Objective:To evaluate the equity of the secondary performance allocation in target hospital.Methods:Through the comparison on the Gini coefficient calculation,the calculation method of Gini coefficient developed by Jianhua Zhang was applied to estimate the secondary allocation result of performance salary in the target hospital from 2014 to 2015.Results:From 2014 to 2015,the Gini coefficient remained at 0.22 or so,the overall allocation was average.Conclusion:Estimating the Gini coefficient was beneficial for the hospital managers control the structure and level of the second performance distribution and modulate the program of the sencond performance distribution in time,so that the distribution of performance salary would be accordant to the designed program and acts as the direction of motivation.

Objective To explore the clinical nursing methods for the treatment of the skin degloving injury in foot by the combination of free femoral anterolateral skin flap transplantation and vacuum sealing drainage (VSD) technique. Methods From January 2010 to January 2014, 18 cases of the skin degloving injury in foot were treated by debridement and implant skin, negative pressure drainage and irrigation at first period, then the operation to repair the foot wound by transplant femoral anterolateral skin flap were done at second period. Nurses applied the key technology of VSD into postoperative nursing. Nurses should master the observation method and characteristics for the flow of blood to the flap skin, the method for foot position nursing, afford effective analgesic care, and flap local high flow oxygen therapy,improve the local tissue oxygen partial pressure and introduce the foot early functional exercise during postoperative. Results Eighteen cases flaps all survived. Clients were followed-up for 6 to 12 months,the discovery showed that all of the clients had good flap blood supply,the skin was soft and elastic,and the function of foot were recovered well. Conclusions The combination of of free femoral anterolateral skin flap transplantation and VSD technique apply into foot degloving injury repairation postoperative care,by application of high quality nursing, it really can improve the success rate of surgery and reduce the pain for clients.

Kaino-sinus syndrome is one new complication of endoscopic sinus surgery. The patient had an operation of endoscopic surgery, because he was suffered from an illness of frontal nasal inverted papilloma again. After operation he was suffering pain in left epicanthal folds and frontal part, and had dry scab in nasal cavity when he breathed cold air. The symptoms could relieve by blocking prenaris. We found he had a big aperture of frontal sinus and dry scab in nasal endoscopic examination. His symptoms disappeared after cleaning and washing accessory nasal cavity by salt water.
Adult ; Endoscopy ; adverse effects ; Humans ; Male ; Nasal Surgical Procedures ; adverse effects ; Paranasal Sinus Neoplasms ; surgery ; Paranasal Sinuses ; pathology ; Postoperative Complications ; Syndrome

Objective:To investigate the effect and mechanism of hypoxia-inducible factor-1α (HIF-1α)in perihematomal brain tissue on the early formation of edema in patients with hyper-tensive intracerebral hemorrhage.Methods:The perihematomal brain tissue in 32 patients with hypertensive intracerebral hemorrhage were treated with hematoma evacuation.The expressions of HIF-1α and vascular endothelial growth factor(VEGF)were measured by immunohistochem- istry staining technique.The volume of perihematomal edema was determined on the basis of reoperative head CT scan.The results of staining and the volume of edema were analyzed by using double-blind method.Resets:Neuron and vascular endothelial cell swelling were observed 4 hours after cerebral hemorrhage,and the scattered HIF-1α positive neurons were visible.The expressions of HIF-1α reached the peak(at 24 to 48 hours,and went on high expressions at 49 to 72 hours.There was significant difference as compared with the normal brain tissue(P＜0.01). There were positive correlations between the expressions of HIF-1α and VEGF (r=0.72,t=6.37,P＜0.01)and the volume of brain edema(r=0.64,t=4.56,P＜0.01).Conclusions: The expression of HIF-1α in perihematomal brain tissue of hypertensive cerebral hemorrhage iS associated with the early formation of cerebral edema.HIF-1α may accelerate the formation of brain edema by inducing and regulating the expression of VEGF.

Objective To assess the ability of pixel-based quantitative evaluation of CT values in differentiating benign and malignant cystic-solid ovarian tumors.Methods CT images of 41 cystic-solid ovarian lesions from 39 patients were reviewed,with 27 benign and 14 malignant confirmed by post-operation pathology or follow-up.Regions of interest (ROIs) were drawn along edges of tumors on all slices of contrast-enhanced images with ImageJ software.CT values of each pixel were extracted.CT values of 20,25,30,35 and 40 HU were used respectively as the threshold to divide cystic and solid components.Solid proportion,the mean and median CT values of solid component were calculated and compared between benign and malignant groups.Results Mean CT values of solid components were all higher in malignant than in benign ovarian masses under all the threshold values (P<0.05).For median CT values, the same trend existed under the threshold of 20,25,35 and 40 HU (P<0.05).For the solid proportion,difference was found only under the 40 HU threshold, with lower value in malignant group (0.67±0.25) than in benign group (0.47±0.31).ROC curves were drawn to differentiate benign and malignant lesions.The highest AUC was obtained by using the mean CT value of solid components defined by 40 HU threshold (AUC=0.735).Conclusion Pixel-based quantitative evaluation on CT images could help to define cystic and solid components of ovarian masses, with 40 HU to be an optimal threshold.Cystic-to-solid proportion and CT value of solid components derived from whole lesion can help to differentiate benign or malignant lesions.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

As an endogenous organism protective measure in vivo, preconditioning/ postconditioning in the process of ischemia/reperfusion may play common protective mechanisms, such as reducing the generation of oxygen free radicals, activating adenosine receptor, increasing endogenous nitric oxide and heat shock protein, inhibiting immune inflammatory response and neuronal apoptosis, activating intracellular signal transduction pathways, opening mitochondrial ATP-sensitive potassium channels, as veil as closing mitochondrial permeability transition pores. Investigating the common target of these mechanisms may provide a new theoretical basis for developing new drugs and reducing ischemia/reperfusion injury.

Remote organ ischemic preconditioning is to conduct a transient and sublethal ischemic adaptation in non-vital organs before occurring cerebral ischemia/reperfusion injury in remote vital organs. Remote organ iscbemic preconditioning has been studied for as long as 15 years in the field of myocardial iscbemia. However, only recently it has become a therapeutic strategy for the treatment of cerebrovascular diseases, This article briefly reviews the methods and mechanisms involved in the protective effects of cerebral ischemia of remote organ ischemic preconditioning.