  Using the linear sigma model, we study the evolutions of the quark condensate
and of the nucleon mass in the nuclear medium. Our formulation of the model
allows the inclusion of both pion and scalar-isoscalar degrees of freedom. It
guarantees that the low energy theorems and the constrains of chiral
perturbation theory are respected. We show how this formalism incorporates
quantum hadro-dynamics improved by the pion loops effects.
