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.

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.

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 evaluate the scavenging efficacy of a novel scavenger in removing isoflurane.Methods Forty five patients undergoing abdominal surgery were enrolled and randomly divided into three groups.The Datex-ohmeda S/5 anesthetic machine was applied to provide general anesthesia with isoflurane in group A,Datex-ohmed Aestiva/5 in group B,and Drager RA2S in Group C.After 60 minutes,the gas samples were taken at the waste gas outlet,airtake and airout of stripe tubes of anesthetic machines by Philips intellivue MP60 Anesthesia monitor to identify the concentrations of isoflurane and PCO2 both before and after the application of the scavenger.Results The novel scavenger could completely eliminate waste anesthetic gases including isoflurane and CO2.Conclusion The eliminating rate is 100% and the air quality in operating room is improved apparently.

Objective · To explore whether stiffness parameter β could help carotid intima-media thickness (IMT) to predict ischemic stroke.Methods · Ninety-nine patients with acute ischemic stroke and transient ischemic attacks were retrospectively evaluated by routine ultrasound and divided into increased IMT group and normal IMT group. The normal IMT group cases were further divided into 30~ 39 years, 40 ~ 49 years, 50 ~ 59 years and ≥ 60 years groups, and were compared with healthy crowd respectively. Results · ① The common carotid artery wall β of both increased IMT group and normal IMT group were significantly higher than healthy crowd (each P=0.000). ② Further analysis showed that β of ≥ 60 years group were significantly higher than healthy crowd (left side P=0.047, right side P=0.007); while the difference was not found across younger age groups (30 ~ 39 years,40 ~ 49 years and 50 ~ 59 years). Conclusion · Stiffness parameter β may help carotid intima-media IMT to predict ischemic stroke in high risk subjects≥ 60 years old without morphology changes.

Objective To evaluate the effect of peer educatio n program by the application of the peer education on human immunodeficiency vir us/aeguired immune deficiency syndrome(HIV/AIDS) prevention and the analysis of the change on knowledge, attitude and behavior about HIV/AIDS among technical sc hool students in Shanghai. Methods Three technical schools in Shanghai were selected randomly. Two classes of each school were selected randomly as education group and the students added up to 284.Two hundred and sixty-one students of another 2 classes in each school were selected as the interior control group. Some freshmen came from medical un iversity were carefully trained as peer educators to conduct the education inclu ding 6 models. The same questionnaires were carried before and after the educati on in both groups. Results After peer education the score of average knowledge abo ut reproductive health, HIV/AIDS, STD was significantly higher than before (P 0.05). Conclusions The conduction of the peer education on HIV/AIDS pr evention among technical school students is effective in promoting the knowledge level,but the change of attitude and behavior is a long term. So we highly adv ocate that not only the health education for HIV/AIDS especially safe sex shall be given and strengthened among technical school students in order to promote t he notion of self-protection but also the conception of care others especially t he HIV/AIDS. J Appl Clin Pediatr,2005,20(2):167-169

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.

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.