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Objective:To construct a leadership evaluation indicator system for managers in primary healthcare institutions.Methods:This study was a qualitative research. Based on the Chinese Academy of Sciences′ Five Forces Model of Leadership, the framework of the leadership evaluation indicator system for primary healthcare institution managers was initially constructed through literature review, expert interviews, surveys, and group discussions. From November 2020 to June 2021, 19 experts were invited to participate in two rounds of Delphi expert consultations. Based on the consultation results, the leadership evaluation indicator system for primary healthcare institution managers was developed, and the analytic hierarchy process (AHP) was used to determine the weight of each indicator.Results:Nineteen consulting experts were included in the study, 13 of whom were aged 40 years or older, and seven of whom had 20 years or more of professional experience. The response rates of the two rounds of Delphi expert consultation questionnaires were 18/19 and 19/19, respectively; the authority coefficients of the experts were 0.92 and 0.91, respectively. In the second round of consultation, the coordination coefficients of each level of indicators were 0.640, 0.557, and 0.512 ( P<0.05), respectively. The constructed leadership indicator system for managers of primary healthcare institutions included five primary indicators, 16 secondary indicators, and 44 tertiary indicators. The primary indicators, in order of their weight, were "influence"(0.299),"decisiveness"(0.245),"control"(0.156),"inspiration"(0.150), and "foresight"(0.150). Conclusions:This study is a preliminary construction of a leadership evaluation indicator system for managers of primary healthcare institutions, which can be a reference for the training and evaluation of relevant talents.
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Objective:To investigate the effects of endocrine drugs on tumor markers and endometrium after breast cancer surgery.Methods:Eighty-eight patients with endocrine therapy for breast cancer admitted to the Heping Hospital Affiliated to Changzhi Medical College from November 2018 to March 2022 were selected, 44 patients taken orally tamoxifen citrate tablets were enrolled in the study group, 44 patients taken orally anastrozole tablets were enrolled in the control group, the patients in the two groups were treated for 12 months. The tumor markers, endometrial thickness were compared between the two groups before treatment and 12 months after treatment. The drug safety was compared too.Results:After treatment, the serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and glycochain antigen 15-3 (CA15-3) in both groups were decreased, and the level of tumor markers in the study group were lower than those in the control group: (3.01 ± 0.23) μg/L vs.(3.89 ± 1.15) μg/L, (4.22 ± 1.21) kU/L vs. (7.38 ± 2.19) kU/L, (16.76 ± 2.19) kU/L vs. (19.87 ± 2.21) kU/L, there were statistical differences ( P<0.05). The endometrial thickness in the study group at 6 months and 12 months after treatment were higher than those in the control group: (7.23 ± 0.22) mm vs. (6.21 ± 0.19)mm, (7.98 ± 0.24) mm vs. (6.47 ± 0.22) mm, there were statistical differences ( P<0.05). At 12 months after treatment, the scores of functional dimension, emotional dimension, social/family dimension and physical dimension in functional assessment of cancer therapy (FACT-G) scale in the study group were significantly higher than those in the control group ( P<0.05). There was no statistically significant difference in adverse reactions between the two groups ( P>0.05). Conclusions:Tamoxifen citrate tablets can effectively inhibit the levels of serum tumor markers and improve the quality of life of patients, and anastrozole tablets can significantly reduce the endometrial thickness of breast cancer patients.
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Objective To analyze the diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) in the detection of incision infection after breast cancer surgery. Methods A total of 152 breast cancer patients admitted to our hospital from June 2016 to April 2018 were enrolled. All patients were given surgery.According to whether the wound infection occurred after operation, the patients were divided into control group (not infected, n=114) and observation group (infected, n=38). The serum levels of PCT, CRP and IL-6 were measured in the two groups on the 2 nd postoperative day. Results The average operation time and hospital stay in the observation group were longer than those in the control group (P<0.05). The serum levels of PCT, CRP and IL-6 in the observation group were higher than those in the control group (P<0.05). The positive rate of the observation group was higher than that of the control group (P<0.05). Conclusion In patients with breast cancer surgery, serum PCT, CRP and IL-6 detection can provide a good reference for the prediction of postoperative incision infection.
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Objective To investigate the present status of early diagnosis and misdiagnosis of nasopharyngeal carcinoma (NPC). Methods A total of 50 patients diagnosed as NPC were recruited at the department of nasopharyngeal carcinoma in our hospital. The time from that patients felt discomfort to be diagnosed of NPC was determined bydifferent symptoms and signs. Furthermore , the status of misdiagnosis were also investigated. The spearmans rank correlation was used to analyze the correlation between the cancer stage and the time of confirmeddiagnosis , and the relationship between the rate of misdiagnosed and the rank of the hospital they visited. The χ2 test was then used to analyze the cancer stage with the time when they were diagnosed. Results Results indicated that the time when patients were diagnosed significantly correlated with pTNM stage (P < 0.05). Patients diagnosed in one month were most at stage Ⅱ, diagnosed in six months were stage III, and diagnosed after twelve months were stage Ⅳ(P < 0.05). Furthermore, we found that the rate of misdiagnosis of NPC was 12%. Moreover,the misdiagnosed rate was associated with the rank of the hospital patients visited. Discussion In conclusion , the present status of the early diagnosis of NPC is not optimistic. Most of the patients with NPC were misdiagnosed in basic medical institutions , especially in town or village health center. Thus, it is important to popularize the health knowledge about the secondary prevention of NPC and train the doctor in basic medical institutions.
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Objective To identify the role of miR-124 in regulating the radiosensitivity and the epithelial-mesenchymal transition (EMT) of nasopharyngeal carcinoma (NPC). Methods Transient transfection of cells with miR-124 mimic or inhibitor was performed and wound-healing assay was used to investigate the role of miR-124 in the EMT of NPC. The apoptosis affected by miR-124 was also measured after irradiation , followed by investigating the cell proliferation by EdU assay. Finally , proteins of Akt and ERK associated with EMT and radiosensitivity, were measured by western blot. Results The migration index from NPC cell line indicated that miR-124 repressed the EMT. The results from caspase-3 activity assay showed that caspase-3 activity after irradiation significantly increased in miR-124 mimic group compared with the control group (P < 0.01). It was also confirmed that irradiation led to a higher percentage of apoptosis in miR-124 group compared with the control group in NPC cells. Cell proliferation after irradiation was significantly decreased in MiR-124 group as compared with control group . MiR-124 inhibited the protein expression of p-Akt . Conclusion MiR-124 may repress the EMT and decrease radio-resistance of NPC via p-Akt signaling pathway , which may provide a new insight into radio-resistance in NPC.
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Objective The radiotherapy resistance is one of important causes for nasopharyngeal carcinoma(NPC) treatment failure.Junctional adhesion molecule A(JAMA)is closely correlated with the tumor poor prognosis.Thus this experiment is to in vestigate the relationship between JAMA expression and the radiosensitivity of NPC.Methods To overexpress or interfere the JAMA expression in CNE2 and HONE1 cell lines.Then different doses of X-ray were adopted to conduct irradiation.The cell clone formation capacity and cellular apoptosis change were detected after 24 h.The role of JAMA in the NPC radiotherapy was understand.The related signal pathway protein in cell lines with different JAMA expression was detected by Western blot.Results The cell lines with low JAMA expression were more sensitive to radiotherapy:After low JAMA expression,the D0 value in the CNE2 cell line was decreased from 3.26 ±0.78 to 1.92 ± 0.23;the Dq value was decreased from 46.51 ± 4.27 to 32.12 ± 3.19.The radio therapy induced apoptosis was significantly increased in the cell lines with low JAMA expression,after low JAMA expressing,thcellular apoptosis was elevated from 6.9 ％ ± 0.9 ％ to 13.7 ％ ± 1.3 ％;the HONE1 cellular apoptosis was elevated from 6.5 ％ + 1.1 ％ to 12.3 ％ ± 1.7％;JAMA overexpression cell lines were significantly decreased.The preliminary mechanism research results showed that JAMA played the effect via Akt signal pathway.Conclusion This research results verifiy that JAMA expression level is closely correlated with the radiosensitivity of NPC cell line:JAMA can increase the radiotherapy resistance of NPC cell lines,which provides a new feasible research direction for NPC enhancing radiosensitivity.
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This case report presents an extracted maxillary third molar,which have 3 separate roots with 5 canals,the canal configuration in mesiobuccal root are 3 separate orifices and canals,1 apical foramen.The clinician should be aware of this anatomical variation,avoid the missed canals.
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ObjectiveTo evaluate the value of three dimensional spiral computed tomography(3D SCT) and its reconstruction technique in the diagnosis of spinal fracture. Methods85 patients of vertebral fractures were examined with helical CT thin scan. After data were transferred to computer workstation,MPR and 3D images were reconstructed. Each study was evaluated for showing the level of the fractures, vertebral alignment, vertebral height loss,line of fractures, posterior element involvement, narrowing of the vertebral canal, and the grade of rotation and/or dislocation. Results85 patients were detected in 104 CT vertebral fractures:C4 ～ C7 4 vertebra,T6 9vertebra,T10 10 vertebra,T11 16 vertebra,T12 22 vertebrae,L1 19 vertebrae,L2 6vertebra,L3 8 vertebrae,L4 10 vertebra. Of 85 cases,The fratures were displayed by the images of CT,MPR is more supcrior in displaying alignment and displaeement of frarue than thoso of other techniques, MPR has an advantage in displaying the small fractures,3D displays the space of bone structures,and neural canal compression. ConclusionSpiral CT diagnosis of vertebral fractures had a high application value. Axial, MPR and 3D in combination, could clear the degree of injury,three-dimensional,visual, multi-directional information needed to provide clinicians, will help the choice of treatment.
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[Objective] To search a reasonable approach to the treatment of nasopharyngeal carcinoma (NC) with traditional Chinese medicine integrated with western medicine. [ Methods ] Seventy - six cases of NC were randomized into Group A and Group B. Group A ( n = 39) was treated with herbs for activating blood and removing blood - stasis, nourishing yin and clearing heat during radiotherapy and herbs for replenishing qi and nourishing yin, generating body fluid, moistening dryness and clearing heat after radiotherapy. Group B ( n = 37) was treated with radiotherapy alone. Short - term therapeutic effect, long - term survival rate, the relief of main symptoms, the reduction of cervical lymph node metastasis and side effect of radiotherapy in the two groups were observed. [ Results ] After treatment, the complete relief (CR) rate was 84.6% and 15.4% and partial relief (PR) rate was 73.0% and 27.0% in Group A and B respectively, the differences being significant ( P