Randomized controlled trial(RCT),considered as the strongest evidence-based method in clinical trial,can provide first-hand scientific evidence for clinical practice and instruct clinicians to make correct decisions in practice.This article introduces the principles for RCT designing,analyzes the common problems concerning RCT in clinical practice and the common mistakes made in RCT statistical methods.It is concluded that application of RCT method and correct statistical methods are of great importance in clinical medical research.

Objective To investigate whether the high intensity focused ultrasound (HIFU) for treating uterine fibroids and adenomyosis leading to pelvic adhesion .Methods 1 672 patients with definitely diagnosed uterine fibroids or adenomyosis were col‐lected and divided into the non‐HIFU group(1 560 cases) and HIFU group(112 cases) according to whether performing HIFU op‐eration .The pelvic adhesion situation in each case was scored according to pelvic adhesion scoring system .Then the results were performed the statistical process .Results No statistically significant differences were observed in the pelvic adhesion situation and pelvic adhesion degree between the HIFU group and the non‐HIFU group (P>0 .05) .The single factor analysis of factors possibly causing pelvic adhesion showed that the age ,past history of endometriosis ,operation and pelvic inflammatory disease ,lesion size and dysmenorrhea history affected pelvic adhesion ,the differences were statistically significant(P<0 .05) .But in the multi‐factor corre‐lation analysis ,various factors in the HIFU group were excluded(P> 0 .05) ,while the operation history and pelvic inflammation disease history had correlation with pelvic adhesion (P<0 .05) .Conclusion HIFU dose not cause pelvic adhesion in treating uter‐ine fibroids and adenomyosis .

Gastroesophageal reflux disease(GERD),a common disorder in the West,is less seen in Asian countries.No nationwide epidemiological study of GERD has been conducted in China up to now and the population distribution of GERD remains unknown.Many factors are believed to be responsible for GERD.In addition to some recognized factors,the influences of factors like obesity,smoking and so on are till unclear.Furthermore,GERD is believed to be associated with many diseases.This article reviews the disease distribution,risk factors and associated diseases of GERD.

Selected course is an important part in higher medical educational curriculum.In order to improve selected courses impact,we reformed our selected courses.The new selected courses give prominence to characteristics of military medical university and incarnate modern educational theory and diversity.

In order to do medical educational research better in our country,we analyzed the Department of Medical Education in the University of Illinois and the Center of Medical Education and Ethics in the University of Washington,and besides we suggested some advice for improving our medical educational research level.

Objective Toinvestigate the effect ofPBLmethod in the pediatrics'nurse teaching.Methods PBL teaching was practiced in trial group,while LBL teaching was practiced in control group.The writers made an analysis of this teaching by way of questionnaire and exam.Results Many students by PBL teaching accept PBL teaching,and improve their self-study ability,understanding ability,analyzing ability and so on.Conclusion PBL teaching method can effectively promote both the teaching quality in pediatric nursing and the students'study interest.

Objective To observe the efficacy of pars plana vitrectomy (PPV) combined with endoscopic cyclophotocoagulation (ECP) for refractory glaucoma.Methods Twenty-eight patients (30 eyes) diagnosed with refractory glaucoma were enrolled in this study.The intraocular pressure was ranged from 28 to 55 mmHg (1 mmHg=0.133 kPa),with the mean of (46.3±10.3) mmHg.There were 24 eyes with initial visual acuity ＜0.05,1 eye with 0.05-0.08 initial visual acuity and 5 eyes with ≥0.1 initial visual acuity.The mean number of intraocular pressure-decreased drugs was 4.All the eyes underwent PPV combined with ECP.The cyclophotocoagulation ranged from 90°-360°,with the mean of (232.5 ±77.6)°.The cyclophotocoagulation was ＜180° in 4 eyes,180°-270° in 6 eyes,＞270° in 20 eyes.The follow-up ranged from 12 to 20 months,with the mean of 15.2 months.The intraocular pressure,vision and the mean number of intraocular pressure decreased drugs before and after surgery were comparatively observed.The relationship between cyclophotocoagulation area and postoperative intraocular pressure was analyzed.Results At the final follow up,the intraocular pressure ranged from 12 to 36 mmHg,with the mean of (18.5± 4.4) mmHg,which decreased 49.4％ compared with preoperative intraocular pressure (t=15.537,P＜ 0.01).Among 30 eyes,the intraocular pressure was ≤ 21 mmHg without any intraocular pressuredecreased drugs in 24 eyes (80.0％),1 eye (3.3％) with ≤21 mmHg who treatment by local intraocular pressure decreased drugs,lose control of intraocular pressure in 5 eyes (16.7％).The vision was ＜0.05 in 15 eyes,0.05-0.08 in 3 eyes and ≥0.1 in 12 eyes.The difference of vision distribution before and after surgery was not significant (x2=6.197,P＞0.05).Compared with preoperative vision,the postoperative vision was improved in 8 eyes (26.7％),stabled in 15 eyes (50.0％),decreased in 7 eyes (23.3％).The mean number of intraocular pressure-decreased drugs was reduced from 4 to 1 (t=8.402,P＜0.01).The cyclophotocoagulation area was positive related to postoperative intraocular pressure (r=4.160,P＜0.05).There were no ocular and systemic complications during and after surgery except slight inflammation.Conclusion PPV combined with ECP for refractory glaucoma can reduce intraocular pressure,stabilize or improve the visual acuity.

[Objective]To explore the feasibility of SF-36 in assessment of health-related quality of life(HRQOL) in patients with total hip replacement.[Method]The reliability,validity and responsiveness of the SF-36 in 90 total hip replacement patients were analyzed.[Result]The SF-36 was of better validity by factor analysis.All domains of the scale,the test-retest reliability correlation coefficients were better and internal consistency coefficients were more than 0.7 for five domains,except role-physical 0.43;vitality 0.57;role emotional 0.15.The SF-36 could detect the change of quality of life over before and after treatment sensitively(P

Objective To investigate the relationship among social anxiety,fear of negative evaluation and self-esteem and supply reference for psychological health education.Methods We adopted Social Avoidance and Distress Scale(SAD),Fear of Negative Evaluation Scale(FNE)and self-esteem(SES)scale to investigate nursing students in a certain university and college.Then we analyzed the investigation results. Results The scores of SAD and SES of nursing students with different education background were distinctly different(P<0.05).The score of SAD was positively correlated with that of SES(r=0.483,P<0.05)and FNE(r=0.316,P<0.01).Conclusion We should strengthen the cuhivation of serf-esteem for nursing students and help them to get rid of fear of negative evaluation and conquer social anxiety.