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.

Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Forearm ; surgery ; Free Tissue Flaps ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods

Objective To investigate the causes and outcome of different treatment methods of iatrogenic rectovaginal fistula. Methods Clinical data of 52 patients with iatrogenic rectovaginal fistula were analyzed retrospectively. Results Twenty-two fistulae occurred after gynecological operation (42.3%), fourteen after obstetric injury (26.9%), thirteen after colorectal operation (25.0%) and three due to miscellaneous causes (5.8%). The fistulae were located in the lower rectum in 27 cases(51.9%), mid rectum in 10 cases(19.2%) and upper rectum in 15 cases(28.9%). They were treated by non-surgical treatment in 9 cases(17.3%), permanent diverting stoma(loop transverse colostomy) in 8 cases(15.4%), and surgical repair by various approaches in 35 cases(67.3%). The fistulae of all nine patients who received non-surgical treatment failed to heal. Eight patients who received permanent diverting stoma had symptomatic improvement without fistula healing. The overall cure rate of surgical repairs in 35 cases was 77.1%(27/35). The cure rates of trans-sphincteric (Mason′s operation), transanal, transabdominal, transperineal and transvaginal approaches were 100%(8/8), 100%(2/2), 83.3%(5/6), 0%(0/1) and 66.7%(12/18), respectively. The cure rate of Mason′s operation for the mid and lower rectovaginal fistulae was higher than that of transvaginal approach (100% vs 66.7%). Conclusions Iatrogenic rectovaginal fistula is caused by obstetric injury or injury of rectovaginal septum due to surgical mismanagement. Surgical repair is the only method that can cure rectovaginal fistulae. Mason′s operation is a favorable treatment method for the mid and lower (especially mid) rectovaginal fistulae.

OBJECTIVETo observe the therapeutic efficacy of Dangfei Liganning Tablet (DLT) in the treatment of antipsychotics induced mild hepatic damage.

METHODSTotally 80 mental inpatients with antipsychotics induced mild liver injury were randomly assigned to two groups, the treatment group (40 cases) and the control group (40 cases). Patients in the treatment group took DLT, two tablets each time, three times per day, while those in the control group took Liver-protecting Tablet (LT), four tablets each time, three times per day. The treatment course was 4 weeks for all. Changes of glutamic-pyruvic transaminase (ALT) and glutamic-oxalacetic transaminase (AST) were observed before treatment, week 1, 2, and 4 after treatment. The therapeutic efficacy was compared between the two groups.

RESULTSCompared with the former time point, ALT and AST gradually decreased in the two groups at week 1, 2, and 4 (P <0. 05). The cured rate was 72. 5% and the total effective rate was 97. 5% in the treatment group. They were 62. 5% and 90. 0% respectively in the control group. There was no statistical difference in the two indices between the two group (P >0.05). No obvious adverse reaction occurred in the two groups.

CONCLUSIONDLT could treat antipsychotics induced mild hepatic damage in a safe and effective way.

Alanine Transaminase ; metabolism ; Antipsychotic Agents ; adverse effects ; Chemical and Drug Induced Liver Injury ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Liver ; metabolism ; Protective Agents ; administration & dosage ; therapeutic use ; Tablets ; therapeutic use

BACKGROUND: Anterior cruciate ligament injury accompanied by unstable rotation is a hotspot in sports medicine. Further understanding of the anatomy and biomechanics of the anterolateral ligament can play a guiding significance for the recovery of knee joint rotational stability.
OBJECTIVE:To systematicaly review current literature on the anterolateral ligament of the knee and to understand the incidence, anatomy, morphology and histology of the anterolateral ligament as wel as mechanism of anterolateral ligament injury.
METHODS: The first author searched the PubMed, Medline, CNKI, Wanfang, VIP databases for articles specificaly addressing the anterolateral ligament. Data extraction related to the incidence, anatomy, morphometry, biomechanics, and histology of the anterolateral ligament and its relation to the “Segond” fracture was performed. The retrieve time ranged from 1878 to 2015. Totaly 362 literatures were retrieved, including 342 articles in English and 20 in Chinese. According to inclusive and exclusive criteria, 42 articles were included in result analysis.
RESULTS AND CONCLUSION:The occurrence rate of the anterolateral ligament ranges from 83% to 100%, and this range occurs because of smal discrepancies in the definition of the bony insertions of the anterolateral ligament. The anterolateral ligament originates anterior and distal to the femoral attachment of the lateral colateral ligament. It spans the joint in an oblique fashion and inserts between the fibular head and Gerdy tubercle of the tibia. Exact anatomic and morphometric descriptions vary in the literature, and there are discrepancies regarding the anterolateral ligament attachment to the capsule and lateral meniscus. The anterolaterial ligament is a contributor to the stability of tibial internal rotation, and histologicaly, it exhibits paralel, crimped fibers consistent with a ligamentous microstructure. The footprint of the anterolateral ligament has been shown to be at the exact location of the Segond fracture. The anterolateral ligament is a distinct ligamentous structure at the anterolateral plane of the knee, and it is likely involved in the control of excessive tibial internal rotation that can cause the Segond fracture.

Animals ; Electric Stimulation ; Neurons ; pathology ; physiology ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Red Nucleus ; pathology ; physiology

Objective To isolate bioactive compound of enhancing fibrinolysis from secondary metabolites of marine microorganism.Methods The separation of microorganism from seawater samples,screening of producing fibrinolytic compound's strain,selection of the active strain's optimum fermentation medium and refining of active compound were done by the method of selective cultivation,measuring of compound's fibrinolytic activity and semipreparative HPLC,respectively.Results Nine hundred and thirty-six single strains from 31 samples were collected 100 meters off the coast,and cultures of the fungus(FG216) contained enhancing fibrinolytic compound.Compounds from modified Czapek medium as the fermentation medium of FG216 showed significant fibrinolytic effect.Finally,active fraction were isolated and refined from cultures of FG216.Conclusion In this paper,active compound of enhancing fibrinolysis were gained from secondary metabolites of isolated single microorganism from seawater.

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.

Objective To develop nanometer-scale bubbles with surfaces of N-palmitoyl chitosan(PLCS) as ultrasound contrast agent and evaluate its characteristics and acoustic effects in vivo. Methods The PLCS nanobubbles were prepared using a cutting technique at differential high-frequency of shear speed. Both optical and transmission electron micrography were performed to determine the nanobubble size and morphology. Concentration, size-distribution and zeta potential of the PLCS nanobubbles were measured by cell counting chamber, Malvern lazer particle analyzer and zeta-sizer at 1-day, 45-day and 90-day. The acoustic effects of the PLCS nanobubbles on myocardium and renal tissue in 6 normal rats were observed using bolus infusion of the nanobubbles intravenously. The maximum video intensity(VI) was measured.Results The PLCS nanobubbles with nice round-shape and uniform site-distribution were demonstrated.The mean diameter,concentration and zeta potential of the PLCS nanobubbles were (617 ± 12) nm, (7.2 ±0.6) × 109/ml and (52.9 ± 1.3)mV at the 1-day,and all of parameters did not change significantly in 45-day and 90-day ( P ＞ 0. 05). A significant contrast-enhancement was noted on myocardium and renal tissue during infusion of the nanobubbles. VI on both tissues was (15.6 ± 1.1)GU and (27.3 ± 2.5)GU,respectively. The visual contrast-enhancement last up to (10 ± 2)min. Conclusions The PLCS nanometerscale bubbles have excellent physical-features and contrast-enhanced ultrasound effects in vivo. It may develop as a novel contrast ultrasound agent which could cross endothelial cell membrances.

Objective To evaluate the safety and efficacy of the CT-guided percutaneous cryoablation of osteoid osteoma in children.Methods Nine children with osteoid osteoma proved by histopathology were treated with CT-guided cryoablation from January 2007 to January 2010.There were 6 boys and 3 girls.Their mean age was ( 13.0 + 1.6 ) years ( ranging from 10.0-15.0 years ).The procedures were performed under local anesthesia.Eight G bone biopsy needles for biopsy and 17 G freezing needles were used in the procedure.CT guidance was used for procedural planning,instrument guidance,and monitoring.Each cryoablation included two freezing-thawing cycles.Follow-up was performed to assess technical and clinical outcome.A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure,and mean VAS for the group was compared pre- and post-procedure with Kruskal-Wallis rank sum test.Results Biopsy and cryoablation were successfully performed in all children.No major immediate or postponed complications were observed.Significant pain relief ( P ＜ 0.01 ) was observed in all patients after procedure.The VAS of preoperation(8 points 1 case,7 points 3 cases,6 points 4 cases,5 points 1 case) compared with that of one month after operation ( 1 point 4 cases,0 point 5 cases),the difference was statistically significant( H =32.838,P ＜ 0.01 ).These patients were allowed to fully weight-bear and function without limitation 3 days after the procedure.Pain was obviously released.Pain recurrence was not observed in all patients.Moderate fever (37.8 ℃ ) was observed in a patient one day after operation and fully recovered 2 days later.Conclusion CT-guided percutaneous cryoablation is a safe and effective minimally invasive method for the treatment of osteoid osteoma in children.