We conducted a questionnaire survey among 36 community health care providers at Jingansi Health Center to learn their status quo.Our results showed that talented person aged less than 35 only accounted for 1/10.97%of the young physicians wished to have more continuous medical education and improved working environment.Proper working regulation,personnel resource management and payment system might help attract,train and retain more qualified persons,improve personnel quality,and achieve sustainable development of community health centers.

Objective To observe and analyze the clinical outcomes of levamisole in combination with vitamin B12 in the treatment of recurrent oral ulcer.Methods The prospective clinical study method was used,67 patients with recurrent oral ulcer who admitted to the dental were randomly divided into the combined treatment group,the levamisole group,and the vitamin B12 group.The combined treatment group was treated by levamisole combined with vitamin B12 .The levamisole group and the vitamin B12 group were treated with levamisole and vitamin B12 respectively. The cure rate,serum IL -6 and vitamin B12 levels were compared among the three groups.Results The cure rate of the combined treatment group was 90.90%,which was significantly higher than 77.72% of the levamisole group and 81.82% of the vitamin B12 group(P <0.05).The combined treatment group had significantly lower level of serum IL -6 than that of the levamisole group and the vitamin B12 group[(56.45 ±11.34)pg/mL vs.(102.35 ±10.23)pg/mL vs.(145.44 ±12.35)pg/mL,P <0.05].The combined treatment group had significantly higher level of vitamin B12 than that of the levamisole group[(523.34 ±13.45)μg/mL vs.(323.34 ±12.53)μg/mL,P <0.05].There was no difference between the combined treatment group and the vitamin B12 group regarding serum vitamin B12 level [(523.34 ±13.45 )μg/mL vs.(554.45 ±33.34)μg/mL,P >0.05 ].Conclusion Levamisole combined with vitamin B12 treatment can significantly decrease serum IL -6 and increase serum vitamin B12 and improve the cure rate for patients with recurrent oral ulcer.It has been proved to be the effective treatment for recurrent oral ulcer.

Enterovirus 71 (EV71) infection can cause hand,foot and mouth disease,due to its neurotropic nature,severe cases can affect the central nervous system and emerge neurogenic pulmonary edema (NPE),respiratory and circulatory failure,and even lead to death.The advances in the pathogenesis of severe HFMD neurogenic pulmonary edema after EV71 infection in recent years are described.

Objective To investigate the clinical effect of periodontal fiber retention periodontal splint and Periocline combined treatment for severe tooth. Methods the control group was given routine retention of fiber periodontal splint treatment, study group in retention of fiber periodontal splint treatment combined with periocline. The changes of PLI, BI, PD and AL before and after treatment in two groups of patients with severe periodontal disease were recorded. The data were input into SPSS software and given statistical analysis. Results The detection of two groups of PLI, BI, PD, AL and other indicators of no significant difference between before treatment; after treatment of different options of group AL, PD decreased than the control group (P<0.05); PLI of the study group after treatment, BI decreased significantly than before (P<0.05), the control group on the index no obvious change than before. Conclusion The application of retention of fiber periodontal splint combined with Periocline treatment of severe periodontal disease can significantly improve the curative effect, is conducive to the protection of the quality of life.

Objective To study the effect of 99Tc-MDP on receptor activator of nuclear factor-κB ligand/osteoprotegerin (RANKL/OPG) system of collagen-induced arthritis (CIA) rat. Methods The CIA was established by subcutaneous injection with type Ⅱ collagen and complete Freud's adjuvant to rats, except the group (n=8, treated with 99Tc-MDP). The histopathological changes of joints were scored based on the extent of infiltration of inflammatory cells, cartilage destruction and bone erosion. The serum levels of RANKL/OPG were tested with ELISA, and the synovial membrane levels of RANKL/OPG were tested with Western blot.Repeated ANOVA and one way ANOVA were used for statistical analysis. Results The MTX group relative value of RANKL/OPG in serum [35 d (1.076±0.016), 42 d (1.140±0.005), 49 d (1.155±0.023)], and in synovial membrane (1.156±0.014), and the histopathological scores [synovial membrane (1.8±0.5), cartilage (1.9±0.6), bone (1.8±0.5) ] were lower than model group ( 1.269±0.025, 1.296±0.015, 1.340±0.011 ), (2.9±0.4, 2.6±0.5, 2.6±0.5), ( 1.340±0.013 )(P＜0.01 ). And all above index of 99Tc-MDP group ( 1.035±0.034,0.986±0.019, 0.991±0.020), (1.5±0.5, 1.4±0.5, 1.2±0.5), (0.098±0.026) were notably lower than the MTX treat ment group (P＜0.01). Conclusion 99Tc-MDP may retard the progression of the disease by decreasing the relative RANKL/OPG expression and it can initiate its effect earlier than MTX.

Endoplasmic reticulum stress will be happened when cells suffer from severe adverse stimulation.Endoplasmic reticulum stress can induce autophagy.Autophagy and endoplasmic reticulum stress can protect cell for survival, however, they can trigger cell death.In tumor cells, the mutual regulation of autophagy and endoplasmic reticulum stress leads to the imbalance between cell survival and death, which is one of the important factors in determining the efficacy of some antitumor drugs.This paper reviews the progress on autophagy induced by endoplasmic reticulum stress in tumor and the effect of autophagic inhibitors on chemosensitivity.

It is of vital importance for medical postgraduates to strengthen moral construction.Based on Bourdieu's field theory,the paper puts forwards methods to enhance the influence of moral education by forming of moral habitus by self-education,clinic practice and academic study and the accumulation of moral educational capital by the combination of mentors,society,schools,families and peer groups.

Objective To study the change of the peripheral blood cells of soldiers in high altitude hypoxia,to analyze its influ-ence on the blood cells.Methods The blood cell were compared among the soldiers in the plains,entered plateau after 6 months and stationed plateau for a long time,and to analyzed the effect of high altitude hypoxia environment on blood cells.Results WBC, RBC,hemoglobin,hematocrit and mean corpuscular hemoglobin concentration were obviously above plain group and long staff group (P <0.05),and mean corpuscular volume was obviously lower than those of plain group and long staff group (P <0.05).White cell and lymphocytes in plateau group were also obviously higher than those in plain group (P <0.05),and long staff group no signifi-cantly differences (P >0.05).platelet,mean platelet volume,platelet distribution width was clearly higher than that of plain group (P <0.05 ).Conclusion Blood cells of soldiers training in the high altitude hypoxia environment are significantly increased,and changes in blood cells are closely related to emplacement time and altitude.

In recent years ,lots of studies indicated that inflammation plays an important role in occurrence and de‐velopment of cardiovascular diseases .Neutrophil to lymphocyte ratio (NLR) is a novel inflammatory marker ,the cost of detection is low and it's easy to obtain .NLR is not only related with poor prognosis of stable coronary artery disease and acute coronary syndrome ,but also closely associated with prognosis of acute heart failure .The present article made a review on the correlation between NLR and cardiovascular diseases .

Azacitidine belongs to a novel family of demethylation antitumor drug.Foreign clinical researches have demonstrated that it may be a low toxic and effective choice for elderly patients with acute myeloid leukemia,whose physical conditions are too poor to sustain intensive chemotherapy.This review will summarize recent reports on azacitidine in the treatment of elderly patients with acute myeloid leukemia.