We studied policies of traditional Chinese medicine (TCM) on four levels ( national,Shanghai city, Pudong New District and community health services (CHS)) from 2008 to 2009 with the method of literature review,questionnaire survey and group interview. 18 national, 5 Shanghai's, 4 Pudong New District's and 87 CHS' TCM related policies were identified. By defining the development target,financial capability, human resource and proper technology of TCM care, those policies ensured and prompted the progression of community TCM services. Yet TCM policy fulfill in community remained lagged,and talent cultivating, medical insurance support and TCM participating in public health needed to be improved.

Objective To conduct a health check-up intention analysis to understand residents' altitude to health eheck-up. Methods A total of 3600 residents living in Shanghai completed the selfdesigned questionnaire. Results About 35.2% participants received health check-up onee per year. In 36 to 60 or > 60 age group, the figure was increased up to 62.6% or 50. 4%, respectively. Public institution employees and those with medical insurance were found to have the highest rate of health checkup. Conclusion Our investigation results suggest that government leadership,health management model and contents, and personnel training should be improve.

Objective To provide basis for clinical teaching methods and course system,this article analyzed practice nursing students self-directed learning readiness status and its influencing factors.Methods The report surveyed a total of 240 nursing students in Zhengzhou University,the Peking Union Medical College by using the general information questionnaire,the Chinese version of Nursing SelfDirected Learning Readiness Scale and The Questionnaire of Clinical Teaching.The total score of the practice nursing students' self-directed learning readiness was obtained on the basis of quantitative analysis,and in this paper,the development and research status had been summarized through document analysis.Results The total score of the practice nursing students' self-directed learning readiness was (116.59±21.79) scores.The influencing factors of practice nursing students' self-directed learning readiness included:whether the students like nursing major,whether perception learning difficulties,whether having the experience of group learning,and the satisfaction to clinical teachers,curriculum system optimization.Conclusions Currently practice nursing students self-learning readiness is relatively low and have many influencing factors.A targeted training should be taken during the clinical teaching and the course system should be optimized to improve the practice nursing students' self-directed learning readiness.

Objective To evaluate the present rehabilitation status of mentally ill patients at community health service centers in Shanghai. Method Investigation on mental disorder network, present prevalence, community disease classification, and cost-effect assessment was conducted in 201 health service centers in Shanghai in 2007. Result Working condition, staff-member constitution, and finical investment were unoptimistic. However, the community health service centers consider the outcomes of community rehabilitation and management were satisfactory. Conclusion It should be necessary to facilitate the development of community mental health service system, achieve various community rehabilitation and health care, and improve social security system of community healthcare providers.

Ensuring the safety of patients is the the duty of medical workers. Nursing safety is the key factor to reflect the quality of nursing service, which is closely related to patient safety. The effective communication between physicians and nurses is a powerful guarantee for the safety of patients. The positive effect of SBAR communication model in clinical communication has been validated in many aspects, which gradually becomes an important communication model. Now reviews the origin, connotation, characteristics and application status of SBAR communication model, then put forward the matters needing attention when using the model, in order to provide theoretical reference for clinical application.

Objective To investigate the effect and mechanism of oetreotide (OCT) on DENA related hepatoeareinogenesis in rats. Methods Fresh diethylnitrosamine (DENA) solution was given to induce the model of rat hepatoeellular carcinoma. The rats were divided randomly into two groups: OCT treatment group and control group. The survival rate and hepatoeareinogenesis rate were observed. SSTR2 mRNA and protein expression were measured. Results The survival rote of OCT treatment group (70.0%, 7/10) was significantly higher than that of control group (30.0%, 6/20) (X2 = 4.344, P<0.05). 16 weeks after DENA treatment, the difference of bepatoearcinogenesis rate between the two groups was not remarkable though the value of OCT treatment group (0%, 0/10) was lower than that of control groups (30.0%, 6/20)(X2 = 3.750, P＞0.05). However, 22 weeks after DENA treatment, hepatoeareinogenesis in control group (83.3%, 10/12) was markedly higher than that in OCT treatment group (22.2% , 2/9)(X2 =7.843, P<0.01). With liver cirrhosis progressing, the expressions of SSTR2 mRNA and protein increased, and reached the peak 16 weeks after DENA treatment, then began to decrease. The expressions of SSTR2 mRNA and protein in hepatocellular carcinoma were significantly lower than those in the liver 22 weeks after DENA treatment (F = 35.010 and 13. 386, P<0.01). The expression levels in OCT treatment group were similar to those in control group 8 and 16 weeks after DENA treatment. But the expression levels in OCT group 22 weeks after DENA treatment didn't lower markedly, and were higher significantly than those in control group (t = 2.806 and 4.498, P<0.05). Conclusion OCT can inhibit efficiently hepatocareinogenesis and reduce the mortality of rots treated with DENA possibly by a mechanism maintaining the expression levels of SSTR2.

AIM:To study the expression of metastasis suppressor gene KAI1 mRNA in osteosarcoma tissue and osteosarcoma cell lines,and the relationship between it and the biological behavior of the tumor cells.METHODS:RT-PCR was used to detect KAI1 mRNA in 18 cases of resected fresh osteosarcoma samples and three cultured osteosarcoma cell lines.The proliferative rate,the adhesive and invasive abilities of the 3 cell lines were detected.The results were treated by analysis system of images and analyzed with t test.RESULTS:The relative amount of KAI1 mRNA in osteosarcomas with lung metastasis was 0.80?0.50,while that was 1.48?0.64 in osteosarcomas without lung metastasis,the former was significantly lower than the latter(P

Objective To analyze the efficacy and prognosis of stereotactic radiotherapy (SRT) and whole-brain radiotherapy (WBRT) in treatment of brain metastases,and to observe the influence of temozolomide (TMZ) on survival rate during the period of radiotherapy.Methods A total of 52 patients with brain metastases were divided into two groups according to treatment methods,including 35 patients treated with WBRT plus SRT and 17 patients treated with SRT alone.WBRT dose was 1.8 - 3.0 Gy per fraction,one fraction a day,five fractions per week,with total dose of 30 - 40 Gy.After WBRT,gamma knife was performed with prescription isodose line of 45％ -70％ surrounding the planned target volume in WBRT + SRT group.The marginal dose was 12 - 15 Gy and the center dose was 20-30 Gy.In SRT group,the prescription isodosc line was 45％ - 70％ and the marginal dose was 36 - 40 Gy while the center up to 70 - 80 Gy.The follow up time was 1 - 2 years.Besides 20 patients in this study took temozolomide capsule during and after radiotherapy.The schedule of concomitant chemotherapy was temozolomide of 75 mg/m2 by oral administration every day until radiotherapy was over,and then temozolomide of 150 mg/m2 was taken for 3 -6 months after radiotherapy.Results The efficiency during 1 -3 months after treatment was 84.62％ in this study.In the WBRT + SRT group,the efficiency was 88.57％ and declined to 76.47％ in the SRT group.The six month-and one year-local control rate were 92.10％ and 85.20％,respectively.The average survival time of WBRT + SRT was 13.2 months and median survival time was 11 months.Six month-,one year-and eighteen months-survival rate were 71.40％,54.30％ and 14.30％,respectively.In the SRT group,the average survival time was 10.2 months and median survival time was 9 months.Six month-,one year- and eighteen month-survival rate were 41.20％,23.50％ and 5.88％,respectively,while those for RT + TMZ group were 80.00％,60.00％ and 10.00％.In comparison,those in RT group were 56.30％,37.50％ and 12.50％,respectively.Conclusions Effect of gamma knife stereotactic radiotherapy combined with WBRT is better than GK stereotactic radiotherapy alone in treatment of brain metastases.Compared with radiotherapy alone,concomitant temozolomide chemotherapy could improve the survival rate of the patients with brain metastases without increasirg adverse reactions significantly.

OBJECTIVE To investigate the nasopharynx carriage status of opportunistic pathogens in non-infectious old people.METHODS The totally of 592 pharyngeal samples from old persons were collected.RESULTS The isolated rates of main opportunistic pathogens were Haemophilus parainfluenzae,Stomatococcus mucilaginosus,Streptococcus pneumoniae and Klebsiella pneumoniaa.The isolated rate of single opportunistic pathogen was 45.8% and that of multiple opportunistic pathogens was 3.9%.The total carriage rate of opportunistic pathogen was 49.7%.The carriage rate of G+ or G-bacteria was 13.2% or 86.8%,respectively.The isolated rates of 2 multiple pathogens,S.pneumoniae and K.pneumoniae were increased with aging.The isolated rate of K.pneumoniae was higher in persons with more than 3 kinds of underlying diseases.CONCLUSIONS Aging,pharyngeal carriaging of S.pneumoniae,H.parainfluenzae,K.pneumoniae,et al and with multiple underlying diseases might be the risk factors for elder people to suffer from infectious respiratory disease.Isolating pharyngeal opportunistic pathogen among non-infection people is necessary and significant for prevention and treatment of infectious respiratory disease.

AIM: To induce rat bone marrow mesenchymal stem cells (BMSC) into cardiomyocytes and investigate the influence of serum coming from acute myocardial infarction (AMI) rat on the procedure. METHODS: The passage 3 BMSC were divided into six groups: groupⅠwas control group; groupⅡwas induced with 5-azacytidine; group Ⅲ was induced with 5-azacytidine and serum from AMI rat; group Ⅳ was induced with 5-azacytidine and serum from normal rat; group V and group Ⅵ were induced with serum from AMI rat or normal rat. The cardiac troponin T, GATA-4 and desmin were detected 30 days after induction. RESULTS: After inducing by 5-azacytidine, 5-azacytidine and two kinds of serum, some cells in the three groups differentiated into cardiac like cells. The expressions of cardiac troponin T, GATA-4 and desmin were positive in cells differentiated from BMSC. The troponin T expression in control group and group inducing by AMI serum alone were negative but GATA-4 and desmin expressed weakly. Some cells induced with 5-azacytidine and serum were slowly beating 2 weeks after induction, but the cells induced with 5-azacytidine alone was not beating.CONCLUSION: Serum from AMI can not induce BMSC to differentiate into cardiomyocytes, but it promotes BMSC differentiate into cardiomyocytes induced by 5-azacytidine and facilitate the differentiated cells to mature.