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 .

10.3969/j.issn.1000-3606.2013.06.015

Objective To evaluate the fallopian tube patency with transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in diagnosis of infertility.Methods Taking laparoscopy and dye test as the reference standard,a total of 126 infertile women underwent both transvaginal real-time 3D-HyCoSy with SonoVue and laparoscopy.Bilateral fallopian tubes were dynamic observed.Results Transvaginal real-time 3D-HyCoSy showed that in clinical suspected infertility patients,125 fallopian tubes were patent,81 fallopian tubes were narrow and circuitous,and 37 fallopian tubes were obstructed.Among all the patients,60 cases (115 fallopian tubes) underwent laparoscopy with chromopertubation.The results showed that 10 fallopian tubes were patent,73 fallopian tubes were narrow and circuitous,and 32 fallopian tubes were obstructed.Taking laparoscopy and dye test as the reference standard,107 fallopian tubes of the 60 cases were diagnosed correctly,and the coincidence rate of 3D-HyCoSy and laparoscopy and dye test was 93.0％ (107/115).Taking laparoscopy and dye test as the gold standard,the accuracyof transvaginal real-time 3D-HyCoSy in diagnosis of fallopian tubes patency or obstruction was 93.0％(107/115),the sensitivity was 94.3％ (99/105),the specificity was 80.0％ (8/10).Conclusions Tansvaginalreal-time 3D-HyCoSy can provide dynamic,real-time and three-dimensional display of the fallopian tubes.Itcan get more accurate diagnostic information,so it's an important method.3D-HyCoSy is a safe and non-invasivemethod,so it plays an important clinical role in the screening,diagnosis and treatment of gynecological diseases.

Previous studies have suggested that glutathione-S-transferase π (GST-π) over-expression in the brain tissue is associated with refractory epilepsy. However, whether the change in GST-π level in the peripheral blood is in line with that in brain tissue remains unknown. This study examined the correlation between GST-π in brain tissue and that in peripheral blood in rat models of pilocarpine-induced refractory epilepsy. The animals were divided into drug-resistant group and drug-responsive group according to the response to anti-epileptic drugs. GST-π expression in brain tissue was immunohistochemically determined, while the expression of GST-π in peripheral blood was analyzed by Western blotting. In the hippocampus and cortex, GST-π was mainly found in the cytoplasm and membrane of neurons, and the GST-π expression level was higher in drug-resistant group than in the drug-responsive group and saline control group (P<0.05). Moreover, there was no significant difference between responders and saline control animals (P>0.05). The change in expression of GST-π in peripheral blood showed the same pattern as that in brain tissues, suggesting GST-π might contribute to drug resistance in epilepsy. Importantly, the GST-π over-expression in peripheral blood could be used as a marker for resistance to anti-epileptic agents.

Granulocyte colony-stimulating factor (G-CSF) has been demonstrated to have neuroprotective effects in rat model with focal cerebral ischemia through anti-apoptotic pathways and by promoting proliferation of neural stem cells. In the present study, we examined the neuroprotective effect of G-CSF in an acute focal cerebral ischemia rat model with lipid metabolism disorder. Eighty male SD rats were randomly divided into normal diet control group (NC group) and high-fat diet group (HFD group) (n = 40 in each). In HFD group, rats were fed on high fat diet to induce atherosclerosis. After 29 days, 4 rats from each group were sacrificed to evaluate the effects of different diets, and the middle cerebral artery occlusion (MCAO) was performed in the rest of the rats. MCAO rats received either G-CSF (50 μg·kg(-1)·mL(-1)) or phosphate buffered saline (PBS) injection through the external jugular vein for 5 days, which was followed by 5-bromo-deoxy uridine (BrdU, i.p., 50 mg/kg) injection for another 7 days. To evaluate the effects of G-CSF treatment on neurological function, the modified neurological severity score (mNSS) was calculated. The vascular distribution, ischemic cells proliferation, cell apoptosis and the expression of vascular endothelial growth factor (VEGF) were measured to determine the effects of G-CSF treatment. Our results showed that G-CSF-treated rats had a lower mNSS than PBS-treated rats in both NC group and HFD group. G-CSF injection promoted endothelial cell proliferation and vascular regeneration, and inhibited cell apoptosis. The serum and tissue levels of VEGF were significantly increased after G-CSF treatment. It is concluded that G-CSF exerts its neuroprotective effect in focal cerebral ischemia rats with hyperlipidemia by enhancing angiogenesis, promoting cells proliferation, decreasing cell apoptosis, and increasing local VEGF expression.

AIM: To investigate the effect of glomerular intercellular interaction under high glucose concentration on the production of reactive oxygen species (ROS) and transforming growth factor ?_1 (TGF-?_1) in co-cultured human ECV304 cells, and to study the intervention with tea polyphenols (TPs). METHODS: The endothelial cells were cultured alone or co-cultured with mesangial cells in high glucose media with or without TPs for 0 h, 12 h and 36 h, respectively. The activity of SOD and the content of MDA in the media of the system were detected by spectrophotometry. The expression of TGF-?_1 mRNA in the endothelial cells was measured by using semi-quantitative reverse transcription PCR (RT-PCR). RESULTS: High glucose decreased the activity of SOD, increased the content of MDA and up-regulated the expression of TGF-?_1 mRNA in co-cultured ECV304 cells and the effect became more prominent than the single-cultured cells. TPs interrupted it more effectively. CONCLUSION: These data suggest that there is interaction between mesangial cells and ECV304 cells under high glucose concentration. The interaction may markedly up-regulate the production of ROS and the expression of TGF-?_1 in co-cultured ECV304 cells. TPs may protect ECV304 cells by intervening intercellular interaction.