A brief description of performance appraisal as used in the healthcare sector, and an analysis of problems existing in performance appraisal for posts in community heahhcare organizations in the country. The paper proposes a job-analysis based performance appraisal for such posts, featuring the appraisal model of "performance + skills + attitude+ work intensity". On the basis of work analysis, a job description should be worked out for such healthcare workers as doctors, nurses and prevention workers in community healthcare organizations, aided by a targeted job-based performance appraisal system. These efforts can effectively enhance the job performance in such organizations, catering to the healthcare needs of community residents.

An analysis of the existing incentives mechanism of performance appraisal for community health service centers, and insight into the challenges for linking the post performance appraisal in community health service centers with incentive measures. It is pointed out the administrators should take a variety of measures including material incentive, target incentive, knowledge incentive, and emotional incentive among others. In addition, such measures should be used sophistically, flexibly and reasonably, while timing of incentives should meet the human resource needs of the institution, notably a combination of positive incentive with negative ones,, mostly the former incentive.

This study aimed to evaluate the feasibility and effectiveness of closing the small bowel in an ex vivo porcine model with high-frequency welding device. A total of 100 porcine small bowels were divided into two groups, and then were closed with two different methods. The fifty small bowels in experimental group were closed by the high-frequency welding device, and the other fifty small bowels in comparison group were hand-sutured. All the small bowels were subjected to leak pressure testing later on. The speed of closure and bursting pressure were compared. The 50 porcine small bowels closed by the high-frequency welding device showed a success rate of 100%. Compared with the hand-sutured group, the bursting pressures of the former were significantly lower (P<0.01) and the closing process was significantly shorter (P<0.01). The pathological changes of the closed ends mainly presented as acute thermal and pressure induced injury. Experimental results show that the high-frequency welding device has higher feasibility in closing the small bowel.
Animals ; Feasibility Studies ; Intestine, Small ; surgery ; Suture Techniques ; instrumentation ; Swine

BACKGROUND:The main component of cartilage, type Ⅱ col agen gene expression in chondrocyte is positively correlated with SOX9 concentration in a dose-dependent manner.
OBJECTIVE:To observe the variation of SOX9 and type Ⅱ col agen mRNA content at different periods in the differentiation process (osteogenic, chondrogenic, adipogenic induction) of mesenchymal stem cel s, and to explore the correlation of SOX9 expression and type Ⅱ col agen.
METHODS:Bone marrow mesenchymal stem cel s were isolated from 4-week-old Kunming mice, and cultured in vitro to passage 3. The cel phenotype was identified with flow cytometry. Cel s were divided into three groups and subjected to three kinds of induction conditions favorable for adipogenic, chondrogenic and osteogenic differentiation, and each group was observed at three time points. In addition, the non-induced cel s were used as a control group. The total RNA of cel s was extracted at 3, 7, 14 days after induction, and SOX9 and type Ⅱ col agen mRNA was quantified with reverse transcription-polymerase chain reaction. The induced cel s were stained by immunofluorescence to observe the differentiation and perform statistical analysis.
RESULTS AND CONCLUSION:Passage 3 bone marrow mesenchymal stem cel s grew wel , and cel phenotype was confirmed as stem cel s by flow cytometry. The staining results showed that, the cel s differentiated into chondrocytes, adipocytes and osteoblasts. The SOX9 mRNA levels in the induced cel s were the highest in chondrogenic differentiation group, then in osteogenic differentiation group, and the lowest in adipogenic differentiation group. Type Ⅱ col agen mRNA levels in the induced cel s were the highest in chondrogenic differentiation group, then in adipogenic differentiation group, and the lowest in osteogenic differentiation group. SOX9 expression in chondrogenic differentiation group increased at 3 and 7 days, and then decreased at 14 days. While type Ⅱ col agen expression increased at 3, 7, 14 days. SOX9 mRNA levels increased as the osteogenic differentiation, while type Ⅱ col agen expression gradual y decreased. There was no significant difference in the SOX9 mRNA expression between adipogenic differentiation group and control group (P>0.05), while type Ⅱ col agen expression was not regularly changed. Experimental findings suggest that, critical effect of SOX9 in chondrogenic differentiation is better than that in osteogenic and adipogenic differentiation. SOX9 is associated with type Ⅱcol agen, which may alter along with the SOX9 in the early chondrogenic differentiation;SOX9 may play a fine-tuning role in the process of chondrogenic and osteogenic differentiation.

AlM: To analyze personality traits in preoperative patients who undergolaser in situ keratomileusis ( LASlK) and to provide psychological basis for the selection of refractive surgery.
METHODS: Eligible patientswere seeking customized LASlK (group A n=53), conventional LASlK(group B n=75)and non-operation patients with ametropia (group C n=71 ) , who completed 16 personality factor questionnaires (16PF). Statistical analyses were performed with one-way ANOVA by SPSS11. 0 software package.
RESULTS: Compared to group C, patients in group A scored high on dominance and tension levels, and low on emotional stability level(P<0. 05), while patients in group B were more venturesome and more experimenting, but were less vigilant ( P<0. 05 ). Additionally, there were statistical differences between group A and group B on dominance, gallantry and vigilance respectively(P<0. 05). CONCLUSlON: The data indicates that personality profiles of LASlK patients with refractive error influence their decision for correction. Patients need suitable psychological assessment before surgery who actively chose customized LASlK seem to be more assertive and suspicious.

In order to reveal genetic diversity of domestic Andrographis paniculata and its impact on quality, genetic backgrounds of 103 samples from 7 provinces in China were analyzed using SRAP marker and SNP marker. Genetic structures of the A. paniculata populations were estimated with Powermarker V 3.25 and Mega 6.0 software, and polymorphic SNPs were identified with CodonCode Aligner software. The results showed that the genetic distances of domestic A. paniculata germplasm ranged from 0. 01 to 0.09, and no polymorphic SNPs were discovered in coding sequence fragments of ent-copalyl diphosphate synthase. A. paniculata germplasm from various regions in China had poor genetic diversity. This phenomenon was closely related to strict self-fertilization and earlier introduction from the same origin. Therefore, genetic background had little impact on variable qualities of A. paniculata in domestic market. Mutation breeding, polyploid breeding and molecular breeding were proposed as promising strategies in germplasm innovation.
Andrographis ; classification ; genetics ; China ; Genetic Variation ; Phylogeny ; Polymorphism, Single Nucleotide

Objective: To understand the main influencing factors of lower limb muscle strength development in children aged 3-6 in coastal areas of Guangxi, and to provide a reference for physical education and health management physical health work for children. Methods: Using stratified cluster sampling method, a total of 15 kindergarten children perform selected from Qinzhou, Beihai and Fangcheng Gang were administered physical tests, and the parents (or guardians) received a face to face questionnaire survey, Univariate analysis and multivariate linear regression analysis were used to analyze determinant factors of lower limbs explosive force. Results: The correlation analysis of the factors affecting lower limb explosive force of children aged 3-6 years showed that there were significant differences in the correlation of 13 indicators including gender, age, height, weight, birth weight and body length, gestational age, parents’ education level, parents’ age, and mother’s height and weight(P<0.05). Furthermore, multiple linear regression analysis showed that age, gender, weight, height, father’s education level and mother’s age had significant effects on lower limb explosive force of 3-6 years old infants in Guangxi coastal areas(P<0.05). Conclusion Growth and development, as well as paternal educational level plays an important role in the development of lower limb explosive force of children aged 3-6 in coastal areas of Guangxi, while weight and length at birth, parental height and weight shows no association with it.

OBJECTIVETo compare the difference between the burn wound and diabetic ulcer wound, and to preliminarily analyze the nonhealing mechanism of diabetic unclear.

METHODSThe tissue of foot ulcer of diabete patients and skin wound tissues from burn patients were harvested. The levels of (FGF)2 and VEGF in the wound tissues were determined after tissue cultivation with enzyme-linked immunosorbent assay (ELISA). The changes in micro-vascular density (MVD) were examined by immunohistochemistry. Human umbilical vein endothelial cells were cultured in medium containing different components, and divided into following groups: A (with treatment of 5 mmol/L glucose for 7 days), B (with treatment of 30 mmol/L glucose for 7 days) and C (with treatment of 30 mmol/L Mannitol for 7 days) groups, then the level of VEGF protein was determined by ELISA.

RESULTSThe levels of FGF2 and VEGF protein in the burn wound were (59 +/- 3) ng/ml and (56 +/- 7) pg/ml, respectively, which were obviously lower than those in diabetic ulcer wound [(89 +/- 6) ng/ml, (108 +/- 5) pg/ml, P < 0.05]. There was also obvious difference in MVD between two kinds of wound (P < 0.05). The level of VEGF protein in both wounds were similar after the addition of FGF2 to the cell culture in vitro, while there were statistically significant difference 2 and 5 days after removal of FGF.

CONCLUSIONThe nonhealing mechanism of diabetic ulcer wound may be related to the inhibition of vacuolation and low expression of factors controlling vessel growth.

Burns ; complications ; metabolism ; pathology ; Cells, Cultured ; Diabetic Foot ; pathology ; Fibroblast Growth Factor 2 ; metabolism ; Foot Ulcer ; etiology ; pathology ; Humans ; Neovascularization, Physiologic ; Vascular Endothelial Growth Factor A ; metabolism ; Wound Healing

OBJECTIVETo investigate the clinicopathological characteristics and prognostic factors of patients with pathological stage pN3 gastric cancer.

METHODSA retrospective study of 310 patients with histologically confirmed pN3 stage gastric cancer undergoing radical gastrectomy from January 2000 to December 2006 in our department was performed. The Kaplan-Meier method was used to analyze the survival. Log-rank test and Cox regression model were carried out for univariate and multivariate analyses.

RESULTSAll the patients were followed up for 2 to 103 (mean 35.7) months. The overall 5-year survival rate was 14.6%. There were 201 cases with stage pN3a and 109 cases with stage pN3b, and the 5-year survival rates were 16.8% and 10.3% respectively (P=0.013). Univariate analysis showed that tumor location, Borrmann type, depth of tumor invasion, surgical method, metastatic lymph node ratio, and pN stage were associated with postoperative survival (all P<0.05). The multivariate analysis revealed that depth of tumor invasion, surgical method and metastatic lymph node ratio were independent prognostic factors, while the pN stage was not. The difference of 5-year survival rate between pN3a and pN3b subgroups was significant in pT4a patients (16.1% vs. 12.8%, P=0.001), while such difference was not significant in pT4b patients (8.6% vs. 3.1%, P=0.137).

CONCLUSIONSPrognosis of patients with pN3 stage gastric cancer after radical resection is poor. Depth of tumor invasion and surgical method are independent prognostic factors for pN3 stage gastric cancer. Metastatic lymph node ratio is valuable to predict the prognosis of pN3 stage patients. The pN3 staging of the 7th UICC provides a more accurate prediction of prognosis.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVETo investigate the risk factors for the prognosis in patients with node-negative gastric cancer.

METHODSClinicopathological characteristics of 138 patients with node-negative gastric carcinoma undergoing curative gastrectomy from January 2000 to December 2005 were retrospectively analyzed.

RESULTSThe overall 5-year survival rate was 62.4%. The univariate analysis revealed that tumor size, tumor location, cell differentiation, invasive depth, operative type and Lauren histologic type had significant effects on the survival. The independent prognostic factors of these patients were tumor size, cell differentiation, and serosal involvement in multivariate analyses.

CONCLUSIONFor node-negative gastric cancer patients, tumor size, poor differentiation and serosal involvement are important markers to evaluate prognosis.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; diagnosis ; pathology ; Survival Rate