Actins ; genetics ; Adolescent ; Cardiomyopathy, Dilated ; genetics ; Child ; Child, Preschool ; Desmin ; genetics ; Female ; Humans ; Infant ; Male ; Mutation

Acceleration of social and economic growth in China is raising China's migrant population to 160 million in 2010.Their reproductive health has a close bearing on the overall national quality of the Chinese people.This reveals the significance of studying the health status for continuous improvement of such a population in China.This study is based in communities to review the challenges faced in reproductive health of migrant population,with five recommendations for upgrading quality reproductive health in communities.

OBJECTIVETo study the expression difference in MicroRNA-21 (miRNA-21) levels of the plasma between the patients with coronary heart disease and the subjects without coronary artery lesions, and its clinical significance.

METHODSPlasma was obtained from the patients with coronary heart disease(trial group,56 cases) and the subjects without coronary artery lesions(control group, 10 cases), patients with coronary disease were divided into angina(AP, 39 cases) and acute myocardial infarction(AMI, 17 cases)subgroup, the contents of miRNA-21 were detected using qRT-PCR method, and the differential expression of miRNA-21 in each group was analyzed. The levels of creatine kinase isoenzyme (CK-MB), high sensitive troponin I(cTnI), B type natriuretic peptide urea (BNP), Gensini, left ventricular ejection fraction (LVEF), integral value of coronary left ventricular end diastole diameter (LV) and homocysteine (HCY) were determined and the correlation between miRNA-21 and these clinical indexes was analyzed.

RESULTSCompared with control group, there was a significant difference in expression of miRNA-21 in patients with angina and AMI (P < 0.05), and miRNA-21 expression in AMI group was much higher than that in AP group. There was statistical significance in CK, CK-MB, cTnI, Genisis integral comparison between AMI group and control group (P < 0.05). The correlation analysis showed that there was a positive correlation between expression of CK, CK-MB, cTnI and the level of circulating miRNA-21 in patients with acute myocardial infarction. And there was a negative correlation between BNP, Gensini integral, LVEF value of coronary artery, LV and circulating miRNA-21.

CONCLUSIONmiRNA-21 was significantly elevated in acute myocardial infarction subgroup than the control group. The level of miRNA-21 associates with the degree of coronary artery stenosis, and might be a potential marker for the diagnosis of acute myocardial infarction. miRNA-21 may play an important role in protecting myocardium from ischemia/reperfusion injury.

Acute Disease ; Biomarkers ; blood ; Coronary Disease ; blood ; Creatine Kinase, MB Form ; metabolism ; Humans ; MicroRNAs ; blood ; Myocardial Infarction ; blood ; Natriuretic Peptide, Brain ; metabolism ; Troponin I ; metabolism

Objective:To survey the enablement level of elderly patients in the community and its influencing factors.Methods:A total of 460 patients aged ≥60 years visiting Changfeng and Fenglin Community Health Service Centers of Shanghai during September 3 to 15, 2018 were invited for a questionnaire survey. A self-made health status questionnaire, Patient Enablement Instrument (PEI), Chinese Health Questionnaire (CHQ-12), the Consultation and Relational Empathy Measure (CARE) were applied for survey.Results:All valid 460 questionnaires were retrieved. The positive rate of patient enablement was 73.91% (340/460). The median score for PEI was 3, Q1 was 0 and Q3 was 6. The univariate analysis showed that patient′s gender( Z=-2.32, P=0.02), age ( H=9.73, P<0.01), reason for visit ( H=42.06, P<0.01), health status in the past year ( H=8.28, P=0.02), consultation time ( H=22.92, P<0.01), sufficiency of communication with the doctor as patient thought ( H=41.83, P<0.01), detailed inquisition ( H=81.11, P<0.01), attending a contracted doctor ( Z=-3.42, P=0.04), the satisfaction of the visit ( H=38.64, P<0.01), total score of CHQ-12 ( Z=-2.01, P=0.04) and the score of CARE were significantly associated with the enablement level of the patient after the visit ( H=288.06, P<0.01). Multivariate linear regression showed that age 60-79( P=0.03), visit for acute disease( P<0.01), good or moderate health status in past year ( P<0.01), communication with the doctor<3 min or 3-<5 min ( P<0.01), sufficient or moderate time for communication with the doctor as patient thought ( P<0.01), detailed or moderate inquisition( P=0.03 or P=0.01), attending a contracted doctor ( P<0.01), CHQ-12 ≥4 ( P<0.01), middle or high CARE score ( P<0.01)were associated with the enablement of elderly patients after visit, with a cumulative contribution rate of 73.40%( F=50.08, P<0.01). Conclusion:The level of enablement of elderly patients after visiting the general outpatient clinic of the community health service center is relatively low. Patient′s age, types of disease, health status and the time of communication with the doctor, the sufficiency of communication time as patient thought, the detailed inquisition, attending a contracted doctor, the mental health status, and the empathy expression of the doctor are associated with the enablement of patients.

Objective To unveil the current situation and bends of Keshan disease in Pingliang city of Gansu province, to evaluate the outcome of related prevention and control measures, and to provide scientific basis for further prevention and treatment of the disease. Methods According to the "the central allowance local public health special funds endemic disease prevention programs grams mountain monitoring programme" and "the diagnostic criteria for Keshan disease" (GB 17021-1997), between 2007 and 2009, local residents from nine monitoring points in Pingliang city of Gansu province were clinically examined, and electrocardiography(ECG) tracings and Xray were taken of suspected cases. Corn, wheat samples and hair samples of children, adults and women were collected, and selenium content of these samples was determined by 2.3-2-amino-naphthalene fluorescence method. Results A total of 5846 residents were surveyed in 3 years, 247 cases of Keshan patients were detected, with a detection rate of 4.23%(247/5846), of which potential cases of Keshan disease 214, the detection rate was 3.66% (214/5846); chronic Keshan disease 33 cases, the detection rate was 0.56% (33/5846); no acute type and subacute Keshan disease detected. A total of 764 abnormal ECG cases were detected, and abnormal detection rate was 13.07%(764/5846). Two hundred and seven cases of suspected patients were examined by chest X-ray, 80 cardiac enlargement cases were detected, the detection rate was 38.6% (80/207). The 262 hair samples of children, adults and women were analyzed, hair selenium was (0.279 ± 0.098)mg/kg. Of the 9 corn and 31 wheat samples collected, corn selenium was (0.0079 ± 0.0029)mg/kg; wheat selenium was (0.0104 ± 0.0078)mg/kg. Conclusions Overall Keshan disease is in a stable and subsided trend in Pingliang city of Gansu province, but there are still a number of potential chronic types, sporadic new cases, suggesting that the disease monitoring, comprehensive prevention and treatment of the patients are the focus.

Adult ; China ; Female ; Humans ; Logistic Models ; Male ; Occupational Health ; statistics & numerical data ; Transients and Migrants ; Young Adult

Animals ; Male ; NF-kappa B ; metabolism ; Otitis Media with Effusion ; immunology ; metabolism ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Th1 Cells ; cytology ; Th2 Cells ; cytology

Objective To investigate the capacity and training needs of the community general practice mentors in different areas of Shanghai.Methods General practice mentors from community health centers,who attended a municipal training program in Shanghai during July 2012 to October 2012,were participated in the survey with a self-designed questionnaire.The general condition,basic ability (clinical skill,teaching ability and professional development),motivation and needs of training were investigated.The factors affecting the willingness of training were analyzed.Results Among 742 mentors receiving the survey,259 were from the urban area,174 from rural-urban continuum and 309 from rural area.The academic degree in urban group was relatively higher:17 out of 257 (6.6％) holding master degree.The ratio of participants who had received standardized training in urban,rural-urban and rural areas was 33.2％,25.3％,37.4％,respectively.The personal quality and communication skills in urban group were significantly higher than those in rural-urban continuum and rural group (18.58 ± 2.49,17.89 ± 2.69,17.85 ±2.34,P ＜0.05).The clinical skill (12.31 ± 1.98,11.95 ±2.02,11.52 ± 1.81),teaching ability (11.99 ± 2.62,11.63 ± 2.86,11.12 ± 2.77) and professional development (6.42 ± 1.61,6.36 ± 1.55,5.61 ± 1.38) in urban group were all significantly poorer than those in other two groups.The main purpose of participation in training was to improve medical knowledge and clinical skills in three groups (70.8％,74.0％,80.4％,respectively),followed by the need for community teaching.The rural group has higher training requirements in improving clinical diagnosis and treatment ability (75.3％,80.1％,85.5％,respectively in three groups),doctor-patient communication ability (38.0％,44.0％,50.7％,respectively) and community preventive care ability (29.4％,30.7％,42.8％,respectively).The urban group had much more requirements in scientific research training (38.8％,34.9％,14.1％,respectively).Logistic regression analysis showed that doctors with supports from the leadership (OR =2.688,P ＜ 0.05) and with less working stress (OR =2.241,P ＜ 0.05) were more willing to participate in mentor training.Conclusion There are discrepancies in basic ability and training needs of community general practice mentors in different areas of Shanghai,so we should develop specific or targeted training program in the future.

Objective To develop an index system for evaluation index system for community general practice teaching base.Methods A draft of evaluation index system for community general practice teaching base was preliminarily developed on the basis of literature research.Two rounds Delphi consultations with 32 experts of general practice were conducted between July 2014 and May 2015.The results of consultation were analyzed and the evaluation index system for community teaching base was established.Results In two rounds of Delphi consultation,the positive coefficients were both 100％,the authority coefficient of experts were 0.879 and 0.897,respectively,and the coordination coefficient were 0.165 and 0.204 (P ＜0.01).The established evaluation index system consisted of 4 first-class indexes,8 second-class indexes and 27 third-class indexes.Four first-class indexes were basic conditions,teaching conditions,teaching staff and teaching practice.Conclusion The established evaluation index system may be used to accredit community general practice teaching base and to improve the quality of general practitioner training.