OBJECTIVE: The sole effective measure for cataract is replaced the epinephelos lens with intraocular lens. So, in this paper, we summarize the research process of intraocular lens, which can provide a reference for further study. METHODS: Medline, China Journal Net, Wanfang Data, SpringerLink, and ScienceDirect database were computer retrieved from 1997 to 2009. RESULTS: A total of 25 papers were included. All the papers were explained intraocular lens from the aspect of current situation, complication following implantation, and develop tendency. According to hardness, intraocular lens can be divided into hard intraocular lens and soft intraocular lens. Acrylic intraocular lenses showed better biocompatibility than the silicone intraocular lenses. In addition, the common complication following implantation was dislocation of lens. Therefore, the trend of further research was injection type intraocular lens. CONCLUSION: The results demonstrated that as a foreign body, the body would react to the implanted intraocular lens, which is a normal reaction. Therefore, it is necessary to consider the biocompatibility, postoperative visual function recovery, regulatory ability, as well as photoprotection in the design of intraocular lens.

Objective To analyze the electrocardiogram and treadmill exercise performance in patients with coronary artery myocardial bridge.Methods 176 patients with myocardial bridging diagnosed by coronary angiography were selected in the study.The performance of myocardial bridge electrocardiogram and treadmill exercise of different depth and stenosis was observed.Results Deep in myocardial bridge ischemic ST segment and T wave changes were significantly higher than superficial type (x2 =11.02,P ＜ 0.01).Systolic myocardial bridge Ⅲ grade stenosis of ischemic ST segment and T wave changes were significantly higher than grade Ⅰ and grade Ⅱ (x2 =12.78,P ＜0.01;x2 =24.45,P ＜ 0.01).The positive rate of myocardial bridge deep in the treadmill exercise test was significantly higher than the superficial type.Myocardial bridge Ⅲ grade systolic stenosis,treadmill exercise test positive rate was significantly higher than grade Ⅰ and grade Ⅱ (x2 =9.23,P ＜ 0.05;x2 =6.76,P ＜ 0.01).Conclusion Patients with myocardial bridge have various changes in the electrocardiogram and treadmill exercise,changes in deep in the type and degree of stenosis Ⅲ grade systolic are obvious.

Taking the Huanggang Central Hospital in Hubei Province as an example,the paper introduces the medical consumables management process before and after the implementation of informatization management,compares the data generated 10 months before and after the informatization management,and states that the scientific management for medical consumables with the information system can optimize the process,reduce the occurrence rate of errors,and improve the working quality and management level of the sterilization and supply center.

Objective To investigate the clinical significance of fine needle aspiration biopsy and immunohistochemical markers in differential diagnosis of thyroid nodule.Methods One hundred and eighty-five cases of thyroid nodule were enrolled in the study.All cases received preoperative fine-needle aspiration biopsy and immunocytochemistry.Results The sensitivity,specificity,diagnostic accuracy of fine needle aspiration biopsy to detect diagnosis of thyroid nodules was 75.0％ (21/28),85.4％ (134/157),83.8％(155/185).The positive rates of p53 and galectin-3 immunodetection in discriminating benign from malignant thyroid nodules were 60.7％ (17/28),85.7％ (24/28),combined with p53 and galectin-3 immunodetection in discriminating benign from malignant thyroid nodules was 50.0％ (14/28).The positive rates of p53 and galectin-3 immunodetection in thyroid adenomas were 0,5.1％ (8/157),combined with p53 and galectin-3 immunodetection in thyroid adenomas was 1.3％ (2/157).The positive rates of p53 and galectin-3 immunodetection in malignant thyroid cytologic specimens,alone or combined were significantly higher than those in thyroid adenomas,there were significant difference(P ＜ 0.05).The diagnostic accuracy of fine needle aspiration biopsy with p53 and galectin-3 immunodetection,alone or combined,in discriminating benign from malignant thyroid nodules [94.1％(174/185),93.5％(173/185),91.4％(169/185)] were higher or equal to those in fine needle aspiration biopsy[83.8％(155/185)],there were significant differences (P ＜0.05).Conclusion Immunodetection of p53 and galectin-3 combined with fine needle aspiration biopsy in the differential diagnosis of thyroid nodules can raise the diagnostic accuracy.

AIM: To investigate the interference of valsartan on blood pressure and plasma angiotensin Ⅱ (ang Ⅱ), aldosterone (ALD) in salt sensitive essential hypertensive patients. METHODS: Eighty-four adult hypertensive patients were enrolled in study, and the salt sensitivity was determined by acute intravenous salt water loading according to Sullvan's criteria. The change of blood pressure and plasma ang Ⅱ, and ALD were compared before and after the treatment. RESULTS: At the end of 2, 4, 6, and 8 weeks, patients with salt sensitive essential hypertensive (group ss) and no salt sensitive essential hypertensive (group nss) were measured. The results showed that sitting systolic blood pressure (SiSBP) was decreased by 17.5 ? 4.3 and 11.0 ? 1.4 mmHg, and sitting diastolis blood pressure (SiDSP) was decreased by 17.0 ? 3.7 and 7.3 ? 1.1 mmHg after the treatment. It was found that patients showed significantly higher plasma ang Ⅱ and lower plasma ALD in group ss and group nss. CONCLUSION: Valsartan can significantly control SiSBP and SiDBP for both groups, interfered plasma angiotensin Ⅱ and I aldosterone, and be more effective for patients with salt sensitive essential hypertensive.

Objective To explore clinical features and antimicrobial resistance of lower respiratory tract infection (LRTI)with Streptococcus pneumoniae (S .pneumoniae)isolated from children in Nanjing.Methods Clinical data of children with confirmed S .pneumoniae LRTI through sputum culture at a children’s hospital in Nanjing between July 2013 and June 2014 were analyzed retrospectively,S .pneumoniae strains were performed antimicrobial susceptibility testing through K-B method and minimum inhibitory concentration (MIC)testing.Results Among 197 children with S .pneumoniae infection,72.59% were <3 years old,63.96% occurred in autumn and winter, 57.87% had elevated leukocyte count,cough and fever were the most common clinical symptoms,complications of digestive and circulatory system were also common.The resistance rates of S .pneumoniae to azithromycin, penicillin,and erythromycin were 94.92%, 92.98%, and 88.83% respectively; the sensitivity rates to vancomycin,chloramphenicol,meropenem,ceftriaxone,and ofloxacin were all > 90%,vancomycin was up to 98.98%.Conclusion The percentage of S .pneumoniae LRTI is high in children < 3 years old,most occur in autumn and winter,resistance rates to azithromycin,penicillin,and erythromycin are all high,antimicrobial agents should be selected for the treatment of infection according to antimicrobial susceptibility testing.

Objective To study the expressions of Cx43,CD105 and VEGF in HBV related HCC tissues and the relationships between Cx43 expression and recurrence and prognosis after cancer radical resection in HCC patients stratified by serum AFP levels. Methods The expressions of Cx43,CD105,VEGF in 234 HBV related HCC tissues were examined by tissue microarray and two-step methods of PV-6000 of immunohistochemistry and the expressions of Cx43 in 20 frozen HCC specimens were examined by RT-PCR. Results Cx43 in HCC tissues was positive as examined by both immunohistochemistry and RTPCR methods.Positive Cx43 expression is correlated with lower early recurrence ( Log Rank P =0.001 ),longer disease free survival (Log Rank P =0.026 ) and overall survival( Log Rank P =0.000 ) as showed by the Kaplan-Meier analysis in patients with AFP ＜ 400 μg/L. The expression of Cx43 is an independent prognostic factor.The positive expression of Cx43 related with lower positive expression of CD105 and VEGF (P =0.018,0.023 ),and correlated with histological differentiation (P =0.002),the number of focus (P =0.033 ),blood vessel tumor embolism ( P =0.029 ). Conclusions The expression of Cx43 is correlative with the expression of CD105 and VEGF,and is predictive of HCC early recurrence and poor prognosis after radical hepatectomy in HBV related HCC patients with serum AFP ＜ 400 μg/L.

Objective To understand the infectious pathogens distribution and drug resistance in the surgical departments of our hospital from 2007 to 2011 to provide the basis for the anti-infective therapy in the surgical patients.Methods TheVitek automatic microbial identification system was used to identify bacteria and fungi.The Kirby-bauer (KB)method was used to study the antibi-otic resistance in the pathogens isolated from the patients in the surgical departments.Results 1218 strains of pathogens were iso-lated,including 669 strains(55%)of Gram-negative bacteria,440 strains(36%)of Gram-positive bacteria and 109 strains (9%)of fungi.The top five of bacteria in turn were Escherichia coli in 182 strains(15%),Pseudomonas aeruginosa in 171 strains (14%), Staphylococcus aureus in 105 strains (9%),Klebsiella pneumoniae in 86 strains (7%)and Enterococcus faecalis in 61 strains(5%). Among 283 strains of Escherichia coli,Klebsiella pneumoniae and proteus mirabilis,the detection rate of ESBLs producing strains was 29.7%.Methicillin-resistant Staphylococcus aureus(MRSA)accounted for 63% of Staphylococcus aureus.The resistance rates of Staphylococcus and Enterococcus to multiple antibacterial drugs were above 50%.Enterobacteriaceae bacteria were more sensi-tive to carbapenems as well as compound antibacterial drugs containing enzyme inhibitor.The lowest resistance rate of Acinetobact-er to cefoperazone/sulbactam was 21.1%.Pseudomonas aeruginosa showed the most sensitive to compound antibacterial drugs con-taining enzyme inhibitor and its lowest resistance rate to cefoperazone/sulbactam was 17.4%.Conclusion The drug resistance phe-nomenon in the pathogens isolated from the surgical patients are relatively serious,this study provides some basis for the preventive antimicrobial drugs use in the perioperative period and the empirical medication in the infection therapy.

Objective To summarize the experience in the diagnosis and treatment of mucinous cystic neoplasms (MCN) of the pancreas. Methods The clinical data of 20 cases who were diagnosed as MCN of the pancreas in the affiliated hospital of Qingdao university from January, 2003 to June, 2008 were collected, data including clinical manifestations, pathological features, treatment and survival were analyzed retrospectively. Results The clinical manifestations mainly included abdominal pain or discomfort, nausea, vomiting; 11 patients had abdominal tenderness, 6 patients had palpable abdominal mass. All the patients underwent ultrasound and CT scan examinations, 13 patients were diagnosed as having benign MCN of the pancreas, 4 were serous cystadenoma, 3 were mucinous cystadenocarcinoma. The tumors were located in the body and tail of the pancreas, with a mean diameter of 4 - 14 cm. All the 20 cases received surgical treatment. The procedures mainly included pancreaticoduodenectomy and resection of pancreatic body and tail. Pathological examinations confirmed there were 10 patients with benign MCN of the pancreas, 3 were borderline mucinous cystadenomas and 7 mucinous cystadenocarcinomas. After a mean follow-up of 26 months, patients with benign MCN of the pancreas or borderline mucinous cystadenomas were still alive without recurrence, the three year survival of patients with mucinous cystadenocarcinomas was 50%. Conclusions MCN of the pancreas mainly occurred in female, and there was no specific clinical features, preoperative ultrasound and CT scan examinations could help to diagnose this disease. Surgical resection was the only effective method to cure MCN with good prognosis.

BACKGROUND: The investigation of culturing, passaging and establishing human limbal stem cells can strengthen the recognition of the stem cells and provide the enough cellular reserve for the basic and clinical research of limbal stem cell transplantation.OBJECTIVE: To explore a method of pessaging and establishing cell line of human limbal stem cells cultured in vitro.DESIGN: Randomized controlled observation.SETTING: Gannan Medical College.MATERIALS: The experiment was performed at Scientific Center of Gannan Medical College and the National Key Laboratory of Ophthalmology Hospital Affiliated to Sun Yat-Sen University from June 2003 to April 2004. Fresh human limbus corneae were isolated from two healthy donors. Procedures were performed according to the informed consent of the donors. Main reagents contained RPMI-1640 (Sigma R8755, containing L-glutamine) and 200 g/L fetal calf serum (FCS) (Gibco 16140-071). DMEM medium, chondroitin sulfatase and human epidermal growth factor (hEGF) were purchased from Sigma Co. USA; HEPES and DMSO were bought from Gibco, USA; 100% glycerinum was purchased from Yunjia Huangpu Pharmaceutical Product Limited Company, PRC; glutaraldehyde was bought from E.Merk, Germany; Alcohol, chlorhydric acid, acetone and methyl aldehyde were purchased from Beijing Chemical Agent Company, PRC; 0.25% parenzyme was bought from Shanghai Xinhua Pharmaceutical Factory, PRC.Above-mentioned reagents were analytical pure grade.METHODS: After digestion, human limbal tissues in limbal basilar part with an abundant pigment were cultured in the culture flask containing RPMI-1640 and 200 g/L FCS and in culture dish containing amniotic extracellular matrix (AECM) as the cultural supporter. Primary and passage cells were observed under light microscope and scanning electron microscope (SEM). The revival ratio of stem cell refrigeration of every generation was calculated by the trypanblau exclusion experiment.MAIN OUTCOME MEASURES: ① Observational results of limbal stem cells during the primary culture and serial subcultivation in vitro, and ② revival ratio of stem cell refrigeration.RESULTS: ①Findings of primary culture: Most limbal stem cells in the culture flask had the adherence and were arrayed uniformly sparsely to form monolayer and adhered to the bottom of culture flask under the inverted phase contrast microscope after 1-day culture. ② Findings of serial subcultivation: After human epidermal growth factor (hEGF) was added into the second passage, cells were scattered into the monolayer and adhered to grow quickly.Morphological variability of all the cells increased obviously when passage the 30th generation. The cellular volume was obviously increasing, and the round or irregular round cells gathered together. The 33rd generation human limbal stem cells still could vigorously differentiate, proliferate and grow in ACEM. ③ The revival ratio of stem cell refrigeration was 82.2%.CONCLUSION: The human limbal stem cell lines were preliminarily established by culturing and freezing the cells of 33 generations in vitro. The human limbal stem cell lines preferred to grow in the culture dish containing AECM as the cultural supporter.