Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective To investigate the value of hepatic T2 value in evaluation of chronic HBV-related acute-on-chronic liver failure (HBV-ACLF).Methods The HBV-ACLF group,chronic hepatitis B group and control group who underwent liver MRI (M-GRASE sequence) were enrolled.The T2 map was produced from the post-processing software,and the mean T2 and R2 value of liver was calculated.The blood biochemical indexes from HBV-ACLF and chronic hepatitis B group were collected in 2 days pre-MR scaning.The differences of T2 and R2 values among 3 groups and the correlation between biochemical indexes and T2 value were analyzed.ROC curve was conducted to evaluate diagnostic efficiency of T2 value for HBV-ACLF.Results There were significant differences of T2value (x2 =19.074,P＜0.001) or R2 value (F=10.411,P＜0.001) among the 3 groups.The AUC of T2 value for diagnosing HBV-ACLF was 0.86 (P＜0.001),with the cut-off value 57.73 ms (R2=0.017).Moderate positive correlation was shown between T2 values and international normalized ratio (INR),prothrombin time (PT),haluronicacid (HA) values (rs =0.65,0.67,0.39,all P＜0.05),and moderate negative correlation was shown between T2 values and prothrombin activity (PTA),albumin (ALB),prealbumin (PA) values (rs =-0.67,-0.48,-0.37,all P＜0.05).Conclusion T2 or R2 value could reflect the liver function,and were correlated with some biochemical indexes,which illustrated a good diagnostic efficiency for diagnostic of HBV-ACLF.

Objective To investigate the effects of virtual reality prism adaptation on visuospatial neglect in stroke patients.Methods Thirty stroke patients with visuospatial neglect were studied.The subjects were divided into atreatment group and a control group.The subjects in the treatment group were treated with virtual reality prism adaptation and routine rehabilitation interventions for 2 weeks,while those in the control group were treated with routine rehabilitation interventions only.All the patients performed a battery of spatial attention tests including line bisection,letter cancellation,clock drawing and the Attention Network Test at the beginning and after 2 weeks of treatment.Results The virtual reality prism adaptation training had significant positive effects on all the measures of visuospatial neglect.Pair-wise comparisons confirmed significant differences between the treatment and control groups after 2 weeks of treatment with regard to all of the measures.Conclusions Virtual reality prism adaptation treatzment combined with routine rehabilitation can be more effective than conventional measures alone in improving the visuospatial performance of stroke survivors.

Objective To investigate the serological characteristics and molecular basis of the B (A)phenotype in ABO blood group and provide the data for clinical transfusion of individuals with B(A) phenotype.Methods The ABO group antigens on red cells of the proband,family members and donors were identified by monoclonal antibodies and the ABO antibodies in sera were detected by the standard A,B,O cells.The compatibility testing for the proband and donors was detected by salted test,polybrene test and antiglobulin test.The coding region of exon 6 to exon 7 in ABO gene was amplified by polymerase chain reaction(PCR) and the PCR products were sequenced.The haplotypes of proband were analyzed by cloning and sequencing.Results It was showed that both A and B antigens were detected on red cells of the proband and her two family members,and there was anti-A_1 antibody in their sera.The serological phenotype of the samples are identified as the A_2B.DNA sequencing showed 261 G/del,297A/G,526C/G,657C/T,700C/G,703G/A,796C/A,803G/C,930G/A heterozygotes in exon 6 to exon 7.It can be deduced that genotype in the proband is B(A)_(02)/O_(01).The genotypes of her mother and grandmother-in-law were B(A)_(02)/B_(101) and B(A)_(02)/O_(01),respectively.After cloning and sequencing,two alleles B(A)_(02) and O_(01) in proband was showed.B(A)_(02) has snigle nucleotide change(700 C>G),which resets replacement of proline with alanine at position 234.Two donors with phenotype A_2B were identified as genotype B(A)_(02)/O_(01) and A_(208)/B_(101),respectively.The results of crossmatch testing is in accordane between the proband and two donors and there was no clinical adverse reaction after transfusion.Conclusions 700C>G in α-1,3galactosyltransferase allele(B allde)can result in B(A)phenotype in individuals with the phenotype of A_2B.The donors in the transfusion for the individuals with B(A) phenotype should include individuals with A_2B phenotype.

Objective To establish a PCR sequencing-based typing (PCR-SBT) method for simultaneous genotyping of human platelet antigen HPA-1 to HPA-16w.Methods All DNA polymorphism sites of HPA-1 to HPA-16w were obtained from the immuno polymorphism database.The specific primers were designed using Primer Premier 5.0 software to amplify nucleotide acid fragments encompassing each HPA polymorphism site.The primer sequence and PCR condition were optimized to obtain specific and single amplification product.The PCR product was purified and then sequenced to determine the HPA genotypes.Two standard DNA samples were detected using the HPA PCR-SBT method to examine the accuracy d this method.Sixteen reference samples (including 6 interference samples with HPA gene mutations) provided by 14th platelet immunology workshop of international society of blood transfusion (ISBT) in 2008 were also tested by this home-brew HPA PCR-SBT method.Results Total eleven pairs of primers were designed to amplify and sequence the sixteen HPA systems.The HPA genotypes of two standard samples were 1aa/2aa/3ab/4aa/5ab/6aa/7aa/8aa/9aa/10aa/11aa/12aa/13aa/14aa/15aa/16aa and 1aa/ 2aa/3aa/4aa/5aa/6aa/7aa/8aa/9aa/10aa/11aa/12aa/13aa/14aa/15aa/16aa,respectively.The 256 HPA genotypes of 16 reference samples were clear.128 genotypes among them were completely accordance with the results provided by ISBT report.Conclusions The PCR-SBT assay combining high-throughput DNA sequencer established in the study provides a simple,rapid and accurate method for HPA-1 to HPA-16w systems genotyping.The assay is suitable for routine clinical HPA genotyping and shows a broad prospect in further applications.

Objective To explore the role of left frontoparietal pathway in controlling spatial attentional function. Methods 60 healthy, right-handed humans (30 males and 30 females) aged 18~22 years were recruited. They were divided into frontal group (n=30) and parietal group (n=30) in accordance with sex for either the left dorsolateral prefrontal cortex or the left posterior parietal cortex stimuli study, respectively. They were measured with the Attention Network Test following the continuous theta burst stimulation to the left frontoparietal pathway. Results During the Attention Network Test, the efficiencies of alerting network improved in participants after both the left dorsolateral prefrontal cortex and left posterior parietal cortex stimuli. However, the efficiency of orienting network was deficit after the left dorsolateral prefrontal cortex stimuli. Conclusion Inhibition of the left frontoparietal pathway may improve the alerting function of spatial attention network.

Objective To investigate the effect of degree of lower extremity arterial disease in treatment of diabetic foot ulcer with platelet-rich gel. Methods A total of 129 patients with diabetic foot ulcer were selected as the study objects. According to ankle-brachial index and lower extremity artery vascular ultrasound results, 49 cases were divided into mild group (49 cases), moderate group (44 cases) and severe group (36 cases). All patients in three groups were given conventional treatment combined with platelet-rich gel therapy. The changes of ulcer area and granulation area before and after treatment in three groups were compared. Results The ulcer area and its difference value before and after treatment among the three groups were statistically significant (P<0.05). The granulation tissue area and its difference value before and after treatment among the three groups showed statistical significance (P<0.05). The difference value in ulcer area was positively correlated with ankle-brachial index (r=0.392, P<0.001), and negatively correlated with diabetes course (r=-0.420, P<0.001); the difference value in granulation area was positively correlated with ankle-brachial index (r=0.406, P<0.001) and negatively correlated with diabetes course (r=-0.375, P<0.001). Conclusion The more severe the lower extremity artery lesionsis, the worse the therapeutic effect of platelet-rich gel on diabetic foot ulcer will be.

Objective To explore the expression of CD133 and CD44 in the primary gastric adenocarcinoma (GAC) and their relationship with the expression of E-cadherin. Methods The expressions of CD133, CD44, and E-cadherin was examined by immunohistochemistry in 145 specimens of GAC tissues and 30 specimens of normal gastric tissues. Results The positivity rates of CD133, CD44, and E-cadherin in normal gastric tissues were 10.0%, 0%, and 100%, respectively, showing significant differences from the rates in GAC tissues (46.9%, 47.6%, and 42.8%, respectively) (P<0.05). The expressions of CD133, CD44, and E-cadherin were significantly related with the tumor volume, differentiation, lymph node metastasis, invasive depth, pathologic-tumor-node-metastasis (pTNM) stages, and postoperative-survival time (all P<0.05); a positive correlation was found between the expression of CD133 and CD44, and they were both negatively correlated with E-cadherin expression (P<0.005). Kaplan-Meier analysis showed a significant difference in the survival rate between CD133-positive and CD133-negative patients (P<0.001) and between CD44-positive and CD44-negative patients;the patients with positive expression of E-cadherin had a significantly longer survival than those negative for E-cadherin. Cox regression analysis indicated that CD133, CD44, and E-cadherin expressions were all independent prognostic factors of GAC (all P<0.05). Conclusion The expressions of CD133, CD44, and E-cadherin are related to the tumor volume, differentiation, pTNM stages, invasive depth, lymph node metastasis, and prognosis of GAC, and their combined detection can be of important value in predicting the prognosis of GAC.

Objective To explore the expression of CD133 and CD44 in the primary gastric adenocarcinoma (GAC) and their relationship with the expression of E-cadherin. Methods The expressions of CD133, CD44, and E-cadherin was examined by immunohistochemistry in 145 specimens of GAC tissues and 30 specimens of normal gastric tissues. Results The positivity rates of CD133, CD44, and E-cadherin in normal gastric tissues were 10.0%, 0%, and 100%, respectively, showing significant differences from the rates in GAC tissues (46.9%, 47.6%, and 42.8%, respectively) (P<0.05). The expressions of CD133, CD44, and E-cadherin were significantly related with the tumor volume, differentiation, lymph node metastasis, invasive depth, pathologic-tumor-node-metastasis (pTNM) stages, and postoperative-survival time (all P<0.05); a positive correlation was found between the expression of CD133 and CD44, and they were both negatively correlated with E-cadherin expression (P<0.005). Kaplan-Meier analysis showed a significant difference in the survival rate between CD133-positive and CD133-negative patients (P<0.001) and between CD44-positive and CD44-negative patients;the patients with positive expression of E-cadherin had a significantly longer survival than those negative for E-cadherin. Cox regression analysis indicated that CD133, CD44, and E-cadherin expressions were all independent prognostic factors of GAC (all P<0.05). Conclusion The expressions of CD133, CD44, and E-cadherin are related to the tumor volume, differentiation, pTNM stages, invasive depth, lymph node metastasis, and prognosis of GAC, and their combined detection can be of important value in predicting the prognosis of GAC.

OBJECTIVETo analyze specific expression of blood group genes using nucleated erythroid cells cultured from un-mobilized peripheral stem cells in vitro.

METHODSHematopoietic stem cells(HSC) bearing the CD34 antigen were isolated from peripheral blood by centrifugation and magnetic beads sorting, followed by suspension culture in vitro. Cells were collected from medium on various stages and analyzed by immunofluorescence. The RNA transcription of RH and ABO blood group genes was analyzed using culture cells on day 12.

RESULTSA total of(3.19±0.13) ×10 (4) CD34+cells were isolated from about 50 mL peripheral blood with a recovery rate of 67.3%±2.7%. The cells amount in erythroid-lineage culture system on day 9 reached a plateau of a 237.1±15.5-fold amplification of the initial cell input. The stem cell-specific CD34 antigen was dropped off, while the erythroid-specific CD235a and CD240D antigens were increased in culture period. RHD/CE and ABO genes can be amplified using RNA extracted from culture cells on day 12, and genotypes of Rh and ABO systems by DNA sequencing were consistent with their serologic phenotypes.

CONCLUSIONA method was established to analyze the gene expression of erythroid blood group derived from un-mobilized peripheral stem cells cultured in vitro. It can be used to study the expression of various erythroid-specific genes.

Antigens, CD34 ; analysis ; genetics ; Base Sequence ; Blood Group Antigens ; analysis ; genetics ; Cells, Cultured ; Erythrocytes ; cytology ; Flow Cytometry ; Hematopoietic Stem Cells ; cytology ; Humans ; Molecular Sequence Data