It elaborates the importance of designing a patient-centered hospital environment, and presents the concept of such a design. The authors hold that such a concept is mostly composed of systematic, people-oriented, informationized and variability designs, and describe the design trends in contemporary hospitals. It is also pointed out that patient-centered principle should be dominant in building a contemporary hospital, as the guideline and development trend, as a satisfactory hospital environment makes a hospital more competitive.

Objective To investigate the effects of temperature and time on the quality of cryoprecipitate.Methods Fresh frozen plasmas were divided into the three groups,and the cryoprecipitate were prepared from fresh frozen plasma by siphonage method thawing at 2℃,4℃ or 6℃ water bat.Thawing time,FⅧ and fibfinogen (Fg) were compared among the three groups.Results The thawing time at 2℃,4℃ or 6℃ was (96.3 ± 5.9) min,(89.6 ± 4.3) min,(81.2 ± 2.7) min.The activity of F Ⅷ was (95.36 ± 4.8) IU,(91.21 ± 3.3) IU,(89.8 ±3.1)IU,respectively.The activity of FⅧ was the highest at 2℃ condition and there was significantly different compared with other two groups (t =6.94,P =0.009,t =8.96,P =0.004).The activity of FⅧ in 4℃ group and 6℃ group were comparable (t =0.669,P =0.19).The concentration of Fg at three groups were similar (258.6 ±12.6) mg,(253.3 ±8.2)mg,(255.9 ±9.7) mg (t =0.321,P =0.37;t =0.270,P =0.56;t =0.424,P =0.29).Conclusion The activity of FⅧ at 2℃ condition were the highest but the thawing time was the longest.The activity of FⅧ at 6℃ condition were lower but met quality requirements and the thawing time was very short.There was no significantly different at Fg concentration among three groups.Thus 6℃ is more suitable for blood center to prepare cryoprecipitate from fresh frozen plasmas.

Objective To explore the levels of neuron-specific enolase(NSE)in serum and cerebrospinal fluid(CSF) of children with convulsion,and its significance to the diagnosis of neuronal damage was evaluated.Methods Sixty patients were enrolled,and they were divided into 4 groups:non-nervous system disease group,peripheral nervous system disease group,brief convulsion group,and prolonged/status convulsion group.The levels of NSE in serum and CSF were detected in 4 groups,and the electroencephalography(EEG) and computed tomography/magnetic resonance imaging(CT/MRI) examinations were taken to observe the changes in patients with convulsion.Results The levels of NSE in serum and CSF of children with convulsion increased significant,especially in the prolonged/status convulsion group.Changes of NSE levels in serum and CSF were similar.Meanwhile,significant changes were found in EEG between the brief convulsion group and prolonged/status convulsion group;but no significantly changes were found in CT/MRI between the 2 groups.Conclusions NSE detection might be valuable to the diagnosis for neuronal damage in early time.The changes of NSE levels are similar to those in EEG,which are more sensitive than the changes in CT/MRI.It is very important to combine the NSE detection in serum or CSF and EEG examination in early time after convulsion for judgement to the neuronal damage and prognosis.

OBJECTIVE:To optimize the preparation process of Naringin liposome gel,and to establish the quality control method of the gel. METHODS:The preparation method of Naringin liposome was investigated by single factor test with encapsula-tion percentage as index. The phosphatide concentration,the proportion of phosphatide to cholesterol and the proportion of phospha-tide to drug in the liposomes were optimized by orthogonal design. Using formability,spread performance and stability as compre-hensive evaluation indicator,the dosage of carbopol and triethanolamine and drug-loading amount in the gels were optimized by or-thogonal design. The quality control method of the gel was established preliminarily. RESULTS:Naringin liposomes were prepared by the method of ethanol injection;the optimal formulation of the liposomes was as follows as phosphatide 30 mg/ml,the propor-tion of phosphatide to cholesterol 3∶1,the proportion of phosphatide to drug 10∶1;that of the gels was as follows as carbopol 0.30 g,triethanolamine 1.0 g,drug-loading amount 1.0 g/20 g. Average encapsulation efficiency of validation test was 40.19% for Lipo-some(RSD=0.10%,n=3);comprehensive score was 9.8,average content of naringin was 0.58%(accounting for 96.67% of la-bel amount)for gels. The quality control method of the preparation was established,i.g. identification,content determination. CON-CLUSIONS:The optimal preparation formulation is feasible,and the preparation is controllable in quality.

Objective To investigate the effect on the menstrual patterns and sexual quality of life of patients with adenomyosis after treated with Mirena IUD.Methods56 patients with adenomyosis who were treated with Mirena IUD were recruited from August 2009 to December 2009.We used Menstrual blood loss chart method,Dysmenorrhea score method and Brief Index of Sexual Function for Women (BISF-W) to evaluate the menstrual pattern,the volume of uterus and sexual quality after1,3,6,9,12 months.{Results53 patients were followed up,the rate was 94.6%.The condition of 56 patients became better after treated with Mirena for 3,6,9,12 months,dysmenorrhea[Placed before:(3.15±0.91)points;After placing:(1.41±0.51)points,(0.22±0.09)points,(0.07±0.01)points,0 points]and menstrual quantity[Placed before:(12.0±57.5)points;After placing:(71±23.1)points,(29±19.4)points,(18±10.5)points,(10±4.7)points]were both reduced(P＜0.05),the symptoms were not significantly improved after 1 month(P＞0.05).D2 indicators was significantly improved after 3 months of treatment (P＜0.05),sexual function was also improved after 6 months(P＜0.05～0.01).ConclusionsMirena IUD has a good effect on the menstrual pattern and sexual function for patients with adenomyosis.

Objective To evaluate the efficacy of combination therapy of cholinergic receptor blocker Tolterodine and Alpha-adrenergic receptor blocker Tamsulosin sustained-release capsules on benign prostatic hyperplasia(BPH)with overactive bladder(OAB) in elderly men.Methods A total of 97 male BPH patients aged 80 years and over(80～98 years old,mean 87.7 years old)were enrolled in this study,who met the diagnosis and treatment guidelines of OAB formulated by Chinese Urological Association and were admitted to our hospital from Jan.2015 to July.2015.Patients were randomly divided into Tamsulosin group(n＝ 51,treated with Tamsulosin) and combination group(n＝ 46,treated with Tamsulosin and Tolterodine).Results In Tamsulosin group after treatment,the international prostate symptom score(IPSS) was reduced from (18.3 ± 2.7) to (13.3 ± 3.1) (t ＝ 14.94,P ＜ 0.05),OAB symptom score(OABSS) from (9.3 ± 2.7) to (6.8 ± 1.9) (t ＝ 3.92,P ＜ 0.05),and post void residual volume(PVRV)from(36.5±32.3)ml to(16.2±12.1)ml(t＝14.98,P＜0.01).And the daily frequency of urgency,urgency incontinence and nocturia were improved in Tamsulosin group after treatment.IPSS,OABSS and PVRV were improved more significantly in combination group after treatment than in Tamsulosin group,and the daily frequency of urgency,urgency incontinence and nocturia were reduced more significantly in combination group than in tamsulosin group(t＝-5.23,-3.98,9.01,11.5,14.8,P＜0.01).While there was no significant difference in prostate volume (PV)and PVRV between the two groups after 8 weeks of treatment(t＝ 1.22,-0.94,P＞0.05).The total incidences of adverse events (mainly mouth dryness)had no significant differences between the Tamsulosingroup and the combination group(8.7％ vs.5.9％,x2 ＝99.47,P＞0.05).No acute urinary retention was found in the two groups.Conclusions The combination therapy of Tamsulosin and Tolterodine has better efficacy and safety than single Tamsulosin application in the treatment of BPH with OAB in elderly men.

Objective To discuss the diagnosis, treatment and following up of the cervical lesions(CIN～cervical carcinoma Ia 1) during pregnancy. Methods Fifteen pregnant women with cervical lesions were reviewed from Jan 1998～Oct 2003 in our hospital. Results Among the fifteen cases, 11 were diagnosed as CIN～ cervical carcinoma Ia 1 based on biopsy results under copolscopy. Ten of the 11 cases had copolscopy repeated every 8 weeks and delivered at term. The left one woman terminated the pregnancy in the first trimester due to carcinoma in situ (CIS) invasion to glands. Among those 10 cases who progressed to term, four were stable during pregnancy (CINⅡ,CINⅢ,CIS and cervical carcinoma Ia1, one for each) and had the same pathology postpartum as antepartum; three had CIN I during pregnancy but changed to inflammation postpartum;one had CIS involved in glands prepartumly while CINⅡ～Ⅲ postpartumly; one had CINⅢ prepartumly and progressed to CIS involved in glands confirmed after conization postpartumly. One woman was missing after delivery. Conclusions Cervical lesions (CIN～Ia 1) less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy when necessary are available. Re examination is necessary within two months after birth. Routine examination for women who have no pap smear within the last one year period would be helpful in detecting cervical lesions during pregnancy.

OBJECTIVE: Synovial sarcoma (SS) of the head and neck is rare in comparison with those took place in the extremities. This study was planned to investigate the relationship between pathological diagnosis, tumor location and clinical outcome of SS of the head and neck. METHOD: Thirty-nine cases of SS in head and neck hospitalized in West China Hospital from 1966 to 2011 was retrospectively studied by reviewing the medical record data, the pathological slices of the operative specimen and followed-up from 1 to 192 months with the mean time of 43.2 months postoperatively. The parameters of clinical outcome were focused on the time to first recurrence after primary surgery and follow-up time. The reviewed results were statistically processed. RESULT: The age of the patients ranged from 8 to 66 years old with the median age of 35, among them 27 are males. Pathologically, 18 cases are biphasic, 17 cases are monophasic and 3 cases are low-differentiated SS. 4 cases were proved by cytogenetic methods of either fluorescence in situ hybridization(FISH) or RT-PCR. 23 cases experienced repeated recurrence with the most up to 4 times operations after sole surgical approach. Only one lymphatic metastasis was suspected in all. 16 patients got adjuvant radiotherapy or chemotherapy. 4 patients died but only one death was associated directly with SS recurrence. There was no significant relationship between pathological subtype and recurrence (Fisher's Exact Test P-value > 0.05), no significant relationship between tumor location and recurrence (Fisher's Exact Test P-value > 0.05). CONCLUSION SS of head and neck is a special entity that has potential of easy recurrence but good prognosis. Surgery should still be the primary treatment approach. Cytogenetic methods are recommended to as certain the diagnosis in order to choose reasonable treatment protocols.
Adolescent ; Adult ; Aged ; Child ; China ; Female ; Head and Neck Neoplasms ; genetics ; pathology ; therapy ; Humans ; In Situ Hybridization, Fluorescence ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Sarcoma, Synovial ; genetics ; pathology ; therapy ; Young Adult

OBJECTIVE:To provide reference for the realization of normalization and standardization of quality control and management of Pharmacy intravenous admixture service(PIVAS). METHODS:The management and effectiveness of PIVAS quali-ty control in our hospital were introduced from aspects of the establishment of internal quality control system,the key indicators and effects of quality control. RESULTS:According to checking items from aspects of examining once in a month,on prescription checking,preparation,infection control,equipments,drugs,consumable materials,sanitation;holding 1 monthly quality control reviews;and analyzing unqualified indexes and existing security risks,the quality control of PIVAS had achieved good results. The qualified percentage of quality control index was increased from 84%(Jan. 2016)to 90%(Jun. 2016),error rate in the same peri-od was decreased from 0.579‰ to 0.099‰. CONCLUSIONS:Developing quality control of the implementation of detailed quality control key indexes for the whole process of intravenous infusion in PIVAS can effectively regulate the position working process,re-duce preparation error and ensure the quality of infusion preparation.

Purpose To establish a new method for detecting p16INK4a in cervical tissues with time-resolved fluoroimmunoassay (TRFIA).Methods 126 cases of paraffin imbedding tissues of cervix were selected for immunohistochemistry (IHC) of EnVision two-step and TRFIA.Results There were 20 cases of no intraepithelial lesion or malignancy,24 cases of low-grade squamous intraepithelial lesion (LSIL),53 cases of high-grade squamous intraepithelial lesion (HSIL) and 29 cases of squamous cell carcinoma (SCC).In the groups of no intraepithelial lesion or malignancy,LSIL,HSIL and SCC,p161NK4a positive was seen in 1,19,53 and 28,respectively.TRFIA test results displayed p16INK4a positive in 3,17,50 and 27 cases,respectively.Positive of p16 using by TRFIA in no intraepithelial lesion or malignancy,LSIL,above HSIL was 15.00％,70.83％ and 93.90％,respectively (P ＜ 0.01).Conclusion TRFIA is suitable for detecting of p16INK4a protein and demand low detection equipment,p16INK4a expression detected by TRFIA may helpful for large scale detection in various clinical institution.