Objective To explore the application of the model of performance management in the nurses overall quality of quantitative management.Methods Many methods were used such as drafting the standards of performance appraisal,calculating the workload of nursing,using the evaluation methods of multilevel,multi-angle,network evaluation,cooperative researching management software,using the results for nurse office promotion,job promotion,salary distribution,and training.Results The turnover rate of nurses between 2006 and 2010 respectively was 2.38％,2.47％,0.45％,0.95％,and 0.59％,and lower than 5.8％ that of 696 Grade A hospitals in 2007.The clinical nurse team were stabilized,the nurse's working enthusiasm was mustered,the level of overall hospital care was improved.Conclusions The application of the model of performance management in the nurses overall quality of quantitative management could lay the foundation for supervisor evaluating the nurse objectively and impartially,and the nurse self-discipline was improved,the work efficiency was improved,the quality of care was improved.

AIMTo investigate glutamate-induced [Ca2+]i changes in cultured rat neonatal cortical astrocytes after hypoxia/reoxygenation, H2O2 or high concentration of L-glutamate injury. In the meantime, the effects of Gingko biloba extract (GbE) were examined.

METHODS[Ca2+]i changes in astrocytes were monitored by laser scanning confocal microscopy with the Ca2+ sensitive fluorescent probe fluo-3.

RESULTSAfter astrocytes were impaired by hypoxia/reoxygenation, H2O2 (50 micromol x L(-1)) or L-glutamate (0.25 mmol x L(-)), the exogenous glutamate (27 micromol x L(-1)) could not induce increase of [Ca2+]i, but decrease by (3.3 +/- 1.6)%, (81 +/- 11)% and (81 +/- 7)%, respectively. Pretreatment with GbE (10 mg x L(-1)) could not improve injured astrocytic glutamate response. But after pretreatment with GbE (100 mg x L(-1)), glutamate-induced [Ca2+]i elevation of astrocytes after hypoxia/reoxygenation, H2O2 or high concentration of L-glutamate injury were (135 +/- 98)%, (117 +/- 93)% and (89 +/- 36)%, respectively. Nimodipine (1.6 mg x L(-1)) could also reverse the abnormal response of astrocytes after different injury.

CONCLUSIONHypoxia/reoxygenation, H2O2 and high concentration of L-glutamate impaired astrocytes' response to exogenous L-glutamate, and then bidirectional communication between astrocytes and neurons could not take place. GbE could improve the abnormal responses and maintain the normal function of astroglical network. These effects support that GbE has potential beneficial actions against brain injury.

Animals ; Astrocytes ; cytology ; metabolism ; Calcium ; metabolism ; Cell Hypoxia ; Cells, Cultured ; Cerebral Cortex ; cytology ; metabolism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ginkgo biloba ; chemistry ; Glutamic Acid ; toxicity ; Hydrogen Peroxide ; toxicity ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Reperfusion Injury

OBJECTIVETo establish strategies for preventing graft versus host disease (GVHD) and reducing treatment associated morbidity while preserving graft versus leukemia (GVL) effect in nonmyeloablative allogeneic bone marrow transplantation (allo-BMT), with or without donor lymphocyte infusion (DLI) after BMT.

METHODS3 x 10(7) bone marrow cells mixed with 1 x 10(7) spleen cells from the same BALB/c mouse were transplanted into the nonablative irradiated inbred 615 mouse which received a single subcutaneous injection of 1 x 10(6) L615 leukemia cells three days before. The experiments were designed as follows (ten mice in each group): myeloablative BMT control group (group A), nonmyeloablative conditioning without BMT group (group B), nonmyeloablative BMT group (group C), and nonmyeloablative BMT + DLI group (group D). GVL effects were assessed by survival time, white blood cell count and L615 cells in peripheral blood and histologic changes. GVHD was assessed by signs of weight loss, ruffled fur, diarrhea and histologic changes of skin, liver and small intestines. Chimerism was detected by cytogenetic analysis and PCR technique.

RESULTSThe survival time of group A, B, C and D was (20.3 +/- 13.4), (15.9 +/- 1.1), (21.6 +/- 1.7) and (37.8 +/- 2.0) days, respectively, being no significant difference between group A and group C (P > 0.05). The survival time of group C was longer than that of group B (P < 0.01). And among group B, C and D, group D had the longest survival time (P < 0.01). GVHD signs and histologic changes were observed in 60% of control group mice at + 14 day, but none of group C and group D. 40% of mice in group A died of treatment associated morbidity within two weeks, but none in group C and group D. Allogeneic chimerism was kept in group A, but excluded gradually in group C.

CONCLUSIONGVL effect seems preserved in nonmyeloablative BMT mice, but weaker than that in myeloablative BMT mice. GVL effect seems to be enhanced by DLI after nonmyeloablative BMT. GVHD and transplantation associated morbidity seems to be reduced in nonmyeloablative BMT.

Animals ; Bone Marrow Transplantation ; immunology ; methods ; Combined Modality Therapy ; Female ; Graft vs Host Disease ; prevention & control ; Graft vs Leukemia Effect ; Leukemia, Experimental ; therapy ; Leukemia, Lymphoid ; therapy ; Lymphocyte Transfusion ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Inbred Strains ; Transplantation Conditioning ; methods ; Transplantation, Heterologous

Objective To explore a practical,measurable difficulty coefficient table of clinical nursing operation techniques,so as to perfect the evaluation system of clinical nursing work quantitative management.Methods Totals of 90 clinical nursing specialists from five three level of first-class comprehensive hospitals and one three level of first-class specialized subject hospital were investigates by questionaire of "the evaluation index system for assessing the difficulty of clinical nursing operation techniques" on 27 basic clinical nursing operation projects and 12 college clinical nursing operation projects.Results Eighty-two questionnaires were taken back,excluding invalid questionnaire eight copies,with 91.1％ of effective recovery rate.The difficulty coefficient of 39 clinical nursing operation techniques ranged between 0.67 and 1.98.Rating on the 27 items of basic nursing projects by nursing experts or backbone from different hospitals had no significant different scores [(1.21 ± 0.22) vs (1.22 ±0.19) ;t =0.495,P ＞0.05],while significant difference was found in 12 items of special nursing projects [(3.4±0.38) vs (2.9±0.31);t=5.169,P＜0.05].Conclusions "The evaluation index system for assessing the difficulty of clinical nursing operation techniques" can evaluate the difficulty of clinical nursing operation techniques systematically and comprehensively.The difficulty coefficient table of 27 items of basic clinical nursing operation techniques can be extended in different nature hospitals.It can be referred to explore the difficulty of college clinical nursing operation techniques.

OBJECTIVETo evaluate the urinary nuclear matrix protein (NMP22) as an adjuvant diagnostic index for transitional cell carcinoma of urinary tract and monitoring the state of disease.

METHODSUrinary samples were collected from 262 patients with transitional cell carcinoma, 198 non-transitional cell carcinoma of the urinary tract and 65 patients with benign diseases. Urinary NMP22 concentration was determined through enzyme linked immunosorbent assay (ELISA).

RESULTSThe urinary NMP22 concentration had significant difference among the three groups (Kruskal Wallis, chi(2) = 197.17 P < 0.001). The detection sensitivity and specificity of urinary NMP22 to transitional cell carcinoma were 71.37% and 87.69% respectively. The NMP22 concentration showed significant difference among three groups divided according to the pathological grade (Kruskal-Wallis test, chi(2) = 34.06 P < 0.01). The NMP22 concentration was significant lower in the recovery patients after the operation than the peoples of pre-operation and recurrence (Kruskal-Wallis test, chi(2) = 37.53, P < 0.001).

CONCLUSIONMP22 is a helpful tumor marker for the diagnosis of transitional cell carcinoma and monitoring the state of illness with increased efficacy.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; urine ; Carcinoma, Transitional Cell ; diagnosis ; urine ; Child ; Female ; Humans ; Male ; Middle Aged ; Nuclear Proteins ; urine ; Urinary Bladder Neoplasms ; diagnosis ; urine

Child, Preschool ; De Lange Syndrome ; genetics ; Female ; Humans ; Mutation ; Proteins ; genetics

OBJECTIVETo evaluate the expression and clinical significance of urinary nuclear matrix protein (NMP22) and cytokeratin 18 (CK18) for transitional cell carcinoma of the bladder.

METHODSUrinary NMP22 and CK18 levels of 293 patients with transitional cell carcinoma of the bladder, 400 patients with non-transitional cell carcinoma of the bladder, and 105 bladder benign disease were analysed by enzyme-linked-immunosorbent assay (ELISA).

RESULTSThe levels of urinary NMP22 and CK18 in the patients with transitional cell carcinoma of the bladder (M = 17.3 U/ml, M(CK18) = 484.2 U/L) were significantly higher than those in the non-transitional cell carcinoma of the bladder (M = 6.8 U/ml, M(CK18) = 156.0 U/L) and the benign disease group (M(NMP22) = 2.3 U/ml, M(CK18) = 66.6 U/L) (P < 0.001). The sensitivity and specificity of urinary NMP22 and CK18 were 79.2%, 88.6% and 78.2%, 82.9%, respectively, for transitional cell carcinoma of the bladder before any treatment. The joint sensitivity of the two markers was 91.7%. The NMP22 and CK18 levels were significantly lower in the recovered patients after surgical operation (P < 0.01), while in patients with recurrence or metastasis the levels of the markers were significantly higher (P < 0.01). There was a significant relationship between NMP22 and CK18, (r = 0.689, P < 0.01). The levels of urinary nmp22 and CK18 were significantly different among pathological grade G1, G2, G3, and stage Ta, T1, T2, T3 (P < 0.01).

CONCLUSIONNMP22 and CK18 are useful tumor marker for diagnosis of transitional cell carcinoma of the bladder and for monitoring the state of illness. The joint use of the two markers can improve the sensitivity of cancer detection. NMP22 and CK18 may become a new class of tumor markers, and to be the basis for development of a new assay with an increased efficacy for the detection and treatment of bladder cancer.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; urine ; Carcinoma, Renal Cell ; urine ; Carcinoma, Transitional Cell ; diagnosis ; pathology ; surgery ; urine ; Child ; Female ; Follow-Up Studies ; Humans ; Keratin-18 ; urine ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; urine ; Neoplasm Staging ; Nuclear Proteins ; urine ; Prognosis ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; diagnosis ; pathology ; surgery ; urine ; Young Adult

OBJECTIVETo evaluate the value of whole-body diffusion weighted imaging (WB-DWI) on detection of malignant metastasis.

METHODSForty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging (MRI) or computed tomography (CT). WB-DWI was performed using short TI inversion recovery echo-planar imaging (STIR-EPI) sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations.

RESULTSWB-DWI demonstrated 143 focuses, 14 of which were diagnosed to be benign lesions in routine imaging. The number of bone metastases depicted on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases. Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain (chi2=30, P<0.001).

CONCLUSIONSWB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mediastinal lymph node, brain, and lung metastases.

Aged ; Bone Neoplasms ; secondary ; Brain Neoplasms ; secondary ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Metastasis ; diagnosis ; pathology ; Neoplasms ; diagnosis ; pathology ; Whole Body Imaging ; methods

Suvivin is a novel member of the inhibitor of apoptosis protein (IAP) family, which is known to be over-expressed in various carcinomas and associated with their biologically aggressive characteristics. The aim of this study was to investigate survivin expression in human medullary thyroid carcinoma (MTC) and a MTC cell line TT, correlate suvivin expression with clinicopathologic features of MTC, and test effects of antisurvivin oligonucleotides (ASODNs) on growth and apoptosis of TT cells. Survivin expression was immunohistochemically determined in formalin-fixed and paraffin-embedded specimens obtained from 10 cases of normal thyroid (NT) and 10 cases of MTC, and in TT cells. In TT cells, we confirmed survivin expression and its down-regulation by ASODNs using RT-PCR and Western blot analyses, and investigated effects of ASODNs on viability and growth by MTT assay and apoptosis by apoptotic analyses including DNA laddering assay, acridine orange/ethidium bromide staining and flow cytometric cell cycle analysis. Immunohistochemical analysis showed high survivin expression in MTC and TT cells, whereas no immunoreactivity was detectable in NT. Statistical analyses revealed no significant correlation of survivin expression with the clinicopathologic features of MTC. In TT cells, survivin expression at both mRNA and protein levels was confirmed and could be down-regulated by ASODNs concomitant with decrease in viability and growth, and increase in apoptosis. Our results suggest that survivin plays an important role in MTC independent of the conventional clinicopathologic factors, and ASODNs is a promising survivin-targeted gene therapy for MTC.
Time Factors ; Thyroid Neoplasms/*metabolism/pathology ; Reverse Transcriptase Polymerase Chain Reaction ; Oligonucleotides, Antisense/genetics/*pharmacology ; Neoplasm Proteins/genetics/*metabolism ; Microtubule-Associated Proteins/genetics/*metabolism ; Male ; Humans ; Gene Expression Regulation, Neoplastic/drug effects ; Female ; Down-Regulation/drug effects/genetics ; Dose-Response Relationship, Drug ; Cell Survival/drug effects ; Cell Proliferation/*drug effects ; Cell Line, Tumor ; Carcinoma, Medullary/*metabolism/pathology ; Apoptosis/*drug effects ; Adult

BACKGROUNDTraumatic brain injury (TBI) is a major cause of death and disability in children and young adults worldwide. Therefore, we investigated the role of AG490 in regulating brain oedema, expression of CD40 and neurological function after TBI.

METHODSSprague Dawley rats (n = 240) were randomly divided into a sham operation group, TBI+saline group and TBI+AG490 (JAK/STAT inhibitor) group. Members of each group were euthanized at 6, 12, 24 or 72 hours after injury. Neurological severity score (NSS) was used to evaluate the severity of neurological damage. Brain water was quantitated by wet/dry weight method. The expression of CD40 was assessed by flow cytometry.

RESULTSIn both the TBI+saline group and the TBI+AG490 group, the brain water content was elevated after TBI, reached a peak at 24-hour and remained high for the rest of the period investigated; the expression of CD40 reached a peak 24 hours after TBI; the NSS was elevated after TBI and then decreased after 6 hours. Elevations in the level of CD40, degree of brain edema and NSS after TBI were significantly reduced in TBI+AG490 group.

CONCLUSIONInhibition of the JAK/STAT signalling pathway reduces brain oedema, decreases the expression of CD40 and exerts neuroprotective effects after TBI.

Animals ; Brain Edema ; metabolism ; Brain Injuries ; drug therapy ; CD40 Antigens ; analysis ; Flow Cytometry ; Janus Kinases ; metabolism ; Male ; Neuroprotective Agents ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; STAT Transcription Factors ; metabolism ; Tyrphostins ; therapeutic use