Objective To explore the competency of community health administrators in a survey of such administrators at large in Shanghai. Methods McClelland's Competency Dictionary was used to set two benchmark positions, while the behavioral event interviewing and questionnaires were made to survey 19 community health service centers in Shanghai. Results The competency model benchmarking on the head of a medical branch consists of 6 character clusters, 11 characteristic items, 27 evaluation dimensions and 27 typical behavior descriptions. The model benchmarking on the community team leader consists of 5 character clusters, 8 characteristic items, 21 evaluation dimensions and 21 typical behavior descriptions. Conclusion Findings of the survey provide objective criteria for competence appraisal of community health administrators, and serve as reference for formulating their development plans as well.

Objective To investigate the therapeutic effects of traditional Chinese medicinal herbs(TCMH) on benign prostate hyperplasia(BPH) and their influence on proliferation and apoptosis of prostate cells in experimental mice. Methods A total of 120 male Kunming mice(weight,30 to 40 g)were randomly divided into 5 groups:①normal control group;②hyperplastic group;③normal saline(NS)(negative control)group;④TCMH group;⑤finasteride (positive control) group.Each group included 24 mice.The mice in normal control group were killed and their prostates were weighed.The BPH model was induced by implanting the urogenital sinus in the mice in other 4 groups.In the 61st day,the prostate weight of the mice in hyperplastic group was examined after they were killed;and the mice in the remaining groups were fed with NS,TCMH and finasteride,respectively.In the 91st day,the mice in these 3 groups were killed and their prostates were weighed.The proliferation and apoptosis of the prostate cells of mice in the 3 groups were determined by flow cytometry(FCM). Results The prostates in hyperplastic group [(149.30?8.46)mg] were heavier than those in TCMH group [(85.60?17.97)mg] ( P 0.05). Conclusions The TCMH has a significant therapeutic effects on experimental mice with BPH.The mechanisms may be as follows:TCMH can regulate the relevant genes of the prostate cells so that they can promote the apoptosis of the prostate cells and as a result,the volume and weight of the prostate of the mice are reduced.

Objective To discuss the maximum tolerated dose of oxaliplatin based on 5-fluorouracil derivative in patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy.Methods From Mar 2015 to Oct 2015,15 locally advanced rectal cancer patients (T3,T4/N +) who received intensity modulated radiotherapy and concurrent chemotherapy with capecitabine and oxaliplatin were enrolled in this study.The prescription dose was 50.6 Gy for gross tumor volume(GTV) and 41.8 Gy for clinical tumor volume(CTV) in 22 fractions within 30 d with concomitant boost.There were four dose-level groups of oxaliplatin as 100,110,120 and 130 mg/m2 tri-weekly and fixed capecitabine dose (825 mg/m2 bid d1-5 per week).The first 12 patients were randomly assigned into 4 groups.For the 130 mg/m3 group,another 3 patients were enrolled because of dose-limiting toxicity (DLT).Treatment related toxicities and response rates were evaluated.Results The most common adverse events(AE) were radiation enteritis,skin reactions,nausea,fatigue,urinary system AE and bone marrow suppression.There was a trend of increase by the dose level of oxaliplatin for toxicities.Groups 100,110 and 120 mg/m2 had none DLT,while group 130 mg/m2 had 1 patient for grade 3 thrombopenia and 1 patient for grade 3 nausea.Postoperative pathology showed that all patients achieved tumor downstaging,among which 0,1,2,3 cases achieved complete remission of the four groups,respectively.Conclusions The combination regimen of capecitabine and oxaliplatin is safe and effective according to the preliminary results.The maximum tolerated dose of oxaliplatin was 130 mg/m2 tri-weekly.

Objective To revise the Chinese version of the National Institutes of Health-Chronic Prostatitis Symptom Index (CHN-NIH-CPSD), and evaluate its feasibility, reliability, validity and responsiveness. Methods The NIH-CPSI was translated into Chinese according to a standard methodology including forward-backward-forward technique. The CHN-NIH-CPSI was pre-tested in consecutive samples of 162 native-speaking Chinese chronic prostatitis(CP)patients. Ninety-five of 162 filled the index again on the same day and after 4-week therapy. Ninety-seven healthy men were included as evaluated. Results The recovery of the questionnaires was 100% and all the patients filled the index completely. The mean time to complete the questionnaire for the patient group was 5.2±2.4 (range 2 - 12) min. The split-half reliability was 0.82. For the overall index and each subscale, the test-retest reliability was 0.98, 0. 98, 0. 98, 0. 97, respectively(P＜0.01);and the Cronbach's α coefficient was 0. 61,0. 71, 0. 59, 0. 75, respectively. The confirmatory factor analysis showed good construct validity with a goodness of fit index of 0. 85 and a x2 of 124.67(P＜0. 01). Of all 162 patients, the scores of the overall index and each subscale were 23. 33±5.91. 8. 80±4.26, 5.30±2.82, 9. 23±1.90, respectively;and those of healthy controls were 1. 95±1.97, 0. 37±1.03, 0. 15±0.58, 1.42± 1.20,respectively. Of the 95 patients, the original scores were 23. 53±5.60, 9.21 ±4.04, 5.10±2.75,9.21 ±2.05, comparing with 19.47±6.36, 7.79±3.95, 3. 58±1.88, 8.11±2.50, the 4 weeks later scores. The group t-test and paired t-test showed good responsiveness. Conclusions The CHN-NIH-CPSI has high feasibility, reliability, validity and responsiveness for testing the patients with CP. It is suitable for Chinese-speaking patients and helpful for cross-cultural comparisons of men with CP in clinical and research settings.

BACKGROUND:Disc functional magnetic resonance imaging studies are mostly carried out under lying and a non-load state, and do not reflect the changes in morphology and function of the upright human body under disc load conditions. Therefore, we need to study characteristics of disc functional magnetic resonance imaging in the upright state. OBJECTIVE: To analyze the effect of axial load on apparent diffusion coefficient and T2 of intervertebral discs. METHODS:The study consisted of 17 patients with low back pain aged 34-65 years. Before and after axial load, T2 weighted MR imaging, T1 weighted MR imaging, diffusion tensor imaging, and T2-mapping imaging of the lumbar spine were performed. Load quality was 40%-50% body weight. At 10 minutes after axial load, another diffusion tensor imaging was performed. After 15-minute load, another T2-mapping sequence was scanned. Diffusion tensor imaging scan parameters: single echo-planar imaging, repetition time 2 500 ms, echo time 89 ms, six diffusion directions, b value of 400 s/mm2, sweep time 4:10 minutes. Raw data of diffusion tensor imaging were used to construct apparent diffusion coefficient map and b0 map. Apparent diffusion coefficient value of intervertebral discs was calculated before and after loading. T2 map was automaticaly constructed using T2-mapping sequence to measure apparent diffusion coefficient and T2 values in the whole intervertebral disc of nucleus pulposus, and the changes of them were analyzed under short-time axial load. RESULTS AND CONCLUSION:Pfirrmann grading results in 17 patients with 85 discs were obtained as folows: 0 in Grade I, 26 in Grade II, 19 in Grade III, 30 in Grade IV, and 10 in Grade V. Al 85 disc T2 relaxation time mapping and 84 disc apparent diffusion coefficient mapping were accepted. Under short-time axial load in 84 discs, apparent diffusion coefficient reduced in the whole disc (reduced 38×10-3 mm2/s,Z=2.567,P < 0.05) and nucleus pulposus (reduced 62×10-3mm2/s,Z=3.461,P < 0.05). Apparent diffusion coefficient changes mainly affected Grade Pfirrmann III discs (reduced 55×10-3mm2/s,Z=2.556,P < 0.05). T2 changes mainly affected normal intervertebral discs (Pfirrmann grade II). Under the load, T2 value of intervertebral discs diminished (reduced 3.17 ms,Z=2.967,P < 0.05). No significant difference in apparent diffusion coefficient and T2 value was detected under the load in other grades of the intervertebral discs (P > 0.05). These results suggest that changes in apparent diffusion coefficient and T2 values were different due to different Pfirrmann grades under short-time axial load. To evaluate magnetic resonance imaging function of intervertebral discs, we should choose different evaluation method according to different degeneration degrees.

Objective To investigate the difference in the pass rate of intensity?modulated radiation therapy ( IMRT) planning in patients with different tumors and its value in determining pass rate thresholds. Methods A total of 35 verified IMRT plans for each of esophageal cancer, nasopharyngeal carcinoma, breast cancer, cervical cancer, and lung cancer were selected consecutively, and a one?way analysis of variance was used to investigate the difference in pass rate. A single pass rate threshold was used to test all IMRT plans, and the pass rate thresholds of IMRT plans for different tumors were calculated based on normal distribution law. Results There was a significant difference in the means between the 5 groups of data ( F=35. 83, P<0. 01) , and there was also a significant difference between any two groups ( P=0. 000) . There were statistically significant differences between nasopharyngeal carcinoma group and other four groups ( P=0. 000) . The difference was not only significant between the breast cancer group and the esophageal cancer group ( P=0. 001) , but also between the breast cancer group and the lung cancer group ( P=0. 033) . The calculated results of each threshold were 93. 37%, 89. 34%, 97. 68%, 95. 99%, and 95. 42%, respectively. Conclusions Different thresholds should be used for IMRT plans for different tumors, and the normal distribution law can be used to calculate the threshold.

Objective To evaluate the therapeutic effect,prognostic factors and the methods to improve long term survival of liver resection for hepatic metastases of colorectal cancer.Methods 52 patients operated on for hepatic metastases from colorectal cancer were followed up,and the clinical and pathologic data of 11 (cases),who survived more than 5 years,were compared with 41 survivors of less than 5 years after hepatic (resection).Results The 1-,3-and 5-year survival rate was 75.0%,30.8%,and 21.2%,(respectively).The important factors affecting prognosis were pathologic type of the primary cancer,(number) of (hepatic) metastasis,selection of the methods and timing of surgery,and postoperative treatment(P

Objective To investigate the curative effect and safety of microinvasive percutaneous nephrolithotomy (MPCNL) and ureteroscope lithotripsy (URSL) in treatment of children′s (≤6 years old) middle and upper segment ureteral calculi. Methods Eighty children (≤6 years old) with middle and upper segment ureteral calculi were selected, and they were divided into observation group and control group according to random number table method with 40 cases each. The children of observation group were treated with MPCNL, and the children of control group were treated with URSL. The operation time, hospitalization time, calculi clearance rate of the first phase, decline situation of the postoperative hemoglobin and hematocrit and complication were compared between 2 groups. Results The operation time and hospitalization time in observation group were significantly shorter than those in control group:(45.43 ± 9.76) min vs. (68.32 ± 11.28) min and (8.12 ± 1.03) d vs. (13.45 ± 2.34) d, the calculi clearance rate of the first phase was significantly higher than that in control group: 100.0% (40/40) vs. 62.5%(25/40), the incidence of complication was significantly lower than that in control group:20.0%(8/40) vs. 60.0% (24/40), and there were statistical differences (P<0.05). There were no statistical differences in the decline situation of the postoperative hemoglobin and hematocrit between 2 groups (P>0.05). Conclusions The MPCNL in treatment of children′s middle and upper segment ureteral calculi has short operation time, high calculi clearance rate of the first phase, and low incidence of perioperative complication. Compared with URSL, the URSL is safe and efficient, and it is worthy of clinical application.

Studies show the waste anesthetic gas is harmful to the person working in operating room.At present,there are some problems in traditional scavengers and the gas absorber.This paper introduces a novel scavenger forwaste anesthetic gas which makes use of atmospheric pressure and negative pressure in operating room.This setting can scavenge the exhaust gas absolutely without affection the normal work of anaesthesia apparatus.

Objective To explore the effect and action principle of extracorpoporeal shock wave(ESW) combine hyperbaric oxygen(HBO) in bone nonunion treatment .Methods Totally 50 standard New Zealand white rabbits were chosen ,and 48 rabbits were successfully made to models .Then ,they were divided into four groups by using the random number table ,12 in each group . The group A was in ESW combine HBO group ;The group B was in hyperbaric oxygen group ;The group C was in pure ESW group ;The group D was in control group .X‐ray inspected before treatment and after treatment in 4 、8 、12 weeks .The calcium con‐tent was checked ,the osteoblast in bone callus was observed by the optical microscope ,and the data was analyzed by statistics .Re‐sults There was a significant difference in 4 ,8 ,12 weeks between group A and group B ,C ,D in the nonunion gap(P< 0 .05) ,there was significant difference in 4 ,8 ,12 weeks between group A and group B ,C ,D in the generation bone callus(P< 0 .05) .Callus calci‐um content of group A was higher than group C ,the difference was statistical significance(P< 0 .05) ,there was significant differ‐ence in 4 ,8 weeks between group A and group C in callus osteoblast count(P < 0 .05) .Conclusion ESW combine HBO treatment for bone nonunion is better than pure ESW therapy ,simple hyperbaric therapy has no obvious help for the treatment of bone nonun‐ion ,HBO can be used as a good synergy method in the extracorporeal shock wave treatment of bone nonunion .