From the perspective of medical safety management, this paper states that it should foster the con-cept of medical safety, establish the goals of safety management, improve the safety management organization, and implement safety management and control measures. Furthermore, it analyzes several factors of doctors that influ-ence the doctor-patient relationship, which include hospital′s development direction and operation mode, the con-tradiction between the patient′s expectation and the limitation of medical technology, and the uncontrollable factors of medical development. Finally, it puts forward that the implementation of safety management is beneficial to en-hance the basic medical quality, decrease the medical errors, and improve the medical service level.

Objective To investigate the relationship of the location of nerve compression and different type of trigeminal neuralgia.Methods Twenty-one patients with typical trigeminal neuralgia and 16 patients with atypical trigeminal neuralgia were treated by micro-vascular decompression.The position of the responsible vessels was probed during operation.Results Compared with atypical trigeminal neuralgia group, the compression rate of trigeminal root entry/exit zone (REZ) in typical trigeminal neuralgia group was significantly higher(P<0.01).The compression rate of trigeminal REZ which oppressed by artery in typical trigeminal neuralgia group was significantly higher than that in atypical trigeminal neuralgia group ( P<0.01 ) .Conclusions The responsible vessels in typical trigeminal neuralgia patients is mostly located in the trigeminal REZ, and the responsible vessels is mostly not located in other location in the trigeminal REZ.The responsible vessels oppress REZ is closely related to types of trigeminal neuralgia.

Whole brain radiation therapy has become the standard treatment of non-small cell lung cancer (NSCLC) with brain metastasis,because it prolongs the survival times of NSCLC patients with brain metastases.The emergence of molecular targeted drugs is a major innovation in the traditional sense of the cancer treatment.Molecular targeted drugs have many advantages such as convenient dosing,rapid onset,improving the intracranial and extracranial tumor lesions at the same time,mild adverse reactions and good tolerance,which provide a new and better choice for the treatment of NSCLC patients with brain metastases.

Viral myocarditis is an acute or chronic inlfammatory disease of the myocardium and may progress to dilated cardiomyopathy (DCM) with life-threatening symptoms including heart failure, arrhythmias and sudden cardiac death. At present, the pathogenesis of viral myocarditis still remains unclear, so it is dififcult for clinicians to diagnose, treat and ifnd a speciifc biomarker. However, the pilot researches showed that pathogenesis of viral myocarditis was associated with genetic susceptibility. This article reviewed the above aspects.

Objective To present a method for breast reconstruction with the deep inferior epigastric perforator (DIEP) flap and to summarize the operative experiences. Methods DIEP flaps were elevated without carrying rectus abdominis muscle. The breast was shaped after the deep inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2000, we have used the DIEP flaps in 15 cases of breast reconstruction. There were 100 % survival in 10 flaps, distal skin necrosis in 2 flaps, and a full loss in 2 flaps. With the follow-up of 6～12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal heria, bulge and weakness in donor sites. Conclusion DIEP flap is the development and refinement of TRAM flap and possesses of advantages such as rich blood supply, abundant tissue volume, minimal donor site morbidity and easy shaping. It is a new but reliable and safe technique for autologous breast reconstruction.

Objective To explore the effect of N-acetylcysteine (NAC) on intercellular adhesion molecule-1(ICAM-1) expression and apoptosis in neonatal rats brain after hypoxic and ischemic brain damage (HIBD). Methods Ninety 7-day old SD rats were divided into sham operative group, HIBD group and NAC treatment group, each group containing 30 animals. ICAM-1 expression and the apoptotic rate of brain cells were measureed at 6h, 12h, 24h, 48h and 7days after model establishment by immunohistochemistry and TUNEL, respectively. Results Compared with sham operative group and NAC treatment group, the number of ICAM-1 expression cells and apoptotic cells in the brain tissue significantly increased in HIBD group. Conclusion NAC could inhibit ICAM-1 expression and cell apoptosis in the brain with HIBD, and had the preventive effect on hypoxic and ischemic brain damage in neonatal rats.

Objective To investigate the status of metabolic syndrome(MS),chronic metabolic disease and insulin resistance(IR) in dwellers over twenty years old in Wulian County,Shandong province.Method 2 127 dwellers over twenty years old were investigated in three towns with multistage stratified sampling and cross sectional methods.Questionnaire was delivered to all the subjects,while physical examination and biochemical test were carried out.Result The prevalent rate of chronic metabolic diseases in dwellers over twenty years old in Wulian County was 64.34%.The prevalent rate of overweight/obesity,diabetes,hypertension and hyperlipemia were 36.24%,3.24%,38.98% and 31.26,respectively.The prevalence of MS having more than three above diseases was 7.9%.The prevalent rate of IR in obesity,diabetes,hypertension,dyslipidemia and MS patients were 43.34%,78.26%,29.79%,33.23% and 64.28%,respectively.Conclusion Near two-thirds of the dwellers over twenty years old in Wulian suffered chronic metabolic disease.IR was common in MS and chronic metabolic disease,especially in diabetes and MS.

Objective To investigate the geriatric syndromes in the very elderly people in Beijing community,in order to provide the basis for management of geriatric syndromes and rational use of medical resources.Methods All community-dwelling residents aged 95 years and over living in Haidian district and some residents aged 85 years and over living in Haidian,Chaoyang and Xicheng districts were investigated in household in Beijing.The survey included the general condition,functional status and geriatric syndromes such as falls,senile urinary incontinence,chronic pain syndrome,chronic constipation and malnutrition occurrence.Results 336 seniors with the mean age of (96.0± 3.0) years were investigated.The percentage of people who had falls within 1 year,chronic pain,and chronic constipation was 27.2％ (88/324),37.3％ (122/327) and 47.6％ (160/336) respectively.The incidence of urinary incontinence was 37.1％ (118/318),with 33.3 ％ (46/138) in males and 40.0％ (72/180) in females,and there was no significant gender difference in the incidence of urinary incontinence (P=0.220).The incidences of malnutrition and malnutrition risks was 10.4％ (31/299) and 50.5％ (151/299).37.2％ of subjects could walk outdoor with a better physical function.The self-rated health satisfaction was lower in elderly people with malnutrition and urinary incontinence than in subjects without those diseases (40.0％ vs.70.4％,34.0％ vs.64.6％,x2 =25.20,25.30,both P＜0.001).26％ of them had never heard of geriatrics.Conclusions Geriatric syndromes are common in community-dwelling older seniors.It is urgent to spread the geriatric knowledge and set a reasonable goal for diagnosis and treatment in the seniors.

ObjectiveTo valuate the clinical effect of maintence of arteriovenous fistula by Songling Xuemaikang capsule.Methods40 cases were obtained from patients with chronic renal failure had received arterio-venous fistula operation,24 cases were observed with the combination treatment and 16 cases were served as control group,Hemorheology and difference value of vein diameter before and after treatment,blood flow of native arteivenous fistula and primary using time were observed.ResultsThe improvement degree of high shear rate and low shear rate were significantly as compared with that in the control group (P =0.000,P =0.001 ),while the blood flow after fistula maturation and ifference value of vein diameter were better than that in the control group( P =0.0356),primary using time between two groups were no significant differences ( P =0.056).ConclusionSonglinxuemaikang capsule was an effective drug for prevention high blood caogulation state,increasing blood flow of native arteivenous fistula,and enlargment vein diameter after arterio-venous fistula operation,which had certain value in clinical application.