Objective To analyze types, mechanism and forensic identification for traumatic visual loss. Methods 109 cases of the evaluation for impairment and disability on traumatic visual loss were retrospectively analyzed, including interocular differences, anisometropia, left or right eye and the distributions of visual acuity, etc. Results The male-to-female ratio was 5.8:1, mainly 30~59 years of age. The ratio of monocular versus binocular injuries was 17.17:1. The ratio of left versus right injured eye was 1.39:1 in intentional injury cases. 115 eyes were injured, 83 of which were in low vision or blindness. 95 patients(87.16%) had large interocular differences( ≥ 3 lines). There were 9 patients with anisometropia from 2.25D to 6.00D and 23 patients with anisometropia larger than 6.00D. Conclusion Interocular differences and anisometropia are common in practice, which are not included in the expertise standard yet. Functional vision should be considered when developing the expertise standard.

Object To investigate the pathological changes,physiological condition,neurobehavior and motor development of the 3-day-old rats with ischemic brain injury.Methods Ninety six 3-day-old male Sprague-Dawley rats were randomly assigned to experimental and control groups.Occlusion of both carotid arteries was performed in the experimental group,while the rats in the control group only received skin incisions without carotid ligation.Physical examinations and neurobehavioral development of the rats were recorded daily from the first day after operation until 3 weeks after birth,including weight,eye opening, incisor eruption,ear unfolding,righting reflex,negative geotaxis,limb placing and grasping reflex. Specimens of the brain tissue were obtained in 24 hours after operation and 3 weeks after birth for the hematoxylin-eosin staining and immunohistochemistry staining to investigate the pathological changes.All the reaults were compared between the 2 groups.Results Compared with the control group,rats in the experimental group were found growth retardation,suppression of primitive reflexes and impaired motor abilities (P < 0.05 ).The brain tissue obtained from the rats after operation showed white matter rarefaction,liquefaction and microglia hyperplasia with Hematoxylin-eosin staining and myelin formation disorder with immunohistochemistry staining.Conclusions Ischemic brain injury of the 3-day-old rats could result the mental retardation,neurobehavioral and motor development disorder because of the white matter injury.

Objective To investigate the distribution of pathogenic bacteria,drug sensitivity,and the relationship between drug sensitivity and Escherichia coli(E.coli) induced enzymes in childhood diarrhea in the last 2 years in Chongqing area,so as to provide important evidence for pediatric clinical therapy.Methods Thirty-one E.coli induced enzymes,extended spectrum ?-laetamases(ESBLs),cephalosporinase(AmpC)detected in different phenotype methods,and drug sensitivity was measured in paper strip method,and the specimens were collected from children′s hospital affiliated to chongqing university of medical sciences from Jan.2005 to Dec.2006 were determined.Among the total,there were 18 enteropathogeic E.coli(EPEC) strains,8 enterotoxigenic E.coli(ETEC) strains and 5 enteroinvasive E.coli(EIEC) strains.In addition,drug resistance tests by paper strip included chloramphenicol(CHL),amikacin(AMK),gentamicin(GEN),norfloxacin(NOF),ciproflocacin(CIP),cefazolin(CEZ),cefoperazone(CPZ),ceftriaxone(CRO),ceftazidime(CAZ),cefotacime(CTX),cefepime(FEP),imipenem(IPM).SPSS 12.0 software was used to analyze the data.Results Three point two percent of the 31 E.coli were drug resistant to IPM,and 35.5%,38.7% to NOF,CIP individually,but more than 60% to AMK,GEN,even more than 67.7% towards cephalosporin(except ceftazidime and cefepime);the gross enzyme-produced rate was 87.1%,rate of single ESBLs,AmpC,and induction of both enzymes simultaneously presented 64.5%,6.5%,16.1% respectively;and there was marked difference in drug resistance when bacteria that produced single AmpC versus bacteria that produced single ESBLs or that produced both ESBLs and AmpC(Pa﹤0.05).Conclusions The relationships among enzyme′s quantity,sort and bacterial resistance are different.These data show E.coli infected by bacterial diarrhea children in Chongqing due to a high rate of induced enzymes,and their drug resistance vary according to the state of induced enzymes.

Objective To determine the minimum alveolar concentration(MAC) of sevoflurane without body movement during laryngeal mask airway(LMA)intubation in premature infants less than 37 weeks of corrected gestational age undergoing total inhalation general anesthesia induction.Methods Twenty-one ASA Ⅰ or Ⅱ premature infants less than 37 weeks of corrected gestational age undergoing elective inhalation general anesthesia were enrolled in this study.At first,the general anesthesia induction was started by inhaling 6 ％ sevoflurane.After the premature infant lost consciousness,the end tidal sevoflurane concentration(ET-sev)was adjusted to the predetermined concentration and maintained stable for 15 min.After that,LMA was inserted.The up-anddown sequential allocation was used to determine MAC.The initial ETsev was 2 ％,which was increased or decreased by 1 gradient concentration in the next case according to the LMA insertion body movement response.The adjacent concentration gradient was 0.2％.The midpoint from th body movement response to non-body movement response was set as the balance point and the mean value of the concentrations of sevoflurane at all the balance points were calculated as MAC.Results The end tidal sevoflurane con centration without the body movement responses to LMA insertion was 1.71％.Conclusion The MAC of sevoflurane without the body movement responses to LMA insertion in premature infants less than 37 weeks of corrected gestational age is 1.71％,which is lower than that in the normal children and probably because imperfect central nervous system development in premature infants.

Objective To investigates factors affecting the positive rate of blocking antibody treated by paternal lymphocyte immunotherapy in patients with recurrent spontaneous abortion (RSA).Methods From January 2008 to August 2012,326 RSA cases undergoing treatment in Infertility Center of Qilu Hospital were studied retrospectively.Those patients were divided into 2 groups randomly:260 cases in intradermal injection group were administered via bilateral forearm intradermal injections for immunotherapy once 21 days,then the blocking antibody was determined after 2 (23 cases),3 (73 cases),4 (74 cases),5(90 cases) times respectively,while in subcutaneous injection group,the 66 cases were administered via subcutaneous injection once 21 days,the blocking antibody measured after 3 times; In both cases,the blocking antibody was all determined 2 weeks later.The positive rate of blocking antibodies and the rate of successful pregnancy was recorded,and then followed up after the blocking antibody turning positive.Results (1)Positive rate of blocking antibodies:the positive rate of blocking antibodies were 17％ (4/23),58％ (42/73),72％ (53/74) and 84％ (76/90) in the 2,3,4,and 5 times of intradermal injection group,respectively (P ＜ 0.05).In subcutaneous injection group,the positive rate of blocking antibodies was 38 ％ (25/66),which was significantly lower than that in group intradermal injection receiving 3 times immunotherapy (P ＜0.05).(2) The rate of pregnancy:the 176 patients out of 200 patients were pregnant when antibody was positive after immunotherapy,with 71.6％ (126/176)of patients gained successful pregnancy(the length of pregnancy more than 5 months).Conclusions The route and frequency of administration of immunotherapy could influence the positive rate of blocking antibody.The rate of successful pregnancy will be increased after blocking antibody turning positive.

Objective To predict the risk of neonatal hyperbilirubinemia by transcutaneous bilirubin (TcB) nomograms and clinical risk factors.Methods Healthy term and late-preterm newborns (≥ 35 gestational weeks,and birth weight ≥ 2 000 g) born in Guizhou Maternal and Child Care Hospital between January 1,2013 and December 31,2013,were included.TcB levels were continuously recorded within 168 hours after birth.The value of hour-specific TcB nomogram combined with receiver operating characteristic (ROC)curves and Logistic regression model for predicting risk of hyperbilirubinemia was evaluated.Pearson's Chisquare test was also used for statistical analysis.Results A total of 5 250 cases were enrolled.TcB increased rapidly in the first 40 hours after birth,slowly increased between 40 to 96 hours,and reached a high level after 96 hours.Among them,the 95th percentile TcB stablized at 96 hours after birth.The 40th,75th and 95th percentile TcB peak levels were 173,217 and 248 μmol/L.Among the 5 250 neonates,there were 277 cases (5.3％) in the high-risk zone within 72 hours.The positive predictive value (PPV) was 22.02％;1 087 cases (20.7％) and 1 854 cases (35.3％) were in the medium-high risk and medium-low risk zones along with the PPV of 10.58％and 3.72％,respectively.There were 2 032 cases (38.7％) in the low-risk zone with the PPV of 1.38％.Multivariate analysis showed that the TcB high-risk zone after 72 hours was associated with gestational age,delivery mode,feeding mode and TcB level of risk zones within 72 hours.Compared to those born at ≥ 40 gestational weeks,those born at ≥ 37-＜40 gestational weeks were more likely in the TcB high-risk zone after 72 hours (OR=1.80,95％CI:1.29-2.51).The likelihood was reduced by 42％ among neonates born with cesarean section compared to those delivered vaginally in term of the TcB high-risk zone after 72 hours.Infants who received mixed feeding were less likely to be in the TcB high-risk zone after 72 hours when compared to breastfed infants (OR=0.51,95％CI:0.29-0.88).With the reduction of the high-risk zone level within 72 hours,the likelihood in the TcB high-risk zone after 72 hours was also decreased.ROC curve showed that the area under the curve (AUC) for predicting hyperbilirubinemia was 0.75 and its 95％CI was 0.72-0.78,with a sensitivity of 90.00％ and specificity of 40.00％.The AUC of a combination of predictive results obtained by the Logistic regression model with significant variables in univariate analysis and high-risk zone after 72 hours was 0.66,and its 95％CI was 0.62-0.69.AUC estimated by Logistic regression model according to the TcB levels of risk zones within 72 hours combining with clinical risk factors was 0.79,and its 95％CI was 0.76-0.82 (P＜0.01).Conclusions Hour-specific TcB nomograms of newborns in our hospital have been obtained,which facilitates the prediction and early intervention of neonatal hyperbilirubinemia.

Objective To explore the risk factors influencing the prognoses by analyzing clinical data of patients with acute paraquat intoxication,and provide a basis for clinical prevention and treatment of the disease. Methods The clinical data of 176 patients with acute paraquat intoxication admitted into our Hospital were retrospectively collected during the period from January 2012 to February 2013. After admission,the conventional medical treatment was given to all the patients,and according to the prognoses of 28 days after poisoning,the patients were divided into death group and survival group. The gender,age,toxic dose,time elapsed from poisoning to admission,time elapsed from poisoning to gastric lavage,number of cases treated with drug lavage,white blood cell count(WBC),alanine amino-transferase(ALT),aspartate amino-transferase(AST),blood urea nitrogen(BUN), serum creatinine(SCr),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ)score,carbon dioxide combining power(CO2CP),number and time of cases revealing arterial blood oxygen saturation(SaO2)<0.90, and the survival rate within 28 days after admission were recorded. Multivariate logistic regression was used to analyze the factors related to the prognosis. Results ①Of the 176 cases,96 survived and 80 died in 28 days,the survival rate being 54.55%.②Univariate analysis showed the poisoning dose(ml),time elapsed from poisoning to admission (minute), WBC(×109/L), ALT(U/L),AST(U/L),BUN(mmol/L),SCr(μmol/L),APACHEⅡ scores, CO2CP (mmol/L),number of cases with SaO2<0.90 in the survival group were significantly lower than those in the death group〔38.14±39.44 vs. 88.50±58.79,41.11±30.29 vs. 90.00±59.31,11.78±3.61 vs. 16.13±5.02,84.46±42.53 vs. 156.35±76.62,76.21±38.69 vs. 184.00±86.48,5.34±2.89 vs. 10.51±6.80,84.17±77.38 vs. 199.74±162.13, 0.96±1.60 vs. 3.60±2.61,22.02±4.47 vs. 18.35±4.19,4(4.17%)vs. 80(100.00%),respectively,all P<0.01〕;there were no statistically significant differences in time elapsed from poisoning to admission(hour),number of cases treated with drug lavage and time of revealing SaO2<0.90(day)between survival group and death group〔7.96±3.39 vs. 8.05±4.26, 20(20.83%)vs. 24(30.00%), 62.25±18.45 vs. 65.70±45.10,respectively,all P>0.05〕.③Multivariate logistic regression revealed poisoning doses>30 ml〔odds ratio(OR)=6.455,95% confidence interval(95%CI)3.177-13.113,P<0.001〕,time elapsed from poisoning to admission>30 minutes(OR=8.639, 95%CI 4.043-18.461, P<0.001), WBC>12×109/L (OR=2.745,95%CI 1.388-5.426, P=0.004),BUN>8 mmol/L(OR=6.713,95%CI 2.650-17.006,P<0.001)and CO2CP≤22 mmol/L(OR=4.737,95%CI 2.389-9.394, P<0.001) were the risk factors correlated with the prognosis of patients with acute paraquat intoxicationl. Conclusion Poisoning doses,time elapsed from poisoning to admission,BUN,CO2CP and WBC are the independent risk factors for predicting prognosis of acute paraquat intoxication.

Objective To explore the in vitro isolation of ?2m-/Thy-1+ bone marrow-derived liver stem cells(BDLSCs) which bear double features of stem and liver cells from bone marrow stem cells(BMSCs)as so to provide suitable donor cells for the treatment of liver diseases by cellular transplant. Methods ?2m-/Thy-1+ BDLSCs were isolated by magnetic bead cell sorting(MACS) method from cholestatic rats in vitro,and cell purity was detected using flow cytometry.Liver associated phenotype markers were characterized by RT-PCR and immunofluorescence staining. Results BDLSCs isolated by MACS were purified and viable,and possessed hepatocyte-like features at gene and protein levels. Conclusion ?2m-/Thy-1+ BDLSCs are special subsets of BMSCs which may have promising potentials in the stem cell-based treatment of liver diseases.

Objective To identify the isolated rat bone marrow derived mesenchymal stem cells(MSCs),and evaluate the efficiency of adenoviral vector expressing human urokinase type plasminogen activator(uPA) in transfection of rat MSCs and its effect on proliferation of MSCs. Methods MSCs were isolated and purified by pasted wall purification,and were identified by immunicytochemistry.The transfection efficiency of uPA was detected by fluorescent microscopy,the expression of uPA in MSCs was detected by Western blotting,and the proliferation of MSCs was evaluated by MTT. Results The harvested MSCs exhibited the typical appearance of MSCs,and it was revealed by immunohistochemistry that the expression of MSCs markers CD29 and CD90 was positive,while that of CD34 and CD45 was negative.A tendency of increase in expression of green fluorescent protein(GFP) was observed with increase of multiplicity of infection(MOI).After transfection with AduPA for 72 h,the transfection efficiency reached(94.0?1.5)% at MOI of 80,and positive GFP cells could still be observed even after 7 d.The transfected uPA had no effect on the proliferation of MSCs. Conclusion MSCs are favourable genetic vectors to express uPA,and can be used for treatment of liver fibrosis.

AIM: To evaluate the efficacy and complications of intravitreal injection of triamcinolone acetonide ( TA ) for the treatment of macular edema caused by pre-retinal membrane of the macular.
METHODS: Totally 23 patients ( 24 eyes ) with macular edema caused by pre-retinal membrane of the macular were treated withintravitreal injection of 4mg TA. Best-corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) , slit - lamp examination, fundus fluorescein angiography ( FFA ) and optical coherence tomography (OCT) were performed before and after treatment. The SPSS 12. 0 software was used for statistical analysis.
RESULTS: After 10, 30, 90d of treatment of TA, as compared with before treatment, visual acuity improved significantly ( P<0. 05 ), and central macular thickness (CMT) was significantly thinner (P<0. 01). The average central macular thickness decreased from 522 ± 126μm before treatment to 264±115μm, 245±128μm, 286±131μm at 10, 30, 90d after treatment. Macular edema reduced. IOP increased in 7 eyes ( 29%) , one cataract case, no other complications associated with vitreous injection.
CONCLUSION: Intravitreal injection of TA in the treatment of macular edema caused by pre - retinal membrane of the macular is simple, safe and easy to operate. It can quickly reduce macular edema, and improve the visual acuity in the short term. Part of patients may recur after injection in the first half of the year.