The community health institution of our country can't take effect really because of some restrictive factors. We have analyzed the issue and the countermeasure in this paper.

Objective:To construct the standard curve for real-time PCR detecting the tissue expression level of Angptl3 in SD rat.Methods:The total RNA of the SD rat's liver was the template.We got lots of the Angptl3 partial DNA sequence by RT-PCR.The products were cloned into the pUCm-T vector,Then we diluted the solution of plasmid and used real-time PCR(SYBR GreenⅠ)to construct the standard curve.Results:The correlation coefficient of the standard curve was 0.997 6.The reaction efficiency was 0.862 3.The correlation and the amplify efficiency were good.Conclusion:It is successful to construct the standard curve for real-time PCR detecting the tissue expression level of Angptl3 in SD rat.

Objective To evaluate the new colposcopy combined cytology thinprep pap test(TCT) in cervical screening in the diagnosis of disease. Methods 1 266 patients detected by gynecologic cervical cytology were conducted on colposcopy and liquid-based thin-layer cytology of the Joint Inspection. Results 1 266 cases in which seized 169 cases of abnormal cervical lesion detection rate of 13. 35%,abnormalities in cervical squamous intraepithelial lesions and 126 cases,accounting for 9.99%. The incidence of cervical intraepithelial lesions detected no difference between age groups was statistically significant(P＞0.05). Conclusion Thinprep cytology combined colposcopy cervical precancerous lesions was a reliable method for early diagnosis.

Objective To systematically evaluate the application effect of clinical pathways in children pneumonia patients by u-sing the system analysis .Methods Published RCT in children pneumonia patients were searched and screened in CNKI ,VIP ,CBM-disc and Wanfang datebase under present standards .The quality of the included studies were evaluated and statistical analyzed by RevMan5 .0 software .Results Total 17 literatures including 2 717 cases were eligible to the criteria (1 359 in clinical pathways group and 1 358 in control group)altogether .The system analysis showed there were significant difference between the clinical path-way group and the traditional treatment group in grasp of health knowledge [RR=1 .30 ,95% CI(1 .17 -1 .44) ,P<0 .01] ,rate of patients ,satisfaction[RR=1 .17 ,95% CI(1 .13 -1 .21) ,P<0 .01] ,length of hospital stay [WMD= -2 .90 ,95% CI(-3 .93 - -1 .86) ,P<0 .01] ,hospitalization expenses[WMD= -620 .02 ,95% CI(-838 .99 - -401 .04) ,P<0 .01] ,the body temperature to restore normal time[WMD= -1 .67 ,95% CI(-2 .10- -1 .23) ,P<0 .01] ,lung sound disappear time[WMD= -1 .80 ,95% CI(-2 .15- -1 .45) ,P<0 .01] .Conclusion Clinical pathways is superior compared with the traditional treatment for children pneumo-nia patients ,be worthy of spread in clinical .

Objective: To explore the preventive measures for early stage pulmonary complications in old patients following thoracic surgery.Methods: We conducted psychotherapy,pulmonary infection control,training in breathing and instructions in expectorating phlegm in 127 old patients(over 70 years) undergoing thoracic surgery.Results: The patients experienced difficult expectoration on the first postoperative day because of increased sputum viscoelasticity,which was gradually improved later.Analgestic and mucokinetic measures produced intended results on the first three postoperative days,with significant improvement of sputum fluidity.And the concept of fast track surgery promoted the recovery of the patients.Conclusion: The preventive measures proved essential for the prevention of early stage pulmonary complications in old patients following thoracic surgery.

OBJECTIVE To study the infection of Pseudomonas aeruginosa after brain operation and drug-sensitivity.METHODS The system of BBLCrystalTM MIND-Crystal identification and Chinese software were used to identify P.aeruginosa.Drug-sensitivity was performed by K-B methods in accordance with NCCLS.RESULTS Totally 261 specimens were isolated from 126 patients during Mar to Dec 2005.From them 99 strains of P.aeruginosa were detected from specimens of 38 patients.There were 50 strains from phlegm,20 strains from suction in trachea,6 strains from urethral catheterization,8 strains from vein catheter,and 15 strains from wound excretion.Seventy seven strains(77.7%)were isolated during the peak period of May to August.Strains that were isolated in the same period possessed uniform drug-sensitivity results,which hinted epidemic of the same clone of P.aeruginosa in the Deparment of Cerebral Surgery.Drug-sensitivity results showed P.aeruginosa had been resistant to the common antibiotics.CONCLUSIONS Infection with P.aeruginosa after brain operation and drug resistance have already been serious,so we should think seriously of it.

Objective To investigate the characteristics of process of the formation of idiopathic macular hole, measurement was made for the patients using optical coherence tomography (OCT). Methods OCT was performed in 55 eyes of 40 cases (40 initially diseased eyes and 15 contralateral eyes). Results OCT images showed that among the 40 initially diseased eyes the number of macular hole of 1, 2, 3 and 4 stages was respectively 1, 11, 23 and 5 eyes. The depth of fovea of eye of stage 1 was 331 ?m. The average diameters of the macular holes in stage s 2, 3 and 4 were respectively 298.1 ?m, 681.2 ?m and 557.5 ?m. Ten out of the 15 contralateral eyes were observed with macular hole (stage 1 and 2 were 6, 3 eyes respectively and lamellar hole was 1 eye). Separation of posterior vitreous was observed in 16 out of 55 macular holes eyes (account for 29%). OCT images showed that there were split and cystic space with separated vitreous centrally attached to the fovea in the case of stage 1. It was observed that the contracted operculum attached to post erior vitreous with an opening apart from the center in the case of stage 2. Stage 3 displayed a full-thickness hole with surrounding edema and stage 4 showed a full-thickness hole and a complete separation of the posterior vitreous from retina. Conclusions OCT can display clearly the size, shape and process of the formation of macular hole. It was observed that the initial changes in the vitreous detachment and fovea by investigation of the contralateral eyes. OCT is also a useful method for the diagnosis, study on the mechanisms of the formation of macular hole.

ObjectiveTo evaluate the clinical efficacy of Sedum freckle capsule combined with hydroquinone cream phonophoresis in the treatment of chloasma.MethodsA total of 180 patients with chloasma were recruited into two groups according to the random number table, 100 in the treatment group and 80 in the control group. The patients in the control group were treated with 2% hydroquinone cream phonophoresis, and those in the treatment group received 2% hydroquinone cream phonophoresis and Sedum freckle capsules, both for 2 months. The symptom and lesion score were usedto evaluate the clinical efficacy. ResultsThe cure rates were 81.00% in the treatment group and 67.50% (χ2=4.320,P=0.038) in the control group at the end of treatment, 92.0% and 76.3% (χ2=5.538,P=0.019) at 2 months follow-up. The total lesion scores at the end of treatment and at 2 months follow-up were significantly lower than before the treatment in the treatment group (1.61 ± 0.84 and 1.30 ± 0.85vs.3.48 ± 1.02;t=14.152, 16.419, allP<0.01) and also in the control group (2.04 ± 0.61 and 2.03 ± 0.51vs.3.45 ± 1.09;t=10.097, 10.554, allP<0.01). The total lesion score at the end of treatment and at 2 months follow-up were significantly lower than in the treatment group was significantly decreased than the control group (t=3.839, 6.767; allP<0.01).ConclusionSedum freckle capsule combined with hydroquinone cream phonophoresis could effectively treat patients with chloasma.

OBJECTIVE:To provide references for medical workers about how to make better use of the PubMed to retrieve foreign literature.METHODS:The PubMed was introduced in detail with example in respect of the retrieving method,special service function,use of special column,storing and printing of retrieving results,etc.RESULTS & CONCLUSIONS:PubMed is generally accepted as one of the most important and authoritative biomedical bibliographic database and its contents cover each field of biomedicine.Mastering the methods and skills of retrieving PubMed is of great help for medical workers to retrieve foreign literature rapidly and accurately.

It is suggested to explore the practice of doctors at different edical institutes in the Project of Medical Reform in 2009.There will be a series of problems when the practice is carried out.The methods to solve these problems would be studied in the aspects of defining the nature of doctors′ practice at different medical institutes,improving system building and transferring conception.