Glaucoma is a degenerative disease of the retina and the optic nerve.The apoptosis of retinal ganglion cells is the pathological basis of glaucoma,but its mechanism has not been fully elucidated.Currently,a large number of studies in vivo and in vitro have demonstrated that retinal glial cells (including Müller cells,astrocytes and microglial cells) are closely related to the development of glaucoma.Retinal glial cells not only release active factors but also express various neurotransmitter receptors,ion channels,surface markers and effector molecules.Therefore,they are actively involved in neuronal information transmission in addition to the traditional view of the role of nutritional support for neurons.In glaucoma,retinal glial cells are activated to undergo a great number of changes in physiology,biochemistry and morphological features.These activated cells initiate different signaling cascades that may serve as a protective role.Meanwhile,they may release toxic factors to start or aggravate the damaging effects on retinal neurons.Usually,both effects occur in glaucoma in parallel,but the underlying mechanisms and signaling pathways are still not clear.More research is needed to understand that how the retinal glial cells are able to rebuild the neuronal function after injury or to promote the neurodamage.With all these unresolved issues in mind,the progress in the study of the mechanism of Müller glial cells,microglial cells and astrocytes participating in the glaucomatous disease were reviewed.

Nitric oxide (NO) is the most important known endogenous vasodilator factor. The competitive inhibitor asymmetric dimethylarginine (ADMA) of endothelial nitric oxide synthase (NOS) inhibits NO synthesis, which makes NO/NOS pathway to be obstructed and the reduction of NO synthesis. The studies in recent years have suggested that ADMA is as-sociated with the occurrence and development of diabetes with cerebrovascular disease. It has provided new insights into further clarifying the mechanism of the disease.

Flipping the classroom is a new teaching mode in which the students learn some-thing through the network autonomous learning before class, in classroom students interact with teach-ers, internalized and absorb what they have learned, and then consolidate it after class. So it can resultin real-timeevaluation of learning effect by different means, different objects and form and can ef-fectively give secondary feed back comments, which has important significance for the improvement of teaching and learning effects at all levels. Article discusses how to effectively use formative assess-ment method to conduct effective monit oringand feed back to improve the flipped classroom activi-ties. It also explore show to strengthen and exercise their student's ability in the application process.

Cariostatic Agents ; therapeutic use ; China ; Dental Caries ; prevention & control ; Fluorides ; therapeutic use ; Health Promotion ; Humans ; Oral Health

Coronary Restenosis ; Drug-Eluting Stents ; Humans

BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy. METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups. RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased. CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.

Arterial Occlusive Diseases ; diagnosis ; etiology ; Coronary Disease ; complications ; diagnosis ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged

Objective To compare the effects of butorphanol,midazolam and innovar on relieving appendix traction response during appendectomy. Methods Sixty-eight patients who underwent appendectomy were randomly divided into butorphanol group(n=21),midazolam group(n=23) and innovar group(n=24).Butorphanol,midazolam and innovar were intravenously administered to patients during skin incision.The appendix traction response,sedation score,heart rate(HR),mean arterial pressure(MAP) and pulse oxygen saturation(SpO2) were recorded and compared among groups.Results Compared with those before operation,there was no significant changes in HR,MAP and SpO2 during operation.The effective rates of butorphanol,midazolam and innovar in relieving appendix traction response were 95.2%,65.2% and 50.0%,respectively.Butorphanol surpassed midazolam and innovar in sedation and relieving appendix traction response(P

In the context of higher medical education reform in our country,to vigorously promote the development of teachers' teaching work can promote the improvement of teachers' teaching ability and level.This study describes the history of the development of teacher education at home and abroad,introduces the form and content of teachers' workshops,seminars,micro courses and lesson study,and compares the form and content of teacher education at home and abroad,which provides scientific reference and basis for the introduction of policies of China's education related departments and the construction of the teacher development alliance between universities and colleges.

Objective To study the feasibility and efficacy of minimally invasive repair for pectus excavatum in adult patients. Methods A total of 23 patients with pectus excavatum aged 18-38 years(mean 24.1?6.6) were treated in our hospital from June 2006 to June 2008.On admission,21 of patients had never been treated,and 2 patients were recurrent cases after Ravitch surgery;the Haller index of the cases ranged from 3.2 to 7.5(mean 4.38?1.16);type I pectus excavatum was diagnosed in 14 of the patients(60.9%) and type II in the other 9(39.1%).Under general anaesthesia with the patients at supine position,two 3-cm incisions were made along the bilateral mid-axillary line at the level of the most pronounced sternal depression.Then,a conductor was penetrated into the mediastinum from the right to the left at almost the same level.After establishing artificial pneumothorax by CO2 gas,a pectus bar(Lorenz) was placed through the mediastinum under the guidance of thoracoscopy.Afterwards,a stabilizer was used to fix the bar at the right side.Both the stabilizer and the bar were fixed to the muscle layer.Chest X-ray was performed to observe the stabilizer and the bar after the operation. Results Among the cases,the procedure was successfully completed in 22 patients.In the other patient,the pericardium and the right atrial appendage were injured,and we had to enlarge the incision for haemostasis.All of the patients were uneventful after the operation.No incisional infection or bar displacement occurred during the perioperative period.During a mean of 16-month follow-up(range 3-24 months),the symptom of chest distress was significant improved,and the cosmetic results were satisfying in 87% of the patients(20/23).Conclusions Minimally invasive repair is feasible and effective for adult patients with pectus excavatum.