Questionnaire survey(n=147)and group interview(n=13)were used for this investigation.Our results showed that 66.7%of participants considered"heavy work burden and insufficient specialists"to be the main challenge.Half of comingnity healthcare providers were not satisfied with thepayment systerm.We suggest that the overall-consideration of community healthcare service development in urban and suburb areas and 4 kinds of performance pattems should be strengthened:the perfommnce appraisal and quality control schemes should be modified;and the employee headcount in community healthcare centers or transferred employees'salary should be moderately increased in the fumre.

Objective To investigate the ability of decision making under risk condition in patients with Parkinson' s disease (PD),and to explore the neural relationship between basal ganglia and the decision-making ability.Method Twenty-five PD patients and 25 healthy controls (HC) were investigated by Game of Dice Test (GDT) with explicit probability.Results PD patients performed poorly in the entire task,selecting more risky options ( PD:10.88 ± 5.58 ; HC:5.72 ± 3.69 ; t =3.86,P ＜ 0.01 ),compared with healthy controls.In general,the final asset of PD group was negative while the result of HC group was always profitable and the difference was significant ( PD:- 3748.00 ± 3923.87 ; HC:684.00 ± 1764.62 ; t =-5.15,P ＜ 0.01 ).The most frequent choice made by PD patients was one number,which is the most risky one.Accordingly,the most frequent choice made by HC group was three numbers (one number:PD:6.48 ±5.81;HC:1.00 ± 1.44;t =4.58,P ＜0.01; three numbers:PD:2.64 ±2.14;HC:7.04 ±2.54;t =-6.62,P ＜ 0.01 ).The frequency of choosing the risky options was correlated with the rate of using negative feedback( r =-0.59,P =0.003 ),and the result of Stroop test( r =0.55,P =0.004).Conclusion Present study has shown that PD patients have significant impairments in decision-making under risk condition,and the impairments are correlated with executive function and negative feedback.

Objective To investigate the capabilities of decision-making in male subjects with Antisocial personality disorder (ASPD).Methods A total of 76 male ASPD subjects were compared with matched 60 healthy controls on the Iowa Gambling Task.At the same time,All of them were evaluated with Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS),Mini-Mental State Examination (MMSE),the MMPI Personality Disorder Scales (MMPI-Pd) and The Barratt Impulsiveness Scale (BIS-11).Results The ASPD group selected less advantageous cards (the number of cards selected from the advantageous decks minus the number of cards selected from disadvantageous decks) than healthy controls ((-4.13 ± 18.27) time,(6.03 ± 19.43) time respectively,t (134) =-3.132,P =0.002).A 2 (group) × 5 (block) ANOVA (analysis of variance) on the cards of net advantageous from the gambling task revealed a significant main effect of group (F(1,134) =9.811,P=0.002).Meanwhile,the ANOVA revealed a significant main effect of block (F(4,5336 =15.456,P ＜ 0.001).The results showed that healthy controls and ASPD group gradually shifted their selections toward the good decks as the game progresses.The study indicated the total number of advantageous cards for subjects with antisocial personality disorder were negative correlation to the MMPI-Pd(r =-0.232,P=0.006).Conclusion The present study suggests that the decision-making impairment might be in the male subjects with antisocial personality disorder.The deficit of decision-making for ASPD might be attributed to the dysfunction of the orbitofrontal,dorsolateral frontal,and anterior cingulate cortex.

Objective To study the antibacterial effect of borneol, honey, gentamicin in Ruchuang Bingmi hydropathic compress agent.Method Staphylococcus aureus(S.aureus), Escherichia coli(E.coli), Pseudomonas aeruginosa(P.aeruginosa) were used to produce the third phase of infection decubitus animal models, respectively.Vaseline as the control group, divided into 12 groups:Vaseline-S.aureus, Vaseline-E.coli, Vaseline-P.aeruginosa;Honey-S.aureus,Honey-E.coli,Honey-P.aeruginosa;Borneol -S.aureus;Borneol -E.coli;Borneol-P.aeruginosa;Gentamicin-S.aureus;Gentamicin-E.coli;Gentamicin-P.aeruginosa;6 rabbits in each group.Honey, borneol, gentamicin was made into a gauze in treatment for decubitus .Organizations do strain identification and colony counts was observed before and after taking the treatment.ResuIts Borneol group ( F =11.059,P<0.01).,there was differences of each groups count cultured by borneol;Time ×Strains(F=11.281,P=0.009),there was no significant interaction between the two groups;gentamicin(F=7.99,P=0.000),gentamicin culture showed a difference in each group count;Time ×Strains(F=12.531, P<0.07),interaction between the two groups showed significant.Borneol has no antibacterial effects on P.aeruginosa , had a certain antibacterial activityon S.aureus and E coli;gentamicin had good antibacterial effect on the three kinds of bacteria, and against P.aeruginosa was particularly significant.ConcIusion The antibacterial activity of gentamicin is better than single herbs borneol in Ruchuang Bingmi hydropathic compress agent, honey has no antibacterial effect.

OBJECTIVE: To study the causes of false-positive hyoid fractures and forensic identification. METHODS: Twelve cases of false-positive hyoid fractures were collected and analyzed. RESULTS: Improper dissection technique (4 cases) and congenital separation (8 cases) were the main reasons for false-positive hyoid fractures. CONCLUSION True fractures can be differentiated from false-positive hyoid fractures. False-positive hyoid fracture caused by improper dissection technique can be identified through examination of peripheral muscle, soft tissue hemorrhage, and the characteristics of fracture end.
Autopsy ; Cell Differentiation ; Diagnostic Errors ; Fractures, Bone/diagnosis* ; Humans ; Hyoid Bone/injuries* ; Muscles

OBJECTIVE: To investigate the pathological features and significance of myocardial contraction band necrosis in sudden cardiac death. METHODS: Using HE and PTAH staining, the distribution sites and pathological features of myocardial contraction band necrosis were observed. The data were analyzed according to the extent of necrosis. RESULTS: The locations, pathological features and the extent of necrosis were similar in different sudden death cases. The locations were related with sites of myocardial damage. The papillary muscles of left ventricular were most occurred, followed by the anterior wall of left ventricular. In the sudden death cases caused by stress cardiomyopathy, the extent of myocardial contraction band necrosis was lighter than the others. Most cases were predominantly level 1, the others were level 2. CONCLUSION Used as the diagnosis basis of acute myocardial ischemia, the myocardial contraction band necrosis has important significance to determination of death.
Adult ; Aged ; Aged, 80 and over ; Coronary Disease/complications* ; Death, Sudden/etiology* ; Death, Sudden, Cardiac/pathology* ; Female ; Heart Diseases/pathology* ; Humans ; Male ; Middle Aged ; Myocardial Contraction/physiology* ; Myocardium/pathology* ; Necrosis

Site surveys were conducted with a self-designed questionnaire for 4102 urban residents regarding their awareness and utilization rate of service projects and satisfaction (total satisfaction,medical environment,service attitude,content of communication and diagnostic & therapeutic modalities).The influencing factors of satisfaction were analyzed by multiple linear regression analysis.The factors of improving total satisfaction were as follows:①When content of communication,diagnostic & therapeutic modalities,service attitude and medical environment improved 10％,total satisfaction rose by 2.44％,2.50％,2.47％ and 0.98％ respectively; ② Utilization rate rose by 2.33％,1.60％ and 0.85％ respectively if they accepted home care services,rehabilitation services and chronic disease management services ; ③Total satisfaction rose by 0.94％ if they became aware of family planning and reproductive health services.And the factors of reducing total satisfaction were as follows:①total satisfaction declined by 1.68％ if their children accepted preventive vaccination services.②total satisfaction declined by 1.13％ if the respondents maintained their health records.

To explore the current status of job burnout among 1210 staffs at local community health stations and analyze its influencing factors with multiple logistic regression analysis.The regression model of high emotional exhaustion had statistical significance (SE =0.070,P =0.000).The possibility of high emotional exhaustion was negatively correlated with the satisfaction of organizational commitment,rules and regulations,cooperation between colleagues,satisfaction of job nature and family supports.And it had a positive correlation with supports from family and colleagues and satisfaction of welfare.The regression model of high depersonlization had statistical significance (SE =0.072,P =0.000).The possibility of high depersonlization had a negative correlation with organizational commitment,cooperation between colleagues,satisfaction of job nature and smooth communications with leaders and family.And it was positively correlated with compensation,promotion,satisfaction of welfare and smooth inter-colleague communications.The regression model of highly reduced personal accomplishment had statistical significance (SE =0.061,P =0.000).The possibility of highly reduced personal accomplishment had a negative correlation with satisfaction of superiors,job category and communication,age,smooth communications with leaders and family.And it was positively correlated with satisfaction of compensation.

Bilirubin ; blood ; Child Development ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neuropsychological Tests

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects