The performance appraisal system of medical institutions serves as the cornerstone for hospital management. Thanks to the grow-th of information technology, information platform has grown into an indispensable tool for performance appraisal in hospitals as well. This paper focuses on the design and application of such a platform for performance appraisal, as well as the innovations on the appraisal contents and forms, setup and control methods for appraisal indicators, and the achievements made with such a platform.

ObjectiveTo investigate the condition of hospital staff in surgery and internal medicine department in a specified hospital for consent of patients. MethodsThis study included 50 hospital staff in surgery and internal medicine department in specified hospital at the second level in Chongqing city in May 2010. We also analyzed the dealership of children and psychopath, consent of patients or relatives for choosing hospitals. ResultsThe ratios of cognition of hospital staff for consent of patients were 68％ and 46％, which had statistical difference ( P＝0.026 ). The main ways were radio and television. About 97％ hospital staff knew that it's hospital staff s duty to inform relative information to patients. ConclusionMedical legislation department and medical institutions should enhance the study of hospital staff on relative laws and regulations. Thus hospital staff have a in-depth understanding on information of consent of patients.

Objective To evaluate the role of extracellular signal-regulated protein kinase 5 (ERK5) in the spinal cord in withdrawal responses in morphine-dependent rats.Methods Ninety-six adult male SpragueDawley rats in which intrathecal catheters were successfully placed,weighing 200-250 g,were randomly divided into 4 groups (n =24 each) using a random number table:normal saline group (group A),withdrawal group (group B),dimethyl sulfoxide (DMSO) group (group C) and ERK5 inhibitor BIX02188 group (group D).Morphine dependence (MD) was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg once a day and was increased by 10 mg/kg once a day from the 2nd to 5th days until 50 mg/kg on the 6th day in B,C and D groups.Morphine withdrawal response (MW) was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in B,C and D groups.In addition,BIX02188 and 1％ DMSO 10 μl were injected intrathecally at 1 h before naloxone injection in D and C groups,respectively.MW and morphine withdrawal-induced hypemlgesia were scored.The rats were then sacrificed after hyperalgesia was scored and the spinal cord was removed for determination of ERK5 and phosphorylated ERK5 (p-ERK5) expression.Results Compared with group A,MW and hyperalgesia scores were significantly increased and the expression of pERK5 was up-regulated in B,C and D groups (P ＜ 0.05).Compared with group B,MW and hyperalgesia scores were significantly decreased and the expression of p-ERK5 was down-regulated in D group (P ＜ 0.05),and no significant change was found in group C (P ＞ 0.05).Conclusion ERK5 in the spinal cord is involved in withdrawal responses in morphine-dependent rats.

Objective To investigate the roles of spinal extracellular signal-regulated protein kinases 5 (ERK5) on morphine withdrawal in rats.Methods Ninety-six male and adult SD rats weighting 230-250 g were randomly divided into saline-naloxone-DMSO group (group A),saline-naloxone-BIX02188 group (group B),morphine-naloxone-DMSO group (group C) and morphine-naloxone-BIX02188 group (group D).To set up morphine dependent model,rats were subcutaneously injected with morphine in the increasing dosage method.On day 6,4 h after the injection of morphine,rats were injected with naloxone (intraperitoneal) to precipitate morphine withdrawal syndrome.The scores of morphine withdrawal symptom and morphine withdrawal-induced allodynia were observed after intrathecal injection of ERK5 inhibitor BIX02188.Result There were not withdrawal symptoms and withdrawal-induced allodynia in group A and B after intraperitoneal injection of naloxone.Compared with group A,teeth chatting (7.5± 1.1),wet dog shacks (4.6± 0.7),jump (5.3± 0.7),abnormal position (8.9± 1.9),diarrhea (7.1 ± 1.6),salivation (2.8±0.6),weight loss (7.9±0.9),total withdrawal score (44.8±5.9),score of withdrawalinduced allodynia (14.6±2.4) of group C and teeth chatting (3.1±0.5),wet dog shacks (1.5±0.4),jump (2.2± 0.5),abnormal position (7.9± 1.6),diarrhea (1.8±0.5),salivation (2.8±0.9),weight loss (3.7±0.6),total withdrawal score (23.1± 1.3) and score of withdrawal-induced allodynia (3.5± 1.1) of group D were significantly increased (P＜0.05).Compared with group C,teeth chatting (3.1±0.5),wet dog shacks (1.5±0.4),jump (2.2±0.5),diarrhea (1.8±0.5),weigbt loss (3.7±0.6) and total withdirawal score (23.1±1.3),score of withdrawal-induced allodynia (3.5±1.1) of group D were significantly decreased (P＜0.05).But there was not significant change in abnoral position (7.9±1.6) and salivation (2.8±0.9).Conclusion Inhibition of the activation of spinal cord ERK5 can significantly alleviate withdrawal symptoms of morphine dependent rats by intrathecal injection BIX02188.

Objective To evaluate the changes in the activity of extracellular signal-regulated kinase 5 (ERK5) in the distal cerebrospinal fluid contacting neurons (CSF-CNs) in the mid-brain of morphine dependent rats.Methods Forty-eight male adult Sprague-Dawley rats weighing 230-270 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group A) and morphine dependence group (group B).Morphine dependence was induced by increasing doses of subautaneous morphine for 5 consecutive days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg everyday until 50 mg/kg on 5th dav.The equal volume of normal saline was injected subcutaneously instead of morphine in group A.On 3rd day after morphine dependence was induced,the distal CSF-CNs in the mid-brain was labeled with 30％ cholera toxin subunit B and horseradish peroxidase compound (CB-HRP) 3 μl injected in the lateral cerebral ventricle in the morning.At 4 h after the last injection of morphine,the segments in which CSF-CNs were located were removed,and CB-HRP positive neurons,phosphor-ERK5 (p-ERK5) positive neurons and CB-HRP/p-ERK5 positive neurons were counted.Results Compared with group A,the number of p-ERK5 and CB-HRP/p-ERK5 positive neurons in the mid-brain was significantly increased (P ＜ 0.05),and no significant change was found in CB-HRP positive neurons in group B (P ＞ 0.05).Conclusion The enhanced activity of ERK5 in the distal CSFCNs in the mid-brain may contribute to the development of morphine dependence in rats.

Objective To report a case of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) combined with idiopathic intracranial hypertension (IIH) and review the relationship between the IIH and OSA. Methods A case of increased intracranial pressure in a middle-aged male patient who was diagnosed as IIH after the MRI and angiography ruled out intracranial lesions was reported. This patient presented with drowsiness, obesity and other symptoms. An overnight polysomnography (PSG) confirmed severe OSA. The simple use of intracranial pressure lowering therapy could not achieve sustained effective control of symptoms of high intracranial pressure. The clinical effects of comprehensive treatment for the OSA including CPAP and weight loss were observed. Results After 3 months treatment, the body mass index of this patient dropped from 35.7 to 31.4, apnea hypopnea index dropped from 72.6 to 10. 1, and the minimum SaO2 increased from 67% to 82%. And the symptoms of high intracranial pressure including headache and papillaedema were continuously improved. Conclusion Sleep apnea is a risk factor for IIH, especially for obese male patients. PSG monitoring could help us to find the important but easily overlooked factor of OSA. Taking active measures to treat OSA can effectively relieve the high intracranial pressure symptoms in patients with IIH.

Items of design and signature from clinical trial drugs were made , the occurrence ratio of every item in 2265 informed consent form ( ICF) from 63 clinical trial drugs in Beijing Youan Hospital affiliated to Capital U-niversity of Medical Sciences were analyzed , and items with lower occurrence ratio were explored .Generally , the design and signature of ICF met the requirement of GCP .However , there were some defects of ICF and antonym of signature .Based on the analysis on the problems , some measures were put forward:formulate relevant standard op-erating procedures , strengthening the management of informed consent , and strengthen the system construction and education training , promote the hospital ethics construction , to protect the rights and interests of the subjects .

Objective To analyse the secondary structure of glutathions S-transferase of Echinoccocus granulosus(EgGST)and predict the B cell and T cell epitopes with informatics tools,in order to provide basic data and references for the following design of epitope vaccine.Methods The B cell and T cell epitopes of EgGST were predicted by DNAstar,Biosun software and Propred MHC class-Ⅱ Binding Peptide Prediction Server software.Results Many distinct antigenic epitopes of EgGST were identified by comput-er,there existed 8 B cell epitopes and 7 T cell epitopes.Conclusion Analysis of predicted epitopes of EgGST antigenic might be sig-nificant for future research of epitope vaccine.

Objective To investigate the roles of spinal N-methyl-D-aspartic acid receptor-extracellular signal-regulated protein kinases 5 signaling pathway in naloxone-induced withdrawal response in morphine-dependent rats.Methods Ninety-six adult male SD rats weighting 230-250 g were randomly divided into 4 groups:control group,withdrawal group,DMSO group and MK801 group.Rats were subcutaneously injected with morphine.On day 6,rats were injected with naloxone (intraperitoneal) to precipitate morphine withdrawal syndromes.To identify the function of NMDAR-ERK5 signaling pathway in morphine withdrawal,morphine withdrawal-like behavior test and western blot technique were used in this research.The scores of morphine withdrawal symptom,morphine withdrawal-induced allodynia and the activation of ERK5 in spinal cord were observed after intrathecal injection of MK801.Results There was no withdrawal symptoms and withdrawal-induced allodynia in group A after intraperitoneal injection of naloxone.Compared with group A,withdrawal score (45.2±7.3),score of withdrawal-induced allodynia (14.4±3.7) of group B,withdrawal score (44.7±6.2),score of withdrawal-induced allodynia (13.2±2.7) of group C and withdrawal score (28.3±1.6),score of withdrawal-induced allodynia (5.9± 1.1) of group D were significantly increased (P＜ 0.05).Compared with group C,the total withdrawal score (28.3 ± 1.6),score of withdrawal-induced allodynia (5.9± 1.1) of group D were significantly decreased (P＜0.05).Compared with group A,the expression of spinal p-ERK5 of group B (12848±621) and group C (12579±396) were significantly increased (P＜0.05).Compared with group C,the expression of spinal p-ERK5 of group D (5 123±546) was significantly decreased (P＜0.05).Condusion The signaling pathway of spinal N-methyl-D-aspartic acid receptor-extracellular signal-regulated protein kinases 5 contributes to naloxone-induced withdrawal response in morphine-dependent rats.

Objective To evaluate the role of spinal neuronal extracellular signal-regulated protein kinases 5/cAMP response element binding protein (ERK5/CREB) signaling pathway in withdrawal responses in morphinedependent rats.Methods Ninety-six adult male Sprague-Dawley rats in which intrathecal catheters were successfully placed,weighing 200-250 g,were randomly divided into 4 groups (n =24 each):normal control group (group A),morphine withdrawal group (group B),dimethyl sulfoxide (DMSO) + morphine withdrawal group (group C) and ERK5 inhibitor BIX02188 + morphine withdrawal group (group D).Morphine dependence (MD) was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg once a day and was increased by 10 mg/kg once a day from 2nd to 5th days until 50 mg/kg on 6th day in B,C and D groups.Morphine withdrawal response (MW) was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in B,C and D groups.In addition,BIX02188 10 μg and 1％ DMSO 10 μl were injected intrathecally at 1 h before naloxone injection in D and C groups,respectively.MW and morphine withdrawal-induced hyperalgesia were scored.The rats were then sacrificed after hyperalgesia was scored and the spinal cord was removed for determination of CREB and phosphorylated CREB (p-CREB) expression.Results Compared with group A,MW and hyperalgesia scores were significantly increased and the expression of p-CREB was up-regulated in B,C and D groups.Compared with group B,MW and hyperalgesia scores were significantly decreased and the expression of p-CREB was down-regulated in D group,and no significant change was found in group C.Conclusion The spinal neuronal ERK5/CREB signaling pathway is involved in withdrawal responses in morphine-dependent rats.