Chronic non-communicable diseases have become one of the public health problems threatening human health.Management measures of chronic diseases were summarized,such as three level prevention and self-management of chronic diseases,and patient joint decision-making.Behavioral interventions on chronic diseases were also summarized,such as risk factors of chronic disease,information technology and telemedicine.It suggests that a variety of chronic disease management and behavioral intervention measures should be applied in practical work to improve the patient compliance while enhancing the prevention and treatment of chronic diseases.

Objective To investigate death reasons for China rural and urban children who aged between 5 and 14 years old during 2008.Methods Using the illness or injury causes of death and demographic indicators of China Health Statistics Yearbook 2009 to describe 5 to 14 year-old children' s disease-related indicators and causes of death,compare difference between rural and urban children.Results Hospitalization rates (23.0‰ vs 12.1‰, χ2 = 255.584 ), prevalence of two weeks (79.8‰ vs 63.9‰, χ2= 142.446 ), attendance of two weeks (95.6‰ vs 68.1‰, χ2 = 376.954) and prevalence of chronic diseases (9.0‰ vs 7.0‰, χ2 = 18.941 ) of 5 to 14year-old children in rural were all higher than urban children, with statistically significant difference.Injury and poisoning,cancer,congenital diseases were the top three causes of death for 5 to 14 children.In many diseases which caused injury and poisoning,drowning was the first cause of death ,traffic accidents accounted for the second place;suicide was the fourth cause of death for city children and second cause of death for city girls.Conclusion High-risk death reasons for Chinese 5 to 14 year-old children in 2008 are the same, but disease threat on the death of are in varying degrees ,which shows urban-rural and gender differences.

Objective To investigate the prevalence and symptoms of post - traumatic stress disorder(PTSD) and the self-esteem of the workers at mineral processing plant 45 days after Wenchuan earthquk. Methods PTSD Checklist Civilian version(PCL - C) , Self -Esteem Scale(SES) , Simplified Coping Style Questionnaire and a self- designed questionnaire were administered to a sample of 81 workers one and a half month after Wenchuan earthquake. Results The prevalence of PTSD among the workers was 26.3% , and the mean total scores of PCL - C was 39.63?10.73.The prevalence difference between the male and the female was not statistically significant (P =0.527). The top psychological activity was worry (86.8%). The mean self- esteem score had no statistical difference with domestic normal level(t = -0.484,P =0.630). Neither self - esteem(P =0.469) nor coping style(P =0.780) was associatied with PCL -C total scores. Conclusion To act more effectively in the intervention, it is important to exactly understand the normal stress response after severe disaster, and correctly grasp the key point in different stage.

Objective To investigate the development tendency of behavioral medicine from papers published in domestic and overseas. Methods Using assist decision support system of science and technology (STADS) to form quantitative expression of academic attention to "Behavioral Medicine". Results In last 30 years, behavioral medicine developed and grew rapidly. The number of domestic and international literatures increased remarkably. The growth rates of domestic and foreign literature were respectively 35.7% and 33.7%,some professional journals and more powerful professional scientific research institutions and core authors who acquired patents and cutting-edge scientific and technological achievements were initially developed.Conclusion Behavioral Medicine uses the advantages of interdisciplinary, focusing on pathogenic mechanisms,influencing factors and treatment, rehabilitation mechanism of psychological and behavioral factors, especially on the effect social and family environment on human physical and mental health, to promote health promotion and medical pattern changing.

Objective To investigate the treatment effects and toxicities of extended-field intensity modulated radiation therapy (EF-IMRT) and intra-cavitary brachytherapy combined with chemotherapy for stage Ⅰ b1-Ⅳa cervical cancer with positive para-aortic lymph nodes.Methods A total of 46 stage Ⅰ b1-Ⅳa cervical cancer patients with positive para-aortic lymph nodes treated at Fudan University Shanghai Cancer Center between 2009 and 2011 were reviewed.Neoadjuvant,concomitant and adjuvant chemotherapy with paclitaxel and carboplatin were administrated for one cycle before radiation therapy,two cycles during radiation therapy or three cycles after radiation therapy.All patients received EF-IMRT and intra-cavitary brachytherapy.The positive lymph nodes received an additional boost dose.Results All patients received EF-IMRT to 50.4 Gy (1.8 Gy per fraction).Twenty-six patients was treated with boost dose of 6.0-8.0 Gy in 2.0 Gy per fraction to positive para-aortic lymph nodes.Thirty-seven patients received a positive paraaortic lymph nodes boost or(and) parametrial boost.All patient also received a high-dose-rate intra-cavitary brachytherapy at the point A dose of 20.0-30.0 Gy in 5.0 Gy per fraction.Total chemotherapy cycles were 189,and the average patient received 4.1 courses.Two cases (4％,2/46) experienced grade Ⅲ gastrointestinal toxicities,no patients suffered grade Ⅳ gastrointestinal toxicities.Fifteen cases (33％,15/46) experienced grade Ⅲ hematological toxicities,and 3 (7％,3/46) experienced grade Ⅳ hematological toxicities.Late grade Ⅲ-Ⅳ toxicity was seen in 3 cases (7％,3/46).The 3 year progressionfree survival rate was 46.2％,and the 3 years overall survival rate was 61.2％.Conclusion EF-IMRT and intra-cavitary brachytherapy combined with chemotherapy is safe and effective for stage Ⅰ b1-Ⅳa cervical cancer with positive para-aortic lymph nodes.

ObjectiveTo explore the influencing factors of health seeking behavior of delivery women in Guangdong province.MethodsStratified random sampling method was used,and 1491 delivery women from primary,secondary and tertiary hospitals were investigated with self-made maternal health seeking behavior questionnaire.Logistic regression analysis was used to analyze the impact of environmental factors and population characteristics on health seeking behavior.ResultsDelivery women with qualified health seeking behavior account for 83.4%.Present pregnancy was planned (OR=2.114),prenatal examination was needed when self-feeling good (OR=2.323),social medical insurance system was socialized medicine (OR=2.755) or medical insurance (OR=1.697),hospital level of secondary hospital (OR=1.568) or tertiary hospital (OR=1.800) were independent positive influencing factors of health seeking behavior.ConclusionThe qualified rate of health seeking behavior of delivery women in Guangdong province is low.Delivery women with the following characteristics of low educational level,low family income,uninsured,coming from rural area and delivery in primary hospital need to be guided scientifically at seeking for health.

Objective To establish the evaluation index system on maternal health seeking behavior with Delphi method.Methods Based on Andersen health service utilization models,literature analysis was used to establish evaluation index system on maternal health seeking behavior,then Delphi method was carried out to revise index system through two rounds questionnaire consulting from 24 experts.Results The confirmed index system of maternal health seeking behavior included 4 first-level index,12 second-level index and 57 third-level index.The average authority degree of experts were 0.869,and the coordination coefficients of expert in the total index were 0.195 and 0.166(P＜0.01).The weight coefficients of the indicators at first level were 0.1529,0.3403,0.2786 and 0.2281,respectively.Condusion The representativeness,authority degree and coordination of expert are good,and the tentatively established evaluation index system on maternal health seeking behavior is scientific and reasonable.

Objective To explore the mental education and continuing education among non-psychiatric medical workers of the general hospitals in Guangzhou city.Methods A cross-sectional study was carried out in 17 general hospitals of Guangzhou city including 2617 participants from December 2012 to April 2013.Results Among 2617 participants,41.6％ of them hadn't taken part in psychiatric course study,66.9％ hadn't received psychiatric rotation,and 66.7％ hadn't received psychiatry and related training;93.8％ of the medical staff had interest in mental specialized training courses,of which 72.0％ medical staff stood for training classes/participation,72.3％ medical staff most satisfied with 4-5 days of a training course,strengthen training every 6 months (2 days) and a psychiatrist to connect.Conclusion Non-psychiatric medical workers of the general hospitals in Guangzhou city lack the knowledge of mental health,and mental health care training are urgently needed.

Objective:To study the preliminary clinical results of the No-touch technique in laparoscopic pancreaticoduodenectomy for pancreatic head cancer.Methods:A retrospective analysis was consulted on 11 patients who underwent laparoscopic pancreaticoduodenectomy for pancreatic head cancer at the Pancreas Center of Guangdong Provincial Hospital of Traditional Chinese Medicine from April 2019 to April 2020. There were 5 males and 6 females, with a Mean±SD age of (63.6±12.2) years. Preoperative evaluation showed all patients were diagnosed to have resectable pancreatic head carcinoma with no local invasion into adjacent arteries and veins, and without metastasis. The surgical strategy consisted of no initial Kocher manoeuvre with no flipping or pulling of the pancreaticoduodenal area. Through unwinding of the pancreatic uncinate process, the pancreatic blood vessels, nerves and lymphatic vessels were completely detached to isolate the tumor. Finally, the pancreaticoduodenal area was totally resected and the digestive tract was reconstructed using the Child’s method. The operation time, intraoperative blood loss, postoperative complications, postoperative pathology and follow-up data of the patients were evaluated.Results:All patients completed the laparoscopic operation without any need for conversion to laparotomy. The operation time of the 11 patients was (422.2±102.2) min, and the bleeding volume was (102.7±65.4) ml. There were 2 patients who developed pancreatic fistula, with 1 patient having a biochemical fistula and 1 patient a grade B fistula. There was no grade C fistula. Other complications included 1 patient with delayed gastric emptying. There were no biliary fistula, no postoperative abdominal bleeding, and no perioperative death. Postoperative pathology showed 6 patients had lymph node metastases, with a positive lymph nodes rate of (4.8±4.4)%. All patients had R 0 resection. The follow-up survival data of the 11 patients showed one patient to develop intrahepatic metastasis 1 month after operation and he died 9 months after operation. Another patient developed liver metastases 2 months after operation. The remaining patients were tumor-free. Conclusion:Laparoscopic pancreaticoduodenectomy using the No-touch isolation and resection technique could achieve complete resection of tumors, and it can safely and effectively be applied to patients with pancreatic head cancer.

Pancreaticoduodenectomy is one of the most difficult abdominal operations, and the difficulty in resection and complicated digestive tract reconstruction have brought great challenges for surgeons. At present, laparoscopic pancreaticoduodenectomy has been widely used in clinical practice, and compared with traditional 2D laparoscopy, 3D laparoscopy has the features of high magnification, high definition, and three-dimensional vision, which enables surgeons to see more clearly and operate more accurately, and thus it has great potential to be widely used in pancreaticoduodenectomy.