Objective To assess the quality of literature on randomized or semirandomized clinical controlled trials of fire needling treatment for rheumatoid arthritis.Method Acomputer search assisted by a manual search was conducted of CBM (1979—2015), CNKI (1979—2015), VIP (1989—2015),Wanfang digital periodical group(1998—2015), PubMed (1966—2015), EMbase (1980—2015) and Cochrane Library (Issue4, 2015).Randomizedor semir and omized clinical controlled trials were included.Two reviewers extracted data independently and checked them each other.The methodological quality of research design, diagnostic and inclusion/exclusion criteria, intervening measures for fire needling/control group,efficacy evaluation criteriaand observation time points, and adverse reaction reporting were assessed according toCochrane Reviewers' Handbook 4.2.8.Ameta-analysis was made of homogeneity studies.The GRADE approach ratedsystem outcomes.ResultA total of sevenr and omized controlled trialswere included.Four included studies made a comparison between fire needling andmedication (analgesic+ antirheumatic) groups andthere was no statistically significant difference in the efficacy rate [RR=1.22, 95%CI(0.97, 1.52)].GRADE ratingwas very low.Internationally accepted diagnostic criteria and general evaluation methodswere still not used universally.Conclusion The current clinical reports show that fire needling treatment has some effect on rheumatoid arthritis, but it still needs related evidence support.

Great progress has been made in tissue engineering cornea construction (i.c.constructing human corneal equivalence by using tissue engineering technique) during the past 20 years.However,a kind of tissue engineering cornea which can be applied to corneal transplantation as human cornea equivalent is yet to be availablc.Scaffold is an indispensable part of tissue engineering cornea.Searching for some kinds of scaffolds with good biocompability,some extent of biodegradation and euough biomechanics property are the issue needing to be resolved immediately in the tissue engineering cornea filed.This article reviewed the development of tissue engineering cornea scaffolds,represented the merits and defects of different scaffolds in order to optimize the project of choosing scaffolds and furthermore lay the foundation for constructing a kind of tissue engineering cornea which may be applied to corneal transplantation as human cornea equivalent in the future.

Objective:To analyze manifestation of spine tuberculosis in CT and MRI, compare two kinds of techniques respectively of diagnosis advantage. Methods: Retrospective analysis of 18 cases confirmed by the surgical operation and pathology imaging of CT and MRI Material of spine tuberculosis. Results: The CT can nicely show that the bone destruction, the bone increase osteoslerosis, sequester and new-born formation and narrow of intervertebral disc, swelling paraspinal soft tissue and psoas major muscle abscess, spinal canal of bone is narrow, calcification. Although CT can show intervertebral disc involvement and terminal plate of vertebral body destruction in sagittal reconstruction, not equal to MRI sensitive, Evaluating intervertebral disc involvement and area of paraspinal soft tissue swells, changed in early days spine tuberculosis of valuation, MRI had obvious advantage. Conclusion: Combining CT and MRI can reflect the image of spine tuberculosis to learn a characteristic completely and be advantageous to diagnosing and discriminate diagnosis of spinal tuberculosis.

Objective To compare the effect of anti-spin intramedullary nail and dynamic hip screw fixation in the treatment of elderly intertrochanteric fractures ,in order to investigate the clinical value of anti-spin intramedul-lary nail in elderly intertrochanteric fractures .Methods 160 elderly patients with intertrochanteric fractures were divided into the observation group and control group according to the random number table .The observation group received anti-spin intramedullary nail fixation , the control group received dynamic hip screw fixation .The fracture healing and hip function of two groups were compared .Results The operative time of the observation group was shor-ter than that of the control group ,and blood loss was less than the control group ,the differences were statistically sig-nificant(t=4.635,3.643,all P<0.05).The function,pain,deformity,range of motion and total scores of the obser-vation group were significantly higher than those of the control group ( t=4.433,4.364,4.865,3.876,3.645,all P<0.05).The postoperative hip function excellent rate of the observation group was 90.0%,which was significantly higher than 72.5%of the control group (χ2 =5.153,P<0.05).Conclusion Proximal femur intramedullary nail anti-rotation fixation in the treatment of elderly intertrochanteric femoral fractures has shorter operative time ,less blood loss,and postoperative hip function recovery is good ,it is worthy of promotion .

Objective To compare the clinical curative effect between transjugular intrahepatic portosystemic stent-shunt (TIPS) and TIPS together with gastric coronary vein embolization (GCVE) in treating cirrhosis portal hypertension (PHT) associated with upper gastrointestinal hemorrhage (UGH),and to discuss the necessity,feasibility and clinical curative effect of TIPS plus GCVE.Methods The clinical data of 38 PHT patients with UGH,who were admitted to authors' hospital during the period from April 2010 to May 2012,were retrospectively analyzed.Only TIPS was employed in 15 patients (group A),and TIPS plus GCVE was adopted in 23 patients (group B).Before and after operation,the indexes,hemodynamics of portal vein and spleen,the morphology of spleen,and the degree of gastrointestinal varices were determined and analyzed.The patients were followed up to observe the occurrence of postoperative complications.Results In both groups,the postoperative portal vein pressure showed an obvious reduction with accelerated velocity of flow,and the splenic venous congestion index was decreased,these changes were statistically significant when compared with the preoperative ones (P＜0.05),and which was more obvious in group B than in group A (P＜0.05).After the treatment,the esophagogastric varices (EGV) was obviously improved,the improvement rates of group B and group A were 94.7％ and 66.6％ respectively,the emergency hemostasis rates of group B and group A were 100％ and 75.0％ respectively,The rates of re-bleeding were 4.3％ and 28.5％ respectively;the above results of group B were statistically better than those of group A (P＜0.05).No statistically significant differences in liver function indexes existed between preoperative values and postoperative ones in the same group as well as in group comparison (P＞0.05).The differences in the postoperative hepatic encephalopathy (HE) occurrence and in primary patency rate of stent between the two groups were not statistically significant (P＞0.05).In both groups,the re-intervention patency rate was 100％.The incidence rate of HE in patients in whom the distal end of stent was located in the left branch of portal vein was strikingly lower than that in patients in whom the distal end of stent was located in the right branch of portal vein (P＜0.05).Conclusion For the treatment of PHT associated with UGH,TIPS combined with GCVE carries reliable curative effect,this therapy is superior to simple use of TIPS.

Following with the naissance and the development of the DICOM(the Digital Image Communication in Medicine) protocol,and numerous medical image equipments factory's support to the DICOM protocol,PACS(picture archiving and communication systems)are popularized quickly in hospital image section room,which pushes the progress of PACS industry.Hospitals have always been certain blindness in ushering and arguing PACS systems,uncertain how to control those providing company exactly on the technique.In this paper,some key problems are introduced in order to make everyone understand the relevant technique.

BACKGROUND: To review progressions in the pharmacological study of natural plant Ficus carica L. (fig), summarize its main pharmacological effects so as to manifest values in clinical practice.DATA SOURCES: .By computer retrieval system, the relevant papers on the researches on Ficus carica were retrieved on Medline from January 1950 to September 2004 and limited at the referred word "Ficus carica" in English. Simultaneously, the relevant papers were searched by the computer on China National Knowledge Infrastructure (CNKI) database from January 1999 to September 2004, focusing on the referred word "Fieus carica" in Chinese.STUDY SELECTION: Of all the relevant papers, ones focusing on the pharmacological study of Ficus carica were selected and the whole text were checked, meanwhile those had no relation with the pharmacological latex as well as various constituents and preparations. Exclusion criterion:repeated studies.DATA EXTRACTION: A total of 226 papers were checked on the study of Ficus carica, 30 papers were consistent with the standards. Among the 196 excluded papers, 189 were excluded because they were clinical experience report or repeated studies, 7 were reviews.DATA SYNTHESIS: Investigations of the fig, its leaves and latex as well as various constituents and preparations, have revealed many pharmacological effects such as: anti-tumor effects, the ability to mediate body metabolism, mediating hyperglycemia, hyperlipidemia and cholesterol levels, enhancing oxidation resistance, antibiotic effects, antivirus effects, the ability to mediate immunity, activating blood coagulation etc. It also may play an important role in supportive therapy in tumor treatment by reducing toxicity and side effects in actinotheraphy and chemotherapy. Several reports of anaphylaxis after fig intake have reported both in China and abroad.CONCLUSION: As an herb, fig has wide pharmacological effects and clinical practise values. The main pharmacological studies of it were focused on its anti-tumor effects and the ability to mediate body metabolism.Separation and purification of its active components and determining the interactions between them as well as the pharmacological and toxicological effects need further study. New pharmacological effect s will be found by studying various fig extracts.

The clinician training system in Japan is different from that in China as their medical students are allowed to take medical doctor examination immediately following their graduation.But they must undergo at least two years of training in basic clinical knowledge and skills prior to taking any clinical practice.This training system is inspirational for us as follows:China should include standardized training of residents into the law of medical practitioners,and medical graduates must take two years of knowledge training in full medicine before they are qualified for clinical practice.On top of this training,they need to undergo at least three years of specialized doctor training,making them competent clinicians with comprehensive knowledge coverage and outstanding skills in specific areas following such staged training.

For medical insurance systems, medical expense examination is a key measure to keep medical expenses under control. In 1948, Japan established an examination authority of legal person status to operate the medical expense examination. Based on years of modifications and improvement in the organizational system and operation mechanism, the system is running smoothly by now. Authors of this paper made a detailed introduction to the specific operations of such a system, and to China's local features as well. On such basis, the study proposed to build in China a third-party medical expense examination institution as a legal entity, and practice the reexamination system and information disclosure system, in an effort to safeguard legitimate rights of insurance organizations and medical institutions.

The Medical Care Act of Japan has undergone five major revisions since it went into effect in 1947. Each revision has been designed to target and tackle main problems found in the medical and health sector in the country. These problems range from the making of regional healthcare plans to the establishment of the hospital with specific functions, from the division of rehabilitation beds to the establishment of nursing insurance scheme, from the birth of medical corporations to the establishment of social medical corporations, and from strengthening of non-profit nature of medical institutions to the construction of medical information system. These efforts were made to provide a safe and convenient health service for the Japanese people. These revisions are closely related to hospital management, and its experiences prove useful for the health reform in China.