Based on the conception analysis of the organizational change leadership of the upper-and mid-level nursing manager,this review described connovations of the organizational change leadership and its applications in nursing field at home and abroad,and pointed out the current research status,limitations and the inspirations we got,so as to provide references for promotion and evaluation of the upper-and midlevel nursing manager's organizational change leadership.

Objective To analyze the optimal scales of secondary public hospitals so as to optimize the expansion of public hospitals.Methods Forty-six secondary public general hospitals in Beijing were selected as the sample,with input and output indicators pinpointed,for analysis of the status of economic return to scale of such hospitals from 1996 to 2012,and identification of inflexion points of the returns to scale.These efforts will help find an optimal scale of such hospitals.Resalts The period from 1996 to 2012 found the general effectiveness of such hospitals in a decline.In 2012,only 4 of the 46 hospitals were in DEA effectiveness status,and the other 42 hospitals were not; Forty-three inflexion points were identified.This study found that the strict control standards for secondary public general hospitals in Beijing were 298 beds and 585 staffs; the flexible control standards were 421 beds and 807 staffs.Conclclsion The optimal scales for secondary public hospitals were drown from the analysis,for references of other regions in China.The hospitals should prioritize resources efficiency instead of scale expansion.

OBJECTIVETo evaluate the effect of lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle.

METHODSFrom May 2009 to October 2013,12 patients with soft tissue defects combined with tendon and bone exposure in the foot and ankle were treated by lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle, including 9 males and 3 females with an average age of 37.5 years old ranging from 19 to 58 years. Ten cases had the soft tissue defects in the dorsum of foot and 2 in the ankle. The defect area of soft tissue was from 11 cm x 9 cm to 8 cm x 5 cm.

RESULTSTwelve patients were follow-up for 3 to 12 months (averaged 7.3 months). The flaps of 9 cases were survived,the flaps edges of the other 3 cases were necrosis,and healed after dressing change. The flaps were slightly swelling without ulcer occurrence.

CONCLUSIONLateral supramalleolar artery descending branch antidromic flap can repairing the damage by one-stage operation with advantage of dissection easy,rich blood supply without sacrifice of major artery.

Adult ; Ankle ; blood supply ; surgery ; Arteries ; surgery ; Female ; Foot ; blood supply ; surgery ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Young Adult

Objective To analyze the effect of quality of life (QOL) on the prognosis of long-term survivors with nasopharyngeal carcinoma (NPC). Methods A total of 192 NPC patients treated between 1999 and 2000 and with tumor-free survival before July 2003 were enrolled in this study. All patients received QOL measurement between July and August in 2003. Measurement scales included Chinese SF-36 questionnaire and a checklist consisting of fourteen items about self-rating symptoms. The median follow-up time was 7.9S years (range 2.67-9.55 years). The effects of QOL, social demographic and clinical factors on prognosis were analyzed. Results Univariate analysis showed that QOL affected the tumor-free survival and overall survival. Multivariate analysis showed that hypomnesia was an independent prognostic factor of tumor-free survival, while trismus, headache and age were independent prognostic factors of overall survival. The younger and the better QOL had better prognosis. The other sociodemographic and clinical factors had no prognostic value. Conclusion QOL is an important factor affecting the prognosis of long-term survivors with NPC, and it should be routinely evaluated during the follow-up.

OBJECTIVETo explore the relationship between the insertion/deletion (I/D) polymorphism of angiotensin converting enzyme (ACE), and blood stasis syndrome (BSS) in patients with coronary heart disease (CHD).

METHODSThe ACE gene type in 48 patients of CHD of BSS type, 52 CHD patients of non-BSS type and 54 healthy subjects (control) was determined by PCR assay, also levels of endothelin (ET), angiotensin II (Ag II), and nitric oxide (NO) were determined.

RESULTSOccurrence of DD genotype and allele genotype of ACE gene was higher in patients of BSS than that in patients of non-BSS and control (P < 0.01). ET/NO level was higher in patients of BSS than that in control (P < 0.01). ET and Ag II levels in patients of BSS were significantly higher than those in patients of non-BSS (P < 0.05) and control (P < 0.01). Levels of ET/NO and Ag II in subjects with DD genotype in various groups were higher than those in subjects with Ag II or ID genotype, the highest level occurred in patients of BSS with DD genotype, when compared with the other two groups, the difference in Ag II was significant (P < 0.05 and P < 0.01), when compared with control, the difference in ET/NO was significant (P < 0.01).

CONCLUSIONDD genotype of ACE gene may be the susceptible gene of CHD in patients of BSS type.

Aged ; Alleles ; Angina Pectoris ; genetics ; Angiotensin II ; blood ; Coronary Artery Disease ; genetics ; Diagnosis, Differential ; Endothelins ; blood ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nitric Oxide ; blood ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic

Objective:To evaluate the effect of lateral supramalleolar artery descending branch antidromic flap for the re-pair of soft tissue defects in the foot and ankle. Methods:From May 2009 to October 2013,12 patients with soft tissue defects combined with tendon and bone exposure in the foot and ankle were treated by lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle ,including 9 males and 3 females with an average age of 37.5 years old ranging from 19 to 58 years. Ten cases had the soft tissue defects in the dorsum of foot and 2 in the ankle. The defect area of soft tissue was from 11 cm×9 cm to 8 cm×5 cm. Results:Twelve patients were follow up for 3 to 12 months(aver-aged 7.3 months). The flaps of 9 cases were survived,the flaps edges of the other 3 cases were necrosis,and healed after dress-ing change. The flaps were slightly swelling without ulcer occurrence. Conclusion:Lateral supramalleolar artery descending branch antidromic flap can repairing the damage by one stage operation with advantage of dissection easy ,rich blood supply without sacrifice of major artery.

OBJECTIVETo observe the effect on intervention of sub-health with pestle needle (Chuzhen).

METHODRandomized controlled trail was adopted for this research. One hundred and fifty-three cases were randomly divided into two groups of a Chuzhen group (79 cases) and a massage group (74 cases). Acupoint of Bazhen (Baihui Bazhen, Shendao Bazhen, Zhiyang Bazhen, Mingmen Bazhen, Yaoyangguan Bazhen), Hechelu on the head, the neck and the lumbar area were adopted in Chuzhen group. While regular whole-body massage was applied in the massage group. The human sub-health score, the cornell medical index (CMI) and thermal texture maps system (TTM) technology of the two groups before and after the intervention were observed.

RESULTS1) After treatment, sub-health condition score, the CMI score, the M-R score and the TTM index were all increased in both groups (all P<0.01) 2) Comparison of D-value of the two groups before and after the intervention: the level of the sub-health score, the total score of CMI, and the index of sleep, pressure, Governor Vessel, Hukou (first web), blood lipid, viscosity of blood, microcirculation of TTM index of the Chuzhen group changed more obvious (all P<0.01), but there was no statistic significances in the M-R score and blood sugar of the TTM (both P>0.05). 3) The sub-health condition score in Chuzhen group was higher than that in the massage group (P<0.01).

CONCLUSIONChuzhen therapy has definite effect on intervention of sub-health, which is better than regular general massage.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Cornell Medical Index ; Female ; Humans ; Male ; Massage ; Middle Aged ; Young Adult

Objective To identify the surface electromyographic (sEMG) characteristics of bilateral stemocleidomastoid muscles in infants with congenital muscular torticollis (CMT) after rehabilitation.Methods One hundred and twenty two infants were enrolled from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2013 and December 2015,including 63 cases receiving rehabilitation (treatment group) and 59 cases without rehabilitation (control group).The sEMG parameters of bilateral sternocleidomastoid muscles in cervical neutral,left and right rotation and stretching posture in the supine position were retrospectively collected before and after treatment/follow-up;and the root mean square (RMS) was analyzed.Results Before treatment,the RMS values of the affected side in cervical neutral position,cervical rotation and stretching posture were significantly lower than those of the unaffected side in both groups(t=15.758 and 11.950,4.871 and 4.746,4.142 and 4.318,P＜0.01).In the follow-up for control group,the RMS values of the affected side in cervical neutral position,cervical rotation and stretching posture were significantly lower than those of the unaffected side (t=10.692,2.198 and 3.239;P＜0.01,=0.03 and ＜0.01).In the treatment group there were no significant differences in the RMS values in cervical neutral position,cervical rotation and stretching posture between affected side and unaffected side after treatment(t=1.647,1.090 and 0.136,P=0.10,0.28 and 0.89).Conclusion Rehabilitation reduces the difference of the RMS values between the affected and unaffected sternocleidomastoid muscles in infants with CMT.

OBJECTIVETo study the expression of peptidyl-prolyl cis/trans isomerase (PPIase or Pin1) in malignant hematopoietic cells and its relation with cell cycle.

METHODSRealtime quantitative PCR with fluorescence probe hybridization was used to measure expression of Pin1 mRNA in malignant hematopoietic cell lines and normal mononuclear cells separated from bone marrow. HeLa cells were blocked with Thymidine and Nocodazole in different cell phases and then the expression of Pin1 mRNA and protein were detected by realtime-PCR and immunoblotting.

RESULTSThe expression of Pin1 in malignant hematopoietic cell lines was significantly higher than that in normal controls (0.339 +/-0.093 compared with 0.038 +/-0.005, P<0.01). Its expression in myeloid malignant hematopoietic cell lines was significantly higher than that in normal controls (0.388 +/-0.115 compared with 0.038 +/-0.005, P<0.01) and so was the malignant lymphocytic cell lines (0.226 +/-0.166 compared with 0.038 +/-0.005, P<0.01). The expression of Pin1 was closely correlated with cell cycle. It was the highest in G1 phase and the lowest in S phase (110.762 +/-16.737 compared with 4.080 +/-0.634, P<0.01).

CONCLUSIONPin1 is overexpressed in malignant hematopoietic cell lines and its expression is different during cell cycle that is highest in G1 phase and lowest in S phase.

Cell Cycle ; physiology ; G1 Phase ; Humans ; Leukemia, Lymphoid ; enzymology ; pathology ; Leukemia, Myeloid ; enzymology ; pathology ; Peptidylprolyl Isomerase ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; S Phase ; Tumor Cells, Cultured