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Objective:To understand the utilization situation of community health service institutions, the awareness of basic public health items and the degree of satisfaction of residents in Guangzhou City, so as to provide direction and reference for improving the quality of community health service in Guangzhou City.Methods:In December 2020, 1 050 residents in a district of Guangzhou City were selected by multi-stage random sampling method to fill out the questionnaire. Single factor analysis was used for Pearson chi-square test, and binary logistic regression analysis was used for multiple-factor analysis.Results:A total of 1 092 questionnaires were sent out and 1 050 were valid, with an effective rate of 96.2%. The average times of seeing a doctor or receiving other health services in community health service center in the past year were (4.60±4.10). The total awareness rate of basic public health services was 91.6%(962/1 050), and the total awareness rate of free public health services was 89.5% (940/1 050). The total scores of residents' satisfaction with community health service institutions were (4.61±0.75) points, among which the basic medical service scored the highest, and the institution facilities, system and basic information scored the lowest. Single factor analysis showed that 10 factors, such as type of medical insurance, preferred medical institution, walking time to community center and medical service time, were the influencing factors of residents' overall satisfaction. Multiple-factor analysis found that institutions and facilities, systems and basic conditions, basic medical services, medical expenses, the type of first-visited hospital were the four influencing factors of residents' overall satisfaction ( OR=21.294, 109.013, 18.203 and 20.989, respectively). Conclusion:The residents have a good utilization of community health services, and they have good awareness of public health service projects, but the residents' satisfaction with community health services still needs to be improved, especially in the aspects of facilities, equipment and service efficiency of medical staff.
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The plasma levels of homocysteine (Hcy),vitamin B12 and folic acid were measured in a total of 101 patients with herpes zoster (observation group) before treatment and 100 healthy controls (control group).And the plasma level of Hcy was also measured in observation group after treatment.There was a significant increase of Hcy level in observation group versus control group (P ＜0.01).And the levels of VitB12 and folic acid did not fluctuate (P ＞ 0.05).The occurrence rate of hyperhomocysteinemia and the level of Hcy differed in age group,onset site and pain severity (P ＜ 0.05).No significant differences existed between gender or onset site (P ＞ 0.05).The level of Hcy significantly decreased after treatment versus before treatment (P ＜0.01).Plasma Hcy significantly increased in patients with herpes zoster.And it was correlated with age,lesion extent and pain severity.However,there was no correlation with gender,onset site or levels of vitamin B12 and folic acid.
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Objective To study the operative techniques and clinical effect of arthroscopic reconstruction for posterior cruciate ligament (PCL) with ligament advanced reinforcement system (LARS)Y-shape double bundles artificial ligament.Methods From June 2006 to August 2010,14 patients (10 males and 4 females,at age range of 19-58 years,mean 38 years) with PCL ruptures were treated with LARS under arthroscopic observation.The injury causes included sports contusion in nine patients,traffic accidents in three and falling from height in two.Five patients were with left knee injury and three with right knee injury.The course of injury was 10-30 days (average 15.7 days).MRI indicated complete PCL ruptures in 14 patients and complete anterior cruciate ligament (ACL) ruptures in two.The combined injuries included medial meniscus injury in five patients,lateral meniscus injury in three and posterior acetabular wall fracture in one.The preoperative Lysholn score was (40 ± 7.9 ) points ( range,20-55 points).According to the international knee documentation committee (IKDC) grading,three patients were rated as grade C and 11 as grade D preoperatively.The operation was performed under arthroscopic observation.The ending point and tunnel of PCL of the femur and tibia were drilled with the help of a locator.ResultsAll the patients obtained primary healing,with no complications such as infection,spontaneous rupture or laxity of graft postoperatively.The regular follow-up for all cases ranged from6-60 months ( average 20.5 months).The postoperative Lysholn score was ( 88 ± 3.6 ) points ( 84-93 points),with statistical difference in comparison with the preoperative score (P ＜ 0.05 ) The IKDCgrading was A in 10 patients and B in four 12 months postoperatively. ConclusionsArthroscopic reconstruction with LARS artificial ligaments can effectively recover the stability of the knees,avoid the complications brought by autologous tendon and prevent the allograft rejection complications induced by allogenic tendon graft.The treatment is characterized by simple procedures,minor wound and fast recovery.
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Objective To investigate the incidence of occult pancreatobiliary reflux and to evaluate its relation to gallbladder epithelial dysplasia and cancer. Methods From July 2006 to Feb 2008,956 cases underwent selective biliary procedure or preoperative endoscopic retrograde cholangiopanereatography (ERCP), bile was collected and amylase was measured. All removed gallbladders were pathologically examined for dysplasia and cancer. Results Occult pancreatobihary reflux was found in 75 of 754 patients in this study, with an incidence of 9. 9%. The biliary amylase values in the patients with occult pancreatobiliary reflux and in controls were 7701±20 378 IU/L and 16±51 IU/L, respectively ( P <0. 01 ).Gallbladder dysplasia and cancer were found in 31.0% and 3.4% of the patients with occult pancreatobiliaryreflux, respectively, and both were higher than those in the patients without pancreatobiliary reflux ( P <0. 05). In the patients with occult pancreatobiliary reflux, the biliary amylase level with gallbladder dysplasia or cancer was 2388 ± 2745 IU/L and was higher than those without gallbladder dysplasia or cancer (P < 0. 01 ). Conclusions With an incidence of 9.9% in patients of normal pancreatobiliary junction,the occult pancreatobihary reflux may contribute to the pathogenesis of gallbladder epithelial dysplasia and cancer.