Objective To observe the influence of telephone follow-up and home follow-up on compliance behavior and activities of daily living (ADL) of stroke patients during rehabilitation. Methods 50 cases were as telephone follow-up group and 50 cases were as home follow-up group extracted from 355 stroke patients who discharged the hospital during August 1, 2010 to July 1, 2012. They were followed up 2 weeks, 1 month and 3 months after discharge respectively. Their ADL were assessed with Bathel index (BI) at discharge and 3 months after discharge, and the compliance behavior were assessed 3 months after discharge. Results There was no significant difference in the score of BI between 2 groups at discharge (P>0.05), and the score of BI improved in both groups 3 months after discharge (P<0.05), but it was higher in the home follow-up group than in the telephone follow-up group (P<0.05), as well as the rate of compliance behavior (P<0.01). Conclusion Regular home follow-up can improve the compliance behavior of stroke patients during rehabilitation.

Objective To analyze the clinical competency test results of general practitioners (GPs) in Shanghai Pudong New Area.Methods Total 1 160 GPs from Pudong New Area attended the clinical ability tests,all participated in theory test and 327 GPs attended practice skill tests.The results were reviewed by computer and the scores were automatically generated.Results The average score and pass rate of theory test were (64.24 ± 12.23) points and 64.2％ (745/1 155),respectively.The average scores of GPs with master or above degree were the highest (67.09 ± 13.38 points),however,the pass rate of GPs with undergradnate degree was the highest (69.7％,349/501).GPs with senior professional title got the highest average score and pass rate [68.26 ± 9.92 points and 82.7％ (43/52),respectively].Introduction to General Practice (69.7％),Internal Medicine (68.6％) and Cancer (66.9％) were the top 3 subjects with the highest correct rate.The pass rate of clinical skills was 39.1％ (128/327),GPs with master degree or above (192.87) and those with junior professional titles (171.08) had the highest scores.GPs with master degree or above (50.0％,8/16) and those with intermediate professional title (40.1％,97/242)had the highest pass rate.Conclusions The analysis shows that the average score and pass rate of both theory test and clinic practice skills test are not satisfactory among GPs in Shanghai Pudong New Area.The clinical ability of GPs need to be further improved,and the study of some specific disciplines need to be further strengthened.

Objective:To summarize experience of vertebral artery stenting in nine cases with vertebral artery stenosis for providing reference for clinical treatment .Methods :Success rate of operation ,vertebral artery stenotic degree before and after operation were evaluated in nine cases undergoing vertebral artery stenting .Results:A total of nine stents were implanted in nine cases and the success rate of operation was 100% ,after stents were implanted blood flow was unobstructed ,stent expansion was good and intracranial blood supply was good .Compared with before op‐eration ,stenosis rate significantly reduced after operation [(84.0 ± 5.7)% vs .(10.0 ± 2.0)% ] (P<0.01) .No vas‐cular restenosis occurred within three‐year follow -up .Conclusion:Vertebral artery angioplasty and stenting is a new emerging ,minimally invasive ,effective and highly safe therapeutic method for vertebral artery stenosis ,the therapeutic effect is sure and application prospect is broad .

Objective·To analyze the choice of smoking cessation methods and its influencing factors in moderate-to-severe nicotine-dependent population.Methods·A retrospective clinical analysis was conducted for170 moderate-to-severe nicotine-dependent smoking-quitters (Fagerstr(o)m scale ≥ 4).Different smoking cessation methods (pharmacotherapy and non-pharmacotherapy) and abstinence rates of the selected population (7 d point prevalence abstinence rates and sustained abstinence rates 1,3,and 6 months after treatment) were compared and possible influencing factors were analyzed.Results·The differences in choosing the smoking cessation method in moderate-to-severe nicotine-dependent population with different ages,levels of education,and employment status were statistically significant (P=0.000).The Logistics regression analysis showed that the level of education was the major factor for choosing the smoking cessation method (P=0.006).The 7 d prevalence abstinence rate was much lower for pharmacotherapy than for non-pharmacotherapy 1 month after treatment (P=0.000) and was much higher for pharmacotherapy than for non-pharmacotherapy 3 and 6 months after treatment (P=0.000).The sustained abstinence rate was much higher for pharmacotherapy than for non-pharmacotherapy 3 and 6 months after treatment (P=0.002,P=0.000).Conclusion·For moderate-to-severe nicotine-dependent smoking-quitters,attention should be paid to the formulation and implementation of personalized strategies.The choice of smoking cessation methods depends on the age,level of education,and employment status.Reasonable pharmacotherapies can significantly increase the abstinence rate.

The paper reports the development of a quality evaluation method for Angelica different processed products. The data of high-performance liquid chromatography, water, total ash and extract were analyzed with SPSS Clementine 11.0 software. Discriminant analysis (DA) established the classification model and parameter for Angelica different processed products. Fish's discriminant functions of Angelica different processed products were generated using 8 predictor variables selected from 59 indexes. The correct rate of discriminating back substitution is 96.7%. Angelica different processed products can be accurately and reliably recognized and validated with DA of SPSS Clementine 11.0 software.

A continuing professional development program was implemented in Shanghai Weifang Community Health Center for general practitioners (GPs) who completed residency training.The program consisted of four aspects: clinical ability, scientific research ability, teaching ability, and management ability.Clinical ability-building included the re-practice of specialty skills, expert mentoring in clinics, continuing education courses and clinic skills competitions.The scientific research ability was built from participating in research projects and talent cultivation programs.GPs were encouraged to be clinical mentors, and teaching ability was developed through attending teacher-training class and teaching practice.For those who were interested in management, the administrative positions related to medical, teaching and research would be provided.The implementation of the program received strong policy support from the health administrations at various levels.

Objective To observe the activation of anti-viral innate immune response of type Ⅰinterferon and inhibition of hepatitis B virus (HBV)genome replication in mice by HBV-3p-siRNA. Methods HBV-3p-siRNA was designed by targeting specific sequence of HBV S/P mRNA and was generated by in vitro transcription.Negative control siRNA (NC-siRNA)and non-modified HBV-siRNA were used as control groups.Blood samples were collected from tail vein of mice and the model of HBV-infected mice were established by hydrodynamic injection.Forty mice were divided into 4 groups with 10 in each group.The model group was only injected with pGL3.0-HBV1 .2 copy plasmid.The negative control group received peritoneal injection of NC-siRNA.HBV-siRNA group received peritoneal injection of HBV-siRNA and HBV-3p-siRNA group received peritoneal injection of HBV-3p-siRNA.The interferon-β(IFN-β)and hepatitis B surface antigen (HBsAg)in serum were detected by enzyme linked immunosorbent assay (ELISA).The copies of HBV DNA were assessed by fluore scence quantitative polymerase chain reaction (PCR ).The statistical difference between groups was determined using One way-ANOVA analysis by LSD or Dunnett T3.Results Serum level of IFN-β was (12.37±5 .32)pg/mL in model group,(22.61 ±6.29 )pg/mL in negative control group,(26.40±5 .39)pg/mL in HBV-siRNA group and (68.37± 21 .00 ) pg/mL in HBV-3p-siRNA group.The secretions of IFN-β into serum were significantly enhanced by HBV-siRNA and HBV-3p-siRNA compared with model group (F =23.988 and 46.523,respectively,both P <0.01).Serum level of HBsAg was (2 864.86±907.11 )ng/mL in model group,(2 198.86±456.89 )ng/mL in negative control group,(1 049.71 ± 396.28 )ng/mL in HBV-siRNA group and (640.86±383.08)ng/mL in HBV-3p-siRNA group.The expressions of HBsAg were inhibited by HBV-3p-siRNA and HBV-siRNA compared with model group (F = 23.537 and 39.144, respectively;P =0.025 and 0.010,respectively).Serum level of HBV DNA was (2.54 ×104 ±1 .46 × 104 )copy/mL in model group,(2.22×104 ±2.62×103 )copy/mL in negative control group,(3.59×103 ±2.88×103 )copy/mL in HBV-siRNA group and (2.65 ×103 ±1 .46×103 )copy/mL in HBV-3p-siRNA group.Serum level of HBV DNA were inhibited by HBV-3p-siRNA and HBV-siRNA compared with model group (F =15 .013 and 16.741 ,respectively,both P <0.05 ).All of the indicated siRNA used in the experiments showed no apparent effects on the body mass index of the mice models.Conclusion HBV-3p-siRNA,which induces the production of IFN-β and inhibits HBV replication through gene silencing in vivo ,may be a powerful bifunctional antiviral molecule.

Objective To explore the change rules of peak area ratio of STR loci to Amelogenin (AMEL) locus (STR/A M EL ), a sex-determ ining gene in DNA degradation, and to evaluate the application of STR/A MEL value in the estim ation of DNA degradation degree. Methods DNA w as extracted from iliopsoas, and the variations of STR/A MEL value (Penta E/AMEL, Penta D/AMEL, FGA/AMEL) w ere analyzed after the artificial degradation w as m ade by DNaseⅠ, and the changes of these three ratios of the iliopsoas naturally degraded in an outdoor environm ent w ere also analyzed. The regression curves w ere analyzed using the periods of DNA degradation and outside the body as the independent variable (x) and the STR/A MEL value as the dependent variable (y) and three curve equations under tw o conditions w ere established. Results B oth under the conditions of artificial and natural degradation, STR/A MEL value had a negative relationship w ith the degradation tim e. The relationship betw een STR/A MEL and degradation tim e can be w ell sim ulated by the cubic function. R2 w as over 0.99 under controlled degradation condition and over 0.86 under natural degradation condition. Conclusion The STR/A MEL value (Penta E/AMEL, Penta D/AMEL , FGA/AMEL ) is negatively related w ith the DNA degradation degree, w hich follow s m athem atical regression m odels strictly, and it m ight be applied to evaluate the DNA degradation degree.

Weifang Community Hearth Service Center started a pilot program of contracted family doctor service in 2011,and the program included 3 stages:1st stage was the establishment of the health archives of the residents;2nd stage was the service signed with key groups in the community;3rd stage was extension of contracted service to whole community.The working mode of responsible family doctor team was formed,and the health service for contracted residents was managed by the family doctor teams.The individualized service was provided to residents according to their different needs.As a trial,the "Pediatrics Studio" was designed to provide special service for focused group among signed residents.Through a series of measures,the signing rate and the extended prescriptions in Weifang community both ranked the first in Pudong New Area,and the visiting rate by the signed patients increased from 30％ to 41％.The preliminary impact of the contracted family doctor service has appeared in Weifang community.

Objective:To analyze factors related to clinic attendance for contracted residents in a community health service center in Shanghai.Methods:It was a cross-sectional study. Through the 'Cloud Management of the Community' APP and the 'Service Fee of Contracted Residents' APP, the basic information, contracted time, hospital visits, number of visits, and medical insurance expenses of the contracted residents in Shanggang Community Health Service Center in 2021 were collected, the visiting rate to the contracted community health center and the contracted medical combination hospitals were analyzed.Results:In 2021, the contracting rate of all residents in the community was 49.96% (51 478/103 033). The contracting rate of the key population was 84.59% (43 545/51 478),among whom 66.28% (34 118/51 478) were over 60 years, 49.93% (25 702/51 478) had been contracted for more than 3 years, and 37.43% (19 270/51 478) had hypertension and/or diabetes. The number of contracted general practitioners was 4.89 times of contracted TCM doctors (1 345.17/274.81). Among all contracted residents 78.75% (40 540/51 478) had at least one visit annually, and 65.00% (33 463/51 478) had at least one visit to community health service center and the average number of visits was 17.63(5.00, 24.00)annually. The rate of visit to contracted the community health service center was (46.97±38.37) %, and 41.78% (16 937/40 540) had≥60% visit to contracted community center; the average visiting rate to the combination hospitals was (70.59±34.57) %, and 55.75% (22 602/40 540) had consultation rate≥80%. These residents were older in age, had longer contract time, higher proportion of hypertension and diabetes, and higher medical expenses, compared to those with less visits to contracted community health center and combination hospitals ( P<0.01). Meanwhile, 11 736 residents (35.07%) only visited to the contracted community health service center. Conclusion:The contracted residents are mainly the elderly and the sick ones in the community, but the use of contracted service is inadequate. Improving the visiting rate to community health center is a challenge for make a full use of the contracted health facilities.