Objective To assess the implementation of essential public health services (EPHS), and determine the main influencing factors for EPHS in Menglian. Methods In September 2012, the questionnaire survey method was employed to collect the data of EPHS implementation in 2011 in three community medical institutes and the EPHS evaluation of health staff sampled by stratified random sampling in Menglian. Results In 2011, the report rates of infectious diseases epidemics, public health emergencies and health inspection were all 100%, the inoculation rates of most vaccines were over 90%,and the health management rates of the children aged 0 to 6 years,pregnant and lying-in woman,aged population,hypertensives, type 2 diabetes patients and serious psychotics were high (about 85%) . The establishment rate of heath archives (60%to 70%),the controlling rates of blood pressure in the hypertensive population (about 50%), the rates of glycemic control in type 2 diabetes patients (55%to 70%) and the steady rates of serious psychotics (50% to 60%), however, were low. The implementation of EPHS was unbalance among towns, suburbs and outer suburbs. The main factors that influenced the EPHS implementation were inadequate human resources, insufficient or unused health devices, ambiguous responsibilities among the health institutes, non-cooperative behaviors, and unhealthy living habits in rural residents. Conclusions The implementation of many EPHS items is good. For promoting EPHS,it is necessary to train human resources,activiate unused health devices,get support of residents and carry out health education.

OR group,moreover the differences were significant(P0.05),however,both genes in the 2 groups′ expression level significantly were lower than that in control group(Pa

Objective To assess prevalence and risk factors of illness within the past 2 weeks among rural residents in Menglian,under the background of essential public health service implemented generally. Methods In February 2012, the questionnaire method was employed to investigate the two-week morbidity in 2011 rural residents sampled by multistage stratified random sampling from Menglian population. Results The prevalence, that of illness within two-week among 2011 rural residents in Menglian, was 97.5‰ (95%CI 84.5‰-110.5‰) . It was lower than that of the rural region IV in China (149.6‰, <0.05) .Its age trend was the same as that of the rural region IV in China,the prevalence in 0-14 years old children,however,was higher than the counterpart in the rural region IV in China. The diseases, which two-week morbidity ranked the top five, were acute upper respiratory infection, acute gastroenteritis, hyperostosis, acute tracheobronchitis and rheumatoid arthritis. The results of multilevel logistic regression model fitted by group-level explanatory variable mountainous area, individual-level random slopes variable gender and other individual background variables indicated that there were across-level interactions between mountainous area and gender ( <0.05), the family income lower than RMB 15000 (odds ration 3.2378, 95%CI 1.9014-5.5130) and age (odds ration 1.0163, 95%CI 1.0002-1.0327) had a positive effect to two-week morbidity, and contrasting to unmarried, married had a negative effect to two-week morbidity (odds ratio 0.4727, 95%CI 0.2534-0.8819) . Conclusions Comparing with that of the rural region IV in China before implementing essential public health service, the two-week morbidity in Menglian was lower. For further elevating the health level of population, the strategies, such as intensifying material and child hygiene in the mountain area, improving sanitary conditions of low income family, and updating health consciousness in single population,would be implemented.

Aged ; Antineoplastic Agents ; therapeutic use ; Benzamides ; therapeutic use ; Drug Resistance, Neoplasm ; Exons ; Gastrectomy ; methods ; Gastrointestinal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Gastrointestinal Stromal Tumors ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Imatinib Mesylate ; Liver Neoplasms ; drug therapy ; secondary ; Male ; Piperazines ; therapeutic use ; Point Mutation ; Proto-Oncogene Proteins c-kit ; genetics ; metabolism ; Pyrimidines ; therapeutic use

Objective To investigate the effects of ischemic postconditioning (Post) on myocardial cell apoptosis and expres- sion of Bcl-2 and Bax protein during ischemia/reperfusion period in rabbits.Methods Eighteen rabbits were randomly allocated to three groups (6 in each group),sham operation (group S),ischemia/reperfusion group(group IR) and ischemic postconditioning group(group Post).Group IR and group Post were subjected to 15 minutes of left anterior descending coronary artery occlusion followed for 30 minutes of reperfusion.Ischemic postconditioning was achieved by three 30 seconds cycles of reperfusion,each followed by 30 seconds ischemia.Cardiomyocyte apoptosis were determined by in situ TDT-mediated dUTP nick end labeling (TUNEL) and DNA electrophoresis.The expression of Bcl-2 and Bax proteins in apoptotic myocardial cells were detected by immunohistochemistry sepa- rately.Results Compared with group IR,apoptotic index was significantly reduced in group Post [(28.06?2.92) % vs.(55.70? 13.96)%,P

OBJECTIVETo compare clinical outcomes between two suturing methods using non absorbable materials through drilling the bone and suturing anchors for the treatment of complete rupture of the deltoid ligament.

METHODSFrom January 2009 to January 2013, 58 hospitalized patients with ankle fracture combined with complete rupture of the deltoid ligament were treated with suturing using non absorbable materials through drilling the bone or suturing anchors. There were 29 patients who received suturing treatments using non absorbable materials through drilling the bone (Group A), including 18 males and 11 females, with an average age of (39.76 +/- 11.81) years old. According to the Lauge-Hansen classification, 12 patients had supination external rotation (SER) injuries with IV degree, 5 patients had pronation external rotation (PER) injuries with III degree, 10 patients had PER injuries with IV degrss, and 2 patients had pronation abduction injuries with III degree. There were 29 patients who received treatments with suturing using anchors (Group B), including 14 males and 15 females, with an average age of (41.79 +/- 13.28) years old. According to the Lauge-Hansen classification,9 patients had SER injuries with IV degree, 6 patients had PER injuries with III degree,13 patients had PER injuries with IV degree, and 1 patient had pronation abduction injuries with III degree. All the patients were treated with open reduction and internal fixation, as well as reconstruction of deltoid ligaments to restore the stability of the medial ankle structures. The clinical examination, imaging evaluation, American society for ankle surgery (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) were used to evaluate the clinical results after operation, and the results of the two groups were compared and analyzed statistically.

RESULTSThe follow-up duration of the 58 patients ranged from 23 to 40 months,with an average of 27.3 months. All the patients had fracture union, and the mean healing time was 12.3 weeks (ranged, 10 to 17 weeks). There were no incision complications and ankle instability. There were no significant differences between two groups in AOFAS (P=0.666) and the VAS (P=0.905).

CONCLUSIONTreatments of complete rupture of the deltiod ligaments with the two suturing methods get similar good clinical effects, but the suturing using non absorbable materials through drilling the bone has several advantages such as reducing the financial burden of patients, saving social medical resources and avoiding the shortcoming in difficult removal of anchor suture.

Adolescent ; Adult ; Ankle Fractures ; surgery ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Lateral Ligament, Ankle ; injuries ; surgery ; Male ; Middle Aged ; Young Adult

Child, Preschool ; Chondromatosis, Synovial ; diagnosis ; diagnostic imaging ; surgery ; Diagnostic Errors ; Female ; Humans ; Tibial Fractures ; diagnosis ; Tomography, X-Ray Computed

Objective To investigate the urinary iodine level and thyroid function during different trimesters of pregnancy in Hangzhou residents and to provide evidence for monitoring iodine nutrition or screening thyroid function. Methods The urinary iodine level and thyroid function of 395 subjects from 5 hospitals in Hanzhou were investigated. The urinary iodine level was measured by arsenic-cerium contact process method. The serum TSH, FT3 and FT4 were measured by chemiluminescence method. Results (1) The urinary iodine median concentration during pregnancy in the 1st, 2nd and 3rd trimesters were 170.3, 170.2, 162.4 μ/L respectively, all significantly lower than that of non-pregnant women (251.9 μg/L, all P < 0.05); (2) The mean value of TSH during the 1st trimester of pregnancy was significantly lower than that of non-preguant women (P < 0.05). The mean values of FT4 and FT3 in the 2nd and the 3rd trimesters of pregnancy were significantly lower than those of the control (P < 0.05); (3) During 2nd trimester, there were 8.7% (9/104, in FT4) and 9.6% (10/104, in FT3) pregnant women below normal lower range while during 3rd trimester, these figures reached 22.7% (22/97) and 17.5% (17/97) resfectively. Conclusions More than half of the pregnant women in Hangzhou have good nutritional status of iodine. There are significant differences in thyroid hormone levels between the non-pregnant and pregnant women as well as between gestation periods. Therefore, it is necessary to establish a trimester-specific reference range of thyroid hormones for normal pregnancy. The screening for thyroid function is recommended for pregnant women besides monitoring routine urinary iodine.

OBJECTIVETo examine serum tissue inhibitors of metalloproteinases (TIMP) -1 and -2 levels in children with nonalcoholic fatty liver disease and to investigate possible roles of the two markers.

METHODSOne hundred and five obese children were classified into 4 groups: simple obesity (n=44), simple nonalcoholic fatty liver (SNAFL, n=25), and nonalcoholic steatohepatitis (NASH, n=36). Serum TIMP-1 and -2 levels were measured using ELISA. Serum ALT and gamma-GT levels were measured with totally automatic enzymatic method.

RESULTSSerum levels of TIMP-1 and gamma-GT increased with the disease development from simple obesity to SNAFL and NASH (P<0.05). Both serum TIMP-1 and -2 levels were positively correlated with gamma-GT levels (r=0.534, P<0.01; r=0.351, P<0.05, respectively). Ninety-seven percent of children in the NASH group had serum TIMP-1 levels over 2 standard deviations of healthy controls (83.35 microg/ L) compared with 76% in the SNAFL group (P<0.05). There were no significant differences in the case proportion with TIMP-2 levels over 2 standard deviations of healthy controls between the NASH and the SNAFL groups.

CONCLUSIONSBoth TIMP-1 and -2 may reflect the state of liver fibrosis in children with nonalcoholic fatty liver disease, and serum TIMP-1 appears to be more reliable.

Adolescent ; Alanine Transaminase ; blood ; Child ; Enzyme-Linked Immunosorbent Assay ; Fatty Liver ; blood ; Female ; Humans ; Male ; Tissue Inhibitor of Metalloproteinase-1 ; blood ; Tissue Inhibitor of Metalloproteinase-2 ; blood ; gamma-Glutamyltransferase ; blood

OBJECTIVETo observe early rehabilitation of two different acupuncture programs for hemiplegia due to stroke.

METHODSSeventy cases of early hemiplegia due to stroke were randomly divided into a treatment group and a control group. The treatment group were treated by acupuncture at acupoints of both the healthy and affected sides, twice each day, respectively, and the control group by acupuncture at the affected side, once daily. Their therapeutic effects were evaluated by the brief Fugl-Meyer movement scale and the modified Barthel indexes.

RESULTSThe patients with over grade IV for FMA accounted for 68.6% and the good rate for ADL was 74.3% in the treatment group, and 31.4% and 42.8% in the control group, respectively, the therapeutic effect of the treatment group being better than that of the control group (P<0.01 or P<0.05).

CONCLUSIONThe acupuncture program in which acupoints at both the healthy and affected sides are applied alternately is more beneficial to recovery of motor function and activity daily living (ADL) of the patient with hemiplegia due to stroke.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Hemiplegia ; therapy ; Humans ; Stroke ; therapy