Objective To investigate the histopathologic changes of andometrium and research the cause of abnomal uterine bleeding in permenopausal women.Methods The biopsy sample of andometrium of 870 cases with abnomal uterine bleeding in permenopausal women were restrospectively analyzed.Results The most commonly hostopathologic change in andometrium of abnomal ulterine bleeding in permenopausal women is endometrial hyperplasia(76.67%).The most cases were simple hyperplasia(66.12%).3.0%of cases were endometrial carcinoma,most of them were well-differentiated endometrioid adenocarcinoma(88.46%).The morphological features of the endometrial adenocarcinomas is loss of polarity of the endometrial glands.The tumor cells have large round vesicular nuclei,prominent nucleoli and coarse chromatin.In addition,endometrial stroma was instead of by the fibrous and/or granulation tissue type stroma,usually with inflammatory response.Conclusions Abnormal ulterine bleeding occurred mainly in permenopausal period.Endometrial hyperplasia is the main cause of abnomal ulterine bleeding in permenopausal period.Most endometrial carcinomas in perimenpausal period are well-differentiated endometrioid adenocarcinomas.An important differential diagnosis of the endometrioid carcinoma in a curettage specimen is to differentiate it from atypical endometrial hyperplasia and atypical polypoid adenomyoma.

Objective To analyze current situation and problems of health manager training in the pilot training areas. Method With the recommendations of health administration deputies in the plot areas of Shanghai, Chongqing and Urumqi, 2 centers for community health services (CHSs) were selected in each area, 9 relative persons were interviewed, 3 focus group discussions (FGDs) involved 18 persons were held totally. The FGDs focused on such questions as“the general information of the training students”“the objectives and purposes of the training in each area”, and so on. Field investigation and qualitative analysis were used to investigate the status quo and main problems of the training of health manager in the pilot areas. Result The problems of the training of health manager existing in the pilot areas mainly are:part of teachers were not fully competent to the training of health manager, training of operant skill was insufficient, training course was not unified, the assessment mechanism was not perfect. Conclusion Optimizing the construction of teachers team, standardizing the training content, increasing the time of operating skills training, establishing a unified and standardized assessment mechanism are essential.