Objective To evaluate the performance of community health institutions of Pudong new district.Methods According to the criteria of the Ministry of Health of China,the performance evaluation system appropriate for local area was developed.A cross-sectional survey was conducted at 44 community health centers,and data was analyzed using descriptive statistics,correlation coefficients and multi-factor linear regression.Results The average score of total performance of these 44 community health centers was 78.53.The average scoring rate for institution management,public health service,basic medical care service,CTM service,and comprehensive satisfaction was 68.49％,89.09％,63.51％,87.80％,76.32％,respectively.Degree of informationization (0.477),regional location (0.331) and participating in medical consortia(-0.309)had significant impact on the total performance.Degree of informationization(0.302)and pilots for family doctors(0.301)had significant impact on the basic medical service performance.Conclusion There is a tremendous room for performance improvement for community health institutions in Pudong.Regional location and degree of informationization were the most crucial factors affecting the performance,irrelevant to institutional sizes.Proposals were raised for strengthening the construction of informationization,expanding pilots for family doctors,perfecting the mechanism of medical consortia.

Objective:To formulate the norm value of auditory verbal learning test(AVLT)in the normal aged in Chinese community.Methods:360 normal old people(55 to 85 years)in city proper of Shanghai were enrolled and evaluated by AVLT,MMSE test of words reading ability and executive ablity,memory self-evaluation and medical history related to cognitive impairment.Results:70% of the normal old people complained of hypomnesia;The age of 70 and 80 was the hinge points of auditory verbal memory decreasing.AVLT had a moderate relation to age,and a lower relation to educational level.Female did better in AVLT than Male.Furthermore,AVLT had a significant relation to MMSE score,a mild relation to memory self-evaluation,and only related to hypertension of all the medical history.The cut off score of short-term recall,long delayed term recall and total AVLT score(-1SD,-1.5SD and-2SD)was listed.Conclusion:Norm value of AVLT is an effective tool of testing memory impairment.

Objective To investigate the relationship between ultrasonographic appearance of the endometrium and steroid. Methods A total of 30 women with normal cycle were used for this study. On the day of positive urinary LH, the subjects were classified into group A, group B and group C according to Gonen's criterions of endometrial echogenic patterns. Blood samples were taken for measurement of FSH, LH, PRL, E_2, P, T levels on the third day of the cycle, the pre-ovulatory phase, and the sixth or seventh day after ovulation. Results During the early follicular phase and pre-ovulatory phase, serum E_ 2 concentration was highest in group A, then group B and lowest in group C; there was significant difference between group A and group C (P

AIM: To investigate the effect of 17?-estradiol(E2) on myocardial hypertrophy induced by endothelin-1(ET-1) and the related mechanism.METHODS: Myocardial cells from neonate rats were cultured in vitro and myocardial hypertrophy model was established with ET-1.The effects of 17?-estradiol on myocardial hypertrophy were observed.The role of ERK1/2 in the effects of 17?-estradiol was also detected.RESULTS: Compared with control group,ET-1 increased cell protein content,cell surface area and -Leucine(-Leu) incorporation.Pretreatment with E2 for 24 h could inhibit the increase in cell protein content,cell surface area and -Leu incorporation induced by ET-1.ET-1 significantly stimulated ERK1/2 activity,which was prevented by pretreatment with E2.Tamoxifen,estradiol receptor antagonist,partially inhibited the effect of E2.The ability of ET-1 to stimulate -Leu incorporation was significantly blocked by PD98059,which could enhance the inhibitory effect of E2 on the increase of -Leu incorporation in cardiomyocytes induced by ET-1.CONCLUSION: E2 can inhibit cardiomyocyte hypertrophy induced by ET-1.This effect is mediated by estrogen receptor.ERK1/2 signal pathway is closely correlated with the inhibitory effect of E2 on cardiomyocyte hypertrophy induced by ET-1.

Objective To evaluate the effect of sevoflurane on the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in hippocampal neurons of rats.Methods Forty-eight pathogen-free healthy adult Sprague-Dawley rats of both sexes,weighing 210-280 g,aged 3-4 months,were divided into 4 groups (n=12 each) using a random number table:control group (group C) and 1%,3% and 5% sevoflurane groups (S1,S2 and S3 groups).In S1,S2 and S3 groups,1%,3% and 5% sevoflurane were inhaled for 1 h,respectively.Morris water maze test was performed at 1 and 7 days after anesthesia to assess the cognitive function.Six rats in each group were sacrificed after the end of the test.The brains were then removed and the hippocampi were isolated for detection of the expression of α7nAChR (by Western blot) and contents of tumor necrosis factor-alpha and interleukin-1 (by enzyme-linked immunosorbent assay).Results Compared with group C,the number of crossing the platform was significantly decreased at 1 and 7 days after anesthesia in group S1,the time of staying at the target quadrant was significantly shortened,the number of crossing the platform was decreased,and the rate of time of staying at the original platform quadrant and rate of swimming distance at the original platform quadrant were decreased at 1 and 7 days after anesthesia in S2 and S3 groups,and the contents of tumor necrosis factor-alpha and interleukin-1 were significantly increased,and the expression of α7nAChR was down-regulated at 1 and 7 days after anesthesia in S1,S2 and S3 groups (P<0.05).Compared with group S1,the expression of α7nAChR was significantly down-regulated at 1 and 7 days after anesthesia in S2 and S3 groups (P<0.05).Compared with group S2,the expression of α7nAChR was significantly down-regulated at 1 day after anesthesia in group S3 (P<0.05).There was no significant difference in each parameter of Morris water maze test among group S1,group S2 and group S3 (P>0.05).Conclusion The mechanism by which sevoflurane induces inflammatory responses in hippocampi is related to down-regulation of α7nAChR expression in hippocampal neurons of rats.

Objectives To explore status of health prevention knowledge awareness and the formation of healthy behaviors of community residents in Guagzhou and provide evidence for health-management-related departments to put forward pertinent intervention strategies. Methods A questionnaire-based survey was conducted among 2 790 community residents in Guangzhou by multistage stratified random sampling. Results The awareness rate of residents′ basic health prevention knowledge was 78.14%, the awareness rate of key knowledge was 74.77%, the rate of health behavior formation was 48.14%. The rate of women′s behavior formation was higher than that of men′s. The awareness rate of basic knowledge among the residents aged over 50 years was lower than that that among those aged less than 50 years , but the awareness rate of key knowledge and behavior formation rate were higher. The level of knowledge awareness and the rate of behavior formation rate of urban residents were higher than those of rural residents and migrants. The knowledge awareness and behavior formationi were positively correlated with degree with statistically significant difference (P < 0.01). Conclusions The health belief and behavior of the community residents should be cultivated and strengthened , the basic prevention knowledge should be made universal for middle-aged and old people , the health education of key prevention knowledge should be strengthened for the middle-aged and young people , the public health services should be made more open and equal further promoted, and the community comprehensive intervention focusing on the health education should be strengthened.

Objective To investigate a special optimization technique for computer aided measure, and provide anatomical basis for screw internal fixation in the cavitas glenoidalis through the coracoid process of scapula. Methods Thirty accurate scapula models were reconstructed from CT data sets. First, special optimization objective function was designed for single screw internal fixation configuration, and the optimal placement of screw was found automatically under constraints. Then, the placements of double screws internal fixation configuration were searched taking advantage of principal component analysis. Finally, statistical measure data were provided according to new anatomical reference landmarks for clinical use. Results For single screw internal fixation configuration, the distance from the optimal screw entry point P to the acromion process point X was (39.15±2.28) mm, to the coracoid process point Y was (28.66±2.68) mm, to the angulus superior point Z was (61.13±6.57) mm;The angle was (81.27±7.15)° between PX and PY, and (133.27±6.84)° between PX and PZ. The mean inclination of the lag screw was (104.08±4.41)° for the angle with line PX, (101.29±3.51)° with line PY, and (76.23±5.03)° with line PZ. For double screws configuration, the distance from the original single screw entry point P to the screw entry point E was (5.12±1.37)mm,to the screw entry point F was (3.88±0.94)mm. The angle between the long axis of coracoid process and line EF was (27.41±3.51)°. Conclusion The automatic optimization technique for computer aided measure is very efficient and has many advantages over the conventional manual dissection methods, and is convenient to design new anatomical reference landmark system for clinical use.

Objective To establish an index system of science and technology evaluation for public hospitals in Shanghai, which is scientific and rational, operable, promotable, and comparable.The purpose is to improve the comprehensive hospital evaluation system and promote the science and medical technology innovation development in Shanghai.Methods Based on overseas and domestic research experiences and Shanghai′s specifics, literature analysis and Delphi specialist consultation method were used for rationalization proposals for building such a system.Results This index system comprises three level-1 indicators of basis and conditions, results and outputs and social benefits and impacts, eight level-2 indicators and 24 level-3 indicators.Conclusions This index system should be improved stage by stage.Classification by type and level of public hospitals should be used in such evaluation, while horizontal development level and vertical development speed of science and technology should be combined.A unified evaluation standard should be developed by professional organizations.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

Objective To evaluate the effect of hyperlipidemia on pulmonary uptake in the patients inhaling sevoflurane for anesthesia.Methods A total of 103 patients of both sexes,aged 20-50 yr,with body mass index of 18-25 kg/m2,of American.Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 0.l mg/kg and etomidate 0.3 mg/kg.Patients were mechanically ventilated after endotracheal intubation.Patients inhaled 2％ sevoflurane for 30 min at an oxygen flow rate of 2 L/min.The inspired concentrations (Fi) and expired concentrations (Fe,Fe≈alveolar concentration [Fa]) of sevoflurane were recorded at 1,3,5,7,10,15,20 and 30 min of inhalation (T0-7).Patients were divided into either control group group C) or hyperlipidemia group (group H) according to the results of blood lipid levels after the end of observation.The ratio of Fa/Fi and time spent in reaching the titration value (Fa/Fi =0.8) were calculated in each group.Results There were 67 cases in group C and 36 cases in group H.Compared with group C,the Fa/Fi ratio was significantly decreased at 5,7 and 10 min of inhalation,and the time spent in reaching the titration value was prolonged in group H (P ＜ 0.05).Conclusion The pulmonary uptake of sevoflurane is increased,which may be associated with increased blood/gas partition coefficient.