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.

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 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.

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 explore the relationship between baseline lipid profiles and long-term cardiovascular outcomes after intervention with hypoglycemic drugs metformin and glipizide and to detect lipid components that can predict the long-term cardiovascular effect of metformin and glipizide.Methods· Liquid chromatography-quadrupole time of flight-mass spectrometry (LC-QTOF/MS) was used to measure 119 lipid components in baseline serum for 116 patients with type 2 diabetes (T2DM) and atherosclerotic heart disease (CHD) who were treated with glipizide (56 cases,the glipizide group)or metformin (60 cases,the metformin group).Cardiovascular complex end points (including cardiovascular death,all-cause death,nonfatal myocardial infarction,nonfatal stroke,and arterial revascularization) of all patients were followed up.The relationship between lipid components and cardiovascular complex end points was analyzed with Logistic regression analysis.The category-free net reclassification index (cfNRI) and the integrated discrimination improvement (IDI) were used to evaluate whether lipid components are helpful for predicting the recurrent cardiovascular events.Results· The differences in baseline drug distribution,clinical characteristics,and biochemical indexes between two groups were not statistically significant,except for diuretics use,serum PC (O-34:2) level,and SM (d18:0-24:0) level.Logistic regression analysis showed that baseline ChE (20:4) was a protective factor for recurrent cardiovascular events in the glipizide group (OR=0.87,P=0.039).ChE (20:4) significantly increased the cfNRI and IDI of cardiovascular complex end points by 69％ and 0.07,respectively (P=0.011,P=0.028).Baseline SM (dl 8:1-22:0) was a risk factor for recurrent cardiovascular events in the metformin group and all participants (OR=1.65,P=0.039;OR=1.64,P=0.014).SM (d18:1-22:0) significantly increased the cfNRI of cardiovascular complex end points in the metformin group and all participants by 74％ and 55％,respectively (P=0.012,P=0.005).Conclusion· Of 119 lipid components measured with LC-QTOF/MS,baseline ChE (20:4) is a protective factor and SM (d18:1-22:0) is a risk factor for cardiovascular complex end points in with T2DM and CHD patients after long-term treatment with metformin and glipizide.Both lipid components are helpful for improving the prediction of recurrent cardiovascular events.

Objective To evaluate the reproducibility of macular ganglion cell layer(GCL)measurements with high?resolution spectral domain?optical coherence tomography(SD?OCT)in both normal people and glaucoma patients. Methods In this study,24 normal subjects and 21 glauco?ma patients were prospectively included. Macular GCL thickness in 9 areas defined by Early Treatment Diabetic Retinopathy Study was measured with Spectralis SD?OCT applying posterior pole asymmetry analysis pattern. Within?subject standard deviation(Sw),coefficient of variation(CV) and intraclass correlation coefficient(ICC)in normal subjects and glaucoma patients were assessed. Results In normal subjects,the GCL thick?ness in macular central area was 12.58±2.69μm,the average GCL thickness in inner ring area was 48.87±3.81μm,the average GCL thickness in outer ring area was 37.28±1.75μm,and the GCL thickness mapping in normal subjects was horseshoe?shaped with opening to temporal. In glauco?ma patients,the GCL thickness in central area was 9.57±2.06μm,the average GCL thickness in inner ring area was 34.70±9.67μm,the average GCL thickness in outer ring area was 28.20±5.51μm,and the GCL thickness in every macular area in glaucoma eyes was thinner than that in normal eyes(P<0.001). For measurements of GCL thickness in normal subjects,Sw was 0.46 to 0.87μm,CV was 0.67%to 3.71%,and ICC was 0.904 to 0.977. For measurements of GCL thickness in glaucoma patients,Sw was 0.53 to 1.65μm,CV was 1.18%to 5.75%,and ICC was 0.833 to 0.993. Conclusion Spectralis SD?OCT had an excellent reproducibility for measurements of GCL thickness in both normal people and glaucoma patients, which is a reliable technique for evaluating longitudinal change and follow?up in glaucoma.

Objective To explore the cognitive process in children with attention deficit hyperactivity disorder (ADHD) using Das-Naglieri Cognitive Assessment System (DN:CAS).Methods Sixty-one children with ADHD and sixty-one healthy controls were enrolled in this study.The cognition of all the studies individuals was evaluated by the DN:CAS.Results Compared with the control group,children with ADHD had significantly lower scores in planning[(24.18 ±5.64) scores vs (30.07 ±5.28) scores,t =-6.985,P ＜ 0.01],simultaneous processing[(33.97 ± 7.64) scores vs (36.90 ± 7.20) scores,t =-2.211,P ＜ 0.05],attention [(26.52 ± 6.80) scores vs (31.21 ± 5.86) scores,t =-4.909,P ＜0.01] in the 4 subtests of DN:CAS,and the total scores [(117.85 ±21.45) scores vs (132.48 ± 17.95) scores,t =-5.286,P ＜ 0.01] are same.And there were significant differences in matching numbers [(8.77 ± 2.33) scores vs (10.87 ± 2.31) scores,t =-5.220,P ＜ 0.01],planned codes [(7.87 ± 2.37) scores vs (9.44 ± 2.61) scores,t =-4.006,P ＜ 0.01],planned connections [(7.54 ± 2.29) scores vs (9.75 ± 2.01) scores,t =-6.643,P ＜0.01];verbal-spatial relations in simultaneous processing [(10.05 ±2.79) scores vs (11.23 ± 3.19) scores,t =-2.382,P ＜ 0.05] and expressive attention [(9.02 ± 2.47) scores vs (10.34 ± 3.03) scores,t =-2.938,P ＜0.01],number detection [(8.16 ±2.31) scores vs (10.08 ± 1.86) scores,t =-5.028,P ＜ 0.01],receptive attention [(9.34 ± 3.68) scores vs (10.78 ± 3.20) scores,t =-3.215,P ＜ 0.01] between ADHD group and the control group.There were significant differences of the percentile rank distribution of the scores between ADHD group and the control group in planning,attention and full score (all P ＜ 0.05).Conclusions Children with ADHD have cognitive deficits in the cognitive processing,and planning and attention deficits are the main features.The DN:CAS could be a useful tool in evaluating cognition of children with ADHD.