Corneal infection is the leading cause of corneal blindness in China.Timely diagnosis and reasonable treatment of infections in the cornea are based on accurate identification of corneal pathogens.With improved realization and technical development,pathogenic diagnostic techniques for infectious corneal disease have improved.However,many scientific issues remain to be challenging.In this article,the scientific issues and constructive strategies are presented for pathogenic diagnosis of corneal infection in China.

Corneal transplantation has been an effective and sometimes the only one of effective method to treat some cornea diseases.It is crucial whether or not a doctor is able to choose the right timing and method of surgery.Because surgical techniques have been improved,the outcome of lamellar keratoplasty (LKP) for infective corneal diseases affirmed,chronic corneal allograft dysfunction after penetrating keratoplasty has been recognized and studied,and acute immunologic rejection is still regarded as the main reason for early graft failure,the conventional indications of penetrating keratoplasty (PKP) and LKP have been challenged and changed a lot.

Herpes simplex keratitis models were created with healthy New Zealand rabbits. During the quiescent period, one group of the rabbits were performed autograft penetrating keratoplasty and another group cross penetrating keratoplasty with noninfeeted rabbits. After removal of the sutures, epinephrine iontophoresis was done for reactivation of the virus, and all the corneal buttons were stained positive of HSV-1 antigens. Transmission electron microscopy revealed signs of viral infection and culture of corneal graft keratoeytes also demonstrated HSV-1 infection, suggesting that the cornea was a site of HSV-1 latency and source of recurrence.

With the clinical application of new technology and immunosuppressive drugs,the early acute graft rejection have been significantly decreased.However,chronic graft failure in long-term transplantation has become one of the most important reasons. As the same as body solid organ transplantation,chronic corneal allograft dysfunction is present after penetrating keratoplasty and has been one of the main reasons of causing repeat keratoplasty.Therefore,studying the mechanism of chronic allograft dysfunction will be of the most important significance in clinical prevention and treatment for chronic graft corneal transplant failure,especially in prolongation of corneal grafts survival rate.

OBJECTIVE:To investigate the reform mode of experiment teaching in pharmaceutical analysis in the new situation of vocational education and provide reference for improving the teaching quality of secondary vocational education. METHODS:The present situation of experiment teaching in pharmaceutical analysis was assessed deeply and in detail,and the problems exist-ing in teaching were analyzed;the reform plan and measures according to the disadvantages of the current teaching were raised. RE-SULTS:The experiment teaching in pharmaceutical analysis existed some problems,involving lagging textbook compilation,single teaching mode,“heavy theory,light practice”for time arrangement,obsolete laboratory apparatus and lack of advanced equipments. So a series of measures were adopted,including writing supplementary teaching materials and experimental guidance;reforming the contents of the experiment teaching;reforming the model of teaching and improving the students’participation;reforming the time arrangements;increasing the investment in laboratory equipment and attaching great importance to extramural cooperation;estab-lishing the virtual laboratory;and establishing a flexible,comprehensive and effective experimental evaluation mechanism.CON-CLUSIONS:Reform experimental teaching mode has fully mobilized the enthusiasm and initiative of students and improved the abil-ity of operating skills,and cultivated the strict scientific research style of students. The reform mode of experimental teaching in pharmaceutical analysis is in accordance with the students’learning needs of pharmaceutical majors,and lay a good foundation for the students better and faster adaption to the job.

TNF-related apoptosis-inducing ligand(TRAIL) is a type II transmembrane protein in TNF family. TRAIL influences a variety of immunological functions including cellular activation, proliferation and death, upon interation with a corresponding super family of receptors. This article is about the new views on the biological functions of TRAIL.

Femtosecond laser has been widely used in ophthalmology for its high precision, safety and minimal damage to tissues, and now its application in the corneal refractive surgery, corneal stromal ring implantation and cataract surgery has been more mature.In recent years, it has been actively developed and applied in penetrating keratoplasty, anterior lamellar keratoplasty and corneal endothelial transplantation, and some achievements have been obtained in experimental research and clinical application.While femtosecond laser promotes the development of corneal transplantation surgery, there are still some problems such as limited indications, uncertain efficacy, expensive equipment, lack of big data support and intelligence in personalized design.Continuous optimization and improvement are still needed to ensure postoperative vision, reduce postoperative complications, simplify parameter design and reduce consumption costs.In this paper, the indications, parameter design, clinical effect and limitations of femtosecond laser in keratoplasty were reviewed.

ObjectiveTo compare the levels and locations of metalloprotionase-2（MMP-2），collagen types Ⅰ and Ⅵ in keratoconus and normal human corneas．MethodsAn immunoperoxidase and indirect immunofluorescent technique were used to visualize the presence of collagen types Ⅰ， Ⅵ and MMP-2．The immunohistochemical staining was further analyzed and the intensity of reaction products was measured with an Image-processing system．ResultsCollagen type Ⅰ was demonstrated immunohistochemicall and indirect immunofluorescent technique in the bowman and stroma layers；collagen type Ⅵ was in epithelium basement，bowman，stroma and descement layers；MMP-2 was in epithelium，stroma and endothelium of all corneal sections．Compared with normal control specimens，the staining intensity of collagen types Ⅰ and Ⅵ was similar，while MMP-2 was markly increased．ConclusionsKeratoconus contained an increased level of MMP-2 and similar of collagen levels．These results lead further support to the hypothesis that degradation processes may be aberrant in keratoconus．

Objectives To conduct nutritional risk assessment analysis of hand-foot-mouth disease in children and to explore rational and feasible nutritional intervention. Methods The information of children with hand-foot-mouth disease in three hospitals in Guilin area was collected by ifxed-spot continuous sampling. Inquiry investigations, physical mea-surements combined with clinical diagnosis were undertaken, and nutritional risk assessment and management were con-ducted by the malnutrition screening tool of children (STAMP scoring). Those with STAMP scores ≥4 were considered at high nutritional risk. Nutritional risk reassessment was conducted on children with high nutritional risk after nutritional intervention and management. Results A total of 192 children with hand-foot-mouth disease were selected. The occur-rence rate of high nutritional risk was 68.75%(132/192). The hospitalization time of patients with high nutritional risk was prolonged and the hospitalization expense was increased apparently. The nutritional support treatment and nutritional edu-cation were undertaken on the children with high nutritional risk. The incidence of high nutritional risk from admission to discharge decreased from 68.75%to 36.98%(P<0.05). The clinical outcomes of those children accepting nutritional inter-vention were signiifcantly improved (P<0.05). Conclusions The occurrence and prognosis of hand-foot-mouth disease is closely related to the nutritional status of children, so nutritional risk assessment, nutritional intervention and management should be performed as early as possible.

Objective To investigate the utility of plasma D-dimer and fibrinogen (FIB) for the severity assessments and predicting the prognosis of patients with community-acquired pneumonia (CAP).Methods The clinical data of patients with CAP admitted to First Affiliated Hospital of Fujian Medical University were retrospectively analyzed.The patients were divided into Ⅰ-Ⅴ level groups according to pneumonia severity index (PSI),and they were divided into non-survivors and survivors according to 30-day prognosis.The data including gender,age,PSI score,platelets count (PLT),white blood cell count (WBC),D-dimer,FIB,and C-reactive protein (CRP) were compared among groups.The correlations between PSI score and D-dimer,CRP as well as FIB were analyzed by Spearman or Pearson correlation analysis.Receiver operating characteristic curve (ROC) was used to assess the prognostic value of these indicators.Results A total of 499 patients with CAP were enrolled with 298 male and 201 female,the average age was (63.4 ± 17.8) years old,and the 30-day mortality was 6.4％ (32/499).There were 77,80,104,162 and 76 patients in PSI Ⅰ-Ⅴ level groups,and there were more male patients in PSI Ⅵ and Ⅴ level groups.There were no significant differences in PLT and FIB among the groups of different PSI levels,but the levels of WBC,D-dimer and CRP were significantly increased as PSI level increased from Ⅰ to Ⅴ (F1 =3.810,x 22 =102.361,F3 =7.070,all P ＜ 0.01).Compared with survivors,the non-survivors were elder (t =-4.773,P ＜ 0.001) with lower PLT (t =3.026,P =0.003)and higher WBC,PSI score,D-dimer and CRP levels (t1 =-2.545,t2 =-8.421,Z3 =-6.947,t4 =-3.770,all P ＜ 0.05).Plasma D-dimer levels in elderly patients (≥ 65 years old) were statistically higher than those in younger patients (＜ 65 years old;Z =-5.338,P ＜ 0.01).It was shown by correlation analysis that PSI score was positively correlated with D-dimer and CRP (r values were 0.475 and 0.260,both P ＜ 0.001),and no correlation was found between PSI score and FIB (r =-0.062,P =0.170).The area under the ROC curve (AUC) for predicting 30-day death of PSI score,D-dimer and CRP was 0.858 [95％ confidence interval (95％CI) =0.802-0.914],0.867 (95％CI =0.812-0.922) and 0.732 (95％CI =0.641-0.823).The combination of D-dimer and PSI score was better than any single indicator for predicting the prognosis with higher AUC up to 0.905 (95％CI =0.867-0.944),all P ＜ 0.001.The sensitivity and specificity for PSI in predicting 30-day death respectively were 78.1％ and 82.4％ with the cut-off of greater than 122,and those for D-dimer were 75.0％ and 82.9％ with the cut-off of greater than 2.10 mg/L,50.0％ and 84.4％ for CRP with the cut-off of greater than 100.50 mg/L.Conclusions D-dimer could well reflect the severity of CAP and be a good indicator for predicting the prognosis.The combination of D-dimer and PSI might improve the accuracy in predicting prognosis.