Objective To investigate the effect of self-management program on low vision patients and the role of intrinsic motivation.Methods A total of 160 low vision patients were assigned into 2 groups by random digits table method with 80 cases each.The control group was given routine doctor's advice and health education,and the observation group was given a self-management program guided by well trained medical personnel on the basis of the control group.The General Self-efficacy Scale (GSS) and Chinese-version Low Vision Quality Of Life questionnaire (CLVQOL) was conducted before and after intervention.The patients' intrinsic motivation also was evaluated by Intrinsic Motivation Inventory (IMI) after intervention.Results The total score and scores of interest/fun,inner selectivity,subjective ability and stress/strain dimensions of IMI were (62.25±3.74),(18.43 ±3.67),(16.13 ± 1.53),(16.05 ±7.34),(11.64 ±2.74)points、in observation group and(50.24±4.32),(13.53±2.78),(13.67±1.75),(13.52±2.42),(9.52±1.77) points in control group,and there were significant differences (t=5.813-18.800,P＜ 0.05).The scores of GSS and CLVQOL in observation group after intervention were (27.49±3.41),(64.30±7.04) points,which were higher than those in control group:(16.54±2.25),(34.86±3.99) points,and there were significant differences (t=23.973,32.540,P ＜ 0.05).After intervention,the total score and interest/fun,inner selectivity,subjective ability and stress/strain dimensions of IMI in observation group were positively associated with the score of GSS (r=0.663-0.739,P ＜ 0.05).The total score of IMI was positively associated with the total score of CLVQOL (r=0.765,P ＜ 0.05).In addition,a positive association was observed between the total score and each dimension of CLVQOL and inner selectivity,subjective ability and stress/strain dimensions of the IMI (r=0.661-0.765,P ＜ 0.05).Conclusions A self-management program can improve low vision patients'self-efficacy and quality of life,intrinsic motivation is the important factor influencing the effect of selfmanagement program.

Objective To explore the influence of plasma matrix metalloproteinase-7 ( MMP-7 ) levels and genetic polymorphism of MMP-7 - 181 A/G on the stability of carotid plaque.Method According to carotid ultrasound examination, 503 patients with carotid atherosclerotic lesions were consecutively recruited and divided into vulnerable plaque group (n = 118) and stable plaque group (n = 385).Plasma MMP-7 levels were measured by enzyme-linked immunosorbent assay (ELISA), and MMP-7 -181 A/G genotypes were determined by polymerase chain reaction-restiction fragment length polymorphism (PCR-RFLP).Results Plasma MMP-7 levels in carotid vulnerable plaque group were significantly enhanced as compared to stable plaque group (t =5.49, P =0.00).The frequency of MMP-7 -181G allele in vulnerable plaque group was significantly higher than that in stable plaque group (11.4% vs 7.0% ,χ2 = 4.78, P= 0.029).Compared to AA genotype, the genotypes with - 181G allele (AG + GG) significantly increased susceptibility to carotid vulnerable plaque ( χ2 = 5.01, OR = 1.81, P = 0.025 ) .When further analyzing the relationship between genotype and plasma MMP-7 levels, no significant differences of plasma MMP-7 levels were observed between AA genotype and AG + GG genotype in stable plaque group.However, in vulnerable plaque group, plasma MMP-7 levels of AG + GG genotype were significantly higher than that of AA genotype( t = 2.62, P = 0.01).Conclusion The present findings suggest that plasma MMP-7 level may be a biomarker for carotid vulnerable plaque.Genetic polymorphism of - 181 A/G in MMP-7 promoter may affect the expression of MMP-7, and seems to be implicated in susceptibility to carotid vulnerable plaque.

Objective To observe the blood biochemical and histological changes before and after pancreas freezing, to provide evidence for cryosurgery for pancreatic cancer. Methods Fifteen healthy pigs were divided into deep frozen group (n = 5), shallow frozen group (n = 5), non-frozen group (n = 3) and normal group (n = 2). After anesthesia and Iaparotomy, a probe of the Argon-Helium Surgical System was inserted into the pancreas, 100% and 10% argon output power were used in deep and shallow frozen group, respectively;and the temperature were - 130 ～ - 140℃ and - 110 ～ - 120℃, respectively;which results in an ice-ball with 15 ～ 20 mm in diameter. Then helium gas was inputted to increase the temperature to 10 ～ 20℃ for three minutes;then the whole process was repeated. A probe was inserted into the pancreas in the non-frozen group only and only laparotomy was performed in non-grozen group normal group and normal group. Serum amylase, IL-6, CRP levels before and after the experiment was determined;the pigs were sacrificed at day 7 and the pancreas was harvested for light microscope and electron microscope examination. Results The frozen pancreatic tissue became pitchy necrosis zone, and it could be distinguished from non-frozen tissue;there were obvious tissue necrosis in the center and para-center of frozen area, and the ultra-structure were destroyed and disappeared, mitochondria degranulation and rough endoplasmic reticulum degrannlation were observed. Serum amylase was elevated in 13 (86.7%) pigs and most returned to normal at 6th day. Serum IL-6 was slightly elevated in 5 (33.3%) pigs. There was no significant difference among all the groups in term of serum CRP. All the pigs were alive until the time of sacrifice. Conclusions Cryosurgery has affirmative fatal ablative effects on pancreatic tissue, and it is safe with no serious complications.