Objective To study the effect of incentive and target assessment mechanism on the operation and manage-ment efficiency of nurse-led clinics.Methods 45 cases in the nurse-led clinic managed by the target assessment mechanism in our hospital from June to December 2021 were selected as the control group,and 46 cases managed by the incentive joint target assessment mechanism in our hospital from February to July 2022 were selected as the observation group.The annual workload,doctors'recognition of nurses,nursing quality and self-efficacy scale(GSES)scores before and after intervention were compared between the two groups,and the satisfaction of nurses in charge of patients was compared between the two groups.Results Be-fore intervention,there was no difference in the annual workload between the two groups(P＞0.05).After intervention,the an-nual workload of the two groups increased,and the observation group was higher than the control group(P＜0.05).Before inter-vention,there was no difference in the scores of recognition degree between the two groups(P＞0.05).After intervention,the scores of communication ability,quality management ability,emergency ability,independent work ability and specialist problem solving ability of the two groups increased,and the observation group was higher than the control group(P＜0.05).Before inter-vention,there was no difference in nursing quality score between the two groups(P＞0.05).After intervention,the quality of nursing cases,the quality of patient safety management,the quality of post work and the total mean score of the two groups were increased,and the observation group was higher than the control group(P＜0.05).Before intervention,there was no difference in GSES scores between the two groups(P＞0.05).After intervention,GSES scores of the two groups increased,and the obser-vation group was higher than the control group(P＜0.05).The total satisfaction rate of patients in observation group was 96.25% ,higher than 86.25% in control group(P＜0.05).Conclusion The incentive and target assessment mechanism can significantly improve nurses'annual workload and nursing quality,doctors'recognition of nurses and patients'satisfaction with nursing.

OBJECTIVETo synthesize compounds based on imidazo-fused heterocycles and evaluate their anti-tumor activity against breast cancer.

METHODSThe compounds 1a-1e, 2a and 2b were synthesized by aerobic copper-catalyzed halocyclization of methyl N-heteroaromatics with aliphatic amines; 3a and 3b were generated by sonogashira reaction and Suzuki reaction, respectively; the compounds 4a-4c were obtained by Buchwald-Hartwig reaction of the corresponding amines and 1e. The effects of these compounds against breast cancer cells and their nephrotoxicity were determined using MTT assay. Annexin VFITC/PI apoptosis detection kit was used to assess the apoptosis-inducing effects of these compounds in breast cancer cells. With normal saline as the control, the safety and anti-tumor activity of the compound 2a (daily dose of 10 mg/kg for 14 days) was tested in a mouse model bearing human breast cancer xenografts.

RESULTSThe compounds 2a, 4a, 4b and 4c all showed obvious anti-tumor activities. Among these compounds, 2a showed the most potent anti-tumor effect against breast cancer cells with an IC of 9.77 ± 2.32 μmol/L, similar to that of cisplatin (IC=8.96 ± 2.35 μmol/L); 2a also showed a slightly lower nephrotoxicity than cisplatin, and their CC was 10.79±0.87 μmol/L and 8.45±0.68 μmol/L, respectively. 2a obviously promoted apoptosis of breast cancer cells and caused a moderate suppression of the breast cancer growth in the tumor-bearing mouse models without producing serious adverse effects.

CONCLUSIONSFour compounds synthesized based on imidazo-fused heterocycles have anti-tumor activities against breast cancer. The compound 2a is capable of dose-dependently promoting apoptosis of breast cancer cells and has a good safety and a moderate efficacy for suppressing tumor growth in mouse models bearing human breast cancer xenografts.