An analysis is made on major issues and difficulties in the application of the performance appraisal system structure,appraisal model and appraisal outcomes.It was discovered that the performance appraisal system,if used in clinical medical technology departments in the hospital,should focus on the system itself,the appraisal process and re-improvement of the system.These three factors are key to determining whether the system is effective and efficient,and key to transforming the system into departmental and hospital performance,even into overall enhancement of hospital performance in general.

d infrastructure quality.Conclusions Raising responsiveness for special medical services will be conducive for improving the quality of non-medical services for these inpatients when they are in the hospital.

Objective To analyze the flow tendency of elderly patients,create a better mechanism to help guide elderly patients to form a good order in seeking medical care,and consequently improve the resource operational efficiency in medical service.Methods Analyzing the data by the descriptive,χ2 test and logistic regression of SPSS 20.0.Results Elderly patients prefer community health service centers and tertiary hospitals;of those visiting tertiary hospitals,nearly 30% seek medical advice for common chronic diseases.Main influencing factors for patient flow are medical insurance coverage and education. They tend not to embrace the two-way referral service,due to such factors of inconvenient process and defective mechanisms.Conclusion Transition from medical demand management to medical supply management.Such factors as quality cost,expense cost,time cost,and public opinion cost should be used to replace and weaken their mindset of the medical hierarchy,and embrace the concept of “seeking medical advice by grades”,thus improving the utilization of medical resources,and optimizing medical service accesibility.

Part-time practice of medical practitioners(PPMP)is one of the important issues involved in reformation of health care system in China.On the basis of literatures review,some aspects such as concept,reason,advantage and disadvantage of PPMP are systemically analyzed in order to provide some suggestions for regular management of PPMP in the reformation of health care system.

Objective:To investigate the effects of Daidzein on behavior of chronic stress depression rats and the expression of hippocampal brain-derived neurotrophic factor ( BDNF ) , neuropeptide Y ( NPY ) and non-specific immune regulation.Methods: 40 healthy adult male SD rats with body weight(210±19)g,clean grade,were chosen and fed with 1%sucrose solution for 4 d to change drinking habits.On the fifth day rats were subjected to water deprivation for 24 h without fasting.On the sixth day rats were fed with 1%surcrose solution.4 h later, preference of 1% surcrose solution was examined.According to the 1% sucrose solution preference and weight rats were randomly divided into 4 groups,normal control group(CG),model control group,(MG),fluoxetine group(FG,10.0 mg/kg),daidzein group(DG,80.0 mg/kg).At the same time of establishing model,rats were administered orally once a day for 32 d.The depression model was established by chronic unpredictable mild stress model and separation.The behavioral changes of the rats were observed, and expression of BNDF in hippocampus and NPY was measured by Western blot technology and immunohistochemistry.It was observed the proliferation function of lymphocytes,spleen index,the number of peripheral blood leukocytes and antibody-secreting cell function.Results: Compared with the normal control group(CG),the weight of rats with chronic stress protocol was lower, 1%sucrose consumption decreased,scores of rats in the open field test dropped significantly,the immobility time in the forced swimming test prolonged,the level of expression of BNDF and NPY decreased,all the differences above were statistically sig-nificant(P<0.01).Compared with model group,weight of rats in fluoxetine treatment group(FG) and daidzein treatment group(DG)in-creased,sugar consumption,scores in the open field test and the levels of expression of BNDF and NPY significantly increased,the differences were statistically significant( P<0.05 or P<0.01 ).The number of peripheral blood leukocytes and antibody-secreting cell function and proliferation of lymphocytes force in daidzein treatment group was significantly higher than the model group,daidzein dose spleen index was significantly higher than the model group(P<0.01).Conclusion: The daidzein can antagonize depressive symptoms in chronic stress mice,daidzein may increased content of BDNF in hippocampus and NPY protein, and enhanced the role of humoral immune response and lymphocyte proliferation in rats with chronic stress model.The mechanisms of antidepressant effects of daidzein might be related to the increase of content of BDNF in hippocampus and NPY protein and non -specific immune regulation.

Objective: To evaluate the effect of Shenfu Injection in treating vertigo of mild vertebrobasilar stenosis. Methods: From January 2005 to July 2008, 66 patients with the primary symptom of vertigo undergoing digital subtraction angiography (DSA) examination were diagnosed as mild vertebrobasilar stenosis (MVS) according to the North American symptomatic carotid endarterectomy trial (NASCET) criteria, and then randomly divided into Shenfu (SF) group (34 cases) and Danshen (DS) group (32 cases), the DS group acting as the control. Degrees of vertigo of the patients were evaluated by the screening version of the dizziness handicap inventory (DHI-S) and scoring system for the dizziness assessment rating scale (DARS) on the admitted day, the third and sixth day after treatment and discharged day respectively. The mean of blood ? ow velocity (Vm), resistance index (RI) of right and left vertebral arterys and basilar artery, hematocrit (Hmc) and fi brinogen (Fbg) level in serum were all examined on both the admitted and discharged days. Results: There was no signifi cant difference on the score of vertigo, the parameter of TCD and the index in serum between SF and DS groups at the admitted time. On the sixth day of treatment and the discharged day, the score of DHI-S and DARS in SF group were lower than those in DS group (P

Objective To determine the clinical use of CM on interventional therapy for middle and late stage cancer.Methods We observed the effect of clinical administration on the patients with interventional therapy or inteventional therapy plus CM,control with themselvies.Results 38(76%) out of 50 patients got better than that of preadministration,cancer mass decreased.Conclusion CM can increase the sensitivity of carcinoma cells to chemicals and decrease its sideeffect.

Objective To investigate the expression of cystein rich 61 (Cyr61) and vascular endothelial growth factor (VEGF) in different stages of multiple myeloma (MM) patients,evaluate their relationship with angiogenesis and prognosis,and to determine the relationship between Cyr61 and VEGF.Methods Expression of Cyr61 and VEGF in BMMNC from 31 patients with different stages of MM and 10 cases of control were detected by RT-PCR.Results Expression of Cyr61 and VEGF in patients with MM (0.3652±1.5423,0.4815±1.3423) were significantly elevated in comparison to control (0.1862±0.7542,0.2012±1.2331) (P ＜ 0.05,P ＜ 0.01).Expression of Cyr61 and VEGF in stage Ⅲ (0.4632±0.1634,0.5356± 0.2342) was significantly higher than those in stage Ⅰ and stage Ⅱ (t =2.423,2.524,P ＜ 0.05),but there was no difference between stage Ⅰ and stage Ⅱ (0.2513±0.1365,0.3064±0.2124; 0.3084±0.2254,0.3653±0.1265) (t =1.782,1.824,P ＞ 0.05).The levels of Cyr61 and VEGF were significantly decreased after chemotherapy compared to before chemotherapy (P ＜ 0.01).Expression of Cyr61 and VEGF were positively correlated (r =0.8941,P ＜ 0.01).Conclusion Cyr61 and VEGF may play roles in the angiogenesis and pathophysiology of MM.It can be used to guide treatment and estimate prognosis by monitoring Cyr61 and VEGF.

BACKGROUND:Studies have shown that vacuum sealing drainage can accelerate wound healing through increasing the wound blood flow, but its influence on activated gelatinases in human chronic wound stil lacks corresponding research. OBJECTIVE:To observe the effect of vacuum sealing drainage on the activity of gelatinase during the healing of chronic wounds. METHODS:Total y 96 trauma patients admitted at the People’s Hospital of Hubei University of Medicine from April 2013 to January 2014 were divided into two groups:52 patients in chronic wound group were treated with vacuum sealing drainage and 44 in control group treated with wound drainage at 3 days after removal of breast cancer. In the chronic wound group, exudates from pressure sores and skin necrosis after removal of breast cancer were col ected as samples A and B;exudates from two cases of venous stasis ulcer were col ected as samples C and D;exudates from traumatic skin wounds col ected as sample E. RESULTS AND CONCLUSION:TLC analyzer showed that:after 15-day negative pressure therapy, activities of matrix metal oproteinase 2 in sample A with low activity of gelatinase, matrix metal oproteinase 9 in sample B, matrix metal oproteinase 2 and 9 in samples C, D, E were al increased significantly (P<0.05);however, the activities of matrix metal oproteinase 9 in sample A with high activity of gelatinases and matrix metal oproteinase 2 in sample B were reduced significantly after treatment (P<0.05). In addition, no significant difference was found in the activity of matrix metal oproteinase 2, matrix metal oproteinase 9 and activated gelatinase betweenthe chronic wound group and control group (P>0.05). These findings indicate that the variation of activated gelatinases activity in human chronic wounds may be the reason why the chronic wounds cannot be healed for a long time, but vacuum sealing drainage can regulate the activity of activated gelatinases in chronic wounds.

Objective To review our experience in the diagnosis and treatment of nonfunctional islet cell tumors(NICT).Method The clinicopathological data of 26 cases of NICT were retrospectively analysed and the medical literature was reviewed.Results In addition to the 26 cases seen in our center,there were 569 cases published in 37 articles in the medical literature.In China,NICT was more common in women.The male to female ratio was about 3 ∶ 7.The mean age of onset of the disease was 35 years old.Most NICT were solitary and malignant,surgery was effective in prolonging long-term survival.Conclusions NICT is rare and it had no specific clinical presentation.BUS and CT are useful for diagnosis and surgery is effective.