Hospital culture plays a more and more important role,among various factors that influence employee satisfaction.Study on hospital culture is gradually growing out of a pure conceptual research and emerging into an area of correlation analysis. Our studies on the hospital culture developments and employee satisfaction in a tertiary hospital,analyzed the correlations between hospital culture and employee satisfaction and its impact,with recommendations for reform strategies.

Garcinia plants are one of the rich sources of natural xanthones and benzophenones which have attracted a great deal of attention from the scientists in the fields of chemistry and pharmacology. Recently, many structurally unique constituents with various bioactivities, especially anti-tumor activity, have been isolated from Garcinia plants. This concise review focused on the anti-cancer activity natural products isolated from Chinese Garcinia plants, and the research finding by authors and collaborators over the past several years were cited.
Antineoplastic Agents, Phytogenic ; chemistry ; isolation & purification ; pharmacology ; Benzophenones ; chemistry ; isolation & purification ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Garcinia ; chemistry ; classification ; Humans ; Inhibitory Concentration 50 ; Molecular Structure ; Plants, Medicinal ; chemistry ; classification ; Structure-Activity Relationship ; Terpenes ; chemistry ; isolation & purification ; pharmacology ; Xanthones ; chemistry ; isolation & purification ; pharmacology

Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Objective:To discuss the effects of walking function-guided interactive Tuina(Chinese therapeutic massage)on spatiotemporal gait parameters in children with spastic cerebral palsy(CP). Methods:Fifty children with spastic diplegic CP were divided into an observation group and a control group following a paired design and random number principle,with 25 cases in each group.The observation group was treated with the walking function-guided interactive Tuina,and the control group was offered the"six methods of spine and back"Tuina,20 min for each session and 5 sessions weekly for 3 consecutive months.The children's changes were assessed using the percentage of dimension E(walking,running,and jumping)of the gross motor function measure-88(GMFM-88)and three-dimensional gait analysis. Results:After treatment,the percentage of GMFM-88 dimension of dimension E(walking,running,and jumping)changed significantly in both groups(P<0.05),and the between-group difference was also statistically significant(P<0.05).After treatment,the step length,walking speed,and step frequency changed markedly in the observation group(P<0.05)and were significantly different from those in the control group(P<0.05).After the intervention,the stance phase and double support extended,and the swing phase became shorter in the observation group(P<0.05);the between-group differences were statistically significant(P<0.05).The maximal knee flexion angle and maximal posterior pelvic tilt angle decreased After treatment in the observation group,and the maximal anterior pelvic tilt angle increased,all showing statistical significance(P<0.05);the between-group differences were statistically significant(P<0.05). Conclusion:Compared with the passive Tuina manipulations,the"six methods of the spine and back",walking function-guided interactive Tuina has its advantage in improving walking function in children with spastic CP,manifesting as better lower-limb force line and walking efficiency.

Background Research demonstrated that alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid GluR2 (AMPA-GluR2) is associated with amblyopia.It has been shown that levodopa and cytidine diphosphate choline can improve visual function of amblyopic children,but the mechanism is unclear.Objective This study was to explore the possible effects of levodopa and cytidine diphosphate choline on amblyopia.Methods Monocular deprivation (MD) animal models were created in 60 2-week-old SD rats by monolateral eyelid suturing and observed for 31 days and reared in natural light together with 15 other matched normal healthy SD rats.The models were randomly divided into the MD group,levodopa group,cytidine diphosphate choline group and normal saline control group,with 15 rats for each group.40 mg/kg of levodopa,80 mg/kg of cytidine diphosphate choline,I ml normal saline were given to the rats,respectively,for 28 consecutive days.Expressions of the AMPA-CluR2 protein and AMPA-CluR2 mRNA in the rat visual cortex were detected by immunohistochemistry,Western blot and real-time fluorescence quantitative PCR.Use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The expression values of the AMPA-GluR2 protein (AMPA-GluR2/β-actin) and AMPA-GluR2 mRNA (2-△△Ct) were significantly lower in the MD group than those of the normal control group (protein:0.32 ± 0.02 vs.0.64 ± 0.05,t =13.287,P＜0.05 ;mRNA:0.30±0.01 vs.0.84±0.03,t=38.184,P＜0.05).Those in the levodopa group were significantly increased in comparison with the normal saline solution group (protein:0.59 ±0.04 vs.0.33 ±0.03,t =11.628,P＜0.05 ; mRNA:0.71±0.06 vs.0.33 ±0.02,t =13.435,P＜0.05).The expression values of the AMPA-GluR2 protein and AMPA-GluR2 mRNA were significantly increased in the cytidine diphosphate choline group compared with the normal saline solution group (protein:0.52 ± 0.04 vs.0.33 ± 0.03,t =8.497,P ＜ 0.05 ; mRNA:0.48± 0.04 vs.0.33 ± 0.02,t =7.500,P＜0.05).Conclusions AMPA-GluR2 is associated with the plasticity of visual development.Levodopa and cytidine diphosphate choline may improve visual function by down-regulating the expression of AMPA-GluR2 in the visual cortex.

Lipoproteins are biological lipids carriers. The natural and reconstituted lipoprotein based drug delivery systems have been extensively developed in recent years. This article reviews the development of natural and reconstituted low-density lipoprotein and high-density lipoprotein based vehicles in the antitumor area.
Animals ; Antineoplastic Agents ; administration & dosage ; chemistry ; Apolipoproteins B ; administration & dosage ; chemistry ; Drug Carriers ; administration & dosage ; chemistry ; Humans ; Lipoproteins ; administration & dosage ; chemistry ; Lipoproteins, HDL ; administration & dosage ; chemistry ; Lipoproteins, LDL ; administration & dosage ; chemistry ; Nanoparticles ; Neoplasms ; drug therapy ; Peptides ; administration & dosage ; chemistry ; Pharmaceutical Vehicles ; chemistry

Background The afferent signals of proprioceptor in extraocular muscles play an important role in controlling eye position and conjugate movement. Palisade ending in the extraocular muscles is the main source of proprioceptive information, and its abnormalities in structure and function may be associated with the occurrence of nystagmus. Objective This study was to observe the changes of palisade ending in the extraocular muscles of patients with congenital nystagmus ( CN) and discuss the probable mechanism. Methods Modified Kestenbaum procedure was performed on 10 patients with CN, and the extraocular muscle samples were collected during the operation. Normal extraocular muscle samples were obtained from the enucleated eyeballs after ocular wound. The ultrathin sections of extraocular muscles were prepared and double-staining by uranyl acetate and lead citrate. The morphological changes of the palisade ending of extraocular muscles were examined under the transmission electron microscopy. Written informed consent was obtained from each subject before surgery. Results The ultrastructure of palisade ending in the extraocular muscle of CN subjects showed the different degrees of alterations. The mild changes included the collapse and disconnection of external capsules and the nonhomogeneous electron-dense substracts. The degeneration and dissociation of myelin in nerve endings, swelling and vacuolation of mitochondria were also exhibited. Myeloid body was found in axon. In the severe patients,the necrosis of Schwann' s cells,dissolve of axon and disappear of capsules were seen. Conclusion The palisade ending of extraocular muscle in the patients with CN are obviously abnormal in comparison with normal one. These alterations are probably associated with the etiology and pathogenesis of CN.

Objective To observe the effect of liver disease special-purpose enteral nutrition preparation on protein metabolism and liver function in children with liver injury.Methods Sixty cases of severe ill with liver injury in hospital,with mean age of (7.8?6.3) years old.All patients were randomly divided into experimental group (n=30) and control group(n=30).The experimental group was treated by adding the liver disease special-purpose enteral nutrition preparation homogenized diet and control group was treated by adding entire protein entire nutrition type enteral nutrition preparation.All patients in both 2 groups were nasally fed with intestinal nutrition,which contained 418-628 kJ/(kg?d).One day before nutritional support and 14 days after nutritional support,the liver function,total serum protein,albumin,hemoglobin were recorded.SPSS 11.5 software was used to analyze the data.Results The baseline indicators were similar before nutritional supports.Fourteen days after nutritional support,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were all significantly lower in experimental group than in control group(Pa

Objective To analyse the effects of serum estradiol levels during controlled ovarian hyperstimulation (COH) on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods The clinical data of 472 patients undergoing IVF-ET with GnRH analogues recombinant FSH long protocol were retrospectively analysed. The area under the curve (AUC) of estradiol (E2) level was calculated during COH, and patients were categorized into groups according to the percentile of AUC of E2(AUCE2) during COH. The general characteristics and parameters related to the outcomes of IVF-ET were compared among groups. Results The 10th percentile and 90th percentile of AUCE2 were 3 347.0 pmoL/L and 14 414.3 pmol/L, respectively. Four hundred and seventy-two patients were divided into lower reaction group (AUCE2 3 347.0 pmol/L, n=48), normal reaction group (14 414.3 pmol/L>AUCE2 > 3 347.0 pmol/L, n=376) and higher reaction group (AUCE2≥14 413.3 pmol/L, n=48). There was no significant difference in age, body mass index, baseline follicle stimulating hormone level, time of treatment with gonadotropin, endometrium thickness on day of transfer and embryos transferred(P>0.05). Compared with lower reaction group and normal reaction group, the number of oocytes per retrieval and number of embryos frozen were significantly larger(P<0.01) and the mild/severe ovarian hyperstimulation syndrome rate was significantly higher in higher reaction group(P<0.05). There was no significant difference in fertilization rate, cumulative embryo score, high-grade embryo rate, clinical pregnancy rate and implantation rate among groups (P> 0.05). Conclusion Sustained snpraphysiological serum E2 levels during the COH process do not adversely affect the quality of oocytes and embryos, clinical pregnancy rate and implantation rate to some extent in IVF-ET.

?In allusion to the training requirements of eight-year program medical students, combining with our own experience in teaching this type of the students in ophthalmology, we have done some thinking about the training methods of eight-year program medical students in order to improving their comprehensive abilities of ophthalmology. Several suggestions are made in various aspects, including the study of the basic theory of ophthalmology, the training of doctor - patient communication skills, the training of basic clinical skills, the interest developments in ophthalmology subspecialty areas and the training of basic experiment skills.