A questionnaire survey was conducted among 319 mental health workers from 319 grassroots health institutions of 21 districts (cities,counties) in Chengdu in March 2013.The items of survey included general information of participants,subjective perceptions and status of community mental health services.Total 252 effective questionnaires were received,the average age of participants was (33.12 ± 9.39) years (19-61);59.5％ had clinical medicine and 16.3％ had public health background;most of them had educational levels of three-year college or below (84.9％);the average duration of working experience was 18 months;86.5％ was part-time;most of participants (87.4％) thought that the mental health service was a hard job and only 25.3％ expressed satisfaction with the work.Only 16.3％ of community health service centers had rehabilitation facilities for mental illness patients.Public health education was carried out for average (2.21 ± 1.62) times/year,the education for mental patients and family members was (1.62 ± 1.83) times/year.Between areas with sufficient detection rate of mental illness and those with insufficient detection rate,there was significant difference in training frequency of mental workers (P =0.012),there were no significant differences in having formal employment of mental workers (P =0.064),professional guidance,co-working with police officers,co-working with Disabled Persons' Federation,and the duration of working experience (all P ＞ 0.05).The results suggest that the capacity of mental health service in community levels is relatively weak in Chengdu,and the personnel training,public education and rehabilitation work of mental health need to be strengthened.

This article analyzed the current factors affecting the clinical teaching quality,proposed some measures,and discussed some aspects such as ideological recognition,implementing rules and regulations,constructing clinical teaching quality control system in order to improve the clinical teaching quality and train the high quality talents.

BACKGROUND: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) is not applicable for clinical fast detection or the detection analysis of multiple genes on a large sample basis for candidate genes of mental diseases, while polymerase chain reaction-sequence specific primer (PCR-SSP) method can make up for these deficiencies.OBJECTIVE: To establish a PCR-SSP method with multiple gene polymorphism, and popularize its application in the molecular study of mental diseases.DESIGN: Observational trial.SETTING: Department of Molecular Biology and Department of Pathophysiology at Xinxiang Medical College.MATERIALS: The experiment was carried out in the Department of Molecular Biology at Xinxiang Medical College from December 2005 to October 2006. A total of 200 blood samples from patients with mental disease were provided by the Second Affiliated Hospital of Xinxiang Medical College, 0.5 mL each sample. All the patients were informed and agreed with the experiment.METHODS: PCR-SSP was used to analyze the polymorphism of the following genes: variation of tumor necrosis factor (TNF)-α-308A/G and -238G/A, variation of interleukin (IL)-6-174G/C, variation of the 188th base pair (C/T) of CYP2D6 *10B exon, variation of the 472nd base pair (G/A) of COMT gene, and variation of the 941st base pair (G/T) of the CDNA sequence of the 8th exon of MAOA gene.MAIN OUTCOME MEASURES: Gene polymorphism of blood samples analyzed with PCR-SSP.RESULTS: The detected genotypes for TNF-α-308NG included G/G and A/G; the detected genotypes for TNF-α-238G/A included G/A, G/G and A/A; the detected genotypes for IL-6-174G/C were all G/G homozygotes; the detected genotypes for the 188th base pair (C/T) of CYP2D6*10B exon included C/C, C/T and T/T; the detected genotypes for the 472nd base pair (G/A) of COMT included A/G, A/A and G/G; the detected genotypes for the 941st base pair (G/T) of CDNA sequence of the 8th exon of MAOA included T/G, T/T and G/G.CONCLUSION: PCR-SSP is suitable for the polymorphism analysis of the mononucleotide site variation of multiple genes on a large sample basis, which is fast and accurate with low cost and is worthy to be popularized in the molecular study on mental diseases.

Objective To explore the therapeutic efficacy of three different treatment regimens for conservative treatment of ec‐topic pregnancy(EP) .Methods Clinical data of 198 cases of patients with EP who were conservatively treated in this hospital from June 2012 to June 2014 were retrospectively analysed .All patients were divided into group A (39 cases) ,group B(92 cases) and group C(67 cases) ,which were treated with single‐dose of methotrexate(MTX) ,MTX combined with mifepristone and multiple‐dose of MTX respectively .The curative rate and time for human chorionic gonadotropin beta‐subunit(β‐HCG) dropping to normal were observed and recorded .Results The total curative rates in three groups were statistically different (P<0 .05) ,additionally , group C had the highest curative rate(86 .57% ) ,followed by group B with 84 .78% and group A with 66 .67% .In the three groups , for patients with serum level of β‐HCG 1 500-3 000 mIU/mL or >3 000 mIU/mL ,the curative rates were statistically different (P<0 .05) .Conclusion Single‐dose of MTX has relative low curative rate .It is recommend to use combination regimens or multi‐ple‐dose of MTX regimens ,and for patients with high level of β‐HCG multiple‐dose of MTX regimens might be the best choice .

Objective To explore the effect of 10％ and 25％ oral glucose on neonatal pain during blood sampling through radial artery.Methods 90 newborns were randomly divided into group A,B and C,each group with 30 cases.2 min before the blood sampling,group A was offered 2ml 10％ oral glucose,group B was offered 2ml 25％ oral glucose,and group C was offered 2ml plain boiled water by oral intake.Pain was evaluated based on Neonatal Facial Coding System (NFCS),Neonatal Infant Pain Scale(NIPS),raise of heart rate and crying cases.Results The scores of NIPS during puncture,the scores of NFCS and NIPS after puncture,the raise of heart rate and crying cases were significantly different between three groups.Group B were lower than group A and group C,while differences between group A and group C had no statistical significance.Conclusions During blood sampling through radial artery,offering newboms 2ml 25％ oral glucose can reduce the pain,while 2ml 10％ oral glucose was ineffective.

We retrospectively reviewed the tongue images and related clinical data of 118 AIDS patients treated in Shanghai Public Health Clinical Center Affiliated to Fudan University. The tongue images included: cyanotic and purplish tongue ( 33, 28.0% ), light-reddish tongue ( 32, 27.1% ), light-whitish tongue (21, 17.8% ) , bulgy tongue(19, 16.1% ), dark-red tongue (7, 5.9% ) and fissured tongue (6,5.1% ). There were significant differences in counts of CD4+T lymphocytes, white blood cells and red blood cells among different tongue imagine groups. The tongue image can indicate the pathogenic factors of disease as well as the functions of viscera in AIDS patients.

OBJECTIVEThis study aims to explore the method that uses primary tumor contralateral facial artery musculocutaneous (FAMM) flap to reconstruct defects of the tongue and floor of mouth.

METHODSSix cases were selected for the use of primary tumor contralateral FAMM flap to reconstruct tongue and floor of mouth defects after tumor resection.

RESULTSThe FAMM flap of the six cases had a long pedicle that could reach the contralateral tongue and floor of mouth. All flaps were intact until post-operation. All patients experienced post-operation complications, such as temporary facial tension and limited mouth opening, which improved after 3 months. Half a year later, the flaps still did not show signs of shrinking.

CONCLUSIONFeatures of the primary tumor contralateral FAMM flap include the tissue-like material provided for reconstructing tongue or floor of mouth defects, easy acquisition, and high survival rate with minimal donor site morbidity. As such, it is an ideal material for repairing tongue and floor of mouth defects.

Objective To investigate the relationship between various stages of chronic hepatitis B virus (HBV) infection and lipid metabolism and its influencing factors.Methods Seventy-two cases of chronic hepatitis B (CHB),40 cases of liver cirrhosis and 17 cases of hepatocellular carcinoma (HCC) were enrolled.One-way ANOVA analyses were used to compare age,gender,liver function,lipid metabolism,and HBV DNA levels of each group.Pearson correlation analysis was used to study the correlation between HBV DNA and lipid metabolism.Binary Logistic regression analyses were performed to explore the risk factors of cirrhosis and HCC in patients with CHB.Results Differences of age,alanine aminotransferase (ALT),albumin (Alb),triglyceride (TG),and cholesterol(CHO) among the three groups (CHB group,cirrhosis group and HCC group) were statistically significant (all P＜0.05).TG levels in cirrhosis and HCC groups were (-0.061± 0.234)lg mmol/L and (-0.061±0.253) lg mmol/L,respectively,which were both significantly lower than that of the CHB group (0.116±0.182) lg mmol/L (F=11.466,P=0.000).CHO level in cirrhosis group was (0.460±0.333) lg mmol/L,which was lower than that in CHB group (0.586±0.101) lg mmol/L (F=4.892,P=0.009).The HBV DNA levels inversely correlated with TG and CHO levels in CHB group (r=-0.266,P=0.024; r=-0.309,P=0.008,respectively).The HBV DNA levels of cirrhosis and HCC patients positively correlated with ALT levels (r=0.355,P =0.007).Old age (OR=1.096,95％CI:1.025-1.172),low Alb (OR=0.000,95％CI:0.000-0.000),and low levels of ALT (OR=0.128,95％CI:0.026-0.641) were risk factors for development of cirrhosis and HCC in CHB patients (all P＜0.05).Conclusions With the progression of liver injuries,TG and CHO levels are reduced.Further studies of correlation between risk factors for the development of cirrhosis and HCC and lipid metabolism in CHB patients are needed.

The contents about the central action mechanisms of needling Zusanli (ST 36) were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that: by comparing acupuncture at Zusanli (ST 36), other acupoints or sham points, most studies showed that Zusanli (ST 36) had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli (ST 36) were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli (ST 36) had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.

Objective:To study the effectiveness and safety of different acupuncture therapies in treating Posttraumatic stress disorder(PTSD)after Wenchuan‘5.12’earthquake.And choose a desirable acupuncture therapy.Methods:A total of 276 patients were recruited in this trial and randomly divided into four groups:scalp electric acupuncture group(group A),scalp electric acupuncture with moxibustion group(group B),scalp electric acupuncture with auricular acupuncture group(group C)and paroxetine hydrochloride group(group D).Each group was treated for 12 weeks.Patients were scored using Clinicianadministered Scale for DSM-IV(CAPS),Hamilton Depression Rating Scale for Depression(HAMD),and Hamilton Anxiety Scale(HAMA).Results:The study was finished well with a balanced grouping and fine baseline.After the analysis of integrations of CAPS,HAMD,and HAMA,we found that the score differences before and after the treatment were of statistical significance in all four groups(P