Objective A cross-sectional survey was conducted to investigate difference in job-related satisfaction indexes among staff working at community health-care service centers ( CHSC ) employing appropriate techniques on a trial basis between east and west areas of China. Methods In total, 339 staff members working at CHSC employing appropriate techniques on a trial basis, including good practice of community medical records management for hypertension , good practice of community case management for type 2 diabetes , good practice of community case management for tuberculosis , etc. , were recruited for questionnaire survey from Tianjin, Jinan and Shenzhen of east China and Chengdu and Chongqing in westChina by cluster sampling. Their demographic information, training for appropriate techniques and job-related satisfaction were collected. Results There was a significant difference in proportion of CHSC staff who receiving training for tuberculosis management launched by local government between west and east areas (34. 8% vs. 41. 4% , P <0. 05). There also was significant difference in satisfaction with the support from the superior sectors of government between west and east areas ( 59. 6% vs. 52. 0% , P = 0. 022 ) . Satisfaction towards income ranked the highest, and that towards work environment the lowest among the staff either in west or east areas. Conclusions Proportion of CHSC staff receiving training for tuberculosis and satisfaction with the support from superior sectors of government vary with communities in east and west areas employing appropriate techniques on a trial basis, and work condition of CHSC should be improved further.

Objective To investigate the effects of a new c-Met inhibitor SU11274 on apoptosis and motility of c-Met-positive basal-like breast cancer cells MDA-MB-231. Methods The concentrations of SUl1274 were set to 0,0.1,1,10 and 20 μmol/L.Morphological change of apoptotic cells was analyzed by Hoechst33342,MitroTrackerRed and Yo-pro-1 staining.The apoptotic rate of MDA-MB-231 cells were determined by Annexin V/PI double-staining. The expression of apoptosis related proteins (Bcl-XL,Caspase-3 and PARP) and phosphorylation levels of c-Met and Akt were analyzed by Western blot.The capability of motility were measured by wound-healing assay and chemotaxis assay. Results After treatment by SU11274( 10 μmol/L) for 48 h,shrinking apoptotic cells of MDA-MB-231 was observed by flurescent microscope and nuclear fragmentation was seen.Annexin V/PI double-staining showed SU11274induced apoptosis of MDA-MB-231 cells (P ＜ 0.05 ),and the apoptotic rates were (7.3 ± 0.9) ％,( 14.1 ±0.6) ％,(35.5 ± 4.4) ％ and (48.2 ± 5.3 ) ％,respectively.SU11274 downregulated the expression of Bcl-XL and promoted the dissection of Caspase-3 and PARP in a dose dependent relationship.SU11274 prolongs the wound-healing time,decreases the migration cell count (P ＜ 0.05 ) and effectively inhibits the phosphorylation of c-Met and its downstream key proteins Akt in a dose-dependent manner.Conclusions C-Met inhibitor SU11274 induces apoptosis and inhibits the motility of c-Met-positive basallike breast cancer cell line MDA-MB-231,probably through inhibiting phosphorylation of c-Met/PI3K/Akt.

Objective To know the change of medical care and health services utilization of Yayuncun community residents in Beijing. Methods Using the prospective study, residents above 15 years old were selected to answer the Beijing Typical Community Resident Questionnaire designed by the local researchers. In 2004 and 2005, the baseline survey was carried. From 2006 to 2008, same questionnaire was used to follow-up survey, and 1412 residents were selected into the last study. Results The proportion of people who should see a doctor but not in past month were decreased, the differences among the three years were significant (P ＜ 0. 01 ); The top three reasons that who should see a doctor but not were the "medical care costs too high", "self- felt the sickness light", "self-treatment". The residents who went to the community health agencies increased from 2006 to 2008. The medical costs ( drugs, medical fees,inspection fees) decreased from 2006 to 2008, the differences were significant (P ＜0. 01 ) ;The satisfaction increased from 2006 to 2008, the differences were significant ( P ＜ 0. 01 ). Conclusion Under the comprehensive promotion of community health services in Beijing, the satisfaction and the utilization of medical care and health services were improved.

Objective To evaluate the changes of physical activity status of residents in Beijing Yayuncun(Asian Games Village)Community.Methods A total of 1765 permanent residents over 15 from 600 families living in Yayuncun Communities since 2000 were selected in this prospective study.Thebaseline survey was carried out with the Questionnaire for Residents of Beijing Typical Community in 2004 and 2005.From 2006 to 2008,same questionnaire was used for the follow-up survey,and 1412 residents were responded to the questionnaire.Results The knowledge levels related to physical exercise of Yayuncun residents elevated(P＜0.01).The source of knowledge gain from Olympics Games promotion,specialized community lectures and intemet increase significantly(P＜0.01),that from other media decreased(P＜0.01).The exercise rate in community was higher than in other sites(P＜0.01)and increased significantly (P＜0.05);while doing exercise in charged sites decreased(P＜0.05).Logistic regression analysis showed that regular physical exercise was related to age,BMI,exercise-related knowledge,exercise sites,attitude for sport facilities and chronological order.Conclusion During the preparation for the Beijing Olympic Games.the status of physical exercise of residents in Yayuncun Community presented the positive trends.

Objective: To analysis the relationship between glucocorticosteroids (GCS) usage and side effects in the treatment of severe acute respiratory syndrome (SARS). Methods: All clinical records of probable SARS patients in Beijing were collected and input into an Epi6 database, in which 1 291 patients had entire information and met the clinical criteria of SARS. The usage of GCS and GCS associated side effects were analyzed retrospectively. Results: Patients accepted GCS therapy were 83.96% (n= 1 084), whereas 16.04%(n=207) did not take GCS. The average dosage of GCS was 160 mg/d in the first week, and then reduced to 80 mg/d and 40 mg/d in the second and the third weeks, respectively. Initial blood glucose, systolic pressure (SBP), and diastolic pressure (DBP) were no significant difference between GCS group and non-GCS group. The highest blood glucose during the treatment in GCS group was markedly higher than that in non-GCS group [(8.68? 4.80 ) mmol/L vs (6.39?3.71) mmol/L, P05). After GCS administration, SBP and DBP were increased gradually, and reached their peaks in the fourth week [SBP (117.2?14.0) mm Hg and DBP (72.5?9.1) mm Hg vs SBP (120.0?12.5) mm Hg and DBP (74.5?8.7) mm Hg, P

Objective:To compare the biomechanical properties of different circular external fixators for the fracture site of oblique long bone fractures.Methods:15 polyethylene (PE) plastic rods with the same batch were selected to make the model of oblique fractures in the middle of long bones. According to the connection between PE rods and external fixators, the PE rods were randomly divided into: the group that was simply used kirschner wires (group kirschner wires), the group that was simply used olive wires (group olive wires), the group that was simply inserted half pins (group half pins), the group that was inserted single cortical fixed half pins at either side of the fracture site after being fixed by the tensioned olive wires (group olive wires+ half pin), the group that was inserted tensioned trans-fracture olive wires after being fixed by the tensioned olive wires (group olive wires+ olive wires). The axial compression tests were carried out, and the interfragmentary displacements under axial loads of 200 N, 400 N, 600 N and 800 N were measured and the axial stiffness was calculated. Then, the torsional tests were carried out, and the interfragmentary torsional angles were measured under torsional loads of 4 N·m, 7 N·m and 10 N·m, and the torsional stiffness was calculated.Results:With the increase of axial load from 200 N to 800 N, the axial interfragmentary displacement in each group gradually increased. The interfragmentary axial displacement of each group in ascending order was: group olive wires+ olive wires, group olive wires+ half pins, group half pins, group olive wires, group kirschner wires. The axial stiffness of each configuration under 800 N axial load in descending order was: group olive wires+ olive wires [863.93 (824.32, 875.87) N/mm], group olive wires+ half pins [119.92 (113.16, 123.58) N/mm], group half pins [81.92(79.42, 82.40) N/mm], group olive wires [76.83 (72.45,79.47) N/mm], group kirschner wires [70.80 (67.49, 71.59) N/mm]. The pairwise comparisons of the axial stiffness data of each configuration had statistical significance (all P <0.05). With the increase of the torque load from 4 N·m to 10 N·m, the interfragmentary rotational angle in each configuration gradually increased. The interfragmentary torsion angle of each group in ascending order was: group half pins, group olive wires+ olive wires, group olive wires+ half pins, group olive wires, group kirschner wires. The torsional rigidity of each configuration under 10 N·m torsional load in descending order was: group half pins [1.80 (1.63, 1.85) N·m/°], group olive wires+ olive wires [1.05 (1.02, 1.07) N·m/°], group olive wires+ half pins [0.99 (0.98, 1.03) N·m/°], group olive wires [0.81 (0.78, 0.82) N·m/°], group kirschner wires [0.75 (0.74, 0.76) N·m/°]. The pairwise comparisons of the torsional rigidity data of each configuration had statistical significance (all P < 0.05). Conclusion:The axial stiffness and torsional stiffness of circular external fixators can be increased by using tensioned olive wires or half pins at the fracture site. Due to the insufficient support between oblique fracture site, when the load is applied, the axial displacement and torsion angle of the fracture site will still be fairly large after being fixed the fracture site with half pins. Treating with tensioned trans-fracture olive wires after being fixed by the tensioned olive wires at either side of the fracture site can effectively control the interfragmentary shear and displacement, thus providing an ideal mechanical environment for fracture healing.

Autophagy is a dynamic process that degrades intracellular proteins and damaged organelles, and maintains environmental stability within the cell and provides good conditions for cell survival. Hyperoxic acute lung injury (HALI) is one of the serious complications of clinical oxygen therapy. The pathogenesis of HALI is still unclear. There are studies having shown that autophagy is involved in the pathogenesis of HALI. There are many pathway mechanisms that regulate autophagy, including phosphatidylinositol-3-kinase/Akt/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway, mitogen-activated protein kinase/extracellular signaling-regulated protein kinase (MAPK/ERK) signaling pathway, adenosine 5'-monophosphate-activated protein kinase/unc-51 like autophagy activating kinase 1 (AMPK/ULK1) signaling pathway, transforming growth factor β (TGF-β) and forkhead box O1 (FoxO1) and Ras guanosine triphosphatease superfamily member Rab11a, each of which is referred to as microRNA-21-5p (miR-21-5p) target gene having a role in regulating autophagy activity in many diseases. In this paper, the above-mentioned signaling pathways of miRNA-21-5p target genes regulating autophagy were reviewed in order to find clues about the mechanism of miRNA-21-5p regulating autophagy in HALI and provide a theoretical basis for subsequent basic research.

Objective:To compare the clinical effect of Ilizarov frame and unilateral frame in the treatment of tibial segmental bone defect combined with soft tissue defect by open bone transport.Methods:A retrospective case-control study was conducted to analyze the clinical data of 32 patients with tibial segmental bone defect and soft tissue defect-up who underwent open bone transport technique in Tianjin Hospital from August 2008 to August 2016 and obtained complete followed-up. There were 22 males and 10 females, aged 22-64 years (mean, 36.8 years). Nineteen patients in the Ilizarov group showed the mean bone defect length of 7.9 cm and mean soft tissue defect area of 41.4 cm 2. Thirteen patients in the unilateral group showed the mean bone defect length of 7.8 cm and the mean soft tissue defect area of 39.2 cm 2. The results of fracture healing, wound healing time, radiological consolidation index, external fixation index, Association for the Study and Application of the Method of Ilizarov (ASAMI) bone and lower-limb function score and incidence of complications were compared between the groups. Results:All patients were followed up for 24 to 60 months [(32.6±1.3)months]. Bone healing was achieved in all patients. The wound healing time was (2.7±2.3)days in Ilizarov group and (2.4±1.8)days in unilateral group ( P>0.05). The consolidation index was (43.4±8.7)d/cm in Ilizarov group and (45.8±10.3)d/cm in unilateral group ( P>0.05). The external fixation index was (52.6±8.9)d/cm in Ilizarov group and (58.7±12.9)d/cm in unilateral group ( P<0.05). The results of ASAMI bone score was excellent in 10 patients, good in 6, fair in 2 and poor in 1 in Ilizarov group, with the excellent rate of 84%; and excellent in 6 patients, good in 4, fair in 2, and poor in 1 in unilateral group, with the excellent rate of 77%, with insignificant difference between two groups ( P>0.05). The results of ASAMI lower-limb function score was excellent in 8 patients, good in 7, fair in 3, poor in 1 in Ilizarov group, with the excellent rate of 79%; and excellent in 6, good in 3, fair in 3, poor in 1 in unilateral group, with the excellent rate of 69%, with insignificant difference between the two groups ( P>0.05). Incidence of axial deviation was zero in Ilizarov group versus 23% in unilateral group ( P<0.05). After operation, Ilizarov group had refracture in 1 patient and pin site infection in 5, and unilateral group had refracture in 1 patient and pin site infection in 1, showing no significant difference between the two groups ( P>0.05). Conclusions:Tibial segmental bone defect with soft tissue defect can be effectively treated by open bone transport with Ilizarov and unilateral frame. Ilizarov frame has better biomechanical properties and is more convenient for correction of poor postoperative axial alignment.

Objective:To probe the exploration and integration of ideological and political teaching resources for College English by medical students' teams, and to build a College English ideological and political teaching resource database in medical colleges, so as to provide feasible experience for the integration of medical students' College English and ideological and political education.Methods:A questionnaire survey was conducted among 1 030 students in a medical college, and SPSSAU statistical software was employed to analyze the results to investigate the attitudes and demands of students towards the integration of English teaching and ideological and political education, the construction methods of College English ideological and political teaching resource database, and the presentation methods and types of resources. Based on the questionnaire results, textbook themes, teaching modules and students' majors, the content analysis and classification method were employed to construct a College English ideological and political teaching resource database that meets the expectations of medical students.Results:① A total of 836 students agreed with the necessity to integrate College English with ideological and political education, hoping to build an ideological and political resource database with videos and audios related to daily life ( n = 731), medical knowledge ( n = 664), social practice ( n = 622), news and current affairs ( n = 604) and guide the students to learn the above resources through the methods "teacher instruction + classroom discussion" ( n = 528). ② The ideological and political integration points in the questionnaire results were matched according to the subjects of the textbook, and further divided into two categories: universal and medically specific ideological and political teaching elements according to the content of the unit modules. Finally, the resource database of College English ideological and political teaching in medical colleges was built. Conclusion:Outstanding courses and resources are jointly explored and built by teachers and students.