Purpose of this study is to re-compute and analyze the hospitalization rates of residents in China and explore the methodology of systematic review in health policy research.Methodology:DThanks to a history of 90 years,USMLE has evolved into a mature system of international recognition in the industry.This paper covers the history and changes of USMLE and details its goals construction and implementation,examination question selection model,procedures and principles,selection of criteria and the development trends.

The aim of China National Medical Licensing Examination (CNMLE) is to check and assess examinee's requirement for medical practice. In a certain extent, the score result of Medical Licensing Examination reflects the examinee's mastery degree of knowledge, ability and skills (SAKs) learned in medical school. Through the subject diagnostic analysis on the Medical Licensing Examination for certain samples, this research reviewed the clinical medical student's mastery degree of different SAKs. The author wishes the conclusion of this paper would be helpful to some aspects of medical education.

Anti-müllerian hormone (AMH) is mainly produced by the granulose cells of the developing preantral and antral follicles in women and a reliable marker of the reproductive function of women.The mean terminal t1/2 of AMH is calculated as (27.6 ± 0.8) h.Serum concentration of AMH declines by 5.6％ per year and several reproductive and lifestyle factors are associated with age-specific AMH levels.AMH can be applied to predict the precise age of the menopause and is a marker of ovarian reserve in women of 25 year old and older.Iu the field of assisted reproductive technologies,AMH is beneficial in the individualization of stimulation protocols at controlled ovarian hyperstimulation and may be positively associated with clinical pregnancy rates,live-birth rates and twin gestation after assisted reproduction.The researches of AMH may be helpful in the studies of mechanism of polycystic ovary syndrome (PCOS).AMH measurement may be included as a diagnostic criterion of PCOS and a useful predictive marker for the efficiency of the treatment of PCOS.AMH has been also shown to inhibit tumor growth in vitro and in vivo and can be used as a tumor marker in granulosa cell tumors.By using AMH,ovarian reserve damages caused by different kinds of diseases and treatments,including rheumatoid arthritis,laparoscopic surgeries of endometriomas,chemotherapy of female cancers have been studied.Some researchers have begun to pay attention to the potential relationship between AMH and the function of human brain.In the future,the applications of AMH maybe probably do significant contributions to make ideal and individualized treatment programs in more and more related fields.

Using registration information on candidates for the written examination in medical synthesis, a part of the doctor qualification examination, from 1999 to 2001 as processing data, the authors made a comparative study on the composition of the candidates in the eastern, middle and western regions of the country from 7 aspects, viz. total number, category of registration for the examination, educational background, time of graduation, age, organization and rank of organization. It was found that the educational background of the candidates was on the whole very low and the number and quality of health personnel in the western region and at the grass roots level was in dire need of enhancement.

Objective To study the changes of insulin resistance due to severe short-term fluctuations of body mass in simple obese patients. Methods 94 women with simple obesity, were treated by low caloric and high protein diet for two months. A series of examinations were taken before and after the treatment. Results After two months, weight, body mass index (BMI), waist, hip, fasting serum insulin and HOMA-IR reduced significantly ( P <0. 01 or P < 0.05 ). But after 6 months follow-up,these data began to regain. After 12 months ,these data were not significantly different. Fasting serum insulin and HOMA-IR increased ( P < 0. 05). Conclusions The low caloric and high protein diet combined acupuncture or cupping could reduce weight. But 44% patients weight rebound, and HOMA-IR increased.

With the aggravation of enviromental pollution, a quickly, sensitive, inexpensive monitoring means should be developed to protect water resources. Luminescent bacteria as biosensor have the advantages mentioned above. During past two decades, luminescent bacteria toxicity test was used widely in comprehensive toxicity evaluation, screening, monitoring and specific pollutants detection in water, the recent progress in this field was reviewed in this paper.

Background Activation of serum complement system is involved in the pathological process of uveitis and open angle glaucoma.Pathogenesis and pathological characteristics of Posner-Schlossman syndrome (PSS) are similar to uveitis and open angle glaucoma.However,etiology of PSS remains unelucidated.The activation complement in PSS patients' serum is rarely reported.Objective The aim of this study was to investigate the activation of serum complement in PSS patients for PSS pathogenesis.Methods A prospective case-controlled study was designed.The peripheral blood simples of 79 PSS patients were collected from Shenzhen Eye Hospital during December 2013 to December 2015,and the peripheral blood simples were obtained from 83 unrelated healthy blood donors as healthy control group.Immuno-scatter turbidmetry was adopted to detect the common activated components in complement pathway in each group including complement C3 (a vital intersection molecule in the three pathways),C4 (the vital molecule both the complement classical and lectin pathways),split products C3a,soluble membrane attack complex (sC5b-9),C 1q (complement classical pathway),L-ficolin (complement lectin pathway),complement factor Bb (complement alternative pathway),IgG,IgA and IgM.The correlation between serum C3a content and sC5b-9 content in PSS group was analyzed.The serum contents of fabric binding protein 2 (FCN2) (a marker of serum classical pathway),factor Bb (a marker of complement alternative pathway),C3a (the common activation products of three complement activation pathways),and sC5b-9 were assayed by ELISA.This research protocal was approved by Shenzhen Eye Hospital and written informed consent was obtained from each PSS patient prior to any medical examination.Results Compared with normal control group,the serum levels of C3,C4,C3a,sC5b-9,C1q,FCN2,IgG,IgA and IgM were significantly higher in PSS group (Z =-4.743,-2.913,-1.985,-2.620,-2.062,-2.500,-7.010,-6.327,-3.652,all at P ＜ 0.05).The serum complement factor Bb level was 13.87 (9.24,32.00) μg/ml in PSS group,which was significantly lower than 20.51 (12.90,33.50) μg/ml in normal control group (Z =-2.515,P =0.012).Serum C3a content was positively correlated with the serum sC5b-9 content in PSS group (rs =0.832,P＜0.001).Conclusions The serum complement system is activated in PSS patients.Complement alternative pathway,classical pathway and lectin pathway might all be involved in the activative process of complement system.

Objective To analysis residents'death causes in the Three Gorges Reservoir Area,and analysis the distribution of causes of death and age,gender characteristics,therefore provide basis for governments at all levels to develop disease prevention. Methods Data for classification of death cause was analyzed by Excel 2003,according to the ICD-10 classification,the years of po-tential life lost(YPLL)was calculated by SPSS1 7.0.Results Totally 62 702 death date of resident population in Three Gorges Reservoir Area from July,2003 to December,2013 were collected.The crude death rate for males and standardized mortality rate was significantly higher than that in female;Cause of death of the top five were:circulatory system disease,respiratory system dis-ease,malignant tumor,injury and poisoning and digestive system diseases;Chronic disease was the main cause of death which ac-counting for 87.76%;years of potential life lost rate of top five were:injury and poisoning,tumor,circulatory system disease,respir-atory system diseases and perinatal diseases.Conclusion The main cause of death in Three Gorges Reservoir area is a county in the circulatory system diseases,malignant tumor,respiratory system disease,and show a younger trend.Therefore,prevent premature death has become one of the focal points of disease prevention and control.

Objective To analyze the features of quality management of maternal serum prenatal screening for Down syndrome in the second trimester and investigate the methods to establish and improve quality control system.Methods Prenatal screening and clinical data were collected for statistical analysis from 17 prenatal screening centers in Zhejiang Province from 2011 to 2012.The impacts of maternal age , weight, gestational age , specimen collection , the median values of serum markers selection and different analysis software on prenatal screening results for Down syndrome were analyzed respectively .Results Totally 417 347 and 463 846 prenatal screening cases were collected in 2011 and 2012 respectively.The maternal age of the entire province presented as a Gaussian distribution.The age distributions of different screening institutions were inconsistent , while maternal weight distributions were similar.The approach to determine gestational age was significantly different among screening institutions.Median MoM of the samples from the blood collection points was different from those of the main screening center.Median MoM-freeβ-hCG was positive bias , particularly the specimens from the blood collection points.After strengthening the control of temperature and time during samples transportation , Median MoM-free β-hCG of specimens from blood collection points became nearly equal to those of main screening center .Use of local median made the median MoM value closer to 1.0 in the centers with positive or negtive bias of the markers , which had little effect in detection rate and decreased the false positive rate and screening positive rate.Six more positive cases were detected by the Lifecycle software instead of 2T software in 213 followed-up positive cases, which means the Lifecycle software can improve the detection rate.Conclusions The impact of maternal age, weight, gestational age, specimen collection and other factors on screening performance should be taken into consideration when it evaluates the screening quality of different laboratory .The use of local medians is necessary in prenatal screening.Optimization of screening analysis software can reduce false negative rate.

A spectrophotometric method for the determination of calcium in milk, hair and urine was developed using metal complezing dye orthocresolphth-alein complexone(OCPC).The organic matter in the tested sample was destroyed by digestion. An aliquot of the digested solution was mixed with color developing reagent, alkaline OCPC, cantaining 8-quinolinol to suppress interference such as magnesium, and the absorbance was measured at 570 nm.The coefficients of variation were 0.87, 3.6 and 1.2% for milk, hair and urine samples; and the analytical recoveries of calcium from milk, hair and urine averaged 100.4, 101.0 and 98.5% respectively. The calcium content of milk and hair determined by this method was closely correlated with that of the ICP-AES method (r =0.994, p