As the important content of excellent quality nursing service, the performance appraisal of nursing staff was closely interrelated to their income distribution, professional title promotion and excellence choosing. Performance appraisal was the requisite part of nursing resource management. This study gave an overview about conception and development of nursing staff′s performance appraisal and summarize key performance indicator,balanced score card,SMART principle and 360 degrees performance appraisal, which was mainly used in domestic hospital. It suggested nursing manager should have complementary advantages of them and utilize foreign mature methods to explore and improve our countries performance appraisal of nursing staff and formulate the system which was in keeping with China′s national conditions.

Objective To investigate the effect of granulesten on hs-CRP and lipid in patients with stroke.Methods 76 patients with acute ischemic stroke were selected and randomly divided into two groups.38 cases in the control group were treated by conventional therapy, 38 cases in the experiment group were treated on the basis of the control group with granulesten.hs-CRP, IL-6, Hcy, and lipid fat were detected and the clinic effect were compared after the treatment.ResuIt Compared with control group, hs-CRP, IL-6, and Hcy of the experiment group were lower(P<0.05), TC, TG and LDL-C were lower, HDL-C was higher ( P<0.05 ) , the clinic effect was higher ( P<0.05 ) , the rate of side effect was higher ( P<0.05 ) . ConcIusion Granulester can significantly reduce serum hs-CRP, IL-6 and Hcy levels, improve blood lipid metabolism, improve the clinical efficacy, and adverse reactions are mild, it has important significance for patients with acute ischemic stroke.

Objective To investigate the clinical significance of circulating tumor cells (CTCs) in pa-tients with small-cell lung cancer patients (SCLC). Methods 42 SCLC patients, 10 patients with benign lung disease(hospitalized from June 2012 to June 2013), and 10 healthy volunteers from the First Affiliated Hospital of Shihezi University Medical College were studied and their clinical information was collected. Negative immuno-magnetic separation method and immunocytochemistry method were applied to collect the Pan-CK +/CD45 - of CTCs, in order to analyze the relationship between CTCs and clinical manifestation. Results CTCs were found in 32 cases of SCLC group, with a positive rate of 76.19%. CTCs was not found in peripheral blood in control group. Difference in the two groups is significant (P = 0.000). The presence of CTCs was correlated positively with the patients′ PS score , clinical stage , M stage , the number of metastatic sites , NSE value and LDH value (P < 0.05). Conclusion The CTCs number is correlated with patients′ PS score, clinical stage, M stage, the number of metastatic sites, NSE value and LDH value, respectively. CTCs detection is useful for more accurate risk assessment of patients.

Objective To investigate the relationship between the presence of circulating tumor cells (CTC) and the clinicopatho-logic characteristics of primary lung cancer patients .Methods Samples of peripheral blood(7 .5 mL) from 65 cases of patients with lung cancer(lung cancer group) and 10 cases of patients with lung benign diseases and 10 healthy volunteers (control group) ,and then those CTC were enriched by negative immunomagnetic separation with anti-CD45 antibody and then dectected by immunocyto-chemistry with anti-pan-cytokeratin antibody .The relationship between the positive rate of CTC and clinicopathologic characteristics of lung cancer patients were analyzed .Results The positive rate of CTC in lung cancer patients was 69 .23% (45/65) ,while CTC was not detected in any patients with lung benign disease or healthy volunteers .The positive rate of CTC in patients at TNM stageⅠ - Ⅱ ,Ⅲ and Ⅳ was 23 .08% (3/13) ,50 .00% (6/12) and 90 .00% (36/40) ,respectively .There was significant difference in posi-tive rate of CTC between patients at different TNM stages (P= 0 .000) .The positive rate of CTC in metastatic (stage M1 ) lung cancer patients(83 .33% ,35/42) was significantly higher than that in non-metastatic(stage M0 ) lung cancer patients(43 .48% ,10/23)(P=0 .002) .With the increasing number(0 ,1 ,2 ,3) of metastatic sites ,the positive rate of CTC increased (53 .48% ,83 .33% , 87 .50% ,75 .00% ) ,and there was significant difference in different positive rates of CTC (P=0 .024) .There was statistically sig-nificant difference in the positive rate of CTC between Cyfra 21-1 normal group(53 .33% ,16/30) and high value group(92 .00% ,23/25)(P=0 .021) ,the same with LDH normal group(55 .00% ,22/40) and high value group(82 .86% ,29/35)(P=0 .004) .Conclu-sion CTC were presented in some lung cancer patients .The presence of CTC in peripheral blood is correlated positively with the patients′clinical stage ,M stage ,the number of metastatic sites ,Cyfra21-1 value and LDH value .CTC detection is useful for more accurate risk assessment of patients with lung cancer .

Objective To observe the therapeutic effect of Di'ao Xinxuekang (DAXXK) on myocardial ischemia-reperfusion injury in rats, and to explore its mechanisms. Methods The myocardial ischemia-reperfusion injury model was established by the ligation of descending coronary artery in rats. Then animals after the modeling were randomized into model group, DAXXK-d (31.5 mg/kg) group, DAXXK-g (63.0 mg/kg) group and Diltiazem (24.8 mg/kg) group. A separate sham group was used as control. The treatment group was given DAXXK once a day for 7 days. Cardiac function and cardiac configuration were measured by color Doppler ultrasound diagnostic method. Hemodynamics was measured by Millar catheter method. The arterial oxygen saturation and blood oxygen pressure were measured by i-STAT 300 blood gas analyzer. Inflammatory cytokines interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, adhesion molecules VCAM-1, ICAM-1, and apoptosis-related protein Bcl-2, Bax were detected by ELISA. Myocardial apoptosis was measured using TUNEL method. Results Compared with model group, the left ventricular fractional shortening (FS), the systolic and diastolic function were improved, and the left ventricular pressure maximum rise/ fall rates (± LVdp/dtmax) were increased, in DAXXK group. DAXXK improved lung function, increased arterial oxygen pressure and oxygen content. The inflammatory cytokines IL-1β, IL-6, TNF-α and adhesion molecules ICAM-1 and VCAM-1 were decreased in DAXXK group. The myocardial swelling and inflammatory infiltration were relieved, myocardial apoptosis was reduced, the expression of Bcl-2 protein was increased and the expression of Bax protein was decreased in DAXXK group. Conclusion DAXXK can protect myocardial ischemia-reperfusion injury, which involved in the inhibition of apoptosis and reduction of inflammatory cytokines.

OBJECTIVE To comprehend the changes in the spectrum of clinically isolated pathogenic bacteria and their drug resistance,and to analyze their tendency.METHODS Totally 5746 pathogenic bacteria isolated from clinical samples of the inpatients in our hospital during 1997-2004 and their drug resistance was statistically(analyzed).RESULTS Most of clinically isolated pathogenic bacteria were Gram-negative.The detected rate of Gram-positive bacteria tended to rise,while the detected rate of fungi obviously increased year after year.Gram-positive cocci and Gram-negative bacilli were resistant to commonly used antibacterials in different degrees,(especially) to ampicillin.The sensitive rate of Gram-positive bacteria was high to vancomycin,while the sensitive rates of Escherichia coli and Klebsiella pneumoniae to imipenem were high.CONCLUSIONS The structure of(nosocomial) infection(pathogens) and their drug resistance patterns are changing continuously.It should be(emphasized) to inspect(bacterial) tolerance in order to select antibacterial reasonably.

Objective To study radiologic (molybdenum target X-ray) findings of ductal carcinoma in situ (DCIS) of breast.Methods The molybdenum target X-ray findings of breast DCIS confirmed by operation or pathology in 20 cases were analyzed.All cases were examined with molybdenum target X-ray at axial and lateral oblique positions in both breasts.Results Among 20 patients,16 cases presented calcifications in the lesions,3 cases showed simple masses,1 case appeared as small dense focus.Conclusion Calcifications are mainly X-ray appearances of DCIS,special attention should be payed to the signs such as masses,small dense focus and so on.

OBJECTIVE: To discuss the characteristics and regular pattern of the adverse drug reactions(ADR) in our hospital.METHODS: A total of 314 ADR case reports collected by ADR monitoring center in our hospital during 2007 were analyzed statistically.RESULTS: 13 categories(178 kinds) of drugs and 338 cases were involved in the total 314 ADR case reports,mainly anti-infective agents(128 cases,38 kinds) and Chinese drugs preparation(51 cases,20 kinds).The ADR were manifested chiefly as lesions of skin and its appendants(134 cases) followed by gastro-intestinal lesion(56 cases).The patients showed a favorable turn and the death occurred in only 1 case.CONCLUSION: More attention should be paid to the monitoring of rational drug use to avoid or reduce the incidence of ADR.

Objective To study the value of echoeardiography for diagnosis of juxtaposition of atrial appendage(JAA) and to discuss its features. Methods Eehocardiographic characteristics of JAA in nine cases were compared with results of cardiac catheterization and operation. The diagnostic features of echocardiography were summarized. Results Seven cases had juxtaposition of left atrial appendage and two had juxtaposition of right atrial appendage. The nine cases were all associated with severe congenital heart disease and the most frequent malformations observed with JAA were double outlet right ventricle, transposition of great artery, single ventricle and so on. Direct visualization of the JAA in the parasternal short-axis view at the base of the heart and visualization of an unusual transverse orientation of the atrial septum were the most features of JAA. Echocardiographie characteristics of JAA cases were correspondent to the results of cardiac catheterization and operation. Conclusions There is high accuracy by echocardiography to diagnosis JAA. JAA should be alerted in severe congenital heart disease.

Objective To evaluate the efficacy and safety of single intra-articular etanercept injection in patients with rheumatoid arthritis (RA) and spondyloarthropathy (SpA) who had knee arthritis.Methods This was a randomized, single-blind, parallel, controlled clinical trial. The subjects were the RA or SpA patients with the knee arthritis without deformity, moderate or severe bone erosion and obvious joint space narrowing in radiography in the target knees, who had taken at least 6-week therapy with routine dosage of disease modifying anti-rheumatic drugs (DMARDs) before the study. The subjects were randomized in 2:1 ratio to receive either single intra-articular 25 mg etanercept injection or 2 ml compound betamethasone to the target knees joint after their synovial fluid being drawn away at baseline. They were followed up four weeks after injection. The primary end-point was the 4-week change in the modified Hospital for Special Surgery (HSS) knee score for the target knee. Results Forty-seven subjects in the experimental group and twenty-three subjects in the controlled group were included in the trial. The modified HSS knee score for the experimental group was baseline mean 65.6 ± 14.0, follow-up 84.3 ±11.1 (P ＜0.0001 ), the controlled group baseline mean 68.2 ± 11.4, follow-up 79.4 ± 15.5(P =0.0015). A mean (34.9 ±38.9)% improvement on the modified HSS knee score was achieved in the experimental group, while ( 17.9 ±24.5)% improvement on the modified HSS knee score was achieved in the controlled group (P =0.0467). Adverse events were observed in eight patients (19.0% ) in the experimental group and eight patients (44.4%) in the controlled group. No serious adverse event had been observed. Conclusions Single intra-articular 25 mg etanercept injection had a better efficacy than 2 ml compound betamethasone. It was an effective and safe therapeutic option for SpA and RA patients who had knee arthritis without obvious change in radiography.