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 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 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 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

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.

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.

BACKGROUND:Endothelial progenitor cells from the peripheral blood and umbilical cord blood are an essential source to repair vascular endothelial cells damaged by various diseases.
OBJECTIVE:To compare the biological characteristics of endothelial progenitor cells from peripheral blood and umbilical cord blood in vitro.
METHODS:Mononuclear cells were isolated from the umbilical cord blood and peripheral blood with density gradient centrifugation method and 6%hydroxyethyl starch precipitation combined with density gradient centrifugation method, respectively. Mononuclear cells were counted. Then the cells were implanted on the culture plate pre-paved with rat tail col agen at the concentration of 1×106/cm2, and cultured in an endothelial cellculture medium for 7 days.
RESULTS AND CONCLUSION:Isolated and cultured endothelial progenitor cells from the peripheral blood and umbilical cord blood had similar morphological characteristics in vitro. Under the optical microscope, with the increase of culturing days, most adherent cells were changed from round to spindle-shaped. Peripheral blood endothelial progenitor cells had cellcolony formation, and spindle cells from the umbilical cord blood arranged typical y in a line structure. After trypan blue staining and drawing of cellgrowth curves, the number of mononuclear cells and endothelial progenitor cells, survival rate and proliferative ability of endothelial progenitor cells from the peripheral blood were al lower than those from the umbilical cord blood (P<0.05). At day 3 after incubation, the proliferation of endothelial progenitor cells from the peripheral blood and umbilical cord blood reached the peak, and then showed a decreased tendency. Flow cytometry and Immunofluorescence staining showed that endothelial progenitor cells from the peripheral blood and umbilical cord blood could express CD34, CD133, and vascular endothelial cellfactor receptor 2. The endothelial progenitor cells from the peripheral blood and umbilical cord blood could swal ow acetylated low density lipoprotein and be combined with ulex europaeus agglutinin Ⅰ. The results confirmed that the endothelial progenitor cells from the peripheral blood and cord blood have similar biologicla characteristics, but the proliferation ability of endothelial progenitor cells from the cord blood is higher.

Objective To study the value of using endoscopy iodine staining combined detecting the expression of p53, survivin and telomerase in the diagnosis of early esophageal carcinoma and precancerous lesions. Methods Three hundred patients who received routine gastrescopy and had high risk of esophageal carcinoma were examined by the iodine dyeing on their esophageal mucosa with 2. 5% Lugol solu-tion. Multiple biopsies were taken from the unstained or light-stained areas when their diameters were over 5mm for pathology diagnosis. The expression of p53, survivin and telomerase were detected by immunohistochemical staining. Results With the Lugol staining method, the incidences of light, moderate and high grade dysplasia and early esophageal carcinoma were 16. 3% ,9. 7% ,3.7% and 4. 3% respectively. The expression of p53, survivin and telomerase were related and the unstained were related to the expression of p53, survivin and telomerase in dysplasia and early esophageal carcinoma. Using endoscopy iodine staining combined testing p53, survivin and telomerase showed sensitiv-ity of 100%, specificity of 92. 3% and accuracy of 91.8% to diagnose of early esophageal carcinoma and high grade dysplasia. Conclusion Lugol solution chromoendscopy combined assay of p53, survivin and telomersse might be useful in the diagnosing early esophageal carcino-ma and precancerous lesion.