OBJECTIVE To investigate the status of community health services and offer a scientific basis for making a direction of community to control the infective disease.METHODS Totally 1503 outpatients were investigated retrospectively for infective diseases in community.RESULTS The average age of these patients was 65,the number of females was much more than males.The most frequently infective diseases were upper respiratory tract infection,bronchitis,periodontitis,etc.CONCLUSIONS It′s necessary to strengthen the community health service and to establish an effective system of health service.The patients must cultivate a health habit of life,they not only need in time diagnosis and treatment,but also enhance own knowledge about health and disease prevention.

Objective To evaluate the effects of statins on the cerebral haemodynamics of ischemic stroke patients with transcranial Doppler(TCD). Methods 70 inpatients with acute ischemic stroke were divided into two groups according whether they had taken statins after stroke.The change of the cerebral haemodynamics was studied in the two groups with TCD three months after stroke. Results Three months later,the systolic flow velocities and mean flow velocities of bilateral middle cerebral arteries in the statins groups significantly increased (P＜0.05). The pulse index of bilateral middle cerebral arteries in statins group significantly decreased (P＜0.05).The flow velocities and pulse index of bilateral middle cerebral arteries in control group don't change significantly(P＞0.05). Conclusions Statins may have the effects of improving the situation of cerebral haemodynamics of patients with ischemic stroke.

Objective To discuss the effects of the health card-based services on community chronic disease management and the utility of community healthcare resources. Methods Follow-up investigation on utilization and satisfaction of card-based health services and coverage of chronic illness management was conducted among cardholder living at Dongcheng District of Beijing during July 1,2006 and December 31,2008. Results The rates of attendance and health education increased from 47.20% or 1.16% to 90.90% and 46.38% ,respectively. The coverage of high blood pressure management and standard hypertension management increased from 47.16% or 45.66% to 80.39% and 78.27%, respectively. The satisfaction of cardholder residents with community healthcare services was improved year by year. Conclusions The health card service pattern plays a significant role in improving chronic disease management,which results in more satisfaction with and utilization of healthcare resources in community.

Objective To evaluate the clinical and pathological characteristics and treatment of malignant phyllodes tumor of the prostate. Methods A 60 year old male patient with malignant phyllodes tumor of the prostate was reported.The complaints consisted of dysuria,intermittent gross hematuria for 1 year,and recurrent symptoms after TURP for 2 months.The enlarged prostate was 5 cm?6 cm and palpated softly and smoothly by DRE,and heterogeneous by CT.His serum PSA level was 1.25 ng/ml.Sarcoma of the prostate was suspected and radical prostatectomy was performed on him. Results The pathology showed a special type of epithelial stromal tumor like cystosarcoma phyllodes of the mammary gland. Microscopically, the tumor was composed of cystically dilated ducts with leaf like stroma projections in the lumen.The stroma cell proliferated obviously with atypia and high mitotic rate,and the epithelial cell also proliferated but with no atypia and no mitosis.The seminal vesicle and bladder neck had tumor infiltration and the diagnosis of malignant phyllodes tumor of the prostate was confirmed.The tumor margin was negative.With immunohistochemical staining,the stromal cells were positive for vimentin,but negative for actin,with the epithelial cells positive for CK,PSA and AE1/AE3,and the basal cells positive for CK34BE12.The patient had tumor recurrence after 6 months,but refused to further treatment and was followed up till now. Conclusions Malignant phyllodes tumor of the prostate is rare but can be diagnosed properly based on clinical and pathological features.Radical prostatectomy is considered to be the most reliable treatment.

0.05).Conclusion Multi-disciplinary techniques combined with 125Ⅰ seeds implantation is effective in the management of the malignant obstructive jaundice.No significant difference for relief and liver function were found between CT-guided and during operation interstitial 125Ⅰ seeds implantations,but it seems more quickly relief or recovery was achieved in the latter.

Objective To provide useful information on reducing risky drinking for the Dept.of Public Health taking a county in Yunnan province as an example to explore the risk factors related to risky drinking.Methods A total of 574 participants identified as Miao,Yi and Han People at or older than 12 years old,who had been living there for 6 months or more were selected and surveyed in 5 townships in the county through stratified sampling.Alcohol consumption was collected using the beverage-specific quantity frequency (BSQF) method and analyzed using binary logistic regression and chi-square test.Results The number of drinkers in the family,undesirable drinking environment among friends and enculturation (β =0.073) could increase the likelihood of risky drinking.Risky drinking pattern was positively associated with age (β =1.006),and negatively associated with gender (β =-2.947) and awareness of risky drinking among rural residents.Conclusion The important measures to control risky drinking behavior in terms of health promotion and education include reducing the number of drinkers in the family,and preventing from undesirable drinking environment among friends and harmful drinking culture.These measures are crucial to prevent early onset of alcohol drinking among teenagers and to reduce risky drinking among middle aged and aged population.

Objective To evaluate the influence of cytochrome P450 (CYP2C9 and CYP4F2) polymorphisms on anticoagulant intensity of warfarin after cardiac valve replacement.Methods A total of 136 patients tak ing warfarin after cardiac valve replacement were identified and classified into 4 groups:CYP2C9 wild type group (CYP2C9*1*1),CYP2C9 mutated type group (CYP2C9*3),CYP4F2 rs2108622 wild type group (CC) and CYP4F2 rs2108622 mutated type group (CT or TT).The patients' baseline data,initial dose of warfarin and base INR measurement resuhs were recorded and then the follow-up was conducted.The initial administration of warfarin to INR standard time for the first time,total amount of warfarin and the average daily amount were recorded.Results Patients carrying CYP2C9* 1* 1 had increased time to reach INR target value for the first time (P ＜ 0.05);and the total warfarin doses and average daily dose when INR reached target value were higher than those carrying CYP2C9*3 (P ＜ 0.05).When compared with those in two wild type groups,patients carrying CYP2C9 and CYP4F2 rs2108622 mutated type needed the shortest time when INR reached target value for the first time,and the total warfarin doses and average daily dose when INR first reached target value was the lowest,which showed significant difference (P ＜ 0.05).And when compared with CYP2C9 mutated type group,the INR average time to reach the first target was shortened and the total warfarin dose of patients carrying CYP2C9 and CYP4F2 rs2108622 mutated type was lower (P ＜ 0.05).Conclusion The gene polymorphisms of CYP2C9 and CYP4F2 are significant hereditary factors influencing warfarin dose.Detection of CYP2C9 and CYP4F2 genotypes prior to medication and predicating warfarin dosage may result in lower incidence of over-anticoagulation and reduce the dosage-adjusting time of warfarin.

Objective To explore the relationship between reduction of regional cerebral blood flow in the normal appearing white matter (NAWM) and the extent of age-related white matter lesions (WML).Methods We used Fazekas scale to divide all participants into four groups (normal,mild,moderate,severe) according to the extent of the lesions showed on MRI.Regional cerebral blood flow (rCBF) in the area of WML and NAWM was measured by xenon contrast CT examination.Results A total of 56 cases were selected.The average rCBF (ml · 100 g-1 · min-1) in the lesions (WML) around ventricle,in right centrum ovale and in left centrum ovale respectively was 20.33 ± 2.52,21.27 ± 1.02,21.03 ± 1.83 for mild; 16.33 ±2.03,15.55 ±1.71,15.91 ±0.98 for moderate; 14.05 ±2.63,14.46 ±2.17,14.23 ± 1.95 for severe.The average rCBF (ml · 100 g-1 · min-1) in the NAWM around ventricle,in right centrum ovale and in left centrum ovale respectively was 20.79 ± 2.78,22.26 ± 1.9,22.15 ± 2.4 for normal; 21.12 ± 2.95,22.17 ± 1.50,22.25 ± 2.13 for mild,18.02 ± 2.41,19.45 ± 1.94,19.62 ± 1.54for moderate; 16.38 ± 3.22,18.18 ± 2.84,16.74 ± 2.97 for severe.The decrease of rCBF in the severe and moderate lesion areas was more serious than that in the mild lesion areas and reached statistic significance (P ＜ 0.05) ; The decrease of rCBF in the severe and moderate lesion areas was more serious than that in the area of NAWM in the same grade and reached statistic significance (P ＜ 0.05).The decrease of rCBF in the area of NAWM around severe and moderate lesion areas was more serious compared with that around mild lesion areas or normal areas (P ＜ 0.05) ; But the difference of rCBF in the area of NAWM around mild lesion areas and normal areas did not show any statistic significance.Conclusions Chronic ischemia was found to be existed not only in the lesions (WML) but also in the area of NAWM around the lesions,and was related to the extent of the lesions.Chronic ischemia may play a key role in the mechanism of aged-related WML.

Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .

BACKGROUND: Security of organ donor attracts more attention, because donor complication and transplantation failure always occur following renal transplantation. Therefore, living-related kidney transplantation should be paid much attention in order to make sure life and quality of life. OBJECTIVE: To investigate the safety of living-related kidney transplantation. METHODS: A total of 38 cases of living relative donor kidney transplantation were retrospectively analyzed. Before transplantation, identify of patients should be determined, and all patients provided the informed consent. The general data of patients were sufficiently dialyzed before transplantation to improve the body status. TacroUmus or mixture of cyclosporine A, mycophenolate, and adrenal cortex hormone were administrated following transplantation to observe renal function, complication incidence, and acute rejection reaction. RESULTS AND CONCLUSION: Due to short waiting time, low price, and long-term survival rate, living-relative donor kidney transplantation has low risk factor, s for donor. However, the safety still needs to be sufficiently evaluated for donors and recipients.