Objective To describe well-child care guidelines in the United States and compare it to China's guidelines so as to inform child health policymakers and providers in developing improvements for China well-child care practices.Methods We used a multistage approach to identify features of well-child care guidelines.The following methods are used:literature review,key informant interviews,site visits to both China and the United States and summarization of experiences.The differences and similarities of the contents were compared.Results Both China and the United States emphasize the importance of well-child care and the basic contents such as immunization,growth monitoring,lab screening and health education are similar for well-child care from 0 to 6 years old.Differences exist in that China's well-child guidelines are a set of general principles,without specific instructions,and only cover children from 0 to 6 years old.There are no guidelines in China for children older than 6 years old.Conclusions China needs a more detailed well-child care guidelines with specific instructions for all-aged children; despite some similarities,there are applicable learnings from that of the United States' for improvement in China's.

Objective To investigate current situation of otoscope use by practitioners at community health-care service facilities in Hainan and Shenzhen and explore its importance and feasibility of spread of its use in community health-care service facilities in China.Methods Group discussion, telephone personal interview, otoscope market survey and literature research all were used among 112 practitioners at 67 community health-care service facilities in Hainan, 47 practitioners at 23 community health-care service facilities in Shenzhen, Guangdong, and 11 representatives involved in general practice training from 11 districts.Results In Hainan, only one community health-care service facility ( 1.5% ) was equipped with otoscopes and only one practitioner (0.9% ) could use it.In Shenzhen, two community health-care service facilities (8.7%) were equipped with it, but which had never be used.All the practitioners at community health-care service facilities surveyed have not been trained for its use, so most practitioners there did not have basic skills to use otoscope.Conclusions Otoscope is not equipped at most community health-care service facilities in Hainan and Shenzhen, and it is little used there even equipped with it.Otoscopy should be used as an adequate and feasible technique at community health-care service and be spread among general practitioners in China.

This study reviewed the reasons for encounter (RFE),diagnoses and the diagnostic categories of patients aged 0-14 y in general practice clinic affiliated to a tertiary hospital from June 2011 to May 2012.The results showed that the most frequent RFE was cough,at a rate of 29.6 per 100 encounters;the second one was fever (21.4％) and the third was nasal problems (9.5％).Medical examinations,skin rashes and follow-up encounters occurred at equal rates (5.2％).The most frequent diagnosis was acute upper respiratory tract infection (41％).Medical examination (6.3％),other viral diseases (5.1％),pneumonia (3.6％) and no detected disease (3.6％) were also common diagnoses.The diagnostic categories included all systems,and the problems of the respiratory system (56.4％) were most common.The results suggest that pediatric care comprises a very important part of primary care.

Objective To investigate the risk factors and clinical characteristics,auxiliary examination char-acteristics,treatment and prognosis for acute stroke patients with deep vein thrombosis (DVT),in the hope of provi-ding the detailed clinical data for hospitalized patients with stroke in early prevention,early diagnosis and early treat-ment of DVT.Methods 160 cases of stroke patients were reviewed including 66 cases of patients with hemiplegia after stroke and ultrasound confirmed DVT data analysis,And compared with the same period of 94 cases of DVT in patients with stroke.The purpose of this study was to evaluate the incidence of DVT,possible risk factors,and clinical characteristics.Results Stroke in patients with DVT spent an average of 16d.DVT occurred in elderly patients (65 years or higher) with 44 cases,accounting for 66.67%;Serious paralytic 42 cases (72.72%),long-term bed 52 cases (78.78%);The most commonly comorbid disease was diabetes mellitus,hypertension and hyperlipidemia;The plasma fibrinogen concentration was (5.02 ±1.38) g/L,which was significantly higher than (2.74 ±1.65) g/L of the control group.Compared with control group,the difference was statistically significant (t=4.78,P<0.01). Conclusion Limb paralysis,long-term lie in bed,older age and high condensation state are DVT risk factors,which should be paid to prevent in advance clinically.

OBJECTIVE: To explore the possible mechanism of Huoxue Qianyang Formula (HXQYF), a compound traditional Chinese herbal medicine, in reversing the left ventricular hypertrophy (LVH) of spontaneous hypertensive rats (SHRs) by analyzing the expressions of mRNAs and proteins of proto-oncogenes c-fos and c-myc in left ventricular muscle. METHODS: The experimental study was carried out in SHRs, the sex- and age-matched Wistar-Kyoto (WKY) rats were served as normal control (n=5, normal saline 10 ml/kg daily). Twenty-five SHRs were randomly divided into five groups: untreated group (n=5, normal saline 10 ml/kg daily), high-dose HXQYF-treated group (n=5, 0.84 g/ml HXQYF, 10 ml/kg daily), medium-dose HXQYF-treated group (n=5, 0.42 g/ml HXQYF, 10 ml/kg daily), low-dose HXQYF-treated group (n=5, 0.21 g/ml HXQYF, 10 ml/kg daily) and cilazapril-treated group (n=5, 1 mg/ml cilazapril, 10 ml/kg daily). The drugs were intragastrically administered once daily for 14 weeks. The expressions of mRNAs and proteins of proto-oncogenes c-fos and c-myc in left ventricular muscle were detected separately by in situ hybridization histochemical method and immunohistochemical method. RESULTS: Compared with the normal control group, the expressions of mRNAs and proteins of proto-oncogenes c-fos and c-myc in left ventricular muscle were significantly increased in untreated group (P<0.01). After treatment, the expressions of c-fos and c-myc mRNAs in left ventricular muscle in HXQYF-treated groups were significantly down-regulated as compared with those of the untreated group (P<0.05). The expressions of c-myc protein were also significantly decreased in high- and medium-dose HXQYF-treated groups as compared with the untreated group (P<0.05), but it had no significant effects in protein expression of c-fos in the three HXQYF-treated groups. CONCLUSION: HXQYF can inhibit the expression of c-myc in ventricular hypertrophy tissue, which may be the mechanism in treating LVH of hypertension.