At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

At present,the quality and safety management of multiple districts of hospital still has problems such as low informatization level,inconsistent quality and safety management mode,and insufficient quality and safety management concept.It takes an orthopedic hospital of Traditional Chinese Medicine as an example to explore the quality and safety management practice of multiple districts of hospital under the homogenization strategy.A three-level quality control management system composed of leadership,executive level and guidance level was constructed,and the general framework of the integrated quality management system and the specific work contents of quality management in each hospital were proposed,in order to provide a standardized and operable management mode for medical institutions to carry out medical quality management.

To investigate the effect and application value of transplantation of the free cutaneous fibular flap combined with antibiotic-loaded calcium sulfate artificial bone graft for the treatment of antibrachial chronic osteomyelitis of Cierny-Mader type IV. Methods From August, 2013 to May, 2017, 12 cases of ulna or (and) radius chronic osteomyelitis of Cierny-Mader type IV were treated by transplantation of the free cutaneous fibu-lar flap combined with antibiotic-loaded calcium sulfate artificial bone graft. There were 7 males and 5 females, with an average age of 36.3 (21-47) years.Pure ulnar osteomyelitis in 7 cases, radius osteomyelitis in 4 cases, and both ul-nar and radius osteomyelitis in 1 case. The average range of osteomyelitis lesions was 6.3 (3.0-9.0) cm. The area of soft tissue defect (including bone scar) ranged from 8.0 cm×2.0 cm to 15.0 cm×5.0 cm. The area of the flap was 10.0 cm×3.5cm-17.0 cm×7.0 cm.The average length of the fibular flap was 8.8 (5.0-12.0) cm.Locking plate internal fixa-tion was used in 9 cases, external fixator in 2 cases, and plate combined with external fixator in 1 case. Vancomycin/gentamicin, an effective component of calcium sulfate artificial bone, averaged 0.64 g/102.7 kU (0.4 g/64 kU-1.0 g/160 kU).Routine postoperative treatment.And monthly outpatient review in the first half year after operation, and outpatient review every 3 months after half a year.One year after operation, comprehensive evaluation of elbow, forearm and wrist function with Mayo Elbow Function Index, Anderson Forearm Double Fracture Evaluation System and Cooney Wrist Function Score. Results Vascular crisis occurred in 1 case after operation, prompt surgical exploration, and ultimately all flaps survived completely.The donor sites healed well in all cases.The lower extremity functions of donor sites had no change compared with that before operation.Followed-up of an average of 22.7 months, there were 2 cases who had sen-sory disturbance in the ulnar nerve innervation area and returned to normal 3 months after operation. The fibular flaps healed satisfactorily with an average healing time of 4.7 (3-6) months.No calcium sulphate artificial bone granules were seen on X-ray at 3 months after operation.One year after operation, bone healing, forearm appearance and wrist function recovered well, but elbow and forearm motor function recovered unsatisfactorily. Conclusion On the basis of master-ing the applied anatomy and vascular anastomosis techniques of microsurgery, this method of transplantation of the free cutaneous fibular flap combined with antibiotic-loaded calcium sulfate artificial bone graft for the treatment of an-tibrachial chronic osteomyelitis of Cierny-Mader type IV has achieved satisfactory results.The recipient area is beautiful. The bone healing is reliable.And it has little influence on the recipient area and the donor area.It is worthy of clinical application.

Objective To investigate the clinical efficacy of tissue flap combined with antibiotic-loaded calcium sulfate and autogenous iliac bone grafting at stage Ⅰ for infected nonunion of long bone.Methods A retrospective case series study was conducted to analyze the clinical data of 51 patients with infected nonunion of long bones admitted to Tongde Hospital of Zhejiang Province from January 2013 to December2017.There were 42 males and nine females,aged 19-71 years,with an average age of 36.3 years.There were 43 patients with bone nonunion at tibia,six at femur,one at humerus,and one at ulna and radius.The range of bone defect area was 1-9 cm,with an average of 2.9 cm.On the basis of thorough debridement,tissue flaps combined with antibiotic-loaded calcium sulfate and autologous iliac bone graft were performed at stage Ⅰ treatment.The survival of skin flaps,infection control,nonunion healing and complications were recorded.Johner-Wruhs joint function assessment criteria were used to evaluate limb function.Results All patients were followed up for 10-35 months,with an average of 18.3 months.All flaps survived eventually.Except for one patient with infection recurrence,the other 50 patients with infection obtained primary cure.All nonunions were healed,with an average healing time of 6.4 months ranging from 4 to 15 months.Complications included venous crisis of skin flaps in five patients,anterolateral femoral cutaneous nerve injury in 20 patients,recurrence of infection in one patient,and infection of external fixator nail tract in three patients.Function evaluation results by Johner-Wruhs criteria were excellent in 34 patients,good in 14,and moderate in three patients,with an excellent and good rate of 94％.Conclusion On the basis of thorough debridement,tissue flap combined with antibiotic-loaded calcium sulfate and autogenous iliac bone graft can control the infection effectively,promote the bone union and improve the limb function.