Objective To identify shortcomings in the current evaluation index system of medical quality. Methods The documentary analysis focused on the existing index system comprises the Hospital Management and Quality Evaluation Standards (2007) by China Hospital Association, Hospital Management Evaluation Guidelines (2005) by the Ministry of Health, and Implementation Rules of Hospital Management Evaluation Standards for Beijing (2007). JCI Accreditation Standards for Hospitals (edition 2) (2003), and New Hospital Accreditation Standards for Taiwan (2005, 2006) were referred to in the study. Results The shortcomings found include the weak operability of indexes, and the deficiency of evaluation indexes from the point of hospital visiting process by patients. Conclusion In view of the hospital visiting process of patients, add more indexes for patients' hospital visiting process,and quantize and highlight the operability of indexes, with summary and optimization of experiences in time by steps.

Objective:To explore the achievements of clinical teaching and scientific research acquired by visiting scholars funded by medical foundation, which will be benefit for the improvement for cultivation of innovative talents in general hospitals.Methods:Questionnaire data of 132 visiting scholars supported by Beijing Li Huanying Medical Foundation from 2010 to 2016 were analyzed and applied by descriptive statistics.Results:Study abroad has played a positive role in promoting clinical skills, teaching level, and scientific research capacity building. Visitors have significantly improved their teaching titles, mentor positions, paper publishing and approved funding projects, in which there was a year-on-year growth trend high level projects funded.Conclusions:Study abroad is conducive to stimulating the enthusiasm and creativity of medical talents, and also an effective way to enhance the overall strength of the hospital. The foundation exerts the overall planning and leadership role of talent construction, and provides full-chain service and management for overseas study personnel, which is the key to maximize the teaching and research output of medical personnel.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.

Apoptosis ; Cardiopulmonary Resuscitation ; Humans ; Out-of-Hospital Cardiac Arrest ; Programmed Cell Death 1 Receptor/biosynthesis* ; Return of Spontaneous Circulation ; Th1 Cells ; Th2 Cells

Increasing the degree of supersaturation of drugs and maintaining their proper stability are very important in improving the oral bioavailability of poorly soluble drugs by a supersaturated drug delivery system (SDDS). In this study, we reported a complex system of Soluplus-Copovidone (Soluplus-PVPVA) loaded with the model drug silybin (SLB) that could not only maintain the stability of a supersaturated solution but also effectively promote oral absorption. The antiprecipitation effect of the polymers on SLB was observed using the solvent-shift method. In addition, the effects of the polymers on absorption were detected by cellular uptake and transport experiments. The mechanisms by which the Soluplus-PVPVA complex promotes oral absorption were explored by dynamic light scattering, transmission electron microscopy, fluorescence spectra and isothermal titration calorimetry analyses. Furthermore, a pharmacokinetic study in rats was used to demonstrate the advantages of the Soluplus-PVPVA complex. The results showed that Soluplus and PVPVA spontaneously formed complexes in aqueous solution the adsorption of PVPVA on the hydrophilic-hydrophobic interface of the Soluplus micelle, and the Soluplus-PVPVA complex significantly increased the absorption of SLB. In conclusion, the Soluplus-PVPVA complex is a potential SDDS for improving the bioavailability of hydrophobic drugs.

Recently, liposomes have been widely used in cancer therapeutics, but their anti-tumor effects are suboptimal due to limited tumor penetration. To solve this problem, researchers have made significant efforts to optimize liposomal diameters and potentials, but little attention has been paid to liposomal membrane rigidity. Herein, we sought to demonstrate the effects of cholesterol-tuned liposomal membrane rigidity on tumor penetration and anti-tumor effects. In this study, liposomes composed of hydrogenated soybean phospholipids (HSPC), 1,2-distearoyl--glycero-3-phosphoethanolamine--[methoxy(polyethylene glycol)-2000] (DSPE-PEG) and different concentrations of cholesterol were prepared. It was revealed that liposomal membrane rigidity decreased with the addition of cholesterol. Moderate cholesterol content conferred excellent diffusivity to liposomes in simulated diffusion medium, while excessive cholesterol limited the diffusion process. We concluded that the differences of the diffusion rates likely stemmed from the alterations in liposomal membrane rigidity, with moderate rigidity leading to improved diffusion. Next, the tumor penetration and the anti-tumor effects were analyzed. The results showed that liposomes with moderate rigidity gained excellent tumor penetration and enhanced anti-tumor effects. These findings illustrate a feasible and effective way to improve tumor penetration and therapeutic efficacy of liposomes by changing the cholesterol content, and highlight the importance of liposomal membrane rigidity.

Transporters are traditionally considered to transport small molecules rather than large-sized nanoparticles due to their small pores. In this study, we demonstrate that the upregulated intestinal transporter (PCFT), which reaches a maximum of 12.3-fold expression in the intestinal epithelial cells of diabetic rats, mediates the uptake of the folic acid-grafted nanoparticles (FNP). Specifically, the upregulated PCFT could exert its function to mediate the endocytosis of FNP and efficiently stimulate the traverse of FNP across enterocytes by the lysosome-evading pathway, Golgi-targeting pathway and basolateral exocytosis, featuring a high oral insulin bioavailability of 14.4% in the diabetic rats. Conversely, in cells with relatively low PCFT expression, the positive surface charge contributes to the cellular uptake of FNP, and FNP are mainly degraded in the lysosomes. Overall, we emphasize that the upregulated intestinal transporters could direct the uptake of ligand-modified nanoparticles by mediating the endocytosis and intracellular trafficking of ligand-modified nanoparticles via the transporter-mediated pathway. This study may also theoretically provide insightful guidelines for the rational design of transporter-targeted nanoparticles to achieve efficient drug delivery in diverse diseases.