Objective To improve the phacoemulsification (PHACO) technical level and management level for hospitals and to support the health decisions of health administration departments , we establish an index system of PHACO quality control of Guangdong province. Methods We determined the critical value , screened indicators and calculated the weight value with a method of literature analysis , Dephi method , percentile method, correlation coefficient and so on. At last, we tested the content validity through literature research and expert opinions and tested construct validity of the indicator system using factor analysis. Results An index system of PHACO assessment of 5 first grade indicators , 11 second grade indicators and 20 third grade indicators was established. Reliability analysis showed that three rounds of positive coefficient were 80.00%, 90.00% and 92.59%. Experts' authority coefficient was ranged from 0.710 to 0.921. Coefficient of concordance were 0.400 , 0.395 and 0.278 (P < 0.01). The standardized Cronbach α was 0.837 and the construct validity was good. The corresponding rate between simulation results and expert assessment was 94.55%. Conclusions It is reasonable and practical to use Delphi method to construct the index system of PHACO assessment. Reliability and validity of the index system and empirical application indicate the feasibility of its practical application.

Objective To study the changes and mechanism of calcaneal quantitative ultrasound (QUS)and the bone mineral density( BMD) of AP lumbar spine( L 2-L 4 ) in elderly patients with type 2 diabetes mellitus. Methods Calcaneal broadband ultrasound attenuation ( BUA) ,sound of speed ( SOS ) and stiffness( STI) by QUS ,BMD of the AP lumber spine by dual energy X-ray absorptometry ( DXA ) and some biochemical markers of bone metabolism in elderly patients with type 2 diabetes mellitus ( n=94 )and in healthy control group ( n=90 ) were measured . Results L 2 BMD values(g/cm 2)of male group with type 2 diabetes mellitus was 0.863, which was lower than that of control group ( 0.931, P

Objective To discuss the medical treatment responsibility caused by unpredictable harm.Method In medical treatment,the court usually applies the "Equitable Responsibility" principle to settle the medical conflicts caused by unpredictable harm,this poses certain limitations.Result The fact that hospitals being liable for compensation or reparation ignores the mutual risk-sharing responsibility of hospitals and patients.Conclusion To establish the system of medical accident insurance is one of the best measure to solve the medical conflicts caused by unpredictable harm.

Objective To observe the effect of stellate ganglion block on patients with cerebral infarction.Methods36 patients with cerebral infarction were randomly divided into the control group and research group.Both two groups were treated with traditional treatment.The research group was added with stellate ganglion block.ResultsAfter 20 days treatment,the Neuro-function Deficit(NFD) scores of both two groups were significantly lower than that before treatment(P<0.01);but the NFD scores of the research group were significantly lower than that of the control group(P<0.01).The scores of Fugl-Meyer Assessment(FMA) and Barthel Index(BI) of both two groups were significantly higher after treatment(P<0.01);but the scores of FMA and BI of the research group were significantly higher than that of the control group(P<0.01).ConclusionStellate ganglion block can improve the nerve function of patients with cerebral infarction.

Objective To investigate the neural proliferation , differentiation and apoptosis of the developing spinal cord of the mouse and to discuss the mechanism of spinal cord ’ s development .Methods 5-Bromodeoxyuridine ( BrdU) assay was used to mark the proliferative neural stem cells , and the immunofluorescent stainings ( DCX, NeuN and Caspase8) were carried out to visualize the newborn neurons , mature cells and apoptotic cells in the spinal cord with 173 mice arrange from E18 to P90.Results BrdU positive neural stem cells appeared evenly in the spinal cord at early days . With age increasing , the neural stem cells differentiated into neuroglial cells and neurons .The newborn neurons in the subventricular zone migrated toward the intermediate zone ( putative gray matter ) and differentiated into mature neurons gradually .With neurons ’ concentrating towards the center , the gray matter formed an “H” shape .In the meantime , with neural differentiation , some apoptotic neurons appeared among the newborn neurons and mature neurons . Double immunostaining showed that most apoptotic neurons were newborn neurons , suggesting the neuroapoptosis more likely occurred in newborn neurons .The statistical data showed that the number of DCX , NeuN and Caspase-8 positive cells reduced with age increasing , suggesting neural differentiation and neuroapoptosis decreased during spinal cord ’ s development .Conclusion Neural proliferation , neural differentiation and neuroapoptosis occur in developing spinal cord . They work together to regulate the formation and development of the spinal cord .

Objective To investigate the clinical features of urothelial carcinoma in a single center.Methods The clinical data of 2 115 urothelial carcinoma patients admitted to Peking Union Medical College Hospital from January 2003 to December 2012 were reviewed retrospectively.Of the 2 115 patients,1414 cases were bladder carcinoma,329 cases were ureter carcinoma and 372 cases were renal pelvic carcinoma.Statistical method was used to analyze the differences of distribution and pathological grading and staging of bladder,ureter and renal pelvic carcinoma among different ages,genders,and urban and rural patients.Results The proportion of low-grade carcinoma was 83.5％ for bladder,68.7％ for ureter and 46.5％ for renal pelvic carcinoma,and the proportion of non-muscle invasive carcinoma was 84.9％,74.8％ and 59.7％ respectively,and significant difference was found in pathological grading and staging among the three groups (P =0.000).In bladder and renal pelvic carcinoma patients,males were common,while females were more common in ureter carcinoma patients.There was significant difference in gender among the three groups (P =0.000),while there was no significant difference in pathological grading and staging between male and female patients(P＞0.05).89.7％ (1 898 cases) were concentrated in the 41-80 years old.The grading and staging of urothelial carcinoma in young,middle-aged and elderly groups showed significant difference (P＜ 0.05).The proportions of high-grade and muscle invasive urothelial carcinoma patients in rural areas were both higher than that in urban areas,the difference in pathological grading and staging between urban and rural patients was significant (P＜0.05).Of the 129 cases (6.1％) with multifocal urothelial carcinoma,there were 89 cases (70.0％) with high grade and 62 cases (48.1％) with muscle invasive carcinoma.Significant difference was found in pathological grading and staging between multifocal and single urothelial carcinoma (P=0.000).Conclusions In the uretholial carcinoma of Peking Union Medical College Hospital in the past ten years,the proportion of bladder carcinoma is the highest,while ureter and renal pelvic carcinoma have higher proportion of high grade and stage.The proportion of patients in the 41-80 years old is higher.The pathological grading and staging of urothelial carcinoma is positively correlated with age,but there is no significant correlation in gender.The patients with high grade and stage carcinoma in rural areas are more than that in urban areas.Multifocal urothelial carcinoma has higher malignancy.

Objective: To reveal the therapeutic effect of acupuncture-moxibustion therapy for the treatment of post-stroke shoulder pain. Methods: Ninety patients with post-stroke acupuncture-moxibustion therapy (AM), acupuncture-moxibustion plus Chinese herbal decoction (AMCH), and Chinese herbal decoction (CH) respectively. Results: In the comparison of the therapeutic effects and blood viscosity, there was significant difference between the AM and CH group, as well as between the AMCH and CH group (P＜0.01); the difference was not significant between the AM and AMCH group. Conclusion:Acupuncture-moxibustion is an effective therapy in the treatment of the post-stroke shoulder pain, and it can also reduce the blood viscosity in short-term.

Objective Candidas rank as the second factor of deep fungal infection .This study aimed to investigate the rela-tionship between Candidas and melanin by screening clinically isolated melanin -producing Candidas . Methods We incubated 360 strains of clinically isolated Candidas with caffeic acid , DOPA agar , and minimal medium at a temperature of 35℃, with Cryptococcus neoformans as the positive control .We observed the changes in the culture media using transmission electron microscopy (TEM) and electron spin resonance ( ESR) spectroscopy . Results Cryptococcus neoforman produced pigmentation in all the three types of medi -um.At 5 days, a standard strain of Candida albicans SC 5314 turned dark brown in the DOPA agar and minimal medium and , at 10 days, 12 and 15 of the 360 Candida strains turned dark brown in the DOPA agar and minimal medium , respectively, which were not shown to be melanin by TEM and ESR spectroscopy . Conclusion Culture media are not reliable enough for the identification of mel-anin-producing Candidas , and the observations need to be further verified by TEM and ESR spectroscopy .

In this study, we explored the establishment of the database of Chinese medicine and minimally invasive surgery (MIS) for tumor based on the internet, thus to promote the application of Chinese medicine in the comprehensive treatment for tumor. The database was composed of general information database, Chinese medicine database, MIS database, which was characterized by the internet-based information system structure. Data exchange between net server and remote terminal can be achieved through the firewall. The results of testing performance showed that the established database can realize the real-time share of case report, and is convenient in basic retrieve and information analysis function, indicating the feasibility and stability of the database.

OBJECTIVE:To establish a HPLC method for the determination of 5-fluorouracil in human plasma METHODS:The plasma samples were extracted with ethyl acetate-isopropanol(85∶15,V/V)following precipitation of plasma proteins with ammonium sulfate The solvent was evaporated to dryness under a stream of nitrogen The dry extract was dissolved in mobile phase and then injected into the Diamonsil C18 column(150mm?4 6mm,5?m)and 0 01mol/L KH2 PO4(pH5 5) was taken as mobile phase The flow rate was 1 5ml/min,UV detection wavelength was 267nm The internal standard was 5-bromouracil RESULTS:The minimal detectable drug concentration in plasma was 0 025?g/ml The calibration curve was linear over a range from 0 3?g/ml to 10?g/ml The intra-day RSD≤5 0%(n=5) and the inter-day RSD≤11 5%(n=5) CONCLUSION:The method can be used for studying the pharmacokinetics and bioavailability of 5-fluorouracil