Questionnaire survey(n=147)and group interview(n=13)were used for this investigation.Our results showed that 66.7%of participants considered"heavy work burden and insufficient specialists"to be the main challenge.Half of comingnity healthcare providers were not satisfied with thepayment systerm.We suggest that the overall-consideration of community healthcare service development in urban and suburb areas and 4 kinds of performance pattems should be strengthened:the perfommnce appraisal and quality control schemes should be modified;and the employee headcount in community healthcare centers or transferred employees'salary should be moderately increased in the fumre.

BACKGROUND: Precise clinical treatment of talar ischemic necrosis remains controversial at present.OBJECTIVE: To observe the changes in the stress and its distribution on talar trochlear articular surface in case of talar necrosis at different levels.METHODS: The present study adopted eight ankle specimens to establish the three-dimensional finite element model of ankle. Through changes in the talar necrosis volume of these models, this study analyzed the change law of talar trochlear articular surface stress and its distribution and calculated the critical necrosis volume of traumatic foot and ankle arthritis or talar collapse that may be induced by talar ischemic necrosis.RESULTS AND CONCLUSION: The experiment successfully established the three-dimensional finite element model of ankle. This study found that talar trochlear articular surface stress distribution showed little change in case of talar medial and lateral necrosis at a lower level; when medial talar necrosis volume reached (26.6±1.5)%, and lateral talar necrosis volume reached (35.0±2.5)%. Stress concentration phenomenon occurred in the boundary area between talar necrosis tissue and normal osseous tissue, and the stress area took the shape of irregular pattern. It is suggested that surgical treatment should be considered due to the high-risk induction of ankle-foot traumatic arthritis or talar collapse.

Adolescent ; Adult ; Female ; Humans ; Male ; Maxillary Fractures ; diagnostic imaging ; Middle Aged ; Nasolacrimal Duct ; injuries ; Tomography, Spiral Computed ; Young Adult

Objective To develop a suit of wireless real-time monitoring system for athletes which can gather,transmit and deal with athlete's vital bio-signals when they are training or healing,such as cardiograph,respiration,body temperature and SpO2.Methods The system consisted of monitoring terminal and data management module.The monitoring terminal schlepped by athletes consisted of data acquisition module and wireless transceiver module.It can gather and transmit physiological parameters.The data management module consisted of wireless transceiver module and embedded computer System.It can receive,deal with and display athlete's physiological parameters.Results The system met the requirement when it was located within the outdoor distance of 400 m or indoor distance of 50 m.Conclusion The system can monitor athlete's multiple physiological parameters whatever exercises the athlete is doing.It also adapts to healthy population when they are doing physical fitness exercises.

AIM: To establish a quantitative analytical method of ferulic acid in Kexintong Dripping Pills (Moschus, Rhizoma Chuaxiong, Rhizoma Corydalis, etc.) based on the capillary zone electrophoresis. METHODS: P-Nitrobenzoic acid was adopted as the internal substauce with a 30 mmol?L -1 borax solution at equal electrophoresis current of 50 ?A, detection wavelength at 295 nm, uncoated fused silica capillary of 75 ?m?50 cm, temperature at 20 ℃. Sample was injected for 5 s at pressure of 20PSI. RESULTS: Good linearity was showed in the concentration range of 4～264 mg?L -1 , RSD was 1.71%(n=6), and the recovery was 100.47%?2.1%. CONCLUSION: The result indicates the proposed method is convenient, rapid, accurate and reliable, it is a proper method for the quantitative analysis of ferulic acid in Kexintong Dripping Pills.

Objective To summarize the experience of the trans-unilateral nasal and sphenoidal approach to pituitary denomas.Methods 20 cases of pituitary adenomas were removed by the trans-unilateral nasal and sphenoid approach under operating microscope,of which there were 2 microadenoma patients,16 macroadenoma patients;2 giant pituitary adenoma patients.Results Of all the 20 patients,12 had total resection of tumor;4 had subtotal resection of tumor and 4 had part resection of tumor.All cases showed improvement.After the operation,3 had diabetes insipidus and 2 had CSF rhinorrhea,which had been cured by the time they left the hospital.Conclusion this method is minimally invasive with short operative distance,time and fewer complications.

Objective To evaluate the clinical value of low field strength MRI in judging the invasion of myometrium of endometrial carcinoma in staging Ⅰ.Methods 32 cases with endometrial carcinoma approved to be clinical staging Ⅰ pathologically were evaluated by MRI before operation.The staging results of MRI were compared with pathologic results and analysed with statistic methods.Results According to 1988 FIGO staging the staging of the lesions was further carried out,including stage Ⅰa in 6,stage Ⅰb in 18 and stage Ⅰc in 8 cases.Compared with pathologic results,the sensitivity and specificity of MR in evaluating myometium invasion were 92% and 83% respectively,the staging accurate rate was 78%.Conclusion The endometrial carcinoma stage Ⅰ can be staged further by low field strength MRI,MRI has significant advantage in estimating the invasion of myometrium.

0.05).After treatment,in neuromus- cular electric stimulation therapy group and ice-massage therapy group,SSA scores and degrade of SaO_2 were improved. There was significant difference between before and after treatment(P

Objective To investigate the anatomic characteristics of the nasolabial fold and to give an accurate description and definition of it in order to to provide theoretical basis for plastic, cosmetic and maxillofacial surgery. Methods Ten (20 sides) adult fresh bodies with vascular perfusion of formalin fixed after morphological observation under a 10 × magnifying len. Results Nasolabial fold was a border between fat-rich zone and non-fat zone in the midfacial region. The nasolabial fold derived from nasal alar skin point in the transverse portion of nasalis, and ended at the outer skin point of zygomaticus major muscle in the mouth. From the anatomy point of view, the nasolabial fold was divided into three segments: the upper, the middle and the under. The upper segment ( Ⅰ ) was the transverse portion of nasalis, (20. 38± 0. 74) mm in length; the middle section ( Ⅱ ): levator labii superioris,(17.13 ± 0.57) mm in length; the under segment (Ⅲ ): modiolus, (20. 81 ±0. 70) mm in length. The nasolabial fold was a connecting region where seven mimetic muscles inserted into the skin point. Superficial musculoapneurotic system (SMAS) and the nasolabial fold were composed of seven mimetic muscles belonging to the same layer. Conclusions The nasolabial fold is a region where the seven mimetic muscles insert into the skin point for connection, and regardless of age, it is an eternal existence. The nasolabial fold is different from the nasolabial wrinkle formed with facial aging and the nasolabial ridges formed by facial mimetic muscles changes.

Objective To establish the theoretical basis of the probiotic application among very low birth weight(VLBW) infants,the efficacy of probiotics on the gut microbiota of VLBW infants on the 14th postnatal day was studied.Method The VLBW infants admitted to BaoAn Maternal and Child Care Hospital from January 2015 to December 2015 were randomly assigned into probiotics group and placebo group.From the first feeding to corrected gestational age of 36 weeks,probiotics group was treated with a combination of Bifidobacterium and Lactobacillus while placebo group with placebo.Fecal samples were collected on the 1st and 14th postnatal day.Total bacterial DNA was extracted and sequenced using high-throughput 16S rRNA gene sequencing on MiSeq sequencing platform.Result A total of 21 VLBW infants were enrolled,9 in probiotics group and other 12 placebo group.No significant differences of clinical data existed between the two group (P ＞ 0.05),The abundance and diversity of microflora (P ＞ 0.05) on the first day between the two group were similar.Compared with placebo group,the relative abundance of Bifidobacterium and Lactobacillales in stool samples on the 14th day was significantly increased,while the Halomonas was significantly decreased.The relative abundance of the Shannon-index was increased,but without significant difference (P =0.16).Conclusion Enteral supplementation of probiotics in VLBW infants may increase probiotic bacterium and microflora diversity.