and infarction in postischemic tissue.

Objective:To investigate whether interferon-gamma inducible protein-10(IP-10) and interferon-gamma(IFN-?) participated in the human cerebral ischemia injury.Methods:Twenty-one cerebral ischemia specimens, collected from patients died of cerebral infarction, were divided into three groups: less than 7 days, 7-14 days and 15-21 days according to the lasting time of cerebral infarction. The infiltrating of inflammatory cells were observed using HE stain as non-ischemic hemisphere was for controls. Expression of IP-10 and IFN-? in sections both postmortem ischemic hemisphere and non-ischemic hemisphere were detected using immunohistochemistry.Results:In the groups of less than 7 days and 7-14 days large quantity of inflammatory cells were infiltrated in ischemia tissue. Expression of IP-10 in three groups was elevated in the ischemic hemisphere compared with non-ischemic hemisphere(1.74-folds, 1.41-folds and 1.52-folds increases respectively, P0.05).Conclusion:These results showed IP-10 and IFN-? are expressed in human cerebral ischemia. It was suggested that IP-10 and IFN-? involve in cerebral ischemia injury. Moreover, it was also suggested that IP-10 participate in the repair for the later stage of cerebral ischemia injury.

Objective To study the multi-slice spiral CT anatomy of pulmonary veins.Methods After accomplishing the scanning of coronary CT angiography in 120 cases with multi-slice spiral CT,the volume rendering and multi-planner reconstruction based on the original transverse images were performed.The pulmonary veins style according to the number of pulmonary-atrium ostium,pulmonary vein,common ostium and additional pulmonary vein were classified.The difference of sex in presence of the common ostium and additional pulmonary vein was analyzed statistically.Results The incidence of the common ostium and additional pulmonary vein was 22.5% and 15.8%,respectively,there was no difference in sex.The pulmonary veins included 4 types:standard type(62.5%),common ostium type(21.7%),additional pulmonary vein type(15.0%),mixed variation type(0.8%).Conclusion Multi-slice spiral CT can accomplish the observation of pulmonary vein,which can provide anatomic informations for clinic.

Objective To investigate the effect and mechanism of sphingosine 1-phosphate(S1P)on action potential(AP)and voltage-dependent potassium current(KV)in isolated guinea pig ventricular myocytes.Methods The ventricular myocytes were isolated by using Langendorff perfusion method.The AP and KV were recorded by whole cell patch-clamp recording technique.Results S1P prolonged the 50% and 90% action potential duration(APD50 and APD90)and decreased KV which were blocked by pertussis toxin(PTX)or Calphostin C.Conclusion S1P decreased KV in a PKC pathway and prolonged action potential duration in guinea-pig ventricular myocytes.

Objective To analyze and compare the differences in application of 24-hour dietary recall and dietary balance index (DBI) in dietary survey and evaluation of patients with type 2 diabetes mellitus,meanwhile investigate their nutrition status.Method This was a cross-sectional study.A total of 100 type 2 diabetes inpatients at the age of 19-59 were recruited from Shanghai Jiaotong University Affiliated Sixth People's Hospital from December 2013 to February 2014.They were surveyed and evaluated by 24-hour dietary recall and DBI respectively.Result The micronutrient intake in patients with type 2 diabetes was not sufficient.Compared with RNI,the intake of vitamin B1,B2,and calcium was less than 50％.The average of DBI lower bound score (DBI-LBS) of the 100 patients was 32.1±6.1,65％; the patients were in moderate or severe deficit of food intake.DBI higher bound score (DBI-HBS) was 4.4±2.8.No significant excess intake problem was found.Dietary quality distance was 36.4±6.9.Eighty-seven percent of them had a dietary patterns of mode B.Conclusion Dietary patterns in type 2 diabetes patients were not reasonable.Nutrition education and nutrition intervention for type 2 diabetes should be emphasized.The two methods can be used to evaluate dietary quality independently,but it would be better to evaluate the quality of the patients' diet using two dietary survey methods together.

Objective To investigate the effect of intermittent hypoxia (IH) with pulmonary emphysema on the ex-pression of hypoxia inducible factor-1α(HIF-1α),Bax and Bcl-2, and the mechanism underlying the role of HIF-1αin he-patocyte apoptosis thereof. Methods Sixty rats were randomly divided into four groups: normal control group, rats were treated normally;IH group, rats were treated by 30 s nitrogen and then 90 s air, and rats were treated by from 9:00-17:00 daily;pulmonary emphysema group, rats were treated by smudging for half an hour, twice a day (8:00 and 18:00);IH with pul-monary emphysema group, rats were treated by 30 s nitrogen and then 90 s air from 9:00-17:00 daily. After exposure four-teen weeks, rats were killed. qRT-PCR assay was conducted to detect the expression of HIF-1α mRNA, Bax mRNA and Bcl-2 mRNA in live tissues. Results The expressions of HIF-1αmRNA, Bax mRNA and Bax/Bcl-2 were significantly higher in IH with pulmonary emphysema group than those in control group,IH group and pulmonary emphysema group (P<0.05). The expression level of Bcl-2 mRNA was significantly lower in IH with pulmonary emphysema group than that of con-trol group and pulmonary emphysema group (P < 0.05), but no significant difference compared with that of IH group (P >0.05). The levels of HIF-1αand Bax were positively correlated with the level of Bax/Bcl-2 (r=0.732 and 0.699),but the lev-els of HIF-1αand Bax were negatively correlated with the level of Bcl-2 (r=-0.705). Conclusion The expression levels of HIF-1αmRNA, Bax mRNA and Bcl-2 mRNA were over-regulated in hepatocytes induced by intermittent hypoxia with pul-monary emphysema. The HIF-1αexpression was correlated with Bax and Bcl-2, suggesting that HIF-1αmay promote the hepatocyte apoptosis through transcriptional co-activators, Bax and Bcl-2.