Recent researches showed the incidence of filtering blebs leakage after anti-glaucoma surgery was 3％-25％.The affecting factors include the usage of antimetabolite medicine.Pathogenesis of filtering blebs leakage is the basement membrane of conjunctival cells fracture,reduced conjunctival cells and subconjunctival cells.It may cause hypotony,bleb infection and even endoophthalmitis.The treatments mainly include conservative therapy and surgery.Conservative therapy methods include package,autoserum or fibrin injection or eye drops and tissue glue.Surgery methods include conjunctival transposition,repair with conjunctival,corneal,scleral,amniotic membrane and biomechanical materials.Filtering blebs leakage may induce severve complications without timely treatments.Conservative therapy and surgery have their own limitations,which need to be considered intently and followed up closely.

Nosocomial infection is a major challenge in modern hospital management. It affects not only patient safety but also the health of the health care workers. Inappropriate control of nosocomial infections will lead to serious results. China introduced the concept of nosocomial infection control in mid 1980s. Since then, tremendous achievements have been made, while lags still exist when compared with the developed countries. Further efforts should be made to strengthen discipline construction and develop scientific control approaches.
China ; Cross Infection ; prevention & control ; transmission ; Humans ; Infection Control

Nonalcoholic fatty liver disease (NAFLD)and gallstone disease (GD)are considered the manifestations of metabolic syndrome in the liver and gallbladder.NAFLD and GD are closely related to insulin resistance (IR),obesity,dyslipidemia,abnormal glucose metabo-lism,and so on.Worldwide studies,which have been reviewed,show that both NAFLD and GD have the common risk factors,such as IR, obesity,dyslipidemia,abnormal glucose metabolism,and middle-aged and elderly women.NAFLD is the risk factor for GD.GD,closely related to nonalcoholic steatohepatitis and liver fibrosis,accelerates the progression of NAFLD.Thus,it is considered that the prevention and treatment of NAFLD can reduce the incidence of GD,and the progression of NAFLD can be delayed by the prevention and treatment of GD.

Background Blepharitis is an induce factor for multiple ocular surface diseases.Research showed that bacteria play an important role in the pathogenesis of blepharitis.To make sure the pathogenic bacteria and effective antimicrobial agents are of clinical significance for the prevention and treatment of blepharitis.Objective The purpose of this study was 1o investigate the bacterial isolates of conjunctival sac secretion and meibomian secretion in the patients with blepharitis and study their in vitro antimicrobial susceptibility.Methods Forty-five patients with anterior blepharitis and 45 cases with posterior blepharitis were included in Beijing Chaoyang Hospital from December 2006 to December 2012,and 45 patients for laser in situ keratomileusis were enrolled in the same period as control group.The secretions of the conjunctival sac and meibomian were collected with sterile cotton swab,and bacterial isolates were cultured in bouillon culture-medium.The number of eyes with different bacteria was examined and calculated.Then the bacteria were switched to blood agar plates,and antimicrobial susceptibility test to erythromycin,gentamicin,tobramycin,rifampin,levofloxacin were performed by M ueller Hinton (M-H) medium paper method.Results The total germiculture positive rates were 81.1％,76.1％ and 65.0％ in the anterior blepharitis group,posterior blepharitis group and the control group,showing a significant difference among them (x2 =12.80,P=0.00).The germiculture positive rates in meibomian secretion were 84.4％ and 78.8％ in the anterior blepharitis group and the posterior blepharitis group,which were significantly higher than 67.8％ in the control group (x2=7.30,P =0.03).There was no statistically significant difference in the germiculture positive rate of conjunctival sac section among the three groups (77.8％,73.3％ and 62.2％) (x2 =5.60,P=0.06).The main bacteria in conjunctival sac secretion and meibomian secretion were staphylococcus epidermidis,staphylococcus aureus and corynebacterium in all the subjects,but streptococcus pneumoniae and gram-negative bacillus were not detected in the control group.Staphylococcus showed the highest susceptibility to gentamicin,tobramycin and rifampicin,with the sensitive rate ＞70％.Corynebacterium was susceptible to various drugs.Streptococcus pneumoniae had susceptibility to erythromycin and tobramycin.However,Gram-negative bacillus was not susceptible to all the drugs above.Conclusions Bacteria participate in the pathogenesis of blepharitis,but the germiculture positive rate,bacterial species and drug susceptibility of bacteria are obviously different between patients with blepharitis and normal population.Reasonable application of antimicrobial agents is important to blepharitis.

Objective To investigate the correlation and risk factors between vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN).Methods A total of 121 cases of VAIN patients was retrospectively analyzed with examination results such as clinical manifestations,liquid based cytology (TCT),human papilloma virus infection,virus infection type,and clinical data of treatment and follow up.Results VAIN Ⅰ,VAIN],and VAIN Ⅲ] were accounted for 33.9％ (41/121),38.0％ (46/121),and 24.4％ (34/121) ; for 40 or less years old patients,VAIN Ⅲ was accounted for 10.7％ (3/28) ; for more than 40 years old patients,VAIN Ⅲ was accounted for 33.3％ (31 /93).Among 121 VAIN patients,77.7％ (94/121) patients had CIN history,15.7％ of which (19/121) had a history of cervical cancer; 27.3％ (33/121) with hysterectomy history,of which 75.8％ (25/33) was due to cervical intraepithelial neoplasia and cervical cancer resection of the uterus.Papilloma viral load in patients with VAIN Ⅰ was detected with a (HPV-HC2) positive rate of 87.8％ (36/41),while in VAIN Ⅱ and VAIN [patients,the positive rate was 100％,the infection of high risk type of HPV ratio was 95.9％ (116/ 121).of which the mixed infection was accounted for 56.9％ (66/116).There was 94.6％ in oatients with VAIN (114/121),and liquid-based cytology test results suggest abnormality; 88.4％ (107/121) in patients with VAIN lesions occurred in upper 1/3 of vaginal.After diagnosed cervical disease,the onset time of VAIN was (3.45 ± 2.02) years,non-total-hysterectomy was (3.24 ± 1.97) years,after hysterectomy to pathological diagnosis time for VAIN was (5.01 ± 3.95) years:for the diagnosis of VAIN disease after resection of cervical original time was (3.96 ± 2.99) years,and rather than non cervical disease resection was an average of (9.94 ±5.37) years.In the course of treatment of the 12l cases of CIN patients,6 cases of patients were progressed to invasive carcinoma.Conclusions The clinical manifestation of VAIN is similar to CIN,the principle of diagnosis and treatment of CIN can also apply to VAIN,high risk HPV infection virus,cervical intraepithelial neoplasia are the risk factors for VAIN.

To determine the effects of Remifentanil on the expression of adhesive factors during acute lung injury, we used immunohistochemistry and reverse transcription polymerase chain reaction (RT PCR) technics to measure the expression levels of ICAM 1, and P Selectin in the lung in a rat model of hemorrhagic shock. We duplicated modified Wigger hemorrhagic shock model in healthy SD rats. The rats were divided into three groups: control group, resuscitation group, resuscitation and drug using group. The positive ratios of ICAM 1 and P Selectin in the lungs at different time points, namely preshock, shock, resuscitation 2 hours, and resuscitation 4 hours were determined. There were 6 rats in each group and each time point. The degree of pulmonary injury in the drug using group was less than that in other two groups. Resuscitation with lactated Ringer's solution led to most serious injury in the resuscitation group. In drug using group, the expression of ICAM 1 and P Selectin was far less than that in the other two groups ( P

Objective To determine the modulating effects of remifentanil on the expression of apoptosis factors during acute lung injury as a result of hemorrhagic shock, we observed the expression of C-Jun, Bax, Bcl-2 in lung with immunohistochemistry in rats with hemorrhagic shock. Methods Hemorrhagic shock model was replicated with modified Wigger's method in healthy SD rats. Seventy-two rats were randomized into three groups: sham resuscitation, resuscitation with lactated Ringer′s solution, and fluid resuscitation with remifentanil. Positive rates of C-Jun, Bax, Bcl-2 were assayed in the lungs at different time points: preshock, shock, 2 hours after resuscitation, and 4 hours after resuscitation. Results ①The model of acute lung injury subsequent to hemorrhagic shock was reproduced in rats. ②The expression of Bcl-2 elevated slowly in three groups, while the expression of Bax elevated rapidly, and there were significant differences between the value of baseline and those of other time points (P

With the development of medicine and health,the experts who have a good command of medicine and law are in great social need,so the major of medical law was introduced.This article,based on the experience and construction of medical law major in Kunming Medical College,put forward that the major of medical law must establish the cultivation goals curriculum system and projects of internship.It emphasizes the approaches to improving the students' knowledge of Arts and comprehensive abilities.

Chylous Ascites ; congenital ; therapy ; Humans ; Infant ; Male ; Parenteral Nutrition, Total ; Somatostatin ; therapeutic use

Objective To study the changes of adriamycin-induced glomerular epithelial cells (GECs) permeability and cytoskeleton, and to explore the role and possible mechanism of epithelia growth factor (EGF) on adriamycin-induced glomerular epithelial barrier function. Methods Rat GECs on Milicell-PCF Inserts were exposed to adriamycin (0.5 ?mmol/L) 24 hours in the absence or presence of EGF. The paracelluar permeability to BSA and cell viability were evaluated. The expression of F-actin and alpha-actinin were analyzed by immunofluorescence and Leica laser scan confocal microscopy. Results After induced by adriamycin for 24 hours, paracelluar permeability to BSA and F-actin reorganization rate increased. Disassembling of cortical cytoskeleton architecture was observed. Stress fiber in cytoplasm disappeared. Alpha-actinin staining showed perinuclear enhancement, which is different from normal cytosolic pattern. EGF significantly reduced adriamycin induced effect. Higher level of BSA passed through GEC monolayer in a dose-dependent manner. EGF prevented adriamycin-induced cytoskeletal reorganization. Disassembled cortical cytoskeleton was recovered, and stress fiber appeared again. Alpha-actinin staining mainly exhibited cytosolic uniform distribution as control GEC. In addition, administration of either AG1478, a specific inhibitor of EGF-receptor tyrosine kinase, or U73122, a specific inhibitor of PLC? before EGF treatment attenuated the EGF-mediated effect, whereas neither AG1478 nor U73122 exerted influence in the absence of EGF. Conclusions Adriamycin increases GEC paracellular permeability to BSA as a result of adriamycin-induced cytoskeleton disassembling and disruption. EGF may prevent adriamycininduced cytoskeleton reorganization and maintain glomerular epithelial barrier function through EGF mediated EGF-EGFR-PLC? signal pathway.