By stratified random sampling method, 10 000 residents were investigated with the questionnaire in Fangzhuang community of Beijing, 9497 valid questionnaires were collected with a return rate of 94. 97%. The results showed that two main purposes for patients to use the community health services were to seek consultation (29. 8% ) and to get prescription (28. 2% ). The three main reasons for residents to choose community health services were the convenience, less medical expenses and more clear explanation from doctors, followed by the personal trust in the doctors.

Effective doctor-patient communication not only affects the doctor-patient relationship,but also affects the normal medical practice.Johari window is referred to as theself consciousness discovery-feedback model or information exchange process management tool.This article introduces the relationship between self-exposure and experience feedback by doctors and patients.As a skill and theory about communication,Johari widow can help doctors to better understand their patients and to improve their ability of communication.

An iceberg model for better understanding the patients was developed.In this model the seeking for consultation is visible part of illness behavior,but the thoughts,concerns and expectations toward his or her illness are the hidden parts.Through detailed history taking,using appropriate language skill (Leichester Assessment Package) and nonverbal communication skill (space distance,eye contact,listening,pronunciation,appropriate silence),physicians can acquaint comprehensive knowledge about the hidden thoughts,concern and expectation of patients about their illness.This model would help general practitioners to raise communication and consultation ability and skills in their practice.

Objective To summarize the experiences in the diagnosis and treatment of the hepatic hereditary hemorrhagic telangiectasia (HHHT).Methods The clinical data of 15 HHHT patients who were admitted to the Qilu Hospital,People's Hospital of Mengyin,People's Hospital of Liaocheng,Henan Provincial People's Hospital,the Second Hospital of Hebei Medical University,First Affiliated Hospital of Zhejiang University were retrospectively analyzed.The clinical manifestation,features of imaging and laboratory examination were summarized,and the diagnosis,treatment and prognosis of the disease were investigated.Results HHHT patients had nonspecific symptoms in the early stage,and some patients presented with right upper quadrant discomfort,shortness of breath,anemia and liver bruit.The condition of HHHT patients could be worsened by liver cirrhosis or portal hypertension rapidly.The results of color doppler ultrasound and computed tomography showed intrahepatic telangiectasia,arteriovenous fistula and hepatic artery aneurysm in the 15 patients.Digital subtraction angiography was not clear enough for 2 HHHT patients with more than 1 enlarged hepatic arteries,but computed tomographic angiography was feasible.According to the degree and stages of the HHHT,all the 15 patients were divided into asymptomatic HHHT,simple HHHT and complex HHHT.Among the 6 patients who underwent surgical treatment,5 received ligation or banding of the enlarged hepatic arteries with subsequent disappearance of symptoms.Three patients received interventional treatment,and the treatment for 1 patient with complex HHHT was failed,and the patient died 30 months after medical treatment.Six patients were treated by conservative treatment,2 patients of them had no symptoms at the beginning,then they suffered from hepatic dysfunction and ascites at 21 and 35 months,respectively,and 1 of them died 6 months later.Four patients received medical treatment,and the results of color doppler ultrasound and computed tomography showed the pathological changes were aggravated gradually.Conclusions Telangiectasia,intrahepatic arteriovenous fistula and hepatic artery aneurysm are the main imaging characteristics of HHHT,and imaging diagnosis has significant value in the diagnosis of HHHT.HHHT is a progressive disease,early,active and individualized treatment is beneficial to the patients.The outcome of ligation or banding of the hepatic arteries is satisfactory.

To implement the effective docking and optimization of a new community comprehensive management information system and cardiocerebrovascular disease-related auxiliary system for a communitybased information platform for intelligent chronic disease management.The cooperation of community team and a distinct division of labors were enforced according to standard operating procedures.This mode of patient-centered medical home (PCMH) could offer scientific and effective management,promote the rational classification of medical and two-way referral systems and improve service efficiency and management capabilities for the goals of achieving a reasonable allocation of medical resources and saving medical costs.

Communication skills are the basic requirement for general practitioners,the continuous improvement of communication skills is the guarantee of the service quality.It is crucial to establish an effective evaluation system in the training of communication skills for general practitioners.This article reviews the current status of evaluation scales of doctor-patient communication skill commonly used in China and other countries to provide reference for the establishment of the communication skill evaluation system for general practitioners which is suitable for China's condition.

Objective To investigate the health-seeking behavior and related factors among hypertensive and diabetic patients contracting medical service in Beijing Fangzhuang Community Health Service Center.Methods By using stratified random sampling method, 830 contracted hypertensive and diabetic patients were selected in the study.A face to face questionnaire survey was conducted in Fangzhuang Community Health Service Center from November 2016 to January 2017.Total 800 questionnaires were completed, and the medical behavior and influencing factors of patients were analyzed.Results The first-contact rate of community for hypertensive and diabetic patients was 73.0%(584/800).The reasons for choosing community service were: near home(86.3%,690/800), shorter waiting time(71.4%, 571/800)and trust in doctors(50.3%, 402/800); while the reasons for not choosing community service were less drug varieties(76.1%, 609/800), poor facilities(32.1%,257/800)and lower technical level(11.4%, 91/800).Its influencing factors were: frequent need of accompanying for visit(χ2=5.719, P=0.012),family income(χ2=4.540,P=0.021),awareness of service scopes(χ2=64.668,P=0.000),purpose of service(χ2=19.234,P=0.000),frequency of doctor contact(χ2=9.367, P=0.001), the awareness of referral(χ2=5.736,P =0.011).Conclusion The community health service centers should take the advantage of easy access, short waiting time and patients′trust,at the same time should improve the service conditions and quality,so as to increase the first-contact rate for patients contracting medical service.

During the prevention and control of new coronavirus pneumonia, Fangzhuang community health service center gave full play the advantages of internet technology, developed and implemented the Intelligent Family Doctors Optimized Coordination Model for epidemic prevention in the community. An epidemic prevention and control team was established in the center, the team carried out the epidemic prevention and control with the opening of health records and by using "doctors around" APP. The center also opened the intelligent voice return visits, the 24-hour service hotline, and WeChat public column to provide consultation for the community residents; it also strentherned pre-check triage, realized the medical insurance sharing and the other measures. All these measures enabled the residents to have a correct understanding of the epidemic situation, eased their psychological panic, enhanced their sense of gain, and made residents more convenient to seek medical treatment nearby reducing interpersonal contact and aggregation, reduced the risk of cross-infection, and achieved accurate health management among community residents during COVID-19 epidemic.

Objective:To evaluate an intelligent voice call system in popularizing knowledge of prevention and control of Coronavirus Disease 2019 (COVID-19) for chronic disease patients in the community.Methods:An intelligent voice call system for popularization of scientific knowledge of COVID-19 and protective measures was developed in Fangzhuang Community Health Service Center of Beijing Fengtai district, in which 12 popular education modules ware designed and 3-6 core points were extracted from each module. During January 23 to January 29, 2020, the system was applied to send voice calls and text messages to all contracted chronic disease patients in Fangzhuang community with popular science education in different time points. Using equidistant sampling method, 400 participants were selected from the patients of successful voice outbound calls. The intelligent voice outbound system was used to investigate the participants′ COVID-19 knowledge levels, the main sources of knowledge and satisfaction with education. The outbound results of the above indicators were queried from the database of the intelligent voice outbound system.Results:A total of 98 487 voice outbound calls were effectively connected, the average call duration per person was 2.24 minutes, and the total call duration was equivalent to 488.5 workdays. A total of 141 201 messages were sent, with a read rate of 97.8% (141 201/144 405) . After the voice outbound education, the participants′ scores in answering the questionnaire on 12 popular science knowledge modules ware all significantly increased compared to those before the education ( t=22.4, 27.5, 24.3, 31.2, 25.6, 18.9, 22.5, 27.3, 28.1, 26.4, 15.2, 22.6, all P<0.01) ; 94.8% (235/248) of participants′ knowledge of COVID-19 mainly came from voice call. In addition, the patient′s overall satisfaction with the application of the intelligent voice call system for popularizing science education was 90.8% (225/248). Conclusions:The knowledge levels of COVID-19 and its prevention and control measures effectively have been improved among the community chronic disease patients with the application of an intelligent voice outbound system. Moreover, this mode is highly acceptable to patients, which would be introduced to other urban communities in China.

Objective:To evaluate the effectiveness of mentorship-Leichester assessment package (LAP) model in general practice teaching.Methods:Sixty five-year Traditional Chinese Medicine (TCM) students undergoing general medicine internship from July 2020 to December 2020 were divided into study group and control group with 30 students in each group. Students in study group undertook general practice internship in Fangzhuang Community Health Service Center with the mentorship-LAP model, including group-based teaching, weekly LAP case discussion and mentor-intern individualized LAP clinical practice teaching; students in control group undertook general practice internship in other community teaching bases with the traditional clinical practice training methods. After one month, students were evaluated with LAP score sheet and the evaluation results were compared between two groups.Results:After one month of training, the scores of medical history collection, physical examination, problem solving, patient management, doctor-patient relationship, expected care and medical records in both groups increased compared with pre-training (the control group: t=4.23, 5.06, 8.94, 4.85, 3.99, 1.04, 5.13, study group: t=1.86, 2.85, 12.42, 13.61, 6.29, 4.83, 5.63, all P<0.05). The scores of medical history collection, physical examination, problem solving, patient management, doctor-patient relationship, and expected care after training in the study group were higher than those in the control group ( t=5.66, 2.83, 5.67, 8.13, 2.76, 2.52, all P<0.05). After the training, in the medical history collection items, the scores of patient-centered communication, RICE recognition, and physical-psychological-social factors in study group were higher than those in the control group ( t=5.66, 7.35 and 2.66, all P<0.05); in the problem-solving items, the scores of clinical data application, comprehensive analysis ability and personal ability limitation in study group were higher than those in the control group ( t=4.32, 3.38 and 2.26, all P<0.05); in the patient management items, the scores of overall management plans, doctor-patient collaboration, dispelling doubts, subsequent visits/follow-up, and the degree of patient understanding the management plan in the study group were higher than those in the control group ( t=3.03, 2.07, 2.43, 3.15 and 2.17, all P<0.05). Conclusion:The mentorship-LAP teaching model is helpful to improve the effectiveness of general practice internship for medicine students.