Objective To assess the effectiveness of long-term prescriptions of hypertensive and diabetic drugs in family doctor contracted service.Methods A survey on long-term prescription in family doctor contract service was conducted from November 2015 to December 2015 in Shanghai Changning district.Ten center managers,101 family doctors and 208 contracted patients from 10 community health service centers were surveyed with 3 different types of questionnaires,respectively.The relevant information of long-term prescription,including medication information,health management,contracted service,patient's acceptance and performance status were collected and assessed.Results The 1-month and 2-month prescriptions accounted for 76.5％ (156/204) and 13.2％ (27/204),respectively.The survey showed that 87.1％ (88/101) of family doctors were willing to make long-term prescriptions;95.6％ (195/204) of patients felt convenience of long-term prescription;88.1％ (89/101) of family doctors affirmed that long-term prescriptions effectively reduced the number of re-visits;93.6％ (191/204) of patients thought that long-term prescriptions reduced the visit number and 60.8％ (124/204) thought that it reduced medical expenses.The main factors influencing family doctors' choice of long-term prescription were the stability of disease condition (72.3％,73/101),the compliance of patients (68.3％,69/101),the accurate diagnosis (50.5％,51/101) and long-term regular medication (45.5％,46/101);70.6％ (144/204) of patients thought that the hypertensive and diabetic drugs included in the tong-term prescription catalogue met their needs.Conclusion The long-term prescriptions can effectively reduce the re-visits and medical expenses of patients,which is highly recognized and accepted by both family doctors and patients.

Based on the suMmary of the implementation of two-way referral system in Changning district,the article describes the system construction,path design,information platform support and achievements,taking into account of general practitioners,specialist and patients.Through a series of reforms,a two-way referral service and its operation mechanism with the local characteristics has been established in Changning district,which guides the first contact care at community and two-way referral as a rational medical service system.

Objective:To evaluate the safety and feasibility of intranodal lymphangiography combined thoracic duct embolization in the treatment of chylous leakage.Methods:The clinical data of ten patients with chylous leakage from July to December 2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 6 cases of chylothorax, 1 case of chylous ascites, and 3 cases of chylothorax combined with chylous ascites, respectively. Conservative treatment was invalid in all cases. The locations of cisterna chyli and thoracic duct were defined by percutaneous puncture intranodal lymphangiography. Then the percutaneous transabdominal puncture of cisterna chyli was performed and the microcatheter was inducted. The location of fistula was visualized by thoracic duct lymphangiography, and the embolization was performed by microcoils combined tissue adhesive agents. The post-operative curative effect and complications were recorded.Results:One patient did not receive thoracic duct embolization because it was failed to visualize cisterna chyli by intranodal lymphatic angiography; thoracic duct embolization was successfully performed in the other 9 patients after chylous leakage fistula was located. Percutaneous transabdominal puncture of cisterna chyli was successfully accomplished in 8 patients. As for the other patient, after repeated failure of puncture, fluoroscopy-guided retrograde puncture at the proximal thoracic duct was performed successfully. After the operation, the drain output was completely disappeared within 3 to 7 days in 8 patients, and decreased down to 120 ml/d in 1 patient. Mild abdominal hemorrhage was found in 1 patient after thoracic duct embolization, without any treatment. No serious complications was found in all cases.Conclusion:Intranodal lymphangiography and thoracic catheter embolization is safe and effective in the treatment of chylous leakage, with a low complication rate.