Neonatal necrotizing enterocolitis (NEC)is a major cause of morbidity and mortality in premature infants.The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity.Probiotic bacteria prevent or limits disease propagation in NEC.The unique characteristics of developing intestinal epithelia focusing on gut development and colonization as well as the inflammatory propensity of immature epithelia are highlighted in this paper.Additionally, potential mechanisms of beneficial probiotic interaction with immature intestinal epithelia including immunomodulation, upregulation of cytoprotective genes, prevention and regulation of apoptosis and maintenance of barrier function are reviewed.Probiotics may restore or supply essential bacterial strains needed for gut maturation and homeostasis.Oral administration of probiotics has been suggested as a promising strategy for prevention of NEC.

Intestinal tract is the central organ of the body's stress,and it has an important barrier function to prevent the harmful substances,such as bacteria and toxins,from the gut into the body.The main factors of intestinal barrier dysfunction are ischemia and hypoxia and endotoxin damage,and it is essential to explore the protective methods of the intestinal mucosa barrier in the early stage to prevent the organ metabolism disorder induced by intestinal derived endotoxin and bacterial translocation.Glutamine,which can effectively protect the integrity of the intestinal mucosa,maintain the normal intestinal permeability and improve the cell immunity,has been used to intensive adult patients and need further studies in the clinical application of newborns.

Objective:To explore the effects of levocarnitine adjunctive therapy on serum nutritional index and inflammatory factor level in maintenance hemodialysis patients. Methods:Totally 62 patients with hemodialysis were randomly divided into the observation group and the control group with 31 cases in each. The observation group was treated with 1g levocarnitine injection with intravenous in-jection after the dialysis, and the control group was treated with 0. 9% physiological saline injection with the same volume after the di-alysis. After 3-month treatment, the nutritional indices including Hb, Alb, TC, TG, LDL-C and HDL-C and the change in inflamma-tory factors including C-reactive protein (CRP), IL-6, IL-8 and TNF-α of the patients in the two groups were studied and compared. Results:After the treatment, the level of Hb and Alb was improved in the observation group (P<0. 05), while the level of TC, TG, HDL-C and LDL-C had no significant change (P>0. 05). All of the indices showed no significant change in the control group (P>0. 05). After the treatment, the level of Hb and Alb in the observation group was higher than that in the control group (P<0. 05). After the treatment, the level of CRP, IL-6, IL-8 and TNF-α was reduced in the observation group (P<0.05), while the control group had no significant changes in the indices (P>0. 05). All of the indices in the observation group was better than those in the control group (P<0. 05). Conclusion:Levocarnitine used in the treatment of patients with hemodialysis can effectively improve the nutritional status and inflammatory factors level without obvious effects on lipid metabolism, which is very important for the reduction of complication and the improvement of life quality, and worthy of clinical promotion.

Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.It is very important to correctly select a treating approach for DME.At present,the treating methods of DME include retinal laser photocoagulation,application of the glucocorticoid,intravitreous injection of anti-vascular endothelial growth factor (VEGF) drugs,administration of inhibitor of protein kinase C,vitrectomy and combined treatment etc.However,each method has its advantage and disadvantage.Retinal photocoagulation,vitrectomy,intravitreous injection and drug delivery system implantation are invasive treatment methods,and they can not rescue damaged retinal photoreceptors.Therefore,it is recommended that DME should be early diagnosed and effective treatment.The research status at home and abroad and future development trends of DME treatment were summarized.

Objective To investigate the therapeutic efficacy of refractory glaucoma with compound trabeculectomy.Methods 26 eyes (24 cases ) of refractory glaucoma were treated with compound trabeculectomy.Results Followed up 1 year.There were functional filtering blebs in 20 eyes ;and the IOP was below 21mmHg in 16 eyes without any antiglaucoma drug and in 8 eyes with 1-2 categories of lower IOP drugs after 12 months.The mean IOP at 1 week,1 month,3 months,6months and 12months was (7.9 ± 3.1 ) mm Hg,( 13.5 ± 3.7 ) mm Hg,( 18.2 ±3.8)mm Hg,( 18.1 ±3.5)mm Hg,( 19.1 ±4.8)mm Hg,significantly higher than the IOP preoperatively( 38.2 ±5.6)mm Hg( P ＜0.01 ).Conclusion It was safe and effective of treating refractory glaucoma with compound trabeculectomy.

Objective To evaluate the accuracy of the soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and lipopolysaccharide binding protein (LBP) as diagnostic indices for neonatal serious bacterial infections (SBI). Methods A total of 171 newborns were enrolled in the study, and were classiifed into SBI group (including early-onset and late-onset), non-SBI group according to clinical manifestations, laboratory examinations and the time of disease onset. Serum sTREM-1, LBP and C-reactive protein (CRP) levels were measured. Receiver operator characteristic curve (ROC) was drawn, and the area under curve (AUC) was calculated. Each index was evaluated for the diagnostic value of neonatal SBI. Results The sTREM-1 and LBP levels were signiifcantly higher in SBI group than those in non-SBI group (P=0.000). The AUC of ROC for sTREM-1, LBP and CRP in early-onset SBI was 0.888, 0.839 and 0.706, respectively. The AUC of ROC for sTREM-1, LBP and CRP in late-onset SBI was 0.860, 0.865 and 0.705, respectively. Conclusions Both sTREM-1 and LBP are useful for the diag-nosis of neonatal SBI.

Diabetic nephropathy is one of the most serious microvascular complications, which is related to many growth factors. Growth factors are a kind of cytokines that can stimulate cells to grow, which includes transforming growth factor-? (TGF-?), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF), connective tissue growth factor (CTGF), and so on. Different growth factors can cause glomerular hypertrophy or proliferation, perinephric angiogenesis, tubulointerstitial fibrosis and the like respectively. To know the relationship between the growth factors and diabetic nephropathy could provide a prospective mean to reduce the diabetic mortality rate. This paper reviews the recent researches about the growth factors and diabetic nephropathy to provide a scientific basis for clinical treatment.

Through analysis on compliment on drawbacks in medical services in a third - grade hospital during the year of 2003 - 2004, the author gives a picture of the stracture of the medical services today and tells a trend of such compliement goes from service itself security and guatity of the services. Facing the now challenge and charges on compliment today, the anthor holds the idea that establishing 3 new principles, 3 nes reformations and 3 new services to make sure the parients are satisfied.

Objective To investigate the protective effect of coenzyme Q10 (CoQ10) in the liver of preeclampsiapregnant rats and the potential etiology. Methods Fifty pregnant SD rats were equally divided into the normal pregnant (NP) group (n=10) and the preeclampsia (PE) group (n=40) randomly. The PE rats (n=40) were equally divided into four groups randomly,distilled water(DW)group,CoQ10 group, CoQ10 combined magnesium(CM) group and magnesium (Mg) group were established by treating the preeclampsia rats on day 15 to 21 of gestation with different measures. As for all the 50 rats, systolic blood pressure (SBP) of rat tail was detected on day 10, 15 and 21 of gestation respectively, 24 hours proteinuria analysis were detected on day 10, 15 and 21 of gestation respectively, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in blood andsuperoxide dismutase (SOD), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), caspase-3, Bcl-2 and Bax protein expression in liver tissue were detected by western blot assay on day 21 of gestation. Results (1)SBP and 24 hours proteinuria analysis:there was no statistic difference among all the five groups on day 10 of gestation (P>0.05). Whereas, SBP and 24 hours proteinuria analysis were significantly higher in CoQ10 group, CoQ10 combined CM group, CM group and DW group than that in NP group on day 15, 21 of gestation (P<0.05). And SBP and 24 hours proteinuria analysis were significantly lower in CoQ10 group, CoQ10 combined CM group and CM group than that in DW group on day 21 of gestation (P<0.05). (2) Liver function: among CoQ10 group, CoQ10 combined CM group, CM group, DW group and NP group, serum levels of ALT were respectively(52±7),(34±9),(49±10), (70 ± 19),(30 ± 7)U/L;and serum levels of AST were respectively(169 ± 25),(84 ± 11),(159 ± 20),(281 ± 26)and(78±18)U/L. ALT and AST serum levels were significantly higher in CoQ10 group, CM group and DW group than that in NP group (P<0.05). ALT and AST serum levels were significant lower in CoQ10 combined CM group than those in CoQ10 group, CM group and DW group, respectively (P<0.05). ALT and AST serum levels were significant lower in CoQ10 group and CM group than that in DW group, respectively (P<0.05). (3) SOD, GSH-PX, MDA, caspase-3, Bcl-2 and Bax expression in liver tissue of rats: SOD expression was significant higher in CoQ10 group, CoQ10 combined CM group than thoes in CM group, DW group and NP group(P<0.05);SOD expression was significant lower in CM group, DW grouo than thoes in NP group(P<0.05);and SOD expression was significant higher in CM group than that in DW group(P<0.05). Compared with CoQ10 group, CoQ10 combined CM group, CW group and DW group respectively, the GSH-PX and Bcl-2 protein expressions were significant higher in NP group(P<0.05), while MDA, caspase-3 and Bax protein expressions were significant lower in NP group(P<0.05);compared with CoQ10 group, CoQ10 combined CM group and CW group respectively, the GSH-PX and Bcl-2 protein expressions were significant lower in DW group (P<0.05), while MDA, caspase-3 and Bax protein expressions were significant higher in DW group (P<0.05). Conclusions Oxidative stress and apoptosis levles were upregulated in PE pregnant liver tissues. CoQ10 could effectively protect the liver by improving the liver functions and decreasing the apoptosis of liver cells in PE pregnant rats, and markedly decrease the oxidative stress and apoptosis in the livers. The protective roles of CoQ10 in liver might through its function of anti-oxidative stress and inhibiting cell apoptosis by regulating the balance of Bcl-2/Bax.

Background Primary iris stromal cysts is a rare clinical disease.In recent years,the pathological findings of primary iris stromal cysts are different from previous literature reports.It is very important to understand the pathological characteristics of primary iris stromal cysts for illuminating its pathogenesis and accurate treatment.Objective This study was to analyze the pathological types and clinical manifestations of primary iris stromal cysts.Methods Histopathological sections of 14 patients with primary iris stromal cysts from January 1979 to December 2012 in Tianjin Eye Hospital were retrospectively analyzed.The primary iris stromal cysts were typed based on the hematoxylin-eosin staining,periodic acid-Schiff (PAS) staining and immunochemistry, and the clinical chacteristics upon different types were evaluated.Results In 14 specimens of primary iris stromal cysts,squamous epithelial type was found in 9 specimens,lens epithelial type in 3 specimens and ciliary body epithelial type in 2 specimens.The primary iris stromal cysts of squamous epithelial type were constituted of non-cuticular stratified squamous epithelium cells,and sporadic goblet cells were found in some specimens.The primary iris stromal cysts of lens epithelial type were consisted of lens epithelium cells and lens capsular analogic tissue and the cysts were tightly adherent to the lens.Crystalline lens dysplasia were seen in 2 specimens.The primary iris stromal cysts of ciliary body epithelial type showed single or stratified ciliary body like epithelium cells.Iris-ciliary dysplasia or anterior chamber angle abnormality was displayed in 1 specimen in this type of cysts.Under the slit lamp microscope,superior-temporal clear cysts were often seen in the primary iris stromal cysts of squamous epithelial type, and translucent cysts or diffuse swelling cysts were exhibited in the lens epithelial type and might be accompanied with lens dysplasia and cataract.Diffuse swelling was found in the cysts of ciliary body epithelial type which were often associated with chamber dysplasia and infantile glaucoma.Conclusions Primary iris stromal cysts are pathologically classified into squamous epithelial type, lens epithelial type and ciliary body epithelial type and present with different clinical appearances.