Objective: To analyze the methods of Lishui Central Hospitals performance management, and evaluate the important role of performance management in the modern hospital management. Methods:Evaluate the hospital operation management data in recent 5 years, basing on the performance management measures of Lishui Central Hospital. Results: During 2007 to 2012, outpatients and emergency patients increased to 80.41%, discharges increased to 89.35%, operating table increased to 84.59%, total revenue increased to 121.61%, average length of stay decreased by 5.1 days, times cost of patients had been effectively controlled, and total assets increased by 149.21%. Conclusion: The reform of Central Hospital performance management has great significance in mobilizing the enthusiasm of workers and enhancing the level of hospital management, and will solve the difficulties of expensive medical treatment problems well.

Objective To discuss the difference of myopia prevalence and spherical equivalent among normal,exophoria and intermittent exotropia children.Methods The children aged between 6 years old to14 years old were divided into 3 groups of orthophoria (n =151),exophoria (n =180) and intermittent exotropia (n =168) based on the result of cover-uncover test.Intermittent exotropia group was divided into three types of basic,convergence insufficiency and divergence excess.Diopter values were retrospectively reviewed,and results were recorded with the average data after the objective optometry of cycloplegia.Results Myopia prevalence of intermittent exotropia of different ages was higher than normal and exophoria (all P ＜ 0.05),but no difference between exophoria and normal (all P ＞ 0.05).There were statistical significant differences in overall prevalence among three groups (intermittent exotropia and orthophoria:P =0.000,intermittent exotropia and exophoria:P =0.000,orthophoria and exophoria:P =0.034).Average spherical equivalent was (0.08 ± 0.99) D in orthophoric group,(-0.16 ± 1.16)D in exophoric group and (-1.23 ± 1.57)D in intermittent exotropic group,there was statistical difference among three groups (P =0.000).The differences were also statistical significant between orthophoria group and exophoria group (P =0.015),intermittent exotropia group and orthophoria group (P =0.000),exophoria group and intermittent exotropia group (P =0.000).In the group of intermittent exotropia,average spherical equivalent was (-1.68 ± 1.61) D in convergence insufficient group,(-1.14 ± 1.44) D in basic group and (-0.85 ± 1.50) D in divergence excessive group,there was statistical difference among three groups (P =0.000).The spherical equivalent in convergence insufficient group was lower than the basic group (P =0.000)and divergence excessive group (P =0.041).Conclusion The myopia prevalence and degree of intermittent exotropia are all higher than normal and exophoria in children.

Autophagy is an active research area in the biomedical field as its role has been identified in many physiological and pathological processes. Accordingly, there is a growing demand to identify, quantify and manipulate the process accurately. Meanwhile, there is great interest in identifying compounds that modulate autophagy because they may have applications in the treatment of a variety of autophagy-related diseases. In this review, we summarize the current status of autophagy screening systems to facilitate identification of autophagy modulators.
Autophagy ; Humans

Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.

OBJECTIVE:To observe therapeutic efficacy and safety of dexrazoxane combined with Shenmai injection in the treatment of anthracycline-induced cardiotoxicity in patients with breast cancer. METHODS:120 female breast cancer patients were randomly divided into group A,B,C and D with 30 cases in each group. Group A was given CAF chemotherapy plan(cyclophos-phamide 75 mg/m2+fluorouracil 500 mg/m2 + doxorubicin 60 mg/m2),ivgtt;group B was additionally given Shenmai injection 50 ml,qd,ivgtt,on the basis of CAF plan;group C was additionally given rapid intravenous of dexrazoxane 60 mg/m2 30 min before chemotherapy,on the basis of CAF;group D was additionally given constant dose of dexrazoxane combine with Shenmai injection on the basis of CAF plan. A treatment course lasted for 3 weeks,they were given 4 courses in total. The change of ECG,LVEF, cTnT and BNP and the incidence of bone marrow suppression were observed before and after chemotherapy. RESULTS:After treat-ment,the rate of abnormal ECG,LVEF value,cTnT value and BNP value of groups B,C and D were all decreased significant-ly,with statistical significance(P<0.05). Compared with group D,above index of groups B and C were decreased significantly, with statistical significance(P<0.05). The incidence of bone marrow suppression was in ascending order,group D

ObjectiveTo investigate the possibility of establishing a model of connective tissue disease-associated pulmonary arterial hypertension (PAH) in rats.MethodsPAH was induced by a single intraperitoneal injection of monocrotaline solution at a dose of 50 mg/kg.The rats of the control group were injected the same volume of 2:8 ethanol saline.After 2 and 4 weeks,a polyvinyl catheter was inserted into the pulmonary artery,and the hemodynamic variables were monitored continuously by Maclab/8 s.The pulmonary vascular pathologic remodelling was examined with hematoxylin and lectin perfusion.Thickness and area indices were calculated.ResultsFour weeks after intra-peritoneal injection of monocrotaline,the systolic,diastolic,and mean pulmonary arterial pressures [(41 ±6),(24.3±3.8),(29.8±4.2) mm Hg] were obviously increased in the experimental group [(23 ±3),(8.5 ±2.4),( 17.1 ±2.5) mm Hg] (P＜0.05) when compared with those of the control groups.Histological examination showed that the thickness of arterial wall increased,the lumen became narrowed,and the thickness and area index(TI:0.723±0.034 vs 0.314±0.023,AI:0.912±0.203 vs 0.414±0.021 ) increased in small pulmonary arteries(P＜0.05).ConclusionThe model of connective tissue disease-associated pulmonary hypertension could be established by intraperitoneal injection of monocrotaline solution.The model has been demonstratedthe characteristic morphologic changes in the pulmonary vasculature.This method may provide an economic,easy,and stable animal model for the study of the mechanisms of pulmonary vascular remodeling in connec-tive tissue disease-associated pulmonary hypertension.

To find a component with the strongest anti-endotoxin effect from the four components (F021, F022, F023, and F024) of chloroform extract (F02) of Radix Isatidis, the protective effects of the five components on endotoxin-challenged mice and their effects on the production of TNFalpha and IL-6 by macrophages from the endotoxin-challenged mice were compared. It was found that the five components all had protective effects on endotoxin-challenged mice in terms of mortality. The mortalities of the mice challenged by 2.42 mg/kg endotoxin were 30 %, 50 %, 20 %, 50 % and 60 % after treatment with F02, F021, F022, F023, and F024. The 5 components all had inhibitory effects on the production of TNFalpha and IL-6 by macrophages from the mice. At a concentration of LPS of 50 ng/mL, the inhibitory rates of F02 , F021 1, F022, F023, and F024 for the production of TNFalpha and IL-6 were 76.54 %, 30.86 %, 78.60 %, 36.63 %, 2.06 % and 75.85 %, 18.45 %, 77.68 %, 24.41 %, 3.64% and at the dose of 100 ng/mL, the inhibitory rates were 49.65 Y, 16.86 %, 66.97 %, 13.39 %, 7.16 % and 59.78 %, 1.28 %, 61.86 %, 2.08 %, 1.44 %, respectively. It is concluded that the component F022 of Radix Isatidis has the strongest anti-endotoxin effect.

To investigate the effect of the anti-endotoxic part of Radix Isatidis on the expression of moesin mRNA in murine tissues induced by lipopolysaccharide (LPS), the sample solution of F(022) part from Radix Isatidis was intraperitoneally administered to experimental mice, and the lipopoly-saccharide (LPS) were injected into the tail vein, and then the tissues of liver, kidney and spleen were colleted and cut into slices. The mRNA was detected by moesin mRNA hybridization in situ. The staining results were observed under microscope. It was found that moesin mRNA expression was increased in the tissues of liver, kidndy and spleen in mice treated with LPS, while in the mice pre-treated with F(022) part from Radix Isatidis, the LPS-induced moesin mRNA expressions in these tissues were inhibited in a dose-dependant manner. Our study showed that F(022) part from Radix Isatidis can inhibit the LPS-induced expression of moesin mRNA in the tissues of liver, kidney and spleen in mice.

Background In patients with syphilis,one of the common manifestations is uveitis.However,the lack of understanding on syphilic posterior uveitis may result in misdiagnosis and delayed treatment.Objective This study was to assess ocular clinical features,treatment and prognosis in patients who had latent syphilis and presented with posterior uveitis as the initial symptom.Methods A serial cases-observational study was designed.Twelve patients(19 eyes)who were diagnosed as syphilis from September 2011 to January 2013 were retrospectively analyzed.All patients were characterized by initial posterior uveitis before the final diagnosis.The clinical manifestation,management and prognosis were evaluated and analyzed.All patients were informed of this study and consented with the use of their data for this retrospective study.Results The patients presented with initial clinical signs of acute or chronic posterior uveitis and lacked systemic syphilis symptom.Bilateral posterior uveitis were found in 7 patients and unilateral in 5 patients.The dust-like and grey-white opacification in vitreous was seen by threemirror contact lens in all the patients.Mild hyperemia of the optical disc was found in 10 eyes with the unclear peripapillary boundary.Yellow-white lesions were observed in retinas of 7 eyes and retinal punctuate hemorrhage was in 1 eye.Fundus fluorescein angiography demonstrated fluorescine staining or hyperfluorescence of optic disc in all of the 19 eyes,and fluorescein leakage from vein in 18 eyes,retinal pigment epithelium dye pooling in 6 eyes and cystoid macular edema in 11 eyes.Rapid plasma reagin (RPR) test and treponema pallidum hemagglutination assay (TPHA) were performed and presented positive results in all patients.The visual acuity improved in 19 eyes and partly elevated in 2 eyes following a standard therapy for neurosyphilis was used,including penicillin and/or small doses of glucocorticoid.Conclusions The serological examination for syphilis should be considered for patients with unexplained uveitis.Early diagnosis and prompt treatment are important for the improvement of prognosis in syphilitic posterior uveitis.

Objective:To analyze the effect of continuing care in patients treated with endonasal endoscopic conjunctivorhinostomy, so as to guide its clinical application.Methods:A total of 192 patients were selected with endonasal endoscopic conjunctivorhinostomy who were admitted to the Aier Eye Hospital of Wuhan University from June 2013 to June 2019 as the research objects. Randomized digital table method was used to divide them into control group and observation group, 96 cases in each group. The control group was given routine instructions before discharge, while the patients in observation group were given continuing care intervention on the basis of control group, including establishment of a continuing care group, establishment of health files of discharged patients, regular follow-up through telephone, establishment of WeChat groups for patients or their families, opening WeChat official account, organization of doctor-patient discussion meeting, and setting up reexamination services. The reexamination adherence rate, medication adherence rate, care satisfaction and treatment efficacy were compared between the two groups 6 months after implementation.Results:The reexamination adherence rate of the observation group on 1, 3, and 6 months after discharge were 85.42%(82/96), 96.88%(93/96), 72.92%(70/96), and the control group were 62.50%(60/96), 73.96%(71/96), and 43.75%(42/96), respectively, the difference between the two groups was statistically significant ( χ2 value was 13.088,20.237, 16.800, P<0.05); the medication adherence rate of the observation group was 89.58%(86/96), and the control group was 62.50%(60/96), the difference between the two groups was statistically significant ( χ2 value was 19.326, P<0.05); the observation group's care satisfaction was 94.79%(91/96), the control group was 78.13%(75/96), the difference between the two groups was statistically significant ( χ2 value was 11.388, P<0.05); the total treatment efficacy in the observation group was 96.88%(93/96), and the control group was 87.50%(84/96), the difference between the two groups was statistically significant ( χ2 value was 5.858, P<0.05). Conclusion:The application of continuing care for patients treated with endonasal endoscopic conjunctivorhinostomy can improve patients′ reexamination and medication adherence, improve care satisfaction, promote patients′ good recovery and achieve better surgical effects, which is worthy to recommend its clinical application.