Twenty-one eyes of 13 patients with juvenile glaucoma confirmed by ocular tension, vision, eye ground and gonioscope underwent trabeculectomy combined with amniotic membrane transplantation. The posttransplant intraocular pressure significantly decreased compared to pretreatment (P

ObjectiveTo investigate the effects of alpha-lipoic acid on serum soluble intercellular adhesion molecule-1 (sICAM-1) and high sensitive-C reactive protein (hs-CRP) levels in patients with early diabetic nephropathy (DN).MethodsA total of 61 patients with early DN were randomized into treatment group (n =31 ) and control group ( n =30 ).The two groups were both treated with dietary control and oral hypoglycemic drugs or insulin.Meanwhile,the treatment group was additionally given alpha-lipoic acid 300 mg/d by intravenous infusion for 20 days.The levels of sICAM-1 and hs-CRP in each group were detected.Results The levels of sICAM-1 and hs-CRP were decreased significantly in alpha-lipoic acid treatment group after 20 days of therapy ( [ 198.03 ±23.67] μg/L vs [271.17 ±34.66] μg/L,[5.16 ±0.43] mg/Lvs [7.95 ±0.88]mg/L,P ＜0.01 ).Conclusion alpha-lipoic acid may decrease the expression of slCAM-1 and hs-CRP,and that may be one of the mechanisms to postpone the progress of early DN.

Objective To investigate the application of CUSUM (cumulative sum control chart) curve in cardiac clinical teaching of resident surgeon education.Methods We chose a surgeon of 10years work experience of attending the preparation operation of internal mammary artery as control reference (standard group,28 patients) and a resident engaged in professional clinical cardiac work no more than 5 years as group 1,a professional training physician engaged in cardiac surgery clinical work more than 5 years as group 2 and took 40 patients' data respectively from the two groups' preparation of internal mammary artery operation.And then we recorded the postoperative mammary artery flow,internal mammary artery preparation time and adverse events data and made statistics analysis with SPSS 19.0,and CUSUM curve with Matlab R2012b polynomial curve.Results When the density of operate interval and the operate numbers came to about 25 cases,the polynomial eurve's slope rate went up to 0,regardless the surgeons' experience,CUSUM value was accumulated from 66 to 76,and overcame the learning curve successfully.However,when the density of operate interval did no reach the standard,the surgeon's CUSUM ploynomial cmwe slope rate never reached to 0,and can't overcome the learning curve.Conclusion CUSUM curve gives a clear quantitative indicator to the cultivation of clinical physician,and makes teaching teachers can understand the young physicians' learning process,so as to change the teaching plan,help young physicians cross the learning curve as soon as possible.

It's very important to establish an evaluation system to match international standards for improving the medical education quality in China.This article reviews the global profile of evaluation process for higher education,and compares it with the current status in China.It introduces the characteristics and experiences from overseas as references to optimize our medical education evaluation system.

MicroRNAs (miRNAs) are small non-coding RNAs which are essential for posttranscriptional gene regulation and have important roles in physiology and pathology. The researches on function of miRNA will be a focus in the future. Several animal models have been built by transgenic technology, making important contributions to our understanding of gene function at the whole scale. Recently, the number of transgenic animal models for microRNAs and construction strategies have been increasing and diversifying. Some roles of miRNA in tumor and cardiovascular disease have been revealed by transgenic animals. Transgenic animals are becoming a kind of powerful tool in microRNA researches.

[Objective] To assess the curative effect of acupuncture therapy to chronic mesenteric lymphadenitis. [Methods] Al 120 children patients are ran-domly divided into two groups, 60 cases each. Control group is treated with cefuroxime sodium for infections, and treatment group with acupuncture at Sifeng(EX-UE 10), Neiguan (PC06), Zhongwan(RN 12),Zusanli(ST 36) and etc. [Results] Markedly effective rate of treatment group was 91.7%,and total effective rate was 98.3%; markedly effective rate of control group was 86.7%, and total effective rate was 95%, which showed significant difference in curative effects.The two groups symptoms were decreased compared with before treatment, the difference was significant( P<0.01);after treatment, symptom scores were lower than the control group, with significant difference. The recurrence rate of treatment group after three months was 3.6%. The recurrence rate of treatment group after six months was 1.9%, evidently lower than control group ’s 57.7%,54% respectively. [Conclusion] Acupuncture therapy to chronic mesenteric lymphadenitis has unequivocal short-term effect, a stable long-term effect, and low recurrence rate,deservers clinical applications.

OBJECTIVE:To explore the clinical efficacy and safety of Leukotriene receptor antagonist combined with Gluco-corticoid nasal spray(called“intranasal steroid”for short)in the treatment of different degree of adenoidal hypertrophy(AH)com-plicated with allergic rhinitis (AR). METHODS:240 AR children with AH were randomly divided into control group,intranasal steroid group and drug combination group,with 80 cases in each group. Control group was given physiological seawater,3 presses each nostrile,in the morning and evening. The intranasal steroid group received Momestasone furoate nasal spray,one press each nostrile,qd. Drug combination group was additionally given leukotriene receptor antagonist Montelukast sodium chewable tablet,4 mg for under 5 year-old and 5 mg for 5-year-old or above,qd,at bedtime. Treatment course of 3 groups lasted for 12 weeks. The change of clinical symptoms and signs(such as nasal obstruction,snore,mouth breathing,etc)and adenoid/pharyngeal ratio(A/N ratio)were compared among 3 groups after treatment as well as the occurrence of ADR. Each group was divided into two sub-groups (medium and severe) according to the severity of AH so as to evaluate therapeutic efficacy. RESULTS:21 children withdrew from the study,including 11 cases in control group,6 in intranasal steroid group and 4 in drug combination group. After treatment,clinical symptom score and A/N in subgroups of drug combination group and intranasal steroid group were all lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in clinical symptom score and A/N between drug combination group and AR complicated with medium AH subgroup from intranasal steroid group(P>0.05). Clini-cal symptom score and A/N of AR complicated with severe AH subgroup from drug combination group were lower than intranasal steroid group,with statistical significance (P<0.05). No obvious ADR occurred in 3 groups. CONCLUSIONS:Intranasal steroid alone and intranasal steroid combined with leukotriene receptor antagonist can improve clinical symptom of AR patients with AH, and reduce adenoid volume. It is suggested to use intranasal steroid firstly for medium AH complicated with AR,and additionally use Leukotriene receptor antagonist for severe AH complicated with AR.

Objective To analyze the CT findings of acute cervical trauma (ACT) and evaluate the value and limitation of CT in the diagnosis of ACT. Methods 78 cases of cervical trauma were examined with X-ray film and thin slice CT. 3D reconstruction was performed routinely. Analysis and comparison of X-ray diagnosis with CT diagnosis were done. Results 60 cases of ACT were diagnosed by X-ray film while 59 cases were confirmed by CT simultaneously. 1 case was diagnosed by X-ray, while its CT findings were normal. Fracture detection rates of CT and X-ray film were 98.3% and 53.3%,respectively. The difference was statistically significant. Conclusion If the patient has the acute cervical trauma, CT can diagnose the fracture, luxation and spinal stenosis more safely and precisely. But CT scan has some limitations. Combining X-ray examination with CT scan is able to raise the diagnostic level.

Objective To analyse the CT findings of acute knee joint injury (AKJI) so as to evaluate the value and limitation of CT in the diagnosis of AKJI. Methods Sixty cases of AKJI were examined with X-ray plain film and thin-section of CT scanning, while three-dimensional reconstruction of CT was performed routinely as well. The results of X-ray films and CT scanning were analysed and compared with clinical data and operative findings retrospectively. Results In 60 cases of AKJI, 141 fractures were found on CT examination, however, only 104 fractures were found on X-ray films. The difference of the results between the two diagnostic imagings was statistically significant(?2=38.12, P

5 cm).The survival rates and the diminished rates of tumors in size were analysed comparatively.Results For small hepatocellular carcinoma,the diminished rates of tumor's size were higher in group PEI than that in group TACE and group CST,and higher in group RF than that in group TACE(P0.05).For large hepatocellular carcinoma,the diminished rates of tumor's size were higher in group TACE and group CST than that in group RF(P