We studied policies of traditional Chinese medicine (TCM) on four levels ( national,Shanghai city, Pudong New District and community health services (CHS)) from 2008 to 2009 with the method of literature review,questionnaire survey and group interview. 18 national, 5 Shanghai's, 4 Pudong New District's and 87 CHS' TCM related policies were identified. By defining the development target,financial capability, human resource and proper technology of TCM care, those policies ensured and prompted the progression of community TCM services. Yet TCM policy fulfill in community remained lagged,and talent cultivating, medical insurance support and TCM participating in public health needed to be improved.

Objective To investigate the applieation of restriction display (RD) technique in the preparation of HCV probes of clinical genotyping microarray. Methods Restriction enzyme Sau3A Ⅰwas chosen to digest the full-length HCV cDNAs of three distinct subtypes, i.e.1a, 1b and 2a. The resultant restrictive fragments were then ligated with universal adapters. PCR primers were designed to match the universal adapters but with one "nesting" base overhanging at the 3′- end. The PCR reactions were performed by ten pairs of different primer combinations. The differential genes were separated through polyacrylamide gel electrophoresis and silver staining. The second-round PCR was performed using the isolated bands as PCR templates. The purified PCR products were then cloned into T-vectors. The recombinant plasmids were extracted from positive recombinant clones and the target gene fragments were sequenced. Results The target HCV gene fragments ranging from 200 to 900bp were isolated and sequenced, which were correlated precisely with the RFLP (Restriction Fragment Length Polymorphism) prediction. A total of 66 different fragments were obtained, averaging about 22 for each subtypes. These fragments could be further used as probes in HCV microarray preparations. Conclusion RD technique is of great value in obtaining a large number of equal sized gene probes, which provide a swift protocol in generating DNA probes for the preparation of microarrays.

[Objective]To observe the changes of contact characteristics of the subtalar joint after calcaneus fracture in load condition, so as to provid a theoretical basis for its clinical treatment.[Method]Six fresh speciments consisting of foots and lower legs were harvested.A specimen,including an intact foot and 15~20cm of the distal tibia and fibula prepared by removing the skin,muscle and tendons down to the level of the hindfoot and the ligaments and joint capsules were kept intact with the exception of the posterior aspect of the posterior facet and the lateralaspect of middle and anterior facets of the talocalcaneal joint.The pressure sensitive film was inserted into the posterior and anterior-middle facets of the talocalcaneal articulation,and 500-N load was applied in the neutral position.After testing of the intact foot,the calcaneus was splited into anterointernal and posterolateral compoments using microoscillating saw to simulate primary fracture of calcaneus.The test was repeated after tile posterolateral fragment was anatomically reduced and displaced 2mm,5mm and 10mm respectively in a planter direction.The changes of contact characteristics of the subtalar joint ware recorded.[Result]The average pressure area of the intact posterior facet was(275.67?46.02) mm~2,the average stress to bear the weight was(1.83?0.56) MPa.The bearing average pressure area decreased to(167.67?25.09) mm~2 when the posterolateral compoment was displaced to plantar in 2 mm,it was significantly lower(P0.05).The bearing stress the anterior and middle facets significant increased only in a 1 10mm plantar displacement of the posterolateral component(P

Objective:To evaluate diagnostic sensitivity of electroneurography(ENoG) for facial neurotmesis.Methods:The data of 24 patients suffering from facial neuratmesis on one side,having non-emergency operation,and having preoperative records of ENoG were collected.Among the patients,18 were men and 6 were women,aged from 3 to 55 years(median 28).The duration of injury before ENoG examination was from 1 to 56 days(mean 23.6 days) for them.The electroneurographic examination was carried out for facial nerves on both sides preoperatively.Percentages of evoked potential amplitude reduction on affected sides were calculated according to the value of normal side.The 90% reduction of amplitude was used as a cutting point.The facial neuratmesis was observed during operation.The sensitivity and false negative proportions of ENoG were analyzed.Results:Among the 24 patients with facial neurotmesis,22 had ENoG amplitude reduction over 90%,and 2 having this reduction less than 90%.The sensitivity and false negative proportions of ENoG in patients with facial neurotmesis were 91.7% and 8.3% respectively.Conclusion:The preoperative ENoG examination is high sensitivity for facial neurotmesis.The patients whose ENoG reduction over 90% should be advised to have a facial neurorrhaphy as soon as possible.

Objective To evaluate the effect of clinical nursing pathway in emergency treatment of for-eign body in respiratory tract of children. Methods Retrospective analysis was carried out in 555 children with foreign body in respiratory tract from February 2005 to December 2007, who were divided into the control group (271 cases) and the experimental group (284 cases). The experimental group was given managed with standardized clinical pathway,the control group received routine management. The preoperative preparation time, average hospital stay, cost of hospitalization, the extent of mastering of health knowledge by patients'par-ents were observed and the data underwent χ2 and t test. Results All patients of the two groups were cured and no nursing complications happened.The mean preoperative preparation time of the experimental group was 10 hours, which was shorter than that of the control group(27 hours). The average length of hospital stay of the experimental group was (4.13 + 0.81)days, which was shorter than that of the control group ,(6.03 + 1.30) days.The average hospitalization cost of the experimental group was (3498.55 + 269.13) yuan, while the control group was(4246.40 + 977.10) yuan. The extent of mastering of health knowledge by patients' parents, including basic knowledge of the disease, preoperative cooperation knowledge,prevention knowledge and diet knowledge, was superior to that of the control group. Conchusions The establishment of clinical pathway of children with foreign body is conducive to the standardized treatment of the disease, it can shorten the preoperative prepara-tion time, improve the capability of emergency treatment, shorten the length of hospital stay, reducing hospital-ization costs, increase the extent of mastering of health knowledge by patients and their families.

Objective To investigate the association of promoter hypermethylation of secreted frizzled-related proteins (SFRPs) in patients with colorectal cancer. Methods The promoter hypermethylation of SFRPs in 20 sporadic colorectal cancer tissues and adjacent mucosa were detected by methylation-specific PCR. The amplified DNA was subcloned into the T-A cloning vector and sequenced. Two colorectal cancer cell lines (HCT116 and SW480) were treated with 5-aza-2' deoxycytidine for demethylation. The promoter hypermethylation and protein expression of SFRPs in colorectal cancer cell lines were detected by methylation-specific PCR and Western blotting. Results It was demonstrated that the hypermethylation of SFRP 1, 2, 4 or 5 was 19/20,17/20,3/20 or 13/20in cancer tissues, respectively, whereas it was 12/20, 8/12, 1/20 or 7/20 in adjacent mucosa,respectively. SFRP 1, 2 or 5 methylation was more frequently found in cancer tissue than in adjacent mucosa (P～0.05). Methylation of SFRP 1, 2, 4 and 5 were found in HCT116 cell line, but only SFRP1 and SFRP2 were found in SW480 cell line. There was a negative correlation between protein expression and methylation of SFRPs. The Western blotting revealed that SFRP protein re-expressedafter it treated with 5-aza-2' deoxyeytidine. Conclusion Methylation of SFRP 1, 2 or 5 gene is associated with the evolution of eolorectal cancer, and is closely related to silencing expression.

OBJECTIVETo investigate the characteristics of exposure to iron oxide nanoparticles in workplace.

METHODSThe real-time particle number (NC), surface area (SAC), and mass (MC) concentrations of nanoparticles were measured in various locations of a selected workplace manufacturing iron oxide nanoparticles. The collected particles were analyzed for morphology and elemental composition.

RESULTSThe average NCs and SACs in milling site (16,566 pt/cm3, 106.082 µm2/cm3), packaging site (12,386 pt/cm3, 89.861 µm2/cm3), shipping site (13,808 pt/cm3, 102.071 µm2/cm3), and product storage room (17,192 pt/cm, 115.044 µm2/cm3) of the yellow powder (α-Fe2O3 . nH2O) were all significantly higher than the workplace background concentrations (11,420 pt/cm3, 85.026 µm2/cm3) (all P<0.05). The NC was highly correlated with the SAC (r= 0.784), while both NC and SAC were loosely correlated with the MC (r1=0.323, r2=0.331). Scanning electron microscopy revealed a spindle-like shape of the iron oxide nanoparticle; the chemical composition of the collected particles contained 19.33 weight percent iron (Fe).

CONCLUSIONThe milling site and product storage room of the yellow powder are exposed to a higher concentration of nanoparticles, which are mainly composed of iron oxide nanoparticles. The NC is highly correlated with the SAC.

OBJECTIVE To prove the diagnosis value for Legionnaires pneumophial pneumonia using polymerase chain reaction. METHODS L. pneumophial-DNA (LPN-DNA) from 47 spuum and 6 bronchoalveolar lavage fluid samples collected from 53 patients with atypical pneumonia was detected by PCR. RESULTS The positive rate of LPN-DNA in 53 patients with atypical pneumonia was 9.4%, while the positive rate of sputum and bronchoalveolar lavage fluid samples was 6.4%and 33.3%, respectively. CONCLUSIONS LPN-DNA detected by PCR for early diagnosis of atypical pneumonia has favorable clinical application.

Objective·To explore effects of pCPT-cAMP on proteinuria and dedifferentiation of podocytes in adriamycin (ADR)-induced nephropathy mice. Methods·Male BALB/c mice were divided into three groups. The control group did not make any intervention, and the other mice were administrated with ADR in a dose of 10 mg/kg by intravenous injection (ADR group). Some ADR-injected mice were treated with pCPT-cAMP [50 mg/(kg·d)] by intraperitoneal injection everyday (A+P group). Albumin urine was detected by Coomassie blue stain. Urine creatinine concentration was estimated by ELISA. The expression of WT-1 was detected by immunohistochemical staining. Immunofluorescence staining and Western blotting were used to evulate the dedifferentiation of podocytes. Results·Compared with the control group, the ratio of urinary albumin/creatinine in ADR nephropathy mice was significantly increased. WT-1 immunohistochemical staining showed that the number of podocytes was significantly decreased, while immunofluorescence double staining of podocyte-specific protein synaptopodin and podocalyxin remarkably reduced, and the expression of desmin was increased. pCPT-cAMP intervention decreased the ratio of albumin/creatinine in ADR mice, elevated the quantity of WT-1 positive cells and the expression of synaptopodin and podocalyxin, while desmin expression decreased. Conclusion·pCPT-cAMP activates the PKA signaling and protects ADR nephropathy mice by preventing the loss of podocytes and ameliorating the urine albumin/creatinine ratio, which may be mediated by pCPT-cAMP-prevented dedifferentiation of podocytes.

Objective To approach the selection of appropriate period and mode of blood purification for treatment of patients with severe acute pancreatitis(SAP)based on acute physiology and chronic health evaluationⅡ(APACHEⅡ)score. Methods The clinical data of 89 patients with SAP were retrospectively analyzed. They were assigned into two groups:the hemoperfusion(HP)and short continuous veno-venous hemodiafiltration(SCVVHDF) group(HP+SCVVHDF,49 cases)and the HP and hemodiafiltration(HDF)group(HP+HDF,40 cases). All the patients were evaluated by APACHEⅡscore. In the HP+HDF group,26 cases with APACHEⅡ<15 were in group A, while 14 cases with 15-25 in group B. In the HP+SCVVHDF group,31 cases with the score 15-25 were in group C, and 18 cases with<15 in group D. One week after the treatment,APACHEⅡscore,oxygenation index(PaO2/FiO2), C-reactive protein(CRP),serum creatinine(SCr),alanine transaminase(ALT)and mortality were observed in all the groups. Results Compared to those before treatment,the APACHEⅡ scores(group A:7.35±2.12 vs. 10.52±3.26,group B:14.35±4.76 vs. 18.43±4.08,group C:11.83±3.85 vs. 19.39±3.64,group D:6.92±2.54 vs. 11.61±2.19),the levels of CRP(mg/L,group A:85.28±23.48 vs. 195.23±56.77,group B:172.67±36.69 vs. 232.65±62.86,group C:112.43±29.48 vs. 257.29±68.39,group D:76.23±29.05 vs. 206.37±65.49),SCr (μmol/L,group A:107.56±73.01 vs. 225.81±119.06,group B:291.49±123.27 vs. 391.76±273.48,group C:254.89±104.37 vs. 403.62±261.53,group D:112.36±55.36 vs. 258.74±128.25)and ALT(U/L,group A:86.93±27.04 vs. 127.56±84.35, group B:116.34±43.98 vs. 189.15±102.85, group C:94.85±74.42 vs. 178.73±87.21,group D:88.49±29.32 vs. 138.24±90.58)after treatment were all decreased markedly in the four groups. The levels of PaO2/FiO2 were obviously higher in the 4 groups after treatment〔mmHg(1 mmHg=0.133 kPa), group A:293.42±31.26 vs. 253.60±26.62,group B:254.12±35.73 vs. 137.56±23.48,group C:283.21±37.48 vs. 131.96±0.45,group D:305.75±29.66 vs. 267.74±31.42〕,but no statistical significant differences in above indexes between group A and group D were found(all P>0.05),while the APACHEⅡ score,PaO2/FiO2,CRP, SCr and ALT were improved more significantly in group C than those in group B(P<0.05 or P<0.01). The mortality rate of those SAP patients with APACHEⅡscore<15 was lower than those in cases with APACHEⅡscore 15-20〔6.82%(3/44)vs. 24.44%(11/45),P<0.05〕. Conclusions Blood purification is an effective measure to save patients with SAP. The APACHEⅡ score used to select the mode of blood purification in appropriate period for treatment of SAP has guiding significance. Currently the modes of blood purification have limited value and cannot cure all SAP patients.