Objective To investigate whether the high intensity focused ultrasound (HIFU) for treating uterine fibroids and adenomyosis leading to pelvic adhesion .Methods 1 672 patients with definitely diagnosed uterine fibroids or adenomyosis were col‐lected and divided into the non‐HIFU group(1 560 cases) and HIFU group(112 cases) according to whether performing HIFU op‐eration .The pelvic adhesion situation in each case was scored according to pelvic adhesion scoring system .Then the results were performed the statistical process .Results No statistically significant differences were observed in the pelvic adhesion situation and pelvic adhesion degree between the HIFU group and the non‐HIFU group (P>0 .05) .The single factor analysis of factors possibly causing pelvic adhesion showed that the age ,past history of endometriosis ,operation and pelvic inflammatory disease ,lesion size and dysmenorrhea history affected pelvic adhesion ,the differences were statistically significant(P<0 .05) .But in the multi‐factor corre‐lation analysis ,various factors in the HIFU group were excluded(P> 0 .05) ,while the operation history and pelvic inflammation disease history had correlation with pelvic adhesion (P<0 .05) .Conclusion HIFU dose not cause pelvic adhesion in treating uter‐ine fibroids and adenomyosis .

Randomized controlled trial(RCT),considered as the strongest evidence-based method in clinical trial,can provide first-hand scientific evidence for clinical practice and instruct clinicians to make correct decisions in practice.This article introduces the principles for RCT designing,analyzes the common problems concerning RCT in clinical practice and the common mistakes made in RCT statistical methods.It is concluded that application of RCT method and correct statistical methods are of great importance in clinical medical research.

Patients replanted severed finger generally have negative emotion after operation. Negative mood could induce vascular crisis and reduce survival of replanting finger. This paper reviewed the studies on negative emotion and psychological intervention in patients after digit replantation in various stages post-operation, and prospected the future.

The teaching material library of nutrition and food hygiene was established based on the concept of integrable ware.This paper discussed on the methods and the experiences.The establishing principle must be clear,knowledge points should be separated into parts accurately,courseware and other computerized teaching materials should be made into full use and convenient and efficient retrieval method must be established.In the future,teaching material library and platform construction should be improved and study of educational technology should be strengthened to improve teaching quality and adapt to modern teaching requirements.

Effective leadership is crucial for health organizations' performance and numerous western universities thus offer leadership courses or modules to their students.However,such education practice has not started in China.In order to optimize knowledge and skills of health service management practitioners,to content with requirements of health service organizations,to cope with dynamic organization environment,to implement health reform successfully and to realized sustainable development of health organizations,it is necessary to provide leadership course for students of health service management at Chinese universities.

This paper introduced the fair benchmarks of evaluation framework for health system constructed by Daniels, et al, and its developmental application in evaluation of health resource allocation fairness .After introdu-cing the resources rational allocation of public health fair benchmarking fixed framework , this paper assessed the al-location of health resources according to the fixed framework .China has achieved good results in public health serv-ice interventions .But public sector governance , macro economic and social policy environment , factors such as ac-countability may restrict the improvement of the health care system .China's health expenditure allocations have un-fairness between provinces , urban and rural areas and different classes .China can use the new benchmark in the field of public health to promote the reform of health resource allocation fairness , make effective social health strate-gies.

Objective To observe the efficacy of pars plana vitrectomy (PPV) combined with endoscopic cyclophotocoagulation (ECP) for refractory glaucoma.Methods Twenty-eight patients (30 eyes) diagnosed with refractory glaucoma were enrolled in this study.The intraocular pressure was ranged from 28 to 55 mmHg (1 mmHg=0.133 kPa),with the mean of (46.3±10.3) mmHg.There were 24 eyes with initial visual acuity ＜0.05,1 eye with 0.05-0.08 initial visual acuity and 5 eyes with ≥0.1 initial visual acuity.The mean number of intraocular pressure-decreased drugs was 4.All the eyes underwent PPV combined with ECP.The cyclophotocoagulation ranged from 90°-360°,with the mean of (232.5 ±77.6)°.The cyclophotocoagulation was ＜180° in 4 eyes,180°-270° in 6 eyes,＞270° in 20 eyes.The follow-up ranged from 12 to 20 months,with the mean of 15.2 months.The intraocular pressure,vision and the mean number of intraocular pressure decreased drugs before and after surgery were comparatively observed.The relationship between cyclophotocoagulation area and postoperative intraocular pressure was analyzed.Results At the final follow up,the intraocular pressure ranged from 12 to 36 mmHg,with the mean of (18.5± 4.4) mmHg,which decreased 49.4％ compared with preoperative intraocular pressure (t=15.537,P＜ 0.01).Among 30 eyes,the intraocular pressure was ≤ 21 mmHg without any intraocular pressuredecreased drugs in 24 eyes (80.0％),1 eye (3.3％) with ≤21 mmHg who treatment by local intraocular pressure decreased drugs,lose control of intraocular pressure in 5 eyes (16.7％).The vision was ＜0.05 in 15 eyes,0.05-0.08 in 3 eyes and ≥0.1 in 12 eyes.The difference of vision distribution before and after surgery was not significant (x2=6.197,P＞0.05).Compared with preoperative vision,the postoperative vision was improved in 8 eyes (26.7％),stabled in 15 eyes (50.0％),decreased in 7 eyes (23.3％).The mean number of intraocular pressure-decreased drugs was reduced from 4 to 1 (t=8.402,P＜0.01).The cyclophotocoagulation area was positive related to postoperative intraocular pressure (r=4.160,P＜0.05).There were no ocular and systemic complications during and after surgery except slight inflammation.Conclusion PPV combined with ECP for refractory glaucoma can reduce intraocular pressure,stabilize or improve the visual acuity.

BACKGROUND:The use of neural stem cels provides a new approach for nervous system functional reconstruction and nerve regeneration. How to solve the induced differentiation of neural stem cels is stil a research hotspot.
OBJECTIVE:To investigate the differentiation of rat neural stem cels into neurons and dopaminergic neurons under induction of glial cel-line derived neurotrophic factor gene.
METHODS:PcDNA3-GDNF-GFP plasmids were constructed and transferredvia lipidosome into rat embryonic neural stem cels. Differentiation of neural stem cels after transfection was identified under a fluorescence microscope. Immunofluorescent staining was used to detect expression of β-tubulin III and tyrosine hydroxylase.
RESULTS AND CONCLUSION:At 3 days after transfection, green fluorescence was observed in the transfected cels that were globular. At 7 days after transfection, the proportion of neural stem cels differentiating into neurons and dopaminergic neurons were significantly increased. These results indicate that the glial cel-line derived neurotrophic factor gene can induce the differentiation of neural stem cels into neurons and dopaminergic neurons.

Objective To research the position transition training effect of general practitioner of northeast district of Chongqing,and find out the problems and their reasons.Methods 326 students and 150 unit leaders were chosen to make a questionnaire survey(recycled 307,150).The Kirkpatrick model was also used for data analysis from 4 levels.The result was described in percentage.Results Reaction Level:42.02％(129/307) of the trainees were not satisfied with the time arrangement of clinical medicine training; Study Level:3 courses were at high failure rate 19.54％(60/307),22.8％(70/307),17.92％(55/307); Behavior Level:81.43％(250/307)of the trainees considered the training effective; Result Level:94.00％(141/150)unit leaders considered the training had a positive impact.Conclusion The time arrangement of clinical medicine training is mostly unsatisfied and the ability of instrument using and result interpretation is weak.Most people consider the position transition training is effective.

Gastroesophageal reflux disease(GERD),a common disorder in the West,is less seen in Asian countries.No nationwide epidemiological study of GERD has been conducted in China up to now and the population distribution of GERD remains unknown.Many factors are believed to be responsible for GERD.In addition to some recognized factors,the influences of factors like obesity,smoking and so on are till unclear.Furthermore,GERD is believed to be associated with many diseases.This article reviews the disease distribution,risk factors and associated diseases of GERD.