Objective To evaluate the therapeutic effect of pedical conjunctival flap transposition on refractory corneal ulcer. Methods The data of 56 eyes of 56 patients with refractory corneal ulcer who underwent pedical conjuctival transposition in a tertiary eye unit in China from June 2005 to June 2009 were retrospectively analyzed. There were 36 infective corneal ulcers, 9 keratoplasty graft ulcers, 4 traumatic ulcers, and 7 chemical burn ulcers. All patients were treated with focal debridement and pedical conjuctival flap transposition. Results Forty-seven out of 56 (83.9%) were cured after one surgery, and 5 (8.9%) had conjunctival flap retraction, among which 3 underwent the second surgery and 2 had the third surgery to completely heal. Four patients (7.2%) turned to lamellar keratoplasty because of fungal corneal ulcer relapse. Ulcer in 52 patients healed and the globe preserved. They had different levels of vision improvement. Conclusion Pedical conjunctival flap transposition is effective for refractory corneal ulcer.

Objective To observe the expressions of Th1 cytokin [interleukin (IL)-12] and Th2 cytokin (IL-4) in gut of the mouse model of postinfcctious irritable bowel syndrome (PI-IBS). Methods Thirty mice were divided into control group (n=8) and model group (n=22,infected with Trichinella spiralis). The weight of the mouse was measured weekly after infection. Visceral sensitivity of colorectal distention in mouse was accessed by abdominal withdrawal reflex (AWR) at 0 and 8 weeks after infection. All mice were sacrificed at the 8th week, and tissues of jejunum, terminal ileum, proximal colon and distal colon were observed for inflammation with HE staining. The mRNA and protein expressions of IL-12 and IL-4 were examined by RT-PCR and Western blotting, respectively. Results Two weeks after infection, body weight was decreased in model group compared with control group ( -1.08%±1.08 % vs 3.09%±1.85%, P<0.05), but there was no significant difference at the 8th week between two groups (P>0.05). Severe inflammation was observed in the gut of mouse 2 weeks after infection, however it was recovered at the 8th week. The score of AWR was higher in model group at 30,45 and 60 mmHg in comparison with control group (P<0.05), whereas the perceptual threshold was lower in model group than in the control group (P<0.05). In comparison with control group, increased expressions of IL-12 mRNA and protein in ileocecum and proximal colon as well as decreased expressions of IL-4 mRNA and protein in all parts of gut were found in model group (P<0.05). Conclusion Th1/Th2 shift may involve in gut of PI-IBS mouse, which provides a new idea for treatment of PI-IBS.

Objective To analyze the computed tomography (CT)characteristics of splenic lymphangioma and the association be-tween CT findings and pathological results.Methods The CT characteristics and pathological findings of 9 patients with splenic lym-phangioma were retrospectively analyzed.Results There were 8 cavernous lymphangioma and 1 cystic lymphangioma.Of the 9 ca-ses,it revealed that the percentage of blood vessel elements ranging from 5% to 50% via microscope.CT found 2 cases were with single lymphangioma,3 with multiple lesions,exhibiting as round or round-like mass;4 cases were found with diffuse lymphangio-ma and different size of cystic masses distributed across spleen.Five of the 9 cases who were with single or multiple lymphangioma showed circular and thin line-like cyst wall,while the remaining 4 cases showed latticed cyst wall in CT characteristics.The content in the cysts were with uneven density in all the 9 cases with CT value ranging from 10 to 40 HU,3 of which combined with sand-like calcification.Enhancement scanning found two characteristics:(a)cyst wall and separation were mildly enhanced,especially in the delayed phase;(b)the content in the cyst presents anomalous small patchy and mild enhancement.The enhancement of the content in the cyst did not change as the increasing of blood vessel composition.Conclusion CT examination will help the diagnosis of splenic lymphangioma and is of significance in informing clinical treatment.

Background: Integrative traditional Chinese and western medicine may be a new approach to improve the eradication rate of Helicobacter pylori (Hp).Aims: To compare the efficacy and safety of Weifuchun tablet versus bismuth combined with standard triple regimen as the first-line therapy of Hp infection.Methods: A total of 141 patients with Hp infection and na(i)ve to treatment were randomly assigned into 3 groups receiving a 14-day eradication therapy.In standard triple therapy group, esomeprazole, amoxicillin and clarithromycin were given twice a day;while in Weifuchun group and bismuth group, Weifuchun tablet and bismuth potassium citrate were added, respectively, to the standard triple therapy.Hp eradication was assessed by 13C-urea breath test at least 6 weeks after the end of treatment.Hp isolates were tested for resistance to antibiotics.Results: One hundred and twenty-eight patients completed the study.Hp eradication rates in Weifuchun group, bismuth group and standard triple therapy group were 83.7%, 91.8% and 79.1%, respectively by ITT analysis and 88.4%, 97.8% and 84.6%, respectively by PP analysis.The eradication rate of Weifuchun group was lower than that of bismuth group and higher than that of standard triple therapy group, but the differences were not statistically significant (P>0.05).Only PP eradication rate of bismuth group was significantly higher than that of standard triple therapy group (P<0.05).The resistant rates of Hp to clarithromycin, amoxicillin and metronidazole were 33.3%, 2.9% and 70.5%, respectively.For eradication of clarithromycin resistant strains, bismuth group was superior to Weifuchun group and standard triple therapy group (100% vs.60.0% and 66.7%, P all <0.05).All three eradication regimens showed good compliance, and no significant difference in incidence of adverse events was found between the three regimens (P>0.05).Conclusions: Weifuchun tablet combined with standard triple regimen is safe and effective for use as first-line treatment for Hp infection, however, the eradication rate is relatively low in cases infected with clarithromycin resistant strains.Bismuth combined with standard triple regimen is a good alternative in areas with high clarithromycin resistance and regions where tetracycline is unavailable.

The absorption-elution test using low ionic strength solution (LISS) has been compared with the test using normal saline in MN typing of 258 bloodstain samples stored 1 to 6 years. The accuracy rate was 94.57％ using LISS method. The present study indicated that the LISS method is more sensitive than tests carried out in normal saline.

Objective To identify the risk factors of refractory secretory otitis and analyse the results .Meth-ods The study subjects were 42 patients(56 ears) with secretory secretory otitis media from June 2003 to June 2011 ,all patients were performed with ears ,nose ,pharynx and throat routine inspection and mastoid HRCT .All patients were retrospectively analyzed possible risk factors :suchas history ,infection ,eustachian tube dysfunction , chronic sinusitis ,deflection of nasal septum ,nose pharynx ministry malignant tumor ,tonsillitis ,adenoid hypertro-phy ,allergic rhinitis ,etc .Results In the multivariate analysis of 42 patients(56 ears) with refractory secretory oti-tis media and the control group of 50 patients(66 ears) ,statistically significant in the history (χ2 = 9 .814 ,P<0 .01) ,mastoid pneumatization adverse (χ2 =15 .301 ,P<0 .01) ,and allergic rhinitis (χ2 =32 .614 ,P<0 .01)were observed .Two of them were found to be significant in the logistic regression model :mastoid pneumatization adverse (OR=4 .44) ,and allergic rhinitis(OR = 15 .13) .Patients of mastoid pneumatization adverse with refractory otitis media is 4 .164 times (95% CI ,1 .903 ~9 .112);patients of allergic rhinitis was 17 .192 times higher than that of in no allergic patients (95% CI ,5 .850 ~ 50 .524) .Conclusion Mastoid pneumatization adverse and allergic rhinitis are the risk factors for refractory secretory otitis media .

Trichinella spiralis infection in rodents is a well-known model of intestinal inflammation associated with hypermotility. The aim of the study was to use this experimental model to elucidate if Th17 cells are involved in the development of gastrointestinal hypermotility. Colonic smooth muscle contractility was investigated in response to acetylcholine. The levels of IL-17, IL-23 and TGF-beta1 in colon were measured by Western blotting. Flow cytometric detection of intracellular IFN-gamma/IL-4/IL-17 cytokine production was used to analyze the proportions of CD4+ T cells subsets in colon. Our results showed that colonic muscle contractility was increased 2 weeks post infection (PI) and stayed high 12 weeks PI when no discernible inflammation was present in the gut. The proportion of Th17 cells and the expression of IL-17 were up-regulated in colon 2 weeks PI and returned to normal 8 weeks PI. The content of IL-17 was correlated with the colonic smooth muscle hypercontracility 2 weeks PI. Meanwhile, TGF-beta1 was increased 2 weeks PI, while IL-23 was normal. Our results suggest that Th17 cells affect the colonic muscle contractility in mice infected with Trichinella spiralis at intestine stage but not at muscle stage and the effect of Th17 cells on muscle contractility might be induced by TGF-beta1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

Objective To inquire into the curative effects of combination of laproscopic cholecystomy and laparoscopic transcystic duct common bile duct exploration on cholelithiasis, cholecystolithiasis and cho-ledocholith. Methods The clinical data of 19 cases were retrospectively analyzed from Sep. 2006 to Jan.2009. Results All the operations were performed successfully. The operative time was 60～120 min, the drainage time was 3～5 d, and the postoperative hospitalization time 4～7 days. All of the patients were fol-lowed up from 3 to 6 months. No complications occurred. Conclusion Laparnscopic transcystic biliary duct exploration is safe, feasible and worth generalizing.

Objective To explore the treatment using two different ventilation tubes insertion for secretory o-titis media ,and to determine which factors are associated with the tympanic membrane perforation after a extrusion or surgical removal of a ventilation tube(VT) .Methods A retrospective analysis of 121 cases (210 ears) with re-fractory secretory otitis media from 1998 June to 2013 March was carried out .There were 58 cases (105 ears ) and 63 cases (105 ears) in patients and control group ,respectively .All subjects had more than 2 years of history ,and were treated by two types of ventilation tube (Goode -T and Shepard tube) .Various factors were analyzed to deter-mine the factors associated with persistence of a tympanic membrane perforation after VT extrusion or removal ,in-cluding gender ,age ,medical history ,ventilation tube pattern ,location ,history of previous VT insertions ,intuba-tion period reason for VT insertion ,condition of the TM ,nature of the tympanic cavity effusion and previous ade-noidectomy ,et .Results Analysis factors of perforation group (105 ears) and the control group (without perfora-tion ,105 ears) ,were statistically significant in ventilation tube pattern (χ2 =6 .916 ,P<0 .01) ,history of previous VT insertions(χ2 =7 .325 ,P<0 .01) ,frequency of previous VT insertions (χ2 =13 .01 ,P<0 .01)and the nature of the tympanic cavity effusion(χ2 =7 .04 ,P<0 .01) .The proportion of perforation group about Goode - T ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were 58 .4% ,57 .3% ,66 .7% and 57 .9% respectively ,others had no significant difference between the two groups . The multivariate analysis showed that ,regardless of the ventilation tube ,the frequency of tube was the tympanic membrane perforation risk factor ;Goode-T tube increased the risk of perforation of tympanic membrane was 1 .637 times than Shepard tube(OR=1 .637 ,P<0 .01) .Conclusion Using the Goode - T type ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were four risk factors for persistence of a tympanic membrane perforation after VT insertion for secretory otitis media .

Objective To explore appropriate organization and financing models of urban employees supplementary medical insurance under the conditions of the market economy. Methods Employee surveys on willingness to participate in, willingness to pay for, and actual enrolment in supplementary medical insurance were conducted in Shanghai, Wenzhou and Chengdu and nationally different operational models were compared so as to analyze prospectively coverage and operational models of feasible supplementary medical insurance options. Results Characteristics of the employees needs for various supplementary medical insurance options were garnered and appropriate coverage and operational models were put forward. Conclusion It is suggested that the role of the government in the development of supplementary medical insurance be clearly defined, the development of supplementary medical insurance be promoted through policy support and guidance, and the supervision of supplementary medical insurance be strengthened.