Objectives:To understand the human resources and costs of essential public health services based on community health service centers in Beijing’s rural areas and to offer policy recommendations for advancing the progress of essential public health services. Methods:With the self-designed questionnaire, the paper collected data from the districts of Changping, Tongzhou, Huairou and Miyun. By cluster random sampling, 12 community health service centers and 108 personnel were surveyed based on the level of economic development. Results: The number of young women, preventive personnel and staff with low ranking positions represents a significant share of all essen-tial public health service providers. Beijing’s rural areas deploy a great deal of human resources for vaccination and health education with little set aside for women’s health and reproductive health. The unit cost of setting special col-umns for health education and field disease treatment is higher than other service items. The suburbs deploy a great deal of human resources for service items than the outskirts while the unit costs are lower. Conclusions: Human re-source for essential public health services in Beijing’s rural areas should be strengthened. The costs of service items differ greatly so that policy adjustments and finances should be implemented based on actual demand and resources.

A comparison was made for the correlation and application scope of the statistical methods commonly used by hospitals for their efficiency measurement.Hospital data processed with PCA (principal component analysis)for dimension reduction were used in a correlation analysis for the results of ratio analysis (RA),stochastic frontier analysis(SFA)and data envelopment analysis(DEA).The authors hold that the RA can expediently display the order of hospital efficiency,the SFA demands a stricter premise yet presents more stable results,while the DEA boasts greater relative advantages and thus suitable for processing hospital efficiency measurement tasks of multi-input and multi-output indexes.

Human resources development in medical and health is of vital importance to medical and health sector reform and development as well as to medical and health existence and service improvement.Medical and health sector in China has made remarkable progress;however,facing the new requirements from economic and social development and people's new needs for medical health service because of their upaating health concepts and the new promotion by the development of biomedical science and technology,we still have some critical problems in medical and health personnel education.Therefore,the task of conducting careful analysis and exploring the solutions to these problems should be given sufficient attention and completed as soon as possible in the field of medical education.

Objective To analyze the present situation of medical service prices in Beijing,and provide scientific basis in order to carry out the reform of medical service prices of the city.Methods Literature review method to collate the administration policy of medical service price in Beijing,and the method of statistical analysis to compare the Beijing medical service prices with 1 9 other provinces across the country.Results The number of medical service projects (4 613 )in Beijing is higher than the national average (4 507),but the average medical service prices (423 yuan)in Beijing is lower than the national average (609 yuan),and medical service price and the regional economic level has no statistical significance Conclusion Medical service prices of Beijing need to be adjusted,and a reform of medical service prices in Beijing should be implemented by the Development and Reform Commission,Health and Family Planning Commission.

Based on China's health-related policy documents,combining the development history of health concepts and quality management theories,the evolution of China's view of healthcare service quality is sorted out.Moreover,based on the objectives of payment reform and the possible impact on healthcare service quality,the focus of healthcare service quality evaluation in the context of health insurance payment reform is elaborated.It aims to explore the focus of medical service quality evaluation at the present stage,and to provide a reference for better utilization of the evaluation results to improve the quality of medical services.

Objective To investigate the role of vitamin D in the synthesis and degradation of aggrecan in rat articular chondrocytes at cellular level. Methods Rat articular chondrocytes were stimulated by IL-1α, IL-1β and TNF-α, respectively. Normal and inflammatory chondrocytes were treated with different doses of vitamin D, respectively. CCK8, Flow cytometry, real time-PCR and western blot analysis were used to examine the proliferation activity and apoptosis level of chondrocytes, and the expression of aggrecan, ADAMTS-4 and ADAMTS-5 at both mRNA and protein levels. Results IL-1α,IL-1β and TNF-α significantly decreased the proliferation activity and increased the apoptosis level of the chondrocytes. Furthermore, IL-1α, IL-1β and TNF-α significantly decreased the expression of aggrecan, and increased the expressions of ADAMTS-4 and ADAMTS-5 at both mRNA and protein levels in the chondrocytes. 1α,25 (OH)2D3supplementation significantly increased the proliferation activity and decreased the apoptosis level of chondrocytes stimulated by IL-1α, IL-1β and TNF-α in a dose-dependent manner, but not affected the normal chondrocytes. Meanwhile, 1α,25(OH)2D3also significantly increased the expression of aggrecan, and decreased the expressions of ADAMTS-4 and ADAMTS-5 at both mRNA and protein levels in the chondrocytes under inflammatory conditions. Conclusions Vitamin D may promote the anabolism of aggrecan and inhibit aggrecanase activity in chondrocytes under inflammatory conditions, which may impact overall protection for articular cartilage.

Objective:To evaluate the homogenization effect of standardized residency training base of internal medicine and to provide reference for further improving the standardized residency training system.Methods:Taking all "unit residents" who took part in the standardized residency training test of Beijing resident physicians in 2015 and 2016 as the research objects, the self-assessment questionnaire survey of resident competency was carried out to analyze the training effect on competency. SPSS 21.0 was used to statistically analyze the collected data.Results:There are differences in self-assessment scores among the four system bases. From high to low, the overall self-assessment score are PUMCH, CCMU, the military, PUHSC. Among the eight abilities, the abilities of teaching and scientific research were the lowest.Conclusion:The training effect of Beijing internal medicine training base has not achieved homogenization. In order to improve the comprehensive ability of residents, it is suggested to strengthen the weak links in the standardized residency training from three aspects: teachers, training process and increasing support.

Objective:To explore the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing, and provide references for reducing the turnover rate of pre-hospital emergency nurses and stabilizing the pre-hospital emergency nursing team.Methods:Pre-hospital emergency nurses from 2 emergency centers in Beijing were selected as the survey objects, and a self-designed questionnaire was used to conduct an online survey in September 2019. The questionnaire covered such aspects as the main demographic characteristics, workload, doctor-patient relationship, professional identity, job burnout and turnover intention. Descriptive analysis was conducted for the data, while rank-sum test and Kappa consistency test were used for univariate analysis, and ordered logistic regression analysis was used for multivariate analysis.Results:A total of 340 valid questionnaires were received, among which 41.5% (141) of the nurses said that they occasionally considered quitting, 11.7% (40) said they often considered quitting, while the scoring of professional identity was (33.29±6.00), and that of job burnout was (63.70±14.90). Univariate analysis showed that age, work units, self-rated health status, professional identity, job burnout, seniority, workload, doctor-patient relationship, and pressure of title promotion were significant ( P<0.05). The results of multivariate analysis showed that job burnout, average number of car trips per shift, and self-rated health status were positively correlated with turnover intention, while professional identity was negatively correlated with turnover intention ( P<0.05). Conclusions:The turnover intention of pre-hospital emergency nurses in Beijing was found at a high level. The authorities are recommended to rationalize the scheduling system and increase the staffing of pre-hospital emergency nurses; establish the diversion policy, title promotion system and post risk special allowance for such nurses; and train medical aid workers to undertake the transfer and lifting of patients, so as to reduce the turnover intention of these nurses.

Objective To establish a reasonable evaluation system of the training effect of residents and professional master degree graduates in order to meet the needs of the construction of medical education system.Methods A questionnaire study had been conducted by stratified sampling to evaluate the abilities of the residents and medical professional degree graduates who had finished residency training in Beijing from 2015 to 2016.The trainees were evaluated by themselves,their colleagues and patients they had dealt with.Results The results showed that 95.29％ of the trainees and 99.00％ of their colleagues or patients thought that the overall abilities of the trainees were "excellent" or "better",and the evaluation results of all kinds of personnel above were consistent.Statistical analysis showed that some of the sub items of each ability index were evaluated better than the others,such as professional ethics,team cooperation ability and interpersonal communication ability,while some of the sub abilities need to be improved such as the information and management ability as well as teaching and research ability.The comparative analysis indicated that the postgraduates were superior to the residents in abilities of clinical diagnosis and treatment,information and management ability,and teaching and research ability.Conclusion The study showed that the training effect of residents and professional degree graduates had met the basic requirements,but the comprehensive quality and innovation ability needs to be promoted.The combination of degree education and resident training helps to cultivate the comprehensive ability of medical talents.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.