Two hundred and forty patients with primary hypertension in Weifang Community were randomly sampled as contract group and another 240 hypertensive patients were sampled as control group.Patients in contract group signed service contract with general practitioners (GPs),who provided individualized service for hypertension management.Patients in control group receive conventional outpatient service for hypertension management.The clinical data of patients before and one year after contracted services were documented and compared with those in control group.The results showed that in contract group the average systolic pressure decreased from 134.60 mm Hg (1 mm Hg =0.133 kPa) to 130.62 mm Hg (P =0.000),reaching-the-target-BP rate increased from 56.3％ to 85.5％ (P =0.000),serum total cholesterol and triglyceride decreased significantly one year after receiving contracted services (P =0.000) ; while these indicators were not significantly changed in control group (all P ＞ 0.05).The results indicate that the contracted services of GPs can improve the effectiveness of hypertension management in community.

We studied policies of traditional Chinese medicine (TCM) on four levels ( national,Shanghai city, Pudong New District and community health services (CHS)) from 2008 to 2009 with the method of literature review,questionnaire survey and group interview. 18 national, 5 Shanghai's, 4 Pudong New District's and 87 CHS' TCM related policies were identified. By defining the development target,financial capability, human resource and proper technology of TCM care, those policies ensured and prompted the progression of community TCM services. Yet TCM policy fulfill in community remained lagged,and talent cultivating, medical insurance support and TCM participating in public health needed to be improved.

Aim To explore the effect of atorvastatin on NF-?B/I?B signal pathway,P selectin and ICAM-1 expression in cholesterol-rich diet-induced rabbit atherosclerosis.Methods 24 New Zealand white rabbits were randomly divided into three groups: control group,high-cholesterol group and atorvastatin group.Nucleus NF-?B p65 and cytoplasma I?B? were detected with Western blot technique.Plasma P selectin was detected with Immunoradioassay.Immunohistochemistry was employed to detect the expression of ICAM-1.Results Compared with the control group,the expression of nucleus NF-?B p65,P selectin and ICAM-1 increased significantly and cytoplasma I?B? reduced in high-cholesterol group(P

DNA methylation is one of the most common epigenetic events in eukaryotic cell.Aberrant DNA methylation is tightly related to tumorigenesis.Recent evidence indicates that DNA methylation is a promosing biomarker for cancer.The cancer-associated DNA methylation events could be detected from serum(plasma),urine,stool and bronchoalveolar lavage,providing a new choice for noninvasive cancer diagnosis.In this review,we summarized the advances on DNA methylation for noninvasive cancer diagnosis.

Normal perfusion pressure breakthrough is a serious complication that may occur in the treatment of cerebral arteriovenous malformations. This article reviews the progress in research on normal perfusion pressure breakthrough in recent years. It mainly investigates its pathogeneses, predictive methods and prevention and treatment strategies.

Objective To study the relationship between overweight, obesity and blood pressure among children living in urban Beijing. Methods A total of 4 267 pupils aged 9～10 years were randomly selected. Overweight and obesity were defined by age and sex specific BMI classification reference for Chinese children. Hypertension was defined by age, sex and height specific reference for US children. Results The prevalence of overweight and obesity in boys was 19.4% and 21.2%, in girls was 10.9% and 12.1%, respectively. Mean levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) have significant different between all study group. The total prevalence of high blood pressure (HBP) was 16.1% for boys and 15.2% for girls, while it was 36.4% and 41.3% among obese boys and girls, respectively. The prevalence of high systolic blood pressure (HSBP), high diastolic blood pressure (HDBP)and HBP gradually increased as weight increased. Compared with the normal weight group, OR(95%CI) for HBP of overweight and obese children were 2.6 (2.1～3.3) and 5.8 (4.7～7.0), respectively. Conclusion Obesity is positive correlation with hypertension in children aged 9～10years of Beijing, and the risk of hypertension was increased with their body weight.

We investigated health condition and evaluate the viability of Barthel's measuring scale for 1297 elder patients at 17 nursing homes.We nursed all patients by standards and performed a comparison study.The nursing percentages of highest and lowest levels were higher than the previous ones ( P ＜ 0.01 ),while the nursing percentage of normal level was lower than the previous one ( P ＜ 0.01 ).The cooperation between doctors and nurses became optimized through progressive patient care.Ideal nursing standard should be based upon the doctors' judgment and nurses' evaluation.The new standard will be more suitable for patients and easier to control for nurses.

Objective To explore the effect of relaxation treatment (RT) on the sleep quality of patients with generalized anxiety disorder (GAD).Methods Ninety-two GAD patients were recruited and evenly divided into a study group (n =46) and a control group.The control group was treated with conventional medications,while the study group received RT in addition.The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to test for changes in sleep before and after treatment.Results There were no significant differences between the two groups before treatment in terms of average PSQI scores or PSG results.After treatment,both groups scored significantly better on the PSQI than before the treatment.PSG showed that after treatment there was less awakening,greater sleep efficiency and longer total sleep time.There was shorter sleep latency and rapid eye movement sleep latency,shorter duration of shallow sleep,and longer duration of deep sleep and rapid eye movement sleep in the study group,as well as fewer awakenings,greater sleep efficiency and longer total sleep time.The PSQI and PSG results of the two groups after treatment were significantly different.Conclusions RT can significantly improve sleep disorders in GAD patients.

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 define basic medical service items in Shanghai community health centers.Methods Two rounds of Delphi expert consultation were carried out with 36 experts specialized in general practice,general practitioner training,internal practice,public health and health management,then the scope of medical service system was set up based on experts' opinions.Results The newly-defined system consisted of three first-grade items:outpatient medical service,hospital medical service and medical service for home beds and temporary home visits.The first-grade items contained 22 second-grade items and the second-grade items consisted of 26 detailed items,including 17 baseline items,8 optional items and 1 restrained item.In two rounds of Delphi consultation the activity coefficient of experts was all 100％,authority coefficients of experts was 0.825,and harmonious coefficient of the importance of the evaluation was 0.361 and 0.488 (all P ＜ 0.01),respectively.Conclusion The preliminarily developed system of basic medical service items in Shanghai community health service can provide a reference frame for government policy-making.