Local policy innovation is a distinct feature in the arena of public administration in China. Previous researches concerned with local policy innovation experience and policy introduction, but they pay little attention to the failure of policy innovations and their termination. This paper uses the theory and concept of public policy process to analyze the reasons for the quick termination process and its mechanism taking healthcare policy as a case study in Chongqing city. It concludes that relative policy strategy is closed in decision-making. The strategy of some special policy target groups as well as the mutual agitation between public and media agenda are the main reasons for the rap-id end of policy innovation. This study is helpful to understand the factors and logic mechanism of the quick termina-tion of local policy innovation as a special type of public policy change which is termed as short-lived and make more scientific healthcare policy decision making and reform in China.

BACKGROUND: Learning memory disorder is one of the major manifestations of aging. The model of aging induced by D-galactose is a commonly used animal model in recent years, and long-term D-galactose exposure may cause nerve cell morphological changes in animals.OBJETCIVE: To observe spatial learning memory behavior during Dgalactose-induced aging process in order to further explore in vivo evoked long-term potentiation in hippocampus dentate gyrus and synaptic morphological changes in hippocampal CA3 region.DESIGN: Randomized controlled observation.SETTING: Anatomical Teaching and Research Secti , Shanghai Second Medical University; Department of Physiology, Shanghai Traditional Chinese Medicine University.MATERIALS: The experiment was carried out at the Physiological Laboratory of Shanghai Traditional Chinese Medicine University between August 2000 and April 2001. Totally 22 male Wistar rats of 3-month birth age were included and randomized into normal group and D-galactose group with 11 rats in each group. D-galactose was produced by Shanghai No. 2 Chemical Reagent Factory, Morris water maze was home-made by the Institute of Geriatrics, Shanghai Traditional Chinese Medicine university.METHODS: Rats were subjected to hypodermic injection of 1 mL normal saline every day in normal group, or D-galactose of 800 mg/kg daily for 6consecutive weeks in D-galactose group. Rat spatial learning memory behavior was assessed by the latency of Morris water maze; hippocampal dentate gyrus community potentials evoked by monopulse stimulation on perforating fibers were recordedin vivo; meanwhile, the amplitude of monopulse evoked potentials was determined before and after high frequency stimulation, with the amplitude before high frequency stimulation taken as baseline. Transmission electromicroscope was applied in combination with imaging analysis to observe synaptic morphology and structure in rat hippocampal CA3 region. Water labyrinth latency was compared using the variance analysis of repetitive survey design, t-test was used to compare the differences of peak potential latency of community potentials at various time points after long-term potentiation. Moreover, inducing rate of longterm potentiation was compared by χ2-test, XY-540 type biological imaging processing system was used to analyze electromicroscopic pictures, and all available data were analyzed with t-test.MAN OUTCOME MEASURES: [1] Main outcomes: Changes of Morris water maze latency, as well as inducing rate of long-term potentiation and community potentials. [2] Secondary outcomes: Synaptic morphological and structural changes in hippocampal CA3 region.RESULTS: Totally 22 rats were enrolled in this study, with no one lost during water labyrinth test, but one rat in both normal group and D-galactose group died during electrophysiological experiment. Finally 3 rats were randomly selected from each group for electromicroscopic observation. [1]Comparison of the latency for Morris water maze: In contrast with that of normal group, latency for seeking submarine platform was obviously prolonged in D-galactose group [(14.77±10.10), (51.36±12.45) s, P ＜ 0.05].[2] Comparison of evoked potential in hippocampus dentate before high frequency stimulation: The two groups did not obviously differ in community potential amplitude and community potential latency [(1.05±0.47),(0.91±0.41) mV; (5.46±2.09), (5.38±2.26) ms; P ＞ 0.05]. [3] Inducing rate of long-term potentiation in hippocampal dentate gyrus: Compared to that of normal group, inducing rate in D-galactose group obviously reduced after high frequency stimulation (80%, 20%, χ2=7.20, P ＜ 0.01). [4] Comparison of community potential ratio at different time points after high frequency stimulation: Compared to that of normal group, it was notably reduced in D-galactose group at post-stimulation 20, 30, 60 minutes, respectively (1.104±0.196, 0.919±0.162; 1.354±0.212, 0.999±0.219; 1.236±0.174,0.875±0.311; P ＜ 0.05). [5] Comparison of synaptic struc tural parameters in hippocampal CA3 region: Compared to that of normal group, postsynaptic dense bodies became thickened in hippocampal CA3 region of D-galactose group [(40.60±18.26), (26.35±8.15) nm, P ＜ 0.05], the synapse gap increased [(17.69±6.28), (26.95±5.67) nm, P ＜ 0.05] while synaptic active zone was shortened [(265.13±76.50), (229.13±90.68) nm, P ＜ 0.05].CONCLUSION: Hypodermic injection of D-galactose does harm to rat spatial learning memory by reducing the long-term potentiation, inducing rate in rat hippocampal dentate gyrus, attenuating the increase of long-term potentiation-evoked potential amplitude, and even remarkably changing the synaptic ultrastructure in rat hippocampal CA3 region. It suggests that Dgalactose inhibits the long-term potentiation at hippocampal dentate gyrus and affects synaptic structure in hippocampal CA3 region, which is considered as the basis of spatial learning memory behavioral disorder.

Objective To explore the transport properties of the radionuclide strontium 90Sr in the soil-plant system,and discuss the accumulation characteristics of strontiumes in different vegetable tissues.Methods Three kinds of vegetables,including Chinese cabbage,radish and celery,were planted in this experiments using stable nuclide 88Sr instead of 90Sr.Strontium concentrations in these kinds of plant and soil were measured with inductively coupled plasma atomic emission spectrometry (ICP-AES),and the transportation factor (TF) of strontium and the concentration ratio (CR) of these plants were calculated.Results The contents of strontium in different tissues of the vegetables increased significantly in response to the strontium concentrations in soil (F =3.75-139.39,P ＜ 0.05).The contents of strontium at 398.33,477.99 and 557.57 mg/kg in different tissues of these vegetables were significantly higher than that in control group (t =-10.49-7.41,P ＜0.05).Except celery stems,there was a positive correlation about contents of the strontium between other tissues of these vegetables and their experimental soils (r =0.88-0.99,t =7.41-15.96,P ＜0.05).Based on dry weight of examples,the TF in each tissue sample of cabbage and radish was higher than 1,and the concentration ratio,for cabbage and radish,was higher in stems than in roots (F =8.22,91.49,P ＜ 0.05).Conclusions Three kinds of vegetables have been shown to have strontium accumulation ability in soil environment.

Objective To explore the risk factors of chronic cough in children.Methods A hospital-based case-control study was conducted.A total of 60 children with chronic cough and 120 non-chronic cough children were interviewed with standard questionnaires.Non-conditional multivariable logistic model was performed to analyze the risk factors.Results Among 192 children that were performed questionnaire survey,180 cases were obtained the complete data with a questionnaire response rate of 93.75％.No significant difference in age,gender,and permanent residence was found between chronic cough and control groups,respectively (P ＞0.05).As shown in multivariable logistic model,parents with sensitive history (OR =1.924),mother or father smoking (mother:OR =1.989 ; father:OR =2.156),poor ventilation (OR =27.906),and interior decoration less than 3 months stay (OR =4.652) increased the risk of chronic cough in children.Conclusions Many factors,even the domestic environmental factors,are associated with chronic cough in children.It's time to strengthen the intervention of risk factors for reducing the occurrence of chronic cough in children.

The training of basic scientific research skills is very important for seven-year medical program students. Through various kinds of scientific research training in preclinical medical teaching stage, the students’ abilities of scientific thinking, performing experiments, and writing scientific papers have been improved.

OBJECTIVE:To investigate protective effects of different doses of atorvastatin pretreatment on non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients underwent percutaneous coronary intervention (PCI). METHODS:A total of 81 NSTE-ACS patients in a hospital during Jan. 2014-Apr. 2016 were divided into high-dose group(40 cases)and low dose group(41 cases)according to random number table. High-dose group was given Atorvastatin calcium tablet 80 mg 12-24 h before PCI,and then 40 mg 2 h before PCI. Low-dose group was given Atorvastatin calcium tablet 10 mg 12-24 h before PCI. Fractional flow reserve(FFR),coronary flow reserve(CFR)and index of microcirculation resistance(IMR)after surgery were all observed in 2 groups. The levels of creatine kinase(CK),creatine kinase myocardial band(CK-MB)and high sensitive C-re-active protein (hs-CRP) were compared between 2 groups before and after surgery. RESULTS:There was no statistical signifi-cance in FFR and CFR after surgery between 2 groups (P>0.05);IMR of high-dose group was significantly lower than low-dose group,with statistical significance(P<0.05). There was no statistical significance in CK,CK-MB or CRP between 2 groups before surgery(P>0.05). After surgery,the levels of CK-MB and CRP in low-dose group were significantly higher than high-dose group,with statistical significance(P<0.05). There was no statistical significance in CK level between 2 groups after surgery (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:During PCI,pre-treatment with high-dose of atorvastatin(80→40 mg)could effectively improve microcirculatory disturbance and inhibit inflammatory reaction of NSTE-ACS patients.

Objective To understand the utilization and satisfaction of Internet hospitals among residents in Guangdong Province,and to provide suggestions.Methods A questionnaire survey was conducted to analyze the use of Internet hospitals and the satisfaction among 601 residents in Guangdong Province.Results 69.88%of residents have used Internet hospitals,54.41%of residents used the Internet hospitals founded by large medical institutions,77.70%of residents used online registra-tion or payment services provided by Internet hospitals,and 60.23%of residents have used online consultation services,and 54.91%ofresidents have used information services about hospitals,doctors,and disease.In terms of detailed services,there was a low utilization rate of return visit and drug support of chronic diseases together with telemedicine,and no more than 20.00%of residents used the three services.75.20%of residents were very satisfied and relatively satisfied with Internet hospi-tals and their services,while residents were mainly dissatisfied with return visit and drug support of chronic diseases as well as telemedicine.Conclusion The utilization rate of Internet hospitals among residents was high,and their awareness and satisfac-tion were also high.However,there was still a problem of 15.31%ofresidents who didn't have used Internet hospitals.It is necessary to further strengthen the propaganda and improve the areas of dissatisfaction.Emphasis should be placed on return visit and drug support among patients with chronic diseases,and telemedicine to improve residents'satisfaction and utilization.

OBJECTIVETo summarize the clinical features of those Duchenne and Becker muscular dystrophy (DMD and BMD) patients who are complicated with epilepsy, and try to analyze the genotype- phenotype correlation.

METHODBy a retrospective analysis of 307 patients with DMD and BMD who attended Peking University First Hospital from February 2006 to September 2014,7 patients complicated with epilepsy were identified and their clinical data were collected. The possible mechanism of epilepsy in DMD and BMD patients was proposed after analyzing the genotype-phenotype correlation.

RESULT(1) Among 307 DMD and BMD patients, 7 cases had epilepsy, the prevalence was 2. 28%. (2) The age of onset of epilepsy ranged from 8 months to 11 years. Focal seizure was the most common seizure type (6 cases) , while other seizure types were also involved, such as generalized tonic-clonic seizure. As to epilepsy syndromes, 1 boy was diagnosed as benign childhood epilepsy with centrotemporal spikes (BECT). Six patients were treated with 1 or 2 types of antiepileptic drugs and seizures were controlled well. On follow-up, 6 of the 7 children had normal mental development, while the remaining 1 patient was diagnosed as mild mental retardation. (3) DMD gene mutations of all 7 patients were analyzed. Exons deletions were found in 6 cases while point mutation was found in 1 case.

CONCLUSIONThe prevalence of epilepsy in DMD and BMD patients was higher than the prevalence in normal population. The age of onset of epilepsy varies, and focal seizure may be the most common seizure type. Some patients may also present as some kind of epilepsy syndrome, such as BECT. In most patients, seizures can be controlled well by 1 or 2 types of antiepiletic drugs. No clear correlation was found between genotype and phenotype in DMD and BMD patients who were complicated with epilepsy, probably due to limited number of cases.

Anticonvulsants ; therapeutic use ; Child ; Epilepsy ; complications ; drug therapy ; epidemiology ; Exons ; Genotype ; Humans ; Intellectual Disability ; etiology ; Male ; Muscular Dystrophy, Duchenne ; complications ; genetics ; Mutation ; Phenotype ; Prevalence ; Retrospective Studies ; Seizures ; Sequence Deletion

Objective: To analyze the role of school based symptom monitoring system in public health emergencies in Hangzhou, to provide the basis for prevention and control strategies for public health emergencies in schools. Methods: Data regarding school public health emergencies in Hangzhou in 2019 were collected from the Public Health Emergencies Report Management Information System, and data regarding public health early warning in schools were collected from the Hangzhou School Symptom Monitoring System. The usage of school symptom monitoring system was analyzed by SAS 9.0 software, and the positive warning events and public health emergencies were compared and analyzed, the rate and composition ratio were compared with the χ 2 test, the number of cases was compared with the non parameter rank and the Mann Whitney test, and the trend test was conducted using Cochran Armitage test. Results: In 2019, the average use rate of the city s school symptom monitoring system was 54.65%, the average response rate of automatic early warning was 70.68%, and the use rate (χ 2=860.79, p<0.01) and automatic early warning response rate (χ 2=1 615.91，P<0.01) of school systems varied greatly by region. In 2019, 161 positive early warning incidents were detected through the school symptom monitoring system, 197 public health emergencies were reported through the emergency network, and fewer public health emergencies were reported in areas where more positive warning events were detected(Z=10.65，P<0.01). The proportion of disease category in positive warning events was different from that in public health emergencies in(χ 2=28.33, P<0.01). The number of cases of positive early warning events of the same disease was much lower than the number of cases of public health emergencies without warning, and the time of positive warning signals was on average 4 days ahead of the time of receiving the report of public health emergencies. Conclusion Smartphone based school symptom monitoring system in Hangzhou plays a sentinel role in public health emergencies prevention and control in schools.

Objective: To explore the association between Vitamin A, E and mycoplasma pneumoniae pneumonia in children. Methods: 153 children with mycoplasma pneumoniae pneumonia and 653 health children were selected as cases and controls, respectively. Propensity score matching (PSM) analysis were conducted to reducing confounding bias between groups. Blood samples were collected to test serum levels of vitamin A and E using high performance liquid chromatography (HPLC). Logistic regression was implemented to determine odds ratios (OR) and 95% confidence intervals (CI) for evaluating the association of mycoplasma pneumoniae pneumonia with the serum levels of Vitamin A and E. Results: After propensity score matching, the study cohort included 153 cases with mycoplasma pneumoniae pneumonia and 306 health children as controls. Before matching, with age and gender adjusted, logistic regression analysis indicated that higher serum levels of Vitamin A and E led to a lower risk of mycoplasma pneumoniae pneumonia (OR=0.075, 95% CI: 0.007-0.815; OR=0.854, 95% CI: 0.792-0.986). After matching, higher serum level of Vitamin E had a significantly lower risk of mycoplasma pneumoniae pneumonia (OR=0.877, 95% CI: 0.810-0.950). Conclusions The serum levels of Vitamin A didn't have a statistically significant association with mycoplasma pneumoniae pneumonia. However, we observed an obvious association between Vitamin E and mycoplasma pneumoniae pneumonia. Hence Vitamin E clinical monitoring and supplementation are vital for preventing and treating mycoplasma pneumoniae pneumonia.