AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy ( PTK ) assisted by anterior segment optical coherence tomography ( OCT ) in the treatment of non II type granular corneal dystrophy.
METHODS: A retrospective case series were studied. Totally 8 patients ( 12 eyes ) who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the II type granular corneal dystrophy ( Avellino corneal dystrophy ) by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.
RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.
CONCLUSION: In patients with non type II granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

Objective To study the intracellular calcium ([Ca2+ ]i) in myocardial cell of obesity rats induced by high-fat diet. Methods Male Sprague-Dawley (SD) rats were divided into obesity resistant (OR, n=15), normal (Nor, n=15) and obesity prone (OP, n=15) group after fed with high-fat diet for 10 weeks. Their body fat and serum lipids were measured. Myocardial cells were isolated with Langendorff perfusion and [Ca2+]i was measured with calcium indicator Fluo-3/AM and laser scanning confocal microscope after KCl depolarization and caffeine- induced. Results Compared with those in Nor and OR rats, the epididymal fat, perirenal fat, omental fat and body fat increased in OP rats (P<0.05), as well as the the level of total cholesterol, triglyceride and low density lipoprotein (P<0.05); the vary of [Ca2+]i elevation and restoration were lower (P<0.05). Conclusion The vary of [Ca2+ ]i elevation decreases in OP rats after KCl depolarization and caffeine-induced, that may associated with arrhythmia in obesity rats.

Objective To investigate the correlation between atherosclerotic renal artery stenosis and hypertension.Methods One hundred and seventy-nine patients underwent renal artery angiography after coronary artery angiography. Results Among the 179 patients, 56.4% patients were detected as renal artery normal, 24% as renal artery disease, and 19.6% as renal artery stenosis. Compared with hypertensive patients with normal renal artery, ARAS patients had higher systolic blood pressure (148?23 mm?Hg vs 136?18 mm?Hg, P

Objective To investigate whether lamivudine antiviral treatment after radical surgery can prolong disease-free survival of patients with hepatitis B virus-related liver cancer.Methods A total of 120 patients with hepatitis B virus-related liver cancer who underwent conventional radical surgery in Dongfeng Hospital Affiliated to Hubei Medical College from March 2014 to March 2016 were enrolled,and among these patients,60 were given conventional treatment (group A) and 60 were given lamivudine antiviral treatment (group B).ELISA was used to measure serum HBV DNA level.The t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,the Kaplan-Meier method was used to compare disease-free survival rate and recurrence rate between groups,and the Spearman method was used to investigate the correlation between serum HBV DNA level and survival time.Results According to the results of the 3-year follow-up,71 patients (59.17％) died (group A:46 patients died of tumor and 4 died of hepatic encephalopathy;group B:20 died of tumor and 1 died of hepatic encephalopathy).Compared with group A,group B had significantly lower recurrence rate (48.33％ vs 90.00％,x2 =16.98,P ＜0.001) and mortality rate within 3 years (35.00％ vs 83.33％,x2 =10.34,P ＜ 0.001).Group B had significantly higher mean disease-free survival time and 1-,2-,and 3-year dis-ease-free survival rates than group A(t =9.82,x2 =7.87,11.43,and 7.98,all P ＜ 0.001).After surgery,group B had a significantly lower serum HBV DNA load than group A [(0.008 1 ±0.003 2) × 105 copies/ml vs (0.014 3 ±0.008 9) × 105 copies/ml,t =18.54,P ＜ 0.001].In group A,there were significant differences in 1-,2-,and 3-year disease-free survival rates between patients with serum HBV DNA load ≥ 1.0 × 105 copies/ml and those with serum HBV DNA load ＜ 1.0 × 105 copies/ml (x2 =8.57,P ＜ 0.05),and further analysis showed that there were significant differences in 1-,2-,and 3-year disease-free survival rates (x2 =4.36,5.36,and 9.53,P ＜ 0.05);in group B,there were no significant differences in 1-,2-,and 3-year disease-free survival rates between these two groups of patients (P ＞ 0.05).Serum HBV DNA expression was positively correlated with patients' survival time (r =0.67,P ＜ 0.001).Conclusion Lamivudine antiviral therapy after radical surgery can effectively reduce serum HBV DNA level,and helps to prolong the disease-free survival time of patients with hepatitis B virus-related liver cancer.

OBJECTIVE:To provide reference for rational use of drugs in hospital under the condition of the separation of drug and medical care. METHODS:The volumes of business,income from drug and income condition of medical staff were compared before and after implementation of separation of drug and medical care. The chance for pharmaceutical work under the condition of the separation of drug and medical care were analyzed to put forward advice for improvement of drug use in medical institutions. RESULTS & CONCLUSION:After conducting Wuhu model in 8 medical institutions,some achievement and experience have been obtained. It should be propelled to implement effective administration for rational use of drugs to resolve the problems on over expensive medical service.

Objective To investigate the risk factors of gallbladder carcinoma,so as to provide theoretical base for the prevention of gallbladder carcinoma.Methods The clinical data of 153 patients with gallbladder carcinoma (gallbladder carcinoma group) who were admitted to the Peking Union Medical College Hospital from January 2000 to December 2010 were retrospectively analyzed. A total of 300 patients with cholecystolithiasis (cholecystolithiasis group) and 300 patients without gallbladder carcinoma or cholecystolithiasis (control group)were collected and matched at the ratio of 1∶2 to conduct the controlled study.Data were statistically analyzed by the Chi-square test and conditional Logistric regression.Results Univariate analysis showed significant difference in age,history of cholecystolithiasis,postmenopausal age,accumulated menstrual period,giving birth or not and number of birth between gallbladder carcinoma group and control group ( x2 =58.22,180.14,9.59,24.30,18.66,15.17,P ＜0.05).Age,history of cholecystolithiasis,accumulated menstrual period and number of birth were the independent risk factors of gallbladder carcinoma (x2 =55.76,180.95,24.30,8.54,P ＜ 0.05).The risk of having gallbladder carcinoma in patients who had a history of cholecystolithiasis was 34 times higher than those who did not have the history of cholecystolithiasis (OR =34.22).Late postmenopausal age (51 -55 years old),longer accumulated menstrual period ( ≥30 years),and the number of birth ( 3 times) were associated with higher risk of gallbladder carcinoma (OR =3.96,9.68,3.51 ). Age,course of cholecystolithiasis and accumulated menstrual period and number of birth were the risk factors of gallbladder carcinoma when comparing patients who have history of cholecystolithiasis in the gallbladder carcinoma group with those in the cholecystolithiasis group (x2 =70.66,16.66,11.59,4.69,P ＜ 0.05 ).Age,course of cholecystolithiasis and accumulated menstrual period were the independent risk factors of gallbladder carcinoma ( x2 =64.29,8.82,5.58,P ＜ 0.05).The risk of gallbladder carcinoma increased as the increase of age and course of cholecystolithiasis. The accumulated menstrual period ≥ 30 years was also a risk factor of gallbladder carcinoma. Conclusions Age,history of cholecystolithiasis,course of cholecystolithiasis,accumulated menstrual period and number of birth may be the risk factors of gallbladder carcinoma.For patients with age above 60 years and course of cholecystolithiasis above 3 years,cholecystectomy should be conducted to reduce the incidence of gallbladder carcinoma,and great importance should be attached to female patients with indications mentioned above.

Insulin resistance, lipid metabolism disorders, independent autonomic neuropathy are high risk factors for gallstone formation in type 2 diabetic patients. In recent years, there have been a lot of new developments on the relationship between type 2 diabetes and gallstones, such as adiponectin, leptin and metabolic syndrome, etc. Based on these studies, the risk factors of type 2 diabetes complicated with gallstones are summarized in this paper.

Objective To determine the risk factors of gallstones. Methods A case-control study was conducted on 4087 patients with gallstones (the study group) and 20435 individuals without gallstones (the control group) at the Health Center of Peking Union Medical College Hospital (PUMCH) between January 2007 to May 2010. Using age and sex, the study and the control groups were matched in 1 : 5 ratio. Data were statistically analyzed using Chi-square test and conditional logistic regression.Results Univariate analysis showed significant differences in diabetic mellitus (DM), systolic blood pressure (SBP), diastalic blood pressure (DBP), triglyceride (TG), high density lipoprotein cholesterol (HDL-CH) and body mass index (BMI) between the study and the control groups (P＜0.05). Multivariate analysis confirmed that DM, SBP, HDL-CH and BMI were associated with gallstones, and their adjusted odds ratio (95％ confidence interval) were 0. 825 (0. 736 ～0. 925), 0. 908 (0. 828～0. 996), 1. 211 (1. 056～1. 389) and 0. 746 (0. 691～0. 805), respectively.The incidences of total cholesterol (TCH) and low deasity dipoprotein cholesterol (LDL-CH) were not significantly different between the two groups (P＞0.05). ConclusionsDM、SBP、HDL-CH and BMI were found to be the risk factors for gallstones. To prevent gallstones, weight reduction, blood pressure control and normalization of blood lipid are important measures.

Many pediatric surgeons have little training in laparoscopic application.The major problem in clinical practice of laparoscopic technician is without regularly training,unsuitable indication,and ignoring peroperation management.so that there are much more serious complications.For these reasons,it is a prerequisite that surgon and anesthetist must be trained before clinical practice,and the qualification of admission should be strictly controlled.