With the burgeoning of continuing medical education, grass-roots hospitals are confronted with quite a number of problems in the implementation of the task, such as a general rush into action with each department going its own way, incontrollable educational expenses that are beyond the hospitals, difficulties in developing programs at the hospital level because of the limitation of academic disciplines, and the buying and selling of credits. In view of the above problems, the authors put forward some suggestions for formulating a series of continuing medical education management strategies that both conform to the situation in our country and suit the needs of health professionals at grass-roots institutions.

The medical staff's ability to apply medical statistics is deficient at present.In order to bring up eligible students and improve the teaching quality of medical statistics,the author has advanced his thoughts and opinions on teaching contents,teaching ways and examination ways.

Iatrogenic gastrointestinal perforation is one of the severe adverse events of endoscopic therapeutic procedure. For acute iatrogenic perforation,management by endoscopic techniques is a simple and rapid modality to close the perforation with minimal invasiveness and avoiding the traditional surgical trauma. Endoclips,suture with special instruments,covered stents,degradable sheets combined with tissue adhesive,and combined endoscopic techniques such as snares combined with endoclips,are the major endoscopic therapeutic modalities for closure of iatrogenic gastrointestinal perforation. In this article,the current status and progress of endoscopic management for acute iatrogenic gastrointestinal perforation were reviewed.

AIM: To observe the changes of NO, ET-1, SOD and MDA levels in plasma of rats exposed to infrasound. METHODS: Using infrasound (frequency: 8 Hz; sound pressure level:130 dB), the rats were exposed for 1 d, 7 d, 14 d, 21 d and 28 d, 2 h daily, then the levels of NO, ET-1, SOD and MDA were measured after exposure. RESULTS: The changes of NO levels in plasma significantly declined at 7 d and 14 d (P0.05). The changes of ET-1 levels in all groups in plasma were significantly increased (P

Objective The present study was designed to investigate the efficiency of simvastatin therapy for experimental pul‐monary hypertension (PH) in rat ,and the effects on the number and function of circulating endothelial progenitor cells (EPC) . Methods Twenty four Sprague Dawley rats were divided into 3 groups randomly :model group ,treatment group and control group , 8 rats in each group .Rats were treated with a single subcutaneous injection of monocrotaline to induce PH (PBS used as control) . The rats in the experimental group were administrated with simvastatin 3 days following subcutaneous injection of monocrotaline .In the 21st day ,the number of circulating EPC ,the right ventricle systolic pressure of rat ,pulmonary vascular structural changes and the quantity of cultured EPC were measured .At the same time ,EPC in each group were cultured in vitro ,then the ability of prolif‐eration and function were analyzed and compared .Results The number of circulating EPC in model group was decreased signifi‐cantly compared to both control and model groups (P< 0 .01) .Compared with model group ,simvastatin treatment markedly de‐creased the RVSP and the ratio of media thickness to eternal diameter (P<0 .01) ,but the ratio of vessel area to total arterial area (VA/TAA) was definitively increased(P<0 .01) .After 7 days of culture in vitro ,both the output of EPC and the ability of prolif‐eration ,conglutination and migration of EPC in treatment group were up -regulated compared with those in model group (P<0 .01) .Conclusion This study confirmed that simvastatin effectively treat experimental PH through improving quantity and func‐tion of circulating EPC .

Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity from those in controls. Nor was there difference in number of myofibers or diameters of myocardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group(P<0.0 l),and the capillary basement membrane in the former was significantly thicker than in the latter(P<0.01).Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.

Objective To investigate the regulative role of N-Acetyl-D-glucosamine(GlcNAc) on the stressed mice macrophages function.Methods The stressed mice model was established by electric footshock method.The mice were divided into 5 groups:normal control group,stressed mice model group,low dose Glc-NAc treatment group(0.25 ml 15% GlcNAc),medium-dose GlcNAc treatment group(0.5 ml 15% GlcNAc) and high-dose GlcNAc treatment group(1 ml 15% GlcNAc).GlcNAc was intragastrically injected to corresponding mice 2 h before the electrical stimulation.Peritoneal macrophage(PM?) phagocytosis capability was detected by phagocytosis saccharomycete assay,and PM? energy metabolism was detected by MTT assay.Results Compared with normal control group,stressed mice PM? phagocytosis capability was significantly lower(P

Objective To prove the prophylactic function of absorbable gelatin sponge and bioprotein glue for prevention of epidural and nerve root scar adhesions after laminectomy. Methods We excised the L6 vertebral plates of 36 adult New Zealand male rabbits,to make vertebral plate excision model and to find nerve root. Then divided them into 3 groups based on different materials:gelatin sponge and bioproten glue (group A),gelatin sponge (group B) and saline solution (group C). The morphological changes of the scars were observed grossly and histologically at 2 and 8 weeks after operation. We also measured the orbit of the nerve root. Results Gelatin sponge combining with bioprotein glue can reduce adhesion obviously(P

OBJECTIVE To seek for an effective,rapid,economic,safety and practical cleaning method,so as to ensure the high quality of sterilization in hospital supply center.METHODS Six hundred moderately contaminated recyclable instruments were divided into three groups randomly,conventional group,experimental group A and experimental group B(two hundred sorts each).The instruments in experimental group A were put into warmed water(40 ℃) for ten minutes first,and that in experimental group B were put into multi-enzyme solution for five minutes first,and then all the instruments in three groups were put into automatic sprinkling cleaning machine to accomplish the cleaning process automatically.After cleaning process,cleaning degree of the instruments and remained blood residues were compared in three groups.RESULTS The cleaning quality in the groups A and B was significantly higher than that of the conventional group,both P

Objective To construct a home-care service package for the urban disabled elderly that satisfy their demands and improve the efficiency of service. Methods From August to October, 2014, a total of 285 disabled (mild, medium and severe) elderly from a cluster sampling were investigated with the self-designed questionnaire about home-care demands among them. An initiatory service package was drawn to meet the demands reported by 40% of them or above. The package was consulted by a group of 15 experts using Delphi method. Results The final service package included 11, 19, 20 items of care for the mild, medium and severe disabled elderly, respectively. Conclu-sion The disabled elderly home-care package in Zhengzhou has been created based on the demands among disabled elderly.