Medical quality management is the core of hospital management.Concerning how to build the improving long-term mechanism of modem medical quality,the article is guided with the theory of modern medical quality management,and tested with the reform of medical quality management about one hospital.It puts forward 10 essential elements on how to construct the long-term mechanism on improving the medical quality,which is based on consulting all kinds of experts.Namely,“qualifications,responsibilities,complete path,reverence for life,reverence for integrity,reverence for rules,value on evaluation,value on case history,value on sum-up,value on teamwork”.Then it will take active effect on hospital workers and hospital managers in strengthening medical quality control,and improve the medical quality persistently.

Objective To investigate the quality of life of the elderly living at a nursing home and its influencing factors.Methods One hundred and sixty elderly living at one nursing home of Shanghai completed 36-item Short Form (SF-36) Health Survey,Social Support Rate Scale,Geriatric Depression Scale (GDS) and UCLA Loneliness Scale (UCLA-LS) to evaluate the factors that influenced the quality of life and the relationship between quality of life,social support,depression and loneliness in December of 2011.Results The mean age of the elderly was (82.0 ± 8.8).The polynary linear step-wise regression analysis showed that physical function of the elderly was mainly influenced by having children or not,frequency of physical activity and self-assessment of health condition.Role-physical,social function,vitality and role-emotional of the elderly were mainly influenced by age,frequency of physical activity and selfassessment of health condition.Bodily pain of the elderly was mainly influenced by sex and self-assessment of health condition.General health of the elderly was mainly influenced by age,frequency of physical activity,chronic diseases,and self-assessment of health condition.Mental health of the elderly was mainly influenced by age,living status,frequency of physical activity and self-assessment of health condition.Subjective support was positively related to role-emotional and mental health.However,the life quality of the elderly was positively correlated with objective support,utilization of support,total score of social support and each dimension of SF-36.The depression and loneliness of the elderly were negtively related to each dimension of SF-36.Conclusions Multiple factors may influence the quality of life of the elderly.The whole society and family members should make concern and set up better environment to for the elderly.

Objective: Our aim was to study the concentrations and regulatory characteristics of heparin-binding epidermal growth factor-like factor (HB-EGF) and its functional consequences in inducing the activities of hexokinases (HKs) and net Glc utilization. Methods: The SV40MES13 cell line was used as cell model for this experiment to measure the total activity of Hks by using a standard G6PDH-coupled assay. The net Glc utilization was measured indirectly as Glc disappearance from the medium using the standard Glc oxidase-coupled reaction(Trinder). Results: The HB-EGF induced HKs activity in time- and dose-dependent manners and increased the net Glc utilization by SV40MES13 cells. Conclusion: The HB-EGF plays an important role in pathogenesis of diabetic nephropathy by inducing total HKs activity specifically and increases the net Glc utilization in mesangial cells.

Since the tumor necrosis factor-related apoptosis-inducing ligand was found as a suitable agent for anticancer therapies,study on tumor research has been attaching more importance to it.Utilized the progress on the study of TRAIL on pancreatic carcinoma aspect recent years and standed the principle in TRAIL inducing pancreatic carcinoma apoptosis,this article first simply reviewed the resistance theory of TRAIL on pancreatic carcinoma.Following the trail of identified resistance theory,carring the method of increasing TRAIL's sensibility with protein inhibition,signal regulation,ect,some new treatments have been received,which are described along with the antitumor effect of TRAIL combined with mature treatment in pancreatic carcinoma,and simply assessed at last in the article,to provide a reference on the synergistic cytotoxic effects of TRAIL combined with valid drugs on panreatic carcinoma.

BACKGROUND:Peroxisome proliferator-activated receptor-gamma coactivator-1 alpha (PGC-1α) may play an important role in the exercise-induced skeletal muscle adaptation, which is involved in the regulation of a variety of exercise-induced biological reactions.
OBJECTIVE:To review the PGC-1αand endurance training induced skeletal muscle adaptations.
METHODS:The relevant articles about relationship between PGC-1αand endurance training-induced skeletal muscle adaptations were searched from PubMed database (1995-01/2010-10) by using the keywords of“PGC-1α, skeletal muscle, exercise, mitochondrial biogenesis, adaptations”, and the language was limited to English. Repetitive contents were deleted. The 59 col ected articles were searched. According to the criterion, 37 were classified and sorted.
RESULTS AND CONCLUSION:Endurance training can typical y increase the expression/activity of membrane transporters and mitochondrial metabolic enzymes as wel as increase capil arisation in the skeletal muscle, together enhancing the oxidative capacity of the muscle and the ability to oxidize both carbohydrates and fatty acids. Studies in PGC-1αknockout and overexpression mice have clearly demonstrated that PGC-1αplays an important role in maintaining the expression of mitochondrial metabolic and anti-oxidant enzymes in the skeletal muscle and does influence exercise-induced adaptations of mitochondrial proteins. However, PGC-1αis not exclusively required, and additional factors must be involved in the regulation of both basal expression and exercise-induced adaptations. Exercise-induced PGC-1αexpression and potential y increased PGC-1αactivity are likely the mechanisms contributing to skeletal muscle mitochondrial adaptations and concomitant health beneficial effects of regular physical activity.

This study was aimed to observe the effect of Pediatric Long-term Cough Decoction in the treatment of long-term cough among children. A total of 96 cases were diagnosed in traditional Chinese medicine (TCM) as qi-yin deficiency, and lung-heat accumulation with constipation. The western medicine diagnosis was mycoplasma pneumoniae pneumonia (MPP) infection in the recovery period after chronic cough. All cases were randomly divided into the TCM group and control group, with 48 cases in each group. In TCM group, the Pediatric Long-term Cough Decoction was used to supplement qi and nourish yin, clear away the lung-heat and excrete feces. In the control group, montelukast was used. For both groups, clinical effect of score and CD4+ T lymphocytes, CD8+ T lymphocytes and CD4+/CD8+ ratio were observed one day before treatment and thirty days after treatment. The results showed that after thirty-day treatment, the clinical effect of score in both groups was obviously improved (P < 0.01). The TCM group was better than the control group (P< 0.01). Compared with pretreatment, the posttreatment CD4+ T lympho-cytes, CD8+ T lymphocytes and CD4+/CD8+ ratio in TCM group were obviously improved (P < 0.05). The CD4+ T lymphocytes and CD4+/CD8+ ratio in the control group were obviously improved (P < 0.05). However, there was no change on the CD8+ T lymphocytes. The regulation effect on CD4+ T lymphocytes and CD8+ T lymphocytes of TCM group was better than the control group (P< 0.01). It was concluded that the Pediatric Long-term Cough Decoction can effectively improve clinical symptoms of chronic cough in children and regulate immune function.

Sinusoid lining endothelial cell(SEC) of the liver is a group of cells different from vessel lining endothelial cells with high heterogeneity characteristics, it shows many biological functions in normal liver and plays a role in liver injury caused by acute and chronic liver diseases as well as fibrogenesis. Increasing attention has been paid to the capillarization in hepatocellular carcinoma in recently years, some studies showed that SEC is attributed to the formation of capillarization with changes of the immunophenotype, such as expression of CD34.The pathological study of SEC on liver disease was briefly reviewed in this paper.

Objective To explore the efficacy and mechanism of combined hemodialysis-hemoperfusion in treating patients with end-stage renal failure associated cutaneous pruritus. Methods Eighty-one outpatients and inpatients with end-stage renal failure associated different degree of cutaneous pruritus were randomly divided into treatment group (combined hemoperfusion-hemodialysis, 50 cases) and control group (simple hemodialysis, 31 cases). At the pretreatment and 24 weeks posttreatment, all patients' serum creatinine, blood urea nitrogen, serum total calcium, serum phosphonium, serum intact parathyroid hormone and the intensity of cutaneous pruritus (visual analog scale,VAS) were determined detected. Results Compared with pretreatment, the intensity of cutaneous pruritus of patients in treatment group was obviously alleviated (P<0.01), but it was not alleviated in control group (P>0.05), there was significant difference between two groups (P<0.01). Compared with pretreatment, serum phosphonium and intact parathyroid hormone declined obviously in treatment group [(2.69±0.46) mmol/L vs (0.98±0.39) mmol/L and (632.78±76.89) ng/L vs(342.81±39.71) ng/L] ((P<0.01), but did not decline obviously in control group (P>0.05), there was significant difference between two groups (P<0.01). Conclusions Combined hemodialysis-hemoperfusion can obviously alleviate the intensity of cutaneous pruritus of patients with end-stage renal failure, but simple hemodialysis can not alleviate it,its mechanism may be that it can clean the internal irritant toxin which leads to cutaneous pruritus well.