Objective To research community residents TCM constitution and impaired glucose regulation and diabetes,for providing the basis of the community carrying out the adjustment of biased constitution,prevention and treatment of impaired glucose regulation and diabetes.Methods The cross-sectional survey was conducted in Hualin Street,Liwan District,Guangzhou,and 1882 cases of elderly residents over the age of 45 were surveyed on their TCM constitution and blood sugar.According to the Chinese constitution scale survey all cases were divided into gentleness type,yang-deficiency type,qi-deficiency type,dampness-heat type,phlegm-dampness type,yin-deficiency type,qi-depression type,blood-stasis type,and special diathesis type.Divided according to the level of their blood glucose,all cases were classified to normal blood glucose,impaired glucose regulation and diabetes.Logistic regression analysis was conducted to study the relation between TCM constitution and impaired glucose regulation and diabetes mellitus.Results The ratio of phlegm-dampness type in glucose regulation damage and diabetes was much higher than normal blood sugar,the value was 10.07％,19.10％ and 4.98％ respectively.The ratio ofyin deficiency type in diabetes was higher than normal blood sugar,the value was 16.85％and 12.27％,respectively.Compared with gentleness type,a logistic regression analysis model showed that the risk of impaired glucose regulation of phlegm (OR 2.08; 95％CI 1.80 to 2.36) and diabetes (OR 4.39; 95％CI 3.56 to the risk of 5.42) were significantly increased in phlegm-dampness type,and the risk of diabetes (OR 1.62; 95％CI 1.31 to 1.99) was significantly increased in yin deficiency type.Excluded the influence of gender,age,eating habits,the second models showed similar results to the first model,with the phlegm of impaired glucose regulation (OR 1.95,95％CI 1.68 to 2.27),diabetes (OR 4.01,95％CI 3.22 to 5.00),yin deficiency diabetes (OR 1.55,95％CI 1.25 to 1.93) all similar to the first model.Conclusion Phlegm-dampness type and yin-deficiency type are the main TCM constitutions that influencing glucose regulation impairment and diabetes.

The paper introduces an overview of Shanghai medical security system, analyzes its effectiveness and challenges, and put forward overall goals and key tasks in the future. Shanghai has formed a multiple, medical security system and basically achieved the short-term goal of medical security system establishment which was requested to put forward in national health system reform. Shanghai medical insurance system has played a positive role in promoting economic and social development and reducing the burden of medical expenses. To further implement requirements of national health system reform, Shanghai will be conducting the integration of different schemes , narrow down the gap of benefit packages, improvement of health care management and the initiatives of nursing care insurance to further improve the medical security system, and strive to cover 98% of household population and 90% resident population in 2012.

Objective:To establish age- and gender-based normative values of sagittal spinal-pelvic alignment in Chinese adult population, and to investigate influence of age, gender and ethnicity on sagittal spinal-pelvic alignment in Chinese normal adults.Methods:A total of 786 asymptomatic Chinese adult volunteers aged between 20 and 89 years were prospectively recruited from different spine centers. The inclusion criteria were: 1) age between 20 to 89 years old; and 2) Oswestry disability index (ODI) scored lower than 20. The exclusion criteria were: 1) previous history of spinal, pelvic or lower limb pathologies that could affect the spine; 2) presence of recent and/or regular back pain; 3) previous surgeries on spine, pelvic and/or lower limb; and 4) pregnancy. Demographic characteristics of these subjects including age, gender, body weight and height were recorded. During the enrollment of volunteers, 16 groups were defined based on the age (20 s, 30 s, 40 s, 50 s, 60 s, 70 s and 80 s) and gender. Whole body biplanar standing EOS X-ray radiographs were acquired to evaluate the sagittal alignment. Spinal-pelvic parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (T 5-T 12, TK), lumbar lordosis (L 1-S 1, LL), lower lumbar lordosis (L 4-S 1, LLL), global tilt (GT), T1 pelvic angle (TPA) and sagittal vertical axis (SVA) were measured. Values of PI-LL and lordosis distribution index (LLL/LL, LDI) were calculated. Radiographic measurements of 100 subjects were randomly selected to determine the intra- and inter-observer reliabilities using inter- and intra-class correlation coefficients (ICC). The spinal-pelvic parameters were compared among volunteers between different age and gender groups. The comparison was also made among various ethnic population. Results:The mean value was 23.7±7.1 kg/m 2 for BMI and 6.9%±2.5% (range, 0-18%) for ODI score. Each sagittal spinal-pelvic parameter was presented with mean value and standard deviationbased on age and gender. The ICCs of radiographic measurements ranged from 0.89 to 0.95, suggesting good to excellent intra- and inter-observer reliabilities. Significant differences were observed between males and females in multiple sagittal parameters (all P values <0.05). Compared to the male subjects, significantly higher values of PI (41.4° for male vs. 45.0° for female, P<0.001), PT (10.7° for male vs. 13.9° for female, P<0.001), PI-LL (-0.5° for male vs. 1.8° for female, P<0.001), and GT (10.9° for male vs. 13.5° for female, P<0.001) were documented in female subjects. Males had significantly higher values of LLL (28.6° for male vs. 26.6° for female, P<0.001) and LDI (0.68 for male vs. 0.63 for female, P<0.001). PI-LL, SVA, GT and TPA increased with aging from Group 40 s to Group 80 s, while LL, LLL and LDI decreased gradually, and TK decreased slowly with aging. Comparison of sagittal spinal-pelvic parameters between different ethnic subjects showed that Chinese adult population presented lower PI, SS, TK and LL as compared with American population; lower PI, SS and LL as compared with Japanese population. But the variation trend with aging tended to be consistent among different ethnic populations. Conclusion:Age- and gender-based normative values of sagittal spinal-pelvic alignment were established in asymptomatic Chinese adult population. Sagittal spinal-pelvic alignment varies with age and gender, and presented different compensation mechanism among different ethnic populations. Therefore, to achieve balanced sagittal alignment, age, gender and ethnicity should be take intoconsideration when planning spine correction surgery.