We conducted a questionnaire survey among 36 community health care providers at Jingansi Health Center to learn their status quo.Our results showed that talented person aged less than 35 only accounted for 1/10.97%of the young physicians wished to have more continuous medical education and improved working environment.Proper working regulation,personnel resource management and payment system might help attract,train and retain more qualified persons,improve personnel quality,and achieve sustainable development of community health centers.

Objective To observe and analyze the clinical outcomes of levamisole in combination with vitamin B12 in the treatment of recurrent oral ulcer.Methods The prospective clinical study method was used,67 patients with recurrent oral ulcer who admitted to the dental were randomly divided into the combined treatment group,the levamisole group,and the vitamin B12 group.The combined treatment group was treated by levamisole combined with vitamin B12 .The levamisole group and the vitamin B12 group were treated with levamisole and vitamin B12 respectively. The cure rate,serum IL -6 and vitamin B12 levels were compared among the three groups.Results The cure rate of the combined treatment group was 90.90%,which was significantly higher than 77.72% of the levamisole group and 81.82% of the vitamin B12 group(P <0.05).The combined treatment group had significantly lower level of serum IL -6 than that of the levamisole group and the vitamin B12 group[(56.45 ±11.34)pg/mL vs.(102.35 ±10.23)pg/mL vs.(145.44 ±12.35)pg/mL,P <0.05].The combined treatment group had significantly higher level of vitamin B12 than that of the levamisole group[(523.34 ±13.45)μg/mL vs.(323.34 ±12.53)μg/mL,P <0.05].There was no difference between the combined treatment group and the vitamin B12 group regarding serum vitamin B12 level [(523.34 ±13.45 )μg/mL vs.(554.45 ±33.34)μg/mL,P >0.05 ].Conclusion Levamisole combined with vitamin B12 treatment can significantly decrease serum IL -6 and increase serum vitamin B12 and improve the cure rate for patients with recurrent oral ulcer.It has been proved to be the effective treatment for recurrent oral ulcer.

Enterovirus 71 (EV71) infection can cause hand,foot and mouth disease,due to its neurotropic nature,severe cases can affect the central nervous system and emerge neurogenic pulmonary edema (NPE),respiratory and circulatory failure,and even lead to death.The advances in the pathogenesis of severe HFMD neurogenic pulmonary edema after EV71 infection in recent years are described.

In recent years ,lots of studies indicated that inflammation plays an important role in occurrence and de‐velopment of cardiovascular diseases .Neutrophil to lymphocyte ratio (NLR) is a novel inflammatory marker ,the cost of detection is low and it's easy to obtain .NLR is not only related with poor prognosis of stable coronary artery disease and acute coronary syndrome ,but also closely associated with prognosis of acute heart failure .The present article made a review on the correlation between NLR and cardiovascular diseases .

Objective To compare clinical efficacy between improved vaginal hysterectomy (IVH)and traditional vaginal hysterectomy (TVH) and its influences on blood glucose and serum corticosteroid levels.Methods One hundred patients undergoing hysterectomy were divided into using IVH (treatment group,50 patients) and TVH (control group,50 patients).Clinical efficacy,blood glucose and serum corticosteroid levels were compared between two groups.Results There was no significant difference in operation time between two groups (P＞ 0.05).The amount of intraoperative bleeding,postoperative exhaust time and postoperative vaginal bleeding time in treatment group were significantly less than those in control group [(86.7 ± 5.7) ml vs.(131.2 ± 14.5) ml,(24.8 ± 12.9) h vs.(42.8 ± 17.7) h,(16.5 ± 2.9) d vs.(24.3 ±6.7) d,P ＜ 0.05],and the time of blood glucose and serum corticosteroid levels returned to normal levels in treatment group were much earlier than those in control group.Conclusion The clinical efficacy of IVH is preonunced,and postoperative stress reaction is mild.

Complement activation induces polymorphonucleal neutrophilic leukocyte (PMN) aggregation in circulation causing microvascular occlusion. The activated PMNs release lysosome enzymes which damage the tissue. It might take an important part in shock and multiple organ failure. We pre-treated rat PMNs with sinomeuine, which was extracted and purified from the stem of Sinomeuium acufum Rehd et Wils. It was found to inhibit the morphological changes and lysosome enzymes release in PMNs activated with zymosanactivated plasma. With administration of sinomeuine PMNs remained a spherical shape, no apparent ruffling or cytoplasmic projection and less aggregation. Elastase and Nacetyl-?-D-glucosaminidase content in PMNs supernatant increased less.

It is of vital importance for medical postgraduates to strengthen moral construction.Based on Bourdieu's field theory,the paper puts forwards methods to enhance the influence of moral education by forming of moral habitus by self-education,clinic practice and academic study and the accumulation of moral educational capital by the combination of mentors,society,schools,families and peer groups.

Objective To study the effect of 99Tc-MDP on receptor activator of nuclear factor-κB ligand/osteoprotegerin (RANKL/OPG) system of collagen-induced arthritis (CIA) rat. Methods The CIA was established by subcutaneous injection with type Ⅱ collagen and complete Freud's adjuvant to rats, except the group (n=8, treated with 99Tc-MDP). The histopathological changes of joints were scored based on the extent of infiltration of inflammatory cells, cartilage destruction and bone erosion. The serum levels of RANKL/OPG were tested with ELISA, and the synovial membrane levels of RANKL/OPG were tested with Western blot.Repeated ANOVA and one way ANOVA were used for statistical analysis. Results The MTX group relative value of RANKL/OPG in serum [35 d (1.076±0.016), 42 d (1.140±0.005), 49 d (1.155±0.023)], and in synovial membrane (1.156±0.014), and the histopathological scores [synovial membrane (1.8±0.5), cartilage (1.9±0.6), bone (1.8±0.5) ] were lower than model group ( 1.269±0.025, 1.296±0.015, 1.340±0.011 ), (2.9±0.4, 2.6±0.5, 2.6±0.5), ( 1.340±0.013 )(P＜0.01 ). And all above index of 99Tc-MDP group ( 1.035±0.034,0.986±0.019, 0.991±0.020), (1.5±0.5, 1.4±0.5, 1.2±0.5), (0.098±0.026) were notably lower than the MTX treat ment group (P＜0.01). Conclusion 99Tc-MDP may retard the progression of the disease by decreasing the relative RANKL/OPG expression and it can initiate its effect earlier than MTX.

Objective To investigate the clinical effect of periodontal fiber retention periodontal splint and Periocline combined treatment for severe tooth. Methods the control group was given routine retention of fiber periodontal splint treatment, study group in retention of fiber periodontal splint treatment combined with periocline. The changes of PLI, BI, PD and AL before and after treatment in two groups of patients with severe periodontal disease were recorded. The data were input into SPSS software and given statistical analysis. Results The detection of two groups of PLI, BI, PD, AL and other indicators of no significant difference between before treatment; after treatment of different options of group AL, PD decreased than the control group (P<0.05); PLI of the study group after treatment, BI decreased significantly than before (P<0.05), the control group on the index no obvious change than before. Conclusion The application of retention of fiber periodontal splint combined with Periocline treatment of severe periodontal disease can significantly improve the curative effect, is conducive to the protection of the quality of life.

OBJECTIVE To investigate the effect of tranilast on cardiac fibroblasts proliferation and phenotype transformation incubated with a high concentration of glucose and the possible mechanism. METHODS The cardiac fibroblasts were divided into seven groups in accordance with different nutrient solutions:normal control group(5.5 mmol · L-1 glucose),hypertonic group(5.5 mmol · L-1 glucose+mannitol 25 mmol · L- 1),high glucose group (25 mmol · L- 1 glucose),tranilast intervention groups (25 mmol·L-1 glucose+tranilast 50,100 and 200μmol·L-1),and activin receptor-like kinase 7(ALK7) inhibitor group(25 mmol · L-1 glucose+10μmol · L-1 SB431542). The cell proliferation was detected by MTT method. The transformation of cardiac fibroblasts was determined by immunfluorescence staining. The expression of fibroblast specific protein 1 (FSP-1),α-smooth muscle actin (α-SMA),transforming growth factor-β1(TGF-β1)and ALK7 was assessed by Western blotting. RESULTS Compared with nor?mal control group,A492 nm of cells in high glucose group was significantly increased(P<0.01),while the expression of α-SMA,TGF-β1 and ALK7 protein in high glucose group was significantly increased(P<0.01),but FSP-1 protein was significantly decreased(P<0.01). There was no difference between normal control group and hypertonic group. Compared with high glucose group,A492 nm of cells in tranilast or SB431542 intervention groups were decreased(P<0.05),and the expression of α-SMA,TGF-β1 and ALK7 protein was significantly decreased(P<0.05),but the expression of FSP-1 protein was increased (P<0.05)in tranilast or SB431542 intervention groups. CONCLUSION Tranilast can inhibit the proliferation and phenotype transformation of cardiac fibroblasts induced by high glucose,which may be related to down-regulation of the expression of ALK7.