The talent researcher resource is a symbol of the integrated strength and thekey of competitive advantage for medical and health institutions.Scientific standards of selection criteria and equitable growing environment play an important role to attract and keep talents.Therefore,Department of science and education of the hospital established a talented management mechanism according to the development of disciplines and hospital,in order to use mechanism ofselect-cultivate-appointinstead of individual subjective.Methods rational systems of staff management and staff assessment were set up,so as to attract the talent and develop their talents,and to promote the development of disciplines and improve the satisfaction of hospital staffs.

Objective To investigate the research status of head nurses of 10 secondary hospitals in Yichang area,to understand the research attitudes and intentions,to provide a reference basis for further research training program.Methods A total of 161 head nurses in 10 secondary hospitals in YiChang were recruited and a questionnaire survey was conducted.Results There are 11.7％ of head nurse involved in research projects,44.7％ of them did not publish paper,and 80％ of them had never received scientific research knowledge and training in school.95.1％ of head nurse think the nursing research is very important,and willing participate in research study,69.6％ of them want to take part in the practical activity.Conclusions The foundation for research in Head nurse is weak inthe secondary hospital with low research achievements,however they have shown a positive scientific attitude,that may improve research ability,the hospital should pay attention to the head nurse research needs,provide effective training,promote nursing research capacity.

Objective To evaluate the role of poly (ADP-ribose) polymerase 1 (PARP1) in spinal cord in a rat model of neuropathic pain.Methods One hundred and eighty male Wistar rats weighing 180-220 g were randomly divided into 4 groups( n =45 each): sham operation group(group S),neuropathic pain group (group NP),siRNA negative control group (group NS) and PARP1-siRNA group (group PS).Neuropathic pain was produced by L5 spinal nerve ligation (SNL).Viral of PARP1-siRNA or viral of siRNA negative control was injected intrathecally after SNL in groups PS or NS.Mechanical pain threshold was determined at 3,7 and 14 d after SNL.Then the rats were sacrificed and L5 lumbar spinal tissues were removed for determination of coexpression of PARP1 with glial fibrillary acidic protein (GFAP) (by immunohistochemistry double stain),protein expression of PARP1 and GFAP (by Western blot),and mRNA expression of PARP1 and GFAP (by RT-PCR).Results Compared with group S,mechanical pain threshold was significantly decreased and the protein and mRNA expression of GFAP and PARP1 up-regulated in groups NP,NS and PS( P ＜ 0.05).Compared with groups NP and NS,mechanical pain threshold was significantly increased and the protein and mRNA expression of GFAP and PARP1 down-regulated in group PS (P ＜ 0.05).There was no significant difference in above indexes between groups NP and NS(P ＞0.05 ).PARR1 was expressed in the astrocytes in the spinal cord.Conclusion PARP1 is involved in the formation and maintainance of neuropathic pain in rats via activating astrocytes.

Objective To investigate the effects of matrix metalloproteinase-3 (MMP-3) in the development of neuropathic pain (NP) in rats.Methods One hundred and eighty male Wistar rats weighing 200-250 g were randomly divided into 4 groups (n =45 each):sham operation group (S group),NP group,MMP-3-siRNA group (Msi group) and MMP-3-siRNA negative control group (NC group).NP was induced by ligation of L5 spinal nerve (SNL).Lentivirus with MMP-3-siRNA was injected intrathecally after SNL in group Msi.Lentivirus with NC-siRNA was injected intrathecally after SNL in group NC.The mechanical pain threshold was measured at day 7,14 and 21 after SNL.The rats were then sacrificed after the last measurement of the mechanical pain threshold.The lumbar segment of the spinal cord (L4-6) was removed for determination of the expression of MMP-3 and TNF-a protein and mRNA by RT-PCR and Western blot.Results The mechanical pain threshold was significantly decreased and the expression of MMP-3 and TNF-α protein and mRNA was up-regulated at each time point in groups NP and NC as compared with group S (P ＜ 0.05).The mechanical pain threshold was significantly higher and the expression of MMP-3 and TNF-α protein and mRNA was lower at each time point in Msi group than in NP group (P ＜ 0.05).Conclusion Up-regulation of the expression of MMP-3 activates microglia and induces the release of TNF-α,resulting in NP in rats.

Objective To analyze the difference of macular retinal thickness between normal subjects and diabetic patients without retinopathy,and discuss the relationship between macular thickness and the course of diabetes,blood glucose level.Methods Twenty-two cases of patients with diabetic without retinopathy without retinopathy in our hospital of fourth Department of Internal medicine from April 2016 to November 2016 were selected as diabetic without retinopathy group,and another 22 normal pemons were selected as the normal group.The central subfield retinal thickness (CSRT),cube volume(CV) and cube average thickness(CAT) of all patients were determined by optical coherence tomography (OCT),and the difference of CSRT,CV and CAT between diabetic patients and normal group were analyzed.Then,the patients with diabetic retinopathy were sub-grouped according to the course of diabetes (group A,B,C,) and blood glucose status (group D and E),and the differences of CSRT,CV and CAT among them were compared.Results With the increase of diabetes duration in the diabetic without retinopathy group,CSRT,CV and CAT were gradually increased,and there was significant difference (P ＜ 0.05).With rising blood sugar in diabetics in the diabetic without retinopathy group,CSRT,CV and CAT were gradually increased,and there was significant difference (P ＜ 0.05).There were positive correlation between CSRT,CV,CAT and course,blood sugar of diabetes mellitus (all P ＜ 0.05).Conclusion Compared with normal population,CSRT,CV and CAT are significantly thickened in diabetes mellitus patients,and CSRT,CV and CAT are increased gradually with the increase of diabetes and blood glucose,which provide reliable reference for the diagnosis of early diabetic retinopathy.

BACKGROUND: Although the sternohyoid muscular valves are traditionally used as reparative material for functional reconstruction after partial laryngectomy, the late-term results are not so satisfactory.OBJECTIVE: To investigate the efficacy of using external layer mucoperiosteum valve of thyroid cartilage to repair the wound surface and reconstruct vocal function.DESIGN: A self-controlled observational trial using the patients as subjects.SETTING: Department of otolaryngology of a municipal hospital.PARTICIPANTS: A total of 57 patients with laryngocarcinoma were selected from the Department of Otolaryngology, Shantou Second People' s Hospital, from June 1998 to May 2004. Among them, there were 56 men and 1 woman who were aged 37 to 78 years with the average age of 60. 38 years and whose disease duration was two months to one year with the average of five months.METHODS: In the 57 patients with laryngocarcinoma, their external layer mucoperiosteum valves of thyroid cartilages in the affected side were preserved and inverted into laryngeal cavities, which were used to cover the wound surface and rebuild the vocal fold.MAIN OUTCOME MEASURES: The final outcome indices: changes in the symtoms and function and Karnofsky scores before and after treatment. Risk indices: adverse events and side effects.RESULTS: The operations on the 57 patients were successful. The incidence of respiratory tract obstruction and hoarseness in the patients before operation was 38.9% and 98. 1%, but 1.9% and 96. 3% after treatment. Karnofsky score was 40 and 70 before and after treatment, respectively. No complications of pharyngeal stricture occurred in the near and long term.CONCLUSION: Vertical partial laryngectomy and laryngeal reconstruction with mucoperiosteum valve are easy to operate. The recovery of the wound surface is good, phonation efficacy is satisfacory, and respiratory function is not affected. The treatment has low incidence of complications and satisfactory long-term results.

Objective:To survey the influencing factors for depression based on path model analysis in late pregnant women, and to explore the interrelationships for depression.Methods:This cross-sectional study was conducted from January 2018 to March 2019.Antenatal women who came for a routine check-up at the antenatal clinic were invited to participate in the study.Collecting general information of pregnant women(including biological, psychological, social and other factors). The Hospital Anxiety and Depression Scale (HADS) was used to evaluate the incidence of depression during pregnancy.The differences between depression group and non-depression group were compared by SPSS 24.0, and the path analysis model was conducted by AMOS 21.0 to explore the influencing factors and interrelations of depression during pregnancy.Results:A total of 1 059 pregnant women completed questionnaire.The incidence of depression depression in third trimester women was 11.1%(118/1 059). The path model fitting well with the sample data(GFI=0.912, AGFI=0.901, RFI=0.920, CFI=0.931, RMSEA=0.033). Anxiety, psychological preparation for the current pregnancy, and level of education had both direct and indirect effects on depression in third trimester women(the total effects of the three factors were 0.381, -0.140 and -0.156, respectively). Sleep quality and family member with whom the pregnant women living during pregnancy had only direct effects (the effects were 0.136 and 0.107, respectively). Residence, monthly income of family and social support had only an indirect influence on depression(the effects were 0.175, 0.103, and 0.102, respectively).Conclusion:Path model analysis suggests that the residence, monthly income of family, family member with whom the pregnant women living during pregnancy and educational level are not easy to change. It is suggested the incidence of depression is reduced by intervening the pregnancy anxiety, social support, sleep quality and the psychological preparation for pregnancy.

Objective To explore the clinical value of magnetic resonance time-resolved imaging of contrast kinetics (MR-TRICKS)in the assessment of lower extremity venous lesions in Klippel-Trenaunay syndrome (KTS).Methods Image data of 20 patients (total 21 affected limbs)diagnosed with KTS in our hospital were analyzed retrospectively.All patients underwent MR-TRICKS angiography and ascending phlebography of the lower extremities.The images acquired by these two methods were graded and compared.Kappa test was used to examine the consistency between the results of two inspection methods.Results The image quality of MR-TRICKS angiography and ascending phlebography graded on excellent proportion were 85.71％(18/21)and 80.95％(17/21)for the deep veins,95.24％(20/21)and 90.48％(19/21)for the superficial veins,and 90.48％(19/21)and 85.71％(18/21) for venous malformation,respectively.MR-TRICKS demonstrated that the deep veins were normal in 61.90％ (13/21),hypogenetic in 25.57％(7/21),atretic in 4.86％(1/21).Superficial vein diseases including varicosis of the great saphenous vein accounted for 25.57％(6/21), varicosis of the small saphenous vein accounted for 14.29％ (3/21 ),while marginal veins in venous malformation accounted for 100％ (21/21).Ascending phlebography of the lower limbs showed that the deep veins were normal in 57.14％(12/21)and dysplasia in 39.10％(8/21),while the other results were consistent with those of TRICKS.Consistency between results from the two methods were excellent (Kappa >0.75).Conclusion MR-TRICKS can accurately describe the angioarchitecture of the lower extremity vena in patients with KTS,and has an important clinical value in providing support for the assessment and treatment of KTS.