Objective:To seek the main incentive factors that influencing medical staff′s enthusiasm through the medical staff satisfaction survey among the grass-roots level medical staff in Shaanxi province.Methods:Choosing the north, middle and south parts of Shaanxi province and using the questionnaire survey, factor analysis method and Krukal-Wallis test were used.Results:Main drive common factor affect the enthusiasm of the staff with train-ing and development, compensation and protection level, management mode and team cooperation, working condi-tions and working environment, and different characteristics of medical staff on incentive satisfaction differences. Conclusion:In order to improve medical staff′s work enthusiasm, it is necessary to combine the Shaanxi regional specific circumstances, to establish a suitable incentive mechanism.

Objective To investigate the clinical value of detection of fluorescence quantitative PCR in detection of HBV DNA and HBV markers.Methods 653 hepatitis B patients in our hospital from 2013 April to 2013 December were selected.First ELISA method using HBV-M model for qualitative detection of the blood samples,the detection order:Hepatitis b virus surface antigen (HBsAg),Hepatitis B surface Antibody(HbsAb),Hepatitis B e Antigen(HbeAg),hepatitis Be antibody(HbeAb),hepatitis B core antibody(HbcAb);Then the FQ-PCR method for the quantitative detection of HBV-DNA,different HBV-m model test results were compared..Results Big 3 this world[1(+)、3 (+)、5 (+)model]and[1 (+)、3 (+)model ]of the HBV-DNA positive rate was 97.97%,94.74% was significantly higher than that in other mode(P<0.05).Big 3 this world[1(+)、3(+)、5(+)model]HBV-DNA expression level is the highest(5.59 ×106 ±2.42 ×105 )copies/mL was significantly higher than that in other mode(P<0.05).Conclusion Combined with qualitative and quantitative detection of HBV-DNA HBV-M,which is of great value to clinical early diagnosis and therapy.

Objective To investigate the protective effects of ethanol-extract of Halenia elliptica D. Don on chemical hepatic injury in mice. Methods Mouse models of chemical hepatic injury were induced by intraperitoneal injection of 0.12 %CCL4. Extract of Halenia elliptica D. Don by alcohol was administered,and serum ALT,AST activities and liver glycogen level were measured in mice. Results Compared with the models,the enzyme activities of ALT and AST were significantly reduced and the content of liver glycogen was significantly increased in the ethanol-ex tract of Halenia elliptica groups. Conclusion It is indicated that ethanol-extract of Halenia elliptica D. Don has an effect in protecting the liver.

OBJECTIVE:To establish the quality standards for Qiqilian capsule. METHODS:TLC was used to identify the As-tragali Radix,Phellodendri chinensis,Coptidis rhizom. HPLC was used to determine the contents of ginsenosides Rg1,ginsenosides Rb1 and notoginsenosides R1. The column was Shim-pack VP-ODS C18 with mobile phase of acetonitrile-water(gradient elution) at flow rate of 1.0 ml/min,detection wavelength was 203 nm,column temperature was 20 ℃. RESULTS:TLC of Astragali Radix,P. chinensis,C. rhizom showed cleer sports and good separation. The linear range was 0.9-9.0 μg for ginsenosides Rg1,0.94-9.4 μg for ginsenosides Rb1 and 0.3-3.0 μg for notoginsenosides R1(r≥0.999 5);RSDs of precision,reproducibility and stability test were lower than 3.0%;recoveries were 96.08%-99.75%(RSD=1.52,n=6),97.03%-99.75%(RSD=1.10,n=6)and 96.38%-98.55%(RSD=0.90,n=6),respectively. CONCLUSIONS:The method is simple,good reproducibility,and can be used for the quality control of Qiqilian capsule.

Objective In order to discuss the contribution and significance of lowering increased serum uric acid levels in cardio-vascular disease prevention and control .Methods All 100 hyperuricemia in senile patients with hypertension and diabetes mellitus were received the standard drug treatments for bloodpressure ,blood sugar management .According to the patients′will divided them into uric acid intervention group(study group) and control group .The study group were given low purine diet and benzbromarone tablet (50 mg/day ,course of 1 year) ,then compare the changes between the 2 group and within each group after 3months ,6months and 1 years in the metabolism indexes before and after intervention (serum uric acid ,glycosylated hemoglobin ,fasting blood glu-cose ,2-hours postprandial glucose ,and the changes of dynamic blood pressure ) ,and follow-up the occurrence of cases in primary end point events (all-cause death ,total cardiovascular death) .Results (1)In study group ,3months ,6months and 1 years after in-tervention ,the serum uric acid lever was significantly lower than that before intervention and the control group ,P<0 .01 .(2)The study group patients′dynamic blood pressure was significantly lower than that before intervention and the control group after 6 ,12 months ,meanwhile the study group patients′success rate of dynamic blood pressure level is higher than themselves before the in-tervention after 6 ,12 months ,P<0 .05 .(3)The 2 groups of patients′glycosylated hemoglobin ,fasting plasma glucose ,2-hours post-prandial glucose ,control rate of blood glucose at each testing point before and after the intervention had no difference .(4)The oc-currence of cases between the 2 groups for all-cause death and total cardiovascular death had no difference .Conclusion (1)Reduc-ing the mortality and disability rate of hyperuricemia in elderly patients with hypertension and diabetes mellitus ,the most critical measures is still a reasonable standard blood pressure and blood sugar management .Based on this therapy ,effectively reducing the increased serum level of uric acid can improve the control rate of blood pressure .

Objective To develop a RP-HPLC method for the determination of Brucine and Strychnine in Semen Strychni and its extractive of total alkaloids. Methods A chromatographic column of Licrospher C18 (4.6 mm×250 mm, 5 μm) was used with the mobile phase of acetonitrile∶0.01 mol/L sodium heptane sulfonate and 0.02 mol/L potassium dihydrogen phosphate mixed with equal amount (adjusted pH to 2.8 with 10% phosphonic acid)=27∶73, detection wavelength at 260 nm, column temperature of 30 ℃ and flow rate of 1 mL/min. Results The calibration curves of Brucine and Strychnine were both in good linearity in the ranges of 0.1-1.0 μg and 0.12-1.2 μg (r=1.000) respectively. The average recovery rates of Brucine and Strychnine were 99.88% (RSD=1.06%) and 100.06% (RSD=0.78%) respectively. Conclusion The method is realiable and accurate, which can be applied to determination of Brucine and Strychnine in Semen Strychi and its extractive.

Objective To investigate the effect of nursing clinical ladder program on the training of nurses in ICU.Methods Seventy seven nurses in ICU were trained with nursing clinical ladder program including defining the ladder system of nurse’s ability, regulating the standard of each level,conditions for promotion,range for practice,establishing courses.Regular assessment,classification and retraining were performed.Result After training,the qualification rate in special theory and skills was increased.The incidences of major complications were significantly lower than that before training(P<0.05).Conclusions Nursing clinical ladder program is good for the development of personal career and specialization.It may promote the improvement of positivity and the quality of nursing.

Objective To investigate the influence factors on the graft hemodynamics after liver transplantation by CT perfusion(CTP).Methods Thirty three liver recipients received CT angiography (CTA)and CTP after liver transplantation.The cases would be excluded when their peak values of the aorta enhancement on time-density curves were out of 95%confidence level.The 95% confidence levels of the hepatic artery perfusion(HAP),portal vein perfusion(PVP),total liver perfusion(TLP)and hepatic perfusion index(HPI)were calculated based on the recipients without postoperative complications and named them as references to those with complication.Results Twenty nine recipients were enrolled in the study.15 of them had no postoperative complication while the other 14 had.The 95% confidence levels of HAP,PVP,TLP and HPI on the 15 recipients without complications were(0.1509-0.3183),the 14 cases with complications.HAP decreased in 7 cases,5 of them had hepatic artery stenosis and 3 of them had splenomegaly.HAP increased in 2 cases.both of them had portal vein stenosis.PVP decreased in 13 cases,8 of them had portal vein stenosis,portal vein thrombosis or occlusion,4 of them had splenorenal shunts and 2 of them had fatty liver.TLP decreased in 12 cases and coincident with PVP decreasing.Only 2 cases had HPI decreasing accompanied with HAP decreasing.Conclusion The hepatic blood perfusion through the hepatic artery and portal vein could be quantitatively measured non-invasively by CTP.The severity and the subtypes of the hepatic ischemia could be evaluated objectively,which is helpful for treatment guidance.

Objective:To investigate the effect of retinoid-interferon-induced mortality (GRIM-19) gene on the apoptosis of colon cancer. Methods: A GRIM-19 eukaryotic expression vector (pCMV-Flag-GRIM-19) was constructed and transfected into SW480 cells. Expressions of GRIM-19 and apoptosis-related proteins were detected by Western blotting analysis. Apoptosis of SW480 cells was measured by Annexin-V/PI assay and mitochondrial membrane potential JC-1 staining. Results: The GRIM-19 eukaryotic expression vector pCMV-Flag-GRIM-19 was successfully constructed. Expression of GRIM-19 in SW480 cells was up-regulated and that of apoptosis-related protein Bcl-xl was down-regulated after transfection with pCMV-Flag-GRIM-19. Apoptosis rate was (7.7±1.39)% in SW480 cells transfected with pCMV-Flag empty vector and (15.0 ± 2.52)% in pCMV-Flag-GRIM-19 transfected cells (P<0.05). Mitochondrial membrane potential was decreased in (7.5±2.09)% of pCMV-Flag transfected cells and (17.5±3.07)% of pCMV-Flag-GRIM-19 transfected cells (P<0.05). Conclusion: In vitro GRIM-19 transfection can effectively induce apoptosis of colon cancer SW480 cells.

The flipped class model is student-centered,which turns the traditional "teaching firstlearning behind" into the "learning first-teaching behind".The flipped class model can improve students' autonomous learning ability and other abilities.This article introduces the application of the flipped class in the course of medical immunology,including the course content selection,building QQ group learning platform,the production and release of independent learning resources,enactment of the task order and learning requirements,the design and implementation of classroom teaching activities and so on.The review and reflection of the formative assessment is also carried out.Through the reflection of the problems in the teaching,it is expected to lay the foundation for the promotion of the overturned class.