ObjectiveTo collect and analyze patients' evaluation of basic medical services in Tianjin community health service institutions and to suggest improvements.MethodsA total of 15 community health service centers and 15 community health service stations in six urban districts of Tianjin were selected by stratified sampling and 300 randomly intercepted patients were surveyed by questionnaire.ResultsApproximately half ( 157/300, 52. 3％ ) the patients selected community health service institution as their first choice to seek medical attention. The most important reason for this, with 89.2％ patients responding yes, was that the community health service institution was close to home and very convenient.One quarter (79/300, 25.3％ ) of the patients regularly consulted the same doctor and 17.7％ (53/300)seldom went to see a doctor. The proportion of patients expressing a high degree of satisfaction to service standards and health professionals was 78. 7％, of which satisfaction with physicians' explanation about the patients' illness ranked highest at 83. 7％ (251/300). Patients' confidence level of doctors' diagnosis,physical examination, and auxiliary examination was 92. 0％. Moreover, most (87. 0％ ) patients reported that doctors communicate well with them; 85.0％ (255/300) patients received health instruction from doctors during visits, and 82. 0％ patients reported that doctors pay attention to protecting patients' privacy.The overall satisfaction of patients to environmental facilities and process management of community health service institutions was 73.6％. On the other hand, patient satisfaction with medicine types, service price,instrumentation and equipment, and environment were all lower than the average satisfaction. Conclusions Patients were basically satisfied with medical service in community health service institutions. Three main problem areas were identified: patients' use of community health services is deficient, medical service ability is partially lacking, and the service feature of general practitioners (GPs) is not obvious. Improvements of basic medical service ability in the community, cultivation of GPs, and basic medicine regulation are advocated.

Objective To investigate the in vivo transduction capability of fusion protein PEP-1-EGFP with mice.Methods Two prokaryotic expression plasmids pET15b-EGFP and pET15b-PEP-1-EGFP were constructed and transformed into E.coli BL21(DE3) to express EGFP and fusion protein PEP-1-EGFP,respectively.The expressed EGFP and PEP-1-EGFP were purified with Ni2+-resin affinity chromatography.Five hundred micrograms of EGFP and PEP-1-EGFP fusion protein were injected into mouse through caudal vein,respectively,the mice were euthanized and perfused with PBS 2 hours after administration.Then,the heart,brain,liver,spleen and kidney were removed and sectioned with a cryostat at 7 ?m for visualization with a inverted fluorescent microscope.ResultsThe brain,heart,liver,spleen and kidney injected with PEP-1-EGFP showed bright and homogenous green fluorescence whereas that with EGFP showed no green fluorescence at all.Conclusion The successful expression and purification of PEP-1-EGFP fusion protein and its efficient transduction into mice in vivo provide a basis for the research on transmembrane delivery of macromolecule drugs mediated by the cell-penetrating peptide,PEP-1.

Objective To identify lesion patterns and stroke mechanisms in middle cerebral artery (MCA) territory using early diffusion-weighted imaging (DWI) combined with CTA as well as EKG and echocardiography.Methods One hundred and forty-eight acute ischemic stroke patients who had (1) symptomatic lesions located in the unilateral MCA territory on DWI performed within 1 week of symptom onset,and (2) either corresponding MCA disease,internal carotid artery (ICA) disease,MCA & ICA disease or cardio embolism (CE),or (3) neither corresponding MCA disease,ICA disease,nor CE which were taken as group of negative results (NR),were reviewed.Acute DWI lesion patterns were classified as (1) single (small perforator < 2 cm;large perforator ≥2 cm;pial;large territorial;border-zone) and (2) multiple according to principle of single-blind.Results There were 12 types of lesions in MCA territory.Distribution of lesion patterns in different stroke subtypes might be different (χ2= 55.88,P = 0.004).No specific pattern could be found in patients with MCA disease,ICA disease,MCA & ICA disease or CE.Big perforator infarcts might be more common in patients with MCA disease than with ICA disease and CE.Compared with negative group,concomitant perforator and pial infarcts were more common in patients with ICA disease (7/27,χ2=6.61,P <0.05),especially with severe stenosis or occlusion (5/16,χ2=7.32,P < 0.05);No specific pattern could be found in patients with MCA disease or CE.Concomitant perforator,pial,with border-zone infarcts (6/30,χ2= 6.41,P <0.05),and concomitant perforator with border-zone infarcts (4/30,χ2= 5.59,P < 0.05) were more often in patients with severe stenosis or occlusion of MCA.Conclusion Different lesion patterns may indicate different mechanisms of stroke such as hypoperfusion and arterial embolism could be coexistent in MCA territory.The relationship has not been identified perfectly.

Objective:To study influence factors on teaching quality,make use of ISO9000 to establish an evaluating system of teaching quality,make a model of teaching quality,offer a method for comprehensive management and offer a basis for continue improvement.Methods:Nominal group process,Delphi,and Cross-sectional study are adopted.Results:Making an evaluate index of system and establishing a model of teaching quality,the evaluating feedback etc.Conclusion:The principle of ISO9000 is embodied for the study method is scientific,the process of evaluation is feasible,index is all-sided and index system is flexible.

Vertical one-and-a-half syndrome (VOHS) is a rare ophthalmoplegia syndrome caused by unilateral thalamo-mesencephalic infarct. It is manifested as a conjugate upgaze palsy and a monocular paresis of downward gaze. Recognition of VOHS helps clinical localization. No cases of VOHS with photos or videos of ocular motility have been reported in China. Herein a case of VOHS caused by unilateral thalamo-mesencephalic infarct is reported, in order to improve awareness about the ocular sign.

Objective To evaluate the efficacy and safety of radiation combined with targeted therapy of EGFR-TKI in the patients with stage IV non-small cell lung cancer ( NSCLC). Methods There were 17 female and 9 male patients with NSCLC enrolled into this study, which included 19 adenocarcinoma, 4 alveolar carcinoma and 3 uncertain carcinoma according to the iconography findings. Sixteen patients suffered from single or multiple bone metastasis,and 10 cases with brain metastasis. Gefitinib 250 mg or Erlotinib ISO mg per day were administrated during and after the process of radiation until the disease progressed. Results All patients had complete combined therapy, 12 of them suffered from diarrhea, 8 from emesia and 12 from erythra. The average score of ECOG improved from 3 to 2 after combined therapy. The bone metastasis control rate was 93.8% ,brain metastasis control rate was 70.0% , and the 6-month local lung lumps control rate was 84. 6%. Conclusion Palliative radiation combined with targeted therapy of EGFR-TKI is an effect and safe therapy for the patients with the stage IV of NSCLC, but the influence on survival shall be observed in further study.

OBJECTIVETo observe the trend in the change of incidence and mortality of female breast cancer in Tianjin and evaluate its effect of prevention.

METHODSMethod of descriptive epidemiology was used to study the epidemic situation of female breast cancer in Tianjin.

RESULTSThe incidence of breast cancer in Tianjin had increased by 39.7% from 1981 to 1997, as compared with the other cities in China. Especially, compared with the developed countries the world over, the incidence of breast cancer in Tianjin is much lower. The mortality rate of breast cancer had lowered by 31.0% from 1981 to 1997 and the 3-year and 5-year survival rates increased to various degrees.

CONCLUSIONEarly detection and diagnosis of breast cancer are very important to both increase of survival and lowering of mortality of breast cancer. Preventive efforts should be made to the high risk people of breast cancer.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; epidemiology ; mortality ; China ; epidemiology ; Female ; Humans ; Incidence ; Middle Aged ; Survival Rate

Objective:To investigate the clinical, neuropsychological, and neuroimage characteristics in patients with corticobasal syndrome (CBS), and to elucidate the exact diagnosis of CBS patients.Methods:Twelve CBS cases admitted to the Department of Neurology, Huashan Hosiptal,Fudan University from April 2019 to July 2021 were retrospectively enrolled in this study. Those data, including clinical features (demographic data and clinical characteristics of cortical dysfunction and movement disorder), neuropsychological assessment [Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales score], brain magnetic resonance imaging (MRI) and multi-mode positron emission tomography (PET)/CT, were collected and carefully reviewed. Exact diagnosis of these patients was given according to the disease diagnosis criteria.Results:Cortical dysfunction and asymmetrical movement disorders were found in all cases, with poor response to levodopa. Patients suffered from cognitive impairment (MMSE score 16.16±9.82, MoCA score 13.44±7.35). The cranial MRI demonstrated significant asymmetric atrophy of frontal and parietal lobes, especially in the pre- and post-central gyrus. Fluorodeoxyglucose PET of 12 patients showed asymmetric frontal lobe and basal ganglia (especially caudate and putamen) hypometabolism (obviously on the contralateral side of the affected limb). Tau PET was implemented in 11 patients and displayed that abnormal tau protein deposition was positive in the cortex and/or subcortex in all patients. Of the 4 cases, who completed amyloid PET, amyloid protein deposition was positive in the cortex of 2 patients. As a result, 6 patients were diagnosed as progressive supranuclear palsy, 1 patient was diagnosed as corticobasal degeneration, and 5 patients were diagnosed as Alzheimer′s disease.Conclusions:The etiology of CBS is heterogeneous. The combination of clinical manifestation, cranial MRI and multi-mode PET/CT helps the differential diagnosis of CBS.