Objective To analyze the prevalence and epidemiological characteristics of chronic diseases in Liaoning Province. Methods 16 370 residents from 3 cities and 3 counties in Liaoning province were se1ected by multistage cluster sampling.A household survey with questionnaire was carried out.Chronic diseases were self-reported. Results The total prevalence rate of chronic diseases was 34.48%,and it was higher in the urban(41.85%) than that in the rural(28.65%),higher in women(39.45%)than in men(29.38%).The prevalence rate significantly increased with rising of age above 25 years old.The first five of the most prevalent chronic diseases were those of circulation system(13.18%),movement system(7.84%),digestion system(3.92%),endocrine system(2.19%) and respiration system(2.15%),and they occupied 84.87% of all the cases. Conclusion Cardiovascular diseases,hypertension and cerebrovascular diseases were the first three kinds of the most prevalent chronic diseases,and they would be the main diseases need to control and prevent.Meanwhile chronic gastritis,peptic ulcer and intervertebral disk diseases in the young people should be also concerned

BACKGROUND:There are two types of epithelial stem cells in the ocular surface tissue:corneal epithelial stem cells and conjunctival epithelial stem cells. The corneal epithelial stem cells play an important role in renewal of corneal epithelial cells and maintenance of corneal transparency.
OBJECTIVE:To study the location of corneal epithelial stem cells using laser in vivo confocal microscopy and immunofluorescent staining.
METHODS:Patients with unilateral limbal stem celldeficiency who went to Henan Eye Institute from September 2009 to September 2012 were enrol ed in this study. Bilateral eyes were scanned by laser in vivo confocal microscopy, and the healthy eye was imaged as a control. The central cornea and limbus were scanned and images were recorded for statistical analysis. The eye bal s were obtained from Henan Eye Bank, China. Central cornea and limbus were dissected and embedded in the OCT compound for frozen section and the proper thickness of the section was 5-7μm. Immunofluorescent staining was used to detect the expression of p63, ABCG2, K3 and Connexin 43 in the epithelial layers of central cornea and limbus.
RESULTS AND CONCLUSION:Twenty-four patients diagnosed with unilateral limbal stem celldeficiency were recruited. Under confocal microscopy, in the affected eyes, the typical morphology of conjunctival epithelial cells and goblet cells was detected instead of corneal epithelial cells;in the limbus, a great amount of fiber scarring tissue was detected instead of Vogt palisade, rete pegs and pigment cells. Immunofluorescent staining showed the expression of p63, ABCG2 was mainly in the basal layer of limbal epithelium, especial y in the outer and middle parts, but the expression of p63 and ABCG2 was not detected in the epithelial celllayers of central cornea. K3 and Connexin43 were not expressed in suprabasal layers of limbal epithelium, but in central cornea, they were expressed highly in the whole epithelial celllayers. Laser in vivo confocal microscopy and immunofluorescent staining showed the corneal epithelial stem cells were located in the basal layer of outer and middle limbal epithelium, mainly in Vogt palisade and rete pegs.

Objective To compare eradication rates,safety and compliance of minocycline quadruple and tailored therapies in patients retreated for Helicobacter pylori (H.pylori) infection.Methods Between January 2014 and June 2014,135 patients with dyspepsia (18-70 years) and H.pylori infection after at least one previous eradication treatment at a tertiary hospital were randomly assigned to a 10-day treatment with minocycline quadruple therapy versus tailored triple regimen of PPI,amoxicillin and a third antibiotic.In the group of tailored therapy,medications were adjusted based on clarithromycin sensitivity and cytochrome P450 isoenzyme 2C19 genotype.Eradication status was assessed 4-12 weeks after treatment.Results Although H.pylori eradication rates were higher in the minocycline therapy group than that in the tailored therapy group in intention-to-treat [84.1％ (95％ CI 75.0％-93.2％) vs 75.8％ (95％ CI 65.1％-86.5％),P =0.245] and per-protocol [88.3％ (95％ CI 80.3％-96.3％) vs 79.7％ (95％CI 69.7％-89.7％),P =0.197] analyses,the differences between the two groups were not statistically significant.The incidence of adverse effects and compliance between the two groups were also comparable.Conclusions The tailored therapy in this study had a poor eradication efficacy in the retreated patients with H.pylori infection.Minocycline quadruple therapy achieved a relatively satisfactory eradication efficacy and may be an alternative choice for the retreatment of H.pylori infection.Clinical trial registration Chinese Clinical Trial Registry,ChiCTR-TRC-13003975.

Objective:To explore the relationship between Tongren analysis EV 71 intestinal virus genotyping and humoral immune function ,for further clinical understanding of enterovirus EV 71 provide references.Methods:February to August 2014 Tongren to our hospital for treatment of intestinal virus EV 71 HFMD infected children ,according to the genetic type of virus infection is mainly divided into three groups ,namely group A,there were A type of intestinal virus EV 71 infection,20 patients;group B,there were B-type intestinal virus EV71 infection,20 patients;group C,there were C-type intestinal virus EV71 infection,20 cases of children.Three groups of patients by detecting immunoglobulin levels and TNF-ɑ, IL-6 and IL-10 levels, and to compare different genotypes affect intestinal virus EV71 HFMD children humoral immune function.Results:After testing,A group of patients with TNF-ɑ,IL-6 and IL-10 levels were (285.60 ±30.50) pg/L,(60.50 ±5.60) pg/L,(25.50 ±4.50) pg/L,than those in group B,high levels of three indicators of group C patients ,a significant difference ( P<0.05 ) ,group C patients with TNF-ɑ,IL-6 and IL-10 levels in three groups of patients than B high level indicators ,with a significant difference ( P<0.05 );tested three groups of patients with IgA ,IgG level pairwise comparisons showed that there were significant differences (P<0.05),the highest a group of patients with IgA,IgG level,group C, followed by the lowest level of group B patients;levels of the three groups of patients with IgM pairwise no significant difference ( P>0.05 ) .Conclusion:Different genotypes of enterovirus EV 71 can cause serious foot and mouth disease ,and could significantly improve the level of serum immunoglobulin levels of inflammatory cytokines ,but the intensity of different genotypes of different pathogenic ,there are some differences ,but the specific mechanisms need to be further explored.

Objective To investigate the significantly elevated incidence of hepatitis C and mortality of cirrhosis and hepatocellular carcinoma (HCC) in Jianping county, and to explore the epidemiological features. Methods The data from database of death registry and infectious disease surveillance in Jianping county, Liaoning Province were analyzed. The distributions of incidence of hepatitis B and hepatitis C, mortality of cirrhosis and HCC in 23 villages and towns were investigated.Spearman's correlation was used to explore the correlations between hepatitis, cirrhosis and HCC.Results The standardized mortality of HCC in males and females in Jianping county were 77. 6/10~5and 22. 0/10~5, respectively, which were 2. 0 and 1. 7 times, respectively of the average levels of Liaoning rural areas. The incidence of hepatitis C was 58. 0/10~5 , which was 9. 5 times of the averagelevel of Liaoning Province. There were positive correlations between incidence of hepatitis C and mortality of cirrhosis (r=0. 495, P = 0. 008), and mortality of cirrhosis and HCC (r=0. 646, P<0.01). Conclusions The incidence of hepatitis C and mortality of cirrhosis and HCC in Jianping county are significantly higher than the average levels of Liaoning Province. Further investigations of the suspected causes are needed.

To analyze the mutations of F12 genein one pedigree with congenital factor FXII (FXII) deficiency , and investigatethe molecular mechanisms of FXII deficiency . Methods Activated partial thromboplastin time(APTT),Prothrombin time(PT), FXII activity(FXII:C), FXII antigen(FXII:Ag) and other coagulant parameters were tested in the proband and his family members .5'and 3'UTR,all exons and their exon-intron boundaries of F12 gene were analyzed by direct sequencing .The detected mutations were confirmed by reverse sequencing .100 healthy persons were as normal controls .Results The proband showed a markedly prolonged APTT (106.4s), the FXII:C and FXII:Ag were 2.0% and 1.0%, respectively .Hissecond daughter and granddaughter had slightly prolonged APTT , and other family members are normal.The FXII:C and FXII:Ag of family members were also decreased ( his son, 23.0% and 21. 0%;his elder daughter , 23.0%and 23.0%;his second daughter ,24.0%and 23.0%;hisgranddaughter , 23.0%and 23.0%).The phenotype of all members is consistent with cross -reactive material negative . Nucleotide sequencing analysis showed that the proband had missense mutations in the F 12 gene, including one homozygous mutationc.1556T >G ( p.Leu519Arg) and a commonly reported single nucleotide polymorphism site within the promoter region of the F 12 gene (46T/T) .Sequencing results from the proband 'children demonstrate them as carriers of a heterozygous missense mutation .The proband 's wife is normal and with 46C/C in the promoter region .Conclusion The c.1556T>G in exon 13 is a novel mutation .This mutation affects FXIIcatalytic function , associated with a reduced level of FXII .

Objective To investigate the effects of necrostatin-1 (Nec-1) on the liver of rats with trauma induced hemorrhagic shock.Methods Trauma induced hemorrhagic shock model was produced by adopting the left femur,tibia fracture and soft tissue injury,bleeding and reperfusion in male Sprague-Dawley (SD) rats.A total of 22 rats were divided into model group and Nec-1 group with 11 rats in each group by randomized digital number method and the 72-hour mortality was observed.In addition,72 rats were randomly divided into sham group,model group,Nec-1 group with 24 rats in each group.Rats in sham group were only received anesthesia,separating and ligating blood vessels,without trauma induced hemorrhagic and reperfusion,and the rats in Nec-1 group were received 1 mg/kg Nec-1 through femoral vein 5 minutes before reperfusion,while the rats in model group were received the same amount of solvent.The serum and liver tissues of each group were collected at 2,4,8 hours after reperfusion.Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected by automatic biochemistry analyzer.The pathology changes in liver were observed by hematoxylin-eosin (HE) staining.The mRNA expressions of tumor necrosis factor-oα (TNF-α) and interleukin-1β (IL-1β) in the liver were detcrmined by reverse transcription-polymerase chain reaction (RT-PCR).The protein expressions of receptor interaction of protease 1/3 (RIP1/RIP3) were also assessed by Western Blot analysis.Results Compared with model group,Nec-1 significantly reduced the 72-hour mortality [18.18％ (2/11) vs.63.64％ (7/11),P=0.040].Two hours after trauma induced hemorrhagic shock and reperfusion,the expressions of ALT and AST in model group were significantly increased compared with those in sham group [ALT (U/L):110.21 ±22.32 vs.80.98 ± 19.94,AST (U/L):364.29 ±64.83 vs.279.76 ±70.64,both P＜0.05],and reached the peak at 8 hours [ALT (U/L):387.41 ± 47.11 vs.82.76 ± 22.44,AST (U/L):973.35 ± 77.51 vs.261.49 ±52.03,both P＜0.01].Levels of serum ALT and AST in Nec-1 group were significantly decreased compared with model group [ALT (U/L) 4 hours:144.64± 33.79 vs.213.96± 36.21,8 hours:159.48 ± 43.57 vs.387.41 ± 47.11; AST (U/L) 4 hours:398.78 ± 59.48 vs.630.61 ± 59.93,8 hours:427.38 ± 80.75 vs.973.35 ± 77.51,all P＜0.01].Under light microscopy,it was noted that the hepatic sinus expansion,liver cells degeneration,necrosis,as well as infiltration of abundant inflammatory cells were observed.But the pathology changes in hepatic tissues were significantly mitigated in Nec-1 group.Along with the time extension,the mRNA expressions of TNF-α and IL-1β and the protein expressions of RIP1 and RIP3 were markedly up-regulated.Compared with model group,difference in the mRNA expressions of TNF-α and IL-1β in hepatic tissues in Nec-1 group were statistically significant,and the most obvious difference was at 8 hours [TNF-α mRNA:1.457 ± 0.081 vs.2.317 ± 0.062,IL-1β mRNA:0.690 ± 0.087 vs.1.812 ± 0.112,both P＜0.01].But there was no statistically significant difference in RIP1 and RIP3 between Nec-1 group and model group [RIP1 protein 8 hours:0.561 ± 0.033 vs.0.587 ± 0.036,RIP3 protein 8 hours:0.976 ± 0.040 vs.1.044 ± 0.115,both P＞0.05].Conclusion Nec-1 may be remarkable protect effect on the liver of rats with trauma induced hemorrhage shock and reperfusion,and the intrinsic mechanisms need further investigation.

Background Local medical treatment of refractory immunologic keratitis is unsuccessful,and systemic steroids and immunosuppressive agents could cause severe side-effects.Tacrolimus is a potent immunosuppressive drug,it has been proved that topical application of tacrolimus could reduce immunologic inflammation.The safety and efficacy of 0.05％ tacrolimus eye drops for refractory immunologic keratitis has not been described.Objective This study was to evaluate efficacy and safety of 0.05％ tacrolimus eye drops for refractory ulcerative keratitis.Methods A retrospective study was performed.Twenty-one eyes of 17 patients with refractory immunologic keratitis,which had uncontrolled inflammation despite initially treatment including topical steroids and 1％ cyclosporine A,were enrolled,including 11 males and 6 females,with the mean ages of 52 years.Infectious ulcer was excluded by laboratory tests.No systemic disease was found in 11 patients,and Wegener's granulomatosis,rheumatoid arthritis and ulcerative colitis were seen in 1 patient,4 patients and 1 patient respectively before presentation and they were all in remission under conventional systemic therapy.Four patients got binocularly involved and thirteen patients were monocularly involved.Of the 21 eyes,2 eyes with ulcer were ≥ 3 quarters of the limbus,and 19 eyes with ulcer were ≤ 2 quarters.All patients were treated with 0.05％ tacrolimus eyedrops after discontinuing cyclosporine A.The dosage was adjusted according to the severity of inflammation and was gradually tapered when improvement occurred.The corneal lesions were examined under the slit lamp microscope and Heidelberg HRT3 Rostock Cornea Module regularly,and inflammatory cell infiltrations were analyzed with Cell Count(R) software (Heidelberg Engineering GmbH).The safety variables were monitored regularly,including adverse response of eye,tacrolimus blood concentrations measured by chemiluminescent microparticle immunoassay (CMIA) and laboratory examinations of blood routine,blood glucose level,liver and kidney function.Results The patients were treated and followed-up for a mean duration of 18.1 months (range,8-24 months).Corneal ulcer area was obviously reduced 1 month after treatment in 19 eyes,and 2 eyes of 2 cases received anterior lamellar keratoplasty due to progressive corneal destruction despite of tacrolimus therapy.Corneal ulcer was cured 3 months after treatment,and stromal edema and infiltration disappeared 6 months after treatment under the slit lamp microscope.The inflammatory cell densities at lesion zone were (958±329),(858±339),(459±261),(192±124),(98±52),(44±24) and (3±2)/mm2 before treatment and 1 week,1 month as well as 3,6,12,24 months following treatment,respectively,showing a gradually decline as time lapse (F =125.439,P =0.000),and the inflammatory cells were significantly decreased in 1,3,6,12 and 24 months following the administration of 0.05％ tacrolimus eye drops in comparison with that before treatment (all at P =0.000).The therapy duration was 12 months in 9 eyes and 24 months in 12 eyes.Transient irritation sensation occurred in 4 eyes during the treating period.Blood concentrations of tacrolimus were below 1.0 ng/ml in all of the patients.No abnormality was found in laboratory tests.Conclusions The use of 0.05％ tacrolimus eye drops is a safe and effective approach to refractory immunologic keratitis.

Background Xenotransplantation is arousing more attention of researchers because of the lack of corneal donors.Biological corneal scaffolds constructed by porcine corneal acellular stroma appears to have an acceptable biocompatibility.However,its clinical effects and the histomorphological features in the corneal tissue of receipts' are still unclear.Objective This study was to evaluate the viability of bioengineered corneas as a new material of human lamellar keratoplasty and observe the in viva biological features after human keratoplasty under the laser confocal microscope.Methods A prospective serial cases observational study was carried out.Fifteen eyes of 15 patients with infectious keratitis were enrolled in Henan Eye Hospital from February to August 2014 under the approval of Ethic Committee of Henan Eye Hospital and informed consent of each patient, including 4 eyes of fungal keratitis,1 eye of bacterial keratitis, 9 eyes of mixed infectious keratitis and 1 eye of leucoma.Corneal lamellar transplantation was performed on the eyes with the bioengineered corneas as grafts and the follow-up time was one year.The survival of grafts was assessed and scored, and the indices including corneal transparency,neovascularization, graft lysis or inflammatory recurrence and visual acuity (logMAR) were evaluated.The morphology and density of corneal epithelial cells and endothelial cells, corneal stroma and subepithelial neural fibers were examined by laser confocal microscope 3,6,9 and 12 months after surgery.Results Postoperative inflammatory response was seen 3 days and disappeared 7 days after surgery.The grafts were clear 1 month after surgery, and no corneal dissolution was found during the follow-up duration.Glaucoma occurred in 1 eye at 6 months and graft rejection occurred in another eye 12 months after surgery.The logMAR, corneal transparency scores and corneal neovascularization scores improved after surgery in comparison with before surgery,with a significant difference among various time points (x2 =92.63,59.37,10.50 ,all at P＜0.05).Complete epithelization of grafts was seen.Compared with the contralateral eyes,the morphology of epithelial cells was similar and endothelial cells were enlarged in the operated eyes.In addition,no stromal cell structure was seen in the corneal stroma in the operative eyes.Subepithelial nerve fibers appeared in 8 eyes at 6 months, but the fiber density was lower in the operated eyes than that in the contralateral eyes.Significant difference was found in epithelial cell density among different time points (F=1.48, P =0.22).The endothelial cell densities were (2 542 ± 119), (1 895 ± 129), (1 869 ± 135), (1 854 ± 101) and (1 844 ± 103)/mm2 before surgery and 3, 6, 9 and 12 months after surgery, showing significant differences between preoperation and postoperative time points (all at P＜0.05).The subepithelial nerve fibers densities were (1.26± 0.13),(3.62±0.81) and (5.98±0.44) mm/mm2 at 6,9 and 12 months after surgery,with significant differences between adjacent two time points (t'=-8.16 ,-7.24;both at P=0.00).Conclusions Bioengineered corneal grafts survive well in human eye after lamellar transplantation,which can reconstruct ocular surface and improve the visual acuity.Biological cornea can replace human corneal materials.

Background Fungal keratitis has poor prognosis and high blinding rate,so it is vital to identify the risk factors that affect the treating outcome and prognosis of fungal keratitis.Objective This study was to evaluate the clinical outcome of fungal keratitis and identify the affecting factors.Methods This was a series cases-observational study.A total of 267 eyes of 267 patients with fungal keratitis were included in Henan Eye Institute during January 2013 to January 2014.Eye examinations were performed including slit-lamp microscope examination,corneal smears,confocal microscopy,fungal culture and identification.Combined anti-fungal drugs were topically used in all eyes for the initial treatment then the treating regimen were selected based on the susceptibility testing.corneal lesion resection combined with conjunctival flap transplantation,lamellar corneal transplantation or penetrating corneal transplantation was performed respectively on the patients with poor curative effect after drug treatment.The clinical prognosis of the patients was graded and the affecting factors for clinical outcome were evaluated.This study protocol complied with Helsinki Declaration and was approved by Ethic Committee of Henan Eye Hospital.Written informed consent was obtained from patients or guardians.Results One hundred and eighty-five eyes were cured by anti-fungal eye drops with the effective rate of 69.29％,and the inflammation was controlled in 60 eyes who received combination procedure of anti-fungal drugs with different surgeries,while 22 eyes lost visual function because of refractory glaucoma and final evisceration.The total clinical effective rate was 91.76％.Aspergillus and Fusarium spp.appeared to be the most common pathogenic fungi by drug sensitivity test.The keratitis caused by Aspergillus had lowest cure rate among different fungi (x2 =11.350,P =0.002) and the most poor clinical prognosis (H=31.285,P =0.013).The medication curative rate was 71.8％ in the patients with positive culture outcome,which was higher than 62.5％ in the patients with negative culture outcome (x2=8.75,P＜0.01).A significant difference was found in the medication curative rate and prognosis between the patients with ≥ 2 kinds of sensitive anti-fungal drugs and the patients with ＜2 kinds of sensitive anti-fungal drugs (77.5％ versus 52.3％,x2 =9.63,P＜0.01;H=24.281,P =0.021).Size of infiltration area,with or without hypopyon,number of sensitive drugs,and pathogenic fungi were significantly correlated with clinical outcome (all at P ＜ 0.05).Conclusions In vitro susceptibility testing can guide clinical drug treatment of fungal keratitis.Infiltration area ＞ 16 mm2,hypopyon ＞2 mm,resistance to those drugs in vitro and infection of Fusarium.spp or Aspergillus.spp are predictors of a poor outcome.