·AIM:To observe the efficacy and the safety of low-dose mitomycin-C (MMC) in the treatment of pterygium.·METHODS:In a prospective,randomized and controlled clinical trial,a total of 550 eyes of 400 patients diagnosed with pterygium were randomly divided into the four groups-group 1:130 eyes of 100 patients,without MMC;group 2:140 eyes of 100 patients,with 0.2g/L MMC;group 3:150 eyes of 100 patients,with 0.3g/L MMC;group 4:130 eyes of 100 patients,with 0.4g/L MMC.They underwent the excision of primary pterygium barely the sclera.Visual acuity,intraocular pressure (IOP),extraocular movement,iridocyclitis,scarring, symptoms (tearing,photophobia,foreign body sensation) and signs (conjun-ctival hyperemia,ulcer of sclera and cornea,perforation of sclera) of subjects,were recorded on the day of enrollment,and after the surgery,on 2 weeks,2 months,6 months,and 1 year.·RESULTS:In group 3 and group 4,the recurrence of pterygium after the excision were less than that in group 1 and group 2 ( P < 0.01 ).In group 4,after the surgery,there were more probability of raising lOP,iridocyclitis,symptoms and signs than that in group 1,2,and 3.·CONCLUSION:Low-dose MMC is effective in the treatment of preventing the recurrence of primary pterygium.Its efficacy rises along with its density.And meantime,the safety of the treatment of low-dose MMC declines.

Objective To investigate the clinical effects of focused ultrasound in the treatment of cervical erosion.Methods 417 patients with cervical erosion were treated with focused ultrasound(Haijixing treatment instrument),and followed up for 3 months to observe the efficacy and adverse reactions.Results In total 417 cases,321cases(76.98％) were cured,and there were effective in 95 cases(22.78％),ineffective in 1 case(0.24％),and the total effective rate was 99.76％.No serious adverse reactions were founded.Conclusion Focused ultrasound(Haijixing treatment instrument) in the treatment of cervical erosion has obvious effect and mild adverse reactions.

BACKGROUND:Traditional treatment of tibia and fibula fractures complicated with skin soft tissue defect is mainly external fixation, wound debridement and dressing plus skin graft or skin flap transplantation after the infection is control ed and granulation grow. This method is disadvantageous due to high cost, great pain, long hospitalization stay, infection and necrosis, even the possibility of amputation.
OBJECTIVE:To explore the clinical efficacy of vacuum sealing drainage (VSD) and external fixator in the treatment of tibia and fibula open fractmes complicated with skin defects.
METHODS:A total of 38 patients with severe open fractures of tibia and fibula complicated with skin defects were selected from Benxi Central Hospital between January 2009 and September 2013. The size of skin defects was more than 5 cm2. After external fixation, the patients underwent complete debridement and dressing, fol owed by VSD treatment for 5-7 days. After granulation tissue grew and the wound became fresh, the patients received intermedite thickness skin graft. And 15 cases treated without VSD were retrospectively selected, serving as control group. The infection control rate and wound healing time in the two groups were compared.
RESULTS AND CONCLUSION:After 5-7 days of VSD treatment, VSD dressings were removed, wound infection was control ed, local wound granulation tissue was fresh. Both the wound and fractures were healed wel , no osteomyelitis or amputation occurred. Among the involved 38 patients, 23 cases were cured, 12 cases were effective, and three cases were ineffective. The total effective rate showed significant differences compared with the control group (92%vs. 53%;P<0.05). VSD can completely remove the wound secretions and necrotic tissue, improve local microcirculation, eliminate the infection, VSD plus external fixator and skin grating is a simple and effective method in treatment of tibia and fibula open fractures with soft tissue defects.

Objective To investigate the family caregivers of patients with indwelling catheter care behavior .By analyzed its in‐fluencing factors to help caregivers improve the quality of life for patients .Methods Convenience sampling method by visit 70 pri‐mary caregivers of family indwelling catheter for the patient′s .They were investigated with gathering general information and Gen‐eral Self‐Efficacy Scale(GSES) ,following with caregivers awareness questionnaire indwelling catheter .Indwelling catheter care be‐havior questionnaire survey analyze behavior and other items to take care of the relationship .Results The general self‐efficacy and caregiver indwelling catheter cognition ,which account for 73 .9% of the total variance of caring behaviors ,were the important fac‐tors affecting care behaviors .Conclusion There is a big shortage in indwelling catheter home care caregiver knowledge and care be‐haviors .According to above professionals can provide targeted guidance for caregivers .

OBJECTIVE: To evaluate the use of Xingnaojing Injection in medical insurance inpatients in Beijing city so as to provide reference for rational drug use and medical insurance billing.METHODS: Inpatient cases using Xingnaojing Injection in 5 Beijing hospitals of different levels were randomly sampled from the 2004 Beijing Medical Insurance Database,and analyzed in terms of indication, dosage, treatment course and ADR.RESULTS: A total of 676 cases were sampled with more than 25 kinds of indications,and among the top 10 indications, 18.0% were inconsistent with the instruction,and 17.5% were in lack of evidence support such as randomized controlled trials.Individual dose of Xingnaojing Injection was(27.9?9.0)mL, which was higher than the usual dose described by the instructions and clinical trials.The mean treatment course of Xingnaojing Injeciton was 14.6 days,with 20.9% exceeding 20 days.Drugs used in combination with Xingnaojing Injection included anti - thrombosis agents( 13.3% ) and traditional Chinese medicines with the action of promoting blood circulation and removing blood stasis (12.7%) .CONCLUSION: The use of Xingnaojing injection in medical insurance patients was not consistant with the instruction or evidence supported by clinical trials.

China ; Humans ; Vascular Diseases

BACKGROUND:Several studies have demonstrated that bone marrow mesenchymal stem cells (BMSCs) inhibit the proliferation and activation of T lymphocytes, exerting a role of negative immunological regulation. OBJECTIVE: To induce rat BMSCs to differentiate into neuron-like cells in vitro using all-trans retinoic acid and to investigate the effects of differentiated cells on T lymphocyte proliferation.DESIGN, TIME AND SETTING: A cytological in vitro observation was performed in Guangdong Medical College in March 2008.MATERIALS: Two male 4-week-old Sprague Dawley rats were provided by the Laboratory Animal Center of Guangdong Medical College. Fresh healthy human blood was provided by the Department of Clinical Laboratory, Guangdong Medical College. METHODS: Rat BMSCs were isolated by adherent method and were passaged in vitro. Cells of passage 5 were pre-induced with Low glucose-dulbecco's modified eagle's medium (LG-DMEM) containing 0.3 mg/L all-trans retinoic acid and 10% fetal bovine serum. Twenty-four hours later, aforementioned LG-DMEM was discarded and LG-DMEM containing 0.6 mg/L all-trans retinoic acid was added to induce cells differentiation into neuron-like cells. Fresh healthy human blood was taken to prepare responding cells. Rat BMSCs, as stimulator cells, were included for one-way mixed lymphocyte reaction. Four groups were designated. Control group: 100 μL of responding cells at a concentration of 1×109/L; Experimental group 1:1×104 neuron-like cells + 100 μL of responding cells; Experimental group 2:1×105 neuron-like cells + 100 μL of responding cells; Experimental group 3:1×106 neuron-like cells + 100 μL of responding cells.MAIN OUTCOME MEASURES: Morphological observation of induce-differentiated cells, identification of nerve cells, and one-way mixed lymphocyte reaction results.RESULTS: Fifty minutes after addition of inducing medium, under the optical microscope, BMSCs exhibited a typical morphology of perikaryon. Three hours later, most of cells became into bipolar or multipolar neuron-like cell appearance with cell bodies and processes. Immunocytochemical staining results showed that majority of cells exhibited neuron specific enolase- and nestin-positive expression and glial fibrillary acidic protein-negative expression. Compared with the control group, radionuclide counts per minute were significantly reduced in each experimental group (P<0.05). There was significant difference in radionuclide counts per minute between experimental groups (P<0.05). With increasing BMSCs amount, the inhibitory effects on T lymphocyte proliferation were more evident.CONCLUSION: AII-trans retinoic acid can induce neuron-like cell differentiation of rat BMSCs in vitro. The neuron-like cells can inhibit human T lymphocyte proliferation in a dose-dependent manner.

Objective To explore the relationship between P-selection,nitric oxide(NO),high-sensitive-C-reactive protein(hs-CRP)and type 2 diabetes mellitus(T2DM)with macroangiopathy.Methods In sernm of 125 T2DM subjects(60 subjects with macroangiopathy and 65 subjects without macroangiopathy)and 55 normal controls,the activity of P-selection,NO and hs-CRP was detected by ELISA,Nitrate Reductase Assay and scattering immunoturbidimetric method,respectivley.Results The activity of serum P-selection and hs-CRP was significantly higher in diabetic macroangiopathie group than in non macroangiopathic group and control normal.Serum NO was significantly lower in diabetic rnacroanglopathic group than in non macroangiopathic group and control normal.Serum P-selection was positively correlated with hs-CRP-systolic blood pressure(SBP),LDL-C,and was negatively correla- ted with NO:P-selection,hs-CRP,LDL-C and SBP were independently risk factors for T2DM with macroangiopathy. Conclusion Determination of P-selection and NO is very important for prevention and diagnosis of diabetic mac- roangiopathy in early stage.

Objective To investigate the therapeutic effects, duration of hematopeietic depression and side effects of FLAG regimen for refractory and relapsed acute myeloid leukemia(AML). Methods 13 cases for 5 days, and granulocyte colony stimulating factor G-CSF 300 μg/d from day 0 till neutruphil recovery (ANC≥1x109/L). 13 patients were 8 males and 5 females. The median age was 41.8 years(range 28-67). It includes 5 relapsed AML patients and 8 refractory AML patients. Results Of the 17 times, 11 showed response to therapy; the rate of complete remission was 35.3 %(6/17); the rate of partial remission was 29.4 % (5/17) and the overall response rate was 64.7 %. Main toxicities were gastrointestinal side effects, myelosupression and the function of liver was lightly damaged. Neutropenia at lowest number began at the time of 5-12 days after regimen initiating and last 7-34 days, thrombocytopenia began at the time of 5-13 days and last 8-30 days. Conclusion FLAG regimen showed obvious effects for refractory and relapsed AML Most patients gained chance for hematopoietic stem cell transplantation. Hemotological and nonhemotological toxicities are acceptable.

The theory framework of "cognition- emotion-behavior" of the Gestalt Psychology is based on to build the conceptual model to integrate service encounter quality, customer consumption emotion and customer satisfaction. Such a model is also used to raise related hypothesis and verified against the backdrop of the medical service industry. Empirical outcomes prove the following: hospital service encounter quality consists such factors as environment dominance, doctor dominance and nurse dominance; in the course of their consumption in hospitals, patients undergo at the same time positive consumption emotion and negative consumption emotion, as the latter exerts negative impacts on the positive one; hospital service encounter quality bears significant impact on both patient' s consumption emotion and patient satisfaction; positive emotion and negative emotion both bear significant impacts on patient' s satisfaction.