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.

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 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.

Objective To compare clinical efficacy between improved vaginal hysterectomy (IVH)and traditional vaginal hysterectomy (TVH) and its influences on blood glucose and serum corticosteroid levels.Methods One hundred patients undergoing hysterectomy were divided into using IVH (treatment group,50 patients) and TVH (control group,50 patients).Clinical efficacy,blood glucose and serum corticosteroid levels were compared between two groups.Results There was no significant difference in operation time between two groups (P＞ 0.05).The amount of intraoperative bleeding,postoperative exhaust time and postoperative vaginal bleeding time in treatment group were significantly less than those in control group [(86.7 ± 5.7) ml vs.(131.2 ± 14.5) ml,(24.8 ± 12.9) h vs.(42.8 ± 17.7) h,(16.5 ± 2.9) d vs.(24.3 ±6.7) d,P ＜ 0.05],and the time of blood glucose and serum corticosteroid levels returned to normal levels in treatment group were much earlier than those in control group.Conclusion The clinical efficacy of IVH is preonunced,and postoperative stress reaction is mild.

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.

Objective To observe the effects of pregnancy induced hypertension on lipid metabolism and bilirubin metabolism in term neonates.Methods 200 term neonates were selected and divided into the two groups,100 cases whose mother were healthy were control group and another 100 cases whose mother had gestational hypertension were observation group.Birth weight,measured in cord blood triglyceride (TG),total cholesterol (TC) levels,high density lipoprotein (HDL-C),low density lipoprotein (LDL-C),adiponectin (APN) level were recorded.Results Birth weight of the observation group had significantly lower birth weight (2 927 ± 492) g,than the weight of the control group (3 452 ± 348) g.The incidence of lower birth weight was higher than in the observation group.TG,LDL-C levels of the observation group were (0.6 ± 0.24) mmol/L,(1.95 ± 0.25) mmol/L,were higher than those of the control group[(0.39 ± 0.17) mmol/L,(1.95 ± 0.25) mmol/L].There was a statistically significant difference between the groups (t =12.35,2.35,P ＜ 0.01 or P ＜ 0.05).HL-C and APN of the observation group were lower than those of the control group (t =1.79,7.00,all P ＜ 0.05).Bilirubin after bomed 24 hours,48 hours,72 hours and bilirubin peak of the observation group were (8.64 ± 2.17) mg/L,(11.06 ± 3.12) mg/L,(10.32 ± 2.47) mg/L,(12.04 ± 2.13) mg/L and were higher than those of the control group [(3.06 ± 0.94) mg/L,(6.98 ± 1.56) mg/L,(7.26±1.89)mg/L,(9.64±1.98)mg/L](t=23.48,11.65,9.84,8.27,allP＜0.01).Conclusion Maternal PIH may affect birth weight,lipid metabolism and bilirubin metabolism.

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.

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.

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 .

Complement activation induces polymorphonucleal neutrophilic leukocyte (PMN) aggregation in circulation causing microvascular occlusion. The activated PMNs release lysosome enzymes which damage the tissue. It might take an important part in shock and multiple organ failure. We pre-treated rat PMNs with sinomeuine, which was extracted and purified from the stem of Sinomeuium acufum Rehd et Wils. It was found to inhibit the morphological changes and lysosome enzymes release in PMNs activated with zymosanactivated plasma. With administration of sinomeuine PMNs remained a spherical shape, no apparent ruffling or cytoplasmic projection and less aggregation. Elastase and Nacetyl-?-D-glucosaminidase content in PMNs supernatant increased less.