AIM: The expression of the Fas Antigen and induction of apoptosis by anti-Fas antibody in esoinophils in vitro were investigated. METHODS: Purified eosinophils from health donors were cultured for 72 h in the presence of human IL-5 and with or without anti-Fas monclonal antibody (MoAb) at various concentrations (1-1000 ?g/L). The expression of the Fas antigen on eosinophils was determined by immunocytochemistry. The changes of eosinophils viability and apoptosis were also studied. RESULTS: The Fas antigen was expressed on freshly isolated eosinophils, which had no significant changes after culture in the presence or absence of IL-5. The anti-Fas MoAb at different concentration suppressed significantly the IL-5-mediated eosinophils survival (78%?9%). When eosinophils were cultured in the presence of IL-5 (1?10 4 U/L) with anti-Fas MoAb (1 000 ?g/L), the percentage of alive cell decreased to 30%?12%( P

Objective This study aimed to construct an index system for nurse performance appraisal based on the quantity,quality,efficiency and technology in holistic nursing mode.Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system,and SPSS17.0 was used to do data statistics and reliability analysis.Results The nurse performance appraisal index system was constructed which contained 4 level-Ⅰ indicators such as level coefficient,nursing workload scores,nursing quality scoring rate and reward amount and 12 level-Ⅱ indicators.The calculation method of each part was also established.The expert positive coefficients were 94.3％ and 100.0％ respectively,the authority coefficients were 0.83 and 0.84,the importance and feasibility mean scores of every index were 4.27-5.00 and 4.26-4.94,and coefficients of variation were 0.00-0.26 and 0.05-0.26 in 2 rounds of enquiry.The importance of level-Ⅰ or level-Ⅱ indicators and operability coordination coefficients were 0.13-0.43,the significance test showed P ＜ 0.05.Conclusions The design of each dimension of the index system gives full consideration to nurse post management,hierarchical using,the nurse in charge of the patient,grading nursing care and many other factors.Representative of key indicators is strong,and it can reflect the distribution concept that more payment for more contributions,best's best reward and rewarding the good and punishing the bad.

Objective To construct the assessment index system for general nursing goals management based on the performance structure theory. Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system, and SPSS17.0 was used to do data statistics and reliability analysis. Results The assessment index system for general nursing goals management was constructed which contained 6 level-Ⅰindicators such as nursing quality, nursing safety, nursing service, teaching and training, the contribution of department and the communication skills and 22 level- Ⅱ indicators. The department monthly examination scores calculation method and feedback mechanism were also established. The expert positive coefficients were 97.6%and 98.8%respectively, the authority coefficients were 0.85 and 0.86, the importance and feasibility mean scores of every index were 3.86-4.98 and 3.98-4.88, and coefficients of variation were 0.03-0.27 and 0.05-0.25 in 2 rounds of enquiry. The importance of level-Ⅰor level-Ⅱ indicators and operability coordination coefficients were 0.10-0.36, the significance test showed P<0.05. Conclusions The design of each dimension of the index system gives full consideration to 3 dimensions of performance: task-adaptive-relationship. Representative of key indicators is strong. The Delphi method used in building is scientific and the results are reliable. The maneuverability of calculate Method is strong, easy to quantify. The feedback mechanism has a strong incentive by combining the assessment results closely with the individual interests. The establishment of the index system can provide scientific and objective basis for the full implementation of the general nursing goals management.

Objective To evaluate the implementation feasibility of the nurse performance appraisal and allocation plan based on the holistic nursing mode, and the clinical effect in mobilizing nursing staff's work enthusiasm and ensuring the quality of nursing service. Methods The nurse performance appraisal and allocation plan were further improved based on the previous research of this index system construction. The model were implemented in 32 clinical departments of Yidu Center Hospital of Weifang City. Four aspects data were collected for analysis six months later to evaluate the effect. They were nurses on merit pay distribution satisfaction, patients′satisfaction, doctors′satisfaction with nursing job, different clinical departments′nursing quality scores. Results Six months later, four factor scores of nurses to the satisfaction of merit pay distribution were significantly improved. The scores of fairness and impartiality evaluation of the merit pay distribution, incentive effect evaluation, pay and return on equity evaluation and performance pay gap rationality evaluation were higher than before [(3.39 ±0.64) points vs. (1.88 ±0.33) points, (3.28 ±0.74) points vs. (1.84 ±0.49) points , (3.28 ±0.71) points vs. (1.88 ±0.42) points and (3.38 ±0.67) points vs. (2.01±0.53) points, t=19.28, 16.22, 18.08, 16.79, all P<0.05]. Patients′satisfaction, doctors′satisfaction with nursing job and different clinical department' nursing quality scores were significantly increased as well [(99.14±0.82) points vs. (96.78±0.84) points, (96.59±0.91) points vs. (93.59±1.27) points and(97.67±0.41) points vs. (95.70±1.13) points]. Difference had statistical significance (t=11.79, 11.63, 9.60, P<0.05). Conclusions The performance salary allocation plan can effectively improve the hospital nurses on performance salary allocation satisfaction, patients′satisfaction, doctor′s satisfaction with nursing work and the quality of nursing department, and has good incentive in arousing the work enthusiasm of nursing staff and in ensuring the quality of nursing service.

Objective To determine the risk factors for severe complications after total aortie areh replacement.Methods Patients with acute type A aortic dissection of both sexes,scheduled for elective total aortic areh replacement,were selected.According to whether or not postoperative severe complications occurred during hospitalization,the patients were divided into either postoperative severe complications group or non-postoperative severe complication group.Factors including age,gender,body mass index,preoperative complications (Marfan syndrome,hypertension and diabetes mellitus),preoperative left ventricular ejection fraetion,levels of serum N-terminal pro-brain natriuretic peptide,hemoglobin and serum alanine aminotransferase,aspartate aminotransferase and creatinine,international normalized ratio,operation time,cardiopulmonary bypass time,selective antegrade cerebral perfusion time,regional cerebral oxygen saturation (rSO2),etc.were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistie regression analysis to stratify postoperative severe complications-related risk factors for this type of patients.Results A total of 98 patients were enrolled in this study.Of the 98 patients,28 patients developed posloperative severe complications,and the incidence was 29c％.The results of logistic regression analysis showed that age＞60 yr,△rSO2-min＜80％ throughout the surgery and △rSO2-min＜80％ during hemostasis were independent risk factors for severe complications after total aortie arch replacement.Conclusion Age ＞60 yr,△rSO2-min＜80％ throughout the surgery and △rSO2-min＜80％ during hemostasis are independent risk factors for severe complications after total aortic arch replacement.

Nurses working in the department of infectious diseases are under tremendous physical and psychological pressure due to the particularity of the unit. The physical and mental status as well as working attitude of nurses are not optimistic. The nursing teams are widely unstable in hospitals. This paper reviewed studies about nurses working in department of infectious disease, aiming to better understand physical and mental health level of nurses as well as their influencing factors and intervention strategies. It can provide policy recommendations for nursing managers to further stabilize the nursing team. At the same time, this paper finds out the existing deficiencies and enlightenment in previous studies from the perspectives of research direction and research method, and provides references for further researches on flow factors of nurses in department of infectious diseases.

Objective To evaluate the role of transthoracic echocardiography ( T T E ) and transesophageal echocardiography( T EE) in the process of transapical mitral valve repair using a novel edge‐to‐edge device( ValveClamp) and this device′s efficacy and safety in a preliminary clinical trial . Methods Six patients with moderate to severe or severe degenerative mitral regurgitation ( DM R) confirmed by T T E and T EE were enrolled . T T E was performed pre and post procedure as well as 30 days post procedures . Related cardiac structure and hemodynamic parameters ,including mitral regurgitation area ( MRA‐max ) , vena contracta width ( VCW ) ,mitral valve effective orifice area ( M VEOA ) ,left ventricular end diastolic diameter ( LVEDD ) , left ventricular end systolic diameter ( LVESD ) , left ventricular ejection fraction ( LVEF) ,max and mean mitral valve pressure gradient ( M VPG‐max and M VPG‐mean) were recorded and evaluated in a central core laboratory . Results All the procedures were successfully performed .M RA‐max , VCW and M VEOA decreased significantly post procedures ( all P ＜ 0 .000 ) , and they remained no significant changes within 30 days post procedures ( all P ＞ 0 .05 ) . M eanwhile ,M VPG‐max and M VPG‐mean slightly increased ( all P ＜0 .01 ) and left atrial anterior‐posterior dimension attenuated 30 days post procedures( P ＜0 .05) ,but all M VPG‐mean were lower than 5 mm Hg ( 1 mm Hg＝0 .133 kPa) . T here were no significant changes in other hemodynamic parameters ( all P ＞ 0 .05) . Conclusions T ransapical mitral valve repair using ValveClamp can be performed safely and a significant reduction in mitral regurgitation can be achieved in patients with DM R . T EE and T T E facilitate the patient selection for ValveClamp procedures as well as perioperative navigation and assessment .

Objective? To anaLyze the infLuencing factors of stress hypergLycemia in patients undergoing surgery for non-diabetic Standard Type A aortic dissection and to expLore the methods of its monitoring and management. Methods? TotaLLy 100 patients with non-diabetic Standard Type A aortic dissection admitted in the Department of Cardiac Surgery, Zhongshan HospitaL were retrospectiveLy incLuded. Their generaL information incLuding age, gender, body mass index (BMI), pain score, operation time and time of circuLatory arrest as weLL as morning fasting bLood-gLucose (FBG) before operation, before extracorporeaL circuLation, before and after circuLatory arrest, after rewarming, after machine haLt, at ICU admission and on 1 - 6 day postoperativeLy was coLLected. Univariate anaLysis and Logistic regression anaLysis were used to expLore the factors affecting the peak bLood-gLucose perioperativeLy. ResuLts? The area under the ROC curve for perioperative bLood-gLucose and overaLL adverse outcome was 0.646 (95%CI 0.528-0.763,P=0.021), and the comparativeLy good cutoff vaLue of perioperative peak bLood-gLucose for the disease was 14.35. The patients' bLood-gLucose started to rise after extracorporeaL circuLation, and the tendency to rise was more significant after rewarming. Their bLood-gLucose remained at a reLativeLy high LeveL at ICU admission. It tended to decrease since 24 h postoperativeLy, and it returned to normaL LeveLs at 6 d post operation. Univariate anaLysis showed that there was statisticaL difference in BMI, white bLood ceLL, C-reactive protein (CRP), time of extracorporeaL circuLation, Acute PhysioLogy and Chronic HeaLth EvaLuation Scoring System (APACHEⅡ) and whether emergency surgery received between the patients with ≥14.35 mmoL/L or ＜14.35mmoL/L bLood-gLucose perioperativeLy (P＜0.05). According to Logistic regression anaLysis, BMI, CRP and time of extracorporeaL circuLation were independent risk factors of stress hypergLycemia in patients undergoing surgery for non-diabetic Standard Type A aortic dissection (OR＞1). ConcLusions? Severe infLammatory response and high BMI preoperativeLy indicate that stress hypergLycemia may occur in patients undergoing surgery for non-diabetic Standard Type A aortic dissection during the perioperative period. Perioperative hypergLycemia can be reduced by reducing the time of extracorporeaL circuLation. MedicaL and nursing workers need to enhance gLycemic monitoring in the process of extracorporeaL circuLation, after rewarming and post operation and deveLop targeted gLycemic management protocoLs for the patients.

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.

Tricuspid regurgitation (TR) interventions are under rapid development. The K-Clip? system is the first domestic transcatheter tricuspid annuloplasty system with unique clamping procedure to achieve annular reduction.Intraoperative echocardiographic monitoring procedures for transcatheter tricuspid annuloplasty have not been reported yet in China. Thus, this review aimed to propose the standard two-dimensional and three-dimensional transesophageal echocardiographic workplanes and procedures to guide and monitor the implantation of K-Clip system based on our experience in Zhongshan Hospital, Fudan University to provide a reference point for the intraoperative echocardiographic monitoring of future transcatheter tricuspid annuloplasty devices in China.