As the important content of excellent quality nursing service, the performance appraisal of nursing staff was closely interrelated to their income distribution, professional title promotion and excellence choosing. Performance appraisal was the requisite part of nursing resource management. This study gave an overview about conception and development of nursing staff′s performance appraisal and summarize key performance indicator,balanced score card,SMART principle and 360 degrees performance appraisal, which was mainly used in domestic hospital. It suggested nursing manager should have complementary advantages of them and utilize foreign mature methods to explore and improve our countries performance appraisal of nursing staff and formulate the system which was in keeping with China′s national conditions.

OBJECTIVE: To analyze the requirement of pharmaceutical care among physicians, nurses and patients and to explore work mode of clinical pharmacists. METHODS: The requirement of pharmaceutical care in concrete cases was summarized by combining with experience of author as clinical pharmacist in cardiology department. RESULTS: The advantage of clinical pharmacist and convenient consultation for selection of drugs contribute to complementary with physicians’ work. CONCLUSION: Clinical pharmacist provides various pharmaceutical care according to the requirement of doctors, nurses and patients.

Induced pluripotent stem cell is a landmark in the stem cell study field, which has rapidly developed in the past 10 years.By obtaining induced pluripotent stem cells from somatic cell, and then differentiating into cardiomyocyte, various cardiomyocyte disease models could be established,which can be used for research of disease mechanisms, drug screening and gene therapy.This review introduces the successfully established cardiomyocyte disease models from human induced pluripotent stem cells, and points out the problems and prospects.

Objective To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol. Methods Mifepristone (150 mg) combined with misoprostol (600 ?g) 3 days later were given to 500 biochemical pregnancies (G_1),500 early clinical pregnancies (G_2) and 500 clinical pregnancies (G_3) which were classified according to amenorrhea days,serum human chorionic gonadotropin-beta subunit (?- hCG) and vaginal B-ultrasonic examinations.All were observed for 6 hours after taking misoprostol and returned for assessment per week.Results Expulsion of conceptus was G_1 123 (24.6%,123/500),G_2 438 (87.6%,438/500) and G_3 467 (93.4%,467/500).Failure rate was G_1 6 (1.2%,6/500),G_2 24 (4.8%,24/500) and G_3 79 (15.8%,79/500) for ongoing pregnancies,hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding.Bleeding cases during the administration of mifepristone were G_1 272 (54.4%,272/500),G_2 141 (28.2%,141/500) and G_3 87 (17.4%,87/500);the mean bleeding days were G_1 (5.8?1.5),G_2 (9.0?2.9) and G_3 (14.3?5.9) days.Other side effects including abdominal pain,nausea,vomiting and diarrhea were low and light in each group,increasing with advancing gestational age.Menses recovery was 486 (97.2%,486/500),452 (90.4%,452/500) and 433 (86.6%,433/500) for each group on scheduled time.Satisfaction was 499 (99.8%,499/500),485 (97.0%,485/500) and 369 (73.8%,369/500) respectively.Conclusion Mifepristone and misoprostol in combination is as safe,and effective for termination of biochemical pregnancies as ordinary medical abortion.It does not need to wait till ectopie pregnancy is excluded.

Objective To investigate the spatio-temporal expression of P2X3 receptor ( P2X3R) in rats with diabetic mechanical allodynia ( DMA ) .Methods DMA model in rats was induced by intraperitoneal injection of streptozocin ( STZ) .The von Frey filaments were applied to identify the changes of the paw withdrawal threshold ( PWT) in DMA rats.Immunofluorescence was employed to detect the spatio-temporal expression of P2X3R in the spinal dorsal horn (SDH), dorsal root ganglion (DRG) and hind paw skin on different time points after intraperitoneal injection of STZ , respectively.The protein expression of P2X3R in SDH and DRG was further semi-quantitatively analyzed by Western blotting.Results Compared with control group , intraperitoneal injection STZ induced significant mechanical allodynia indicated by the reduced PWT from 7 days, and which reached the peak on 14d and maintained to 28days (P<0.05). The expression of P2X3R in DRG neurons was significantly increased on 14 days and 21 days (P<0.05), while that in SDH and skin was markedly increased on 21 days and 28 days, compared with control group (P<0.05).Conclusion With the progress of DMA, the expression of P2X3R was significantly increased in the SDH, DRG and skin, which was almost parallel with the mechanical allodynia , but the changes in SDH and skin were 1 week later than that in DRG .These results suggest that P2X3R may play a key role in the maintenance of the DMA .

Objective To explore the influence of nursing intervention on the pocket infection and other related problems following CRT-D therapy in chronic heart failure patients.Methods The causes of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy from March 2008 to March 2011 were reviewed,then analyzing and summarizing them to work out a detailed nursing interventions plan.During April 2011 to June 2013,nurses carried out the nursing intervention on patients who accepted CRT-D implantation.At last we compared the occurrence of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection during the period of 6 months after CRT-D therapy between the two groups.Results After the implementation of nursing interventions,the incidence of pocket infection and other related problems following CRT-D therapy in chronic heart failure patients reduced significantly.Conclusions The interventions such as rigorous preoperative skin preparation,eliminating the potential factors of infection,intraoperative strict aseptic operation,choosing the appropriate position of pocket,the implementation of interventions to prevent bleeding,meticulous and rigorous postoperative nursing,providing healthy knowledge sufciently and strengthening follow-up,finding problems and solving them timely can prevent the pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy effectively.

Adult ; Female ; Gas Poisoning ; drug therapy ; Glycoproteins ; therapeutic use ; Humans ; Male ; Middle Aged ; Quinuclidines ; therapeutic use ; Treatment Outcome ; Young Adult

Objective To investigate the effect of MDR1 and MDR3 gene silence by shRNA of human breast carcinoma cell line MCF-7/Adr,and explore the role of MDR1 and MDR3 in adriamycin-resistance of breast carcinoma cells. Methods shRNA plasmid vector specifically targeting MDR1 and MDR3 gene was transfected into cells. The control group was transfected with empty vector. The concentration of adriamycin was detected by the flow cytometry (FCM). Cell apoptosis was analysed by FITC-Annexin-V/PI double staining. Cell viability and the IC50 of adriamycin on MCF-7/Adr cells were determined by MTT method. MDR1 and MDR3 mRNA were assessed by RT-PCR. P-gp expression was detectedby immunochemistry. Results After treatment with ABCB1 and ABCB4 shRNA plasmid vector, the apoptosis of MCF-7/Adr cells was (30.21±1.65)%and (22.07±2.17)% respectively. Compared with untransfecedgroup and empty vector transfection group the difference was significant(P＜0.01). MDR1 and MDR3 shRNAcould increase cellular adriamycin accumulation of MCF-7/Adr cells. MCF-7/Adr cells viability and the IC50were significantly decreased after transfection. Compared with untransfeced group and empty vector transfectiongroup, the mRNA level of MDR1 and MDR3 in MCF-7/Adr cells were decreased by (89.5±0.8)%and(85.1±1.2)%, the reduction of MDR1 and MDR3 mRNA was in a time-dependent manner. Immunochemistry proved that the expression of p-gp was significantly inhibited. Compared with untransfeced group and empty vector transfection group the difference was significant (P＜0.05). Conclusion The shRNA can effectively and specifically silence the expression of MDR1 and MDR3 gene, reverse the adriamycin-resistance mediated by P-gp in MCF-7/Adr cells. The reversal effect of adriamycin-resistance by shRNA of MDR1 is more effective than that of MDR3.

OBJECTIVETo observe the effect of β₃adrenoceptors (β₃-AR) activation on rat thoracic aorta smooth muscle contractility and the possible related mechanism.

METHODSThe endothelium removed thoracic aorta was pre-contracted with 30 mmol/L KCl physiological saline solution (PSS). Then the tension of the thoracic aorta was recorded in presence of BRL37344 (BRL) to determine the action of β₃-AR. The tension of the thoracic aorta was also recorded in the presence of Propranolol (PRA), SR59230A (SR), L-NNA, H-89 and Iberiotoxin (IBTX) respectively to reveal the underling mechanism of β₃-AR activation on rat vascular smooth muscle. Immunohistochemistry was adopted to confirm the existence and the distribution of β₃-AR in rat thoracic aorta.

RESULTSThe results showed that: (1) The thoracic aorta was relaxed by β₃-AR activation, with a relaxation percentage of (10.59 ± 0.79). (2) β₃-AR was expressed in both endothelial and smooth muscle layer in thoracic aorta sections of rats. (3) PRA did not block the effect of BRL on the thoracic aorta. The relaxation actions of BRL could be antagonized by pre-incubating the thoracic aorta with SR. (4) L-NNA (a NOS inhibitor) and H-89 (a PKA inhibitor) reversed the relaxation effect of BRL on vascular smooth muscle. (5) The effect of BRL was decreased after application of Ibriotoxin (IBTX), a large conductance calcium dependent potassium channel blocker.

CONCLUSIONThe results confirmed that activation of β₃-AR led to relaxation of thoracic aorta smooth muscle. The relaxation action of β₃-AR on smooth muscle of rat thoracic aorta was related to activation of NOS and PKA signaling pathway. Large conductance Ca²⁺-K⁺ channels were involved in the relaxation action of β₃-AR activation on rat thoracic aorta smooth muscle.

Animals ; Aorta, Thoracic ; physiology ; In Vitro Techniques ; Isoquinolines ; Large-Conductance Calcium-Activated Potassium Channels ; physiology ; Muscle Contraction ; Muscle Relaxation ; Muscle, Smooth, Vascular ; physiology ; Nitroarginine ; Peptides ; Propanolamines ; Propranolol ; Rats ; Receptors, Adrenergic, beta-3 ; physiology ; Signal Transduction ; Sulfonamides