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 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 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 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 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.

ObjectiveTo investigate the optimal reconstruction windows for coronary angiography using 320-detector row dynamic volume CT (DVCT) and evaluate their effects on image quality,radiation dose and diagnostic accuracy.MethodsFrom 77 patients [mean heart rate (70 + 13) bpm,range:46-102 bmp] were scanned with retrospective ECG-gating 320-detector row DVCT.The relationship between heart rate and optimal reconstruction windows was analyzed.From 53 patients [mean heart rate ( 75 ±11 ) bpm,range:57-114 bpm] were scanned with prospective ECG-gating 320-detector row DVCT.The effects of prospective ECG-gating on image quality,radiation dose and diagnostic accuracy were evaluated.Friedman test was performed for image quality scores in random groups.Linear regression and Spearman correlation were performed to test bivariate data.ResultsThe proportion of systolic duration in the cardiac cycle increased significantly with higher heart rate (r =0.78,P ＜0.01 ).The image quality in systolic and diastolic phases were significantly influenced by heart rate ( r =0.38,0.82 ; P ＜ 0.01 ).According to the regression analysis of image quality score in different heart rate groups,the optimal reconstruction windows were determined as followed:when heart rate was ＜ 70 bpm,the optimal reconstruction windows should be preset at 65％-80％ ; 70 to 80 bpm,70％-85％ ; 81 to 90 bpm,70％-90％ ; ＞90 bpm,35％-50％.Compared with retrospective ECG-gating,prospective ECG-gating which preset reconstruction windows according to the phases mentioned above,could decrease radiation dose [(6.1 ± 3.8 )vs (12.4 ± 7.0) mSv],without deteriorating the image quality (t =6.5,P ＜ 0.01 ).However,in higher heart rate,the radiation dose of prospective ECG-gating DVCT was still higher ( r =0.64,P ＜ 0.01 ).ConclusionsDVCT can provide high image quality in a wide range of heart rate with prospective ECG gating.It is still recommended to control heart rate strictly since the radiation dose increases significantly in high heart rate.

Objective To apply the optical coherence tomography(OCT) to detect the characteristics of coronary artery plaque and to investigate its correlation with levels of serum matrix metalloproteinase 7(MMP 7),MMP9 and MMP12.Methods The patients undergoing coronary arterial angiography for diagnosing coronary arterial lesions in the cardiology department of our hospital from October 2014 to March 2016 were collected and included into the research subjects.The subjects were divided into the stable plaque group and unstable plaque group based on the results of OCT scanning.The neovascularization characteristics such as the fibrous cap thickness of plaque,angle of lipid pool,macrophage infiltration and plaque cracks were detected by using OCT.ELISA was used to measure serum MMP7,MMP9 and MMP12 levels.Results (1) The fibrous cap thickness in the stable plaque group was more than that in the unstable plaque group(P＜0.01);the lipid pool angle,microphage infiltration,intima erosion and plaque cracks in the unstable plaque group were more than those in the stable plaque group(P＜0.05).(2) The MMP7 and MMP9 levels in the unstable plaque group were higher than those in the stable plaque group and control group(P＜0.05).(3) The fibrous cap thickness had significantly negative correlation with serum MMP9 level(r=-0.336,P=0.034);the MMP7 and MMP9 levels in the microphage infiltration group were higher than those in the non-microphage infiltration group(P＜0.05);the MMP9 level in the intima erosion group was higher than that in the non-intima erosion group(P＜0.01).Conclusion OCT can detect and find unstable plaque and the serum levels of MMP7 and MMP9 are significantly elevated in the patients with unstable plaque,which can be used as an important basis for predicting unstable plaque and guiding the treatment decisions.

Objective To study the inhibition effect of non custodial terpenes-3β-alcohol to experimentally in-duced autoimmune encephalomyelitis in guinea pigs. Methods Different doses (25 mg/kg, 50 mg/kg and 100 mg/kg) of non custodial terpenes-3β-alcohol were given to the experimentally induced autoimmune encephalomyelitis model of guinea pigs by gavage for 8 weeks. Plasma levels of CD4+/CD8+, IL-1, IL-2, IL-6, IL-10, neuropeptide Y (NPY), beta endorphin (β-EP) , transforming growth factor-β(TGF-β), matrix metalloproteinase (MMP-2), nitric oxide synthase (NOS) and leuko-cyte differentiation antigen CD3 were assessed. The brain neuron morphology changes was observed under light microscopy while its ultrastructure changes was observed under electron microscope. NOS expression in neurons was observed through immunofluoresce technology. Results Non custodialterpenes-3β-alcohol inhibited the increase of plasma CD4+/CD8+, IL-1, IL-2, IL-6, IL-10, MMP-2, CD3 and NPY while decrease of plasmaβ-EP, brain TGF-β. It also increase NOS expres-sion in neuronal cytoplasm and maintained neuron morphology. Conclusion Non custodial terpenes-3β-alcohol inhibit-ed the experimental autoimmune encephalomyelitis in guinea pig.

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.

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.