Objective:To analyze the health responsibilities of both the supply and demand sides in the process of community chronic disease management for the elderly,as well as to provide a reference for the fulfillment of the health responsibilities of both the supply and demand sides in the process of chronic disease management.Methods:Elderly people were extracted as research subjects from communities,that were under the jurisdiction of the 27 community health service centers we selected.By using the method of questionnaire surveys and in-depth interviews,this paper analyzed the health responsibilities of both the supply and demand sides from the perspective of chronic diseases and health awareness among the elderly,self-management responsibilities of the elderly,and the health responsibility of community health service institutions.Results:There was still room for improvement in the fulfillment of health responsibilities by both the supply and demand sides,and the ability of elderly people to fulfill self-management responsibilities needs to be improved.Under the guidance of the three-level prevention theory,there were varying degrees of deficiencies in the fulfillment of health responsibilities by community health service institutions in all dimensions.Conclusion:It is suggested to clarify the health responsibilities of both the supply and demand sides for chronic disease management,with the goal of achieving the health of the elderly population,to complete both the supply and demand sides to jointly build an interactive model of health responsibility of chronic disease management in the elderly community,and to realize the health co-construction and sharing.

Objective To observe the expression of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(Akt)signal transducer in liver tissue of rats with bilateral ovarian castration(OVX)by electroacupuncture at Guanyuan(CV4)point,and explore the mechanism of electroacupuncture in up regulating PI3K/Akt signal pathway,regulating lipid metabolism,and reducing weight was investigated.Methods Thirty-two female SD rats were randomly divided into blank,sham operation,model and electroacupuncture group,with 8 rats in each group.Perimenopausal obesity(PMO)model was prepared by OVX in the model and the electroacupuncture group.After the model was successfully prepared,the electroacupuncture group was subjected to electroacupuncture at CV4(continuous wave,2 Hz,1 mA),once day,20 min once time,and for 14 consecutive days.The body mass of each group of rats was recorded during the whole experiment,and Lee's index was calculated during sampling.The pathological changes of liver were observed by HE staining.Serum levels of HDL,LDL and TG were detected by ELISA.Western blot analysis of PI3K,Akt,p-Akt protein expression and p-Akt/Akt in liver tissues.Results Compared with blank group and sham operation group,the body mass of rats in model group was significantly increased(P＜0.05),Lee's index was increased(P＜0.05),fat vacuoles appeared in liver,serum HDL level was decreased(P＜0.001),LDL and TG levels were increased(P＜0.01).PI3K,Akt,p-Akt,p-Akt/Akt were decreased in liver(P＜0.05).Compared with model group,body mass and Lee's index of rats in electroacupuncture group were decreased(P＜0.05),fat vacuoles in liver were decreased,HDL level was increased(P＜0.01),LDL and TG levels were decreased(P＜0.05,P＜0.01),PI3K,Akt and P-Akt were decreased(P＜0.05),and p-akt/Akt decreased(P＜0.01).Conclusion Electroacupuncture at CV4 can significantly up-regulate PI3K/Akt signaling pathway,improve lipid metabolism disorder and accumulation,and reduce body mass in OVX rats.

Objective This study aim to evaluate the therapeutic efficacy of ultrasound-guided acupuncture,specifically targeting the Tiaokou(ST38)acupoint through Chengshan(BL57)to elicit the Deqi sensation,in the context of acute scapulohumeral periarthritis.Methods Utilizing a randomized controlled trial design,a total of 60 subjects diagnosed with acute scapulohumeral periarthritis underwent random allocation into either the observation or control group,with 30 subjects in each.Under ultrasound guidance,acupuncture was administered unilaterally at the specific acupoint ST38 through BL57.The observation group received needling traversing the calf interosseous membrane,reaching the deep fascia of the tibialis posterior muscle,employing lifting and inserting twisting techniques to induce Deqi.In contrast,the control group received acupuncture targeting the sub-superficial fascia without needle manipulation or the requirement for Deqi.Both groups underwent a singular acupuncture session,with a standardized 20-minute needle retention period.Results Post-acupuncture intervention,the observation group exhibited a statistically significant total effective rate of 76.66％,greater than that in the control group at 30％(P＜0.01).Comparative analysis revealed substantial enhancements in the observation group,including improvements in VAS score,Constant shoulder joint function score,the highest △T of red external thermal imaging around the shoulder,and patients'subjective acupuncture sensation scores(P＜0.05).Additionally,within the observation group,post-treatment reductions were observed in VAS score and △ T of red external thermal imaging,coupled with an elevation in Constant shoulder joint function score(P＜0.01).Importantly,neither group manifested discernible adverse reactions.Conclusion Ultrasound-guided acupuncture,facilitating Deqi at Tiaokou(ST38),emerges as a clinically significant and secure intervention for acute scapulohumeral periarthritis.These findings substantiate its potential as a viable therapeutic modality,promoting broader clinical adoption.

Objective To observe the expression of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(Akt)signal transducer in liver tissue of rats with bilateral ovarian castration(OVX)by electroacupuncture at Guanyuan(CV4)point,and explore the mechanism of electroacupuncture in up regulating PI3K/Akt signal pathway,regulating lipid metabolism,and reducing weight was investigated.Methods Thirty-two female SD rats were randomly divided into blank,sham operation,model and electroacupuncture group,with 8 rats in each group.Perimenopausal obesity(PMO)model was prepared by OVX in the model and the electroacupuncture group.After the model was successfully prepared,the electroacupuncture group was subjected to electroacupuncture at CV4(continuous wave,2 Hz,1 mA),once day,20 min once time,and for 14 consecutive days.The body mass of each group of rats was recorded during the whole experiment,and Lee's index was calculated during sampling.The pathological changes of liver were observed by HE staining.Serum levels of HDL,LDL and TG were detected by ELISA.Western blot analysis of PI3K,Akt,p-Akt protein expression and p-Akt/Akt in liver tissues.Results Compared with blank group and sham operation group,the body mass of rats in model group was significantly increased(P＜0.05),Lee's index was increased(P＜0.05),fat vacuoles appeared in liver,serum HDL level was decreased(P＜0.001),LDL and TG levels were increased(P＜0.01).PI3K,Akt,p-Akt,p-Akt/Akt were decreased in liver(P＜0.05).Compared with model group,body mass and Lee's index of rats in electroacupuncture group were decreased(P＜0.05),fat vacuoles in liver were decreased,HDL level was increased(P＜0.01),LDL and TG levels were decreased(P＜0.05,P＜0.01),PI3K,Akt and P-Akt were decreased(P＜0.05),and p-akt/Akt decreased(P＜0.01).Conclusion Electroacupuncture at CV4 can significantly up-regulate PI3K/Akt signaling pathway,improve lipid metabolism disorder and accumulation,and reduce body mass in OVX rats.

Objective This study aim to evaluate the therapeutic efficacy of ultrasound-guided acupuncture,specifically targeting the Tiaokou(ST38)acupoint through Chengshan(BL57)to elicit the Deqi sensation,in the context of acute scapulohumeral periarthritis.Methods Utilizing a randomized controlled trial design,a total of 60 subjects diagnosed with acute scapulohumeral periarthritis underwent random allocation into either the observation or control group,with 30 subjects in each.Under ultrasound guidance,acupuncture was administered unilaterally at the specific acupoint ST38 through BL57.The observation group received needling traversing the calf interosseous membrane,reaching the deep fascia of the tibialis posterior muscle,employing lifting and inserting twisting techniques to induce Deqi.In contrast,the control group received acupuncture targeting the sub-superficial fascia without needle manipulation or the requirement for Deqi.Both groups underwent a singular acupuncture session,with a standardized 20-minute needle retention period.Results Post-acupuncture intervention,the observation group exhibited a statistically significant total effective rate of 76.66％,greater than that in the control group at 30％(P＜0.01).Comparative analysis revealed substantial enhancements in the observation group,including improvements in VAS score,Constant shoulder joint function score,the highest △T of red external thermal imaging around the shoulder,and patients'subjective acupuncture sensation scores(P＜0.05).Additionally,within the observation group,post-treatment reductions were observed in VAS score and △ T of red external thermal imaging,coupled with an elevation in Constant shoulder joint function score(P＜0.01).Importantly,neither group manifested discernible adverse reactions.Conclusion Ultrasound-guided acupuncture,facilitating Deqi at Tiaokou(ST38),emerges as a clinically significant and secure intervention for acute scapulohumeral periarthritis.These findings substantiate its potential as a viable therapeutic modality,promoting broader clinical adoption.

Objective　To evaluate the effect of occupation al protection measures on reducing blood exposure. Methods　A s urvey was carried out to investigate medical staff in Shanghai hospitals. Sing le-factor and multi-fa ctor analysis measures were used. Results　The more protection m eas ures adopted, such as gloves using, occupational training and strict rules and r egulations, the less occupational exposure. The resul ts also showed that there were statistical difference. Conclusions　It is important for medical staff to strength occupational protection in order to avoid acqu iring hospital infection.