Objective This study aims to conduct an evidence-based analysis of the research progress and management status of the competence of clinical department heads and nurse managers in China,providing reliable references for further devel-oping their management research and improving the human resource management in Chinese hospitals.Methods The VIP,CNKI,WANFANG Chinese databases,online resources,and relevant official websites were searched to retrieve literature related to the competence of clinical department directors and nurse managers in China.Descriptive analysis was conducted using biblio-metrics and evidence-based principles and methods.Results A total of 82 articles were included,mainly focusing on the con-ceptual theories of clinical department directors and nurse managers,the construction of competence models,and application re-search.The research on the competence of clinical department directors and nurse managers in China started relatively late and showed a trend of initial growth followed by decline.The distribution of journals was relatively scattered,and the literature mainly came from higher education institutions and medical institutions.The research development has stagnated at the stage of empirical research and has not progressed to the stage of evaluative research.Conclusion The research on the competence of clinical de-partment directors and nurse managers in China is still in the stage of application and practice,lacking systematic research.It is mainly led by higher education institutions and medical institutions,and the attention from the national government in terms of competence of clinical department directors and nurse managers in hospitals needs to be strengthened.

Animals ; Mice ; Chlamydia muridarum ; Mice, Inbred BALB C ; Antigens, Bacterial ; Chlamydia Infections

Early-onset epilepsy is a neurological abnormality in childhood, and it is especially common in the first 2 years after birth. Seizures in early life mostly result from structural or metabolic disorders in the brain, and the genetic causes of idiopathic seizures have been extensively investigated. In this study, we identified four missense mutations in the SETD1A gene (SET domain-containing 1A, histone lysine methyltransferase): three de novo mutations in three individuals and one inherited mutation in a four-generation family. Whole-exome sequencing indicated that all four of these mutations were responsible for the seizures. Mutations of SETD1A have been implicated in schizophrenia and developmental disorders, so we examined the role of the four mutations (R913C, Q269R, G1369R, and R1392H) in neural development. We found that their expression in mouse primary cortical neurons affected excitatory synapse development. Moreover, expression of the R913C mutation also affected the migration of cortical neurons in the mouse brain. We further identified two common genes (Neurl4 and Usp39) affected by mutations of SETD1A. These results suggested that the mutations of SETD1A play a fundamental role in abnormal synaptic function and the development of neurons, so they may be pathogenic factors for neurodevelopmental disorders.

The adhesion in the gallbladder triangle is the most important factor influencing the conversion to laparotomy in laparoscopic cholecystectomy (LC).The degree of adhesion in the cholecystic triangle is closely related to the difficulty of LC operation.With the reduction of cholecystic triangle adhesion,the treatment of gallbladder during LC will be easy and the rate of conversion to laparotomy will decrease accordingly.In order to investigate the causes of cholecystic triangle adhesion and its influence on LC,this paper reviews the current research progress.

Objective Four different methods were examined to identify a safer and more reliable method for tail vein punctures in C57BL/6 mice. Methods In total,320 mice were randomly divided into four groups: a blank group, incandescent lamp baking method group,three-line method group,and combined method group. Blood samples were taken from the left or right peripheral vein of puncture mice. Puncture success rate of each group was recorded. SPSS 13.0 software was used to compare statistical difference among groups. Results Compared with the blank group,success rates of the other three methods were significantly higher(P < 0.001). Further, the three-line method was better than the incandescent lamp baking method(P< 0.001). The success rate of the combined method was significantly higher than the three-line and incandescent lamp baking methods(P< 0.001). Conclusions The combined method greatly improved the success rate of tail vein punctures in C57BL/6 mice. This method is more reliable and should be more widely used in the future.

Objective To study the effect and mechanism of down-regulating Silt2/Robo 1 signaling pathway on rabbit iliac artery after angioplasty restenosis. Methods The 30 male New Zealand white rabbits were divided randomly into 3 groups , namely the blank group , the control group , and the experimental group , 10 rabbits in each group. Hign-fat feeding , the rabbits were produced endothelial denudation of iliac artery stenosis model. Another 4 weeks of feeding , percutaneous balloon angioplasty was performed. Then R5 antibody was injected into the abdominal cavity. After 4 weeks of feeding ,angiography again. The results of angiography was analysied by image workstation. The concentrations of Slit2 and Robo1 was detected by ELISA. The iliac artery tissue examined by HE staining. Results The rabbit iliac artery after angioplasty restenosis animal model was set up successfully. Compared with the control group and the experimental group , the serum concentration of Slit2 and Robo1 were significantly higher (P < 0.01) than the blank group. But in the experimental group, the Slit2 and Robo1 serum concentrations were significantly lower than those in the control group (P < 0.05) after R5 antibody intervention. The area ratio stenosis and diameter stenosis rate of iliac artery were reduced that confirmed by angiography. Conclusion The expression of Slit2/Robo1 was significantly higher in the rabbit model of vascular restenosis. R5 antibody can effectively inhibit the expression of Slit2/Robo1. Down regulation of Slit2/Robo1 signaling pathway in the treatment of restenosis after angioplasty in rabbits.

Objective To investigate the effects of CD147/MMP-9 pathway on early left ventricular remodeling Methods 30 healthy eight-week male SHR were divided into 3 groups (n = 10 for each group). SHR group received tail vein injections of normal saline weekly; CD147 group received CD147 of 600 ng·kg-1 weekly; and CD147+DOX group received CD147 of 600 ng/kg weekly and intragastric administration of DOX ( doxycycline ) of 30 mg/kg daily . 10 healthy eight-week male Wistar-Kyoto rats (WKY group) were treated as SHR group. Echocardiography, myocardial sections microscopy examination (HE and VG stain), and Western blot (for assessing levels of MMP-9, TIMP-1, CD147, and collagen I and Ⅲin myocardial tissues) were performed on day 56. Left ventricular weight index (LVWI)was measured and calculated. Collagen volume fractions (CVF) were obtained by image analysis. Results As compared with WKY group , levels of CD147 , MMP-9 , and MMP-9/TIMP-1 were lower but TIMP-1 and collagenⅠand Ⅲ were significantly higher in SHR group. The abundance of CD147 and MMP-9 protein and the ratio of MMP-9/TIMP-1 were obviously increased in CD147 group than in SHR group (P < 0.05). Levels of CD147, MMP-9, and MMP-9/TIMP-1 did no differ between CD147+DOX group and CD147 group. LVWI and contents of collagenⅠand Ⅲ were obviously declined in CD147 group as compare with SHR group. Cardiomyocyte hypertrophy , partial myocardial fibre rupture , myocyte dissolution and fuzzy myocardial fibre boundaries , more abundant of collagen fibers, and higher CVF were found in SHR group. Cardiac fibrosis was significantly improved after CD147 intervention, but the action was suppressed as DOX was administrated simultaneously. Conclusions Early ventricular remodeling may be involved in the inhibition of CD147/MMP-9 pathway in SHR. Input of CD147 to upregulate the pathway can improve the remodeling.

Objective To compare the effect of TNF-α preconditioning and ischemic preconditioning on hepatic ischemia-reperfusion injury ( IRI) and investigate the underlying mechanisms of TNF-αpreconditioning. Methods Fourty healthy male Wistar rats were random-ly divided into four groups which were Sham-operated group ( SO) ,ischemia-reperfusion group ( IR group:produced by total inflow occlusion for 30 min) ,ischemic preconditioning group ( IPC group:induce with 10 min hepatic ischemic and open 10 min before IR) and TNF-αpre-conditioning group ( TPC group:intraperitoneal injection with 1 μg/kg TNF-a 30 min prior to IR) . The sample of blood and hepatic tissue of all groups were taken after experiment. The protein levels of NF-κBp65 and Bcl-2 in the hepatic tissue were detected by immunohistochemis-try. Results There was significant difference (P<0. 05) between IR group and IPC group,TPC group on the level of ALT,AST and the expression of NF-κBp65 and Bcl-2,apoptosis index in hepatic tissue. There was no significance difference (P>0. 05) between IPC group and TPC group. Conclusion TNF-α preconditioning decreased the intensity of hepatic IRI,just as ischemic preconditioning,by induces an de-crease in the NF-κBp65 expression and an increase in the Bcl-2 expression.

OBJECTIVETo assess the feasibility and safety of using the modified active fixation pacing leads model to pace the right ventricular outflow tract septum.

METHODSA total of 136 patients undergoing artificial heart pacemaker implantation with active fixation pacing leads were randomized into two groups to receive conventional right ventricular outflow tract pacing (CRVOTP) or modified right ventricular outflow tract pacing (MRVOTP). The electrode lead wire core was modeled in a double-curved three-dimensional shape in CRVOTP group and in a J-shaped bend in MRVOTP group before fixation at the right ventricular outflow tract septum.

RESULTSRight ventricular outflow tract septum pacing was achieved successfully in all the patients. None of patients experienced serious complications. No significant differences were found between the two groups in the number of times of electrode fixation, pacing thresholds, impedance, R wave height or QRS wave width during the operation, but MRVOTP was associated with a reduced time of X -ray exposure and operation (P<0.05) due to the convenience in electrode modeling and in passing the leads through the tricuspid annulus and the direct access to the right ventricular outflow tract septum. Postoperative follow-up of the patients showed no incidence of active fixation pacing lead dislocation and comparable pacing thresholds of the ventricular electrodes, impedance, R wave height and QRS wave width between the two groups.

CONCLUTIONSUsing the modified active fixation pacing leads model to pace the right ventricular outflow tract septum can reduce the time of X -ray exposure and operation with a low probability of lead damage.