Objective To understand the residents’ demands and utilization of the community health services and provide a basis for the construction of reasonable medical service system. Methods From July to September 2015, a purposive sampling questionnaire survey on general team mode service to bring benefits to the community residents was conducted in 20 provincial-level administrative regions of the country. SPSS 13.0 software was used for data analysis. Results A total of 1 300 questionnaires were distributed, and 1 273 valid questionnaires were recovered. In the 221 residents who were aware of the composition of general team, the awareness rate of general team composed of traditional Chinese medical doctors and gynaecologists/pediatricians was low (70.14%, 75.11%, respectively). The awareness rate of medical services including disease diagnosis and treatment, health consultation, health education and prescription in the 1 273 residents was 70.46%, 61.19%, 59.62% and 67.56%, respectively; the residents’ top five willing to accept medical services was prescribing medicine (77.77%), infusion (74.08%), health consultation (73.21%), health education (70.54%), and planned immunization (64.49%). The biggest change of the 433 patients with chronic diseases before and after treatment in the community was the increase in self-health management (70.67%) and the healthy lifestyle improvement (56.35%). Conclusion Community general team should be oriented by the objective needs and real demands of the residents; based on the ability of medical services supply, the adjustment of the key points of medical services should be made and the rational use of medical services should be guided for the residents.
目的 探讨成都市高脂血症患病率及合并心血管危险因素的现状及城乡差异。 方法 2010年3月－11月随机抽样选取城市和农村社区，采用问卷、体格检查和实验室检查共调查35～70岁人群2 032例，其中城市社区1 015例，农村社区1 017例。进一步调查其中高脂血症患者合并的主要心血管危险因素。 结果 ① 成都市城乡高脂血症患病率为23.53%（474/2 032）。城市高于农村，分别为27.88%（283/1 015）和18.78%（283/1 017）；② 城市高脂血症人群中合并高血压、糖尿病和冠心病均高于农村。高脂血症合并高血压人群最多，城乡分别是51.95%（147/283）和31.94%（61/191），其次是合并“糖尿病”和“冠心病”人群；③ 城市高脂血症患者合并高血压人群无论男女均高于农村，但城市男性合并糖尿病者高于农村，城市女性合并冠心病者高于农村；④ 城乡高脂血症患者在合并饮酒、脑卒中史、腹型肥胖和肥胖之间差异无统计学意义（P＜0.05）。 结论 高血压、糖尿病和冠心病是城市高脂血症患者干预的重点危险因素。其中城市男性的糖尿病和城市女性冠心病干预更为重要。
Objective To assess the effect of problem-based learning (PBL) to improve clinical practice skills for clinical students after graduation. Methods Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL. The quality of the included studies was critically evaluated and data were analyzed. Results A total of 16 articles were included. The results showed that in integrated capabilities, PBL teaching was superior to traditional teaching methods. Whether in self-evaluation or objective evaluation, in terms of legal and ethical aspects of health care, research and presentation skills and ability to solve problem, PBL teaching was superior to non-PBL-learning methods. But in other aspects, it was yet controversial whether PBL-learning was better than non-PBL-learning. Conclusion Problem-based learning could improve clinical practice skills for clinical students after graduation. However, most trials included are of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective To evaluate the clinical efficacy and safety of triple-antiplatelet treatment based on Cilostazol for restenosis after percutaneous coronary intervention. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2009), PubMed (1966 to 2009), EMbase (1974 to 2009), CNKI (1994 to 2009), CBM (1978 to Feb. 2009), VIP (1989 to Feb. 2009), and CMD Digital Periodicals (1998 to 2009). Two reviewers independently evaluated the quality of the included studies and extracted the data. Meta-analyses were performed using RevMan 5.0 software. Results Five randomized controlled trials (RCTs) involving 2 348 patients were included. The results of meta-analyses showed that triple-antiplatelet treatment based on Cilostazol could increase minimum lumen diameter (MD=0.31, 95%CI 0.11 to 0.51) and decrease restenosis rate (OR=0.49, 95%CI 0.37 to 0.65). In addition, it could decrease death rate (OR=0.52, 95%CI 0.31 to 0.88), but it could not change target-vessel revascularization, stroke rate, palpitation rate, and the rate of major adverse cardiac and cerebral events and major adverse cardiac events. Conclusion Evidence shows that triple-antiplatelet treatment based on Cilostazol could increase minimum lumen diameter and decrease restenosis rate and death rate. Their clinical application is worthy to be advocated.
Objective To investigate the medical technical services of the primary health care institutions in Chengdu and provide suggestions to improve their capability. Methods From October to November 2016, a questionnaire survey was conducted towards all the 390 primary health care institutions (including urban community health service centers and rural township health centers) in the 22 districts/cities/counties of Chengdu. Descriptive statistical methods was used for analysis. Results A total of 390 questionnaires were issued, and 379 valid questionnaires were recovered. In the primary health care institutions, the proportion of laboratory technicians, ultrasound technicians, electrocardiogram technicians and radiological technicians accounting for overall medical staffs was 3.32%, 2.04%, 1.75%, and 2.43%, respectively. The setup rate of laboratory, B-ultrasonic room, electrocardiogram room in the urban community health service centers was 94.02%, 93.16%, and 94.02%, respectively, which was similar with the rural township health centers (93.51%, 95.42%, and 90.08%, respectively). The top three medical technical services provided by the primary health care institutions were blood glucose test (96.04%), blood routine test (95.25%) and urinary routine test (95.25%), and the latter three were lung function test (18.21%), blood gas analysis (8.18%) and CT (5.28%). Conclusion Primary health care institutions in Chengdu need to improve the standardization of medical technical projcects and improve their service capability.
【摘要】 目的 调查成都市未成年犯管教所民警心理健康水平。 方法 2010年5月采用症状自评量表（symptom checklist 90，SCL-90）和健康调查简表（short form 36 health survey questionnaire，SF-36）调查成都市某未成年犯管教所153名民警的心理健康水平，并对比相应人群的常模分数。 结果 未成年犯管教所民警SCL-90阳性率57.5%，SCL-90总分及各因子分均高于1999年修正常模、1986年全国常模（Plt;0.05）。SCL-90的人际关系敏感因子分与北京监狱民警常模差异无统计学意义（Pgt;0.05），偏执因子分低于北京监狱民警常模（Plt;0.05），SCL-90总分及其余因子分均高于北京监狱民警常模（Plt;0.05）；SCL-90总分及各项因子分男性高于女性（Plt;0.05），直接监管犯人者高于内务、管理工作者（Plt;0.05）；年龄lt;35岁者的抑郁、偏执、精神病性因子分高于年龄gt;35岁者（Plt;0.05）。SF-36各因子分均低于1998年四川居民、2005年上海公安局民警（Plt;0.05）；SF-36各因子与SCL-90总分、各因子均呈负相关（Plt;0.05）。 结论 应重视并改善未成年犯管教所民警的心理健康水平。【Abstract】 Objective To investigate and analyze the mental health of policemen in juvenile reformatory and their relationships. Methods The mental health of 153 policemen working in a juvenile reformatory were assessed by using symptom checklist (SCL)-90 and short form 36 health survey questionnaire (SF-36) in May, 2010. The data was compared with norm and other relative data, such as SCL-90 China norm, norm revised in 1999, SCL-90 of judicial police in Beijing, etc. Results The positive rate of SCL-90 of policemen in reformatory was 57.5%. The total score and factor score of SCL-90 were significantly higher than that of the China norm revised in 1999. Furthermore, compared with the judicial policemen in Beijing, except for the interpersonal sensitivity and paranoid ideation, the total score and other factor scores were significantly higher. The SCL-90 total score and various factors of the males were significantly higher than that of the females. The score of the guards was higher than that of charging of quarters and management. In youth (less than 35 years old) depression, paranoid ideation, psychoticism factor scores were significantly higher than that in the middle-aged groups. SF-36 factor score of the reformatory police was significantly lower than that of Sichuan resident in 1998, and also the policemen in Shanghai Public Security Bureau in 2005. And SF-36 factor score of the reformatory policemen had a significant negative correlation with the total score and every factor score of SCL-90. Conclusion We should pay attention to the juvenile reformatory policemen’s mental health and and improve it.
Objective To investigate the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, DKK-1 (dickkopf-1), sclerostin. Methods A total of 100 elderly patients with knee osteoarthritis in Sichuan Province Orthopedic Hospital from September 2017 to December 2018 were selected and divided into bone marrow edema group (50 cases) and non-bone marrow edema group (50 cases). The patients’ basic data, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores and Visual Analogue Scale scores were collected. The patients’ serum osteoprotegerin, DKK-1, sclerostin, C-reactive protein, and erythrocyte sedimentation rate were tested, and the differences between the two groups were compared. The correlation of the detection indicators and bone marrow edema and its clinical indicators was explored. Results There was no significant difference in age, gender, course of disease, C-reactive protein and erythrocyte sedimentation rate between the two groups (P>0.05). WOMAC scores (76.1±5.4 vs. 67.5±6.6), Visual Analogue Scale scores (8.4±1.1 vs. 5.5±0.9), proportion of synovitis (84.0% vs. 52.0%), osteoprotegerin [(1.3±1.1) vs. (0.6±0.5) μg/L], DKK-1 [(18.4±16.9) vs. (6.9±6.0) μg/L] and sclerostin [(147.3±119.4) vs. (99.7±70.7) pg/mL] in the bone marrow edema group were higher than those in the non-bone marrow edema group (P<0.05). There was no statistically significant correlation of the bone marrow edema volume score and degree score and serum osteoprotegerin of patients in the bone marrow edema group (P>0.05). The bone marrow edema volume score and degree score of patients in the bone marrow edema group were positively correlated with serum DKK-1 (volume score rs=0.464, P=0.001; degree score rs=0.379, P=0.007) and sclerostin (volume score rs=0.316, P=0.025; degree score rs=0.461, P=0.003). Conclusion In elderly patients with knee osteoarthritis and bone marrow edema, the local bone metabolism indicators of osteoprotegerin, DKK-1 and sclerostin are up-regulated, especially DKK-1 and sclerostin are related to the severity of bone marrow edema.
Liddle syndrome and Gordon syndrome are two rare single-gene inherited hypertension diseases. In patients≤40 years, the prevalence of Liddle syndrome is about 1% and Gordon syndrome is uncertain all over the word, for which is often misdiagnosed and mistreated. The therapies of those diseases are targeted at gene mutation sites, as well as combined with modified lifestyle, and can achieve satisfactory diseases control. This paper reports a patient who is diagnosed with Liddle syndrome and Gordon syndrome at the same time. We aimed to consolidate and improve the diagnosis and accurate treatment of those two diseases by sharing, studying and discussing together with clinical doctors.