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 analyze the influence of different types of seizures and nonepileptic events on peripheral white blood cell (WBC)counts. Methods We prospectively collected blood samples from all patients and detered WBC count to evaluate the relation of each type of seizure,duration,frequencies,and ttme lapse between a seizure and collection of blood sample to peripheral WBC count. Results Peripheral WBC count was elevated in about 50% cases after a generalized seizure. The length of a seizures was positively associated, whereas its frequencies and the lapse time was negatively correlated with the increase in WBC counts. Conclusion Peripheral WBC counts increase significantly after a generalized seizure.

OBJECTIVE: To perform a Meta-analysis of all randomized controlled trials that compared the efficacy and adverse events profile of Mabs for LA HNSCC. METHOD: Several databases were searched, including CBM, PUBMED, EMBASE, and CENTRAL. Primary outcomes included overall response rate (ORR), overall survival (OS), progression-free survival (PFS). Secondary outcomes included serious adverse events, such as grade 3-4 skin reaction, dysphagia, mucositis, and nausea/vomiting. The results were expressed as relative ratio (RR) or hazard rate (HR) with their corresponding 95% CI. RESULT: The final analysis included 10 trials. The primary analyses indicated that Mabs did not improve ORR and PFS, except OS for locoregionally advanced (LA) HNSCC [ORR 1.21, 95% CI (0.97 - 1.49); PFS 0.87, 95% CI (0.75 - 1.01); OS 0.82, 95% CI (0.71 - 0.95)]. Analysis of adverse effects demonstrated that grade 3 - 4 skin reaction ERR 1.87, 95% CI (1.11 - 3.16)] was statistically significantly associated with Mabs except dysphagia ERR 0. 95, 95% CI (0.75 - 1.19)], Mucositis ERR 1.03, 95% CI (0.67 - 1.57)], and nausea/vomiting ERR 1.15, 95% CI (0.71 - 1.86)]. CONCLUSION Anti-EGFR Mabs may be satisfactory for improving OS of LA HNSCC. During the Mabs therapy, skin reaction should be much more monitored.
Antibodies, Monoclonal ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; Disease-Free Survival ; ErbB Receptors ; immunology ; Head and Neck Neoplasms ; drug therapy ; Humans ; Randomized Controlled Trials as Topic ; Squamous Cell Carcinoma of Head and Neck

Objective:To explore the relation between parental cohesion,peer acceptance and the loneliness of left-behind children,and furthermore explore the mediation role of self-esteem.Methods:Totally 427 left-behind children in Hubei Province (275 males,152 females) were surveyed,and the Parental Cohesion Scale (PCS),Peer Nomination (PN),Self-Esteem Scale (SES) and Children Loneliness Scale (CLS) were used to assess parental cohesion,peer acceptance,self-esteem and loneliness respectively.The relation between parental cohesion,peer acceptance andthe loneliness of left-behind children,and the mediation role of self-esteem wereanalyzed.Results:The CLS scores in left-behind children were negatively correlated with the scores of PCS,PN,and SES (r =-0.31,-0.37,-0.50,P ＜ 0.01),the SES scoresplayed a mediation role in the relation between PN scores and CLS scores (95 ％ CI:-7.02--0.01),and between PCS scores and CLS scores (95 ％ CI:-0.18--0.09).Furthermore,the unique effect of the PN scores on the CLS scores (sr2 =0.10) was higher than that of PCS scores (sr2 =0.06).Conclusion:The current research indicates that the loneliness,parental cohesion,peer acceptance and self-esteem of the left behind children have a close relationship.Furthermore,it suggests that self-esteem may play partial mediating effects between parental cohesion,peer acceptance and the loneliness of left-behind children.

Objective To evaluate the curative effect of sedation on broncholiths through bronchoscope with holmi-um laser. Methods From Jan.2008 to Dec. 2015, 12 cases with broncholiths through bronchoscope with holmium laser, male 7, female 5; the age from 35 to 64.12 cases visit a doctor when they cough, panting, haemoptysis and cough out stones. The predilection sites of bronchinal calculus: left main bronchus in 6, right middle bronchus in 4, main bronchus in 2. Thoracic computerized tomography was performed in 12 patients, which showed bronchial intra-luminal high-density shadow with distal bronchial stenosis, bronchiectasis, COPD, hilar calcifications, or mediastinal lymph node calcifications. Through bronchoscopy examination was performed in 12 cases, Broncholiths were found in 9 patients and granulomatous lesion wrapping hard lesions in 3 patients.12 cases were treated by using Dexmedeto-midine combined with Sufentanil for sedation through of bronchoscope with holmiun laser. Results All the operations were successful, the operation time 45~90 min, average 60 min . During the surgery, the patient have stable heart rate, oxygen saturation without falling, blood pressure is stable, stable hemodynamics, the patients did not complain of discomfort, without obvious heart and lung failure and other complications occurred, the operation without bleed-ing, pneumothorax, complications. All cases of postoperative respiratory system were improved after operation. The average time stay in hospital was (2.5 ± 1.4) days. Follow-up for 1~24 months (mean, 6 months) in 12 cases found no recurrence of stones and serious respiratory tract infection. Conclusions The method of Dexmedetomidine com-bined with Sufentanil for sedation on broncholiths through of bronchoscope with holmiun laser is safey, feasible and therapeutic effects were clearly, which provides a new method for the clinical on Broncholiths.

This study was designed to investigate the impact of ultra-filtration extract mixture from Astragals mongholicus (UEMAM) o radiosensitivity of H22 ascitic tumor in mice to 12C6+ ions radiation. The H22 ascitic tumor model was established in mice by intraperitoneal injection of 0.2 mL H22 ascitic cells. The animals were subsequently divided into 4 groups randomly, treated with normal saline, UEMAM, heavy ion beam radiotherapy and UEMAM plus heavy ion beam radiotherapy, respectively. The body weights, abdomen circumference of the mice were measured and the mouse behavior was monitored every day; survival time was recorded to evaluate life extension effect; flow cytometry technique was used to detect H22 cell apoptosis and cell cycle; protein levels of p53, Bax, Bcl-2 and cleaved Caspase-3 were analyzed by Western blot; the single cell gel electrophoresis was used to detect the level of deoxyribonucleic acid damage (DNA damage). The results suggest that UEMAM significantly increased survival time, and decreased body weights and abdomen circumference over the saline control group. The treatment increased cell apoptosis, cycle arrest and DNA damage compared to the saline control group. UEMAM significantly enhanced the therapeutic effect of heavy ion beam radiation in survival time, and decreased body weights and abdomen circumference in the tumor-baring mice. The combination increased cell apoptosis, cycle arrest and DNA damage compared to the radiotherapy group. The results of Western blot suggest that the treatment significantly enhanced p53-induced apoptotic signals. The experiment discovered that UEMAM could improve radiosensitivity of H22 ascitic tumor through activation of p53-mediated apoptotic signal pathway.
Animals ; Apoptosis ; Astragalus Plant ; chemistry ; Cell Cycle ; Cell Line, Tumor ; DNA Damage ; Ions ; Mice ; Neoplasms, Experimental ; drug therapy ; radiotherapy ; Plant Extracts ; pharmacology ; Radiation Tolerance ; Signal Transduction

The formulation for sustained release tablet of Epinedium component was selected and the evaluation equation of in vitro release was established. The liquidity of component was improved with the help of colloidal silica aided by spray drying, which would be the main drug in the sustained release tablets. Dissolution was selected as an evaluation index to investigate skeletal material type, fillers, impact porogen, lubricants and other materials on the quality of sustained release tablet. The sustained release tablets were prepared by dry compression. Formulation of sustained release preparations was main drug 35%, HPMC K(4M) 20% and HPMC K(15M) 10% as skeleton material, MCC 31% as filler, PEG6000 2% as porogen and magnesium stearate 2% as lubricant. The sustained release tablets released up to 80% in 8 h. The zero order equation, primary equation and Higuchi equation could simulate the release characteristics of sustained release tablets in vitro, the correlation coefficients r were larger than 0.96. The primary equation was most similar in vitro release characteristics and its correlation coefficient r was 0.9950. The preparation method is simple and the results of formulation selection are reliable. It can be used to guide the production of Epimedium component sustained release preparations.
Chemistry, Pharmaceutical ; methods ; Delayed-Action Preparations ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Epimedium ; chemistry ; Kinetics ; Tablets ; chemistry

Objective To investigate the pharmaeokinetics of levofloxacin in rat's pancreatic tissue. Methods Pancreatic tissue and blood were sampled in vivo by microdialysis simultaneously. The concentrations of levofloxacin in beth blood and tissues were measured by high performance liquid chromatography. All date were analyzed by WinNonlin software. Results The maximum concentration of free levofloxacin in blood and pancreatic tissue were (65.23 ± 12.9) μg/ml at 10min and (30.56±3.22) μg/ml at 20 min, respectively, then beth continuously decreased. Concentration of free levofloxacin in pancreatic tissue was higher than that in blood from 20min to 100min, then returned to similar level. The area under the concentration curve(AUC)of unbound levofloxacin was(2465.11±258.56)min·μg~(-1)·ml~(-1) in pancreas,and (2914.38±205.73)min·μg~(-1)·ml~(-1) in blood.Conclusions Microdialysis with reversed phase high performance liquid chromatography established in this essay could be used to determine the pharmacokinetics of levofloxacin objectively. High concentration of levofloxacin in pancreatic tissue and blood was observed.

Objective To probe the definition of cicateicial cryptotia and its plastic and reconstructive surgery.Methods Local skin flaps combined with full-thickness skin graft by zonation grafting technique were used to treat twenty-six patients with thirty-three cicateicial cryptotia.A cicateicial adhesion between auricle and cranial wall and mastoidea was removed,cranioaural angle was reformed,and helix and auricular lobule were reconstructed.Results All skin flaps survived,and the survival rate of skin grafts reached over 95 ％.The appearance of auricle was very good,its major constructions might be noted,and cranioaural angle nearly returned to normal.The follow-up results from three months to one year post-operation showed that the appearance of auricle kept well,and the patients felt satisfactory.Conclusions In view of deformity characteristics of cicateicial cryptotia,it might be an effective approach to treat cicateicial cryptotia to take a seris of appropriate surgical procedures.

Objective To summarize the experience of emergency treatment and cosmetic repair of facial trauma.Methods The clinical materials of 584 wounds from 291 cases of facial trauma,recruited in hospital from January 2010 to August 2012,were summed up retrospectively.The principles of medical aesthetics and plastic and cosmetic surgery were followed.A high pressure douching technique was employed to carry out thorough debridement,but occasion of the debridement did not emphasize with intensive attention.A wound without skin and soft tissue defect was sutured accurately according to tissue zonation with a new suture technique,and the needle distance or side distance was limited in 0.2 cm to 0.3 cm.Otherwise,the wound was repaired by full-thickness skin graft or various flaps according to the repair principle ofrather near than further,rather simple than complicated.Attention was paid to rehabilitation care.Results After debridement,328 wounds were sutured directly,147 wounds were repaired by full-thickness skin grafting and 109 wounds by various flaps.A total of 571 wounds healed on the first stage,and the healing rate reached 97.8％.The wounds were in satisfactory apposition and without obvious cicatrix.Five senses did not appear in malposition and deformity.The other 13 wounds did not heal because of bad taking of skin grafts and flaps or wound splitting.Among them,4 wounds were repaired by second operation,and 9 wounds healed by changing dressings.By means of rehabilitation care,scar hyperplasia and pigmentation appeared slightly in those 13 wounds.A total of 454 wounds from 217 cases were followed up.The results showed good appearance and slight cicatrix hyperplasia,a pigmentation in different degree appeared in 11 wounds covered by skin grafting.In addition,eyebrow excalation,auricle excalation or total lose appeared in 12 cases.Conclusion During treating emergency cases of facial injuries,if an idea cosmetic repair of traumais followed,the theory of aesthetics and the techniques of plastic and cosmetic surgery are fully used,a multiple-discipline cooperation is brought into full play,and a prompt and accurate treatment is put into practice,the aim of cosmetic repair would come true.