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.

Myopia is not only a global public health problem, but also a significant socio-economic problem. There are various hypotheses about the pathogenesis of myopia, which is basically the result of the combination of environmental and genetic factors. Although a large number of epidemiological studies have been carried out on the influencing factors of myopia, most of them are cross-sectional studies, longitudinal cohort studies are relatively few. This paper will summarize the influencing factors of myopia at homeland and abroad in recent years.

Objective　To understand the overall under-reporting of cause of death monitoring in Hainan Province, and to provide a scientific basis for evaluating the data from death registration report and health planning in Hainan. Methods　Multi-stage cluster random sampling was used, all towns/streets in cities and counties of the province were ranked from highest to lowest in terms of crude death rate, divided into high, medium and low levels (the number of each level was basically the same), and one was randomly selected from each level. A total of three towns/streets were used as survey areas, and all households in the area were survey households. Death information of resident population during 2018-2020 was collected and compared with routine surveillance data for the same period. The under-reporting rate was calculated, and comparison between groups was performed by chi-square. Results　A total of 12 583 death cases were investigated from 2018 to 2020, and the average mortality was 621.48/105. 4 809 cases were missed with the total under-reporting rate of 38.22%. The under-reporting rate from 2018 to 2020 were 39.75%, 39.99% and 34.77% (χ2=30.404, P<0.01) respectively. The under-reporting rate in eastern and central and western areas were 30.33%, 30.10% and 60.15% (χ2=931.901, P<0.01) respectively. The negative rate were different in different years old group (χ2=14.834, P<0.05). Of the 4 809 under-reported cases, as many as 93.49% died at home, and the composition of deaths in hospitals was about 10 times higher in the center than in the east and west, and the proportion of those who died in hospital in central areas was about 10 times higher than in eastern and central areas. Conclusions　More than half of the cities and counties in Hainan Province have improved the completeness of cause of death surveillance data. The under-reporting rate in age group <5 years are still high, and regular under-reporting investigations are still needed to strengthen the reporting and management of death information.

BACKGROUND: Apatite-wollastonite containing glass-ceramic (AWGC) is a kind of good bone repairing materials with excellent bioactivity, which is prepared by traditional melting process.OBJECTIVE: To observe AWGC prepared with sol-gel method and its bioactivity.DESIGN: Design experiment of materials process and in vitro bioactivity experiment.SETTING: College of materials science and Engineering of Sichuan University.MATERIALS: AWGC.METHODS: This experiment was conducted at the laboratory of College of Materials Science and Engineering of Sichuan University between August 2002 and May 2003. AWGC was prepared from sol-gel and followed by heattreating process. Bioactivity was investigated in vitro by immersing in the simulate body fluid (SBF) at 37 ℃ for 7 days . JL-1155 laser particle analyzer, X-ray diffraction, Fourier transform infrared spectroscopy and scanning electron microscope were used for micro-morphological structure analysis.MAIN OUTCOME MEASURES: ①The crystalline structure and microstructure of sol-gel derived glass-ceramic② The apatite forming process in simulate body fluid③ The diameter of the pore of the sol-gel derived apatite/wollastonite glass-ceramicRESULTS: ①Main crystalline phases of the sol-gel derived glass-ceramic materials were hydroxyapatite/fluoroapatite [Ca10(PO4)6(OH, F)] and β-wollastonite[β-CaSiO3]; Microstructure contained many micro-pores of 2-3μ m;② Sol-gel derived AW glass ceramic had excellent bioactivity: plenty of apatite granules were generated on the surface of the material after soaking for 7 days. ③Porous scaffolds possessed good macro-porous structure with the interconnected macro pores of 300-400 μm in diameter;CONCLUSION: Apatite-wollastonite containing glass-ceramic (AWGC)with excellent bioactivity was developed by sol-gel process. The material is expected to be a good candidate for bone-repairing and bone tissue engineering scaffold materials.

The diabetes is mainly treated by the oral administration of western medicines at present. Despite their rapid curative effect, there have been still many reports for the western medicines about their clinical adverse reactions, failure of effective prevention and treatment of complications and drug resistance. Hence, they are not suitable for long-term administration. Traditional Chinese medicines have a long history in treating diabetes mellitus (DM) , which is commonly known as Xiaokezheng in the theory of traditional Chinese medicines. In recent years, many scholars have taken extracts from traditional Chinese medicines or separated active constituents as the study objects in the expectation of developing new-type drugs for treating and preventing diabetes. Therefore, a large number of study reports have been emerged in this field. Due to their significant glucose-reducing effect and specific effect in treating complications of diabetes, traditional Chinese medicine Gardeniae Fructus and its iridoid component geniposide shall be given full attention. This paper summarized the advance in studies on the curative effect and action mechanism of Gardeniae Fructus and geniposide in preventing and treating diabetes.
Animals ; Diabetes Mellitus ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Fruit ; chemistry ; Gardenia ; chemistry ; Humans ; Hypoglycemic Agents ; administration & dosage ; chemistry

Objective To investigate the mechanism of PBEF in pulmonary vascular endothelial permeability increasing after car-diopulmonory bypass ,in order to provide the basis for a better lung protective measures during cardiopulmonary bypass .Methods Animal models were established ,group A :the rats were transfected with the lentiviral AD-PBEFshRNA ;group B :the rats were took 30 min deep hypothermic circulatory arrest ;group C :the rats were took 30 min deep hypothermic circulatory arrest ,then trans-fected with the lentiviral AD-PBEFshRNA ;control group :the rats were anesthetized and established CPB tube ,without CPB by-pass .Lung tissue was detected with Western blotting and ELISA .Results PBEF ,phosphorylation of P38MAPK ,ERK ,MLC ,VE-cadherin ,FAK in group C had significant difference with group A ,B and the control group(P<0 .05) .VEGF ,MMP2 ,MMP9 ,W/D in group C had significant difference with group A ,B and the control group(P<0 .05) .The pathological results showed that rat lung tissue of the control group was normal ,while in group C ,it had severe pathological damage ,the pathological damage degree in group A ,B reduced compared to group C .Conclusion PBEF can through MAPK/PI3K-Akt/VEGF signaling pathway ,increase pulmonary vascular endothelial permeability .

Objective To analyze the overall developmental stages of traditional Chinese materia medica patent technology in China and abroad and the causes of the differences. Methods In this study, the Shanghai Intellectual Property Information Platform, Thomson Innovation, Derwent Innovations Index were utilized and graphic illustration method for patent technology life cycles was used to determine the overall developmental stages of traditional Chinese materia medica patent technology in China and abroad. Results The numbers of applications for patent traditional Chinese materia medica and their applicants were obtained. With information of the two parameters, the text made a preliminary prediction of overall trend for the number of applications. Conclusion The patent technology of traditional Chinese materia medica progressed into developing stages in China and appeared the feature of mature or recession stage abroad.

Objective To assess the efficacy and safety of ACD-A solution as anticoagulant during continuous renal replacement therapy (CRRT) in high risk of bleeding patients.Methods Forty high risk bleeding patients on continuous veno-venous hemofiltration (CVVH) were randomly divided into two groups:ACD-A group (22 patients,61 cases) and heparin-free group (18 patients,47 cases).Serum creatinine,function of the coagulation system,electrolyte and acid-base were monitored pre-and post-CVVH.The vital signs of the patients during treatment,dialyser clotting and the incidence of bleeding episodes were recorded.Results (1) The serum level of creatinine decreased significantly after treatment in both groups,but the rate of decrease was obviously higher in ACD-A group than that in heparin-free group[(55.4± 10.2)％ vs (42.0±5.2)％,P=0.031].(2) The average duration of CVVH treatment was (17.3±3.8) h in ACD-A group and (9.7±4.5) h in heparin-free group.There was significant difference between them (P =0.019).The frequency of dialyzer clotting was much higher in heparin-free group than that in ACD-A group (88％ vs 4.9％,P ＜ 0.001).(3) There was no significant difference in the function of the coagulation system between pre-and post-CVVH in either group (P ＞ 0.05).(4) Electrolyte,acid-base and glucose tended to be stable during the treatment in ACD -A group.(5) The vital signs were kept stable and no bleeding episodes were found in all patients of two groups.Conclusions Anticoagulation with ACD-A is safe,effective and convenient for CRRT in critically ill patients at high risk of bleeding.The occurrence of complications can be reduced by configurating appropriate replacement fluid and close laboratory monitoring.

AIM: To compare the visual acuity and contrast sensitivity of eyes with different corneal spherical aberration implanted with the same aspherical IOL and evaluate the effect of different ocular spherical aberration on visual performance after phacoemulsification.
METHODS:It was a prospective case series study. Forty-six eyes of thirty-nine age-related cataract patients in our department were included. The patients were divided into 3 groups according to the value of preoperative corneal spherical aberration. Eyes with corneal spherical aberration≤0. 2μm were assigned to group A, those with corneal spherical aberration >0. 2μm and ≤0. 3μm to group B, and those with corneal spherical aberration≥ 0. 3μm to group C. All patients underwent phacoemulcification and recieved AcrySof IQ aspheric IOL. Uncorrected visual acuity ( UCVA ) , best-corrected visual acuity( BCVA) , contrast sensitivity, and total ocular higher - order aberrations for a 6. 0mm pupil were recorded 3mo postoperatively. ANOVA were used to analyze the data.
RESULTS: There were no significant differences in UCVA and BCVA between the 3 groups (P=0. 287, 0. 115). Contrast sensitivity was no statistically significant difference between the 3 groups at any spatial frequency under photopic、 mesopic, and mesopic with glare conditions (P>0. 05). With a 6. 0mm pupil diameter, root mean square values for total ocular higher - order aberrations were lower in groups A and B than that in group C (P=0. 000). The difference of total ocular spherical aberration was statistically significant between the 3 groups (P=0. 000). Coma and trefoil were similar between the groups (P=0. 788,0. 590), with no statistically significant differences.CONCLUSION:Implantation of the same aspherical IOL in eyes with different corneal spherical aberration results in similar visual acuity and contrast sensitivity. Small differences of ocular spherical aberration after phacoemulsification have no effect on visual performance.

Objective To assess the adhesive behavior of dual-targeted microbubbles carrying both Sialyl Lewisx and anti-ICAM-1 monoclonal antibodies in vitro. Methods Selectin-targeted (with Sialyl Lewisx) microbubbles (MB-S),ICAM-1-targeted (with anti-ICAM-1 monoclonal antibodies) microbubbles (MB-Ⅰ),and dual-targeted (with both ligands) microbubbles(MB-D) were prepared by attaching the ligands to the biotinylated lipid-microbubbles via multi-step avidin biotin bridging chemistry. A parallel plate flow chamber combined with a novel automated tracking algorithm,were used to analyze the transient velocities,rolling and firmly adherent numbers of microbubbles at various shear stress (0. 6,2.0 and 4.0 dyn/cm2)over 6 min. Microbubbles detachments were tested by ramping up the shear stress at 30 s intervals. Results At 0.6 dyn/cm2 shear stress, the rolling numbers of MB-S and MB-D were remarkably more than that of MB-I( P＜0.05), while at 2.0 and 4.0 dyn/cm2 MB-S performed higher rolling efficiency as compared with either MB-I and MB-D ( P＜ 0.05). In all flow conditions, the adhesive numbers of MB-D to the targets were obviously greater than those of MB-S and MB-I ( P＜ 0.05). Half-maximal detachment decreased gradually in MB-I, MB-D and MB-S by turns ( P＜ 0.05). Conclusions MB-I, MB-S and MB-D have different adhesive behaviors. MB-I exhibites primarily firm adhesion with low rolling efficiency, while MB-S reveales unstable or transient adhesion with high rolling efficiency,and MB-D exhibites firm adhesion with high rolling efficiency. MB-D may be suitable for molecular imaging in high-flow vessels.