Objective:In the performance appraisal of public hospitals,the lack of detailed degree of personalized appraisal,inadequate attention of hospital leaderships and unreasonable performance appraisal indexes were analyzed to provide measurement.Methods:Using the equity theory to conduct specific analysis on the problem.Results:To promote the stable and sustainable development of public hospitals,it mobilized the enthusiasm,initiative and creativity of the employees.Conclusion:It needed to create more economic and social benefits and enhance the core competitiveness of the hospital.

Atrial fibrillation is one of common arrhythmias and can significantly increase risks of stroke and heart failure with high rates of mortality and disability. The incidence of atrial fibrillation increases year by year due to aging population, high incidences of coronary heart disease and hypertension, and lifestyle changes. As one of widely consumed drinks in the world, coffee affects the daily life of modern people. The intake of caffeine, which is the main ingredient of coffee, can influence the incidence of atrial fibrillation, but the relationship between them is still controversial. Most studies deem that the intake of caffeine is negatively correlated with the incidence of atrial fibrillation. This paper reviews current studies in China and abroad on the relationship between the intake of caffeine and the incidence of atrial fibrillation.

Objective To analyze the risk factors of intracranial infection after neurosurgery and the effect of vancomycin.Methods 28 cases of craniotomy in this study, The First Hospital of Ningbo City from January 2011 to July 2014 during the years after the occurrence of intracranial infection patients as the research object, a retrospective analysis of the age, gender, emergency, basic diseases, mastoid airroom, ventricle drainage, posterior fossa surgery, reoperation and operation time (more than 4h).The clinical data, summarize the risk factors of postoperative intracranial infection in department of neurosurgery and to observe the clinical effect of vancomycin in the treatment of such patients.Result The high risk factors of intracranial infection include: Open mastoid gas room during operation, ireoperation, ventricular drainage and operative time (more than 4h).In 28 cases with intracranial infection after craniotomy, the total effective rate of vancomycin treatment was 100.00%.Conclusion The high risk factors of intracranial infection after operation include open surgery, mastoid room, reoperation, ventricular drainage and longer operation time.Vancomycin is an effective drug in the treatment of intracranial infection in the department of neurosurgery.

Objective To compare the isometric muscle strength of muscle groups in the lower extremities of children with spastic hemiplegia among sides or ages. Methods17 spastic hemiplegic children were measured the muscle strength of hip, knee and ankle muscle groups with hand-held dynamometry (HHD). ResultsMuscle strength was weaker in the involved side than in the other side. In younger children, it was weaker of overall extremity, while in the older it was of the distal end mainly. ConclusionWhen applying strength training to spastic hemiplegic children, it is important to notice strength of all groups in lower extremity in younger children and the distal groups in older ones.

Objective To investigate the relationship between depression and personality and social support of the urban and rural empty-nest, clear the influence factors of depression in the empty-nest elderly. Methods 398 cases of urban and rural empty-nesters selected from the Chifeng district, were valuated with the general information questionnaire, the Geriatric Depression Scale (GDS), Eysenck personality Questionnaire- Revised Short Scalr for Chinese (EPQ-RSC) and the Social Support Scale (SSRS), and to investigate the demographic data, depression, personality and social support. Results Rural cases had a higher level (14.41±3.09) points of depression than (12.90±2.64) points of urban cases, and the difference was statistically significant (t=5.254, P<0.01);rural empty nesters′subjective support (18.35 ± 2.14) points, objective support (6.37 ± 1.40) points, support utilization degree (6.01 ± 1.17) points and social support score (30.37 ± 4.24) points, were lower than (19.83 ± 2.27) points, (7.34 ± 1.13) points, (6.95 ± 1.12) points, (34.12 ± 3.73) points of urban′s, and the difference was statistically significant (t=6.673-8.490, P<0.01); the extraversion score of urban empty nesters was (7.58 ± 2.51) points which was higher than (6.37 ± 2.02) points of rural empty nesters, and the difference was statistically significant (t=5.273, P<0.01);the neuroticism score (10.38 ± 2.06) points and psychoticism score (9.42 ± 2.17) points of urban empty-nest were lower than (12.41 ± 2.25) points, (10.94 ± 2.10) points of empty-nest′s, and the difference was statistically significant (t=9.401, 7.107, P<0.01). Neuroticism and psychoticism was shown to be positively associated with depression while extraversion and social support to be negatively associated with depression (P<0.01). Regression analysis showed that marital status, income, children visit frequency and the education level were the main influencing factors of depression in the urban and rural empty-nesters. Conclusions There are differences between rural and urban empty-nest elderly in the aspect of general data, depression status, personality and social support, and should intervention them effectively according to their different characteristics.

Objective To investigate the correlation of serum high-mobility group box-1 (HMG-B1) with the severity of lesion of coronary artery disease (CAD) and its prognosis in elderly patients.Methods A total of 180 CAD patients with coronary stenosis exceeding 50 percent by coronary angiography were divided into three groups:one branch stenosis;two branches stenosis and three branches stenosis.The control group included 50 patients without coronary stenosis.The degrees of coronary stenosis were diagnosed as mild stenosis,moderate stenosis and severe stenosis based on improved Gensini scores.The severity of decrements of left ventricular ejection fraction (LVEF) by echocardiogram were divided into three groups:mild,moderate and severe LVEF.Levels of HMGB1,hs-CRP and glucose were measured in all the patients.According to whether there was a complication of type 2 diabetic mellitus (T2DM),the 180 patients were classified as two groups.The patients were also divided into two groups according to whether there were adverse events.Results The HMGB1 levels of the CAD group were increased along with the number of affected vessels [three bunch group (40.5±6.0) ng/ml,double bunch group (33.1±4.9)μg/L,single bunch group (20.5±3.3)μg/L and control group (6.2±1.4)μg/L (all P＜0.05)].And the HMGB1 levels of the CAD group were increased along with the degrees of CAD stenosis [severe stenosis group (43.0±5.8)μg/L,medium stenosis group (32.1±4.5)μg/L,mild stenosis group(19.3±2.0)μg/L] (all P＜0.05).Meanwhile,the levels of HMGB1 were increased along with the decrement of left ventricular ejection fraction [left ventricular severe dysfunction group (41.0 ± 5.5) μg/L,medium dysfunction group(33.1± 4.3)μg/L,mild dysfunction group (21.3± 2.0)μg/L] (all P＜0.05).CAD with T2DM had a higher HMGB1 level than non-T2DM group[(35.7±5.0) (C)/L vs.(23.3±3.0) (C)/L,P＜0.05].The adverse events group had a higher HMGB1 level than non-adverse events group[(38.7±5.5) (C)/L vs.(25.3±3.3)μg/L,P＜0.05].Besides,HMGB1 had a positive correlation with levels of hs-CRP and glucose(r=0.680,0.571,P＜0.05).Conclusions Serum HMGB1 change is closely related to morbid change degree of elderly CAD patients as well as prognosis.As a new type of inflammatory factor,HMGB1 may serve as a new target for disease treatment.

By participating in the national medical colleges and universities students' clinical skill competition and summarizing the experiences after the competition,we reflected on problems and weakness in the past clinical teaching including weak sterile concept and lack of clinical thinking,humanities,communication skills,teamwork awareness,etc.We should take methods to future improve medical students' clinical training capabilities including strengthening the concept of sterile and clinical skills,promoting training of comprehensive clinical thinking ability and problem-solving ability,emphasizing on humane care and communication between doctors and patients; cultivating teamwork awareness thus to comprehensively enhance the overall quality of medical students.

Objective To investigate the status on health‐related knowledge and skills among the patients in the Chongqing area and to provide basis for developing public health‐related knowledge and skills .Methods Seven hundred and sixty‐eight patients from 8 general hospitals were sampled ,using the stratified random sampling method .A cross‐sectional investigation on health literacy was conducted with questionnaire“ health awareness survey of patients”,and SAS8 .0 was used to statistically analyze the data .Results The awareness rate of health literacy in Chongqing was 4 .82% .As for the 3 health literacy related aspects including basic health concept and knowledge ,health lif‐estyle and behaviors ,and the health related skills ,the rates were 16 .28% ,2 .21% and 38 .41% respectively .Besides ,the rate of the 5 as‐pects including health conception ,the prevention of infection ,the prevention of chronic diseases ,the safety and the first aid ,the basic medical treatment of analysis were 10 .68% ,20 .31% ,8 .59% ,23 .57% ,10 .68% respectively .There noticed significant differences in different re‐gions ,education ,profession ,the condition of relatives engaged in medical ,medical insurance category(P<0 .05) .Profession and the condition of relatives engaged in medical were the main influencing factors on the level of health‐related knowledge and skills among the patients(P<0 .05) .Conclusion The prevalence of basic health‐related knowledge and skills is low in Chongqing city and we should make comprehensive interventions to improve health liter of patients .

Objective The purpose of this study was to evaluate the protective potential of the Aspergillus fumigatus thiore -doxin reductase GliT ( TR) antigen by establishing and optimizing ELISPOT assay for TR antigen-specific T cells ( TR/AST) secreting IFN-γand IL-4 in peripheral blood mononuclear cells ( PBMCs ) and explore the role of TR/AST in invasive aspergillosis ( IA ) . Methods We optimized the reaction conditions of ELISPOT by preliminary checkerboard titration and determined the frequencies of positive spot-forming cells ( SFCs) specifically secreting IFN-γand IL-4 in the PBMCs of 20 healthy individuals with TR as specific stimulant and with PHA and PMA as positive controls ,. Results Checkerboard titration demonstrated the best result of ELISPOT with the TR antigen at the final concentration of 10μg/well and PBMCs at 3 ×105/well.The median frequency of IFN-γSFCs was sig-nificantly higher (15 [3.5, 59.5]) than that of IL-4 SFCs (0 [0, 0]) (P<0.001).TR induced IFN-γresponses in all the 20 healthy donors, including 9 cases of strong IFN-γresponse (SFCs>20/3 ×105 PBMCs), accounting for 45%, but failed to induce IL-4 response in 19 of the healthy individuals . Conclusion The Aspergillus fumigatus TR antigen could induce an immunodominant Th1 response , and therefore might be a potential protective antigen .

Background and purpose: Postoperative chemotherapy targets the metastatic cancer in the remaining lymph nodes, but the heterogeneity in multidrug resistance (MDR) of metastatic cancer cells is a main factor affecting chemotherapeutic efficacy. Recent studies only examined the primary lesion of esophageal squamous cell carcinoma(ESCC). There is no report about heterogeneity between the primary tumor and metastases lymph node. The purpose of this study was to explore the heterogenous expression and clinical signiifcance of multidrug resistance (MDR) associated proteins in primary tumors and metastatic lymph nodes in patients with thoracic ESCC. Methods:The expressions of lung cancer associated resistance protein (LRP), P-glycoprotein (P-gp), topoisomeraseⅡ(TOPO-Ⅱ), thymidylate synthase (TS), glutathione S-transferase-π (GST-π) were examined by immunohistochemistry in primary lesions and corresponding metastatic lymph nodes in 54 patients with thoracic ESCC. The differences between expression of primary lesions and matched metastatic lymph nodes were compared and analyzed in relationship with tissue differentiation degree. Results: The discordant rates of the expression and drug resistance between primary lesions and corresponding metastatic lymph nodes in LRP, P-gp, TS, TOPO-Ⅱ and GST-π were 63.0% and 26.9%, 42.6%and 22.2%, 48.1%and 25.9%, 50.0%and 29.6%, 18.5%and 1.9%respectively. The expression of LRP showed signiifcant difference between the primary tumors and lymph nodes (P=0.026). No signiifcant differences were found for the other four proteins, and GST-πwas expressed in all patients in both the primary tumors and lymph nodes. Protein expression was not associated with degree of differentiation. Conclusion:There is evident of heterogenous expression of MDR associated proteins in metastatic lymph nodes compared to the primary tumors of ESCC. The examination of expression levels of MDR associated proteins in metastatic lymph nodes is helpful to select the postoperative rational chemotherapy plan.