Health appropriate technologies are applied nationwide in our country and have produced good results. But the informatization of health appropriate technologies lags behind and is still at a preliminary stage.As the network of Zhejiang basic health appropriate technologies has been estabished,this paper discusses some issues related with the informatization of health appropriate technologies.

Objective: To assess trends of β-blocker use within 24h of admission in ideal candidates with acute myocardial infarction (AMI) in eastern urban China from 2001 to 2011. Method: A 2-stage random sampling design was performed. In the first stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select cases from the participating hospitals. Data was obtained by central medical record abstraction. 10-year trend and predictors of early β-blocker application were assessed with weighted calculation for each year to represent the overall situation of eastern urban China. Results: 35 hospitals were sampled and 32 of them were finally participated. With necessary exclusion, 1399 ideal candidates were included in this analysis. The early weighted β-blocker application rates in 2001, 2006 and 2011 were 64.7%, 69.7%, and 60.9% respectively, P=0.0447 for trend. Patients with chest pain at admission (OR=2.22, 95% CI 1.19-4.13), higher systolic blood pressure (OR=1.40, 95% CI 1.11-1.77) or faster heart rate (OR=2.01, 95% CI 1.58-2.55) were more likely to use β-blocker; in contrast, compared with NSTEMI patients, STEMI patients seemed less likely to receive such treatment (OR=0.55, 95% CI 0.37-0.81). Conclusion: The early β-blocker therapy in eastern urban China is suboptimal for ideal AMI patients who could benefit from it. The application pattern has not been changed from 2001 to 2011 which might be related to physicians' misunderstanding of relevant evidence or guidelines. Our study may help to create an important target to improve the quality of AMI care.

Objective To access the changes of lung function of newborns with pneumonia and to investigate the feasibility of measuring lung function in the body plcthysmograph for diagnosing and treating respiratory diseases.Methods There were 117 infants,1 day after being diagnosed with mild or moderate pneumonia,aged 4-28 days,involved in the study,those who needed oxygen cure,mechanical ventilation,or had complications from pneumonia were ruled out.Pulmonary function tests (PFTs) were performed in the baby body plethysmography to access tidal breathing,plethysmographic functional residual capacity (FRCp),and effective airway resistance (Reff).The other 126 contemporaneous healthy children took the same test for comparison.According to their ages,infants were grouped into 4-7 d,8-14 d,15-21 d and 22-28 d.Results Of the 117 infants with pneumonia,79 (67.5 ％ equivalently) had abnormal lung function.Compared with the controls,infants with pneumonia had significantly higher values of peak tidal expiratory flow [(59.4 ± 16.6) mL/s vs (52.9 ± 16.6) mL/s],expiratory flow at 75％ tidal volume [(57.4 ± 16.7) mL/s vs (49.5 ± 16.7) mL/s],special effective airway resistance (0.48 kPa · s vs O.27 kPa · s),Reff [6.96 kPa · s/L vs 4.82 kPa · s/L] and Reff per kilogram [1.99 kPa · s/(L · kg) vs 1.44 kPa · s/(L · kg)],but lower values of time to peak tidal expiratory flow as a percentage of total expiratory time [(26.5 ± 10.0) ％ vs (36.8 ± 9.9) ％],volume to peak tidal expiratory flow as a percentage of total expiratory volune [(27.9 ± 7.3) ％ vs (35.6 ± 8.4) ％]and expiratory flow at 25％ tidal volume [(36.3 ± 11.7) mL/s vs (40.1 ± 12.4) mL/s].There were no sig± nificant differences in the values of respiratory rate,FRCp and FRCp/kg between the pneumonia children and the healthy control chidren.Compared with the infants aged ≤ 14 days,there were more significant differences in relative parameters of lung funetion between the pneumonia group and the healthy control group for infants aged 15-28 days.Conclusions Newborns with pneumonia had a high ratio of abnormal lung function,which went up to 67.5％,and had apparent obstruction of small airways.Neonates with pneumonia aged 15-28 days had more apparent lesion of lang function.Measuring lang function by means of plethysmography among newborns is feasible and it can detect abnormal lung function sensitively.

Shanghai district and county health system performance evaluation conceptual frameworkwas proposed based on health services system performance assessment frameworks raised by some countries and international organizations,and combined with Shanghai district and county health system characteristics.This framework contains two first grade indices and seven second grade indices:In the long term goals,'health','satisfaction' and 'disease risk protection' are the county's longterm effects of health system performance assessment dimensions; in the medium-term goals,the'accessibility','cost',' efficiency' and 'quality' are the county' s medium-term effects of health system performance assessment dimensions.This study aimed to evaluate Shanghai county health system's overall performance.Further study is needed in constructing its third grade indices.

BACKGROUND: Artificial humeral head replacement is an effective method for the treatment of complex proximal humeral fractures, which has received good results in relieving pain. However, the final functional recovery is unpredictable. OBJECTIVE: To compare biomeshanical stability between anatomical and overlapping reconstruction of the greater tuberosity in cadaveric humeral head replacement models.METHODS: Eight pairs of fresh-frozen shoulder cadavers (16 shoulder joints) were match-paired into two groups. Standardized humeral head replacement procedure was performed in all specimens, and anatomical and overlapping reconstruction of thegreater tuberosity was adopted in each group respectively. For overlapping group, the greater tuberosity was reattached to the proximal humeral shaft in an overlapping style, which was achieved by an additional 5 mm bone osteotomized from the medial cortex of the humeral diaphysis. Custom mounting apparatus and fixation jigs were designed for designated shoulder motion.RESULTS AND CONCLUSION: When the shoulder was external rotated to neutral position, the mean displacement of greater tuberosity in the anatomical reconstruction group was smaller than that of the overlapping reconstruction group (P < 0.05). When the gleno-humeral joint was elevated to 30～ and 60～ forward flexion (accounting for 45° and 90° shoulder forward flexion), there was no significant difference of greater tuberosity displacement between the anatomical group and overlapping group. The findings demonstrated that, although overlapping reconstruction can increase the bone healing area between the greater tuberosity and the humeral diaphysis, there may be some loss in mechanical stability as the trade-off. Even though we strictly follow the standardized postoperative rehabilitation protocol after humeral head replacement, prominent displacement between the greater tuberosity relative to the humeral diaphysis was detected. Accordingly, postponing of the postoperative rehabilitation program after humeral head replacement for a decent period may improve tuberosity healing.

The paper presented the thoughts and steps taken by the National Center for Cardiovascular Diseaes in biobank quality management system.By means ofprocess approach,the organizational structure,identification and analysis process were established,along with the management mechanism and normalized documentation.Centering onPlan,Do,Check and Act(PDCA),a complete set of quality management system was established.This system enables normalized management of biobanks in China,and provides practice guidelines for development industry standards of the country as well.

Objective To understand the status of Toxoplasma gondii infection in the population of Pu er City so as to pro-vide the evidence for formulating the strategy of toxoplasmosis control. Methods The population from Jingdong Jinggu and Menglian counties in Pu er City was surveyed IgG of T. gondii in serum was detected by ELISA. Results Totally 906 resident serum samples were detected and the IgG positive rate was 24.2%. The positive rates were higher in the aged groups of 30-39 years and 60-69 years and the difference among different aged groups was significant χ2=17.77 P 0.01 . There were no si-gnificant differences between different sexualities and among different educational levels and living habits P 0.05 . The posi-tive rates were 26.6% 194/730 15.5% 22/142 and 8.8% 3/34 in farmers students and other occupations respectively and there was a significant difference among them χ2=12.51 P 0.01 . The positive rates were 23.3% 198/849 and 36.8%21/57 in the farmers who had the habit of rearing pigs in pens and the farmers who had the habit of free ranging pigs respec-tively and there was a significant difference between them χ2=5.33 P 0.05 . Conclusion The IgG positive rate of T. go-ndii is very high in Pu er City and therefore the health education for toxoplasmosis control should be strengthened.

Objective To compare the clinical efficacy and radiologic changes between constrained and non-constrained titanium plate in anterior cervical corpectomy and fusion (ACCF) in elderly cervical spondylosis patients.Methods A total of 58 elderly cervical spondylosis patients who underwent ACCF were divided into group 1 (patients treated with constrained titanium plates,n =30) and group 2 (patients treated with non-constrained titanium plates,n=28).The Japanese Orthopedic Association (JOA) score,fusion rate,the loss of segmental height and cervical lordosis were recorded.The clinical efficacy and imaging features were compared between the two groups.Results The improvement rate of JOA score had no significant differences between group 1 and group 2 [(77.7±18.6)％ vs.(75.8±23.2)％,t=0.340,P＞0.05].At 3 months after operation,the fusion rate was higher in group 2 than in group 1 (89.3％ vs.63.3％,x2 =5.327,P＜0.05).At 3,6 and 12 months after operation,there were no significant differences in the loss of segmental cervical height and lordosis between group 1 and group 2 [(2.42±3.05)mm vs.(0.98±2.86)mm,(3.95±3.65)mm vs.(2.34±2.97)mm,(3.60±4.33)mm vs.(2.40±2.96)mm,(1.64±2.33)° vs.(0.66 ± ±2.14)°,(2.13∧±±3.79)° vs.(0.70±2.99)°,(2.39±4.26)° vs.(0.86±3.25)°,respectively,all P ＞0.05].Conclusions The clinical efficacy is similar in ACCF with the two types of titanium plates.The non-constrained titanium plate can increase the fusion rate in early time,but may aggravate the loss of segmental cervical height and lordosis,which should be used with caution in elderly osteoporosis patients.

Objective:To evaluate the performance of RapidArc technique on cervical cancer patients with various filling status of the bladder. Methods: Conventional fixed field intensity modulation radiated therapy (IMRT) is used as the benchmark. In 10 fe-males suffering from cervical cancer, two CT scans were performed for treatment planning:one with an empty bladder and the other with filled bladder. The prescribed dose was 50 Gy. The images of that with an evacuated bladder and that with filled bladder were planned in the dual-arc RapidArc and the 7-field IMRT, respectively. The implementor of the plan was the Varian TrueBeam linear ac-celerator. Dose-volume histogram was used to evaluate the data from each plan. Results:When the bladder was filled, IMRT and Rapi-dArc homogeneity were 1.05 and 1.04 (P>0.05), respectively. When the bladder was emptied, the homogeneity was 1.04 for both plans (P>0.05). With or without bladder filling, the conformity index was 0.71 and 0.73 for IMRT and RapidArc (P>0.05), respectively. The effect of V30 and V40 (volume for receiving doses of 30 and 40 Gy) on the intestine and the bladder was more favorable in a full than in an empty bladder. No significant difference between the two plans was observed. IMRT exhibited improved V30 on the rectum and on the bladder. RapidArc was much better in terms of monitor unit (MU) and deliver time. Conclusion:No significant differences in the homogeneity and conformity index between dual-arc RapidArc and 7-field IMRT were observed. Filled bladder is better than empty bladder in intestine and bladder protection in both RapidArc and IMRT. IMRT is better on V30 of the rectum and the bladder, whereas RapidArc improved MU and deliver time.

Objective To investigate the distribution of cytotoxin-associated gene A (cagA) of Helicobacter pylori (Hp) and the polymorphism of EPIYA motifs in patients with upper gastrointestinal diseases in Changchun area of China and to evaluate the association between EPYIA motifs patterns and gastrointestinal diseases.Methods Hp strains were isolated from clinical samples.Their cagA gene was analyzed by PCR and sequencing analysis.Nucleotide sequence of cagA gene was translated into amino acid sequence by using DNAMAN software,and then the amino acid sequence was imported into software MEGA6.0 for multiple comparisons and construction of a phylogenetic tree.Results A total of 60 Hp strains were isolated and identified from gastric mucosa specimens collected from 298 patients.Hp infection was not correlated with patient's age or sex (P>0.05).The isolation rate of Hp in peptic ulcer disease (PUD) group was higher than that in non-peptic ulcer dyspepsia (NUD) group (P<0.05).Of the 60 Hp strains,90% (54/60) carried cagA gene.Twenty-three out of 26 successfully sequenced strains (88.4%) were East Asian-type including 22 containing EPIYA-ABD motif and one containing EPIYA-ABBD motif.The other three strains (11.6%) were Western type including two carrying EPIYA-ABC motif and one carrying EPIYA-BC motif.Results of the phylogenetic tree showed that the sequences of cagA gene were clustered into two groups,East Asian-type and Western-type groups.East Asian-type strains caused no disease cluster of statistical significance.All Western-type Hp strains were isolated from patients with peptic ulcer disease (PUD).Four mutant Hp strains were detected in the PUD group and the amino acid mutations preferentially occurred in the EPIYA-B segment.Conclusion The positive rate of Hp cagA gene is 90% in this region.Its distribution is not related to the type of gastrointestinal diseases.EPIYA-ABD (84.6%,22/26) is the predominant EPIYA motif.The amino acid mutation of EPIYA-B segment is closely related to peptic ulcer disease.Neither significant change in the sequence of 3' region of Hp cagA gene nor regional difference is observed in those Hp strains circulating in Changchun area of China.