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Objective: On the basis of typical cases, the objective of this study is to assess the service quality of primary healthcare institutions under the vertically integrated model from the perspective of demanding side.Methods: The vertical model between Renhe Hospital and Lixian Township Health Center was selected as the case study.Quantitative data were collected by exit review using Primary health-Care quality service Assessment Tool (PCAT)-Chinese version from the patients seeking services in Lixian.Quantitative data were analyzed by descriptive statistics and multiple linear regression equations while qualitative data were analyzed by thematic framework analysis.Results: Under the vertical model, the PCAT total score was 20.09.The scores on the first diagnosis, continuity of care, and comprehensiveness of care and coordination of care were 6.59, 3.27, 4.58 and 5.62 respectively.The scores on the three dimensional extensions, family-centered, community-oriented, medical culture were 3.07, 1.86 and 2.67 respectively.The difference was significant for the PCAT total score between a number of visits and the length of waiting time for services in Lixian.Conclusions: Under the vertical model, primary healthcare institutions did better in the first diagnosis while weaker in continuity and the three dimensional extensions.With the development of the integration, the primary healthcare institutions need to strengthen the continuity and downward referral in the future.Future researches and follow-up, analysis is needed to track the impact of the vertically integrated model.
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<p><b>OBJECTIVE</b>To explore the relationship between expression of coiled-coil domain-containing protein 80(CCDC80) and obesity in serum and adipose tissues.</p><p><b>METHODS</b>A cross-sectional survey was conducted in a hospital in Tangshan in September 2010. 100 people including 78 healthy people and 22 with type-2 diabetes were recruited. Another 36 female patients with benign tumor of Obstetrics and Gynecology were also recruited. Demographic characteristics and serum samples were collected from all subjects, basic biochemical indicators were tested. All subjects were divided into 'Normal Weight' and 'Overweight and Obese' according to their BMI (BMI <24.0 kg/m(2); BMI≥24 kg/m(2)). Serum CCDC80 of the 100 subjects was detected by ELISA. Visceral and subcutaneous fat were derived from the other 36 female subjects, and Real-time PCR was used to detect CCDC80 mRNA expression in adipose tissues. Pearson correlation and multiple linear regression were used to analyze the correlation between serum or adipose CCDC80 expression and waist, BMI, and other biochemical indicators.</p><p><b>RESULTS</b>The age of 100 subjects was (52.9±8.4) years old. 44% of them were women (44 cases) and 56% of them were men (56 cases). After dividing them into three groups according to their BMI, covariance analysis were conducted, and age and gender were adjusted. The HDL-C level was significantly different among three groups (F = 10.73, P < 0.001): 'Overweight and obese combined with diabetes' group ((0.90±0.06) mmol/L)< 'Overweight and obese' group ((1.14±0.04) mmol/L) < 'Normal weight' group ((1.28±0.05) mmol/L). The adjusted expression of serum CCDC80 of the 100 subjects was (5.84±0.16) pg/ml, (5.81±0.98) pg/ml among men and (5.97±0.89) pg/ml among women, and there was no significant difference (t = -0.812, P = 0.419) between genders. ANOVA revealed that there was no significant differences of the expression of serum CCDC80 among three groups (F = 1.06, P = 0.351), 'Normal weight' group was (5.84±0.16) pg/ml, 'overweight and obese' group was (6.11±0.14) pg/ml, and 'Overweight and obese combined with diabetes' group was (5.84±0.19) pg/ml. The analysis showed that FBG had a negative correlation with serum CCDC80 (R(b) = -0.223, P = 0.026). Multivariate linear regression had a similar result, with 1 mmol/L increase of serum FBG, serum CCDC80 decreases for 0.24 pg/ml (β = -0.24, 95% CI: -0.21--0.02). There was also a negative correlation between serum CCDC80 and FBG in overweight and obese people (R(a) = -0.368, P = 0.013). Besides, CCDC80 mRNA was detected in both subcutaneous and visceral adipose tissue of 36 cases, the expression level was 0.06±0.02 for subcutaneous fat, was 0.05±0.04 for visceral fat, and the expression in visceral fat was lower (0.05±0.03) than that in subcutaneous fat (0.06±0.03) (t = 2.50, P = 0.025) among overweight and obese group. There was a negative correlation between waist and visceral CCDC80 mRNA expression (r = -0.472, P = 0.035).</p><p><b>CONCLUSION</b>This study suggested that CCDC80 may be involved in energy and insulin metabolism, and plays a protective role in obesity and diabetes.</p>