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.

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 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

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.

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.

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 investigate the clinical effects of transpedicular graft of biological artificial material (BAM) -induced artificial bone and posterior pedicle screw fixation in the treatment of osteoporotic thoracolumbar fractures.Methods A total of 72 patients with osteoporotic thoracolumbar fractures treated by transpedicular reduction by leverage,BMA-induced artificial bone grafting and posterior pedicle screw fixation from 2005 to 2010 were reviewed and followed up.The frontal and lateral X-ray radiograph of the spine was performed before and after operation and during the follow-up.The anterior and posterior height of the injured vertebrae,thoracolumbar kyphotic angle ( Cobb' s angle),ratio of anterior to posterior vertebral height were determined.Also,the America Spinal Injury Association (ASIA) scale was used to evaluate the neurological recovery and the visual analog scale (VAS) was applied to assess the back and waist pain.Results All patients were followed up for a mean period of 18.3 months,ranging from 12 to 28 months.Meanwhile,all the patients obtained bone union,with no rejection of artificial bone graft,breakage or loosening of screws,or obvious loss of both vertebrae height and deformity correction angle.Notable improvement of neurological function was achieved in all patients except for two patients with Frankel A nerve injury.The VAS score descended from pre-operative ( 8.4 ± 2.5 ) points to (2.2 ± 1.6 ) points at latest follow-up,which showed obvious alleviation of back and waist pain.Conclusions Transpedicular bone graft plus internal fixation is an effective,reasonable and easy method for managing osteoporotic thoracolumbar fractures.In addition,the implanted BAM-induced artificial bone is of good biological and mechanical properties.

ObjectiveTo observe the clinical effects of biological artificial material (BAM)induced artificial bone in the repair of lower extremity bone defects. MethodsThe study involved 32 patients with lower extremity bone defects treated by BAM artificial bone grafting from January 2008 to December 2010.Their age was at a range of 21-77 years (mean,32.5 years).The volume of bone defects was 1.0 cm × 2.0 cm × 2.5 cm-3.0 cm × 3.5 cm × 5.0 cm ( mean,15.4 cm3 ).The main causes of bone defects were comminuted fracture,bone cyst,fibrous dysplasia,and chronic osteomyelitis.A followup was performed immediately after the surgery and at 1,2,3,5,7,9,12,18 months after surgery to observe the systemic and local reactions,changes of blood calcium/phosphorus,repair of bone defect and restoration of function of the affected extremity.ResultsAll patients were followed up for 9-18 months (mean,10.5 months).There were no local or systemic grafts rejection from the postoperative period to the last follow-up.Follow-up X-ray films showed fuzzy boundary of BAM artificial bone implantation area and bone tissues around bone defects three months postoperatively and new bone formation. Apparent bone ingrowth into the BAM artificial bone implantation area,integrated artificial bone materials and bone tissues,and basically repaired bone defects were founded six months postoperaively.The time for full weight-bearing of the affected extremity was on postoperative 2.5-4 months ( mean,3.2 months).ConclusionBAM artificial bone is characterized by good biocompatibility,osteogenesis effect and a certain stiffness and strength of inner structure and can he used to repair the lower extremity bone defects.

Objective To perform a mechanical test of fresh cadaver specimens and compare the biomechanical properties of the novel minimal invasion dynamic hip plate (MIDHP) and the dynamic condylar screw (DCS) in treatment of subtrochanteric fractures of the femur.Methods All specimens were firstly used to simulate models of Seinsheimer type ⅡA subtrochanteric fractures of the femur,which were later divided into DCS group and MIDHP group.Based on experimental requirements,the femoral head and distal femur were embedded using seff-freezing type dental base acrylic resin powder.Torsion strength test was given in the first place,succeeded by compression strength test.Finally,destructive test was made to record the limit load.All experimental data were analyzed statistically.Results Torsion strength test showed that specimens of both groups were basically stable as the reverse was within 3°.Torque for specimens in DCS and MIDHP groups was (3.16 ± 0.13) N · m and (3.31 ± 0.27) N · m respectively as the reverse was 1.5°.Both torque and torsion stiffness had no statistical significance between the two groups,and the anti-rotation features of the two internal fixations were similar.Compression strength test showed that compression stiffness of specimens in DCS group was (532.27 ±61.02) N/mm and (581.98 ±77.56) N/mm in MIDHP group at a load of 800 N,with evidently higher compression displacement and stiffness in MIDHP group (P ＜ 0.05).Destructive test showed the maximum load of specimens in DCS and MIDHP groups was (2 994.38 ±244.81) N and (3 322.13 ± 141.21) N respectively,far higher in MIDHP group (P ＜ 0.01).Conclusions MIDHP is characterized by reasonable design,strong anti-rotation property and anti-compression property over DCS.In comparison with DCS,MIDHP has biomechanical advantage in treatment of femoral subtrochanteric fractures,for it can be performed minimally invasive and is worthy of further application.