Objective:To build a performance evaluation index system of family doctor contracting service for urban communities, so as to evaluate the effects of such service.Methods:Based on the conceptual framework of performance appraisal of family doctor contracting service, such means as Delphi method and analytic hierarchy process were employed to evaluate the performance appraisal system of such service. A measured simulation test was made in Guangzhou.Results:A library of performance appraisal candidate indexes for such service was established, based on the performance appraisal concept framework of " structure, input, output, result" of such service. A questionnaire made based on such a library was developed for correspondence inquiry of 20 experts from December 2018 to June 2019. Based on results of such inquiry, a performance appraisal system for family doctor contracting service in Guangzhou was developed, consisting of 4 level-1 indexes, 10 level-2 indexes and 34 level-3 indexes. In the system, level indexes include organizational structure and management(weight 0.21), resource input(weight 0.24), contracting service process(weight 0.19), and contracting service effect(weight 0.36). A community health center in Guangzhou was used as the measurement site, for adjustment and improvement of data acquisition methods of individual indexes or scoring criteria.Conclusions:The index system is developed scientifically; appraisal tools are designed focusing on results and outputs, ensuring the appraisal of contracting service quality from multiple perspectives of supply-demand sides and health management patterns; the system can provide appraisal tools for policy appraisal authorities to evaluate the performance of contracting service reform.

Objective To investigate the relationship of Helicobacter pylori(Hp) and gastric cancer in animal.Methods Ninety of two-grade Wistar male rats were randomly divided into experimental group and control group.In 12 weeks after the rats of experimental group were infected with SS1 Hp strain,animal in two groups were then randomly subdivided into blank ,MNNG subgroup and MNNG+NaCl subgroup,15 rats in each subgroup.Animals in the MNNG and MNNG+NaCl subgroups received 100?g/ml of MNNG in the drinking water,and in the MNNG+NaCl still received 10% NaCl 1 5ml,two times a week for ten months.The blank received water plus libitum.All animals were sacrificed in two months after the above treatment.Histopathological features of the glandular stomach were assessed by HE stainning.Results By the end of the study ,87 rats were survival,3 rats died from the mistakes of perfusion of NaCl.Hp was detected in all infected rats.Adenocarcinoma had developed in the antrum of one experimental rat in the MNNG+NaCl subgroup. Adenomatous hyperplasia were observed in two groups,but its incidence in the MNNG and MNNG+NaCl subgroups of the experiment were 40% and 57 14% respectively,higher than that of the control(6 67% and 15 38%)(P0 05).Conclusions We demonstrated that long-term Hp infection could induce the chronic active and atrophic gastritis in animal model,increase the sensitivity of glandular gastric mucosa to carcinogen,and promote the incidence of pre-carcinomatous lesion.

On the basis of principal-agent theory,this paper analyzed the reasons of doctor-patient problems from the perspective of patients and hospitals,hospitals and physicians,and patients and physicians.It included asymmetric medical information,ethical risks of physicians,incomplete contracts between physicians and patients,and uncertainty of medical results.Aimed at these problems,this paper put forward relevant suggestions.In the view of recognition,patients are supposed to get a rational idea in the process of selecting hospitals and try making a contract with general practitioners.In the view of improvement,the pattern of performance assessment to physicians should be developed.In the view of system,the corresponding management measures of health service should be improved so as to better serve patients.

Modern medical education is characterized by innovative education,but the specialty of medical education determines the complexity of its innovative education.The paper elaborates the construction of cultivation mode of talents of creative pattern in medical universities by infiltrating and implementing the ideas and practice of innovative education into the full process of higher medical education proceeding with such innovative thoughts and quality training links as education concept,teaching mode,knowledge structure,training of methods and ability.

The fashion of innovative medical education prompted the teaching mode and teaching aims in medical colleges into fundamental innovation.In this paper,the authors have analyzed the advantages and disadvantages of talent training mode from medical colleges at home and abroad in the past few decades.The training mode for the innovative talents in the new period has been discussed.It includes the flowing aspects:the teaching aims,curriculum setup,teaching methods and education evaluation system.

The article discusses the main problems existing in training medical students’ creativity and practice ability. By re-realizing the connotations of creativity and practice ability, this paper explore the paths for improving medical students’creativity and practice ability from students,teachers,teaching supervisors,and the college itself.

The forecast of health human resources demand is the most important and one of the most complex aspects of health manpower planning projections. There are many methods in forecasting human resources demand,and each method has its own advantages and disadvantages. Five kinds of commonly used basic methods are comparatively analysised in this paper.

Objective To examine the chemo-preventive effect of cyclooxygenase-2(COX-2) inhibitor (celecoxib) in an animal model of stomach carcinogenesis. Methods Eighty-six male Wistar rats were divided into six groups. The rats were given water alone (group A, n=5), N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) (group B, n=16), 3 mg/kg of indomethacin daily (group C, n=16), 5 mg/kg of celecoxib daily (group D, n=17), 10 mg/kg of celecoxib daily (group E, n=16) or 20 mg/kg of celecoxib daily (group F, n=16). The animals in group B to F were given 10% sodium chloride (in the initial 6 weeks) and drinking water containing MNNG (100 ?g/ml) to induce gastric adenocacinoma. All animals received treatment for 40 weeks, and were sacrificed after death or at week 48. Gastric tumor was evaluated histologically. Results Among 86 rats, 26 rats died, and 60 rats completed the experiment. The incidences of gastric cancer were found 0 (0%) in group A, 12 (75.0%) in group B, 11 (68.8%) in group C, 12 (70.6%) in group D, 3(18.8%) in group E, and 5(31.3%) in group F. There were significant differences in tumor incidence (P=0.002), multiplicity (P=0.001) and volume (P=0.009) among different groups. When compared with group B, the group E had the greatest reduction in tumor incidence (P=0.004), tumor multiplicity ( P=0.006) and mean tumor volume (P=0.02). Treatment with indomethacin had no significant effect on tumor development. Conclusion While treatment with indomethacin had no significant effect on tumor development, treatment with celecoxib reduced gastric cancer incidence and growth in rats.

In this study, to analyze the influence of the brightness value of the supranasal point and the apex nasi on their dominant wavelength and excitation purity according to the spectrocolorimetry data of the supranasal point and the apex nasi in healthy adults that were collected based on optical spectrum colorimetry.

[Objective] To investigate the change of liver histology, proliferation of BDEC, and expression of TGF-β in different stages of liver chelestusis. [Methods] ①Rat cholestatic livers were induced by common bile duct ligation (BDL) and separated into 3 groups, namely control group (DO), 7 days after BDL group (DT), and 18 days after BDL group (D18). ② Histological changes of livers in different groups were evaluated based on Knodell HAI score. ③ Real-time PCR was used to detect the expression of TGF-β in liver tissue and isolated BDEC in different groups. ④ Statistically analyzing the correlation between Knedell HAl score and the levels of TGF-β_1 mRNA. ⑤ In vitro study was performed to investigate the effect of TGF-β_1 on an immortalized mouse intrahepatic bililary epithelial cell line (mIBEC). [Results] (I) Knedell HAI score and the proliferation of intrahepatic bile ducts increased as the liver cholestasis aggravated. ② The levels of TGF-β_1, TGF-β_2, and TGF-β_3 mRNA were significantly up-regulated in liver tissues and BDEC as the liver cholestasis aggravated. ③ Positive correlation was found between Knedell fibrotic score and the levels of TGF-β_1 mRNA in liver tissues and BDEC(r=0.9376, P<0.05 and r=0.9682, P < 0.01). ④ In vitro study showed that TGF-β_1 inhibited the proliferation of mIBEC. [Conclusion] ① Liver injury, biliary proliferation, and the levels of TGF-β mRNA expression increased as liver cholestasis aggravated. ② The interaction of TGF-β_1 and BDEC plays an important role in the pathogenesis of BDL induced cholestatic liver disease. ④ Up-regulated expression of TGF-β_1 mRNA in the proliferated BDEC participates in the formation of BDL induced cholestatic liver fibrosis.