Background Identifying and testing of pain is very necessary for the care and decrease of the suffering of experimental animal in medical experiment.Effective method for testing the pain and distress status of experimental animal with eye disease is still absent in China.Objective This pilot study was to establish an evaluating system for assessing the pain and distress status of bullous keratopathy rabbit model.Methods This study was approved by the Ethic Committee of Beijing University First Hospital.Twelve healthy New Zealand rabbits were selected in this experiment.Bullous keratopathy model was established in the left eyes of 9 rabbits by scraping corneal endothelium as the experimental team,and other 3 rabbits were served as the control team.The cornea lesion was examined by manipulate slit lamp,and the central cornea thickness (CCT) was measured by ultrasound biomicroscopy (UBM).Weight+20 Indexes For Pain and Distress Status Referring Guidelines for Pain and Distress in Laboratory Animals made by International Animal Care and Use Committee (IACUC) were assessed and measured as well.Results Corneal edema and opacity were obvious 1 day after surgery.Corneal bullous appeared from the third day after surgery,and cornea erosion was seen at the location of bullous breakage.The corneal lesions remained until 14 days after surgery.CCT value was (1468±100),(2313±588),(2391±271) and (2362±151) μm,respectively in day 1,3,7 and 14 after the establishment of models,which showed significant increase in comparison with the preoperative CCT (390±6)μm (all P=0.000).However,no significant difference was seen in the CCT between day 3,7 and 14 (P＞0.05).Body weight of the rabbits was (3.29±0.20),(3.20-0.17),(2.77±0.25) and (3.10±0.30)kg respectively in day 1,3,7 and 14 after operation,with significant decrease in comparison with the pre-operative weight (3.52-0.18)kg in the experimental team (P=0.008,0.007,0.003,0.004).The scores for pain and distress status of all rabbits in pre-operation of the experimental team and in the control team were zero,and the score was 7 (7,7),11 (10,12),9 (8,10),9 (9,9)in day 1,3,7 and 14 in the experimental team after surgery,with the highest score in day 3,which was bullous and bullous breakage duration.Seven of twenty indexes,including the reduce of diet and drinking,self-imposed isolation/hiding,grinding teeth,aggression,deceased movement,abnormal posture,vocalization occurred in the model animals after surgery.Conclusions Weight+20 Indexes For Pain and Distress Status is an effective,impersonal and quantitative method for observing and evaluating the pain and stress status in bullous keratopathy rabbit.

ObjectiveTo investigate the influence of timing of definitive operation on prognosis of patients with iatrogenic bile duct injury (IBDI). MethodsThe clinical data of 38 patients with IBDI were retrospectively analyzed. Of the 38 patients, the injury happened in 7 patients in our hospital while 31 patients were transferred in from other hospitals. We analyzed the previous operative records, the clinical manifestations of the patients, the radiological images and our operative findings in the definitive operations. According to the timing of the definitive operation, the patients were divided into the intraoperative repair group (n=26), the early repair group (n=15) and the delayed repair group (n=17). ResultsPatients in the intraoperative repair group had the best short-and long-term results, the shortest length of hospital stay and the lowest total cost. The early repair group, though having worse Results than the intraoperative repair group was still better than the delayed repair group. However, early detection of injuries and the ability to carry out timely corrective procedures depended on the availability of surgical expertise in the hospital. ConclusionsThe timing of definitive operation to provide corrective surgery to IBDI was a vitally important factor which affected prognosis.It is best to repair the injury within the same operation. The repair should be carried out by a doctor with ample experience in bile duct surgery.

Objective To investigate the diagnostic value of ADC in the evaluation of small round cell malignant tumors(SRCMT) of nasal and paranasal sinus.Methods This study included 143 patients with surgically confirmed SRCMT and Non-SRCMT of nasal and paranasal sinus between 2008 and 2015, all patients underwent diffusion weighted MRI at 3.0 T with a b factor of 0 and 1 000 s/mm2.Quantitative analysis of ADC values was performed.Difference in ADC values between SRCMT and Non-SRCMT was evaluated using the independent samples t test.One-way analysis of variance(ANOVA) test was performed to compare the ADC values of SRCMT.Receiver operating curves (ROC) were developed to determine the cutoff points to differentiate SRCMT from Non-SRCMT.Results There were 98 SRCMT, of which 20 lesions were rhabdomyosarcoma(RMS), 19 lesions were non-Hodgkin's lymphoma(NHL), 4 lesions were malignant melanoma(MM), 14 lesions were neuroendocrine carcinoma(NEC), 12 lesions were Ewing sarcoma or primitive neuroectodermal tumor(EWS or PNET), 11 lesions were extramedullary plasmacytoma(EMP), and 8 lesions were olfactory neuroblastoma(ON).There were 45 Non-SRCMT, of which 28 lesions were squamous cell carcinoma(SCC) and 17 lesions were adenoid cystic carcinoma(ACC).The mean ADC value of SRCMT[(0.66 ± 0.12) × 10-3mm2/s] was significantly different (t=14.97, P＜0.01) from Non-SRCMT [(1.02± 0.16)× 10-3mm2/s].All of 7 kinds of SRCMT were divided into 3 groups according to ADC values: NHL,MM, NEC,EMP;RMS,EWS,PNET;ON.There was statistically significant difference among all 3 groups(F=39.743, P＜0.01), and the differences between any 2 groups were still statistically significant.The area under the ROC of ADC values diagnosing SRCMT was 0.975.Compared with pathological results, an ADC value of 0.82 × 10-3mm2/s was used as the threshold for diagnosing SRCMT with a sensitivity of 97.8％ (44/45),specificity of 89.8％(88/98), and accuracy of 92.3％ (132/143).ADC value had high correlations compared with pathological results (Kappa value was 0.831).Conclusion The ADC value is a non-invasive imaging parameter that can be used to effectively assess SRCMT of nasal and paranasal sinus.

This study researched the results transformation problem in medical universities,sorted the current situation in this filed,analyzed the causes of the low transformational rate.Then by referring to the domestic and overseas experience,the author designed the classified transforma tional path of medical research results according to their respective features,finally put forward policy suggestions for institutional guarantee policy to promote the transformation of medical universities.

In the past,it is always believed that routine drainage after pancreaticoduodenectomy (PD) is one of the most crucial methods to prevent and detect postoperative complications and to reduce mortality.However,in more recent years,with the development of fast track surgery,scholars in pancreatic surgery have investigated the necessity of drainage after PD together with its merits and faults.Therefore,this paper gives a brief review on this topic.

Objective To investigate the effect of electromyographic biofeedback motion sensing game on upper limb function in chil-dren with obstetric brachial plexus palsy (OBPP). Methods From March, 2013 to February, 2014, 41 children with OBPP were randomly as-signed into conventional rehabilitation group (n=21) and motion sensing game group (n=20). Both groups underwent a comprehensive course of rehabilitation, and the motion sensing game group received upper limb occupational therapy in the motion sensing game, for four weeks. They were assessed with Mallet shoulder function scale and the surface electromyogram (EMG) of the deltoid muscle when abduct-ing the shoulder before and after treatment. Results Before treatment, there was no significant difference in the Mallet scores between two groups (t=0.730, P>0.05), the scores improved after treatment in both groups (t>5.085, P<0.05), and the scores after treatment and the D-val-ue scores before and after treatment were higher in the motion sensing game group than in the conventional rehabilitation group (t>3.195, P<0.01). The integral EMG (iEMG) value, average EMG (aEMG) value and maximum EMG (EMGmax) value of the deltoid muscle improved in the motion sensing game group after treatment (t>4.420, P<0.05), however, only aEMG and iEMG improved in the conventional rehabili-tation group (t>2.282, P<0.05). All of them after treatment and the D-value were higher in the motion sensing game group than in the con-ventional rehabilitation group (t>2.155, P<0.05). Conclusion Electromyographic biofeedback motion sensing game therapy plays a role in the rehabilitation of upper limb function and muscle strength in children with OBPP.

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis which is closely related with abnormal autoimmune.To some extent,it is too difficult to identify the diagnosis between AIP and pancreatic cancer.The treatment includes hormone therapy and surgery.In this article,based on accumulating the experience in the diagnosis and treatment of AIP cases for many years and reviewing the related literatures,we evaluate its type,the etiology and the clinical presentations,as well as summarize the typical characteristics of pathology,radiology and serology.

Objective To evaluate and monitor the efifcacy of GnRH analogs (GnRHa) therapy. Methods Thirty girls with central precocious puberty diagnosied by LHRH stimulation test were treated with GnRHa for 6-24 months. The LHRH stimula-tion test were performed again at 3 months after initiation of therapy and then every 6 months during treatment. The relationship of peark LH and clinical suppressing pubertal (including Turner stage, bone age, grwoth speed) were compared. The monitor effect of peak LH to efifcacy of GnRHa were eveluated. Results Ninety LHRH stimulation tests were performed, only 7 cases were found to have clinical pubertal development. After 6 months treatment, the base LH level of thirty girls (0.48±0.20) IU/L was signiifcantly lower than that before the treatment (0.75±0.35 IU/L) (P=0.000). The correlation coefifcient between base LH and peak LH was 0.62. The best correlation between clinical suppressing pubertal and LHRH stimulation test was achieved when peak LH was less than 2 IU/L (85.7%sensitivity, 100%speciifcity). Conclusions Base LH value can be used in preliminary as-sessment of the efifcacy of GnRHa therapy for girls with central precocious puberty. The peak LH less than 2 IU/L can be as the indicator of treatment efifcacy.

Objective To investigate the diagnosis and treatment of intraductal papillary mucinous neoplasm (IPMN) of the pancreas.Methods The clinical data of patients with pathologically verified IPMN who underwent surgical treatment between January 2006 to April 2014 in the First Affiliated Hospital of Harbin Medical University were studied retrospectively.There were 27 males and 21 females.The average age was (57.8 ± 8.8) years old.The average caliber of the main pancreatic duct was (1.1 ± 0.6) cm.The average size of the branch duct IPMN was (4.6 ± 1.5) cm.Results 35 patients underwent pancreaticoduodenectomy.Eight patients underwent distal pancreatectomy.Two patients underwent duodenum-preserving pancreatic head resection.Two patients underwent splenic-preserving distal pancreatectomy and one patient underwent total pancreatectomy.No patient died in perioperative period,and the median length of hospital stay after surgery was 14.3 days.Postoperative pathological examination revealed 5 (10.4％) adenoma,12 (25.0％) moderate-grade dysplasia,14 (29.2％) high-grade dysplasia and 17 (35.4％) invasive carcinoma.The postoperative complication rate was 22.9％.The mean follow up period for the noninvasive tumors was 48.9 months,with no recurrence or deaths.The mean follow up period of the invasive tumors was 43.2 months,with 1 death and no recurrence.Conclusions The indications for resection of IPMN should be based on treatment guidelines and on the patient' s general condition.It is suggested that the diagnosis and treatment of IPMN should be conducted in specialized pancreatic surgery centers.

Objective To explore the factors influencing the recovery of ability in the activities of daily living (ADL) after intracerebral hemorrhage. Methods A total of 108 patients with intracerebral hemorrhage admitted for rehabilitation to the rehabilitation medicine department of Huashan Hospital between January 2007 and June 2011 were studied.Twelve items of clinical data were collected with regard to the patients' medical history,physical status,modified Barthel index (MBI) score and Brunnstrom stage at admission.Functional status was classified according to the MBI scores and Brunnstrom stages assessed at admission and before discharge.Linear regression analysis was used to relate the variables. Results After rehabilitation,the MBI scores and Brunnstrom stages had improved relative to the scores at admission.Factors influencing the MBI improvements included the intervention timing of rehabilitation and the course of therapy employed. Conclusions It is very important to comprehend the factors influencing the recovery of ADL ability after cerebral hemorrhage in order to design effective rehabilitation strategies,better predict functional outcomes and improve patients' ADL ability effectively.