A typical investigation on third-tier general hospitals, third-tier specialty hospitals, second-tier district or county central hospitals, urban community hospitals, and rural township health centers in Shanghai was conducted so as to examine the responsiveness of outpatients and inpatients to the health system. Most of the patients surveyed said that they could get prompt attention and that they had convenient access to medical information from the community or the mass media. More than half of the inpatients and outpatients thought that they had autonomy with regard to treatment and a greater number of patients made their own choices of doctors and nurses. Most of the patients were willing to talk freely with their doctors about their confidential medical history and could get rational explanations about their conditions from the doctors. The results indicate that reform of the health system in Shanghai has attached importance to the responsiveness of patients and that good effects have been achieved.

Objective To assess language function in children with benign epilepsy with centrotemporal spikes in children(BECTS) and its association with the age of epilepsy onset.Methods We assessed language function in 63 children with BECTS and 30 age and sex matched controls by the subtest of CWISC.Results Children with BECTS performed significantly worse on all language tasks as compared to controls and overall better language function was positively correlated with older age of the child.Early age at seizure onset demonstrated significant negative correlation with language dysfunction,age below 6 years being related to the lowest performance scores(P ＜ 0.05).There was no relationship between the language function and the laterality of epileptic focus,seizure treatment status,or the duration of epilepsy(P ＞ 0.05).There was significant relationship between the language dysfunction and onset age of epilepsy (P ＜ 0.05).Conclusion Children with BECTS have language difficulties that are more pronounced in younger age group.Despite better language functioning in older children with BECTS,their verbal abilities remain inferior to those of children without epilepsy.Early age at seizure onset is a significant factor predicting worse language functioning in children with BECTS.

Objective To investigate the safety and efficacy of the conservative laparoscopic operation in treatment of tubal pregnancy by drug water pressure embryo separation. Method 58 cases with tubal pregnancy without rup-ture, the first focus on internal injection of MTX dilution 5 ml to 3 ml, and then to the near corner of the uterus in-jection of 3 ml MTX dilution, and then the line to retain the fallopian tube laparoscopic embryo removal. Results After 2 weeks, the blood β-HCG was monitored, and the average follow-up was 18 months. There was no persistent ectopic pregnancy, the fallopian tube was unobstructed, 22 cases were married of 16 cases (72.73 %) in the in-trauterine pregnancy. Conclusion Separation of ectopic pregnancy and proximal tubal MTX injection method laparo-scopic conservative surgery in the treatment of fallopian tube pregnancy by methotrexate (MTX) dilution water pres-sure, curative effect is exact, retained the fallopian tube of the normal anatomy and physiological function treatment of tubal pregnancy is safe and effective method.

To summarize the status of chinese medicine syndrome study in chronic prostatitis, emphatically analyze the key problems. In the national standard and textbook, the names of four syndrome types are not unifi ed, difference of symptoms description still exist, and diagnostic criteria of basic syndrome type needs to be clarified. Analysis of literature showed that syndrome differentiation was commonly based on the experience of physician in clinical practice. In addition to the four syndrome types, occurrence frequency of spleen qi deficiency and liver qi stagnation syndrome types are relatively high. Research method of syndrome should be improved urgently. This paper proposes counter measures: Clarify the commonly basic syndrome types and syndrome differentiation standards. Formulate the quantitative diagnostic criteria of basic syndrome types.conduct the prospectively multicenter clinical survey.

Objective:To investigate the clinical effect of Weinaian Capsules on chronic erosive gastritis with HP positivity and its effect on HP.Methods: 90 patients with chronic erosive gastritis with HP positivity were divided into 2 groups. 50 cases in the treatment group were given drug Weinaian Capsules orally, 4 capsules each time, 3 times a day. 40 cases in the control group were given drug Compound Aluminum Hydroxide Tablets orally, 2 tablets each time, 3 times a day. Both groups were treated for 6 successive weeks. Results: The effective rates were 92% for the treatment group and 67.5% for the control group ( x 2=23.87,P

Objective This research puts the academic leader under the competency background to investigate the current status of academic leaders in tertiary hospitals in Shanghai,combines the theories a-nalysis with practice on the Correlative Research,takes evaluation of academic leaders as the target to deep into the discussion,studies the application value and special significance of the competency model on culti-vation,introduction and evaluation of academic leaders in tertiary hospitals in Shanghai area.Methods Core elements of competency of the academic leaders were investigated by literature reviews,expert inter-views,behavioral event interview,and questionnaires.The questionnaire of the competency of academic leaders was prepared and the numbers and induction relevant to characteristic items of the competency were obtained.Results The notion of six feature families is proposed by study of the competency model which composed 18 relative characteristic items.Six feature families are leadership,organization team with coordi-nation,innovation and implement of project,strategic thinking and overall outlook,self-control and self-management,pursuit excellence and development.Conclusions The academic leader not being lack of professional quality,it is the deep characteristics under the Iceberg Model that influenced the development degree,efficiency,effects of subjects.The study on the competency of the academic leader is helpful for e-valuation of academic leaders'comprehensive abilities and put forward some proposal about stuff rundle con-struction for reference in hospital.

Objective To evaluate the efficacy and safety of Shenqi Fuzheng injection in the treatment of patients with laparoscopic gastric cancer. Methods A total of 94 cases with laparoscopic gastric cancer included in this study were divided into control group and experimental group with 47 cases in each group.The patients in both groups received laparoscopic gastric carcinoma.Patients in control group received fluorouracil, leucovorin and oxaliplatin infusion( FOLFOX4 ) chemotherapy and patients in the experimental group revieved Shenqi Fuzheng injection.Both groups received two courses treatment of 14 days for one course.The clinical efficacy, inflammatory levels, tumor indicators and adverse drug reactions were compared between the two groups.Results The clinical efficacy in experimental group was 95.74%, which was significantly higher than that in control group 82.98%(P<0.05 ) .The serum level of serum serum albumin (ALB), prealbumin (PA), glutathione-S-transferase (GST), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) after treatment in experimental group were lower than the control group (P<0.05) .The adverse drug reactions was not statistically different between the two groups.Conclusion Shenqi Fuzheng injection has significant efficacy in the treatment of laparoscopic gastric cancer with high safety.

Objective To compare the impacts of right ventricular outflow tract pacing and right ventricular apical pacing on short-term cardiac function, QRS duration and pacing parameters in children undergoing VVI pacemaker therapy. Methods The clinical data of 38 children undergoing VVI pacemaker treatment in our department from July 2006 to November 2013 were retrospectively reviewed and analyzed to make grouping: 22 with right ventricular outflow tract pacing based on the operational records were assigned in one group and 16 with right ventricular apical pacing as the other group. The two groups were compared in terms of cardiac function indexes , QRS complex width and intra- and post- operative parameters of the implanted pacemakers. Results There were no significant differences between the two groups in pre-and post-operative cardiac function indexes , intra- and post-operative difference in pacing thresholds, pacing wire impedance and R-wave amplitude. The pre-and post-operative QRS duration [(134.95 ± 12.86)ms vs.(147.44 ± 22.35)ms, t=1.35, P=0.01] was statistically significant between the groups. Conclusion The right ventricular outflow tract pacing for children patients is safe and feasible. Although the two pacing approaches achieved lengthened duration of QRS, the right ventricular outflow tract pacing is more effective in lengthening the duration of QRS.

Objective To discuss the effect of residual renal function on prognosis of maintenance dialysis in patients with end-stage renal disease ( ESRD) .Methods 90 cases of patients of maintenance hemodialysis were selected and divided into group A and group B based on different eGFR levels at the beginning of dialysis, 51 cases in group A of eGFR≤5 mL/( min· 1.73 m2 ) , while 39 cases in group B of eGFR>5 mL/( min· 1.73 m2 ).The renal function of two groups were observed,all patients underwent a five-year clinical follow-up and mortality rates, hemoglobin (Hb), serum albumin ( Alb) , C reactive protein ( CRP) of patients in both groups were observed.Results The renal function of urea nitrogen, serum creatinine, blood uric acid, urinary protein and urine creatinine in group B before dialysis was better than those in group A (all P<0.05).The Hb and Alb levels of group A were significantly lower than those of group B, while the CRP levels was significantly higher than that of group B (all P<0.05).The mortality rate of group A was 43.14%,compared with 20.51% of group B,and there was no significant difference.The two main reasons of death was cardiovascular and pulmonary infection, accounted for 50.00% and 33.33%, respectively.Conclusion Residual renal function of patients with ESRD before dialysis has important clinical significance for prognosis judgment.When eGFR level is lower before dialysis, the mortality rate of patients is higher in five years, prone to cardiovascular and cerebrovascular, with poor nutritional status, which is more vulnerable to infection.

Objective To evaluate the effect of mind-map in health education of elderly patients with knee osteoarthritis in community.Methods 71 elderly patients with knee osteoarthropathy were randomly divided into observation group(n=35)and control group(n=36).The control group received routine oral mode health education,and the observation group applied mind map to health education.Before and after the intervention,the self-designed disease knowledge and compliance questionnaire were used to evaluate the effect of two groups of health education.Results There was no significant difference in score between the two groups(P=0.997).After intervention,the score of disease knowledge questionnaire(20.25±3.01)points in the observation group was higher than(18.17±3.12)points in the control group,the difference was statistically significant(t=2.858,P=0.006).At the 1st,3rd and 6th month,the compliance scores of the observation group were(19.35±3.14)points,(19.68±3.22)points,(20.18±3.42)points,respectively,which of the control group were(17.42±3.11)points,(17.89±3.35)points,(18.32±3.47)points,respectively,the differences between the two groups were statistically significant(t=2.602,2.294,2.274,P=0.011,0.025,0.026).The scores of the observation group questionnaire were all more than 3 points,the difference was statistically significant between the two groups(all P=0.000).Conclusion Using mind map to carry out health education to middle-aged and elderly patients with knee joint disease can help patients master disease knowledge and improve compliance,its effect is better than traditional method.