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

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

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 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

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

Taiwan is aging fast, and so are neighborhood countries in eastern Asia. The rapid demographic transition triggers the need of developing elder-friendly health care system. However, developing geriatric services in eastern Asia was not as successful as western countries due to various reasons. In Taiwan, the development of geriatric services has been highly supported by the Veteran Affairs Commission in the past few years. Outpatient and inpatient geriatric services, as well as the post-acute care services have been successfully developed. The success of developing geriatric services in Taiwan was related to the development of geriatric specialty training program, which provided well-trained geriatricians for institutes to start new services. The success of specialty training programs also extended into clinical geriatric researches, especially the health service researches that proved the clinical benefits of outpatient, inpatient, post-acute and long-term care services with active participation of geriatricians. This review summarized the development of geriatric services and clinical geriatric researches in Taiwan in recent years.
Academies and Institutes ; Aged ; Aging ; Delivery of Health Care ; Far East ; Geriatrics ; Health Services ; Humans ; Inpatients ; Long-Term Care ; Outpatients ; Population Dynamics ; Residence Characteristics ; Taiwan ; Veterans

OBJECTIVETo repair cartilage defects at non-weight-bearing area of the femoral condyle in rabbits with invitro amplified cartilage cell using calcium alginate column scaffold combined with calcium alginate gel injection, and to study repair effects of combination with different form of the same material.

METHODSTwenty-four New Zealand rabbits were divided into 4 groups randomly. The wounds of rabbits in the Group 1 were repaired with injection of calcium alginate gel; the wounds of rabbits in the Group 2 were repaired with in planting of calcium alginate column scaffold; the wounds of rabbits in the Group 3 were repaired with in planting of calcium alginate column supporter firstly, and then injection of calcium alginate gel at the surrounding; and Group 4 is control group, the rabbits in the group were repair and without any support. The repair effects were demonstrated with Xij, and the effects of all animals were studied with statistical analysis.

RESULTSThe Xij scores of each rabbits were calculated, and the scores in four groups were compared. The statistical results showed that combination therapy was better than other methods (F = 69.0, P < 0.05).

CONCLUSIONThe calcium alginate with column shape has better shaping effects and certain mechanical strength. The calcium alginate gel has better stick nature and can be used to integrate artifical material with normal structure. They can be used together, which meeting the desire of repair and integration in cartilaginous tissue engineering.

Alginates ; administration & dosage ; Animals ; Cartilage, Articular ; pathology ; surgery ; Collagen Type II ; analysis ; Female ; Gels ; Glucuronic Acid ; administration & dosage ; Hexuronic Acids ; administration & dosage ; Immunohistochemistry ; Knee Joint ; pathology ; surgery ; Male ; Rabbits ; Tissue Engineering

OBJECTIVEThe purpose of this study is to comprehensively explore the risk factors of primary open angle glaucoma (POAG) in China.

METHODSTwo groups of data based on distinct resources were analyzed to explore the risk factors of POAG. One group of data was based on hospital records between 1995 and 2000 which composed of 107 patients with POAG and 149 controls without POAG. The other group of data was based on 40 patients with POAG and 120 matched controls without POAG. The former was designed by non-matched case control study, the latter was done by 1:3 matched case control study. The relationships between POAG and the factors such as age, sex, family history, diabetes, hypertension, intraocular pressure (IOP), cardiovascular diseases, smoking, drinking and mutation of TIGR gene were studied by logistic regression analysis.

RESULTSThe simple factor analysis showed that the risk of POAG was related to age, family history, hypertension, IOP, cardiovascular diseases, smoking, drinking and the mutation of TIGR gene (T353I). However, logistic regression analysis confirmed that POAG mainly related to IOP, family history, hypertension, smoking, alcohol intake and the mutation of TIGR gene.

CONCLUSIONThe most important risk factor of POAG was IOP. Family history, hypertension, smoking and the mutation of TIGR gene were also important risk factors of POAG. However, alcohol intake was a protective factor for POAG.

Adolescent ; Adult ; Age Factors ; Aged ; Alcohol Drinking ; adverse effects ; Case-Control Studies ; China ; epidemiology ; Cytoskeletal Proteins ; Eye Proteins ; genetics ; Female ; Glaucoma, Open-Angle ; epidemiology ; genetics ; Glycoproteins ; genetics ; Humans ; Male ; Middle Aged ; Risk Factors ; Smoking ; adverse effects