Objective: In order to better understand the influencing factors of vertical rural health services integration and put forward policy suggestions for its sustainable development.Methods: 288 residents were investigated through questionnaire survey in three sample areas of Jiangsu province in August 2015.Results: In this study, 4 common factors have been found, namely organizational management, incentive mechanism, policy and supporting measures, as well as information sharing and business communication.The overall scores given by health managers, doctors and nurses, and public healthcare professionals were 0.03, 0.04 and-0.02 respectively.Conclusions: Therefore, in order to succeed, it is very necessary to introduce targeted supporting policies, establish a mutual communication mechanism, and make an effective incentive mechanism.

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BACKGROUND: It is easy and feasible to treat anterior urethral stricture using internal urethrotomy, however, its drawback is high recurrence in the long-term follow-up. OBJECTIVE: To evaluate the effect of submucosal injected verapamil on prevention of anterior urethral stricture recurrence after internal urethrotomy. METHODS: Totally 60 consecutive males with anterior urethral stricture underwent internal urethrotomy with or without urethral submucosal injection of verapamil, in the Department of Urology, First Affiliated Hospital of Fujian Medical University, from December 2006 to April 2008, were selected. All cases were followed up at least 24 months.RESULTS AND CONCLUSION: All cases were followed up for 24-39 months, with an average of 28.5 months. Urethral stricture recurred in two cases in the verapamil-treated group but 8 cases in the untreated group. This difference in stricture recurrence between the two groups was statistically significant (P < 0.05). The results demonstrated that submucosal injection of verapamil at the stricture site significantly reduces the stricture recurrence rate after internal urethrotomy. Further studies involving larger number of cases and longer follow-up are warranted to confirm the efficacy and safety of this therapy.

Inductive diagram material database is a branch material database to complement the multimedia courseware material database.It has a lot of advantages such as brief,explicit and emphasis characteristics,could enhance teaching efficiency and quality.This paper would discuss the advantage of application of inductive diagram in rehabilitation education.

Diabetes mellitus is a chronic disease, it is thus necessary for its patients to participate in its treatment and self-management. The emerging foreign and domestic methods for self-management of diabetes mellitus pa-tients were detected on different Websites and suggestions were proposed for its treatment and self-management in order to improve the quality of life in diabetes mellitus patients.

Toimprovethesensitivity,aCuOnanoparticledopedinmolecularlyimprintedpolymer(MIP)film for the determination of phenobarbital was prepared by using methacrylic acid as functional monomers, ethylene glycol maleic rosinate acrylate as a cross linking agent by thermal polymerization method. The electrochemical properties of the nano-doped sensor were investigated using cyclic voltammetry ( CV ) , differential pulse voltammetry ( DPV ) , electrochemical impedance spectroscopy ( EIS ) and chrono-amperometry ( CA) . The chemical structures and morphologies of the imprinted films were characterized using Fourier transform infrared spectroscopy and scanning electron microscopy. The results indicated that the sensors response value of peak current showed a linear dependence on the phenobarbital concentration in the ranges of 1. 2 × 10-7-1. 5 × 10-4 mol/L of phenobarbital. ( Linear regression coefficient=0. 9984 ) with the detection limit ( S/N=3 ) of 8. 2 × 10-9 mmol/L. The prepared sensor was successfully applied to the determination of phenobarbital in practical samples with recovery ranging from 96 . 5% to 103 . 0%.

How to effectively using the electronic health records (EHR) in contracted family doctors service was studied according to the new model of HER-based community medical service with community health service station as a center in combination with large hospitals,and suggestions were put forward for the solution of problems in contracted family doctor service,namely establishing and perfecting the community health service system,enlarging the scale of HER,strengthening the construction of general doctors team,and training the technically competent community health service staff.

Using the concept and method of evidence-based medicine,the paper systematically analyzes the functions and shortage of intelligent health Application (App) in disease diagnosis,treatment and self-management,and describes the functions of health and disease management App,so as to promote the development of App and enable App to better assist in health management.

Objective To evaluate the efficacy of mitomycin (MMC) intravesical chemotherapy for superficial bladder carcinoma by in vitro chemosensitivity using histoculture drug response assay (HDRA).Methods Forty-one cases of superficial bladder transitional cell carcinoma(TCC) were obtained,including 30 males and 11 females with mean age of 55 years.Of them,10 cases were Ta and 31 were T1 according to TNM stage system (UICC 2002) while 9 cases were G1,22 were G2 and 10 were G3 (WHO1973).All cases had no chemotherapy history before operation and were operated to retain bladder.Tumor specimens were cultured by three-dimensional histoculture.HDRA with im-proved MTT assay was utilized for chemosenstivity test of MMC with 1 g/L concentration and 2 hours exposure.Growth inhibition rate (GI) exceeding 70% was defined as high-sensitive while less than 50% GI was defined as insensitive,others were moderate-sensitive.All cases were performed standard intravesical chemotherapy with MMC 40 mg plus 40 mt saline.Every case was followed up every 3 months.The patients were followed up for 5 years or untill recurrence.Results The MMC chem-osensitivity was different among 41 patients.Thirteen cases were insensitive including 1 of Ta,12 of T1 (P=0.009) and 1 of G1,7 of G2,5 of G3(P=0.101).Total recurrence rate was 39%(16/41) af-ter 3 to 5 years follow-up.There were 1 of Ta,15 of T1 (P=0.059) and 10 of G2 6 of G3 (P=0.016).Insensitive group recurrence rate was 77% (10/13) while sensitive group was 21% (6/28,P= 0.004).Patients in sensitive group showed a longer median time(49.2 months) than patients in insen-sitive group (16.5 months,P<0.001) according to Kaplan-Meier analysis with Log-rank test.The MMC chemosensitivity was independent prognostic factor examed by Cox regression analysis (P= 0.008).There was a 78% correlation rate of chemosensitivity by HDRA to clinical effect of MMC in-travesical chemotherapy.Conclusion HDRA could evaluate MMC intravesical chemotherapy for su-perficial bladder TCC,improve therapeutic effect and lower tumor recurrence rate.

Objective To study the application of pediculated skin flaps in the treatment of com-plicated long urethratresia. Methods From March 1999 to May 2006, a total of 18 male patients with complicated long urethratresia were treated by using the pediculated skin flaps. The causes of urethratresia were 7 cases of postoperative pelvic fractures with posterior urethral stricture, 4 cases of transurethral intravesical chemotherapy, 3 cases of postoperative bulbar urethral stricture, 2 cases of gonorrhea, and 2 cases of long-time urethral catheter placement. Four cases were urethratresia nf cor-pus penis, 7 cases were anterior urethral obliteration, 7 cases were posterior urethral and anterior ure-thral obliteration. Urethro-perineal fistulas were found in 8 cases, posterior urethrorectal fistulas in 7 cases, false passage formations in 8 cases. The average length of urethratresia was 15.1 cm (range 8. 7 to 23. 0 cm). The urethral scar was rasected, the posterior urethrorectal fistula was repaired, and different kinds of pediculated skin flaps depending on the length of urethratreaia was used. Results All the patients were followed up for 12 to 18 months (mean 14 months). Fifteen patients voided well 3 months postoperatively, none of the urography showed stricture. The mean peak urinary flow rate was 16. 9 ml/s (range from 16. 5 to 21.7 ml/s). Of the other 3 cases, 1 case experienced difficult voi-ding due to the long and circuitous tabularized skin flap but recovered after proper shortening;1 case had restenosis for the infection of anastomosis but voided well after excision and reanastomnsis;1 casehad a urinary fistula resulting from hematoma and infection, but was successfully treated by the neo-plasty of the urinary fistula. The mean peak urinary flow rate was 17.0 ml/s (range 15.0 to 22.0 ml/s) for 17 patients 6 months postoperatively, except for one who experienced genuine urinary incon-tinence. At 9-18 months after operations, the mean peak urinary flow rate was 17.5 ml/s (range 15.8 to 22.5 ml/s) for 17 patients. Conclusion The single-stage urethroplasty based on pediculated skin flaps is a reliable and durable method for complicated long urethratresia.