Diabetic retinopathy (DR) is one of the most significant microvascular complications of diabetes,and its incidence increases with the prolongation of DM;meanwhile,it can lead to severe vision loss.Recently,the pathogenesis of DR has been one of the focuses both at home and abroad,but the basic mechanisms are not fully elucidated.More and more scholars believe that DR may be a chronic and low degree of inflammatory response.Moreover,it is well established that microglia is a monocyte-macrophage,with antigen-presenting function.Especially in the retina,as microglia is activated,followed by the release of a large number of inflammatory factors,microglia involves in DR inflammatory response.Understanding the activation mechanism of microglia can provide a new perspective for the prevention and treatment of DR.Therefore,recent advances in activation of microglia in diabetic retinopathy and its intervention mechanism will be reviewed in the article.

OBJECTIVE:To provide suggestions for the development of training mode for pharmaceutical monitoring personnel in China.METHODS:The training mode of Office of Regulatory Affair University(ORA U) was introduced to analyze the difference of training mode for pharmaceutical monitoring personnel between China and America.RESULTS & CONCLUSIONS:America has established a systematic,continuous and uniform pharmaceutical monitoring personnel training system,which is more flexible and advanced than that in China.Our country could draw experiences from the training mode of FDA personnel to develop uniform and diversified training system with suitable budget mechanism.

Objective Medical statistics is an important tool in scientific research and practice.The article was to evaluate the current knowledge, learning needs and related influencing factors of medical statistics among medical doctoral students to provide references for the optimization in the teaching mode of medical statistics. Methods A questionnaire was used to investigate Grade 2014 doctoral students who took medical statistics course before and after the teaching in a medical university. Results The knowl-edge of doctoral students were at different levels and they had different learning requirements.More than 81.4% of the respondents have difficulty in the choice of scientific and reasonable design and the scientific design.Over 50%students had insufficient knowledge of advanced statistics and poor software application ability.They had the demands for more practical cases explanation in theory course, more software teaching hours and some short term specialized courses. Conclusion The university and teachers should carry out teaching reform according to the particularity of doctoral students and teach in small sections according to their knowledge levels of sta-tistics and learning requirements.It is suggested that the teaching should be combined with the students'own research projects in order to improve the teaching effect and improve the students'ability in sta-tistical design and solving the practical problem in scientific research statistics.

Objective To study the interactive debridement methods in treatment and nursing of the wound in patients with abdominal surgical incision infection.Methods In May 2010 to December 2013 in West China hospital of Sichuan University,54 patients with postoperative incision infection accompanied with tissue necrosis after gastrointestinal surgery were divided into two groups,23 cases who accepted interactive debridement treatment were set as the observation group,31 cases with traditional dressing hypertonic saline gauze debridement were named as the control group.The wound debridement completion time,wound healing velocity,wound healing time,dressing change frequency and cost were compared between two groups of patients.Results Compared with those of the control group,in the observation group,the wound debridement completion time was shorter,wound healing velocity was faster,dressing change frequency was longer.Although single dressing change cost was higher in the observation group,but the total dressing change cost was lower compared with the control group.Conclusions The interactive debridement methods used in treatment and nursing of patients with abdominal surgical incision infection showed good effect and safety,which is worthy of wide clinical application.

Arthralgia ; diagnosis ; etiology ; therapy ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Tendon Injuries ; diagnosis ; therapy

Objective To investigate the effects of Cilazapril and Valsartan on atrial structural and functional remodeling and its mechanism in atrial fibrillation(AF)dogs induced by chronic rapid atrial pacing.Methods Twenty-seven AF dog models were built by the First Affiliated Hospital of Harbin Medical University from Mar.2006 to Oct.2006.The experimental dogs were randomly divided into sham-operated group(n=6),control group(n=7),Cilazapril group(n=7)and Valsartan group(n=7).The dogs in control group,Cilazapril group and Valsartan group were paced at 400 bpm for 6 weeks.The dogs in Cilazapril and Valsartan group received Cilazapril(1 mg?kg-1?d-1)and Valsartan(30 mg?kg-1?d-1)1 week before rapid atrial pacing until pacing stop respectively.Transthoracic and transoesophageal echocardiographic examinations were performed to detect changes in structure and function of left atrium and left atrial appendage,before and after 6-week rapid atrial pacing.Atrial collagen volume fraction(CVF)was analyzed by Masson staining.The expression of ERK1 and ERK2 in the atrial tissue were tested by immunohistochemistry.TUNEL technique was used to detect the atrial cell apoptosis.Results (1)Compared with the control group,the LA and LAA volumes were significantly smaller,LAEF,LAAEF,V-LAA+ and V-LAA-were dramaticaly higher in the Cilazapril group and the Valsartan group after 6-week rapid atrial pacing.(2)Compared with the control group,the incidence of apoptosis,CVF and the expression of atrial ERK1 and ERK2 decreased dramatically in the Cilazapril group and the Valsartan group.Conclusion Cilazapril and Valsartan could prevent atrial fibrosis and cell apoptosis in the atrial fibrillation dogs induced by chronic rapid atrial pacing.

Study of the strategic objectives chosen by hospitals from the perspective of stakeholders is now under the spotlight of researchers at large. To identify whether there exist differences in strategic objectives among various groups in the hospital and probe into the causes, the author called into play the competing values framework as the analysis tool. An evidenced-based study on public hospitals in Hangzhou identified marked differences on choices of strategic objectives among various internal stakeholders in the hospital For example, hospital administrators tend to focus on internal control, while medical doctors tend to focus on interactions between the hospital and the external environment. On this basis, further studies are proposed.

Objective: To investigate factors related to alexithymia of patients with essential hypertension or type 2 diabetes mellitus. Method: 42 patients wi th essential hypertension, 40 with diabetes mellitus and 45 healthy control were assessed by TAS (Toronto Alexithymia Scale), SCL-90 and EPQ (Eysenck Personalit y Questionnaire). Multiple correlation analysis and multiple stepwise regressio n were used in data analysis. Result: Compared with normal contr ol, patients with hypertension or diabetes showed alexithymia. They were deficient in the abilit y of describing emotion, recognizing and distinguishing between emotion and body feeling, and used to extroversion thought. Besides these, patients with diabete s showed fancy-lacking either. There was close relation between personality and a lexithymia. The more introversive of the hypertensives, the more deficient they were in describing emotion. The more introversive of the diabetics, the more de f icient they were in recognizing and making distinguish between emotion and body feeling. Hostility ideation and neuroticism of hypertension patients were major factors related to alexithymia. Paranoid ideation and psychoticism had similar e ffects in diabetics. Conclusion: Patients with essential hypert ension or diabete s have alexithymia relating to their personality traits and psychological state .

Donation of relique is important to not only medicine development,but the social civilization also.But the development of it is late and laggard in China.According to investigation and analysis in some regions,we find several factors restricting the donation of relique such as the obstacle of morals,the lag of legislation,lack of the humanistic care.These are the keys for us to change the behindhand situation of relique donation in China.

Relations between doctors and patients are the most basic and important human relations in medical practice.Some reports indicate that non-technical medical factors result in most cases of physician-patient conflicts.In this paper we analyzed non-technical medical factors from the fields of society,ethics and mentality,and concluded main reasons for physician-patient conflicts are the lack of "being discreet when alone",the absence of "patients-oriented service concept",the ignorance of responsibility of "life-saving",and the missing of humanity care.