Based on the theory of organizational performance appraisal and the needs of developing China's hospital performance assessment system, the paper proposed the concept and emphasized the significance of establishing a comparative hospital performance assessment system in China. By sharing identical experiences from overseas, the paper also advocates that as China is building its comparative hospital performance assessment framework, it is imperative to verify the comparability of hospital performance assessment indicators, build a quality-centered comparative model for hospital performance assessment, and a three-tier comparative model to cover hospitals, departments and posts. These efforts will further improve China's performance assessment system.

Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia.Methods PubMed,EMBASE,Cochrane Library,and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia.The modified Jadad scale was used for quality assessment.Evaluation indexes included VAS scores at 1,6,12 and 24 h after operation,consumption of morphine within 24 h after operation,and incidences of nausea and vomiting after operation.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.2 software.Results Fourteen randomized placebo-controlled trials involving 1086 patients were included in our meta-analysis.The modified Jadad scale scores for the 14 studies were ≥ 4.The patients were divided into 2 groups:placebo group and parecoxib sodium 40 mg injected before operation group.The results of meta-analysis showed that VAS scores at 1,6,12 and 24 h after operation were significantly decreased,the consumption of morphine within 24 h after operation was reduced,and the incidences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group (P ＜ 0.05).Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.

Objective To evaluate the clinic application effects of laparoscopy in the diagnosis and treatment of abdominal difficult and complicated diseases.Methods The clinical data of 64 cases of agnogenic abdominal diseases underwent laparoscopic exploration and biopsies were retrospectively analyzed.All the patients were difficult cases to diagnose,who have one or more clinical situations,such as abdominal pain,ascites of unknown origin,abdominal mass and intestinal obstruction,and obscure hemorrhage of small intestine.Results Definite diagnosis was made in 62 patients after laparoscopy (96.9％).In patients with ascites,abdominal mass,intestinal obstruction and hemorrhage of small intestine,the definite diagnostic rate were 93.3％,100.0％,100.0％ and 6/6,respectively.The complication rate of laparoscopic exploration was 1.6％ (1/64).Underwent laparoscopic exploration,14 of 64 cases (22％) were treated by operation.Among them,8 cases (8/14) were treated by therapeutic laparoscopy,and other 6 cases (6/14) were treated by abdominal surgery without any comliactions.Conclusion Laparoscopic exploration is safe and effective in diagnosis and treatment of abdominal difficult and complicated diseases.

In order to train higher vocational nursing talents with strong theoretical knowledge,practical ability and humanistic quality,Kunming health Career Academy specially has developed clinical nursing comprehensive training course.Focusing on the training of students' occupation ability and the employment orientation,this course introduces multi-station concept,design and arrange the site teaching content,uses rich teaching methods and practices scientific and strict assessment,and especially it puts forward and implements intensive training t of site teaching before the practice of nursing students.Finally,the graduation test scores between the students who studied the course and the previous students who didn't are compared and analyzed.The result shows that the teaching of this course has obviously improved the theory,skill level and humanistic quality of nursing students in our hospital.

Objective The aim of this study is to evaluate the accuracy of EUS in rectal cancer restaging after neoadjuvant therapy. Methods EUS staging was performed after neoadjuvant therapy in 61 patients who were diagnosed as having local advanced rectal cancer. All patients underwent subsequent surgi-cal resection and complete pathologic staging. Results Compared with pathological staging, the total accura-cy of post-therapy EUS T-staging was 59.0% (36/61). The T-overstaging rate was 36.1% (22/61) and un-derstaging rate was 4.9% (3/61). Accuracy of EUS N-staging was 68.9% (42/61), N-overstaging and un-derstaging rates were 14.7% (9/61) and 16.4% (10/61), respectively. Conclusion The accuracy of EUS restaging for rectal cancer after neoadjuvant therapy is relatively low.

Objective To investigate the inhibitive effect of siRNA(small interfering RNA,siRNA) on the phosphodiesterase type 5(PDE5) in smooth muscle cells of human corpus cavernosum,and provide experimental groundwork for the gene therapy of erectile dysfunction (ED). Methods Small interfering RNAs targeting PDE5 gene were systhesized by using web design software provided by Ambion,there siRNAs and control siRNA were systhesized by Ambion. SiRNAs were transfected into smooth muscle cells of human corpus cavernosum by using siPORTTM Lipid reagent;down-regulation of PDE5 mRNA was detected by RT-PCR;the inhibitive effect of PDE5 was detected by Western Blotting. Results The results of RT-PCR indicated siRNA1、siRNA2 and siRNA3 made down-regulations of PDE5 mRNA expression in the transfected groups 58.2%、14.9% and 11.8%;the PDE5 expression decreased 70.5%、19.8% and 17.3%;however the expression did not have different in control siRNA and frank group. Conclusions The synthesized siRNAs in vitro were able to down-regulate the expression of PDE5.There were different capabilities of the specific siRNAs down-regulation.It was suggested that the siRNA technique provide not only an extremely powerful tool for the functional analysis of genome but also a new method for ED gene therapy.

Objective To evaluate the characteristics of abdominal aorta wall motion in different stages of rats atherosclerosis with velocity vector imaging (VVI) technique. Methods Twenty-four healthy SD rats were on high-fat feeding after one week ordinary diet. Abdominal aortic intima-media thickness (IMT), end-systolic blood vessel diameter (Ds), peak systolic velocity (Vs), resistance index (RI), pulsatility index (PI) were measured before and at the end of 8th and 12nd week. Artery wall peak velocity (V_(max)), maximum tangential strain (S_(max)) and the maximum tangential strain rate (SR_(max)) were caculated with VVI. Results Abdominal aortic intima was rough and a small amount of foam cells were found under the light microscope at the end of 8 weeks of high-fat feeding. The values of Smax and SRmax measured at the end of 8th week of high-fat feeding decreased significantly than those of before high-fat feeding (P<0.05). At the end of 12nd week, abdominal aortic intimal was thicker and atherosclerotic plaque appeared somewhere. There were significant differences in artery IMT, Ds, Vs, RI, PI between before and the end of 2nd week of high-fat feeding (P<0.05);the values of V_(max), S_(max), SR_(max) decreased significantly than those of before and at the end of 8th week of high-fat feeding (P<0.05). Conclusion VVI can quantitatively evaluate the vessel wall elasticity in different stage of arteriosclerosis rats.

Objective To observe the effectiveness of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.Methods Seventy patients (17 males,53 females,aged 20-65 years,ASA grade Ⅰ or Ⅱ) undergoing laparoscopic cholecystectomy were randomized to receive either dexmedetomidine (group R,n=35) or dexamethasone (group D,n=35).The patients in the group R received 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine before intubation.The patients in the group D received 8 mg dexamethasone before intubation.The BP and HR were recorded at the following points: on arrival in the operating room (T1),before intubation (T2),5 minutes after intubation (T3),5 minutes after the beginning of the operation (T4),30 minutes after the beginning of the operation (T5),at the end of operation (T6) and 5 minutes after extubation (T7).The inhaling concentration of sevoflurane,extubation time,operation time and anesthesia time were recorded.The incidence of nausea and vomiting were recorded at 8,24,48 hours after operation.Results The incidence of nausea and vomiting at each point were similar between two groups.The HR at T2-T7 in group D was significantly lower.But MAP was similar between two groups.Conclusion 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy,similar to dexamethasone.

A new type of gastric electrical stimulator (GES) was introduced. After the stimulator was implanted in beagle dogs, its stimulating effects and the pathological changes at the implant site were observed to study the safety and efficacy of stimulator as well as the tissue compatibility of the materials used. The results showed that, this type of stimulator was safe and capable of inhibiting food intake of the dogs, and that the materials used had good tissue compatibility.
Animals ; Dogs ; Electric Stimulation ; instrumentation ; methods ; Electrodes, Implanted ; Female ; Histocompatibility ; Stomach ; physiology

OBJECTIVE: To identify the newborns who should receive hearing evaluation by hearing screening in high risk newborns; to find and confirm the high risk factors of hearing disorders in high risk newborns. METHOD: The first screening was performed by DPOAE. Newborns did not passed the first screening undertook second screening using DPOAE + ABR. and newborns did not passed the second screening received hearing evaluation. High risk factors of hearing loss were found by Logistic regression analysis. RESULT: Three hundred and twenty-seven cases were screened. The positive ratio in first screening was 37.0%. The positive ratio in second screening was 11.0%. Ten cases were diagnosed as hearing loss and the incidence of hearing loss was 3.39%. High risk factors of hearing loss were asphyxiation, very low born weight (<1,500 g) and head and neck abnormality. CONCLUSION (1) DPOAE combined with ABR is credible and feasible in hearing screening of high risk newborns. (2) High risk factors of hearing loss were asphyxiation, very low born weight (<1,500 g) and head and neck abnormality in this study.
Female ; Hearing Disorders ; diagnosis ; epidemiology ; prevention & control ; Hearing Loss ; diagnosis ; epidemiology ; prevention & control ; Hearing Tests ; Humans ; Incidence ; Infant, Newborn ; Male ; Neonatal Screening ; Risk Factors