ObjectiveTo investigate the methods of reducing eye injury in phacoemulsification．MethodsPhacoemulsification with intraocular lens（IOL）implantation was performed on 98 cases（98 eyes）of cataract using a new type of phaco tip（MicroTip）with high vaccum and low energy．All the nuclei was harder than Grade Ⅳ．Postoperative visual acuity and eye injury were observed，including corneal edema，anterior chamber in flammation，intraocular pressure，IOL position and retinal condition．ResultsPostoperative visual acuity is 0.5 or better in all cases，1.0 ? or better in 28 cases（28.6％）．The complication during operation，such as anterior chamber hemorrhage，posterior capsule rupture and vitreous loss，did not occur．Postoperative complications were very slight．Two eyes（2％）suffered mild corneal edema that lasted no more than a week．No other complications were found．ConclusionMicroTip is a kind of safe and effective facility for phacoemusification，with which we can reduce the eye injury，especially dealing with the hard nuclei．

Objective:To observe the efficacy and safety of Feilike mixture and Xuanfei Zhisou mixture in the treatment of children acute tracheobronchitis bronchitis. Methods:Totally 110 cases of children with infantile bronchitis were randomly divided into Feilike group(37 cases),Xuanfei Zhisou group(37 cases)and the control group(36 cases). The control groups was treated with the conventional therapy including amoxicillin clavulanic acid potassium dispersible tablets with oral administration and hydrochloric acid ammonium bromide injection with atomization inhalation. Feilike group was treated with Feilike mixture additionally,and Xuanfei Zhisou group was treated with Xuanfei Zhisou mixture additionally. The treatment course was 7 d. Fever,cough and rale disappearance time were observed,and the efficacy and adverse reactions were also compared. Results:The total effective rate of Feilike group and Xuanfei Zhisou group was 94. 6% and 91. 9% ,respectively,both were higher than that of the control group(P < 0. 05),while there was no significant difference between the two groups(P > 0. 05). The disappearance time of cough and rale in Feilike group and Xuanfei Zhisou group was shorter than that in the control group(P <0. 05),and the time was shorter in Xuanfei Zhisou group when compared with that in Feilike group(P < 0. 05). No obvious adverse reaction was shown in the three groups. Conclusion:Feilike mixture and Xuanfei Zhisou mixture both show notable curative effect in the treatment of children acute tracheobronchitis bronchitis with good safety.

Objective To investigate the knowledge,attitude and behavior of medical staffs on foodborne diseases.Methods To investigate the knowledge,attitude and behavior of medical staffs on foodborne diseases by random sampling following the questionnaire.Results There were 332 medical workers attending the survey.The medical staffs were lack of knowledge for foodborne disease,percent of pass was 34.33％.The pass rate of attitude and behavior were 88.88％ and 98.19％.The knowledge score of medical staff of top three hospital (6.49± 2.18)were lower than the community health service center(7.04±2.26) (P＜0.05),but attitude and behavior score of this two staffs had not statistical differences(P＞0.05).Conclusion It is necessary to help medical staff to improve the attitude of foodborne diseases,and improve the monitoring of underreporting case.

Sixty-nine cases of acute hyperthyroid myopathy admitted from 1990 to 2011 were retrospectively analyzed.Hoarseness was the most common symptom; 17.39％ of the patients had difficulty in breathing; respiratory muscle paralysis and aspiration pneumonia were the main causes of death.Efficient treatment lasting for two weeks was carried out in 81.16％ of the cases.Patients with severe bulbar palsy were often complicated with aspiration pneumonia and thus had high mortality rate.The main treatments in cluded anti-hyperthyroid drugs,corticosteroids,energy supports,and symptomatic management,which usually resulted in good clinical improvement.

Objective To explore the characteristics of T cell immunity in peripheral blood of patients with carboxypeptidase - H antibody (CPH-Ab). Methods Forty-two latent autoimmune diabetes in adults (LADA) patients with CPH-Ab~+ alone, 20 Type 2 diabetes mellitus patients (T2DM), and 22 healthy controls were selected and their peripheral blood mononuclear cells were isolated. Human recombinant carboxypeptidase (CPH) protein was expressed and further used as a stimulant in Enzyme-linked immunospot (ELISPOT) assay to detect IFN-γ-Th1 and IL-4-Th2 cells in the 3 groups. Th1/Th2 ratios were also calculated. CPH-Ab and glutamic acid decarboxylase antibody (GAD-Ab) were determined by radioligand assay. Results Compared with healthy controls and T2DM, IFN-γ-Th1 and IL-4-Th2 numbers did not increase significantly in CPH-Ab~+ group, nor did the Th1/Th2 ratios (P ＞0. 05). We further divided the CPH-Ab~+ patients into a short duration group (n = 22) and a long duration subgroup (n = 20) according to the duration of 3 years. CPH-IL-4-T in the short duration subgroup was significantly higher than that in T2DM and healthy controls (1. 8 vs. 0.2 and 0.3, both P ＜ 0. 05) and we did not find any factor that was significantly correlated with the IL-4 spots number. There were not any significant differences in T cell responses to phaseolus vulgaris agglutinin (PHA) among all groups (P＞0.05). Conclusion CPH does not directly involve in the cellular pathological mechanism of LADA. Anti-CPH immunity may be associated with more slowly aggressive beta cell autoimmunity.

Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Objective To observe the difference between Radix AstragaLi(RA) and Radix Fici Hirtae(RFH) in immune regulation and improvement of anaemia.Methods Fatigue resistance,brain hypoxia and normal hypoxia tolerance were observed to measure the anti-stress function.Bloodletting-induced anemia model and cyclophosphamid-induced anemia model were used to observe the effect of blood enrichment.Phagocytic function of macrophage,serum hemolysin level and delayed type hypersensitivity(DTH) reaction were also detected.Results RA and RFH could improve the fatigue resistance,normal hypoxia tolerance and brain hypoxia tolerance,and increase the red blood cell count and hemoglobin content,enhance phagocytic function of macrophage and serum hemolysin level,and increase the DTH reaction.Conclusion Both RA and RFH have an effect on improving anti-stress ability,immune function and blood enrichment,and there are no significant difference between RA and RFH.

0.05).Conclusion The PAI-1 genotype perhaps may not be one of independent risk factors for both T2DM and FA-IMT in T2DM patients.

Objective To investigate the distribution,variability and antibiotic resistance of the pathogen sisolated from bloodstream infections.Methods The bacterial strains were routinely isolated from blood samples and identified.Brucella trains were identified by PCR and gene sequencing.Antimicrobial susceptibility were routinely tested for these isolates.Results A total of 2 152 strains,excluding coagulase negative Staphylococcus,were isolated from blood specimens during the 5-year period from 2009 through 2013.Gram-positive cocci,gram-negative bacilli and fungi accounted for 35.3% (761/2 152), 57.7% (1 242/2 152)and 6.9% (149/2 152),respectively.The top three gram-positive bacteria were S.aureus,E.faecium and E.faecalis.E.coli,K.pneumoniae,P .aeruginosa,A.baumannii,and Brucella were the most frequently isolated gram-negative bacteria.In 2009,only one Brucella melitensis was isolated,but increased to 50 in 2013 (7.1%),including one strain of Brucella suis .The prevalence of MRSA was 54.1% in S.aureus.No staphylococcal isolate was found resistant to vancomycin or linezolid.More than 60% of the E.faecalis isolates still showed low resistance (< 30%)to ampicillin and levofloxacin.But E.faecium strains were highly resistant to most antibiotics (>70%)except glycopeptides and linezolid.E. coli and K.pneumoniae isolates displayed low resistance rate (< 15%)to piperacillin-tazobactam,amikacin,cefoxitin and
were still the most common pathogens in blood stream infections.Attention should be paid to the increasing prevalence of Brucella in blood stream infections.Various levels of antibiotic resistance are found in the pathogens of blood stream infections.Antibiotics should be prescribed reasonably according to local susceptibility testing data.

We have evaluated the plague epidemic situation in the Three Rivers Source Region,Qinghai Province in recent 20 years to provide the basis for revising the plague prevention countermeasures.We have analyzed the time distribution and the plague epidemic situation between animals and human beings during twenty years in the Three Rivers Source Region,Qinghai Province by describing epidemiology.The animal plague in the natural source of Marmot plague was extremely serious in the Three Rivers Source Region during the past 20 years.It mainly distributes in Yushu State and Tanggula County,Germu City and the serious season ran through the whole period of marmot camp ground activities and the peak was between June and August.Human plague epidemic took place between May and October each year and reached its peak between July and September.The peak covered about 41.67％ at most.It mainly endemic distributes in Nangqian and Xinghai Country.During the past 20 years,we have totally found 14 human plague epidemics in the Three Rivers Source Region,among which 48 cases took place and there were deaths of 17 cases.The fatality rate was 35.42％.The lung type was the majority among 48 cases,which startde with the glandular type.During the past 20 years the plague epidemic has been active and the animal plague epidemic broke out continuously in the Three Rivers Source Region,Qinghai Province.The variety of animals and insects infected the plague epidemic was increasing.The human plague epidemics is most serious with high fatality rate,but it is on the decline as a whole.