Objective Overall evaluation of the outcomes of the 10,000 primary care doctors to rural households campaign in Jining city,to provide a reference for further implementation of the policy.Methods Multi-stage stratified random sampling method was used for field questionnaires and interviews of rural residents,village doctors and medical workers sent from cities engaged in the campaign.Results The 90.0％ of the rural residents under contract feel satisfied with the level,items,attitude and activeness of the service provided by doctors from cities; 98.3％ of the village doctors said they have been trained by medical workers from cities; 87.0％ and 68.4％ of the village doctors and such medical workers hold that this campaign helps with sinking high quality health resources into rural areas.Conclusion The campaign and policy are conducive to upgrading health service in rural areas,which can be proliferated with further optimization.

Horn-Meter model was used to analyze the problems and obstacles in the10,000 primary care doctors to rural households campaign in Jining city,in terms of policy objectives sand standards,policy resources,institutional characteristics,execution mode,policy implementation environment,and preferences of those who carry out the policy.Based on the energy level and person-post matching,a policy sustainable development model was built and demonstrated,for policy recommendations of optimization and promotion.

Doxorubicin is an effective anthracycline chemotherapeutic drug, which is widely used in single or combined chemotherapy for various malignant tumors. However, the cardiotoxicity caused by doxorubicin has limited its clinical application. Despite a large amount of research investment, no suitable target has been found to reduce cardiotoxicity caused by doxorubicin while guaranteeing the effect of chemotherapy. Recent studies have found that non-coding RNA is related to doxorubicin-induced cardiomyopathy. Further explaining the relationship between the two may provide new strategies for the diagnosis, prevention and treatment of doxorubicin-induced cardiotoxicity.

ObjectiveTo investigate the efficacy of superficial surround needling plus quadriceps femoris training in treating knee osteoarthritis and observe electromyographic amplitude variations by knee osteoarthritis.MethodNinety patients diagnosed with knee osteoarthritis were randomly allocated to treatment and control groups, 45 cases each. The treatment group received superficial surround needling plus quadriceps femoris training and the control group, acupuncture alone. Both groups were treated for two weeks. Pre-treatment and post-treatment knee joint functions were scored and compared using the Visual Analogue Scale (VAS), the Lysholm Knee Score Scale and the electromyographic integral value. Meanwhile, electromyography was performed and electromyographic amplitude variations by knee osteoarthritis were compared between the two groups of patients.ResultThe total efficacy rate was 88.9% in the treatment group and 60.0% in the control group. It was higher in the treatment group than in the control group (P<0.05). After treatment, the VAS score, the Lysholm score and the electromyographic integral value were significantly better in the treatment group than in the control group (P<0.05).ConclusionSuperficial surround needling plus quadriceps femoris training has a marked therapeutic effect on knee osteoarthritis.

Objective To analyze influencing factors of physicians' turnover intention at public county hospitals from career stage perspective.Methods Physicians career life was divided into three stages according to professional ranks and titles.The sample was drawn using stratified multistage random methods from public county hospitals in Shandong province and 677 questionnaires were completed,giving a 90.3％ valid response rate.Data were analyzed using multi-group stepwise linear regression.Results The percentage of responders with middle and high-level turnover intention was 23.0％and 6.5％ respectively,and there was no statistically significant difference in turnover intention across three stage subgroups.In physicians at stage 1,the most important factors to predict turnover intention were superiors ' appreciation (r =-0.22,P ＜ 0.05) and payment rationality (r =-0.21,P＜0.05),while in physicians at stage 2,the most important predicting factors were autonomy (r=-0.39,P＜0.05)and learning demand(r=-0.22,P＜0.05),and in physicians at stage 3 were career development(r=-0.31,P＜0.05)and autonomy(r=-0.21,P＜0.05).Conclusion Autonomy and workload are common factors of turnover intention with different predicting power across three career stages.Physicians adjust their career needs to self-actualization with development of career stage,so welltargeted incentives should be taken to stabilize the medical staff of public county hospitals.

ObjectiveTo analyze the association between single nucleotide polymorphisms (SNPs) in DISC1 gene.MethodsThe studied sample consisted of 528 patients with schizophrenia (264 males and 264 females) and 528 healthy controls (264 males and 264 females).Two function SNPs were selected and gcnotyped by Illumina Golden Gate assay.Genotype and allele frequencies were compared between patients and controls to assess the association to schizophrenia.The clinical features of the hospital first patients were further examined with the Positive and Negative Syndrome Scale (PANSS) before trcatment with antipsychotics.ResultsTwo SNPs were genotyped in subjects.A significant association was found between rs3737597 and schizophrenia in genotype (387:133:8,350:164:14) and allele frequencies (907:149,864:192,P＜0.05 ).Moreover,the haplotypes,A-A constructed from two SNPs showed significant differences between cases and controls ( P＜ 0.05).For rs821616,there were significant difference in positive syndrome score,delusions and poor rapport between patients with genotypes AA or not.ConclusionThis study describes a positive association between DISC(1) and schizophrenia in the Han Chinese population and DISC1 is the susceptible gene in schiz ophrenia.

With the quick development of information network,a new disease-Internet Addiction has been paid more and more attention,and how to prevent and cure it has become one important problem that need to be resolved.At present,the rate of Internet Addiction among medical students is rising year by year,so we should make a united effort to prevent and control Internet Addiction among medical students.This article tries to explore how to prevent and control medical students'Internet Addiction from the point of view of law and ethics and expect to prevent them form being patients of Internet Addiction and help them thrive promptly.

As a social problem,college students'Internet Addiction has drawn attention widely.A lot of domestic areas and departments have done research on college students' Internet Addiction and achieved some sucess.On the basis of retrieval of papers on students' Internet Addiction,this article analyzes former research and brought up some proposals for the future research aimed at its deficiences.

Objective To analyze the residents′ willingness to hierarchical medical system and their intention of first visit hospitals.Methods Customized questionnaire was used for in-home survey of 1 500 households in three cities of Shandong province,with 773 of the residents aware of hierarchical medical system used as the study samples.Descriptive analysis and multi factor Logistic regression were employed for statistical analysis of their intention.Results 85.0% the residents expressed willingness to embrace hierarchical medical system.55.0% of the residents prefer primary medical institutions as their first visit in case of mild illness,a choice chosen by more rural residents(58.9%)than urban residents(48.0%),a difference of statistical significance(P<0.01).In the case of severe illness,87.3% of them prefer major hospitals as their first visit,and more urban residents(94.3%)take this option than the rural residents(83.3%),a difference of statistical significance(P<0.01).Service ability of medical institutions and residents′ concept for medical service played a key role in their choice of first visit hospitals.Conclusions The key to ensuring the implementation effect of hierarchical medical system lies in better service ability of primary medical institutions and correction of residents′ irrational medication concepts.

Objective To investigate lymph node metastasis on the middle and lower segment of lⅡ and Ⅲ stage of esophageal squamous cell carcinomas,understand the factors influencing the lymph node metastasis,and provide the basis for the key areas of lymph node cleaning.Methods A retrospective study was made on the specimens of 186 patients who were middle and lower segment of Ⅱ and Ⅲ stage of esophageal squamous cell carcinomas,who had underwent radical operation through left thoracic,thoraco abdominal two field lymph node cleaning.All the cases were patients from April 2010 to December 2013 at the Inner Mongolia Medical University Clinical Medical College of Chifeng.Results A percentage (67.9％) of patients (126/186) was found with lymph node metastasis.A total of 4259 lymph node was dissected,with an averaged cleaning of (22.9 ± 8.1) lymph nodes for each case.A total of 622 lymph nodes (14.6％ =622/4 259) existed metastasis.The rate of mediastinum metastasis for middle and lower segment of esophageal cancer was 56.1％ and 16.5％,respectively.The rate of metastasis to the lower mediastinal lymph nodes was 34.6％ and 54.4％,respectively.The rate of metastasis to the celiac lymph nodes was 23.4％ and 46.8％,respectively.A significant difference was found in the metastasis locations of middle and lower segment of esophageal carcinomas (P ＜ 0.05).The top three locations of lymph node metastasis in the middle segment of esophageal squamous cell carcinomas were the lymph nodes of left artery paraesophageal,carina,and gastric bypass.The top three locations of lymph node metastasis in the lower segment of esophageal squamous cell carcinomas were paraesophageal,cardia,and gastric lymph nodes.The depths of tumor invasion,differentiation,intravascular cancer embolus were statistically significant effect on lymph node metastasis rate (P ＜ 0.05).Tumor location,and lesion length had no significant effect on the lymph node metastasis rate (P ＞ 0.05).Conclusions The lower segment of Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the lower mediastinal and abdominal lymph nodes.The middle segment Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the thoracic and abdominal lymph nodes with Jump transfer characteristics.The lymph node cleaning of the mid-dle segment includes the left artery near the stomach,paraesophageal,and carina lymph node.The lymph node cleaning of the lower segment includes paraesophageal,cardia,and gastric lymph nodes.The metastasis rate of vascular tumor thrombus is related to the depth of tumor invasion and differentiation degree.