Hospital TQM system is designed to fit China′s specifics,based on the Total Quality Management (TQM)theory and integrating the system theory concepts, comprising two structural modules of perceived quality and non-perceived quality.The former is a trinity framework made up of patient satisfaction,employee commitment and social reputation,while the latter is a management system featuring“Six pillars and six columns”,constituting a three-dimensional management for integrated operation and integration of the hospital.

Objective To investigate whether HA affects the inflammatory cytokines and chemokines of synoviocytes. Methods FLS were derived from the SD mice with knee OA by papaya enzyme and stimulated by IL-1. Then, FLS were cultured with 600 ~ 800 kDa HA. Anti-CD44 blocking experiments were determined. The expressionsof TNF-γ, IL-1 , IL-6 , MMP-3 , MMP-9 , CX3CL1 , CCL11 , CCL2 , CXCL12 were detected by RT-PCR. In addition, the tunel test was used to detect the apoptosis rate. Results MMP-3, CX3CL1 and CCL2 gene expression were down regulated by HMW-HA in unstimulated FLS and TNF-α,MMP-3, CX3CL1 and CCL2 expression were decreased by HMW-HA in IL-1-stimulated FLS. CD44 blocking inhibited the down-regulatory effects of HMW-HA. Besides, HMW-HA promoted cell apoptosis under condition of inflammation. Conclusion HMW-HA has an anti-inflammatory effect by down-regulating of pro-inflammatory cytokines and chemokines and promoting apoptosis, possibly through the interaction of CD44 and HMW-HA.

Objective To investigate the ability of decision-making under risk condition in benign epilepsy children with centrotemporal spikes (BECT).Method Seventy-eight BECT patients and seventyfive healthycontrols were studied by Iowa Gambling Task (IGT) with inexplicit probability and Game of Dice Test (GDT) with explicit probability.Results (1) There was a significant difference in IGT task scores between the two group (t=-2.56,P＜0.05).The total number of advantageous choices in IGT were lower in BECT group (49.35±5.38) than that in healthy control group (52.24±6.23).BECT group (-1.41 ± 10.60) performed worse on task than healthy control group (4.43±11.88),and the difference was statistically significant (t=-3.21,P＜0.05).The control group scored higher on Blockl,Block4 and Block5 than that of BECT group (P＜0.05).(2) There was no significant difference between the BECT group (4.42±7.74) and the control group(5.49±6.81) in the GDT test scores (t=-0.91,P=0.37).(3) Pearson correlation analysis showed that there was no significant correlation between the age,age of onset,education,seizure frequency and onset duration and the score of IGT and GDT (r =-0.091-0.274,all P ＞ 0.05).Conclusion There is no significant decision-making disability in children with BECT under the condition of certain risk probability,while there is significant impairment under the condition of uncertain risk probability.The decision-making disability may be associated with impaired frontal lobe function.

AIM:To investigate the roles of ClC-3 chloride channels in the regulation of cell cycle and the re-lationship between ClC-3 chloride channels and the cell cycle regulators , such as cyclin D1, cyclin-dependent kinase (CDK)4, CDK6, P21 and P27 in the HeLa cells.METHODS:ClC-3 genes were silenced by the siRNA technique in the HeLa cells.The transfection efficiency of ClC-3 siRNA was detected by real-time PCR.The cell cycle distribution was ana-lyzed by the flow cytometry .The protein expression of ClC-3, P21, P27, CDK4, CDK6 and cyclin D1 was determined by Western blot .RESULTS:ClC-3 was knocked down by ClC-3 siRNA in the HeLa cells .Transfection of the cells with ClC-3 siRNA arrested the cells at G0/G1 phases, decreased the expression of cyclin D1, CDK4 and CDK6, and increased the expression of P21 and P27.CONCLUSION:ClC-3 plays an important role in the cell cycle of HeLa cells through the G 1-S transition point.ClC-3 may regulate the cell cycle progression by up-regulation of cyclin D1, CDK4 and CDK6 expression and/or by down-regulation of P21 and P27 expression.

Objective To investigate the characteristics of attention networks impairment in benign epilepsy children with centrotemporal spikes.Methods The attention network test was performed in benign epilepsy children with centrotemporal spikes (n =75) and normal controls (n =75) on the efficiency of three anatomically defined attention networks:alerting,orienting,and execrtive control.Results The correct rate of attention network test was significantly lower in benign epilepsy children with centrotemporal spikes (95.77％ ± 5.63％) than that in normal controls (98.55％ ± 1.80％ ; t =4.063,P ＜ 0.05).The total average response time was significantly longer in benign epilepsy children with centrotemporal spikes ((946.87 ± 199.82) ms) than that in normal controls ((729.00 ± 146.75) ms ; t =-7.611,P ＜ 0.05).The orienting network effect (29 (12,56)ms) was lower in benign epilepsy children with centrotemporal spikes than in normal controls (51 (21,78) ms; Z =-2.771,P =0.006).The executive control network effect was higher in benign epilepsy children with centrotemporal spikes (80 (50,105) ms) than in normal controls (57 (25,88) ms; Z =-2.146,P =0.032).However,the difference in alerting network effects between the two groups was not statistically significant (P ＞ 0.05).Logistic regression analysis showed that the age on onset of the disease was an independent risk factor for the correct rate of attention network test and the total average response time (OR =1.830,95％ CI 1.193-2.807,P =0.006 ; OR =1.635,95％ CI 1.176-2.275,P =0.003).Conclusions The benign epilepsy children with centrotemporal spikes have impairment of attention networks.The age on onset of the disease has a significant impact on the attention of children with rolandic epilepsy.

The diagnosis and treatment characteristics of head-wind sha in She medicine were analyzed and summarized. By visiting She-nationality villages and towns in Zhejiang province and Fujian province and interviewing hundreds of doctors of She medicine, the sha diagnosis, sha differentiation, experience and theory of treatment were arranged, and a comprehensive summary on theory and application of head-wind sha in She medicine such as pathogeny, name of disease, mechanism, diagnosis, differential diagnosis and treatment was made. It is believed that the methods of diagnosis and treatment in She medicine for head-wind sha could effectively enhance curative effect, safety and patients' quality of life, and the further research should be carried out.
Acupuncture Therapy ; China ; ethnology ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Headache Disorders ; diagnosis ; drug therapy ; ethnology ; therapy ; Humans

Objective To investigate the relationship among Helicobacter pylori(H.pylori),CD4 positive cells and CD8 positive cells in gastric mucosa of the AIDS patients with gastritis.Methods Fiftyeight AIDS patients with upper abdominal pain were diagnosed with chronic gastritis through gastroscopy.The gastric biopsies from them were used for H.pylori detection with rapid urease test and Giemsa staining,pathology examination with HE staining,and immunohistochemistry analysis for CD4,CD8 positive cells in Gastric mucosa.And the application of flow cytometry was for the detection of peripheral blood CD4 and CD8 lymphocytes from the patients.Results H.pylori was positive in 26 cases,and negative was in 32 cases.CD8 cell expression in gastric mucosa of the AIDS patients with H.pylori positive was significantly higher than H.pylori negative patients(P＜0.05).There is no difference CD4 cell expression in gastric mucosa between the AIDS patients with H.pylori positive and H.pylori negative patients.Moreover,CD8 positive lymphocytes in gastric mucosa of those patients with H.pyloriinfection were significantly stronger than the CD4 positive lymphocytes.However,the peripheral blood CD4 lymphocytes from the patients with H.pylori infection were more than those from H.pylorinegative patients significantly(P＜0.05).Conclusion The expression level of CD8 cells in gastric mucosal tissues of AIDS patients with H.pylori infection were higher than those without H.pylori infection.The CD4 lymphocytes from the peripheral blood of the patients with H.pylori infection were more than those without H.pylori negative patients.

OBJECTIVETo investigate the clinical effect of hemoperfusion combined with hemodialysis in the treatment of severe organophosphate pesticide poisoning.

METHODSNinety-eight patients with severe organophosphate pesticide poisoning who were admitted to the emergency department of our hospital from March 2005 to September 2013 were equally divided into control group and observation group according to treatment methods. The control group was given conventional emergency treatment, while the observation group was given hemoperfusion combined with hemodialysis and the conventional emergency treatment. The clinical outcomes and complications of two groups were compared.

RESULTSIn the control group, 35 patients were cured and 14 patients died, so the cure rate was 71.4%. In the treatment group, 46 patients were cured and 3 patients died, so the cure rate was 93.9%. The treatment group had a significantly higher cure rate than the control group (χ² = 8.611, P < 0.05). And the treatment group had significantly shorter duration of coma (P < 0.01), mean length of hospital stay (P < 0.01), and time to recovery of cholinesterase activity (P < 0.01) and a significantly reduced dose of atropine than the control group (P < 0.01). The control group had significantly more cases of urinary retention than the treatment group (18 vs. 6, χ² = 4.991, P < 0.05). And the control group had more cases of intermediate syndrome, respiratory failure, delayed neurological damage, and rebound than the treatment group.

CONCLUSIONHemoperfusion combined hemodialysis has a good clinical effect and causes fewer complications in treating severe organophosphate pesticide poisoning, so it is worthy of clinical promotion.

Atropine ; Hemoperfusion ; Humans ; Insecticides ; poisoning ; Organophosphate Poisoning ; therapy ; Organophosphates ; Organophosphorus Compounds ; Renal Dialysis ; Time Factors

Objective To understand the real experience of male patients with gynecomastia before and after breast endoscopic surgery,and to provide evidence for the development of perioperative nursing strategies.Methods A qualitative phenomenological study was conducted to conduct in-depth interviews with 14 male patients undergoing endoscopic mastectomy.Results Fourteen male patients with gynecomastia were interviewed during the course of treatment and during the perioperative period of endoscopic surgery.Four themes were summarized:(1) self-image disorder (inferiority complex,sensitive psychology,dissatisfaction with body shape);(2) anxiety and confusion about the disease before surgery;(3) desire to obtain professional knowledge from medical staff.(4) cognitive differences in the treatment of breast endoscopic surgery (repeated worries about the disease,improvement of health-related cognitive ability).Conclusions Gynecomastia patients with low self-esteem,sensitive psychological status and lack of knowledge of breast endoscopic surgery may lead to anxiety,depression and other psychological problems,seriously affecting their physical health.In order to provide theoretical basis for the nursing of gynecomastia patients under endoscopy,the holistic rehabilitation of heart should update nursing strategy and improve the service mode.

Objective To investigate the effects of human milk fortifier on premature infant's cardiac function.Methods From January 2014 to December 2016, sixty premature infants of paediatric preterm infants were selected from Daqing Longnan Hospital,Heilongjiang province. The random number table method was divided into 30 cases (milk feeding and strengthening agent) and the control group of 30 cases (pure milk feeding).The heart rate of premature infant was measured before, during and after using human milk fortifier. After using human mike fortifier for 1 week, heart rate, electrocardiogram (p-wave duration, QRS wave duration, P-R interval, incidence of arrhythmia), echocardiogram (LVEF, RVEF, E/A ratio of mitral and tricuspid valves) and myocardial enzymes (the quantity of AST, LDH, CK and CK-MB) were compared between experimental group and control group.Results The heart rate of premature infant during using human milk fortifier was significantly faster than those before and after using human milk fortifier and that of children in the control group (P<0.05). There were no statistically significant differences in electrocardiogram (p-wave duration, QRS wave duration, P-R interval), the systolic and diastolic function of the heart and myocardial enzymes between the experimental and control groups (P>0.05).Conclusions Human milk fortifier can increase the heart rate of premature infant, and has no harmful effect on cardiac electrical activity, pump function and myocardial enzymes.