Objective To establish patient-experience based key indicators for quality of care.Methods Literature review,collection of proven surveys on patient experience and satisfaction,study of China's conditions,with demonstrations by experts team.Results A framework was built for patientexperience based key indicators on quality of care.Level-1 indicators within the framework are tangibility,reliability,responsiveness,assurance,care and continuity.There are 28 level-2 indicators and 83level-3 indicators.Conclusion Such key indicators are highly practical as the basis for developing the scale of patient experience.

An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, collecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessing medical services quality.

Objective To analyze differentially expressed genes between hilar and distal cholangiocarcinoma and to clarify the molecular mechanism of tumorigenesis. Methods Gene-expression profiles of 3 samples of hilar cholangiocarcinoma and 4 samples of distal cholangiocarcinoma were analyzed using oligo microarray containing 21 329 genes. The differentially expressed genes between the two groups were analyzed using the Significance Analysis of Microarrays (SAM) in order to get the specifically differentially expressed genes. The gene expression presence was verified by real-time PCR (RT-PCR). Results A total of 725 genes of cholangiocarcinoma was regulated significantly compared to normal bile duct. Of them, 244 genes were upregulated and 399 genes were downregualted in both groups; on the other hand, 82 gene expressions between hilar and distal cholangiocarcinoma had significant differences (ratio ≥ 2.0 or ≤ 0.5). The SAM analysis showed that 40 genes, including AREG, EPHA2, SPP1, PACE4, and so on, were identified as differentially regulated between the two groups (q=0). Conclusions These data are helpful for a better understanding of the tumorigenesis of cholangiocarcinoma and contribute to the development of diagnostic and therapeutic strategies. The gene expressions between hilar and distal cholangiocarcinoma are significantly different, which suggests that the two tumors have different molecular mechanisms of tumorigenesis.

A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.
Adenocarcinoma ; diagnosis ; pathology ; Adenocarcinoma of Lung ; Bone Neoplasms ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Maxillary Sinus ; pathology ; Middle Aged ; Nose Neoplasms ; secondary

Extraction of teeth is the most basic and widely used operation of oral and maxillofacial surgery. According to characteristics of extraction of teeth, the author views medical ethics principles which in the diagnoses and treatments process from the aspect of medical ethics, they are,①Doctors must intensify their own quality and self - cultivations and establish the idea of " People First ". ②Doctors must carry on the overall and systematic inspection, make the plan of diagnoses and treatments synthetically toimplement the idea of " People First ". ③Doctors should pay attention to interact with patient, meet different patients' demands and create the harmonious medical environment.

egrated interventional and minimally invasive therapy could improve the life and survival and it is an effective adjunctive therapy for primary hepatocellular carcinoma with metastasis outside the liver.

Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment while the other factor scores were not significantly changed.Trazodone wes effective without severe side effects and dependence.The study group showed significantly lower scores in learning,calculation,the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive function than after treatmemt (P ＜ 0.05 ).Conclusion Trazodone is an ideal medicine to senile insomnia.

Objective To elucidate the relationship between quality of life (QOL) and disease activity of systemic lupus erythematosus (SLE),as well as to reveal the factors impacting disease activity and the QOL of SLE utilizing the combination of SLE-specific quality of life questionnaire (SLEQOL) and the medical outcomes survey short form 36 (SF-36).Methods SLEQOL and SF-36 health survey questionnaire were applied.Information on gender,disease duration,age,education level were collected.Serum complement (C3 and C4) level and erythrocyte sedimentation rate (ESR) were measured.Patients were divided into inactive,mild active,moderate active and severe active respectively according to SLE disease activity index (SLEDAI).Pearson's product moment correlation coefficient was used to analyze the correlation between the activity of disease and the QOL.Multiple linear regression was employed to explore the factors which could impact on SLEQOL.Results The physical function of SLEQOL was positively correlated with SLEDAI (r=0.36; P＜0.05).The association between reported health transition of SF-36 and SLEDAI was positive (r=0.19; P＜0.05).Physical functioning,role-physical,role-emotional,body pain and vitality were all negatively correlated with SLEDAI (r:-0.20,-0.19,-0.19,-0.19,-0.21 respectively; P＜0.05).The scores of patients with severe disease activity were significantly increased in the physical functioning of SLEQOL than other three groups (18±10 vs 11±5,12±6,13±7; P＜0.05).Scores on the Health transition of patients with moderate and severe disease activity were lower than those of whom with mild disease activity (23±28.14±17 vs 34±39,P＜0.05).Patients with mild or severe disease activity had lower score than those of patieuts in disease inactive (30±41,34±39 vs 44±44,P＜0.05).Multiple linear regression analyses showed that disease duration and education level might be the influencing factors of SLEQOL.Conclusion QOL of patients with SLE is related to the level of disease activity and is impacted by disease duration and education.

AIM: To compare the contents of calycosin and fermononetin between Radix Astragali and its fried product with honey. METHODS: The chromatographic column was a Waters SunfireTM C18 column(250 mm ? 4. 6 mm,5 ?m). The mobile phase was the mixture of methanol and water with a linear gradient elution at a flow rate of 1 mL/min. The ultraviolet wavelength was set up 254 nm,and the column temperature was maintained at 35 ℃. RESULTS: The contents of calycosin and fermononetin in Radix Astragali were 0. 247 9 mg/g and 0. 125 2 mg/g respectively,the contents of calycosin and fermononetin in Radix Astragali fried with honey were 0. 225 6 mg/g and 0. 108 2 mg/g,respectively. CONCLUSION: The contents of calycosin and fermononetin in Radix Astragali fried with honey decreased.

As a new model of pre-cancer, organoid is essential for the basic understanding of tumor characteristic and effective tumor treatment. Organoids derived from prostate play an especially important role in the research of fundamental oncology and anticancer drug screen against prostate cancer. Prostate cancer cell lines and xenografts derived directly from primary human tumors are widely used now as models to study prostate cancer and have proven very valuable. But there are some caveats and shortcomes of these two models that have to be accounted for. Here we outline organoid as a third preclini?cal cancer model which may potentially overcome the shortcomes of cancer cell lines and PDTX. This article aims to summa?rizee recent progress of the role of organoid in prostate cancer research.