ABSTRACT
Objective To assess the knowledge and attitude towards hierarchical medical system among patients in Beijing Xicheng district community health service centers.Methods A questionnaire survey was conducted between July and August 2016,among randomly-selected patients who were visiting community health service centers in Beijing Xicheng district.Results A total of 2 770 patients were investigated.The percentage of patients who knew the hierarchical medical system was 62.2％ (1 722/2 770).Logistic regression showed that the degree of knowledge was significantly correlated with the visit number in the recent year and the education levels of patients.The percentage of patients who had a positive attitude to the system was 89.5％ (2 478/2 770).The main reasons for negative attitude to the system were "worry about the delay of treatment","inconvenience" and "fewer drugs in community health service centers" and "weak capacity of community health service centers".Logistic regression showed that the education level was negatively correlated with the attitude.In the case of mild illness,2,485 (89.7％) participants would chose "community health service center or service station".Conclusions The knowledge of hierarchical medical system among patients in community health institutions are moderately high,while most of them have positive attitude towards the system.The service capacity of community health service institutions should be further improved,and publicity should be strengthened to improve the awareness of hierarchical medical system among community residents.
ABSTRACT
A liquid chromatography-tandem mass spectrometry ( LC-MSMS ) method has been developed for the simultaneous determination of N3-methyladenine ( N3-MeA ) and N3-ethyladenine ( N3-EtA ) in calf thymus DNA. The DNA samples has been purified and enriched by cation exchange cartridge ( Waters Oasis MCX) . d3-N3-MeA and d5-N3-EtA were used as isotope internal standard. The DNA samples were injected with autosampler. The injected volume was 3 μL and analysis time was 13 min. The sample separation was carried out on hydrophilic interaction chromatograph ( Waters XBridge HILIC ) with 10 mmol/L ammonium formate-acetonitrile (5:92, V/V, pH=4. 0) as mobile phase. The flow rate was set at 250 μL/min. Mass spectrometry was performed by electrospray ionization ( ESI ) with multi-reactions monitoring ( MRM ) . The optimized operation conditions of MS were as follows: nebulizer gas 369 Pa; curtain gas 185 Pa, turbo ionspray temperature 400 ℃, ionspray voltage 5500 V, dwell time 40 ms. The limits of detection were 0. 043 and 0. 007 μg/L for N3-MeA and N3-EtA, respectively. The recoveries were between 87. 8% and 103. 0%for N3-MeA and N3-EtA. This method was successfully applied to the determination of N3-MeA and N3-EtA in calf thymus DNA by cigarette smoke condensate ( CSC) exposure. This method is appropriate for routine analysis and accurate quantification of N3-MeA and N3-EtA by CSC exposure.