BACKGROUND:Studies demonstrated that matrix metalloproteinase-1(MMP-1) and tissue inhibitor of metalloproteinases-1(TIMP-1) exhibit important role in corneal defect of rats with alkali burns.OBJECTIVE:To observe the promoting effect of recombinant human epidermal growth factor(rhEGF) on rats' corneas following alkali burns,in addition,to explore the effect and significance of rhEGF on the expression of MMP-1 and TIMP-1 in alkali burned rats.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed at the Laboratory Animal Center,Liaoning Medical College from March 2008 to May 2009.MATERIALS:Sixty healthy SD rats,weighting 180-210 g,with 6-8 weeks old,half male and half female.All rats were confirmed that no anterior segment disease before the experiment with slit lamp microscope examination.METHODS:Sixty rats were randomly divided into experimental and control groups,with 30 animals in each group.After the preparation of corneal alkali burn models,cornea of rats in the experimental and control groups were given rhEGF eye drops,and physiological saline eye drops respectively,fourth a day,consecutive for 21 days.Six rats of each group were killed at days 1,4,7,14 and 21 after operation.MAIN OUTCOME MEASURES:①Changes of cornea after alkali burned was observed by slit lamp microscope.②The expressions of MMP-1 and TIMP-1 in cornea were detected with immunohistochemistry and computer image analysis system at different time points.RESULTS:The slit lamp microscope results showed that the area of corneal ulcer in the experimental group was obvious smaller than the control group at the corresponding time points.The expression of MMP-1 gradually increased and reached a peak level at 14 days after surgery,then began to decrease.TIMP-1 expressed in the early phrase,but later,its activity gradually decreased,reached the lowest level at 14 days,then began to increase,and peaked at 21 days.The level of MMP-1 in the experimental group was greatly lower than that in the control group at each time points.However,the level of TIMP-1 of the experimental group was greatly higher compared with the control group.CONCLUSION:The rhEGF eye drops can improve effectively the healing of corneal epithelial defect by adjusting the proportion of matrix metalloproteinase and its tissue inhibitor.

Objective To investigate the effect of case simulation and participatory feedback teaching used for neonatal resuscitation training. Methods One hundred and twenty medical staff was selected as subjects from Obstetric and Pediatric department and were randomized into 4 batches to receive a neonatal resuscitation training program that consisted of theoretical lectures and skill practice. In the control group (first two batches), the teacher demonstrated procedures of neonatal resuscitation, then trainees practiced alone and the teacher corrected their wrong procedure. In the observation group (last two batches), interactive teaching was employed and the training was performed into three steps:practice of skill in teams, watch the procedure of their practice, the feedback. The theoretical exami-nation score, practical examination score, teamwork ability and satisfaction were compared between two groups. SPSS 16.0 was employed for statistical analysis, with α=0.05 as detection level. Results The theoretical examination scores of control group and observation group were (34.27 ±2.26) vs. (33.68±2.32). There was no significant difference in theoretical examination score between the two groups ( P=0 . 166 ) . The practice examination score s of control group and observation group were (36.15±1.46) vs. (34.79±2.43), with significant differences (P=0.000). The teamwork ability of control group and observation group were (35.78 ±1.26) vs. (33.63 ±1.98), with obviously significant differ-ences (P=0.000). The trainees individual study interest, practice intent, knowledge and satisfaction with the training in the observation group were significantly higher than the control group. These results were (8.45±2.75) vs. (6.24±2.28), P=0.001;(8.25±2.05) vs. (6.48±2.75), P=0.003;(7.23±1.37) vs. (5.75 ±1.74), P=0.000; (8.21 ±1.45) vs. (6.34 ±1.69), P=0.000. Conclusion Application of the teaching in neonatal resuscitation training can enhance comprehensive practical skills and team coop-eration ability in med-ical staff, and it improves trainee's satisfaction with the training.

Objective To explore the preventive effect and mechanism of pioglitazone on nonalcoholic fatty liver disease in rats.Methods Thirty six male Sprague-Dawley ( SD) rats were randomly divided into normal control group , high-fat diet group , and pioglitazone intervention group , with 12 rats in each group .Normal control group fed with standard diet for eight weeks , and the rest two groups fed with high fat diet .Pioglitazone intervention group fed with pioglitazone in the four to eight weeks , the rest two groups in the same period fed with distilled water .Fasting serum alanine aminotransferase , aspartate aminotransferase , total cholesterol , triglyc-erides, fasting glucose , and fasting blood insulin levels were determined .The fasting insulin resistance index was calculated .Routine histological features of hepatic section were observed by hematoxylin eosin (HE) staining.The shape change of Kupffer cells in the liv-er was detected .The levels of tumor necrosis factor ( TNF)-αand nitric oxide ( NO) secreted by Kupffer cells were measured .Results The fasting insulin resistance index , triglycerides , and total cholesterol in rats of high-fat diet group were significantly higher than in normal control group ( P <0.05 ) .Histopathological examination showed hepatocellular macrove sicular steatosis , lobular inflammatory cell infiltration, and inflammatory cell infiltration .Hepatic Kupffer cell morphology change , its produced TNF, NO and liver tissue pa-thology changes were positively correlated ( P <0.05 ) .The fasting insulin resistance index , triglycerides , total cholesterol was signifi-cantly lower in rats of pioglitazone intervention group than the high-fat diet group ( P <0.05 ) .The liver tissue structure was obviously improved pioglitazone intervention group rats , morphology and function of liver Kupffer cells were normal .Conclusions Pioglitazone can prevent the nonalcoholic fatty liver disease induced by high fat diet .The mechanism may be related to improve insulin resistance , reduce blood fat , and regulate function of Kupffer cells .

Objective To explore the anxious condition and the influencing factors of chronic hepatitis B patients, and to take appropriate care measures. Methods Self-designed questionnaire for general information of patients, a comprehensive Zung self-rating depression scale(SDS)and Zung self-rating anxiety scale(SAS)were used to investigate 100 patients with chronic hepatitis B patients(the study group), and the results were compared with 80 normal persons(the control group). Results The SDS and SAS score of the study group was significantly higher than the control group. The negative emotion factors of the study group included social context, family, education, self- respect. Conclusions Patients with chronic hepatitis B has obvious negative mood, and are influenced by many kinds of factors. Strengthening the comprehensive psychological intervention can improve the negative emotional state, and promote rehabilitation of patients.

The subject service platform was constructed for nursing science using Drupal according to the low edu-cation level, high work load, much fragmentary time, and low information literacy of nursing staff.Web 2.0 infor-mation service was provided for nursing staff,such as literature pushing, cloud tag revealing and personal customiza-tion by integrating the library-holding resources ( including paper literature resources , electronic literature re-sources and literature resources on networks ) .The literature literacy level and scientific research ability of nursing staff were improved by making the full use of their fragmentary time.The new service mode in hospital libraries was studied in Web 2.0 environment .

Objective To analyze the relation between ischemic mitral regurgitation (IMR)and the changes of left ventricular systolic synchrony and volume parameters before and after percutaneous coronary intervention (PCI)in patients with subacute myocardial infarction and to evaluate the impact of PCI on IMR by measuring such changes with three-dimensional echocardiography volume quantitation technology. Methods Eighty-seven patients were enrolled and echo data were acquired before and 6 months after PCI. Patients were classified into alleviation group (group Ⅰ)and non-alleviation group (group Ⅱ)according to the change of mitral regurgitation volume (MRvol).The systolic synchrony indexes (Tmsv 1 6-SD%,Tmsv 1 6-Dif%)and left ventricle volume parameters (LVEDVI and LVESVI)before and after PCI for patients of two groups were measured and contrasted.Results Systolic synchrony indexes of all patients of two groups were improved after PCI.Left ventricular volume parameters were decreased after PCI in group Ⅰ,and the remodeling was reduced.Correlation analysis of the parameters variations showed that,there was significant positive correlation between variations of left ventricular volume and MRvol in all patients and no significant correlation between variation of systolic synchrony index and MRvol.Conclusions PCI can improve left ventricular systolic dyssynchrony for submyocardial infarct patients.Left ventricular volume index that reflects the remodeling process is closely related to IMR.

Objective To evaluate the performance and efficiency of public hospitals in Sanming city,for suggestions on bettering their medical resources deployment efficiency and operational efficiency.Methods Descriptive analysis was used to longitudinally describe the general performances of such hospitals,leveraging the operating data of 21 public hospitals of the city.Meanwhile,appropriate indexes were selected to construct data envelopment analysis models for analysis of hospital operational efficiency and variations.Results Longitudinal analysis showed the operation process as stable,the efficiency as improved,and the structure as optimized thanks to the reform.Horizontal analysis found three hospitals (14％ of all) as efficient in general,and seven (33％) as efficient technically.Those hospitals found as inefficient technically suffer from overinvestment or output deficiency to varying extents.Three hospitals (14％) were found with scale efficiency,while those found without scale efficiency were regarded as diminishing returns on scale.Conclusions Reforms measures must be adhered to consolidate outcomes of the ongoing reform;Regional healthcare resources planning must be consolidated to improve the efficiency of resource allocation;Delicacy management must be made to enhance service delivery capabilities.

AIM:To find an efficient and simple surgical procedure of the external dacryocystorhinostomy ( EXT- DCR) in the treatment of chronic dacryocystitis.
METHODS:A total of 270 cases were performed in this retrospective study. A comparison of clinical effects and hemorrhage complications between the experimental group, in which 189 eyes of 167 patients that underwent traditional EXT-DCR without packing, and the control group, in which 121 eyes of 103 patients that underwent traditional EXT-DCR with Vaseline gauze were performed. The postoperative follow-up ranged from 6 to 36mo ( the mean follow-up was 15±3. 6mo).
RESULTS: There were no significant differences in the curative rates between the two groups (97. 9% vs 97. 5%, P>0. 05). But the incidence rate of moderate or severe postoperative nasal bleeding was lower in the experimental group (15. 9%, 30 eyes) than the control group (31. 4%, 38 eyes) and P<0. 01.
CONLUSION: The traditional EXT - DCR without packingis an effective procedure and is more effective in reducing moderate or severe postoperative bleeding when the intraoperative anastomose and the postoperative drainage are well done and the intraoperative bleeding is well controlled.

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