Objective To survey health management cognition of residents in Shanghai city communities,and to analyze the causes,and to put forward related suggestions.Methods In October of 2013,this study was conducted in communities of Shanghai central district (Xuhui District),urban border area (Minhang District),and suburban area (Jinshan District); 800 residents from each health management cognition outpatient clinic (400 people from each of hospitals and community health service center),totally 2 400 residents were studied and investigated in the communities of Shanghai city,and 2 082 questionnaire were received (the questionnaire recovery rate was 86.75％).We used stratified random cluster sampling method,and self-designed investigation form,and did pre-experiment.The Survey included:Whether family doctors need to carry out the evaluation work about risk factors,to implement health management for school students,to implement health management for people over 60 years old,to implement the elderly health management for pension agencies,to implement special crowd health management for special people;conduct questionnaire of demand level for different population groups (type,age,gender,marital status,retirement,occupation,level of education and medical insurance form).Results The research results found that,when asked about the family doctor whether to carry out risk assessment,family doctor whether to implement special health management,whether family doctors need to teach health management to students, whether family doctor should undertake the health management work for the people over the age of 60,whether family doctors should implement special health management,whether a person thinks that it is indifference (9.3％,7.4％,3.8％,6.2％ and 5.7％) and unnecessary (3.6％,4.4％,2.5％,4.2％ and 3.9％)in the minority,the majority of people believe that they need (51.1％,52.9％,57.2％,55.6％ and 55.3％),then the general (24.5％,18.9％,12.4％,18.0％ and 16.5％) and very necessary (11.5％,16.4％,24.1％,16.0％ and 18.6％).Among them,the occupation,whether retired or not,level of education,medical insurance form and different age groups had different cognition and demand level for health management work.Conclusion To Strengthen the health management training,to take specific health management services according to different groups of people and to improve community health management services are very important.

On the basis of a retrospective summary of the policies for foreign-invested hospitals in China,this paper analyzed the main issues facing wholly foreign-owned hospitals and suggested a basket of strategies to promote the development of such hospitals in China (Shanghai)Pilot Free Trade Zone.

Multiple myeloma (MM) is a clonal plasma cell malignancy, a low proliferative and low apoptotic activity molecular cloning of a disease, which indicates that apoptosis inhibition may play an important role in the pathogenesis of MM. Therefore, the study of MM pathogenesis-related promoting apoptosis genes/proteins and inhibiting of apoptosis genes/proteins, as well as the correlation between them provides a new strategy for molecular targeted therapy.

Objective .To evaluate the role of cystatin c in the risk judgement of coronary artery disease. Methods 77 patients with coronary artery disease were involved in the study.They were divided into two groups:Group 1 were patients with angiographically diagnosed coronary artery disease ( CAD) with their first acute coronary syndrome ( n=55);Group 2 were patients who had clinically diagnosed coronary disease but were negative on angiog-raphy ( n=22) .Serum Cys C levels in the two groups and the correlation to CAD were analyzed.Results Serum Cys C levels in patients of Group 1 were higher than that of Group 2 [(1.23 ±1.07)mg/L vs.(0.71 ±0.32)mg/L,P=0.002],but no significant difference was found between the two groups in crea levels [(123.76 ±80.44)μmmol/L vs.(117.63 ±65.43)μmmol/L,P=0.230].A ROC analysis revealed that there was a significantly higher risk of ACS above a cystatin c level of 0.875mg/mL (sensitivity:84.3%,specificity:38.8%).A similar analysis carried out for eGFR did not find any significant cut-off points above which risk of ACS was higher.Conclusion The data showed that a high level of cystatin c level is a risk factor for ACS.This could play an important role in the early diag-nosis and prevention of adverse cardiovascular events.

Objective To explore the clinical effectiveness of transcervical resection of polyps (TCRP) under hysteroscopes and dilatation and curettage in treatment for endometrial polyps infertility.Methods Ninety patients with endometrial polyps infertility from October 2010 to August 2012 were enrolled in this study.In them,45 patients were treated with TCRP under hysteroscopes (TCRP group),45 patients were treated with dilatation and curettage (dilatation and curettage group).Patients were followed up for 1 year,menstrual blood volume and endometrial thickness in ovulatory before operation and after operation for 3,6 and 12 months were recorded and compared between two groups.While the recurrence rate after operation for 6,12 months and 1-year pregnancy rate were also recorded and compared between two groups.Results The menstrual blood volume and endometrial thickness in ovulatory before operation between two groups had no significant difference (P ＞ 0.05).The menstrual blood volume after operation for 3,6 and 12 months in TCRP group was (125.2 ±56.4),(154.0 ±72.3) and (189.8 ±96.6) ml,respectively.While in dilatation and curettage group was (215.3 ± 87.8),(267.5 ± 98.4) and (297.5 ± 125.6) ml.There were significant differences (P ＜ 0.05 or ＜ 0.01).The endometrial thickness in ovulatory after operation for 3,6 and 12 months in TCRP group was significantly lower than that in dilatation and curettage group (P ＜ 0.05 or ＜ 0.01).The recurrence rate after operation for 6,12 months and 1-year pregnancy rate in TCRP group was 4.4％ (2/45),8.9％ (4/45)and 20.0％ (9/45) ; in dilatation and curettage group was 8.9％ (4/45),35.6％(16/45) and 26.7％ (12/45).The recurrence rate after operation for 12 months in TCRP group was significantly higher than that in dilatation and curettage group (P ＜0.01).Conclusions The prospective efficacy of TCRP under hysteroscopes in treatment of endometrial polyps infertility is better than dilatation and curettage.It is one of better methods and worthy to spread.

The onset of irreversibility of cardiovascular diseases caused by obesity has showed a rising trend,the underlying cause of the disease is the endothelial damage.Injury caused by obesity through four aspects:systolic and diastolic imbalance,anticoagulant and procoagulant imbalance,growth factors and growth factor imbalances and endothelial progenitor cell changes in endothelial damage.This paper reviews the reason and the mechanism of the endothelial damage through the change of the endothelial factors and progenitor cells.

Objective To study the clinical effect of trimetazidine on patients with unstable angina pectoris. Methods133 patients with unstable angina pectoris were randomly divided into regular group and trimetazidine group,the effects after two weeks' treatment were evaluated. ResultsThe therapeutic effect in trimetazidine group is much better than the regular group. ConclusionThe therapeutic effect of trimetazidine on unstable angina pectoris patients is definite.

Objective To explore the perioperative nutritional support and nursing countermeasures for laryngeal cancer patients. Methods 28 cases of hospitalized laryngeal surgery patients, in accordance with the working method of clinical pathway, finished product and homemade homogenate enteral nutrition was fed through nasogastric tube. Nutrition evaluation was finished by use of body mass index (BMI), blood biochemical indicators on 1d preoperation and 14 d postoperation, All indexes were compared between preoperation and postoperation. Results Nutrition assessment with BMI showed incidence of mild malnutrition as 10.7% and 14.3% on 1d preoperation and 14 d postoperation. Nutrition evaluation index such as HB, BUN was statistically significant, and BMI、 TLC、ALB、TP showed no statistical sisnificant difference between 1d preoperation and 14 d postoperation. Conclusions Clinical pathway in accordance with the working method, using the reasonable meal is laryngeal cancer patients homogenate perioperative enteral nutrition support a more scientific and deserves popularization of nursing countermeasures.

Objective To explore the efficacy of borneol and Norfloxaein in treating patients with stage IV pressure sore. Methods 132 patients with pressure sore were randomly divided into the obser-vation group(applying borneol and Norfloxaein)and the control group(applying iodophors and gentamycin). The effect of the two methods was compared. Results The curative rate of the observation group was 98.5%,and 47.7% for the eantrol group. Total effective rate of the observation group was 100%,and 81.5% for the control group.The average curative time for the observation group was shorter than that of the control group. Conclusions Borneol and Norfloxaein is superior to iodophors and gentamycin in treating pa-tients with stage Ⅳ pressure sore.

Objective To explore the relationship between homocysteine (Hcy)expression and diabetic ret-inopathy(DR)in patients with type 2 diabetes mellitus (T2DM).Methods 79 patients with T2DM were selected and divided into proliferative DR group (n =26),background stage of DR group (n =25)and without DR group(n =28)according to the degree of retinopathy.28 cases of healthy physical examination were involved as control group. Blood glucose levels,Hcy and clinical significance were detected and compared among the groups.Results The FPG and Hcy levels in the control group,without retinopathy group,background stage of DR group and proliferative DR group showed an increasing trend,there were significant differences among groups (F =448.53,174.25,all P <0.01).The FPG level of the control group was (4.86 ±0.42)mmol/L,which was significantly lower than the back-ground stage of DR group[(8.73 ±0.48)mmol/L,t =31.59,P <0.01 ]and the proliferative DR group[(10.9 ± 0.95)mmol/L,t =30.59,P <0.01].The FPG level of proliferative diabetic retinopathy DR group was also signifi-cantly higher than without retinopathy group(t =17.72,P <0.01).The Hcy level of the control group was (7.93 ± 0.70)μmol/L,which was significantly lower than the background stage of DR group[(9.45 ±0.83)μmol/L,t =7.69,P <0.01]and the proliferative DR group[(13.55 ±1.56)μmol/L,t =11.0,P <0.01].The Hcy level of the proliferative DR group was also significantly higher than without retinopathy group(t =12.52,P <0.01).Conclusion Hcy may involved in the process of T2DMwith DR,it may be used as an important reference index for the degree of retinopathy.