Objective To explore the methods and means to improve standardized management of regional quality control using quantitative indicators and information technology.Method The Quality Management and Control Indicators for Beijing health and medical institutions were converted into secondary and tertiary entries for quantitative scoring in accordance with the principles of standardization and management in the Integrated Management System of Health Examination under the regional information platform (Beijing Physical Examination Information Platform).APP was downloaded and applied in the on-site quality inspection.The data were obtained in paper forms completed on-site at 185 medical institutions with valid quality inspection scores in Beijing in 2014 and from the 2016 Beijing medical institutions' physical examination quality inspection.The inclusion criteria were as follows:185 institutions were divided into three groups (Level 3,Level 2,Level 1 and below),and each group was further divided into three subgroups with scores of 0-360,361-480,and 481-600;a total of 63 institutions were randomly selected from seven subgroups.Experts used the Integrated Management System of Health Examination Quality Control mobile app for the inspection.The two data groups were compared to check for quality improvement and the consistency of the quality inspection experts.Results The total quality score of medical institutions at Level 1 and below in 2016 (510.02±42.95) was higher than that in 2014 (483.16±79.06),and the difference was statistically significant (t=2.431,P＜0.05).There was no statistically significant difference between Level 2 and Level 3 medical institutions in 2014 and 2016.The scores of institutions at different levels are higher in the laboratory internal quality control and external quality assessment,and the difference was statistically significant (P＜0.05),whereas the score of physical health examination quality management organization only improved in the medical institutions at Level 1 and below,with statistically significant difference (P＜0.05).The changes of scores in the consistency of quality inspection experts was reduced after the application of the system,and the difference in institutions at Level 3 and Level 1 and below was statistically significant (P＜0.05),while not statistically significant in institutions at Level 2 (P=0.840).Conclusion Quantitative indicators and information technology are effective in regional standardized management of physical examination quality,and worthy of further exploration.

Objective To investigate whether vascular endothelial cells in choroidal neovascularization whether hypoxia condition can up-regulate SNAI1 and activate matrix metalloproteinase (MMP)2 and MMP9 therefore to participate in choroidal neovascularization(CNV).Methods Sixteen SPF male C57 mice aged 6-8 weeks were divided into control group and model group.CNV models were induced by retinal laser photocoagulation,and flatmount and frozen sections of retinal pigment epithelium (RPE)-choroid-sclera compound were prepared at 7 days after modeling.The CNV in flat-mount was examined by Isolectin B4 staining,and the location of SNAI1,MMP2 and MMP9 in frozen sections was determined by immunofluorescence technology.The expression of SNAI1,MMP2 and MMP9 at mRNA level in CNV was detected by real-time fluorescence quantitative PCR (real-time PCR).The use and care of experimental animals complied with Statement for the Use of Animals in Ophthalmic and Visual Research.The RF/6A cells were divided into normoxia group and hypoxia group and cultured for 24 hours in 5％ CO2condition and mix condition of 94％ N2,5％ CO2 and 1％ O2,respectively.The expression of SNAI1,MMP2 and MMP9 in the cells at mRNA and protein levels was detected by real-time PCR and Western blot assay,respectively.Small interfering RNA of SNAI1 (siSNAI1) was transfected into the cells,and then the expression of MMP2 in the cells at mRNA and protein levels was detected by real-time PCR and Western blot assay,respectively,and the migrating number of the cells was assayed by Transwell chamber assay.Results CD31 and SNAI1 positive-response cells were seen in RPE-choroid-sclera flat-mounts under the laser scanning confocal microscope.The relative expression levels of SNAI1mRNA and MMP2 mRNA in RPE-choroid-sclera tissues were higher in the model group than those in the control group (SNAI1 mRNA:1.291 ±0.060 vs.0.759±0.074,P =0.001;MMP2 mRNA:1.610±0.424 vs.0.772 ±0.080,P =0.044).The expression of MMP9 mRNA was not significantly elevated between model group and control group (P＞0.05).The relative expression level of MMP2 mRNA was higher in comparison with MMP9 mRNA in the model group (P＜0.01).The relative expressions of hypoxic induced factor 1α (HIF-1α),SNAI1 and MMP2 at mRNA level and protein level in RF/6A cells were significantly higher in the hypoxia group than those in the normoxia group (all at P＜0.05) and no considerable difference was seen in MMP9 mRNA expression between the two groups (P＞0.05).The relative expressions of MMP2 mRNA in the cells were 0.217±0.036 and 0.818±0.105,and those of MMP2 protein in the cells were 0.236±0.009 and 1.043±0.120 in the hypoxia+siSNAI1 group and only hypoxia group,respectively,with significant differences between them (P =0.002,0.003).The migrating number of the cells was (254.60 ±71.31)/field in the hypoxia+siSNAI1 group,which was significantly less than (534.10±96.21) /field in the control group (P =0.029).Conclusions The hypoxic environment at CNV can activate MMP2 by up-regulating the expression of SNAI1,which promotes the migration of vascular endothelial cells and therefore participates in CNV formation,and the intervention of SNAI1 activation under the hypoxic condition can inhibit this process.