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 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 compare the therapeutic results between low-molecular-weight heparin therapy and combined therapy of low-molecular-weight heparin and Shuxuetong for deep venous thrombosis (DVT) after lower extremity fracture.Methods Forty-two patients with DVT from 1,037 patients with lower extremity fracture treated from December 2010 through November 2012 were included in the study.There were 31 males and 11 females,aged from 26 to 82 years (mean,63 years).The patients were assigned to administration of 4,250 IU low-molecular-weight heparin subcutaneously,twice daily (Group A,n =19)and 4,250 IU low-molecular-weight heparin subcutaneously,twice daily plus shuxuetong to 6 ml intravenously,once daily (Group B,n =23) according to the random number table.A period of treatment was a week.Color Doppler sonography was performed to detect DVT.Results Longest course of treatment was 3 weeks.In Group A,the results were recanalization in 2 patients with mean time of 2.50 weeks,significantly effective in 3 patients with mean time of 2.67 weeks,effective in 7 patients with mean time of 3 weeks,and invalid or worse in 7 patients with mean time of 3 weeks.Whereas in Group B,the results were recanalization in 7 patients with mean time of 1.86 weeks,significantly effective in 12 patients with mean time of 1.83 weeks,effective in 3 patients with mean time of 3 weeks,and invalid or worse in 1 patient with mean time of 3 weeks (P ＜ 0.05).Conclusion Low-molecular-weight heparin plus Shuxuetong is effective in treatment of DVT after lower extremity fracture and hence can be as an option in clinical application.

Objective To verify result consistency of the improved examination method and the standard operation method with the erythrocyte osmotic fragility test (OFT).Methods The samples and reagents were reduced half volume and used different testing equipment to evaluate methods for OFT.Selected 100 samples that the brittleness were increased and de-creased (50 samples positive and negative respectively),used a kind of improved examination method and traditional test method to evaluate the consistency.Results The detection result of improved examination method and the detection results of the manufacturer standard method were consistent (t=1.660 8,P >0.05).So,there was no significant difference of con-trast between two groups of data.Conclusion Improved mothed OFT alternatives to traditional OFTscreening method could be faster,more objectively the results of clinical service,and could effectively reduce reagent and manpower cost,improve the efficiency of work.Therefore,this method could be used to groups detection and lack of equipment for the primary care of hospital screening thalassemia desease method is preferred.

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.

OBJECTIVE To investigate the nuclear proteomes in mitochondrial DNA (mtDNA)-depleted A549 cells (Rho0 cells) and their parental cells (Rho+ cells),and to learn more about the nuclear responses to mitochondrial dysfunction.METHODS The nuclear proteomes of Rho and Rho + cells were characterized by two dimensional electrophoresis (2-DE) and SELDI-TOF ProteinChip technologies,the differentially expressed protein- spots were identified by MALDI-TOF mass spectrum (MS),the nucleophosmin and P53 expression were detected by Western blotting assay,and the mitochondrial memhrane potential (MMP) was measured by the laser scanning confocal microscope.RESULTS 2-DE results showed 11 protein-spots were down-regulated and 21 protein-spots were up-regulated in Rho0 cell nuclei.SELDI-TOF MS analysis with NP20 ProteinChips revealed 4 protein-peaks decreased in Rho0 cell nuclei.One down-regulated protein-spot was identified as elF-6,and 4 up-regulated proteinspots were identified as nucleophosmin,SFRS1,SFRS3 and hnRNP G,respectively.The increased expression of nucleophosmin in Rho0 cells was verified by Western blotting.Based on the clues from proteomic analysis,P53 expression in Rho0 cells was higher than in Rho + cells,and MMP was consistent in Rho + and Rho0 cells.CONCLUSION mtDNA-depletion induces nuclear proteome alteration.Rho0 cells can be used as a model to study the crosstalk between mitochondrion and nucleus.

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.