With the rapid development and increased integration of Chinese economy with global economy, China assumes more responsibilities and obligations for global health, resulting in great poten-tial needs for professionals in global health. From the angle of global health talent need , this article deeply illuminated that the global health talent training was helpful to take advantage of international resources to solve the problem of health, serve China's peaceful development strategy, comply with development trend of public health, and remedy limitations of traditional medicine undergraduate. Training undergraduates in global health who are China-specific and global competent is the only way to meet the talent demand of China's future. Multi-level global health education will become an important part of medical education in future in China.

Objective Direct amplification of length polymorphism (DALP) as a new molecular marker was used to establish a set of stable DALP reaction system for the plants of Rhodiola L. Methods Some significant parameters of DALP reaction procedure were investigated and optimized by taking the DNA genome for the plants of Rhodiola L. as template. Results The reaction system was : 20 ?L reaction system containing 2. 5 mmol/L Mg2+ , 1. 25 mmol/L dNTPs, 60 ng DNA template, 1 ?L 5 pmol/L selective primer, 3 ?L 5 pmol/L reverse primer, selective primer: reverse primer is 1 : 3, and 2 U Taq DNA polymerase. Amplification program is 95℃ pre-denatured for 5 min, 94℃ denatured for 30 s, 50℃ annealed for 30 s, 72℃ extending for 1 min; after 30 cycles, and then 72℃ extending again for 10 min to the end of PCR reaction. Conclusion This DALP reaction system is efficient to identify the species and local populations for the plants of Rhodiola L. repeatedly with the stronger stability and reliability.

Objective To assess the therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiation therapy in order to decrease the recurrence rate after endourethral surgery. Methods A total of 286 patients with anterior urethral stricture (stricture length ranging from 0.5 to 2.5cm, averaging at 1.6cm) were divided randomly into two groups after internal urethrotomy and cicatrix electrotomy. The radiation group of 173 patients was treated as soon as possible with iridium 192 radiation therapy on the stricture sections while the control group of 113 patients was not. The recurrence rate was compared between the two groups during one year's follow-up. Results Among all the 286 successful operations, stricture recurred in 19 patients of the radiation group (recurrence rate of 10.98%) and in 62 ones of the control group (recurrence rate of 54.86%), with a significant difference (P=0.003). Conclusion It is an effective way to prevent recurrence by treating patients as early as possible with iridium 192 radiation on the stricture sections after endourethral operation on anterior urethral stricture.

Objective To discuss the treatment of femoral fracture combined with ipsilateral acetabular fracture and femoral head dislocation and the reasons for the misdiagnosis of the injury. Methods According to AO classification, there were 3 cases of type 32A, 2 of type 32B, and 1 of type 32C, who were treated with internal fixation of interlocking nails. There was 1 case of type 33C3, who was treated with femoral condyle supporting plate. There were 2 cases of type 31A2, who were treated with DHS. According to the Letournel classification, fracture of the acetabular posterior wall was found in 8 cases and fracture of the acetabular posterior column and wall in 1 case. All the cases of acetabular fracture were treated with internal fixation of titanium alloy reconstructive plates. Delayed diagnosis was found in 2 cases in this group. Results The 9 patients were followed up for 13 to 38 months (averaging 22.4 months). According to the American criteria, 8 cases was rated as excellent, and 1 case as good, with thd total excellent and good rate being 100%. Conclusions Femoral fractures combined with ipsilateral acetabular fracture and femoral head dislocation are a rare, complex and serious injury. They usually involve other organs, and are easy to be misdiagnosed. The surgeries should be done as early as possible. The internal fixation plays a key role in management of the fracture of acetabular.

Objective To summarize the clinical characteristics of patients with occupational melanosis. Methods Diagnostic data of 69 patients with occupational melanosis was analyzed using retrospective analysis. Results The main occupational hazards for the 69 patients with occupational melanosis were coal tar, petroleum and its fractionated products, pigments and dyes and their intermediates, rubber additives and rubber products. The median length of occupational exposure and disease latency were 8.0 and 6.0 years, respectively, with a highly positive correlation between them (Spearman correlation coefficients=0.962, P<0.01). Skin lesions were mainly found on exposed areas such as the face-to-neck and limbs, prevalence of 94.2% and 75.4% respectively. And 78.3% of patients had skin lesion on more than two sites. The lesions were mostly in the form of irregular flakes (59.4%), with a gray-black color (44.9%). About 43.5% of patients experienced skin itching. Complete blood count, liver function, and kidney function were all within normal ranges. Skin biopsy results showed that epidermal hyperkeratosis, thinning of the spinous layer, liquefaction degeneration of basal cells, increased superficial dermal melanocytes, and infiltration of lymphocytes, histiocytes, and melanocytes around the blood vessels. Reflectance confocal microscopy (RCM) detection showed focal liquefaction degeneration of basal cells in the lesions, with a significant infiltration of melanocytes and inflammatory cells in the dermal papillae and superficial layers. Conclusion The primary target organ of occupational melanocytes is the skin, and no damage to other organs was identified thus far. Results from skin biopsies and RCM examinations can be used for differential diagnosis.

Objective To investigate the high risk factors of endometrial polyps (EPs)in infertile patients and its impact on the pregnancy outcome after embryo transfer.Methods A case-control trail was conducted on the infertility patients who undergoing embryo transfer in our hospital for the first time after hysteroscopy from January 2016 to December 2022.Their clinical data were collected and retrospectively analyzed.Univariate and stepwise logistic regression analyses were used to identify the risk factors for EPs,and the impact of polyps on the pregnancy outcomes of assisted reproductive pregnancy was analyzed with propensity score matching (PSM)at a 1:2 ratio.Results A total of 388 patients diagnosed with Eps and undergoing hysteroscopic endometrial polypectomy were assigned into the Eps group,and 2163 non-polyp patients were into the non-Eps group.Univariate analysis showed statistical differences were observed in age[31 (29,34)vs 31 (28,33),P=0.002],history of pelvic inflammatory disease (42.78％vs 64.17％,P=0.000),age at menarche[14 (12,14)vs 13 (12,14)years old,P=0.000],number of pregnancies[0 (0,1 )vs 1 (0,2),P=0.000],primary infertility (60.30％vs 50.20％,P=0.000),duration of infertility[4 (2.1,6.0)vs 4 (2.0,6.0)years,P=0.002],concomitant endometriosis (9.53％ vs 6.52％,P=0.032),concomitant uterine fibroids (11 .85％vs 6.93％,P=0.001 ),and basal estrogen level[38.12 (27.00,59.00)vs 36.00 (25.00,53.00)μg/L,P=0.016]between the 2 groups.Logistic stepwise regression analysis indicated that age (OR=1 .082,95％CI:1 .053～1 .113,P<0.05 ),primary infertility (OR=2.951,95％CI:1 .990～4.376,P<0.05),and elevated basal estrogen (OR=1 .003,95％CI:1 .001～1 .005,P<0.05)were risk factors for Eps.The postoperative biochemical pregnancy rate (59.28％vs 52.70％),clinical pregnancy rate (53.09％vs 45.48％),and live birth rate (43.81％vs 35.82％)were significantly higher in the matched Eps group than the non-Eps group (P<0.05 ).No statistical difference was observed in pregnancy outcome in the patients with different polyp locations and sizes.The patients with multiple polyps had an obvious higher rate of early miscarriage than those with single polyp (17.27％ vs 7.29％,P<0.05 ),while those with recurrent polyps also had a higher rate of early miscarriage than those with primary polyps (27.78％vs 11.23％,P<0.05).Conclusion Age,primary infertility,and elevated basal estrogen are risk factors for Eps in infertility patients,while hysteroscopic endometrial polypectomy prior to embryo transfer results in improved pregnancy outcomes in those with Eps.The location and size of endometrial polyps have weak impact on pregnancy outcomes following embryo transfer,but,the presence of multiple or recurrent polyps may elevate the risk of early miscarriage.

Objective To investigate the clinical efficacies of free endoscopic nasobiliary drainage (ENBD) in primary duct closure (PDC) following laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis.Methods The retrospective cohort study was conducted.The clinical data of 312 patients with extrahepatic bile duct stones accompanied with or without cholecystolithiasis who were admitted to the 11 medical centers [86 in the Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,62 in the Second Affiliated Hospital of Zhejiang University School of Medicine,44 in the West China Hospital of Sichuan University,29 in the First Affiliated Hospital of Xi'an Jiaotong University,27 in the First Hospital Affiliated to Army Medical University (Third Military Medical University),25 in the Hunan Provincial People's Hospital,17 in the Beijing Friendship Hospital of Capital Medical University,10 in the First Affiliated Hospital of Hainan Medical University,5 in the Henan Provincial People's Hospital,4 in the Beijing Tian Tan Hospital of Capital Medical University,3 in the First Affiliated Hospital of Fujian Medical University] from January 2011 to June 2017 were collected.All patients underwent LCBDE+PDC,and 81 and 231 patients with and without ENBD were respectively allocated into the ENBD group and PDC group.Observation indicators:(1) comparisons of operation situations;(2) comparisons of postoperative recovery;(3) comparisons of postoperative complications;(4) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative complications up to June 2017.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed by the t test.Measurement data with skewed distribution were represented M [interquartile range (IQR)],and comparison between groups was analyzed by the nonparametic test.Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Results (1) Comparisons of operation situations:all the 312 patients underwent successful laparoscopic LCBDE + PDC,without conversion to open surgery,including postoperative death of 1 patient in the PDC group.The common bile duct diameter,cases using interrupted sutures,continuous sutures,absorbable threads and nonabsorbable threads were respectively (1.2±0.4)cm,106,125,195,36 in the PDC group and (1.1±0.5)cm,76,5,79,2 in the ENBD group,with statistically significant differences between groups (t =2.497,x2 =56.706,8.457,P＜0.05).The numbers of stones,stone diameter,cases with common bile duct wall (≤ 3 mm and ＞3 mm),normal and abnormal Oddi sphincter contraction function,volume of intraoperative blood loss and operation time were respectively 2.1±1.7,(1.1-±0.6)cm,148,83,226,5,20 mL (10-45 mL),(116± 49)minutes in the PDC group and 1.9±1.6,(1.0±0.6)cm,49,32,75,6,20 mL (15-30 mL),(113± 23)minutes in the ENBD group,with no statistically significant difference between groups (t =1.021,0.329,x2 =0.329,3.428,Z=1.147,t=0.521,P＞0.05).The further analysis:of 312 patients,cases and time using interrupted sutures and continuous sutures were respectively 182,130 and (133±.49) minutes,(103±34) minutes,with a statistically significant difference between groups (t =-6.605,P＜0.05).The volume of intraoperative blood loss and cases with postoperative complications using interrupted sutures and continuous sutures were respectively 20 mL (15-31 mL),21 and 20 mL (10-45 mL),18,with no statistically significant difference between groups (Z =-0.285,x2 =0.369,P＞ 0.05).Of 312 patients,cases,operation time,volume of intraoperative blood loss and postoperative complications using absorbable threads and non-absorbable threads were respectively 274,(116±44)minutes,20 mL (15-40 mL),33 and 38,(115±35) minutes,18 mL (10-26 mL),6,with no statistically significant difference between groups (Z =0.971,t =0.023,x2 =0.154,P＞ 0.05).(2) Comparisons of postoperative recovery:recovery time of gastrointestinal function,time of abdominal drainage-tube removal,using time of antibiotics and duration of hospital stay were respectively (2.0± 1.5) days,(4.0 ± 2.4) days,(4.0±2.8) days,(5.5±3.0) days in the PDC group and (4.0±1.9) days,(6.9±3.5) days,(10.0± 3.9) days,(11.1±3.7)days in the ENBD group,with statistically significant differences between groups (t =-9.507,-8.258,-15.103,-13.575,P＜0.05).The total expenses of hospital stay in the Affiliated Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology were respectively (5.1 ±0.6)× 104 yuan in the PDC group and (6.5-±0.5)× 104 yuan in the ENBD group,with a statistically significant difference between groups (t =-9.516,P＜0.05).(3) Comparisons of postoperative complications:incidence of complications in the PDC group was 14.29％ (33/231),including 16 with biliary fistula,11 with biliary tract infection,3 with wound infection,1 with biliary tract bleeding,1 with residual stones of common bile duct and 1 with death;incidence of complications in the ENBD group was 6.17％ (5/81),including 2 with biliary fistula,2 with biliary tract infection and 1 with biliary tract bleeding,showing no statistically significant difference between groups (x2 =3.151,P＞0.05).(4) Follow-up situations:of 312 patients,252 were followed up for 2-67 month,with a median time of 15 months,including 175 in the PDC group and 77 in the ENBD group.During the follow up,there was no occurrence of jaundice,cholangitis and pancreatitis,and stone recurrence and postoperative cholangiostenosis were not detected by abdominal color Doppler ultrasound or CT or magnetic resonanced cholangio-pancreatography.Conclusion On the basis of grasping operative indication strictly,ENBD in PDC following LCBDE for choledocholithiasis is safe and effective.

Objective To explore the prevalence of the female sexual function and the quality of life in cervical cancer patients, and to investigate their correlation. Methods A total of 221 cervical cancer patients from March to December in 2013 were investigated by the questionnaire of Female Sexual Function Index (FSFI)and the scale of FACT-G. Results The total score of FSFI was (15. 59 ± 8. 59), which was at the level of sexual dysfunction. The female sexual function index was significantly positively correlated with the quality of life and the subscale of physiology, emotion and function (r = 0. 201,0. 178,0. 134,0. 180, respectively). The quality of life was significantly positive correlated with the female sexual function index and the subscale of desire, lubrication, orgasm, satisfaction and pain ( r = 0. 201, 0. 176, 0. 181, 0. 157, 0. 243, 0. 177, respectively). Conclusions The medical workers should not only provide the disease-related knowledge, but also provide the knowledge of female sexual function, so as to improve their quality of life.

Objective To investigate the role of micro RNA-124 (miR-124) in regulating activation of microglias and secretion of pro-inflammation cytokines and its potential mechanism.Methods (1) BV-2 cells were exposed to different concentration oflipopolysaccharide (LPS) for different durations;relative expression level of miR-124 was detected by real time-quantitative PCR (RT-qPCR).(2) The BV-2 cells were divided into four groups:PBS group,LPS group,LPS+ctrl-simulant group and LPS+miR-124 simulant group.Protein and mRNA expressions of inflammatory factors (tumor necrosis factor [TNF]-α and interleukin [IL] 1-β) were evaluated by RT-qPCR and ELISA.Expressions of p38α,phosphorylated (p)-p38α,ERK and p-ERK were detected by Western blotting.(3) Besides the above groups,four groups were added:LPS+VX702 group,LPS+miR-124 inhibitor group,LPS+VX702+miR-124 simulant group and LPS+VX702+miR-124 inhibitor group;pretreatment with p38α specific inhibitor VX702 was given to the BV-2 cells,the latter two groups were given miR-124 simulant or miR-124 inhibitor,and LPS was used to activate the cells;the expressions of TNF-α and IL-1β were evaluated by ELISA.Results (1) As compared with control group,miR-124 was significantly down-regulated in LPS-stimulated BV-2 cells (P＜0.05),in a dose-and time-dependent manner.(2) As compared with cells in the LPS+ctrl-simulant group,cells in the LPS+miR-124 simulant group had significantly decreased TNF-α and IL-lβ mRNA and protein expressions,and p38α and p-p38α levels (P＜0.05);the ERK and p-ERK levels showed no significant difference between the two groups (P＞0.05).(3) The TNF-α and IL-1β levels between LPS+VX702 group and LPS+VX702+miR-124 simulant group were not significantly different (P＞0.05);those between the LPS+VX702+miR-124 inhibitor group and the LPS+VX702 group were not significantly different (P＞0.05).Conclusion The miR-124 is down-regulated in LPS-activated BV-2 cells and miR-124 could suppress the secretion of pro-inflammatory mediators by targeting to p38α.