Total Processing Quality Management ( TPQM ) is an effective administration tool to improve clinical education quality. Deep meaning of TPQM is illustrated. By means of 5W1H, key points and relationship map of clinical education process are analyzed. Furthermore, valuable steps to execute TPQM of clinical education are put forward.

Objective　To study the relationship between HCV infection and hepatocellular carcinoma. Methods　PCR techniques were used to detect the serologic markers of HCV-RNA of 92 patients with hepatocellular carcinoma (HCC), 117 patients with liver cirrhosis (LC) and 100 paraffin-embedded liver tissues from patients from Huainan area. The 89 HCV-RNA positive sera from the 209 patients were analyzed by restriction fragment length polymorphism (RFLP). Results　The infection rates of HCC, LC, liver tissues were 29.3%, 26.5%, 31.0%. HCV genotype of all groups was mainly of type Ⅱ (65.2%) whereas that of type Ⅲ was 31.5%. Conclusion　HCC is associated with the infection of HCV in Huainan area. The infection of HCV type Ⅱ appears to play a main role in the development of HCV-associated HCC and LC in this area.

ObjectiveThis study explored the change of IL-18,and IFN-γ and their role in the pathogenesis of primary Sj(o)gren's syndrome (pSS) by determining the expression of IL-18,IFN-γ in labial glands and blood of patients with pSS.MethodsThe levels of IL-18,IFN-γ in labial glands of patients with pSS were determined by immunohistochemical method.The level of serum IL-18 was determined with enzyme linked immunosorbent assay ELISA.The level of γ globulin was measured by the cellulose acetate membrane method.SPSS 17.0 statistical software was used for data analysis.The t test,Fisher's exact probability test and index correlation analysis were performed with linear correlation analysis.Spearman's test was used to examine the association between the expression of IL-18 and IFN.ResultsThe positive rate of IL-18 and IFN-γ in patients with pSS was much higher than normal control group(P＜0.05).And the IL-18 and IFN-γ levels were positively correlated withpatients with pSS (P＜0.05).The level of serum IL-18 in patients with pSS was (216±85) pg/ml,which was much higher than normal control group(39±8) pg/ml.The IL-18 level and γ globulin(23.2±2.6)％ was positively correlated in patients with pSS (r=0.538,P＜0.05).ConclusionThe expression of IL-18 and IFN-γ in labial glands of patients with pSS are much higher in patients with pSS than those of the normal controls.Theresults have shown that IL-18 and IFN-γ may be involved inthe pathogenesis of pSS.

The reform experiences of physician fee system ( PF ) practiced at a hospital in Nanjing were analyzed to come up with key influencing factors to make the reform a success,including income level,income makeup and income equity.Most noteworthy of the authors' points was income equity,proposing such reforms as target physician salary and inter-departmental balance,especially the two key factors of implementing the price target factor and inter-departmental balance.Their efforts aim at exploring a brand new idea and successful experiences in making PF system a success in China's hospitals.

The life cycle of Trichobilharzia sp.can be completed in Radix auricularia and domestic or wild ducks,and people can contract cercarial dermatitis through water contact.Natural nidus of Trichobilharzia exists in Huainan area.

‘Two-way’ training of teaching basic skill and medical education method was conducted for young and middle-aged teachers according to characteristics of clinical teachers in teaching hospitals.After two years of training,clinical teachers' teaching ability and teaching enthusiasm and the quality of classroom teaching have obviously improved based on the analysis of related data.Clinical teacher training strengthen the teaching faculty quantitatively.This thesis discussed the importance of clinical teachers' training and further explored the improvement of clinical teacher education mode.

Objective To investigate the effect of livzon weisanlian(bismuth agent 0.22g,bid+tinidazole,0.5g,bid+clarithromycin 0.25g,bid) for 7 days for eradication of H.pylori and infection of patients suffering from chronic gastritis and peptic ulcer in Huannai area.Methods Four pieces of gastric mucosa were taken out by gastroscopy,two pieces of them from gastric antrum 3～5cm near pylori and the others from gastric body.All of them were detected for H.pylori and biopsy and smear.If both the former and the one of the later are all positive the patient was diagnosed with H.pylori and treated with livzon weisanlian.Results The positive of CSG is 81.6%,CAG is 63%,GU is 90.8% and DU is 93.3%.Conclusion The positive rate of patients suffering from chronic gastritis and peptic ulcer in Huainan area is high.The eradicative rate with livzon weisanlian is also high and it shows that livzon weisanlian is feasible to treat chronic gastritis and peptic ulcer.

Objective To investigate the effect of immunotherapy of recombinant chimeric epitopes of major allergen group 1 from Dermatophagoides farina on asthma of mice. Methods Forty mice were randomly divided into 4 groups:a negative con?trol group,an asthma group,an immunotherapy group of Der f 1,and an immunotherapy group of Der f 1A. On the 1st,7th and 14th day,the mice in the asthma group,immunotherapy group of Der f 1,and immunotherapy group of Der f 1A were injected intraperitoneally with the extract of D. farina 3 times to sensitize;and on the 21st day,the atomized inhalation was carried out for 7 days. In the control group,phosphate buffer solution(PBS)was applied for sensitization and inhalation. In the immunother?apy groups,Der f 1 and Der f 1A were applied to carry out the specific immunotherapy respectively for 30 min before the inhala?tion. Then,the leukocytes in the bronchoalveolar lavage fluid(BALF)were numbered and the pathological sections of lung tis?sues were observed;IL?5 and IFN?γin BALF and spleen cell culture supernatants(SCCS)as well as the specific IgE,IgG2a in the sera were detected. Results Compared with the asthma group,the lung inflammation of mice in the immunotherapy groups was lightened,and the total numbers of leukocytes in BALF were significantly reduced;IL?5 was significantly reduced and IFN?γwas significantly increased in BALF and SCCS of mice in the immunotherapy groups;and the specific IgE was significantly re?duced and IgG2a was significantly increased in the sera of mice in the immunotherapy groups(all P<0.01). Conclusion The recombinant chimeric epitopes of major allergen group 1 from D. farina could effectively relieve the symptom of asthma in mice, so as to provide the evidence for specific immunotherapy.

Objective To construct and express a chimeric gene with T-/B-cell epitopes of the major allergen group 1 from Dermatophagoides farina(Der f 1). Methods Two chimeric genes,Der f 1A and Der f 1B,were synthesized as B1-T1-B2-T2-B3-T3-B4-T4-B5-T5-B6 and B1-B2-B3-B4-B5-B6-T1-T2-T3-T4-T5 pattens. Two recombinant vectors,pET-28a(+)-Der f 1A and pET-28a(+)-Der f 1B,were constructed for prokaryotic expression. These chimeric genes were induced by 1 mmol/L IPTG (final concentration),digested with restriction enzymes and sequenced. The chimeric proteins were analyzed by SDS-PAGE and Western blotting. Results After digestion by restriction enzymes and sequencing,the recombinant vectors were constructed successfully. The specific bands for chimeric proteins were visible by SDS-PAGE and Western blotting,suggesting that these proteins were purified successfully. Further analyses were performed for IgE-binding properties of Der f 1A and Der f 1B to sera from patients sensitized to house dust mite. Compared with the parental allergens Der f 1,Der f 1A and Der f 1B had reduced IgE-binding capacity(both P<0.05),whereas the difference between Der f 1A and Der f 1B was not statistically significant(P>0.05). Conclusion Two chimeric proteins are expressed successfully,which contain T-/B-cell epitopes of Der f 1 and provide a basis for specific immunotherapy.

Hospitals need to explore based on their own specifics how to establish a modern hospital governance system and how a lean hospital administration level be achieved. This paper introduced the practice and exploration of modern hospital governance system construction in Beijing Tsinghua Changgung Hospital as follows. The hospital is run by a board of administration featuring co-administration by both Beijing Municipal Hospital Administration Center and Tsinghua University; A hospital charter is developed and agreed upon to regulate decision-making, day-to-day operations and supervision; The hospital president′s responsibility is under the leadership of the hospital′s Communist Party Committee; Benefiting from best practices of Taiwan Changgung′s medical system, the hospital′s specialized medical teams and professional administrative teams operate in cooperative governance, and under professional management model and a lean operation management system. The practice and exploration of Beijing Tsinghua Changgung Hospital can serve as references for building and perfecting a modern hospital governance system.