Objective:To observe the changes and significance of pulmonary vascular endothelial cells (VEC),ICAM-1 and E-selectin in sepsis rats.Methods:60 SD rats were randomly divided into 2 groups:the control group and the sepsis group.The sepsis model was prepared by injection of lipopolysaccharide(4 mg/kg).The expression of ICAM-1 and E-selectin in pulmonary VEC of rats was detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical method.The VEC apoptosis in lung was analyzed with Hoechest-33258 staining.The ultramicrostructure of pulmonary VEC was observed under electron microscope.Results:Compared with the control group,the expression of ICAM-1 was significantly increased in the sepsis group (P<0.01),the expression of ICAM-1 was increased gradually and achieved the peak value at 24 h.The expression of E-selectin was achieved the peak value at 6 h and decreased gradually during 24 h.The apoptosis and necrosis of pulmonary VEC was increased gradually and achieved the peak value at 24 h (P<0.01).Conclusion:The expression of ICAM-1 and E-selectin in sepsis rats is significantly increased,probably leading to both necrosis and apoptosis of pulmonary VEC,resulting in the occurrence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).

Objective To explore the effect of glutamine on changes in the expression of intercellular adhesion molecule-1(ICAM-1)and E-selectin and the characteristics of pulmonary vascular endothelial cells(VECs)in sepsis rats.Method Totally 56 Sprague-Dawley rats were randomly divided into three groups:a control group,a sepsis group and a treatment group.All experiments were performed at the animal research center at Sun Yat-sen University in Guangzhou.Sepsis was induced by injecting 4 mg/kg lipopolysaccharide(LPS).The treatment group was injected with 4 mg/kg LPS and 0.3 g/kg glutamine.The control group was not injected with either LPS or glutamine.The rats were killed at 6,12 or 24 h after treatment and pulmonary tissue samples were obtained.The expression of ICAM-1 and E-selectin in VECs was detected by reverse transcription-polymerase chain reaction and immunohistochemistry.Apoptosis of VECs lung tissue was analyzed by Hoechest-33258 staining.The ultramicrostructure of VECs was observed under an electron microscope.Data were analyzed using analysis of variance using SPSS 13.0.Results At 6,12 and 24 h,the expression of ICAM-1 and E-selectin was significantly higher in the sepsis group(relative expression;ICAM-1:0.0864 ± 0.0101,0.141 ± 0.0147 and 0.1677 ± 0.0127,respectively;E-selectin:0.1535 ±0.0180,0.0811 ±0.0107 and 0.0505 ± 0.0031,respectively)compared with the control group(ICAM-1:0.021 ±0.0032,0.0228±0.0042 and 0.0204±0.0059,respectively;E-selectin:0.0423 ±0.0108,0.0412 ±0.0066 and 0.0418 ±0.0092,respectively)(all:P＜0.01).Glutamine treatment significantly decreased(P＜0.01)the expression of ICAM-1(0.0646±0.0136,0.1202±0.0143 and 0.1378 ±0.0085,respectively)and E-selectin(0.1071 ±0.0189,0.0628±0.0088 and0.0463±0.0049,respectively)at all time points compared with the sepsis group.However,the expression of ICAM-1 and E-selectin remained significantly higher than that in the control group(all:P＜0.05).There were similar changes in the expression of pulmonary ICAM-1,E-selectin mRNA and the results of VEC apoptosis.Electron microscopy confirmed these findings.Conclusions The expression of ICAM-1 and E-selectin was significantly increased in sepsis rats,leading to necrosis and apoptosis of VECs,and the onset of acute lung injury.Glutamine had a protective effect in VECs against lipopolysaccharide-induced sepsis.

Objectives To analyse the clinical feature,drug and surgical treatment and prognosis of rheumatic diseases associat- ed corneal melting.Design Retrospective case series.Participants 14 patients (22 eyes) with rheumatic diseases associated corneal melting.Methods The clinical data of patients were analysed,including history,visual acuity,slit-lamp microscopy examination,drug and surgical treatment and follow-up results.Main Outcome Measures The clinical feature,therapeutic effects and recurrence. Results The follow-up was 6～24 months.Rheumatic diseases associated corneal melting always firstly occurred from the upper corneal limbus.The marginal lesions of cornea included melting of the stroma,resulting in corneal thinning or even perforation,with neovascu- larization.The corneal lesions in 4 eyes were within 1 quadrant,10 eyes within 2 quadrants,6 eyes within 3 quadrants,and 2 eyes in 4 quadrants.Eight eyes of 5 cases,whose corneal lesions were thinner than 2/3 of normal corneal thickness,received 1% cyclosporine A and 0.5% heparin eyedrops.Among those,the lesions in 3 eyes of 2 cases progressed worse.Fourteen eyes of 9 cases,whose corneal lesions were thicker than 2/3 of normal corneal thickness,received marginal lamellar keratoplasty.Among those,recurrent signs were noted in 10 eyes of 6 cases.Conclusions Rheumatic diseases associated corneal melting has typical clinical features.Local cy- closporine A and heparin treatment are effective for patients in early stage.A high recurrent rate is found for patients in late stage re- ceived marginal lamellar keratoplasty.

Most patients with allergic conjunctivitis in children are vernal keratoconjunctivitis.Dry eye accompanied with al- lergic conjunctivitis in children is correlated with the decline of tear film stability.However,tear film stability decline is correlated with eosinophilic activation and concomitant release of inflammatory mediators.Moreover,conjunctival epithelial,goblet cells and tear film are damaged,then dry eye occur.Main symptom of dry eye in children is twinkling frequency increasing,followed by eye itch,eye red and photophobia.When allergic conjunctivitis in children is diagnosed,dry eye should be considered at the same time.Proper manage- ment for those allergic conjunctivitis can decrease ocular surface damages.

Objective To make the contrast analysis of concentrated training on clinical skill to college students before probation. Methods The students were devided into traning group (320pers) and contrast group (240pers), the training group undertook concentrated training on clinical skills before probation, while contrast group didn't. To make the contrast analyses on these two groups on medical record writing and to make questionnaire by those clinical teachers. Results The performance of traning group on medical record writing is higher than the contrast group (P<0.01) , and there also were significant difference in physical examination, medical record writing and comprehend capability. Conclusion The performance of clinical skills were elevated by concentrated training,and there were good teaching effects on the clinical teaching by the oncentrated clinical training.

AIM: To investigate the clinical effect of cataract combined lens dislocation greater than 2 quadrants` patients after having phase I intracapsular cataract extraction and anterior vitrectomy,postoperative corrected vision greater than 0.3,and then taking phase II small incision suture-fixation of intraocular lens suspension.METHODS: Totally 34 cases with cataract combined lens dislocation greater than 2 quadrants had been treated in our hospital from July 2014 to December 2016.We investigated their 1wk,1 and 3mo postoperative complications and the uncorrected visual acuity,best corrected visual acuity,intraocular pressure,corneal astigmatism who took phase II small incision suture-fixation of intraocular lens suspension with corrected vision greater than 0.3 after having phase I intracapsular cataract extraction and anterior vitrectomy.RESULTS: Along with the recovery time extension,patients` uncorrected visual acuity and best corrected visual acuity increased obviously than preoperative in each phase.On the 3mo postoperatively,the best corrected visual acuity of 1 eyes was between 0.3 and 0.1,8 eyes was between 0.5 and 0.3,16 eyes was between 0.7 and 0.5,and 9 eyes was better than 0.7.The best corrected visual acuity was achieved or near the best corrected visual acuity before surgery.Intraocular pressure rechecked became in the normal range at 1wk,1 and 3mo postoperative.Surgery did not significantly increase the corneal astigmatism.CONCLUSION: It is a safe and effective way in improving eyesight effectively,with stable intraocular pressure and fewer complications towards cataract combined lens dislocation greater than 2 quadrants` patients having phase I intracapsular cataract extraction and anterior vitrectomy,whose postoperative corrected vision greater than 0.3,and then phase II small incision suture-fixation of intraocular lens suspension.

Objective To search for a way of treating chi1dren's idtopathic nephrotic syndrome (INS) hypoadrenocorticismand its significance. Meethods Thirty-nine patients (31 males and 8 females) with INS were randomly divided into twogroups: 21 patients in tera-peutic group (treated by prednisone, astragali and acanthopanax root) and 18patients in control group (Simply treated by prednisone). 1ml blood was respectively drawn from all thepatients at 8 o'clock (one time before treatment and one time after treatment), the serum cortisol wasdetermined by radioimmunoassay (RIA). Results In control group, the levels of serum cortisol still remained lower than the normal value aftertreatment and the levels after large dosages prednisone treatment were markedly lower than that beforetrea-tment. The values of serum cortisol returned to be normal after treatment in therapeutic group. Conclusion Astragali and acanthopanax root can restore the hypoadrenocorticism in children with INS.

Objective To explore the anti-inflammatory mechanisms of purslane by evaluating its effects on the expression of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule 1 (ICAM-1).Methods A model of inflammation was developed in 45 mice by painting xylene to the auricle of the right ears,which were then divided into 3 groups to receive no treatment (negative control group),be topically treated with the extraction of purslane from South Korea (positive control group) or Yunnan province (experimental group).Fifteen mice receiving no sensitization nor treatment served as the blank control group.Two hours after the single topical treatment,skin tissue samples were obtained from the site of experimental inflammation and subjected to pathological examination by using hematoxylin and eosin (HE) staining.Immunohistochemistry was performed to quantify the expression of TNF-α and ICAM-1 in the tissue samples.Results Pathological examination showed blood vessels and a small quantity of lymphocytes in murine dermis of the blank control group as well as loose and edematous dermis infiltrated with massive lymphocytes in the negative control group.However,there was only mild edema and perivascular infiltration with some inflammatory cells in the dermis of the positive control group and experimental group.Neither TNF-α nor ICAM-1 was expressed in the skin tissue of the blank control group,but an intense expression was observed for TNF-α in the vascular endothelial cell membrane and for ICAM-1 in the vascular endothelial cell membrane and lymphocyte membrane in the negative control group,which was significantly downregulated by the purslane from South Korea in the positive control group and by the purslane from Yunnan province in the experimental group (all P ＜ 0.01).Rank sum test showed a statistical difference in the expression level of TNF-α and ICAM-1 between the blank control group and experimental group (both P ＜0.01).Conclusion The purslane from Yunnan province may counteract inflammation by affecting the expression of TNF-α and ICAM-1.

Objective To explore the effect of ischemia-reperfusion injury on the retinal functions of rats. Methods Seventy Wistar rats were selected, 20 of which were selected randomly and divided into two groups (control group and single-irrigated group). The rats were anesthetized and their anterior chambers of the right eyes were cannulated with a 7-gauge needle connected to a reservoir containing ringers balanced salt solution, which was maintained at the same level of the eye for 1 hour. After that, ERG was recorded in both eyes of all rats. All the left rats were divided randomly into 10 groups and they were treated as the single-irrigated group. Retinal ischemia was induced by raising the reservoir to a height of 150 mm Hg. One hour later except the single ischemia group, all of the groups resumed perfusion after 3,6,12,and 24 hours and 3,5,7,14,and 21 days separately. ERG was recorded in both eyes of all rats. Results There was no difference in the results of ERG between left and right eyes in either the control group or the single-irrigated group. All the waves of ERG vanished in the single-ischemia group after 1 hour. In the ischemia-reperfusion groups, the waves of ERG partly recovered and the amplitude reduced persistently and progressively. Conclusion Ischemia-reperfusion injury may affect the function of the retina persistently and progressively.

Objective To explore the potential value of multiple tumor markers chip( C- 12) in preoperative diagnosis of gastric cancer. Methods The serum levels of 12 rumor markers were measured in 45 gastric cancer patients, 38 benign gastrosis patients and 65 normal controls by use of C-12 in order to find out the most levels of CA199, CEA, CA242, AFP and CA125 in the gastric cancer patients were significantly higher than those of the benign gastrosis patients and normal controls. Moreover, the serum levels of β- HCG and HGH were also significantly higher in gastric cancer group than benign gastric disease group and control group ( P ＜sis of gastric cancer. CEA is the TM with the highest sensitivity, validity and negative predictive value of 57.8% ,81.8% and 77.1% ,respectively whereas CA242 is the TM with the highest specificity and positive CEA + CA125 + CA199 and CEA + CA242 + CA199 + CA125, respectively. The sensitivity, specificity and validity of the best combination of 2 TMs, 3 TMs and 4TMs for gastric cancer were not statistically significantly different from those of C-12 and the best TM ( P ＞ 0.05 ). Conclusion The multiple tumor markers chip ( C-12 ) has a relatively high value in the preoperative diagnosis of gastric cancer. The best combinations of 2 TMs ( CEA + CA125) ,3 TMs ( CEA + CA125 + CA199 ) and 4TMs ( CEA + CA242 + CA199 + CA125 ) for gastric cancer diagnosis could be sufficient to replace the combination of 12 TMs.