Presented herein are the concepts and methodology for the appraisal indicator model of personal performance management in hospitals. Based on studies of mature appraisal indicator models for hospital departments and the particularity in the process of personal performance evaluation, the authors hold that the model of such an appraisal model should comprise an indicators inventory, data warehouse,indicators system, and appraisal database among others. It is also described that the evaluation process is made up of targets identification, indicators selection, weight distribution, performance implementation and data updating, on top of recommendations for building the model.

Objective To introduce the strategy of perioperative blood glucose control and the early outcome in diabetic and non-diabetic patients undergone coronary artery bypass grafting (CABG). Methods A total of 1019 CABG were performed and the patients were divided into diabetic and non-diabetic groups (n=211, 808, respectively). The demography was comparable between the two groups with the exception that the percentage of preoperative myocardial infarction was significantly higher in diabetic group than that in non-diabetic group. Off-pump and conventional CABG were routinely performed and the left internal mammary artery (IMA) and great saphenous vein (GSV) were used as conduit. Perioperative blood glucose was controlled according to the close supervision. The aim of preoperative 6mmol/L and postoperative 8mmol/L was achieved by means of oral medication or subcutaneous injection of insulin, which was complimented by continuous pump infusion of regular insulin to optimize the glucose level. Results 99.2% patients were discharged. The overall perioperative mortality was 0.8% and the percentage was 1.4% and 0.6% respectively in diabetic and non-diabetic group with significant difference(P0.05), respectively. Cerebral infarction occurred in 1.4% diabetic patients and in 0.5% non-diabetic patients(P

0.05). But there have extremely significant between the normal and abnormal groups.(P0.05) , but the stunting group was extremely significant with the other three groups (P

Humans ; Occupational Health ; Polymorphism, Single Nucleotide

Objective To investigate the expression changes of SSR in the process of cardiac remodeling.Methods Myocardial infarction (MI) was induced by left anterior descending coronary artery ligation in mice to establish cardiac remodeling model.Mice subjected to isoproterenol (ISO) subcutaneous injection for 2 weeks to establish acute cardiac injury model.Mice subjected to aortic banding (AB) to establish a mouse model of cardiac hypertrophy.RT-PCR was used to detect the expression change of SSR in various cardiac remodeling models.Results The expression levels of SSR subunit 1 (SSR1) and 3 (SSR3) were significantly decreased in mice after 2 weeks of MI (P ＜ 0.05),and were also decreased in acute cardiac injury induced by 2 weeks of ISO injection (P ＜ 0.05),and reduced afterl week of AB operation (P ＜ 0.05).However,the expression of SSR1 and SSR3 increased at 2 weeks after AB (P ＜ 0.05),and sustained to 8 wccks after AB (P ＜ 0.05).Conclusion The expression of SSR3 and SSR1 in different models of cardiac remodeling were significantly changed,and showed dynamic changes,suggesting that it may participate in the occurrence and development of cardiac remodeling.

OBJECTIVE: To determine Ginsenoside Rg1,Ginsenoside Re and Ginsenoside Rb1 in Yixin fumai granula by HPLC.METHODS: Samples were determined on a Diamond C18(150 mm?4.6 mm,5 ?m).The mobile phase consisted of accetonitrile-water by gradient elution with flow rate at 1 mL?min-1,UV detection wavelength at 203 nm,column temperature at 25 ℃ and sample size at 10 ?L.RESULTS: The linear ranges of Ginsenoside Rg1,Ginsenoside Re and Ginsenoside Rb1 were 0.645～6.450 ?g(r=0.999 8),0.54～5.40 ?g(r=0.999 7) and 0.605～6.050 ?g(r=0.999 9),respectively;the average recoveries were 100.59%(RSD=2.03%),98.70%(RSD=1.46%)and 98.99%(RSD=1.19%),respectively.CONCLUSION: The method is sensitive,simple and accurate,and it can be used for the quality control of Yixin fumai granula.

BACKGROUND: Differences of thick and thin tissues in imaging areas is great because of postero-anterior images in cervical spine-thoracic spine.Although there are many image processing functions in direct digital radiography(DR)image with big range dynamic exposing,but routine direct DR hardly reveals anatomic structure of cervical spine-thoracic spine to detect diseases.Image quality of cervical spine-thoracic spine requires improvement.OBJECTIVE: To evaluate the difference between direct DR image with tissue equalization(TE)technique and standard DR in cervical spine-thoracic spine,so as to explore the best image quality in cervical spine-thoracic spine.METHODS: A total of 200 cases were randomly selected from DR cervical thoracic image from Department of Radiology,General Hospital of Chinese PLA between April 2005 and August 2009 to evaluate the difference between these images of DR processed by tissue equalization and that of standard DR.RESULTS AND CONCLUSION: The detail images of DR with tissue equalization in different thickness area of body could be revealed clearly in the same image,while the detail images of standard DR in cervical thoracic could be revealed clearly by adjusting window width and location repeatedly.Results show that the image quality of TE technique of direct digital X-ray radiography in cervical spine-thoracic spine could be clearly improved,it could be easily read and avoid the influence of body thickness area.Moreover,it could reveal clearly other part of body in detail.DR image with TE technique in cervical spine-thoracic spine can be applied widely due to simple operation,high diagnosis rate and low cost.

Objective The aim of this study is to address learning curve and clinical outcomes of totally robotic atrial septal defect repair on the basis of a single - center experience.Methods 54 cases of atrial septal defect (ASD) were repaired using “da Vinic S surgical system on arrested ( group Ⅰ,54 cases) or beating heart ( group Ⅱ,40 cases) from January 2007 to December 2010.Learning curves were assessed by means of regression analysis with logarithmic curve fit.The effect of operative variables on clinical outcome was analyzed by linear by regression using the Spearman's rho coefficient.Results All cases were accomplished successfully without complications.No residual shunt was detected at intraoperative or postoperative echocardiography.Significant learning curves were noted for corss clamp time in group Ⅰ:y (min) =68.741 -8.283 (n) (x)( r2 =0.489 ; P ＜ 0.01 ) ; the operation time in group Ⅱ:y (min) =355.51 - 56.29 (n) (x) ( r2 =0.581 ; P ＜ 0.01 ).No correlation was detected between operation time,cardiopulmonary bypass time,or cross clamp time and intubation time,intensive care unit stay,or total length of stay.Conclusion The robotic atrial septal defect repair can be performed safely.The learning curves is steep and the longer cardiopulmonary bypass times,operation time or cross clamp time had no negative impact on intraoperative and postoperative outcome.

Objective To study the generation of metallo-β-lactamase(MBLs) and its related gene carrying situation in the clini-cal isolates of Pseudomonas aeruginosa .Methods Ceftazidime and imipenem were adopted to preliminarily screen MBLs of Pseudo-monas aeruginosa .The phenotypic confirmatory of imipenem-resistant and ceftazidime-resistant Pseudomonas aeruginosa was per-formed by using 2-mercaptopropionic acid (2-MPA) or EDTA synergy test and the MBLs genotypes of the positive strains in the preliminary screen were detected by PCR .Results The positive rate of the MBLs preliminary screen test in multi-resistant strains was 10 .9% ,and the positive rate of the MBLs in multi-resistant strains detected by CAZ/EDTA ,CAZ/2-MPA ,IMP/EDTA and IMP/2-MPA was 7 .5% ,7 .9% ,8 .8% and 9 .5% respectively .The positive rates of ipm1 and vim gene by PCR were 10 .4% and 8 .3% respectively .The strains with positive spm ,sim1 and gim were not found .Conclusion The MBLs test results detected by different methods are different ;MBLs genes carying ipm1 and vim are the main reason for carbapenem-resistant multi-drug resist-ant Pseudomonas aeruginosa in the hospital .