A survey on satisfaction of supply and demand sides of community health services in Shanghai / 上海预防医学

ObjectiveTo investigate the satisfaction of both service providers and users in community health service centers through questionnaires， and to analyze the reasons， so as to put forward suggestions for improving satisfaction. MethodsSampling was conducted in 247 community health service centers in 16 districts of Shanghai， and data were collected from employees and patients through on-site questionnaires. ResultsA total of 10 334 eligible questionnaires were collected from community health service centers， of which 7 712 were from patients and 2 622 were from employees. In 2021， the public's satisfaction with community health service centers was 96.51 points， and the satisfaction of employees was 94.08 points. The public expressed lower satisfaction with the availability of essential drugs for outpatient services， while the staff were less satisfied with their salary and benefits， work recognition， and career development. Regarding family doctor services， 73.38% of the public had signed up for family doctor services， while 23.57% of the public did not know about the family doctor services， and 16.18% believed it was necessary to improve the publicity of basic public health services. ConclusionThe public's overall satisfaction with the service of community health services is gradually increased. The basic medical services of community health are recognized by residents. Drug allocation needs to be improved urgently， and publicity and promotion need to be further strengthened. The overall satisfaction of employees is high， but further improvement is needed in terms of salary and benefits， work recognition， and career development.

The Nucleus Accumbens CRH-CRHR1 System Mediates Early-Life Stress-Induced Sleep Disturbance and Dendritic Atrophy in the Adult Mouse / 神经科学通报·英文版

Adverse experiences in early life have long-lasting negative impacts on behavior and the brain in adulthood, one of which is sleep disturbance. As the corticotropin-releasing hormone (CRH)-corticotropin-releasing hormone receptor 1 (CRHR1) system and nucleus accumbens (NAc) play important roles in both stress responses and sleep-wake regulation, in this study we investigated whether the NAc CRH-CRHR1 system mediates early-life stress-induced abnormalities in sleep-wake behavior in adult mice. Using the limited nesting and bedding material paradigm from postnatal days 2 to 9, we found that early-life stress disrupted sleep-wake behaviors during adulthood, including increased wakefulness and decreased non-rapid eye movement (NREM) sleep time during the dark period and increased rapid eye movement (REM) sleep time during the light period. The stress-induced sleep disturbances were accompanied by dendritic atrophy in the NAc and both were largely reversed by daily systemic administration of the CRHR1 antagonist antalarmin during stress exposure. Importantly, Crh overexpression in the NAc reproduced the effects of early-life stress on sleep-wake behavior and NAc morphology, whereas NAc Crhr1 knockdown reversed these effects (including increased wakefulness and reduced NREM sleep in the dark period and NAc dendritic atrophy). Together, our findings demonstrate the negative influence of early-life stress on sleep architecture and the structural plasticity of the NAc, and highlight the critical role of the NAc CRH-CRHR1 system in modulating these negative outcomes evoked by early-life stress.

Comprehensive evaluation of community health services in Shanghai / 中华医院管理杂志

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.

Analysis of 994(G--> T) mutation in the plasma platelet-activating factor acetylhydrolase gene in the patients with cerebral infarction / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between plasma platelet-activating factor acetylhydrolase (PAF-AH) gene 994(G--> T) mutation in exon 9 and the patients with cerebral infarction in Chinese Hans.</p><p><b>METHODS</b>The authors conducted a case-control study including 108 patients in three groups (atherosclerotic cerebral infarction group, lacunar infarction group and cerebral embolism group) and 215 normal subjects as controls. Genomic DNA was analyzed for the mutant allele by a specific polymerase chain reaction.</p><p><b>RESULTS</b>The frequency of the mutant genotype in the 102 patients with cerebral infarction was 35.19%(32.41% heterozygotes and 2.78% homozygotes), and was 38.10%(34.92% heterozygotes and 3.18% homozygotes) in the atherosclerotic cerebral infarction group, being all significantly higher than the control group's 20.46% (18.60% heterozygotes and 1.86% homozygotes)(P< 0.01); however, the frequencies of the mutant genotype in the lacunar infarction group and cerebral embolism group were 32.35% (29.41% heterozygotes and 2.94% homozygotes) and 27.27% (27.27% heterozygotes and 0 homozygotes) respectively, being not statistically different from those of the controls (P> 0.05).</p><p><b>CONCLUSION</b>These findings show that the 994(G--> T) mutation of plasma PAF-AH gene may be an independent risk for atherosclerotic cerebral infarction, but not for lacunar infarction.</p>