Based on the theory of organizational performance appraisal and the needs of developing China's hospital performance assessment system, the paper proposed the concept and emphasized the significance of establishing a comparative hospital performance assessment system in China. By sharing identical experiences from overseas, the paper also advocates that as China is building its comparative hospital performance assessment framework, it is imperative to verify the comparability of hospital performance assessment indicators, build a quality-centered comparative model for hospital performance assessment, and a three-tier comparative model to cover hospitals, departments and posts. These efforts will further improve China's performance assessment system.

Objective To understand the psychological health status and related factors in the primary caregivers of schizophrenia patients in Inner Mongolia,in order to provide empirical basis for nursing care.Methods A sample of 264 chronic schizophrenia patients and their primary caregivers,and 260 local normal individuals were selected according to random cluster sampling.The Symptom Check List-90 (SCL-90) and Social Support Rating Scale (SSRS)were used to evaluate the psychological health status.Symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS).Results The total SCL-90 score of caregivers of patients was higher than that of local normal individuals,especially the scores of somatization,interpersonal sensitivity,depression,anxiety,hostility,and paranoid ideation were higher than those of local normal individuals.Multiple regression analysis showed that caregivers' sex,caregivers' age,duration of illness,positive symptomatology,negative symptomatology and social support were significant predictors of caregivers' psychological health status.Conclusions The primary caregivers of patients with schizophrenia have worse mental health.Health care professionals should pay close attention to psychological health status in the primary caregivers and provide continuous individualized services,and thereby to improve the primary caregiver' psychological health status.

Objective To examine the relationship between social functioning and psychiatric symptoms,and the mediation effect of self-esteem and emotion between social functioning and psychiatric symptoms among schizophrenia patients of the convalescent stage.Methods The Personal and Social Performance Scale,Brief Psychiatric Rating Scale,Self-Esteem Scale,General Self-Efficacy Scale were used to investigate patients with schizophrenia of the convalescent stage of Chifeng.Results Social functioning for patients with schizophrenia of the convalescent stage could predict psychiatric symptoms directly.Self-esteem and self-efficacy could make a negative prediction for psychiatric symptoms.Self-esteem and self-efficacy played a mediating role between social functioning and psychiatric symptoms.Conclusions Mental health workers should pay close attention to the mediating roles of self-esteem and self-efficacy,and give comprehensive assessment for the patients and provide continuous individualized psychosocial interventions,and thereby to alleviate psychiatric symptoms.

The paper presented the theoretic basis for the comprehensive hospital evaluation system, and initiated the indicator system for hospital comprehensive evaluation results with both Delphi method and the balance scorecard. Two rounds of experts consultation have decided to evaluate hospital comprehensive strengths from such aspects as hospital resources deployment, business process, financial standing, customers, customers, public welfare and development potential of the hospital. Under these grade-1 indicators are 13 grade-2 ones and 83 grade-3 ones. The importance, operability and sensitivity of these indicators are accepted by experts unanimously.

Objective To investigate the effects of asymmetric dimethylarginine (ADMA) on apoptosis and phosphorylation of c-jun N-terminal kinase (JNK) in endothelial outgrowth cells (EOCs). Methods The mononuclear cells were harvested from umbilical cord blood by ficoll density gradient centrifugation, and induced into EOCs and then expanded in vitro. The identified EOCs were treated with different concentrations of ADMA (0, 1, 5, 10, 20 μmol/L) for 48 h. The adherent cells were treated with 10 μmol/L ADMA,then different concentrations of JNK specific inhibitor SP600125 (0, 5,10,20 and 40 μmol/L) were added and incubated for 48 hours. Caspase-3 activity was measured by microplate reader. Apoptotic incidences of EOCs were quantitatively determined by flow cytometry. The expression of Caspase- 3 and phosphorylase-JNK (p-JNK) were detected by Western blot assay. Results The treatment of ADMA (1-20 μmol/L) significantly induced apoptosis in EOCs by enhancing Caspase-3 express and also induced phosphorylation of JNK (P<0.05). Meantime, the JNK specific inhibitor SP600125 could attenuate the apoptosis induced by ADMA during this process (F=6.733,P<0.05) and inhibit the expression of Caspase-3 and p-JNK. Conclusion ADMA can induce apoptosis in EOC, which may be achieved by activating JNK signal transduction pathway.

Objective To learn the recent development and regional distribution of clinics in China.Methods Based on statistics and a nationwide survey of clinics in the country,a simple linear regression was made to find factors determining clinics regional distribution.Results Clinics in China were found to have grown sizably from 134 000 in 2008 to 155 000 in 2014;medical technology workers to 2.31 per clinic in 2014;and the total revenue of these clinics accounted for only 0.724% of all medical institutions,while there are more clinics in the east than the west regions in China.Conclusions The role of clinics in attracting high quality medical resources to primary care should be further enhanced for development of the hierarchical medical system in China.

Objective: To investigate the effects of γ-tocotrienol (γ-T3) on the invasion and migration of human gastric cancer SGC-7901 cells as well as its possible molecular mechanism. Methods: The different concentrations (0, 15, 30, 45, 60, and 100 μmol/L) of γ-T3 were used to treat SGC-7901 cells. Then the proliferation, migration and invasion of SGC-7901 cells were detected by CCK-8 assay, cell scratch wound healing assay and Transwell invasion assay, respectively. Furthermore, the expressions of cyclooxygenase-2 (COX-2) and nuclear factor-kappa B (NF- κB) signal pathway proteins were detected by Western blotting. Results: After treatment with different concentrations (15-100 μmol/L ) of γ-T3 for 24, 48 and 72 h, the proliferation of SGC-7901cells was evidently inhibited in a time- and dose-dependent manner (all P<0.01). After treatment with γ-T3 (15-60 μmol/L) alone or combined with tumor necrosis factor-alpha (TNF-α) (10 ng/mL) for 24 h, the migration and invasion abilities of SGC-7901 cells were significantly inhibited (all P<0.01). The expressions of NF-κB, NF-κB p65 and COX-2 proteins were significantly down-regulated in SGC-7901 cells after γ-T3 (15-60 μmol/L) treatment for 24 h (all P<0.01). Conclusion: γ-T3 can inhibit the invasion and migration of human gastric cancer SGC-7901 cells. Its mechanism may be associated with blocking NF-κB signal pathway and reducing the expression of COX-2 protein.

Objective To investigate effect of nonverbal psychological intervention on emotional state of ICU awake patients with intubation.Methods A total of 114 ICU awake patients with intubation were divided into two groups,the control group with 57 patients treated with conventional care,while the observation group with 57 cases added nonverbal psychological care.Emotional state and quality of life after nursing of two groups were compared.Results Before intubation,the difference in HAMA,HAMD score of two groups was not significant (P ＞ 0.05);HAMA,HAMD score decreased significantly compared with the control group at 3,7 d of intubation and when extubation (P ＜ 0.05).There was no significant difference in quality of life scores before intubation (P ＞ O.05),but it was significantly increased in the observation group at 3,7 d after intubation compared with the control group (P ＜ 0.05).There was no significant difference in two groups before intubation in NOS,5-HT content (P ＞ 0.05),but they were significantly lower than the control group,and the result revealed significant difference (P ＜ 0.05).Conclusion Nonverbal psychological intervention can improve bad emotion and quality of life of ICU awake patients.

Objective To investigate effect of nonverbal psychological intervention on emotional state of ICU awake patients with intubation.Methods A total of 114 ICU awake patients with intubation were divided into two groups,the control group with 57 patients treated with conventional care,while the observation group with 57 cases added nonverbal psychological care.Emotional state and quality of life after nursing of two groups were compared.Results Before intubation,the difference in HAMA,HAMD score of two groups was not significant (P ＞ 0.05);HAMA,HAMD score decreased significantly compared with the control group at 3,7 d of intubation and when extubation (P ＜ 0.05).There was no significant difference in quality of life scores before intubation (P ＞ O.05),but it was significantly increased in the observation group at 3,7 d after intubation compared with the control group (P ＜ 0.05).There was no significant difference in two groups before intubation in NOS,5-HT content (P ＞ 0.05),but they were significantly lower than the control group,and the result revealed significant difference (P ＜ 0.05).Conclusion Nonverbal psychological intervention can improve bad emotion and quality of life of ICU awake patients.

Objective:To investigate the association between split foot and electrophysiology in patients with amyotrophic lateral sclerosis (ALS).Methods:The clinically definite or clinically probable ALS patients hospitalized in the Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital from April 2021 to December 2022 were prospectively collected. From April 2021 to December 2022, patients who visited the Chinese People′s Liberation Army General Hospital for other reasons without abnormal electrophysiological examination were collected as the control group. The incidence of split leg [the limb whose modified Medical Research Council Muscle Strength Scale (mMRC) score of ankle dorsiflexors was lower than that of ankle plantarflexors] in ALS patients was calculated, and the incidence of split foot (the limb whose mMRC score of hallux dorsiflexors was lower than that of hallux plantarflexors) in ALS patients was calculated. The amplitude of compound muscle action potential (CMAP) of common peroneal nerve and tibial nerve was detected to observe the involvement of motor neurons innervating ankle dorsiflexors and ankle plantarflexors. The characteristics of split leg and split foot in ALS patients were analyzed from the perspective of muscle strength, and the characteristics of split foot in ALS patients were analyzed from the perspective of electrophysiology. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of peroneal nerve/tibial nerve CMAP amplitude ratio in distinguishing ALS patients from controls.Results:A total of 101 ALS patients with lower limb involvement and 110 controls with normal lower limb muscle strength were collected. Among the 101 ALS patients with lower limb involvement, strength of ankle plantarflexors was greater than that of ankle dorsiflexors in 35.64% (36/101) patients, strength of ankle dorsiflexors was greater than that of ankle plantarflexors in 5.94% (6/101) patients, and strength of ankle plantarflexors and ankle dorsiflexors was equal in 58.42% (59/101) patients. Strength of hallux dorsiflexors was lower than that of hallux plantarflexors in 53.47% (54/101) patients, strength of hallux dorsiflexors was greater than that of hallux plantarflexors in 1.98% (2/101) patients, and the strength of hallux dorsiflexors and hallux plantarflexors was equal in 44.55% (45/101) patients. The incidence of split leg was negatively correlated with age ( OR=0.25, 95% CI 0.16-0.40, P<0.05), course of disease ( OR=0.52, 95% CI 0.38-0.80 P<0.05) and ALS functional revised scores ( OR=0.29, 95% CI 0.12-0.67, P<0.05). The incidence of split foot was negatively correlated with the onset time of lower limb symptoms ( OR=0.96, 95% CI 0.93-0.99, P<0.05). Compared with the control group, the differences of the decrease of CMAP amplitude in the common peroneal nerve and tibial nerve [the common peroneal nerve (6.45±2.56) mV vs (3.63±1.83) mV, tibial nerve (12.87±4.72) mV vs (9.18±6.22) mV] were statistically significant ( t=-4.65, t=-3.44, both P<0.001) and the differences of the peroneal nerve/tibial nerve CMAP amplitude ratio (0.54±0.24 vs 0.36±0.18) decrease was statistically significant ( t=-4.31, P<0.001) in patients with split foot. ROC curve analysis showed that the area under the ROC curve of CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot was 0.70, indicating that the accuracy of CMAP amplitude of common peroneal nerve/tibial nerve in distinguishing ALS patients from controls was low. Conclusions:In ALS patients with lower limb involvement, strength of ankle dorsiflexors is weaker than that of ankle plantarflexors, and strength of hallux dorsiflexors is weaker than that of hallux plantarflexors. At the diagnostic level, the CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot has a lower accuracy in the diagnosis of ALS.