Random clustering was conducted among a total of 1068 residents aged 18 years or older at a certain Shanghai community.And they completed a questionnaire survey.Logistic data processing and model building were performed.The respondents were willing to go to a community health center for the following reasons:close proximity (88.4％),excellent service attitudes (40.4％) and low drug prices (37.8％).No statistically significant differences existed in terms of first choices of community health service,occupation,monthly income and-walking distance (P ＞ 0.05).However,statistically significant differences existed in education level,age and chronic diseases (P ＜ 0.05).

Objective To observe the effect of reteplase on the thromboelastogram tracing of patients experiencing acute is-chemic stroke(AIS).Methods Selected 43 AIS inpatients in the Third People’s Hospital of Liaocheng from October,2013 to August,2015,who received reteplase less than 4.5 hours after the onset of syndrome of AIS.Blood samples were obtained before reteplase administration and at 0.5,1,2 and 4 hours after reteplase administration and measured by thromboelastogra-phy.Results The parameters R,K,Angle and MA of the thromboelastogram had changed after beginning administration of reteplase.The R value at 0.5 h after thrombolysis was significantly higher than that before thrombliysis,however,the R Value at 1h after thrombolysis was the most highest,and the K value.At 0.5 h after thrombolysis was the highest.At 0.5 h after thrombolysis MA and Angle values were the lowest,the differences were statistically significant (P<0.001).Conclu-sion The study suggests that the thromboelastogram is an useful tool for determining changes in the coagulation system of patients receiving reteplase.

Objective To analyze and evaluate the impact of trusteeship on hospital management and operating status. Methods The state of affairs, technical merit and financial situation and other datawere invested and analyzed in some trust hospital in Xinjiang from 2007 to 2010. Results The number of outpatients, inpatients and surgeries compared before hosting increased by 30. 3%, 61.3% and 26. 3%, respectively. The average in hospital shortened 1.1 days. The growing medical expenditure of average outpatientand inpatient was controlled at a reasonable range. 33 new technologies were carried out after trusteeship. The total revenue in 2010 increased 54.2% compared to 2007, with the balance between revenue and expenditure. Conclusion Hospital trusteeship helped improve hospital operation and management. Measures for hospital trusteeship should be suited to local conditions and sensible.

Objective To investigate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in critically ill patients complicated with sepsis. Methods Fifty-six cases of systemic inflammatory response syndrome (SIRS) who admitted in intensive care unit (ICU) of the Second Hospital of Tianjin Medical University between May 2009 and June 2010 were recruited. The SIRS patients were divided into two groups: sepsis group (n= 32) and non-sepsis group (n= 24). The levels of procalcitonin (PCT), C-reactive protein (CRP) were measured within 24 hours of hospitalization.Levels of sTREM-1 were measured by enzyme linked immunoabsorbant assay (ELISA). Based on the receiver operating characteristic curve (ROC), cut-off value, sensitivity and specificity of sTREM-1 in diagnosis of sepsis were calculated. Comparison between groups was done by t test and Mann-Whitney U test. Count data were compared by chi square test. ResultsThe serum level of sTREM-1 were significantly higher in sepsis group than that in non-sepsis group (250.9 ng/L vs 103.6 ng/L, Z= 12. 864,P=0. 002). Areas under the curve (AUC) of sTREM-1, PCT and CRP were 0. 935, 0. 891 and 0. 602, respectively. With a cut-off value of 135.0 ng/L, the sensitivity and specificity of sTREM-1 in diagnosing sepsis were 93. 8％ and 84. 7％, respectively. With a cut-off value of 2. 0 μg/L, the sensitivity and specificity of PCT were 84. 4％and 87. 8％, respectively.ConclusionSerum level of sTREM-1 could be used as an early indicator for diagnosing sepsis.

Objective To investigate the relationship between the serum levels of vascular endothelial growth factor(VEGF) and severity and prognosis by evaluating its changes in severe sepsis patients. Method Us-ing control study design, a total of 29 severe sepsis patients who admired in ICU department of Second Hospital of Tianjin Medical University from July 2006 to November 2007 were enrolled. The patients were divided into survival group (n=16) and death group (n=13) according to the clinical outcomes at 28 days after onset.A total of 31 healthy persons were enrolled into the control group. Clinical and laboratory data including blood routine test,blood-gas analysis,blood chemistry,C-reactive protein,lactic acid were collected on the first,third and 7th day after on-set,respectively. APACHE Ⅱ score were calculated. VEGF levels were determined using ELISA method. Quantita-tive data were analyzed by Ftest. Results The VEGFlevels ofthe control groupwere (78.77±8.15) pg/mL, the VEGF levels of the survival group on the first,third and 7th day were (210.47±59.40) pg/mL, (161.79 ±32.58) pg/mL and (85.33±12.13) pg/mL, respectively. The peak value of VEGF levels appeared on the first day, Then,it decreased with the progression of the disease. The VEGF levels did not differ significantly between the control group and survival group on the 7th day (P>0.05). The VEGF levels in the death group on the first, third and 7th day were (324.12±44.35) pg/mL,(185.40±30.92) pg/mLand (273.32±55.23) pg/mL, respectively. The peak value of VEGF levels in the death group also appeared on the first day, but it did not de-crease significandy on the 7 th day as compared that on theist day. The value of VEGF levels on the 7 th day were significantly higher than that of the control group (P<0.01 ). The levels of VEGF were positive correlated with APACHEⅡ score(rs = 0.510,P<0.01), both VEGF levels and APACHEⅡ score were risk factors for the clinical outcomes of these patients. Conclusions The serum levels of VEGF are elevated at early stage in severe sepsis patients. The VEGF levels, which might be a potential prognositic factor for sepsis patients are significantly correlated with APACHE Ⅱ score.

Objective To explore systematic intervention methods on life quality of heroin addicts during convalescence stage of drug detoxification period in order to supply evidence for effective nursing intervention. Methods 156 patients accorded with standard were selected by subjective sampling method and were grouped randomly. 78 patients in the control group were given routine nursing,78 patients in the intervention group received systematic intervention including psychological and behavioral intervention and the therapy of physical symptoms. QOLDA was used to evaluate the life quality of all patients. Results The scores of the intervention group were significantly higher than those of the control group, and the intervention group had a higher body mass index (BMI). Conclusions Systematic nursing intervention can perfect the physiological function, mental function and social function, reduce the withdrawal syndrome and adverse effect of heroin addicts, and improve their quality of life.

Objective To investigate the effect of H.pylori infection on cyclooxygenase-2(COX-2)expression in gastric antral mucosa. Methods The expression of COX-2 in 20 patients with H.py lori -infected chronic gastritis and in 14 with uninfected chronic gastritis w ere investigated by immunohistochemical method. The expressions of COX-2 in the antral mucosa were compared before and after H.pylori eradication. Results The mean percentage of the cells stained with COX-2 was s ignificantly higher in H.pylori -infected mucosa than that in uninfected mucosa ( P

cases of acute promyelocytic leukemia (APL) were treated with drugs of all trans retinoic acid (ATRA) and Proplylene glucol mannurate sulfate (PGMS).Complete Remission rate was 90%. Because of using Proplylene glucol mannurate sulfate (PGMS), the rate of DIC and the rate of death were decreased.

Objective:To explore the levels of serum adiponectin,insulin growth factor Ⅰ (IGF-Ⅰ) and prealbumin in preterm infants,and analyze their correlation with preterm EUGR infant.Methods:321 cases of preterm infants who were born in our hospital and transferred to neonatal department in 24 hours from January,2014 to January,2016 were enrolled in the present study.According to the weight at discharge,they were divided into the EUGR group and the non EUGR group,the growth and development as well as the levels of serum adiponectin,IGF-Ⅰ and PA in the two groups were compared.Results:The occurrence rate of EUGR was 55.76％ (179/321) in the 321 cases ofpreterm infants;the weight of EUGR group was significantly lower than that of the non EUGR group at 42 th days and three months after birth(p＜0.05).The SDS of both groups were all negative,and that of EUGR group was significantly lower than non EUGR group (p＜0.05).The levels of serum adiponectin,IGF-Ⅰ and PA of both groups were significantly lower than the control group at seventh days of birth,and the PA level of EUGR group was significantly lower than non EUGR group (p＜0.05).There was no significant difference in the serum adiponectin and PA levels between 7 days and 14 days in EUGR group (P ＞ 0.05),however,the serum adiponectin and PA levels in the non EUGR group was obviously increased and significantly higher than that of the EUGR group (p ＜ 0.05).The level of IGF-Ⅰ in both groups keep unchanged during two weeks (P＞0.05).Conclusion:The lower levels of serum adiponectin,IGF-Ⅰ and PA were closely related to the EUGR of preterm infants,which could be used as biochemical indexes to early diagnosis of EUGR.

Objective To describe the psychological experience of the patients with end-stage cardiopathy in China. Methods Phenomenology method was used in the study. Fifteen end stage cardiopathy patients received a non-structured interview. Results Four themes were extracted including heavy psychological burden about the disease and the selection of treatment options; complex psychological responses to families and relatives; wishing of social support;lose heart to personal future and prospects. Conclusions The patients on the end stage cardiopathy have complicated and intensive psychological responses. Medical staff should focus on the emotional of these patients, and provide effective strategies to promote patients'physical and psychological rehabilitation.