Community Health Committee (CHC), an innovative public participation mechanism of grassroots health service management, established a bottom-up communication channel between the public and government to communicate health related problems and opinions, and set up a grassroots community health services supervision system. The rural residents were endowed with opportunities to take part in grassroots health care decision making and management by CHC. CHC changed the top-down model of traditional health management, improved the grassroots medical services, and increased governance capability of local government We introduced the CHC practice in Zhejiang project counties, exhibited the primary effects and experience of this pilot program, and explored new mechanism and model for rural community residents to participate in grassroots health service management

Objective To evaluate the effect of tirofiban injection in coronary artery occlusion by suction catheter on the opening time of the coronary artery occlusion , the improvement of the blood flow and the incidence of adverse events in 30 days. Methods A total of 97 patients with acute myocardial infarction in recent 4 years were included , whose culprit vessels were subtotal occlusion or total occlusion by angiography and were randomly divided into thrombus aspiration group (group A) and tirofiban injection in occlusion and thrombus aspiration group (group B). The opening time of the coronary artery, the improvement of the blood flow and the incidence of adverse events in 30 days were compared between two groups. Results The opening time of the coronary artery occlusion in group A was shortened when compared with group B but the blood flow arriving TIMI III grade in group B was shorter (P < 0.05). No-reflow incidence in group B was lower while the proportion of blood flow arriving TIMI III grade was higher than that in group A in early phase (P < 0.05). The incidence of adverse events in 30 days was decreased in group B when compared with group A ,but the difference wasn't statistically significant (P > 0.05). Conclusion Direct tirofiban injection in coronary artery occlusion could effectively shorten the opening time of the coronary artery occlusion reduce no-reflow incidence , and improve coronary perfusion but could not decrease the incidence of adverse cardiovascular events in 30 days.

Objective To analyze risk factors for the perioperative complications and death following hip fracture in the elderly. Methods The present study included 1352 elderly patients (≥65 years) who had received hip fracture surgery from January 2010 to June 2015 in Huadong hospital affiliated to Fudan University. Their clinical data were analyzed to determine risk factors for perioperative complications and death. Results Factors significantly affecting the perioperative complications included gender, preoperative serum albumin, ASA grade (≥Ⅲ), cardiac functional grade (≥Ⅲ), respiratory system disease and blood transfusion. Factors significantly affecting the death included preoperative serum albumin, ASA grade (≥Ⅲ), cardiac functional grade (≥Ⅲ) and blood transfusion. Multivariate Logistic regression analysis revealed that the independent risk factors for perioperative complications included gender (B=-0.686, P=0.019), preoperative serum albumin (B=-0.808, P=0.006), cardiac functional grade (≥Ⅲ, B=1.181, P=0.004), blood transfusion (B=0.890, P=0.004) and respiratory system disease (B=3.118, P=0.000);while the independent risk factors for death included preoperative serum albumin (B=-2.516, P=0.000) and blood transfusion (B=1.396, P=0.010). Conclusions In elderly patients undergoing hip fracture surgery, the independent risk factors for perioperative complications included gender, preoperative serum albumin, cardiac functional grade, blood transfusion and respiratory system disease, while the independent risk factors for death included preoperative serum albumin and blood transfusion. Perioperative risk assessment and prevention are the keys of better prognosis.

This article reported a case of fetal testicular torsion diagnosed by prenatal ultrasound. Ultrasound examination at 38 weeks of gestation showed a slightly enhanced echo in the left testicle of the fetus and fluid accumulation within the testicular sheath cavity and between the sheath and fascia, presenting a 'double-ring' sign. An emergency cesarean section was performed considering the risk of acute fetal testicular torsion. Postnatal ultrasound images revealed abnormalities in the left testicle of the neonate and peripheral effusion with a 'double-ring' echo. The patient was considered to have congenital testicular torsion (with a high possibility of extravaginal type) and received an emergency treatment of left testicular torsion reduction combined with testicular fixation surgery and right testicular fixation surgery. Six months after surgery, reexamination by ultrasound showed the testicles of the newborn were normal.

Objective: The purpose is to explore the method and clinical effects of total nasal reconstruction with the assistance of three-dimensional (3D) scanning, 3D printing and monitoring the blood circulation after operation. Methods: 3D scanning: Artex Eva 3D scanner was used to record the nose data of 500 volunteers from Xuzhou Medical University and its affiliated hospital from September 2016 to February 2017. A nose database of normal individuals was established, of which male was 138 and female was 362. In addition, 3D facial scanning was performed in patients wish to total nasal reconstruction. 3D printing: The individualized nasal structure was designed, with the assistant of patients′facial characteristics, combined with the normal nose database and the opinion of the patients. Anactual nose model was used as guidance during the operation. Postoperative monitoring: The blood flow and the retraction rate of forehead flap after surgery were measured using Laser Doppler Flowmeter and Geomagic Qualify software. The blood flow values, the temperature and the surface area of the flap were recorded and analyzed. Results: The nasal database of normal people in the Huaihai region successfully established. Overall, the width of the nose takes up a quarter of the width of the faces, and the length is 1/3 of the distance from the hairline to the chin. From February 2017 to June 2018, 7 cases underwent total nasal reconstruction operations were performed by this procedure. The nasal models were all successfully printed out, as the guide of flap taken during the operation. The mean operation time of the cases was (2.45±0.75) h, and the follow-up time was 5-15 months, with an average of 12.5 months. After the operations, the retraction rate of the forehead flap were (21.8±2.72)% in one month, and (29.1±1.82)% in six months. All patients are satisfied with the nasal appearance. Conclusions Nasal reconstruction with forehead flap based on 3D scanning and 3D printing, provides objective targets for nasal fine-structure in a noninvasive way. The postoperative monitoring of the blood flow promotes the successful completion of the total nose reconstruction.

Objective To understand the level of nuclear radiation knowledge and attitude towards nuclear power plant construction among health emergency personnel around a nuclear facility, to enhance public awareness and education targeted at these individuals, to increase confidence in the safety of nuclear power plants, and to aid health emergency response work. Methods In September 2022, following the survey plan developed by National Institute for Radiological Protection, China CDC, a survey was conducted using a questionnaire designed by the institute. The survey was conducted by filling online questionnaire by 238 individuals engaged in health emergency gathered at their working units, including designated centers for disease control, hospitals, and township health clinics at the municipal, county, and township levels. The collected data were analyzed by SPSS 22.0 statistical software. The categorical data were statistically described by proportion and subjected to chi-square test. The continuous data were described by \begin{document}$\bar{x} \pm s$\end{document} and subjected to correlation analysis using multiple linear regression. Results A total of 225 valid questionnaires were collected. The scores were relatively high for professional and technical personnel of radiation health protection agencies, personnel with postgraduate degrees, and male personnel, and their scores were 10.83 ± 2.13, 12.4 ± 1.67, and 10.48 ± 2.8, respectively. Sex and education were the factors influencing the level of radiation knowledge (P < 0.05). Most of the respondents were very concerned and worried about the safety of nuclear power plants, supported the construction of nuclear power plants by the state but took a neutral attitude towards the construction of nuclear facilities in the local area, and showed high level of trust in the government and the authoritative media. Conclusion According to the characteristics of the health emergency personnel, different publicity and education methods and activities should be used to enhance understanding of radiation knowledge. The authoritative role of the government and the media should be emphasized to build confidence in the safety of nuclear power plants.

Objective To investigate the intervention effect of 1,25(OH)2D3 on serum level of parathyroid hormone,bone metabolic markers and muscle strength in the community elderly with low bone mass.Methods A total of 132 residents aged 60 years and over from Shanghai communities diagnosed as osteopenia or osteoporosis were enrolled and treated with 0.5 μg/d calcitriol for 3 months.Serum levels of parameters in blood biochemistry and bone metabolic markers were determined by Cobas Diagnosis System of Roche before and after treatment,and the handgrip strength of both left and right hands were measured at the same time.Results The average age of 132 patients was(66.1 ± 6.3) years,4 cases (all female) terminated their medication in advance,and 128 patients completed the treatment for three months.The baseline serum levels of 25 (OH)D and PTH were 19.6 ± 7.9 μg/L and 41.0 μg/L respectively.According to the median value of serum PTH before treatment,patients were divided into the two groups:the high PTH group and the low PTH group.Compared with the low PTH group,the serum levels of 25OHD and serum calcium were decreased in the high PTH group[(17.1 ± 7.0) μg/L vs.(22.1 ± 8.2) μg/L,2.4 mmol/L vs.2.5 mmol/L,P＜0.05].After 3 months of intervention,serum levels of creatinine,urine calcium and left handgrip were significantly elevated[(68.2 ± 13.8) μmol/L vs.(65.2 ± 13.4) μmol/L,(5.9 ± 2.8)mmol/24 h vs.(4.4 ± 2.0) mmol/24 h,23.8 kg vs.21.0 kg,all P ＜0.05],while serum levels of PTH,eGFR,phosphorus were significantly decreased[35.5 ng/L vs.42.0 ng/L,(87.0 ± 17.0) ml/min vs.(93.1±17.9) ml/min,1.2 mmol/L vs.1.3 mmol/L,all P＜0.05).There was a significant negative correlation between serum 25(OH)D and PTH before treatment(r=-0.312,P＜0.05),but the negative correlation between them was no longer significant after 3 months of treatment (r =0.042,P ＞ 0.05).A multivariate logistic regression analysis revealed that the increment of left handgrip strength greater than 25％ (OR =0.138,95％ CI:-0.002-8.383),the increment of serum calcium levels(OR =2.578,95％CI:1.0345-8.693)and age(OR =0.103,95％CI:0.035-0.345) were significantly correlated with the decrement of serum PTH levels greater than 30 ％ after three months of treatment.Conclusions Vitamin D diminution or deficiency is common in the elderly.The shortterm treatment of calcitriol can obviously reduce serum PTH,inhibit bone absorption and increase muscle strength.The effect of calcitriol on serum PTH is closely related to promoting calcium absorption and improving handgrip strength.

Objective To systematically evaluate the intervention effect of social psychological intervention on the health status of patients with bariatric surgery(BS).Methods 8 databases,including PubMed,PsycInfo,and Embase and Clinic Trials,were retrieved to recruit randomized controlled trials with computer from database establishing time to Sep.2022.Independent quality evaluation was conducted by 2 researchers,and Meta-analysis was performed by the RevMan5.3 software.Results Totally 23 RCTs were included.The meta-analysis showed that psychosocial interventions in BS patients improve emotional eating and binge eating behavior[SMD=-0.44,95％CI(-0.78,-0.09),P=0.010;MD=-5.88,95％CI(-8.65,-3.11),P＜0.001],promote better quality of life[SMD=0.30,95％CI(0.02,0.59),P=0.040]and physical mobility,alleviates anxiety and depression[SMD=-0.37,95％CI(-0.67,-0.08),P=0.010;SMD=-0.59,95％CI(-0.84,-0.33),P＜0.001].However,the effect on improving eating disorders[MD=-0.01,95％CI(-0.19,0.18),P=0.950]is not significant,and subgroup analysis results of different intervention measures and follow-up times showed that there was no statistically significant difference in weight changes between the social psychological intervention group and the control group.Conclusion Psychosocial intervention can effectively improve the mental state and eating behavior of the bariatric surgery patients,improve the quality of life and increase physical activity of patients.However,the effect of intervention on eating disorder and weight change is still unclear.More high-quality clinical studies need to be carried out for further verification.

Objective:To discuss the medication law in prescriptions of Professor Shao Nianfang in the treatment of kidney deficiency and bone marrow loss in senile dementia based on data mining.Methods:Medical cases of kidney deficiency and bone marrow loss in senile dementia in the Geriatric Hospital of Shandong University of Traditional Chinese Medicine from 1st Jan. 2014 to 31st Oct, 2019 were collected. Through hospital electronic medical records system prescription statistics, using ancient and modern medical case cloud platform (V1.2.4), medication frequency, property ans taste, efficacy analysis, correlation rule analysis, clustering analysis and complex network analysis were performed.Results:Totally 110 cases were included in medical cases, involving 238 kinds of Chinese materia medica. The top 10 Chinese materia medica with use frequency were Poria, Acori Tatarinowii Rhizoma, Corni Fructus, Dioscoreae Rhizoma, Rehmanniae Radix Praeparata, Alpiniae Oxyphyllae Fructus, Rehmanniae Radix, Astragali Radix, Chuanxiong Rhizoma, Atractylodis Macrocephalae Rhizoma; the properties were mainly mild, warm slight cold, and cold; the tastes were mainly sweet, bitter, pungent, and light; the meridians were mainly spleen, liver, lung and kidney meridians; the efficacy was clearing dampness and promoting diuresis, clearing heat and promoting blood circulation, calming mind, clearing heat and detoxification, reducing dampness and promote appetizing, tonifying spleen; the association analysis found 15 groups of drug combinations used more than 25 times, they were: Corni Fructus and Poria, Corni Fructus and Dioscoreae Rhizoma, Dioscoreae Rhizoma and Corni Fructus, Rehmanniae Radix Praeparata and Corni Fructus, Dioscoreae Rhizoma and Poria, Astragali Radix and Poria, Alismatis Rhizoma and Poria, Moutan Cortex and Poria, Rehmanniae Radix Praeparata and Poria, Rehmanniae Radix and Poria, Polygalae Radix and Acori Tatarinowii Rhizoma, Moutan Cortex and Corni Fructus, Moutan Cortex and Dioscoreae Rhizoma, Alismatis Rhizoma and Corni Fructus, Alismatis Rhizoma and Dioscoreae Rhizoma; clustering analysis identified four groups of new prescriptions, the first group: Poria, Rehmanniae Radix, Rehmanniae Radix Praeparata, Alismatis Rhizoma, Moutan Cortex, Corni Fructus, Dioscoreae Rhizoma; the second group: Acori Tatarinowii Rhizoma, Cistanches Herba, Morindae Officinalis Radix; the third group: Alpiniae Oxyphyllae Fructus, Chuanxiong Rhizoma, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle; the fourth group: Atractylodis Macrocephalae Rhizoma, Codonopsis Radix, Astragali Radix, Angelicae Sinensis Radix; the results of complex network analysis showed that the core prescription was modified Liuwei Dihuang Pills. Conclusion:This study found that in view of kidney deficiency and bone marrow loss in senile dementia, Professor Shao pays attention to strengthening the healthy qi, and focuses on tonifying deficiency, taking into account the methods of clearing dampness, clearing heat, detoxification, removing blood stasis and restoring consciousness. The four new prescriptions found in the study can provide a reference for modified medication for syndrome differentiation.

Objective To investigate the prevalence and risk factors of vertebral fractures in the elderlys in Shanghai community. Methods Stratified sampling was performed according to the age distribution of the population in 3 urban and 2 suburban communities in Shanghai, and a total of 2 929 old people aged over 65 years were enrolled. The thoracic and lumbar radiographs and questionnaires were obtained in all the participants. The diagnosis of vertebral fractures were evaluated using Genant′s semi-quantitative method, and the prevalence of vertebral fracture was calculated. Logistic regression was used to analyze the risk factors of vertebral fracture. Results ( 1) The prevalence of vertebral fractures in community-dwelling elderly was 14.4%totally,and 20.1%in individuals above 80 years old,which was significantly higher than the others (P<0.05). The prevalence of vertebral fractures in females was significantly higher than that in males (18.5%vs 12.4%, P<0.05). (2) The most common vertebral fracture sites were T12 and L1. Grade 1 vertebral fracture was most common in our cohort. The proportions of grade 2 and grade 3 were significant higher in females than that in males (30.6% vs 17.0%, P<0.05). (3) Gender and sex had an interaction effect on the prevalence of vertebral fractures. Prevalence of vertebral fractures increased steadily with age in both genders, although the gradient was steeper for women (P<0.001). (4) Logistic regression analysis showed that: female, age, parental hip fracture history, previous fracture history, and alcohol consumption were risk factors of vertebral fractures in community elderly. Smoking, long-term use of glucocorticoid, various diseases associated with secondary osteoporosis had no significant correlation with vertebral fracture. Conclusion The vertebral fractures were more common and serious in women than in men in community elderly. Age was significantly correlated with the presence of vertebral fracture in women than that in men. Female, age, parental hip fracture history, previous fracture history, and alcohol consumption were risk factors of vertebral fractures in community elderlys.