Objective:To establish a set of dynamic definition methods and key operational techniques for community pediatric services contents within the framework of an integrated children health services model.Methods:This was a cross-sectional study. From December 2023 to June 2024, a study was conducted at the Shanghai Gumei Community Health Service Center. The study was divided into three phases: identifying the health needs of community children (Phase A), developing the service content and methods for community children (Phase B), and establishing a community children service network (Phase C). A variety of methods, including questionnaires and focus group interviews, were comprehensively employed in each phase to develop the ABC demand network and its construction approach for community children, and to establish a networked service system.Results:A total of 512 questionnaires were distributed in Phase A, of which 499 were returned for an effective recovery rate of 97.5%. Of the parents, 488 (97.8%, 488/499) would actively seek information related to children′s health. Of those parents, 90.6% (452/499), 80.8% (403/499), and 71.9% (359/499) expressed concern about their children′s growth and development, mental health and social adaptation, and the prevention and treatment of common, frequently occurring diseases, respectively. The research clarified the health needs of children in the community and the health issues of children in different age groups. This included the mental health and social adaptation of community children, as well as common and frequently occurring diseases. The study also revealed a lack of mental health and social adaptation's services for children in the community. After sorting the community′s services into categories such as children′s growth and development detection, diagnosis and treatment of common diseases, and planned immunizations, and establishing corresponding service methods, it was found that Gumei community Health Service Center had strong diagnostic service capabilities for children aged 0-3 and 4-6, but need improved for children aged 7-12 and 13-15. At the same time, a service network consisting of five major categories, represented by medical alliances, has been established to address unmet needs in diagnosis and rehabilitation care for mental health and social adaptation, as well as major diseases.Conclusions:The study has developed an ABC demand network and its construction method for community children. It provides new ideas for defining the content of community pediatric services and establishing supporting methods, and it offers a practical basis for the constructing a community pediatric service system.

Focusing on effective methods and strategies for diabetes prevention in primary healthcare settings globally, this study constructs a comprehensive clinical prevention framework tailored for community health institutions. The framework encompasses continuous prevention services across the entire diabetes cycle, targeting all population segments—including healthy individuals, those with prediabetes, early-stage diabetes, and individuals in clinical or rehabilitation phases—to establish a systematic five-level prevention system. Through comprehensive and systematic implementation of preventive activities at all levels, this approach aims to achieve universal, systematic, and sustainable diabetes prevention and control, thereby offering insights for integrated diabetes management.

Since 2017, Changfeng Community Health Service Center in Putuo District, Shanghai, has innovatively integrated the "Dual-Contracting" program by combining integrated general-specialist outpatient services with teaching clinics. This integration has progressively evolved into a comprehensive general practitioner (GP) training model. This model cultivates competencies encompassing: core service delivery, specialized disease diagnosis and treatment, complex case management, chronic disease management within specialties, teaching and mentoring skills, and capacities for self-reflection and continuous learning. It effectively bridges the training objectives and needs for GPs across both pre-service and in-service stages. Against the backdrop of senior medical experts being deployed to primary care settings, this model not only systematically enhances the professional competencies of community GPs but also optimizes medical resource utilization and elevates the overall quality of healthcare services.

Objective:To establish a set of dynamic definition methods and key operational techniques for community pediatric services contents within the framework of an integrated children health services model.Methods:This was a cross-sectional study. From December 2023 to June 2024, a study was conducted at the Shanghai Gumei Community Health Service Center. The study was divided into three phases: identifying the health needs of community children (Phase A), developing the service content and methods for community children (Phase B), and establishing a community children service network (Phase C). A variety of methods, including questionnaires and focus group interviews, were comprehensively employed in each phase to develop the ABC demand network and its construction approach for community children, and to establish a networked service system.Results:A total of 512 questionnaires were distributed in Phase A, of which 499 were returned for an effective recovery rate of 97.5%. Of the parents, 488 (97.8%, 488/499) would actively seek information related to children′s health. Of those parents, 90.6% (452/499), 80.8% (403/499), and 71.9% (359/499) expressed concern about their children′s growth and development, mental health and social adaptation, and the prevention and treatment of common, frequently occurring diseases, respectively. The research clarified the health needs of children in the community and the health issues of children in different age groups. This included the mental health and social adaptation of community children, as well as common and frequently occurring diseases. The study also revealed a lack of mental health and social adaptation's services for children in the community. After sorting the community′s services into categories such as children′s growth and development detection, diagnosis and treatment of common diseases, and planned immunizations, and establishing corresponding service methods, it was found that Gumei community Health Service Center had strong diagnostic service capabilities for children aged 0-3 and 4-6, but need improved for children aged 7-12 and 13-15. At the same time, a service network consisting of five major categories, represented by medical alliances, has been established to address unmet needs in diagnosis and rehabilitation care for mental health and social adaptation, as well as major diseases.Conclusions:The study has developed an ABC demand network and its construction method for community children. It provides new ideas for defining the content of community pediatric services and establishing supporting methods, and it offers a practical basis for the constructing a community pediatric service system.

Focusing on effective methods and strategies for diabetes prevention in primary healthcare settings globally, this study constructs a comprehensive clinical prevention framework tailored for community health institutions. The framework encompasses continuous prevention services across the entire diabetes cycle, targeting all population segments—including healthy individuals, those with prediabetes, early-stage diabetes, and individuals in clinical or rehabilitation phases—to establish a systematic five-level prevention system. Through comprehensive and systematic implementation of preventive activities at all levels, this approach aims to achieve universal, systematic, and sustainable diabetes prevention and control, thereby offering insights for integrated diabetes management.

Since 2017, Changfeng Community Health Service Center in Putuo District, Shanghai, has innovatively integrated the "Dual-Contracting" program by combining integrated general-specialist outpatient services with teaching clinics. This integration has progressively evolved into a comprehensive general practitioner (GP) training model. This model cultivates competencies encompassing: core service delivery, specialized disease diagnosis and treatment, complex case management, chronic disease management within specialties, teaching and mentoring skills, and capacities for self-reflection and continuous learning. It effectively bridges the training objectives and needs for GPs across both pre-service and in-service stages. Against the backdrop of senior medical experts being deployed to primary care settings, this model not only systematically enhances the professional competencies of community GPs but also optimizes medical resource utilization and elevates the overall quality of healthcare services.

Objective:To explore the quality improvement in the organization structure and management model of the integrated community child health services.Methods:This was a qualitative study, including two parts: cause analysis and service improvement suggestions. In the analysis part the data mining was conducted to identify valuable patterns and relationships in the comprehensive child health services. Semi-structured interviews were conducted with 12 relevant department heads and health workers of the comprehensive child health service team at Gumei Community Health Service Center in December 2023, and the causes of the key problems were explored. In the service improvement part, focus group discussions were held to propose suggestions, then improvement measures were formulated to address the identified problems.Results:Through data mining and semi-structured interviews, the key problems were identified: information isolation among multiple departments and lack of coordination mechanism in the comprehensive child health service team. A team organizational structure based on the "three definite" principle was established. The organizational structure should include the pediatric family doctor team, general practitioner management team and departments of pediatrics, maternal and child health care, immunization and child rehabilitation; the management model should include a cross-department resource and information sharing mechanism, the pediatric family doctor model, optimization and integration of physical space, and enhancement of publicity activities for the comprehensive child health services.Conclusion:Based on the analysis in Gumei health service center, this study identified key problems in community integrated child health services, and proposes the quality improvement measure in the organizational structure and management model of the service team.

Objective To explore the expression of TLR2,4,7 mRNA on peripheral blood mono-nuclear cells (PBMCs) in patients with chronic cystic echinococcosis(CE) infection, and the level of serum IL-10. Methods The expression level of TLR2,4,7 mRNA on peripheral blood mononuclear were tested in 42 chronic CE cases and 28 normal controls (NC) by real-time fluorescent quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) method. GAPDH was selected as the internal control. The level of serum IL-10 was determined in ELISA. The subjects were determined by t test. The correlations between TLR2, TLR4, TLR7 and IL-10 were determined by differences of expression of TLR2, TLR4, TLR7 on PBMCs and serum IL-10 in two groups of study linear correlation test. Results The expressions of TLR2, TLR4,TLR7 mRNA in chronic CE group were higher than those of in NC group. Compared with the NC group, the expressions of TLR2, TLR4 and TLR7 mRNA increased more than 7.3-, 3.6-, 3.6-fold, respectively. In chronic CE group, TLR2, TLR4 and TLR7 mRNA expressions were 1.0729 ±0.4006, 5.0976 ±1.6682, 0. 6481 ±0. 2574, respectively. TLR2, TLR4 and TLR7 mRNA expressions were 0. 1468 ± 0.0435, 1.4067 ±0. 3279, 0. 1804 ±0. 0568 in NC group, respectively. Compared with NC group, the differences of TLR2 and TLR4 mRNA expression were significant (P = 0.0287, 0. 033), while the expression of TLR7 mRNA was not difference (P =0.0862). Moreover, in chronic CE group, the level of serum IL-10 was higher than that of in NC group. In chronic CE group and NC group, the level of serum IL-10 was (17.6770±1.6298) pg/ml, (9.4898 ±0.7049) pg/ml. Compared with NC group, there was significant difference in chronic group (P<0.01). Significant positive correlation between TLR2 and TLR4 was found in chronic CE group, r = 0. 1135, P =0.036. Others were not correlations. Conclusion In the development of chronic CE, TLR2 and TLR4 participate in this progression. As the receptors of antigen of cystic echinococcus, TLR2 and TLR4 can regulate the immune response through interacting with different antigens from cystic echinococcus. Meanwhile, under the participation of TLR2, TLR4 and increased serum IL-10, they will approach to Th2 immune reaction, which play an important role in chronic CE that can induce immune evasion.

Objective To investigate the change of T helper 17 cells (Th17) in the peripheral blood mononuclear cell (PBMC) in patients with liver cystic echinococcosis. Methods Fifty-six subjects were divided into three groups: healthy controls (HD, n = 20), patients with cystic echinococcosis (CE, n= 18) and patients with cystic echinococcosis combined with bile fistula (BF,n= 18). The frequency of Th17 cells in CD4+ T lymphocytes was detected by flow cytometry. Th17-related cytokines including interleukin (IL)-17 and IL-23 were measured by enzyme-linked immunosorbent assay (ELISA). The data were analyzed by t test and Pearson correlation analysis.Results The frequency of Th17 in the peripheral blood was significantly lower in CE group compared to BF group and HD group [(0. 23±0. 11)% vs (0. 76±0.43)% vs (0.52±0.50)%; t=2. 225 and4. 077 respectively, both P＜0.05), while there was no statistical difference between BF group and HD group (t=1. 931, P＞0.05). The levels IL-17 and IL-23 were (12.1±3.7) ng/L and (84.4±46.0) ng/L respectively in CE group, which were lower than those in BF group [(15.5±4.1) ng/L and (138.6±37. 9) ng/L, respectively; t=2. 515 and 3. 649 respectively, both P＜0.05] and those in HD group [(14.8±4.4) ng/L and (138.1±48. 7) ng/L, respectively; t=2. 401 and 3. 706 respectively,both P ＜0.05], while there was no statistical difference between BF group and HD group (t=0. 534,P ＞0.05). Serum concentrations of IL-17 were all positively correlated with the concentrations of IL23 in these three groups (r=0. 657, P＜0.05). Conclusion The frequeny of Th17 cells in PBMC and the serum concentrations of IL-17, IL-23 are significantly reduced in patients with cystic echinococcosis.