Objective To analyze the clinical efficacy and safety of holmium laser lithotripsy under ureteros-copy in the treatment of ureteral calculi .Methods The clinical data of 160 patients with ureteral calculi were retro-spectively analyzed .All patients received the epidural or general anesthesia surgery ,guide wire was inserted through ureteroscopy,holmium laser lithotripsy line,postoperative indwelling double J tube 2-4 weeks.Results Of 160 cases, a single stone crushing operation was 94.37%;mean operative time was 51min.All patients had mild hematuria,3 ~4d may disappear.By 1 to 3 months follow-up,stone clearance rate was 97.5%.The success rate of gravel for surgical ureteral calculi was 70.27%, and middle and lower ureteral stone gravel-time success rate was 99.20%.Conclusion Holmium laser lithotripsy under ureteroscope in the treatment of ureteral calculi is safe ,effective,and has minimally invasive,fewer complications.

Objective To observe the clinical efficacy of acupuncture in treating cancer-related fatigue (CRF) due to spleen-kidney deficiency.Method Sixty eligible subjects with CRF due to spleen-kidney deficiency were randomized into a treatment group and a control group, 30 cases in each group. The control group was intervened by nutritional support and symptomatic management, while the treatment group was treated with acupuncture in addition to the intervention given to the control group. The Karnofsky Performance Status (KPS), Piper Fatigue Scale (PFS), and peripheral blood test were observed before and after treatment.Result The KPS scores were significantly changed after treatment in both groups (P<0.05). The PFS item scores (behavior, affect, sensory, and cognition) were significantly changed after intervention in the treatment group (P<0.05). The behavior score in the control group was significantly changed after treatment (P<0.05). After treatment, there were significant differences in comparing the PFS item scores between the two groups (P<0.05). There were significant differences in comparing the lymphocyte levels between the two groups after treatment (P<0.05).Conclusion Acupuncture is an effective method in treating CRF due to spleen-kidney deficiency, and it can up-regulate the peripheral blood cells and strengthen the immunity.

Chinese Center for Disease Control and Prevention published three confirmed novel H 7N9 avain influenza virus in-fection cases on March 31 ,2013 .The disease then spread across China and caused extremely high morbility and mortality , which trig-gered extensive attention .These cases were caused by a novel H 7N9 avian influenza virus which was highly mutable .Once the virus a-dapted to human respiratory epithelium receptors , a pandemic outbreak would occur immediately .This article summerizes the research progress on the H7N9 avain influenza, including epidemiologic characteristics , etiology features, clinical manifestation, detection tech-niques as well as theraputic and prevention strategy .

The three-level prevention theory is called into play as guided by the contemporary medical model and combination of prevention and treatment,to classify the services into three levels.Services by maternal and child health care institutions are designed as Level-1,early discovery,early diagnosis and early treatment prevention as Level-2,while clinical prevention as Level-3.The paper also clarified misunderstandings and proposed the general healthcare concept for such institutions.

OBJECTIVETo observe the effect of Tai Ji Quan (TJQ) training on strength and function of lower limbs in the aged.

METHODSSixty senile subjects were recruited and assigned to the TJQ group and the control group (imparting health knowledge)by random digit table. Patients in the TJQ group received 24-style TJQ training for 18 months (60 min each time, 5 times per week), while those in the control group were imparted with sarcopenia related causes, pathogeneses, prevention and control measures. The maximum isometric strength of bilateral iliopsoas, quadriceps femoris, tibialis anterior muscle, hamstrings; the time for 5 sitting-up tests and Time Up and Go Test (TUGT), one-leg standing time with closed eyes test; and the score of Berg balance scale were compared between the two groups.

RESULTSCompared with before treatment, muscle strength increased in the TJQ group with an average increased capacity (rate) as follows, bilateral iliopsoas 5.5 kg (16.9%), quadriceps femoris 5.5 kg (26.2%), and tibialis anterior muscle 8.5 kg (36.2%) (all P < 0.05). The time for TUGT and 5 sitting-up tests was shortened by 1.3 s (16.7%) and 0.9 s (14.5%) respectively in the TJQ group. The time for one-leg standing time with closed eyes test was increased by 8.4 s (left) and 9.1 s (right) respectively. The score of Berg balance scale increased by 4.3% (P < 0.05). Compared with the control group, bilateral quadriceps femoris and tibialis anterior muscle strength increased significantly (P < 0.01); the time for TUGT and 5 sitting-up tests, the time for one-leg standing time with closed eyes test, scores of Berg balance scale were all improved in the TJQ group after intervention (P < 0.05).

CONCLUSIONTJQ training could improve strength of iliopsoas, quadriceps femoris, tibialis anterior muscle in the aged, elevate their balance and locomotor activities, and possibly prevent and treat sarcopenia.

BACKGROUND: Platelet-rich plasma (PRP) contains growth factors that affect tendon, ligament, muscle and bone healing. On this basis, researchers gradually realize that such molecules released after PRP activation can regulate the early inflammation of peripheral nerve injury, activate Schwann cells, promote the polarization of macrophages, and actively prevent the hyperplasia of collagen fibers, thus becoming the key drivers of nerve function recovery. OBJECTIVE: To evaluate the value of ultrasound-guided PRP injection in the repair of sciatic nerve crush injury. METHODS: Twenty-eight healthy New Zealand white rabbits (provided by the Beijing Longan Experimental Animal Breeding Center) were randomly divided into normal group, control group, single PRP group and multiple PRPs group. In the normal group, the right sciatic nerve was exposed and then sutured directly. In the control group, a compression injury model of the right sciatic nerve was established. In the single PRP group, autologous PRP was injected around the injured nerve under ultrasound guidance at 24 hours after modeling. In the multiple PRPs group, autologous PRP was injected around the injured nerve under ultrasound guidance at 24 hours after modeling, and then the PRP injection was performed once at the 3rd and 5th weeks after modeling. Histological and morphological observation of regenerated nerves, wet weight recovery and histological manifestations of the denervated muscle were evaluated at 12 weeks after modeling. The study protocol was approved by the Administrative Committee of Experimental Animals in PLA General Hospital with the approval No. 2015-x10-02. RESULTS AND CONCLUSION: The integral optical density values of NF-200 and S100 staining, myelinated nerve fiber density, myelinated nerve fiber diameter and myelin sheath thickness were significantly increased in the single PRP and multiple PRPs groups compared with the control group (all P < 0.05), and the multiple PRPs group showed better outcomes than the single PRP group (all P < 0.05), but was still inferior to the normal group (all P < 0.05). Compared with the control group, wet weight and cross-sectional area of muscle fibers significantly increased in the single PRP group and multiple PRPs group (P < 0.05), and the multiple RPRs group showed better outcomes than the single PRP group, but was still inferior to the normal group (P < 0.05). To conclude, ultrasound-guided multi-frequency injection of autologous PRP has a good effect on the repair of sciatic nerve crush injury.

Objective To divide the medical services currently offered by various medical institutions into priority,extended and non-essential items.Methods The items were divided according to their actual usage at these hospitals,and such services were screened based on hospital positioning and clinical pathway of diseases.Results The selected priority services at the primary,secondary and tertiary hospitals were 255, 378 and 820 respectively.Their proportions in total medical services of these hospitals were 92.9%,95.9% and 97.4% respectively,and the proportion of their costs in total medical service costs were 57.9%,76.8% and 84.5% respectively.Conclusions The selected priority items had covered most of the services and costs,which deserve promotions at all the hospitals as it embodied the principle of benefiting the majority of the population.

Objective To determine the main contents and key points of the essential medical services by means of priority setting of diseases with high incidence and serious damage based on the demand of residential medical services.Methods The priority setting method is applied in this study,and the incidence,prevalence,hospitalization rates and the ratio of different types of inpatient are used as indicators to reflect medical demand and utilization.The integrated balance method is also used,and the priority diseases list is made based on the analysis from the view of disease onset,considering the service delivery,social equity and the health financing.Results Based on the data analysis made,this paper proposed that the priority diseases cover 29,66 and 103 types for primary hospitals,secondary hospitals and tertiary hospitals respectively.The main diseases so determined include hypertension,diabetes, maternal and child health,severe mental illness,infectious diseases,emergency treatment,etc.Conclusions The method and result of setting priority disease and main disease can be the basis of setting for main diseases in essential medical services.

Boundaries definition plays a key role in defining the scope of essential medical coverage of the country and the governmental role positioning in medical service offerings.It is also a precondition of furthering the ongoing healthcare reform.This paper analyzed the data of health service demand,supply and financing using the priority setting and the integrated balance methods.It suggested that the definition of the essential medical services should embody Chinese characteristics and be consistent with the Party′s governing philosophy and social core values.It also should be fully considered that the administration system,the governing philosophy,the medical insurance system and the government duty in the healthcare system of China.This paper proposed a multiple-criteria defining of the essential medical services,which should focus on main healthcare issues in China,and be adapted to the current healthcare reform process.Three dimensions need to be considered in the defining,which are the demand,supply and financing of the healthcare services,along with the impact of the housing,equipment,personnel, technology,supplies,drugs and other medical service elements.This paper presented the overall framework of essential medical services in four levels,which is composed of the basic package,the core package,the priority package and the expansion package.

Objective To explore the clinical effect of creatine phosphate on infantile with rotaviral enteritis and myocardial damage.Methods One hundred and twenty children with rotaviral enteritis and myocardial damage were randomly divided into the control group (n =60) and observation group (n =60).Two groups were given antiviral,rehydration,nutritional support,redressing acid-base imbalance and electrolyte disorders and other conventional treatment.The patients of the control group were given 160 mg/(kg · d) 1,6Fructose Diphosphate(1 times/d) on the basis of routine treatment,while those in the observation group were given 1.0 g creatine phosphate + 150 ml 5％ glucose injection(1 times/d) on the basis of routine treatment,both courses of two groups were 7 days.The levels of myocardial enzymes were measured and the clinical effect and adverse reactions were recorded.Results The total effective rate in observation group was 95.0％ (57/60),obviously higher than that of control group (80.0％ (48/60)) and the differences were statistically significant (x2 =6.268,P ＜ 0.05).There were no statistical significant difference in terms of myocardial enzyme between the two groups before treatment(P ＞0.05).The level of lactate dehydmgenase(LDH),creatine kinase (CK),creatine kinase isoenzyme (CK-MB) and aspartate aminotransferase (AST) of observation group were (163.8 ±18.5) U/L,(152.8±26.4) U/L,(19.4±7.8) U/Land (24.4 ±6.8) U/Lafter treatment,and (193.4 ± 22.8) U/L,(168.6 ± 32.6) U/L,(27.4 ± 9.2) U/L and (35.4 ± 9.8) U/L of control group,and the differences between the two groups were significant (t =3.484,3.228,4.278 and 4.729; P ＜ 0.05).There was no obvious adverse reaction during the treatment course.Conclusion The clinical effect of creatine phosphate on infantile with rotaviral enteritis and myocardial damage is remarkable and safe,and it is worth of clinical application.