Objective To investigate the curative effect of microwave ablation for non-small cell lung cancer (NSCLC) patients,and to analyze the serum concentration changes of vascular endothelial growth factor (VEGF),arginase-1 (Arg-1),inducible nitric oxide synthase (iNOS) before and after microwave ablation and their correlations.Methods A total of 30 cases of healthy people (control group) and 30 cases of advanced NSCLC (test group) were selected.The serum concentrations of VEGF,Arg-1 and iNOS in control group and test group (before microwave ablation,the first postoperative day,the third postoperative day and the first postoperative month) were measured by enzyme-linked immunosorbent assay (ELISA).Results The effective rate of microwave ablation for advanced NSCLC was 33.3％ (10/30),and the disease control rate was 70.0％ (21/30).The concentrations of VEGF,Arg-1 and iNOS in test group before microwave ablation were (816.56 ± 13.26)pg/ml,(5.17±0.20) ng/ml and (544.18 ± 13.93)pg/ml,which were higher than those in control group (93.43 ± 9.93) pg/ml,(1.08 ± 0.05) ng/ml and (8.08 ± 0.33) pg/ml,and the differences were statistically significant (t =239.093,P ＜ 0.001;t =110.359,P ＜ 0.001;t =210.792,P ＜ 0.001).The concentrations of VEGF were (708.41 ± 10.49) pg/ml,(592.63 ± 7.25) pg/ml and (521.91 ± 8.32) pg/ml on the first day,third day and 1 month after microwave ablation in patients with advanced NSCLC,which were significantly lower than those before treatment (all P ＜ 0.05).The homologous concentrations of Arg-1 were (5.95 ± 0.10) ng/ml,(7.02 ± 0.13) ng/ml and (7.67 ± 0.92) ng/ml,which were significantly higher than those before treatment (all P ＜ 0.05).The homologous concentrations of iNOS were (453.01 ± 9.48) pg/ml,(393.21 ± 9.42) pg/ml and (352.60 ± 8.31) pg/ml,which were significantly lower than those before treatment (all P ＜ 0.05).The expression of iNOS was positively related with VEGF in NSCLC patients before treatment (r =0.379,P =0.039),and the expression of Arg-1 was negatively related with VEGF (r =-0.556,P =0.001).However,the expression of iNOS was not associated with Arg-1 (r =-0.238,P =0.205).Conclusion Microwave ablation is effective for local therapy of NSCLC,which can directly kill cancer cells,and affect the levels of VEGF,Arg-1 and iNOS.VEGF has certain correlation with iNOS and Arg-1,but there was no correlation between iNOS and Arg-1.Microwave ablation can change the tumor microenvironment in a certain extent,and stimulate the body to produce anti-tumor immunity.

The existing doctor-patient communication pattern often falls prey to insufficient informed consent and even medical disputes. In the patient centered perspective, Zhejiang Provincial People′s Hospital explored a new communication mode centering on patients. Based on diagnosis-related groups catalogues and high-frequency surgeries catalogues of the departments, multimedia technology was called into play to produce dubbed PPTs and videos that were easy to understand, standardized and homogeneous, which were embedded into medical records system. Following observation of the PPT or video, patients could directly sign an informed consent on the computer. This practice not only deepens patient′s understanding and achieves homogeneous level of the communication, but also elevates doctor′s work efficiency, contributing to building a harmonious doctor-patient relationship.

The construction of safe hospital is the foundation of high-quality development of the hospital, and innovation provides power for the construction of safe hospital from the perspective of high-quality development. Taking Zhejiang Provincial People′s Hospital as an example, the authors introduced the innovation construction path of safe hospital in detail, and put forward the construction strategy of safe hospital with " two hearts" (patient-centered, employee-centered)and " four wings" (multimedia doctor-patient communication, Wulin aunt medical studio, integrated operation safety inspection, third-party medical liability insurance). Through the combination of basic safety management and innovative practice, the hospital vigorously promoted the culture of " two hearts" , and established an efficient collaborative information management system, so as to form replicable and promotable practical experience and promote the development of safe hospital.