The paper first offers a comprehensive analysis of the current situation of and contradictions in community health service in China and then, in view of the major problems, puts forward the view of improving the mechanism of community health service with reform as an impetus. The chief steps to be taken include: strengthening confidence, clarifying orientation and bringing into play the primary, comprehensive and preventive role of community health service; taking advantage of the current “founding activities” to deepen the reform and construction of community health service; focusing on the priorities and speeding up the cultivation of the contingent of talents; and perfecting as soon as possible the policy of setting quotas for subsidies to community health service and promoting in an all-round way community health service development.

Community health service in the new century has entered a new stage of development. To ensure the healthy advancement of community health service in the course of system building, the following guiding principles must be adhered to: spurring on system innovation with concept innovation and giving full play to the staying power of community health service; taking the introduction of the competition mechanism as the soul and unremitting impetus of innovation; persisting in the solution of problems accompanying advance and development with methods promoting development; taking the strategic readjustment of health resources as the main line of development; taking the attainment of a favorable external environment as the impetus of development; and sticking to a path of coordinated growth that stresses both quality and speed.

A nationwide pilot project concerning community health sendees, the major part and chief link of the reform in the urban medical health system, has basically come to an end. The author expounds against the background of reform in the health system in China the motives and orientation of reform in the medical health system and the current situation of and problems in the development of community health services. It is pointed out that advancing community health services entails all of the following:①genuinely transforming concepts and seeking unity of thinking; ②adopting the mechanism of competition and enhancing the sense of innovation; ③persisting in keeping abreast of the times and laying emphasis on reform and development;④accelerating the readjustment of resources and optimizing resource allocation; ⑤ceating a sound environment and seeking common development; ⑥giving priority to the improvement of quality and avoiding superficial transformation.

Objective To observe the clinical effect of small gauge vitrectomy (SGV) treatment for proliferative diabetic tractional (PDR) with retinal detachment (TRD).Methods The data of 42 patients (50 eyes) with PDR combined with TRD who had received SGV treatment were retrospectively analyzed.There were 22 males and 20 females,with an average age of (44.5±11.2) years.There were 16 eyes with TRD involving the macular area,34 eyes without TRD involving the macular area.The eyes with rhegmatogenous retinal detachment or retinal hole were excluded.The best corrected visual acuity (BCVA) was worse than finger counting in 18 eyes,worse than 0.1 in 15 eyes,0.1-0.3 in 16 eyes and better than or equal to 0.3 in 1 eye.Post operative tamponade was delivered for patients with iatrogenic retinal breaks,including 5 eyes with long acting gas and 7 eyes with silicone oil.The mean follow-up time was 9.7 months.The visual outcome,rate of retinal reattachment and complications were analyzed.Results The visual acuity improved in 34 eyes (68.0％),unchanged in 12 eyes (24.0％) and decreased in 4 eyes (8.0％).The difference of visual acuity before and after surgery was statistically significant (t=7.087,P＜0.01).The total rate of retinal reattachment was 96％,and 84％ of eyes achieved anatomic reattachment after single surgery.The rate of retinal reattachment was 89.5％ (34/38) for these eyes without iatrogenic retinal breaks,4/38 eyes without iatrogenic retinal breaks still had retinal detachment in 3 months after surgery and received tamponade of long-acting gas or silicone oil.The rate of retinal reattachment was 66.7 ％ (8/12) for these eyes with iatrogenic retinal breaks and received post-operative tamponade.There were 17 eyes experienced postoperative vitreous hemorrhage,which were treated with anti-vascular endothelial growth factor (VEGF) antibodies or vitreous cavity lavage.There were 9 eyes with transient ocular hypertension,and 4 eyes with neovascular glaucoma (NVG).Among 4 eyes with NVG,2 of which were controlled through anti VEGF treatment or laser treatment,and 2 eyes of 2 patients refused to have further treatment.Conclusion SGV is safe and effective treatment for PDR combined with TRD,and intraocular tamponade is not necessary in the absence of iatrogenic retinal break.

Objective To approach the protective actions of Red Rose Capsule for Releasing the Dysmenorrhea(RRC) on the mice of primary dysmenorrhea.Method Sixty four health rats with the similar menstrual cycle were divided into four groups-NS group,RRC low dose group,RRC high dose group and Yueyueshu group.The indexes of TXB2 and 6-Keto-PGF1? in plasma were observed.Result RRC had significant effect on increasing 6-Keto-PGF1 ? and decreasing TXB2 in plasma of primary dysmenorrhea mice.Conclusion RRC has protective action against primary dysmenorrhea by influencing the content of TXB2 and 6-Keto-PGF1?.

Objectives To investigate the effect and mechanism of terbutaline sulfate on pulmonary fluid transport in pre-mature rats. Methods Pregnant rats were randomly divided into 5 groups (control group, premature group, low-dose terbutaline group, high-dose terbutaline group and dexamethasone group). Drugs were administered by gavage after rats were fertilized for 16 days and continued for 3 days. Premature rats were taken out from the 19 days pregnant rats, and mature rats were delivered on the due day. Lungs were collected, and the ratio of pulmonary wet weight to dry weight (W/D), Na+, K+-ATP ase activity and concentration of cyclic adenosine monophosphate (cAMP) were measured in lungs. Results The W/D rate, Na+,K+-ATPase acti-vity and cAMP concentration in lungs had significant difference among different groups (P<0.01). The W/D rate was highest in premature group and lowest in the control group. It was lower in the high-dose terbutaline group than in the low-dose terbutaline group and the dexamethasone group (P<0.05). The Na+,K+-ATPase activity was lowest in premature group and highest in high-dose terbutaline group. It was higher in dexamethasone group, low-dose terbutaline group, and high-dose terbutaline group than in premature group, and it was higher in high-dsoe terbutaline group than in low-dose terbutaline group and dexamethasone group (P<0.05). The cAMP levle was lowest in premature group and highest in high-dose terbutaline group. It was higher in dexamethasone group, low-dose terbutaline group, high-dose terbutaline group than in premature group, and it was higher in high-dose terbutaline group than in low-dose terbutaline group and dexamethasone group (P<0.05). Conclusions Terbutaline sulfate facilitates lung fluid transport in premature rats, leading to reduce the W/D rate in terbutaline-treated group. We speculate that this effect is related to the increased cAMP level and Na+, K+-ATPase activity in lung tissue.

Objective:To explore the inflammatory responses of macrophages treated with Helicobacter pylori. Methods:Cytokines IL-23,IL-10,TNF-α and IL-8 in cell culture supernatant of macrophages stimulated with Helicobacter pylori were determined by ELISA kits,and the expression of intracellular proteins NOS2 and COX2 in Helicobacter pylori treated macrophages was analyzed by Western blot. Then,the apoptosis of Helicobacter pylori stimulated macrophages was detected by flow cytometry. Results:The secretion of cytokines IL-23,IL-10,TNF-α and IL-8 in the culture supernatant of Helicobacter pylori treated macrophages increased significantly (P<0. 05),and the expression of NOS2 and COX2 was enhanced evidently(P<0. 05). Meanwhile,helicobacter pylori could induce the apoptosis of macrophages obviously ( P<0. 03 ) . Conclusion: The inflammatory responses of macrophages treated with Helicobacter pylori would be promoted to inhibit or kill Helicobacter pylori,furthermore,Helicobacter pylori could induce the apotosis of macropha-ges.

Objective To investigate the effect of p53-gene expression on renal function in rat with low birth weight ( LBW) .Methods Fifteen pregnant rats were randomly assigned into normal group, LBW group, and L-arginine ( L-Arg)-treated group.For normal group, pregnant rats were fed with 21% protein diet during pregnancy.For LBW and L-Arg treated groups, rats were fed with 10%protein diet.After de-livery, all rats were fed with 21%protein diet.For L-Arg-treated group, rats were given a supplementation with L-Arg (200 mg/kg) drinking water during 21 d lactation, other rats were given running water.At the age of 2m, the ultrastructural change in mesangial cell and podocyte was observed with electron microscope. At the age of 7 d, 21 d, 2 m, and 3 m old, the p53 mRNA expression in renal tissues was observed with re-verse transcription polymerase chain reaction ( RT-PCR) , blood and urine were collected to detect biochem-ical indicators of renal function and 24 h-urine protein.Results ⑴At the age of 3 m,the blood urea nitro-gen ( BUN) and urine cretinine ( UCr) in normal group were significantly lower than those in LBW group ( P <0.01).Compared to normal group, the Ucr of LBW group was significantly lower at the age of 2 m ( P<0.05).At the age of 3 m,the Ucr of L-Arg treated group and LBW group was significantly lower ( P <0.05), the level of 24 h-Urine protein was notably increased in LBW group and L-Arg treated group than that in normal group ( P <0.01, P <0.05) .⑵At the age of 3 m,the expression of p53 mRNA in LBW group was higher obviously than that in normal group.There is a significantly negative correlation between the expression of p53 mRNA and the level of Ucr in LBW group ( r =-0.91, P <0.05).⑶ There were mesangial cell proliferation with matrix increase, filtration membrane podocyte reduction, and partially dis-solved in LBW group, the mesangial cell proliferation of L-Arg treated group was decreased compared to that in LBW group.Conclusions The higher expression of p53 gene in LBW group might be one of reasons for the decreased renal function in LBW rats.

Objective To compare the contents in polysaccharide of aloe in gel of aloe with preparation in different processing methods on fresh aloe of outer cuticle and investigate their stability. It could provide technology of preparation of polysaccharide of aloe.Methods The aloe gel had been prepared through the fresh juicing method, and alcohol sinking was applied to abstract polysaccharides of aloe in proportion of sixty, seventy, eighty and ninety percent. The colorimetric method of anthracenone - thick sulfuric acid had been taken to determine contents of polysaccharide in different proportions by alcohol sinking. The contents of polysaccharide were compared among different processing methods in fresh aloe of outer cuticle, and then the stability on condition of different temperatures, pH and the reagent of reductant-oxidant with polysaccharides of aloe were investigated. Results The content abstracted from polysaccharide of aloe was the higher when the proportion was eighty percent and its character of powder was better. And content abstracted from polysaccharide of aloe with the outer cuticle was higher than that out of the outer cuticle. The powders from the polysaccharide of aloe with the outer cuticle were gray-green, gray-brown or gray-white. The powders from polysaccharide of aloe without the outer cuticle were partial-white, more well-distributed and delicate. The stability in polysaccharide of aloe was better with the condition of low temperature, reducing agent and the solution with pH from five to seven, while the stability was lower when in high temperature, oxidizing agent and the solution with strong acid and strong alkali. Conclusions The proportion of eighty percent with alcohol sinking, decorticating the outer cuticle of fresh aloe has the higher content and the better character in the polysaccharide of aloe.

Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation.Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group.There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group,with an average age of (7.0± 1.28) years.The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks,the birth weight (BW) of (1402.33 ±369.61) g and the number of laser burns was (517.86 ± 277.40).The control group included 7 females (13 eyes) and 6 males (12 eyes),with an average age of (7.17 ± 0.96) years.The age (t=0.691) and gender (x2=1.425) were comparable between the two groups (P=0.491,0.233).The data of patients and controls were retrospectively analyzed including best corrected visual acuity,refractive examination,automated perimetry test.The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed.ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB),mild VF loss group (MD ≤ 6 dB) and moderate VF loss group (MD ＞6 dB) according to the results of automated perimetry test,the differences of gestational age (GA),PA,BW,number of laser burns and SE between these groups were comparatively observed.Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27 ± 3.34 dB,respectively;the difference between the two groups was statistically significant (t=-4.01,P＜ 0.001).The subgroup analysis showed that BW,number of laser burns,and SE were significantly different between no VF loss group and VF loss group (t=2.074,-1.996,-2.162;P=0.042,0.026,0.034);while the GA was not significantly different between these two groups (t=1.973,P=0.052).The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002).For refractive outcomes,the BW and ROP stage correlated with SE significantly (r=-0.304,-0.387;P=0.015,0.002).The mean BCVA in ROP group was 0.84±0.23,and 59 eyes (91.2％) with BCVA better than 0.5.Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss,with good visual outcome.