This paper introduces the development situation and mode of physician group in China, and analyzes its main legal risks and countermeasures.The main legal risks include: the nature of the Physician group is fuzzy and specific laws and regulations lack a clear stipulation;the legitimacy of the cooperative mode of the physician group is difficult to define and lacks legal protection for its contract effectiveness and implementation;the practice is driven by the interests and loopholes in legal norms and physicians may illegally transfer the patients;the multipoint practice policy is not perfect and brought legal risks for the development of the physician group.Therefore, the following measures are proposed to take adequate precautions: firstly, the nature of the physician group and its standards of supervision and taxes should be identified and clarified;secondly, the legitimacy standard for the physician group should be established for its cooperation mode to standardize the doctors` behavioral standards;and finally, we should make sure the multipoint practice policy and physician practice law are coherent during implementation.

Objective To investigate the long-term effects of microendoscopic discectomy for lumbar intervertebral disc herniation. Methods A retrospective analysis was made on 218 cases of lumbar intervertebral disc protrusion treated by microendoscopic discectomy. The Japanese Orthopedic Association (JOA) scoring system for lumbar myelopathy was used to evaluate surgical outcomes for each patient. Results All the patients were followed for more than 3 years postoperatively. Excellent outcomes were achieved in 121 cases, good in 80 cases, fair in 16, and poor in 1, the rate of excellent or good outcomes being 92.2% (201/218) . Conclusions Microendoscopic discectomy for lumbar intervertebral disc herniation has definitive long-term effects. Skillful surgical performance and proper postoperative rehabilitation training are crucial to good surgical outcomes.

The quality and quantity of published SCI papers written by the Third Military Medical University from 2010 to 2012 were analyzed to provide information for the scientific research administration.The problems of assessment with SCI was discussed.At last,suggestions were proposed to improve scientific research administration,innovation ability and scientific and technological level.

Objective To compare the clinical result of Da Vinci robot-assisted distal pancreatectomy(RDP) and laparoscopic distal pancreatectomy(LDP), and to evaluate the clinical application experience of Da Vinci robotassisted spleen-preserving distal pancreatectomy.Methods From March 2013 to June 2015, totally 12 patients undergone RDP and 22 patients undergone LDP in our department were analyzed retrospectively.Results Intraoperative blood loss, hospitalization duration and postoperative fast time in RDP group was less than that in LDP group, the spleen-preserving rate and hospitalization expenses were higher in RDP group(P ＜ 0.05).There was no statistically significant difference in the rate of surgery duration and incidence of postoperative complication between two groups (P ＞ 0.05).The following-up period was 1-28 months with a mean of (9.94 ± 8.99) months, 1 case of peritoneal infection occurred in RDP group, 1 case of survival with tumor recurrence and 3 case suffered peritoneal infection in LDP group.Others were no metastasis, recurrence or death.Conclusions RDP is safe and feasible, the short-term prognosis is better than that of LDP.It has advantages of cleat 3 D visual field, stability in control,less invasive,and quick recovery.It is worth further clinical use.

Objective To investigate the effect of palliative surgical treatment and minimally invasive biliary drainage of hilar cholangiocarcinoma.Methods Retrospectively collected 244 hilar cholangiocarcinoma patients clinical data in Affiliated Hospital of Qiingdao University between Jan.1,2008 to Dec.31,2011.Survival accoding to different treatment methods was compared using Kaplan-Meier method.The continuous measurement data were analyzed using the one-way ANOVA and the U test.The categorical variable were analyzed using the chi-square test or Fisher exact test.Result Among 244 patients, the R1/R2 resection group in 93 patients, the endoscopic retrograde biviar drainage group in 69 patients, the percutaneous transhepatic cholangial drainage group in 82 patiens.Three groups of median survival time and l-, 2-, 3-year survival rate and median survival time were (13.5 months, 8.9 months, 8.6 months), (63.0％, 24.7％, 7.4％), (33.3％, 3.3％, 0), (32.4％,4.2％, 0), respectively.There was significant difference in the survival time between R1/R2-resections and endoscopic retrograde biviary drainage treatments (P ＜ 0.001).R1/R2-resections and percutaneous transhepatic cholangial drainage treatments were statistical differences in survival time (P ＜ 0.001).Endoscopic retrograde biviary drainage and percutaneous transhepatic cholangial drainage treatments were no statistical differences in survival time (P =0.971).Conclusions Palliative surgical treatment for hilar cholangiocarcinoma patients had a more significant effect.Endoscopic retrograde biviary drainage and percutaneous transhepatic cholangial drainage of minimally invasive jaundice reducing method for prognosis in patients with hilar cholangiocarcinoma was same.

Objective To analyze the distribution status of soil-transmitted nematodes infection for prevention and treatment.Methods The inquiry field test and grade random sampling were emplyed on a group of people naturally selected in Shanxi Province.The people were examined through pathogen test and statistical diagnosis.Results A total of 7 726 people were investigated.Soil-transmitted nematodes infection rate was 18.86%.Ascaris,enterobius,trichuris,and hookworm was 15.87%,11.46%,0.82%,and 0.04% respectively.The intensity of ascaris infection was 97.74%,1.60%,and 0.66% respectively in light,moderate,and serious conditions,and that of trichuris infection was 88.89%,7.41%,and 3.70% respectively in light,moderate,and serious conditions.Conclusions Soil-transmitted nematodes infection rate is lower than that in 1992.Its cases are mainly distributed in rural areas and schools,closely related to education level.Improving water-drinking conditions and personal hygiene is still key to the prevention and control of the infections.

Objective: To select the telomerase positive cancer cell lines of gastrointestinal tract and to provide a convinced methodology for future telomerase study. Methods: Fifteen cancer cell lines (carcinoma of stomach 4, of liver 6, of pancreas 2, of colon 3) were cultured and telomerase activity were detected by TRAP-ELISA. The normal hepatic cells were taken as control. Results: Thirteen cell lines were telomerase positive in the 15 lines(86.7%). Conclusion: Most of gastrointestinal tract cancer lines express telomerase, indicating the detection of telomerase activity has clinical potential.

Objective To evaluate the implementation effect of Malaria Elimination Project supported by the Global Fund in Shaanxi Province so as to provide the evidence for the scientific implementation of Malaria Elimination Action Plan and the exami-nation and evaluation work. Methods The data of malaria prevention and control work were collected and analyzed statistically in 27 counties from 2010 to 2012 in order to evaluate the measures and effects of malaria control. Results There were 64 reported cases in the project areas from 2010 to 2012,and the average annual incidence rate was 0.15/10 million with a declining trend. The infected area sources of patients were mainly imported overseas accounting for 79.69%of the total cases. The blood completion rate of febrile patients was 94.14%,and the scope of the blood smears testing work had expanded to 88 counties(including 61 third-class counties). The training coverage rate of malaria prevention knowledge and skills had achieved to 100%. The awareness rates of malaria prevention and control were 91.68%and 89.44%in the students and local residentsrespectively. The case reporting with-in 24 h after diagnosed,epidemiological case study and outbreak disposal,laboratory testing and confirming and the other case management capabilities had also improved significantly. Conclusions The implementation of the Global Fund Malaria Project in Shaanxi Province has accelerated the process of Malaria Elimination work and improved significantly the malaria control ability in the project areas.

Objective To determine the contents of geniPoside in different Parts of the fruit of Gardenia jasminoides Ellis with different maturity degree Produced in fangxian,in order to find the oPtimum harVest Periods and the medicinal Parts. Methods The maturity of gardenia fruit are diVided into four leVels according to the color from totally green to yellow and red, and then the contents of geniPoside were determined by HPLC. Results The contents of geniPoside in all four leVels of maturity reached the standard by the Chinese Pharmacopoeia. The content of geniPoside in fruits of caesious color is uP to 13. 01%. Conclusion There is a negatiVe correlation between the maturity and the content of geniPoside in the mature fruit of Gardenia jasminoides Ellis. Caesious fruit has the best maturity degree. It is reasonable to use the whole fruit as medicine according to the Chinese Pharmacopoeia.

Objective: To discuss the conversion coefficient of morphine injection with continuous intravenous pump delivery or subcutaneous injection for the patients with advanced cancer pain demanding high dose of opioids.Methods: Using a retrospective survey, the patients with advanced cancer pain demanding high dose of opioids with poor efficacy were divided into 3∶1 group and 2.5∶1 group, and the conversion coefficient of 3∶1 or 2.5∶1 was used for the opioids equivalently conversed to intravenous or subcutaneous injection of morphine.After the conversion, the degree of pain relief, the analgesic efficiency in the conversion process, titration time, daily oral morphine equivalent amount at stable pain, morphine related adverse reactions and the other indicators were studied to evaluate the analgesic effect of morphine injection with different conversion coefficient.Results: There was no statistical significant difference between the two groups in the degree of pain relief, the effective rate of analgesia and the daily oral akministration amount of morphine at sable pain(P>0.05).The adjustment times for morphine in the two groups was (1.57±0.93) and (1.0±0.00), respectively, and the difference was statistically significant (P<0.05).The daily oral administration amount of morphine at stable pain in the two groups respectively was (226.67±69.74) mg and (258.67±101.34) mg;the morphine related adverse reactions were mainly constipation, and there was no significant difference in the incidence (P>0.05).Conclusion: Giving morphine injection to the patients with terminal cancer pain demanding high dose of opioids with poor effect, the use of PCA pump through intravenous or subcutaneous injection can effectively relieve pain.Using the conversion coefficient of 2.5:1 can quickly complete the titration process, and safely achieve the effective analgesia.