Objective:To explore the effect of plan-do-check-action (PDCA) theory in nursing human resource allocation.Methods:From January 2018 to December 2019, we selected shared nurses who had obtained qualification certificates after participating in hospital specialist nurse training as the research object. We carried out "Plan, Do, Check and Action" following the PDCA principle and analyzed the influencing factors of the lack of nursing human resources by the fishbone diagram. We also discussed the improvement measures and implemented them, and observed the implementation effect.Results:After the application of PDCA cycle management, patient satisfaction and nurse satisfaction were higher than those before improvement, and the incidence of adverse nursing events above grade Ⅳ decreased, and the difference was statistically significant ( P<0.05) . Conclusions:PDCA cycle management can effectively improve the lack of nursing human resources and has certain promotion value.

OBJECTIVE： To provide reference for pharmaceutical manufacturers improving the quality system of GMP and drug regulatory departments improving their supervision level. METHODS： Through analyzing and summarizing the problems existing in the 28 pharmaceutical enterprises which had been published on the website in the National Medical Products Administration from February 6th， 2018 to January 25th， 2019， the common problems were found and their causes were analyzed， then the regulatory countermeasures were put forward. RESULTS & CONCLUSIONS： Pharmaceutical enterprises have some problems of inadequate implementation of GMP， such as the inadequate performance of personnel in key positions and the unsatisfactory training effect of relevant personnel， the inconsistency between actual production technology and approved legal technology， the non-standard management of enterprise materials， the incomplete batch production records and the inability to effectively monitor the production cycle. However， there are also some problems in the supervision department， such as the large difference in the scale of inspectors’ on-site inspection， the need to strengthen the inspectors’ inspection ability and level， and the lack of innovation in the means of supervision. It is suggested that pharmaceutical manufacturers should improve the construction of GMP quality management system and strengthen the training of relevant personnel； the regulatory authorities should continue to promote the reform of “release， control and service”， strictly enforce the access conditions of inspectors， strengthen the training of inspectors and ideological construction of the inspector team，further strengthen the construction of supervision system and enhance the innovation of supervision means， so as to jointly maintain the safety， effectiveness and quality controllability of medicines.

Objective To investigate the correlation between C-reactive protein (CRP) level at admission and severity and early outcome of acute ischemic stroke.Methods Inpatients with acute ischemic stroke were enrolled retrospectively.The demographic and clinical data were collected.The National Institutes of Health Stroke Scale (NIHSS) at admission was used to evaluate the neurologic deficits,≤8 was defined as a mild stroke and ＞ 8 was defined as a severe stroke.The modified Rankin scale was used to evaluate the outcomes at discharge,0-2 was defined as good outcome and ＞ 2 was defined as poor outcome.Multivariate logistic regression analysis was used to determine the independent influencing factors of severity and early outcome of acute ischemic stroke.Results A total of 120 patients with acute ischemic stroke were enrolled in the study.Their mean age was 63.35 ± 11.51 years,71 (59.17％) were males;81 had mild stroke (67.5％),39 (32.5％) had moderate to severe stroke;71 (59.17％) had good outcome,and 49 (40.83％) had poor outcome.There were significant differences in the age,CRP level,and proportions of ischemic heart disease,atrial fibrillation,smoking,and drinking between the mild stroke group and the moderate to severe stroke group (all P ＜0.05).Multivariate logistic regression analysis showed that ischemic heart disease (odds ratio [OR] 4.407,95％ confidence interval [CI] 1.100-17.653;P=0.036),atrial fibrillation (OR 6.603,95％ CI 1.190-36.635;P =0.031) and CRP (OR 1.022,95％ CI 1.001-1.043;P =0.041)were independently and positively correlated with the severity of stroke.There were significant differences in baseline NIHSS score,fibrinogen and CRP level,as well as the proportions of the patients with atrial fibrillation,smoking,and drinking between the good outcome group and the poor outcome group (all P ＜0.05).Multivariate logistic regression analysis showed that smoking (OR 8.895,95％ CI 1.699-46.557;P=0.010),baseline NIHSS score (OR 2.241,95％ CI 1.567-3.206;P ＜0.001),and CRP (OR 1.195,95％ CI 1.030-1.386;P =0.019) were independently correlated with the early poor outcomes.Conclusion CRP level at admission was the independent influencing factor of severity and early outcome of acute ischemic stroke.

BACKGROUND:The differentiation of mesenchymal stem cells(MSCs)is strictly regulated by both genetic and epigenetic Factors .Emerging evidences have demonstrated that microRNA also plays an important role in this process.OBJECTIVE:To explore the differential expression of microRNA-125b during neuronal dliferentiation of Flk1~+ adipose-derived MSCs(AD-MSCs).MATERIALS:The fat samples were provided bv healthy female volunteers aged 15-35 years and recruited from the Plastic Surgery Hospital affiliated to the Chinese Academy of Medical Sciences.METHODS:Adult adipose tissues were obtained from healthy voluntears with age of 15-35 years .Using adherence method,Flk1~+ MSCs were obtained and the 3~(rd) passage cells were taken in the experiment.Cultured in neuronalinduction medium.these MSC were induced to differentiate towards neuronal lineage.The expression of microRNA-125b was examined at days 0,4,8 and 12.To explore its role in neuronal differentiation,we need to change its expression.RT-PCR and Taqman real-time PCR were carried out to explore the difierentially expression of microRNA-125b during neuronal differentiation of AD-MSCs.The effect of inhibitor on the expression of microRNA-125b was detected.RESULTS AND CONCLUTION:①The Flk-1~+MSCs were successfully induced into neuronal differentiation and displayed typical morphological changes 12 days after induction:Most cells retracted their cytoplasm ,fomling spherical cell body and emitted cellular protrusions.RT-PCR and immunocytochemistry studies confirmed their phenotype with expression of known neuronal cell markers including neurofilament,glial fibrillary acidic protein.②The expression of microRNA-125b was significant up-regulated during neuronal differentiation .Results of RT-PCR and Taqman real-time PCR were concordarlce with that of microRNA chip technology.③Inhibitor could down-regulate microRNA-125b.The results implied that microRNA-125b may play an important role in neuronal differentiation.