Objective To study outcomes of the family doctor contact system and outpatient coordination system in Qingdao.Methods Random selection of 400 community residents and 576 outpatients for a questionnaire survey,using t tests and time series analysis.The purpose is to analyze the number of insured workers,community referrals,costs of hospitalization and the proportion of out-of-pocket payment,and impacts on community healthcare services.Results Number of insured works increased year by year,up to 1,739,931 in 2010.The proportion of community referred hospitalization was raised to 56.97％ in 2010 and increased 54.26％ compared to 2007.Hospitalization costs and the proportion of out-of-pocket payment were reduced.Conclusion The family doctor contact system and outpatient coordination system in Qingdao proved a success,as the practices were highly popular among the employees,and benefited community health centers as well,making it worthwhile to promote.

Objective To explore the effectiveness of the home-community-hospital network management (HCHNM) on the prevention and treatment of stroke.Methods From June to December 2011,HCHNM was implenented in Qingdao of Shandong Province to prevent and treat stroke patients.According to community residents healthcare records,A total of 80 stroke patients were randomly selected from Badahu and Fushanhou communities (study group) and another 80 patients from Zhongshan Road and Liaoning Road communities (control group).A household questionnaire survey was then conducted among these participants.Chi-square test and t test were used for data analysis.Results The overall effective rate of the study group was 86.25％ (69/80),which was significantly higher than that of the control group (67.5％) (x2=221.807,P＜0.05).The study group also showed largely improved quality of life (total score:t=4.593;physical fitness,family activities,movement,mood,self-care ability,social activities,upper limb function and work ability scores:t values were 7.775,2.244,5.329,3.832,5.463,2.979,5.924 and 3.555,respectively; all P＜0.05),although language,character,thinking and vision abilities had no statistically significant difference from the control group (t values were 0.561,1.466,0.831 and 1.000,respectively; all P＞0.05).The scores of daily activities and life satisfaction of the study group were higher than those of the control group,while per capita medical cost was much lower (t values were 12.998,20.760 and-29.777,respectively; all P＜0.05).Conclusions As an effective,safe and economy therapy model,HCHNM could improve rehabilitation,self-care ability,quality of life,and life satisfaction of community stroke patients.In addition,it greatly mitigates medical burden.

Based on the urban residents' basic medical insurance system in Qingdao,with hospitals,community aging care institutions and families as the carriers,Qingdao city explored and implemented the long-term medical care insurance system(LTMCI),and established mechanisms for fundraising,payment,handling,service and supervision.The city also designed a scientific application and reimbursement process.Three service modes are designed and put into practice as follows:Long-term care in designated nursing homes or pension institutions; Medical care at designated hospitals; and home health care.These services are charged by quota-lump per bed per day,with the reimbursement ratio of 96％,90％ and 96％ respectively.A practice over a year proved the LTMCI as effectively alleviating disease burden of patients,and guiding long-term care to serve communities.This way a new type of medical care system comes into being,with medicine-care-recovery-endowment for disabled population.

A systematic summary of the concept and operational mechanism of the intensive disciplines management in a hospitals group,and that of the intensive disciplines management for hospitals groups,as well as a comparison of the differences found in department service capacity,service quality,discipline development and patient satisfaction before and after the intensive discipline management is in place.The practice proved that the departments practicing intensive management have witnessed significant rise in outpatient headcount,hospitalization headcount and surgical operation headcount.Their weight in the group is also higher.For example,their curative rate and rescue success rate of dubious and acute diseases higher than before (P＜ 0.05).The Group has 8 provincial key medicine-specialties,including 5 intensive management departments.It has 8 provincial key clinicaldisciplines,including 2 intensive management departments.The overall patient satisfaction for service of such departments is 92.1％,the satisfaction for convenience is 84.4％,that for service quality 90.0％,that for service attitude 92.5％,and that for medical service experience is 89.5％.All of which are significantly higher than that those on their admission to the hospital.The intensive management has enabled unified management of internal medicine and surgery of the same profession in the campus,integrated workforces of both internal medicine and surgery department along with those of medical technicians.In addition,it has enhanced departmental service capacity and quality,discipline competence,as well as outpatients' convenience,patients' satisfaction and medical experience.

Objective:To identify Down syndrome (DS) fetal encephalopathy related genes and signaling pathways via bioinformatics analysis, and to explore their potential mechanisms underlying the occurrence and development of DS neuropathology.Methods:Retrospective study.In December 2021, dataset GSE59630 was downloaded from the gene expression omnibus (GEO), and differentially expressed genes (DEGs) between DS and normal fetal brain tissue were identified by R software.Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and gene set enrichment analysis (GSEA) were performed on the genes identified.The protein-protein interaction (PPI) network was constructed based on search tool for the retrieval of interacting genes online database and Cytoscape software, and key modules and hub DEGs were identified.Real-time quantitative polymerase chain reaction technique was used to verify the expression of hub genes related to neurodegeneration in brain tissue of 3 pairs of DS and normal fetuses at the gestational age of 22-33 weeks.Results:A total of 225 DEGs were screened out from DS and normal fetal brain tissue, including 18 up-regulated genes and 207 down-regulated genes.GO functional enrichment analysis showed that DEGs were mainly enriched in neurogenesis, neuronal apoptosis, transcriptional regulation, mitochondrial energy metabolism, etc.KEGG pathway enrichment analysis revealed that DEGs were associated with a variety of neurodegenerative diseases.GSEA suggested that apoptosis and inflammatory responses play a vital part in the occurrence of DS neuropathology.Ten hub genes were identified by the PPI network established, and they were mainly related to histone acetylation and transcriptional regulation.According to the tissue verification result, the variations of RAB8A, TBP and TAF6 expression conformed to the microarray data. Conclusions:The key genes and signaling pathways identified by transcriptome analysis of fetal brain tissue facilitate the comprehensive understanding of the molecular mechanism of DS neuropathology.This study provides a novel insight into the clinical diagnosis and treatment of neurodevelopmental abnormalities and mental retardation in DS.

This study was aimed to reveal characteristics of functions, main indications and applications of Chinese patent medicines in order to provide references for development of new Chinese patent medicines for antitussive ef-fect. Chinese patent medicines recorded in the Pharmacopoeia of the People's Republic of China and the New Na-tional Chinese Patent Medicines were taken as research subjects. Chinese patent medicines classified in the function and indication with key words of cough-relieving, cough-suppressing, cough and chronic cough were col-lected. Analysis was made on the prescription characteristics, such as functions, main indications and applications. The results showed that there were 684 Chinese patent medicines and 462 terms, which were used for a total of 1533 times. The frequently-used terms are antitussive effect with expectorant, antitussive effect, expectorant, heat-clearing and exterior-releasing, antiasthmatic, wind-expelling and antipyretic, antitussive effect with antiasthmatic, purging lung heat, relieving exterior syndrome and moistening the lungs. All 684 Chinese patent medicines were used 48 ma-jor treatments for a total of 1107 times. The main indications include acute and chronic trachitis / bronchitis, exoge-nous wind-heat type of common cold, exogenous wind-cold type of common cold, cough with abundance of phlegm due to phlegm-heat obstructing the lung, acute upper respiratory tract infection, asthma, acute and chronic pharyngi-tis, lung heat cough, and etc. All 684 Chinese patent medicines used a total of 537 kinds of herbs and chemical medicines, including 441 kinds of herbal medicine, 36 kinds of animal medicine, 25 kinds of mineral medicine and 35 kinds of chemical medicine. The top ten herbs in terms of using frequency are Glycyrrhizae radix et rhizoma, Platycodonis radix, Armeniacae semen amarum, Menthae haplocalycis herba, Citri reticulatae pericarpium, Ephedrae herba, Scutellariae radix, Perilla frutescens (L.) Britt, Pinelliae rhizoma, Fritillariae cirrhosae bulbus. Among them, 1/4 of Chinese patent medicines used extract. Five kinds of food or fruits were also used, which were orange, fresh gin-ger, pear, watermelon and dried mushroom. It was concluded that Chinese patent medicines for antitussive effect can be adopted in the treatment of various kinds of diseases, especially for the treatment of cough(heat cough in partic-ular), abundance of phlegm, asthma, pharyngitis, laryngitis, and etc. The treatment methods of clearing heat, dis-pelling wind and relieving exterior syndrome played an important role in the realization of antitussive effect. However, the expression of functions and main indications is far from standardized and clear. Drugs commonly used are herbal medicine plus animal medicine, mineral medicine and chemical medicine as well as food and fruit. The discovery of preparations with certain clinical curative effect from ethnomedicine and the using of their extracts as a major ingre-dient are one important way to develop new Chinese patent medicines with antitussive effect.