Objective To explore the influence of policy support on attitude of staff toward contracted service in community health service ( CHS) centers in different areas of China. Methods A multi-stage stratified cluster sampling method was used to select participants, and questionnaire survey was conducted among 192 staff (99 from Chengdu and 93 from Xiamen) from 4 community health service centers in Chengdu and Xiamen. In addition, documents on contracted service in CHS were collected and analyzed. EpiData software was used to establish database. Double input and cross-check were implemented. SAS version 9.4 was used for data analyses. Results Differences were found in goals, financial modes and insurances coverage in contracted service in the two areas. Among the 192 participants, 80.7% considered that contracted service was worth to carry out; 90.8% supported the implementation of contracted service in local settings and 78.1% were willing to take more work load on contracted service. In contrary, only 41.6% wished their child work as a family doctor. The main reasons for the negative attitudes were that the performance-based salary system had not been well established or implemented, and there was much more work load that resulted from contracted service. Conclusions The majority of the study subjects held positive attitude toward contracted service, but there were disparities between the four study sites. Relative policy and financial support, proper human resource distribution were critical determinants of contracted service.

Ferroptosis,a new form of programmed cell death marked by iron-dependent phospho-lipid peroxidation,is regulated by complex cellular metabolic pathways,including iron metabolism,lipid metabolism,and oxidation-reduction system,is associated with many organ injuries and degenera-tion,and has great potential in the treatment of ischemic diseases and lipid peroxide-related degenera-tive diseases.Myocardial ischemia reperfusion injury(MIRI)is the most common cause of death in patients with acute myocardial infarction after revascularization therapy.Recent studies have shown that ferroptosis is intimately related to the pathological process of MIRI.Ferroptosis is associated with MIRI through oxidative stress,iron metabolism,lipid metabolism,endoplasmic reticulum stress and inflammatory response.Intervention of ferroptosis during reperfusion can effectively improve cardiac function and reduce myocardial infarct size.In this paper,the research progress was explored between ferroptosis and MIRI,and the specific role of ferroptosis in MIRI was discussed.

Ferroptosis,a new form of programmed cell death marked by iron-dependent phospho-lipid peroxidation,is regulated by complex cellular metabolic pathways,including iron metabolism,lipid metabolism,and oxidation-reduction system,is associated with many organ injuries and degenera-tion,and has great potential in the treatment of ischemic diseases and lipid peroxide-related degenera-tive diseases.Myocardial ischemia reperfusion injury(MIRI)is the most common cause of death in patients with acute myocardial infarction after revascularization therapy.Recent studies have shown that ferroptosis is intimately related to the pathological process of MIRI.Ferroptosis is associated with MIRI through oxidative stress,iron metabolism,lipid metabolism,endoplasmic reticulum stress and inflammatory response.Intervention of ferroptosis during reperfusion can effectively improve cardiac function and reduce myocardial infarct size.In this paper,the research progress was explored between ferroptosis and MIRI,and the specific role of ferroptosis in MIRI was discussed.

Objective:To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods:From May, 2011 to September, 2012, middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou. The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender. The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis, and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results:A total of 9 437 residents were included. The overall prevalence of vitamin D deficiency was 97.7%. Compared with the group with lower vitamin D level, participants in the group with higher vitamin D level showed evidently lower body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride/ high density lipoprotein cholesterol (TG/HDL-C) ratio in the total population and females, while only WC, LAP, VAI and TG/HDL-C in the males (all P<0.05). Spearman correlation analysis showed that BMI, WC, LAP, VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females, while only LAP, VAI and TG/HDL-C in the males (all P<0.05) . Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females, while only higher LAP, VAI and TG/HDL-C in the males (all P<0.05). The effects of higher LAP was the most prominant in the total population ,the females and the males. Conclusion:Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women, while only visceral obesity and abnormal lipid metabolism are related to vitamin D deficiency in middle-aged and elderly men, with LAP being the most important influencing factor.