Acute cerebral infarction following extracorporeal membrane oxygenation treatment in patients with cardiogenic shock: 2 cases report and review of the literature / 中华危重病急救医学

OBJECTIVE@#To explore the diagnosis and treatment of acute cerebral infarction following extracorporeal membrane oxygenation (ECMO) therapy in patients with cardiogenic shock to review the literature.@*METHODS@#The clinical data of two patients with cardiogenic shock treated with veno-arterial ECMO (VA-ECMO) complicated with acute cerebral infarction admitted to department of intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University were retrospectively analyzed and the treatment experience was shared.@*RESULTS@#Case 1 was a 46-year-old male patient who was admitted to the hospital on September 16, 2021, due to "repeated chest tightness, shortness of breath, syncope for 2+ years, and worsened for 15 days. Coronary artery angiography showed 3-vessel coronary artery disease lesions. On October 15, 2021, coronary artery bypass grafting (CABG), pericardial fenestration and drainage, thoracic closed drainage, femoral bypass, thoracotomy exploration, and sternal internal fixation were performed under support of extracorporeal circulation. After surgery, the heart rate was 180-200 bpm, the blood pressure could not be maintained, and the improvement was not obvious after active drug treatment. The right femoral artery and femoral vein were intubated, VA-ECMO support treatment was performed, and the patient was transferred to the ICU. Intra-aortic balloon pump (IABP) was treated on the day of transfer because the circulation could not be maintained. Due to acute cerebral infarction in the left hemisphere and right parieto-occipital lobe, subfalcine herniation, tentorial herniation, the patient ultimately died after withdrawing from ECMO. Case 2 was a 43-year-old male patient who was admitted to the hospital on June 29, 2021, with "fever for 8 days and vomiting for 4 days". Bedside ultrasound showed cardiac enlargement and diffuse wall motion reduction in the left and right ventricles. On June 30, 2021, the patient underwent catheterization through the right femoral artery and femoral vein, VA-ECMO support, and was transferred to ICU for treatment. Acute cerebral infarction on both sides of the cerebellum occurred, and after treatment, the patient was discharged with mild impairment of daily living ability.@*CONCLUSIONS@#Strengthen monitoring of anticoagulation; regular neurological examination of patients undergoing ECMO therapy; ECMO under light sedation or awake can be performed if the condition permitsif the condition permits, perform light sedation or awake ECMO, which helpful for the early detection of nervous system injury.

Advance in research of microRNA-21-5p regulate autophagy by targeting gene / 中华危重病急救医学

Autophagy is a dynamic process that degrades intracellular proteins and damaged organelles, and maintains environmental stability within the cell and provides good conditions for cell survival. Hyperoxic acute lung injury (HALI) is one of the serious complications of clinical oxygen therapy. The pathogenesis of HALI is still unclear. There are studies having shown that autophagy is involved in the pathogenesis of HALI. There are many pathway mechanisms that regulate autophagy, including phosphatidylinositol-3-kinase/Akt/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway, mitogen-activated protein kinase/extracellular signaling-regulated protein kinase (MAPK/ERK) signaling pathway, adenosine 5'-monophosphate-activated protein kinase/unc-51 like autophagy activating kinase 1 (AMPK/ULK1) signaling pathway, transforming growth factor β (TGF-β) and forkhead box O1 (FoxO1) and Ras guanosine triphosphatease superfamily member Rab11a, each of which is referred to as microRNA-21-5p (miR-21-5p) target gene having a role in regulating autophagy activity in many diseases. In this paper, the above-mentioned signaling pathways of miRNA-21-5p target genes regulating autophagy were reviewed in order to find clues about the mechanism of miRNA-21-5p regulating autophagy in HALI and provide a theoretical basis for subsequent basic research.

Influence of policy support on the attitude of staff toward contracted service in community health service centers / 中华医院管理杂志

Objective To explore the influence of policy support on attitude of staff toward contracted service in community health service ( CHS) centers in different areas of China. Methods A multi-stage stratified cluster sampling method was used to select participants, and questionnaire survey was conducted among 192 staff (99 from Chengdu and 93 from Xiamen) from 4 community health service centers in Chengdu and Xiamen. In addition, documents on contracted service in CHS were collected and analyzed. EpiData software was used to establish database. Double input and cross-check were implemented. SAS version 9.4 was used for data analyses. Results Differences were found in goals, financial modes and insurances coverage in contracted service in the two areas. Among the 192 participants, 80.7% considered that contracted service was worth to carry out; 90.8% supported the implementation of contracted service in local settings and 78.1% were willing to take more work load on contracted service. In contrary, only 41.6% wished their child work as a family doctor. The main reasons for the negative attitudes were that the performance-based salary system had not been well established or implemented, and there was much more work load that resulted from contracted service. Conclusions The majority of the study subjects held positive attitude toward contracted service, but there were disparities between the four study sites. Relative policy and financial support, proper human resource distribution were critical determinants of contracted service.

Effect of heme oxygenase-1 on the apoptosis of type Ⅱ alveolar epithelial cells in rats with hyperoxia-induced acute lung injury / 中华危重病急救医学

Objective To investigate the effect of heme oxygenase-1 (HO-1) on the apoptosis of type Ⅱalveolar epithelial cells (AEC-Ⅱ) in rats with hyperoxia-induced acute lung injury (HALI). Methods Twenty-four healthy male Sprague-Dawley (SD) rats were randomly divided into 4 groups (n = 6): control group, HALI group, HO-1 group, and HO-1 inhibition group. The control group was fed in the room air; the HALI group was fed in the hyperoxia box (the oxygen concentration was more than 90%, the temperature was kept at 25-27 ℃, the humidity was maintained at 50%-70%, and the CO2concentration was less than 0.5%); the HO-1 group was fed in the hyperoxia box after HO-1 (0.2 μmol/L) treatment; and the HO-1 inhibition group was fed in the hyperoxia box after treatment with zinc protoporphyrin Ⅸ (20 μmol/L). After 48 hours of hyperoxia treatment, rats were sacrificed, left upper lung tissue was stained with hematoxylin-eosin (HE) and the pathological changes of lung tissue were observed under light microscope. The ratio of wet/dry weight (W/D) was measured in the lower left lung. AECⅡ was extracted from the right lung tissue, the apoptosis rate was detected by flow cytometry, and the expressions of apoptosis-related proteins Bcl-2 and caspase-3 were detected by Western Blot. Results ①It was shown by light microscopy that the lung tissue structure of the control group was clear. In HALI group and HO-1 inhibitor group, the lung tissue structure was disordered, alveolar wall was broken and fused into pulmonary alveoli, alveolar septum was obviously swollen and widened, a large number of inflammatory cells infiltrated, and edema fluid and inflammatory cells appeared in alveolar cavity. The pathological changes of lung tissue in HO-1 group were significantly less than those in HALI group. ② Compared with the control group, the lung W/D ratio, the apoptosis rate of AECⅡand the expression of Bcl-2 protein in the HALI group and the HO-1 inhibitor group were significantly increased, and the expression of caspase-3 was significantly decreased [lung W/D ratio: 4.61±0.41 vs. 3.68±0.45, apoptosis rate of AECⅡ: (42.44±0.93) % vs. (24.74±0.64) %, Bcl-2 (integral absorbance): 0.72±0.18 vs. 0.41±0.12, caspase-3 (integral absorbance): 1.32±0.32 vs. 1.81±0.69, all P < 0.05]. Compared with the HALI group, the lung W/D ratio, the apoptosis rate of AECⅡ, the expression of Bcl-2 protein in HO-1 group were significantly decreased, and the expression of caspase-3 was significantly increased [lung W/D ratio: 3.82±0.28 vs. 4.61±0.41, apoptosis rate of AECⅡ: (26.67±1.58) % vs. (42.44±0.93) %, Bcl-2 (integral absorbance): 0.39±0.08 vs. 0.72±0.18, caspase-3 (integral absorbance): 1.78±0.46 vs. 1.32±0.32, all P < 0.05]. There was no significant difference between HO-1 inhibitor group and HALI group. Conclusions HO-1 can reduce the apoptosis rate of AECⅡin rats with HALI, which may be related to the expressions of apoptosis related proteins Bcl-2 and caspase-3.

The clinical therapeutic effect of N-acetylcysteine on chronic bronchitis: a Meta-analysis / 中国中西医结合急救杂志

Objective To observe the clinical therapeutic efficacy of N-acetylcysteine (NAC) on chronic bronchitis. Methods The data were retrieved by computer from data bases, including the data bases in Cochrane library, American National Library Pubmed, Holland Medical Digest EMBase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wanfang and the Chinese Journal of Science and Technology (VIP), starting from the dates of various database establishments to April 2017 for collecting the randomized controlled trials (RCTs) of using NAC combined with conventional drugs like ambroxol hydrochloride, montelukast or placebo (treatment group) and simply using the conventional drug alone as above conventional drugs (control group) for treatment of chronic bronchitis, and the therapeutic effects were compared between the two groups. The main indicators were total effective rate, lung function indexes [forced vital capacity (FVC), percentage of forced expiratory volume in one second (FEV1) / the predictive value (FEV1%)]; the secondary indicator was St. George Hospital Respiratory Questionnaire evaluation score (the SGRQ evaluation score). Document quality evaluation and data acquisition were carried out independently by two researchers. Meta-analysis was performed by using RevMan 5.3 software. A funnel graph was drawn to evaluate the article publication bias. Results There were 7 Chinese and 3 English RCTs, including 1521 patients in the study. The results of Meta analyses showed: NAC could elevate the overall therapeutic efficiency of patients with chronic bronchitis [relative risk (RR) = 1.17, 95% confidence interval (95%CI) was 1.10-1.25, P < 0.00001], FVC [mean difference (MD) = 0.22, 95%CI was 0.02-0.42, P = 0.03), FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005) and lower the SGRQ score (MD = -6.32, 95%CI was -10.48 to -2.17, P = 0.003), showing that the therapeutic effects on these aspects in using NAC treatment group were more prominent than those in the control group. The subgroup analyses showed that NAC combined with ambroxol hydrochloride could elevate overall therapeutic efficiency (RR = 1.20, 95%CI was 1.11-1.29, P <0.00001), FVC (RR = 1.18, 95%CI was 0.99-1.41, P = 0.04) and FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005), showing that the therapeutic effects on these aspects in using NAC combined with ambroxol hydrochloride group were more prominent than those in the control group; the total rate of therapeutic effect of NAC combined with montelukast was superior to that of the control group (RR = 1.12, 95%CI =1.03-1.22, P = 0.006); NAC combined with placebo in elevating FVC aspect was better than the control group (MD =-0.01, 95%CI = -0.02 to -0.01, P < 0.00001); funnel plots showed that no publication bias was found in the literatures in the study. Conclusion It is shown that NAC for treatment of chronic bronchitis can improve the overall therapeutic efficiency, lower the SGRQ evaluation score and elevate the lung function in FVC and FEV1% aspects, but no effect on FEV1/FVC.

The clinical therapeutic effect of N-acetylcysteine on chronic bronchitis: a Meta-analysis / 中国中西医结合急救杂志

Objective To observe the clinical therapeutic efficacy of N-acetylcysteine (NAC) on chronic bronchitis. Methods The data were retrieved by computer from data bases, including the data bases in Cochrane library, American National Library Pubmed, Holland Medical Digest EMBase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wanfang and the Chinese Journal of Science and Technology (VIP), starting from the dates of various database establishments to April 2017 for collecting the randomized controlled trials (RCTs) of using NAC combined with conventional drugs like ambroxol hydrochloride, montelukast or placebo (treatment group) and simply using the conventional drug alone as above conventional drugs (control group) for treatment of chronic bronchitis, and the therapeutic effects were compared between the two groups. The main indicators were total effective rate, lung function indexes [forced vital capacity (FVC), percentage of forced expiratory volume in one second (FEV1) / the predictive value (FEV1%)]; the secondary indicator was St. George Hospital Respiratory Questionnaire evaluation score (the SGRQ evaluation score). Document quality evaluation and data acquisition were carried out independently by two researchers. Meta-analysis was performed by using RevMan 5.3 software. A funnel graph was drawn to evaluate the article publication bias. Results There were 7 Chinese and 3 English RCTs, including 1521 patients in the study. The results of Meta analyses showed: NAC could elevate the overall therapeutic efficiency of patients with chronic bronchitis [relative risk (RR) = 1.17, 95% confidence interval (95%CI) was 1.10-1.25, P < 0.00001], FVC [mean difference (MD) = 0.22, 95%CI was 0.02-0.42, P = 0.03), FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005) and lower the SGRQ score (MD = -6.32, 95%CI was -10.48 to -2.17, P = 0.003), showing that the therapeutic effects on these aspects in using NAC treatment group were more prominent than those in the control group. The subgroup analyses showed that NAC combined with ambroxol hydrochloride could elevate overall therapeutic efficiency (RR = 1.20, 95%CI was 1.11-1.29, P <0.00001), FVC (RR = 1.18, 95%CI was 0.99-1.41, P = 0.04) and FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005), showing that the therapeutic effects on these aspects in using NAC combined with ambroxol hydrochloride group were more prominent than those in the control group; the total rate of therapeutic effect of NAC combined with montelukast was superior to that of the control group (RR = 1.12, 95%CI =1.03-1.22, P = 0.006); NAC combined with placebo in elevating FVC aspect was better than the control group (MD =-0.01, 95%CI = -0.02 to -0.01, P < 0.00001); funnel plots showed that no publication bias was found in the literatures in the study. Conclusion It is shown that NAC for treatment of chronic bronchitis can improve the overall therapeutic efficiency, lower the SGRQ evaluation score and elevate the lung function in FVC and FEV1% aspects, but no effect on FEV1/FVC.

Nutritional risk screening and nutritional support survey of patients with severe stroke / 药学实践杂志

Objective To discuss the signficance using nutrtional risk screening (NRS) to evaluate nutritional status in patients with severe stroke .In the meantime compare the clinical application value between enteral and parenteral nutritional support therapies .Methods A retrospective survey was adopted to analyze the nutritional status in 267 patients with severe stroke .Their nutritional statuses were evaluated by NRS 2002 nutrtional risk screening . Patients were divided into three groups ,including enteral nutrition (EN) group ,parenteral nutrition (PN) group and EN+ PN group based on the type of their nutritional support .By comparing changes of indicators before and after of adiministration of nutritional support ,the clinical efficacy and adverse reactions for each group were evaluated .Results In EN group and EN+ PN group total protein and albu-min level were significantly increased after 10 days nutritional support (P<0 .05) .Small changes in patients'liver and kidney function indices in EN group .The incidence of co-infection was 16 .67% in EN group ,which was lowest among three groups . Conclusion Enteral nutrition support could not only improve the nutritional status of patients with severe stroke ,but also could reduce the incidence of infections and gastrointestinal complications .It significantly improves the prognosis of patients .

Measurement and analysis of staffing standards of family doctor interdisciplinary team / 中华医院管理杂志

Objective To measure and analyze the staffing standards of family doctor interdisciplinary team by means of the WHO workload indicator of staffing need (WISN)method,for reference of the government in building family doctor interdisciplinary teams.Methods 150 community health centers in 16 provinces were selected.The related data from 150 centers were collected to analyze the population served by each family doctor,and the staffing standards of family doctor interdisciplinary team by means of the WHO workload indicator of staffing need(WISN)method.Results There were 10 721 community health professionals in the sample centers which provide 132.14 million standard equivalents of service to the public.1 9 6 1 6 community health professionals were needed to ensure the quality of service and no extra workload after work for professionals.Averagely,each family doctor can serve 1 558 residents,who needs 1.3~1.5 nurses or public health workers.Conclusions A huge gap was found for community health professionals.The population served by each family doctor should be lowered compared to the governmental requirement and more nurses should be introduced to the family doctor interdisciplinary team.

Survey on the service contract signature of primary medical and health institutions in China / 中华医院管理杂志

Objective To understand the status of service contract signing conducted by primary medical and health institutions.Methods A questionnaire survey and in-depth interview methods were used to study the service contract signing at primary health care institutions.Results The contract signing rate of the institutions surveyed was 1 9.1%,and valid contract signing rate was 76%.Senior people above 65 years old accounted for 33.5% of those signers,while hypertension patients accounted for 1 9.5% and diabetes patients for 10.6%.Interviews to the general practitioners team at the primary health institutions found that main factors affecting residents′ intention to sign were drug availability, attraction for signing the services,treatment habits among others.Interviews to the staff the primary health institutions found that contracted services are facing such difficulties as medical staff shortage,lack of motivation,lack of competence among others.Interviews to leaders of the primary health institutions found that the lack of publicity and support of medical insurance also has great influence to service contract signing.Conclusions The enthusiasm of general practitioners and residents to sign up for the service remains to be improved.

Effect of sign-contract service on blood pressure control and patients satisfaction of hyperten-sive patients in primary health centers:Based on investigation in 10 provinces / 中国卫生政策研究

Objective:To investigate the effects of sign-contract services on hypertension patient disease control and the satisfaction of medical staff. Methods:a face-to-face questionnaire survey was conducted among hypertension patients selected from 20 primary health centers in 10 provinces in China. Results:This paper collected 1 ,881 valid questionnaires, and the average age of the population was 65. 72 ± 10. 88. Respondents that received sign-contract services accounted for 53. 88%, and there was no difference between patients who signed the service contract and who did not in terms of demographics. In self-reporting of blood pressure controls, respondents who signed the service contract, aged 40~50 years old, enjoyed the free medical care, preferred to seek medical services from primary a-gencies ( i. e. community health centers and township hospitals) for minor illnesses, controlled their blood pressure better ( P<0. 05 ) . Respondents enjoyed the civil resident medical insurance, preferred to seek medical care from community health centers for minor illnesses and signed the service contract were more likely to be satisfied with their medical practitioner (P<0. 05). After adjusting for age, gender, education level, medical insurance style, patient willingness to seek medical care for minor illnesses, signing service contracts was found to be an independent factor both associated with blood pressure self-control and attitudes towards medical service providers, with the odds ratio of 3. 007 (95%CI:2. 572 -3. 517) and 1. 814 (95%CI: 1. 563 -2. 105) respectively. Conclusion: Contracts are correlated with blood pressure control and satisfaction toward medical practitioners, which means that patients who signed the service contract control their blood pressure better and are more satisfied with their medical deliverers.

Measurement and analysis of community health staffing standards / 中华医院管理杂志

Objective To measure the gap of community health staffing and establish new norms for community health facilities by means of the WHO Workload indicator of staffing need (WISN) method,for reference of the government in evaluation and decision making of community health staffing. Methods With Xicheng District of Beijing as an example,we collected data on community health staffing and calculated the total demand,measuring the total demand and supply,and gap or surplus in the staffing.Results in 2013,the demand of community health staffing was about 1 7.18 million standard equivalents in Xicheng,while the supply was 10.5 12 million.The WISN ratio was 0.67 for community health supply and demand,in which the ratio of physicians was close to 1,while that of nurses and public health workers was far below 1.850 extra community health staff was needed to reach the total of 2 602 persons.Conclusion The demand and supply of community health service in Xicheng District was seriously unbalanced,a huge gap featuring overstaffing of nurses and inadequate public health workers.This results from the enhancement of primary public health services and rising utilization of community healthcare services in recent years,which deserves high attention from government of all levels,by increasing the staffing of community health staffing standards.

Analysis common gene mutation spots of 127 non-syndromic deafness natients in Guangxi Drovince / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the mutation characteristics of common deafness gene from 127 non-syndromic hearing loss patients in Guangxi province.@*METHOD@#Deafness-related gene mutations detection kit was used to detect 15 mutation sites in four deafness-associated genes, and a total of 127 hearing impaired patients were tested. The samples that could not be diagnosed with DNA microarray were subjected to PCR and sequenced to detect other mutations.@*RESULT@#Among the 127 patients with non-syndromic deafness, the total mutation rate is 8.66% (11/127), including GJB2 235delC homozygous in 3 cases (2.36%), 235delC single heterozygous mutation in 2 cases (1.57%), GJB2 235delC and 109 A > G mutations in 2 cases (1.57%); SLC26A4 1229C > T homozygous in 1 case (0.79%), IVS7-2A > G, IVS11 + 47T > C and 15448insC mutaion in 2 cases (1.57%); mitochondrial 12S rRNA gene mutations were not detected. The result indicates that GJB2 and SLC26A4 were the main genes in this study, and the mutation rate is significantly lower than the national average level. Three new mutations (SLC26A4 IVS11 + 47T > C,1548insC and GJB2 109A > G) were found. There may be rare mutations among sites or genes associated with deafness in Guangxi.

Impact analysis on the health management programs among community-based 0-36-month-olds on their growth and development / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the impact of implementation on health management programs among the community-based 0-36-month-olds regarding their growth and development.</p><p><b>METHODS</b>18 Monitoring Bodies in 8 pilot areas were selected to enroll this study, using a multistage stratified cluster sampling method. All the children aged 0 to 36 months were followed, according to the health management specification, and their health archives were collected.</p><p><b>RESULTS</b>A total of 13 464 children were involved in the specified management program with a total of 59 648 person-time under follow-up, with 54.26% of them were boys. Results from the multi-layer linear model indicated that the average height of children in the specified management group was higher than that in the non-standardized management group. Children in the specification management group, their weight gain had also been more effectively controlled. At the same time, with the increasing number of follow-ups according to the specification, the prevalence rates of under weight, stunt, emaciation and overweight were all significantly decreased (P < 0.05).</p><p><b>CONCLUSION</b>The implementation of the community-based programs on 0-36-month-olds regarding their health management specification had improved children's growth and development.</p>

Outcome analysis of the management policy for category-B large medical instruments deployed in Beijing / 中华医院管理杂志

Objective To learn the policy outcomes of the management of category-B large medical instruments deployed in Beijing.Methods Call into play the data from the surveys made in 2005,2007 and 2010 on the five types of category-B large medical instruments deployed in the city.Summarize and analyze the outcomes of such instruments in terms of their total configuration volume,and the growth,distribution and use.Results From 2005 to 2010,CT scored the fastest growth of these five types of instruments,with 48 units deployed; SPECT was the lowest,with 8 units deployed.Conclusion The volume growth,instruments distribution,and use efficiency of such instruments in Beijing are rationally evolving,which proves that the deployment and management of category-B large medical instruments is compliant with conditions of the city.

A survey on training and satisfaction of staff working at community health-care service centers employing appropriate techniques on a trial basis in east and west China / 中华全科医师杂志

Objective A cross-sectional survey was conducted to investigate difference in job-related satisfaction indexes among staff working at community health-care service centers ( CHSC ) employing appropriate techniques on a trial basis between east and west areas of China. Methods In total, 339 staff members working at CHSC employing appropriate techniques on a trial basis, including good practice of community medical records management for hypertension , good practice of community case management for type 2 diabetes , good practice of community case management for tuberculosis , etc. , were recruited for questionnaire survey from Tianjin, Jinan and Shenzhen of east China and Chengdu and Chongqing in westChina by cluster sampling. Their demographic information, training for appropriate techniques and job-related satisfaction were collected. Results There was a significant difference in proportion of CHSC staff who receiving training for tuberculosis management launched by local government between west and east areas (34. 8% vs. 41. 4% , P <0. 05). There also was significant difference in satisfaction with the support from the superior sectors of government between west and east areas ( 59. 6% vs. 52. 0% , P = 0. 022 ) . Satisfaction towards income ranked the highest, and that towards work environment the lowest among the staff either in west or east areas. Conclusions Proportion of CHSC staff receiving training for tuberculosis and satisfaction with the support from superior sectors of government vary with communities in east and west areas employing appropriate techniques on a trial basis, and work condition of CHSC should be improved further.

Analyses on the change of medical care and health services utilization of Yayuncun community residents in Beijing / 中华全科医师杂志

Objective To know the change of medical care and health services utilization of Yayuncun community residents in Beijing. Methods Using the prospective study, residents above 15 years old were selected to answer the Beijing Typical Community Resident Questionnaire designed by the local researchers. In 2004 and 2005, the baseline survey was carried. From 2006 to 2008, same questionnaire was used to follow-up survey, and 1412 residents were selected into the last study. Results The proportion of people who should see a doctor but not in past month were decreased, the differences among the three years were significant (P ＜ 0. 01 ); The top three reasons that who should see a doctor but not were the "medical care costs too high", "self- felt the sickness light", "self-treatment". The residents who went to the community health agencies increased from 2006 to 2008. The medical costs ( drugs, medical fees,inspection fees) decreased from 2006 to 2008, the differences were significant (P ＜0. 01 ) ;The satisfaction increased from 2006 to 2008, the differences were significant ( P ＜ 0. 01 ). Conclusion Under the comprehensive promotion of community health services in Beijing, the satisfaction and the utilization of medical care and health services were improved.

Survey on health knowledge among Yayuncun community residents in Beijing / 中华全科医师杂志

A baseline survey on health knowledge was conducted in Yayuncun (Asian Games Village) Community in 2004 and 2005 respectively. A sample consisting of 1765 residents aged 15 and above from 600 households, who had lived in the community at least 5 years, was randomly taken; the "Beijing Typical Community Resident Questionnaire" was used for survey and the participants were followedup annually from 2006 to 2008. The results showed that the awareness rate of food nutrition and disease prevention increased year by year; however, the participants with educational level lower than junior middle school had the lowest rate of overall health knowledge. The main channels for local residents to acquire health knowledge were activities, lectures and other programs with the title of the Olympic Games; the educational level and the year of survey were independent affecting factors on overall health knowledge among residents.

Changes of physical activity status of residents in Beijing Yayuncun community / 中华全科医师杂志

Objective To evaluate the changes of physical activity status of residents in Beijing Yayuncun(Asian Games Village)Community.Methods A total of 1765 permanent residents over 15 from 600 families living in Yayuncun Communities since 2000 were selected in this prospective study.Thebaseline survey was carried out with the Questionnaire for Residents of Beijing Typical Community in 2004 and 2005.From 2006 to 2008,same questionnaire was used for the follow-up survey,and 1412 residents were responded to the questionnaire.Results The knowledge levels related to physical exercise of Yayuncun residents elevated(P＜0.01).The source of knowledge gain from Olympics Games promotion,specialized community lectures and intemet increase significantly(P＜0.01),that from other media decreased(P＜0.01).The exercise rate in community was higher than in other sites(P＜0.01)and increased significantly (P＜0.05);while doing exercise in charged sites decreased(P＜0.05).Logistic regression analysis showed that regular physical exercise was related to age,BMI,exercise-related knowledge,exercise sites,attitude for sport facilities and chronological order.Conclusion During the preparation for the Beijing Olympic Games.the status of physical exercise of residents in Yayuncun Community presented the positive trends.

Side effects of glucocorticosteroids in the management of 1 291 patients of SARS / 北京大学学报(医学版)

Objective: To analysis the relationship between glucocorticosteroids (GCS) usage and side effects in the treatment of severe acute respiratory syndrome (SARS). Methods: All clinical records of probable SARS patients in Beijing were collected and input into an Epi6 database, in which 1 291 patients had entire information and met the clinical criteria of SARS. The usage of GCS and GCS associated side effects were analyzed retrospectively. Results: Patients accepted GCS therapy were 83.96% (n= 1 084), whereas 16.04%(n=207) did not take GCS. The average dosage of GCS was 160 mg/d in the first week, and then reduced to 80 mg/d and 40 mg/d in the second and the third weeks, respectively. Initial blood glucose, systolic pressure (SBP), and diastolic pressure (DBP) were no significant difference between GCS group and non-GCS group. The highest blood glucose during the treatment in GCS group was markedly higher than that in non-GCS group [(8.68? 4.80 ) mmol/L vs (6.39?3.71) mmol/L, P05). After GCS administration, SBP and DBP were increased gradually, and reached their peaks in the fourth week [SBP (117.2?14.0) mm Hg and DBP (72.5?9.1) mm Hg vs SBP (120.0?12.5) mm Hg and DBP (74.5?8.7) mm Hg, P