Objective To assess the quality of literature on randomized or semirandomized clinical controlled trials of fire needling treatment for rheumatoid arthritis.Method Acomputer search assisted by a manual search was conducted of CBM (1979—2015), CNKI (1979—2015), VIP (1989—2015),Wanfang digital periodical group(1998—2015), PubMed (1966—2015), EMbase (1980—2015) and Cochrane Library (Issue4, 2015).Randomizedor semir and omized clinical controlled trials were included.Two reviewers extracted data independently and checked them each other.The methodological quality of research design, diagnostic and inclusion/exclusion criteria, intervening measures for fire needling/control group,efficacy evaluation criteriaand observation time points, and adverse reaction reporting were assessed according toCochrane Reviewers' Handbook 4.2.8.Ameta-analysis was made of homogeneity studies.The GRADE approach ratedsystem outcomes.ResultA total of sevenr and omized controlled trialswere included.Four included studies made a comparison between fire needling andmedication (analgesic+ antirheumatic) groups andthere was no statistically significant difference in the efficacy rate [RR=1.22, 95%CI(0.97, 1.52)].GRADE ratingwas very low.Internationally accepted diagnostic criteria and general evaluation methodswere still not used universally.Conclusion The current clinical reports show that fire needling treatment has some effect on rheumatoid arthritis, but it still needs related evidence support.

Great progress has been made in tissue engineering cornea construction (i.c.constructing human corneal equivalence by using tissue engineering technique) during the past 20 years.However,a kind of tissue engineering cornea which can be applied to corneal transplantation as human cornea equivalent is yet to be availablc.Scaffold is an indispensable part of tissue engineering cornea.Searching for some kinds of scaffolds with good biocompability,some extent of biodegradation and euough biomechanics property are the issue needing to be resolved immediately in the tissue engineering cornea filed.This article reviewed the development of tissue engineering cornea scaffolds,represented the merits and defects of different scaffolds in order to optimize the project of choosing scaffolds and furthermore lay the foundation for constructing a kind of tissue engineering cornea which may be applied to corneal transplantation as human cornea equivalent in the future.

Objective To compare the clinical curative effect between transjugular intrahepatic portosystemic stent-shunt (TIPS) and TIPS together with gastric coronary vein embolization (GCVE) in treating cirrhosis portal hypertension (PHT) associated with upper gastrointestinal hemorrhage (UGH),and to discuss the necessity,feasibility and clinical curative effect of TIPS plus GCVE.Methods The clinical data of 38 PHT patients with UGH,who were admitted to authors' hospital during the period from April 2010 to May 2012,were retrospectively analyzed.Only TIPS was employed in 15 patients (group A),and TIPS plus GCVE was adopted in 23 patients (group B).Before and after operation,the indexes,hemodynamics of portal vein and spleen,the morphology of spleen,and the degree of gastrointestinal varices were determined and analyzed.The patients were followed up to observe the occurrence of postoperative complications.Results In both groups,the postoperative portal vein pressure showed an obvious reduction with accelerated velocity of flow,and the splenic venous congestion index was decreased,these changes were statistically significant when compared with the preoperative ones (P＜0.05),and which was more obvious in group B than in group A (P＜0.05).After the treatment,the esophagogastric varices (EGV) was obviously improved,the improvement rates of group B and group A were 94.7％ and 66.6％ respectively,the emergency hemostasis rates of group B and group A were 100％ and 75.0％ respectively,The rates of re-bleeding were 4.3％ and 28.5％ respectively;the above results of group B were statistically better than those of group A (P＜0.05).No statistically significant differences in liver function indexes existed between preoperative values and postoperative ones in the same group as well as in group comparison (P＞0.05).The differences in the postoperative hepatic encephalopathy (HE) occurrence and in primary patency rate of stent between the two groups were not statistically significant (P＞0.05).In both groups,the re-intervention patency rate was 100％.The incidence rate of HE in patients in whom the distal end of stent was located in the left branch of portal vein was strikingly lower than that in patients in whom the distal end of stent was located in the right branch of portal vein (P＜0.05).Conclusion For the treatment of PHT associated with UGH,TIPS combined with GCVE carries reliable curative effect,this therapy is superior to simple use of TIPS.

Objective To evaluate the influence of ProTaper rotary nickel-titanium files root preparation on root canal filling . Methods 30 cases of molars pulpitis and 20 cases of premolars pulpitis or periapical periodontitis were equally divided into two groups .The group A(30 cases) used the ProTaper rotary nickel-titanium files in root canal preparation and the group B (30 cases) adopted the common K files modified step-back technique for root canal preparation .The influence of the root preparation by 2 sets of apparatus on the effect of root canal filling ,and the several aspects of the root canal filling time ,the matching degree of main root canal file and master gutta-percha ,proper filling rate ,postoperative reaction of root canal filling were compared for conducting the e-valuation .Results In the mean root canal filling time of the group A ,average premolar time was 4 min 25 s and molar was 1 min 30 s ,however in the group B ,average premolar was 5 min 30 s and molar was 11 min 41 s ,the time in the group A was greatly short-ened with statistical difference(P<0 .05);the matching degree of main root canal file and master gutta-percha in the group A was 86 .37% for premolar and 88 .89% for molar ,however in the B group ,which was 62 .50% for premolar and 26 .67% for molar ,the matching degree in the group A was greatly improved with statistical difference between them (P<0 .05);the proper filling rate of upper premolar from the X-ray film was 72 .73% in the group A and 70 .83% in the group B ,while which of molar was 80 .0% in the group A and 77 .78% in the group B ,here was no statistical difference between them (P>0 .05);the postoperative pain reaction of root canal filling in both groups were very low and weak without statistical difference .Conclusion The ProTaper rotary nickel-titanium files root preparation can accelerate the root canal filling speed ,improve the matching degree of main root canal files and master gutta-percha and simplify the root-filling therapy procedure .

Objective To investigate the role of imaging characteristics of cerebral infarction in different regions in predicting the progressive cerebral infarction (PCI). Methods Patients with cerebral infarction were selected in the De?partment of Neurology of Hefei third People’s Hospital from January 2010 to June 2014. Brain MRI were examined the location of cerebral infarction. Patients were then classified into four groups accordingly:cortical infarction, basal gangli?on infarction, coronaradiata infarction and posterior infarction. Patients were further divided into PCI group and non-PCI group according to their clinical manifestations. MRI imaging features and risk factors were analyzed and compared be?tween PCI group and non-PCI group. Results A total of 150 patients with cerebral infarction were enrolled, including 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there were 46 cases of cortical in?farction, 25 cases of coronaradiata infarction, 47 cases of basal ganglion infarction and 32 cases of posterior infarction. There were significant differences in subtype cerebral infarction between PCI group and non-PCI group(χ2=19.239,P=
0.001). The percent of cortical infarction were significantly higher in PCI group compared to the non-PCI group. Cortical infarction was correlated to PCI and the value of R and P was 0.170 and 0.026, respectively. Logistic regression revealed that Imaging of subtypes of cerebral infarction was correlative with PCI (P=0.002). The frequency of progression was sig?nificantly increased in cortical infarction than in other subtypes of cerebral infarction (P=0.002). The trend was still sig?nificant even after adjustment for age and blood glucose, (P=0.014). Conclusion The location of cerebral infarction is closely correlated to PCI in which cortical infarction is more likely to develop PCI.

The Medical Care Act of Japan has undergone five major revisions since it went into effect in 1947. Each revision has been designed to target and tackle main problems found in the medical and health sector in the country. These problems range from the making of regional healthcare plans to the establishment of the hospital with specific functions, from the division of rehabilitation beds to the establishment of nursing insurance scheme, from the birth of medical corporations to the establishment of social medical corporations, and from strengthening of non-profit nature of medical institutions to the construction of medical information system. These efforts were made to provide a safe and convenient health service for the Japanese people. These revisions are closely related to hospital management, and its experiences prove useful for the health reform in China.

The clinician training system in Japan is different from that in China as their medical students are allowed to take medical doctor examination immediately following their graduation.But they must undergo at least two years of training in basic clinical knowledge and skills prior to taking any clinical practice.This training system is inspirational for us as follows:China should include standardized training of residents into the law of medical practitioners,and medical graduates must take two years of knowledge training in full medicine before they are qualified for clinical practice.On top of this training,they need to undergo at least three years of specialized doctor training,making them competent clinicians with comprehensive knowledge coverage and outstanding skills in specific areas following such staged training.

For medical insurance systems, medical expense examination is a key measure to keep medical expenses under control. In 1948, Japan established an examination authority of legal person status to operate the medical expense examination. Based on years of modifications and improvement in the organizational system and operation mechanism, the system is running smoothly by now. Authors of this paper made a detailed introduction to the specific operations of such a system, and to China's local features as well. On such basis, the study proposed to build in China a third-party medical expense examination institution as a legal entity, and practice the reexamination system and information disclosure system, in an effort to safeguard legitimate rights of insurance organizations and medical institutions.

Interleukin-24 (IL-24) is a novel cancer suppressor cytokine. It can suppress cancer cell growth, induce cancer cell apoptosis, inhibit angiogenesis, stimulate the PBMC secretion of cytokines, and enhance the antitumor activity of radiotherapy, chemotherapy and targeting gene-virotherapy. It is reasonable to suggest that IL-24 may be a powerful and effective protocol for combinatorial cancer treatment in the clinic.

Following with the naissance and the development of the DICOM(the Digital Image Communication in Medicine) protocol,and numerous medical image equipments factory's support to the DICOM protocol,PACS(picture archiving and communication systems)are popularized quickly in hospital image section room,which pushes the progress of PACS industry.Hospitals have always been certain blindness in ushering and arguing PACS systems,uncertain how to control those providing company exactly on the technique.In this paper,some key problems are introduced in order to make everyone understand the relevant technique.