Objective To observe the clinical characteristics and efficacy of laser photocoagulation of aggressive posterior retinopathy of prematurity (AP-ROP).Methods Twenty-eight eyes of 14 infants with AP-ROP from May 2008 to December 2010 were enrolled in this study.The infants were examined using RetCam photography and indirect ophthalmoscopy.Among the 28 eyes,24 eyes were classified as zone one and 4 eyes zone two.All eyes were treated within 24 hours using binocular indirect ophthalmoscope and laser photocoagulation.The initial energy was 200 mW,using energy was 200 - 500 mW,exposure time was 200 ms.Every two photocoagulation spot was linked together,but no overlap.Follow-up ranged from 3 to 24 months,with a mean of 11.5 months. The retinal bloods,the iris surface vessels,the fiber hyperplasia on retina,retinal detachment or ruffle form were observed.Results Twenty-five of 28 eyes (89.3 ％) recovered or were classified as control; 1 of 28 eyes (3.6 ％) was suffered retinal detachment one month after treatment.The detachment was resolved through vitrectomy Surgery.Two of 28 eyes (7.1 ％)did poorly.The parents gave up treatment resulting in loss of vision.No treatment-related complications were observed during the follow-up period,such as damage to cornea,iris and lens. Conclusion Photocoagulation is a safe and effective way to treat most AP-ROP.

Objective: To explore the effects of the bi-directional referral system from the perspective of the medical service consumer.Methods: A balanced panel data which was adjusted by Propensity Score Matching was employed to evaluate the effects of two-way referral system using difference-in-difference (DID) for the 2013 and 2015 data.The evaluation indicators including actual cost sharing ration, out-of-pocket cost per unit, the possibility of high cost, annual inpatient visits and length of hospital stay per unit were used.Results: Compared with the control group, the two-way referral system resulted in an 11.3% (P<0.001) increase in actual cost sharing ratio and an increase of 0.710 (P<0.001) annual inpatient visits in the intervention group.However, the policy did not significantly reduce the possibility of high-cost medical expenses and reduce the length of hospitalization and the annual cost hospitalization.Conclusion: Based on the key findings of the analysis of this study, the two-way referral system has beneficial effects on reducing inpatient financial burden and optimizing resource allocation.

Creativity is the demand of the time.The cultivation of creativity is what we should put first in the education of graduates.The Fourth Military Medical University attempts to consummate the selection,training and evaluating system of supervisors by strictly checking the qualification of supervisors and examining the enrollment qualification,sending supervisors abroad for further education and making them attending academic conferences for academic communication.The university also modularizes English teaching and giving lectures on political theory courses in order to establish a curriculum system which integrates the education of theory,practicing and the cultivation of comprehensive quality.Moreover,by creating funds for graduates' searching and international academic communication of academy,the university tries to complete stipend and scholarship systems to encourage innovation and exploration.By doing these,the cultivation of graduates' innovation ability has been improved.

Epidemiology,as a major subject in the field of public health science,plays a pivotal role in the construction and development of disease prevention and control system.It is also vital for the public health system to improve the emergency response ability and to cultivate high-quality talents.After analyzing current situation of graduate education of epidemiology,we found some problems.In our research,deepgoing dissection was carried out and possible solution was provided.

Objective To observe the clinical effect of pulsed radiofrequency electrotherapy combined with acupuncture or electroacupuncture in treating neuralgia after herpes zoster infection.Methods Eighty-eight patients were divided into a control group,an electroacupuncture group,a pulsed electrotherapy group and a combined group using a random number table.The 4 groups were routinely given gabapentin and tramadol,while the electroacupuncture group was additionally treated with electroacupuncture,the pulsed electrotherapy group received radiofrequency irradiation of the dorsal root ganglion,and the combined group was given CT-guided pulsed radiofrequency electrotherapy combined with electroacupuncture or acupuncture.Before the treatment and 15 days and 1 month afterward,everyone was evaluated using a visual analogue scale (VAS) for pain intensity,the Hamilton anxiety (HAMA) and depression (HAMD) scales and the short form 36 (QOL-SF36) quality of life assessment.The area of painful skin was also measured.Results There were no significant differences among the 4 groups at the outset in any of the measurements.Significant improvement was observed in all of the measurements 15 and 30 days after the treatment except in the control group.The combined group was by then significantly better than the other 3 groups.Their dosage of gabapentin and tramadol had decreased significantly compared with the other groups after 3 months of treatment.Conclusion CT-guided pulsed radiofrequency electrotherapy combined with acupuncture or electroacupuncture is safe and effective for treating post-herpes neuralgia.It is worthy of clinical application and promotion.

In order to train professionals in medical laboratory technology who are directly engaged in medical examination and medical laboratory work and who have strong practical ability and can adapt to the development of precision medicine, the reform of precise teaching for experiment is implemented. Through the precise stratification of experimental projects and knowledge points, the design of precise teaching activity and the construction of precise evaluation system for experiments, guided by precision medicine during the experimental process, the standardization and precision training of basic skills for students are strengthened in clinical laboratory test. The students can more well adapt to the needs of society for technical and innovative talent in the new period. The precise teaching for experiment will become one of the main characteristics of medical laboratory technology education in our school.

Objective To observe the clinical effect of combining extracorporeal shock waves with pulsed radiofrequency irradiation of the dorsal root ganglia in the treatment of spinal cord-derived abdominal pain. Methods A total of 88 patients were randomly divided into a control group, a shock wave group, a pulsed irradiation group and a combination group, each of 22. All of the patients were given etocoxib and pregabalin medication for 3 weeks. In ad-dition to the drugs, the shock wave group received extracorporeal shock wave therapy, and the irradiation group re-ceived pulsed radio frequency irradiation of the dorsal root ganglia. The combination group received both. A visual an-alogue scale was used to assess perceived pain. The quality of life short form 36 ( QOL-SF36) , Hamilton anxiety scale and Hamilton depression scale were administered to all 4 groups before the treatments and after 1, 4 and 12 weeks of the treatments. The development of diseases, gastrointestinal function, medical treatment and medical expenses of the 4 groups were observed for two years after the treatments. Results After 4 weeks of treatment, the average scores of all four groups in all of the evaluations had improved significantly compared with before the treatment. In combination group′s average results were significantly better than those of the other 3 groups from 4 weeks until 12 weeks after the treatment. During the subsequent two years that group′s gastrointestinal symptoms, hospital visits and medical expen-ses were all significantly lower, on average, than those of the other groups. Conclusion Extracorporeal shock waves combined with pulsed radio frequency irradiation of the dorsal root ganglia has significant clinical efficacy for alleviating spinal cord-derived abdominal pain. It can significantly reduce medical costs and is worthy of clinical pro-motion.

Objective To observe the clinical efficacy and safety of non-surgical spinal decompression com-bined with intervertebral foramen injection in the treatment of lumbar intervertebral disc herniation. Methods Nine-ty-six patients were randomly divided into a control group, a decompression group, an injection group and a combined group. All of the subjects were given loxoprofen sodium and chestnut seed extract. The decompression group was trea-ted with non-operative spinal decompression. The injection group received intervertebral foramen injections. The com-bined group received both treatments. Pain perceptions, quality of life perceptions and lumbar dysfunction were ob-served before the treatment, and 2 days, 1 month, 6 months and 12 months afterward. Results There were no sig-nificant differences among the groups in average pain perceptions quantified using a visual analogue scale ( VAS) be-fore the treatment. The average scores on a 36-item short-form health survey, the Oswestry disability index and a Jap-anese Orthopedic Association instrument also were not significantly different. All of those indicators had improved sig-nificantly in the decompression, injection and combined groups at 1, 6 and 12 months after the treatment, but the combined group′s average indicators were all significantly better than the other groups′ averages at the same time points. All of the significant improvements in the combined group′s averages occurred in the first month after the com-bined treatment. Conclusion Non-operative spinal decompression has a synergistic effect with intervertebral fora-men injection in treating patients with lumbar disc herniation. Their combined effect is better than either treatment a-lone. Their combined effect is lasting, safe and has few complication risks. It is worthy of clinical application.

Objective:To observe any effect of combining ultrasound-guided stellate ganglion pulsed radiofrequency irradiation with electroacupuncture in treating migraine.Methods:Seventy-two migraine patients were randomly divided into a combined group, an electroacupuncture group and a control group, each of 24. All three groups were treated with etocoxib and zolmitriptan dispersible tablets, while the electroacupuncture group and the combined group were additionally provided with electroacupuncture or ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture. The therapeutic interventions were administered once daily for 7 days. A visual analogue scale (VAS), a migraine-specific quality of life questionnaire (MSQOL), the Hamilton anxiety scale (HAMA), the Hamilton depression scale (HAMD) and a migraine disability scale (MIDAS) were used to evaluate each patient before the experiment and on the 3rd, 7th, 30th and 90th days after completion of the treatment.Results:The average VAS, MSQOL, HAMA and HAMD scores of the combined and acupuncture groups had improved significantly at all time points. Moreover, the average MIDAS scores of the combined and acupuncture groups had improved significantly 30 and 90 days after the treatment. On the 3rd day after the treatment, the average VAS, MSQoL, HAMA and HAMD scores of the combined group were significantly higher than the acupuncture group′s averages, while the average MIDAS score of the former group was significantly lower on the 30th and 90th days after the treatment. The average VAS, HAMA and HAMD scores of the combined group were significantly lower than the control group′s averages 3, 7, 30 and 90 days after the treatment, while their average MSQOL score was significantly higher. The average MIDAS score of the combined group was significantly lower than the control group′s average 30 and 90 days after the treatment.Conclusion:Ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture can significantly relieve the symptoms of migraine and improve the life quality of migraine patients for at least 3 months.

Objective To investigate the effect of hyperbaric oxygen (HBO) on the behaviors, organizational morphology and the expression of protein kinase R-like ER kinase (PERK) in rats with spinal cord injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into normal group, sham group, model group and HBO group, with nine cases in each group. The normal group did not receive any treatment, the sham group received only laminectomy, and the other two groups were established spinal cord injury model with modified Allen's method. Six hours after operation, the model group was treated with regular air, and HBO group received HBO treatment for seven days. The recovery of locomotor function was evaluated by BBB (Basso Beattie and Bresnahan) on the day before operation and six hours, three days, seven days after operation. HE staining was used to observe the change of tissue morphology in injured spinal cord, and the expression of PERK in spinal cord was detected by Western blotting. Results There was no neurological deficit in the normal group and the sham group. The neurological score was lower in the model group than in the sham group three days and seven days after operation (P < 0.05), and was higher in HBO group than in the model group seven days after operation (P < 0.05). There was no obvious structural change in the normal group and the sham group, however, the model group showed swelling cells, condensed cytoplasm, and nucleus pycnosis hyperchromatic, and the HBO group showed slighter swelling cell compared with the model group. The expression of PERK was higher in the model group than in the sham group, and was lower in HBO group than in the model group seven days after operation (P < 0.05). Conclusion HBO could reduce the expression of PERK in the injured spinal cord, and improve the recovery of hind limb locomotor function in spinal cord injury rats.