Objective To investigate the effects of silymarin on expressions of nuclear factor kappa B(NF-?B) and intercellular adhesion molecule-1(ICAM-1) in the kidneys of rats with unilateral ureteral obstruction(UUO)-induced renal fibrosis.Methods Seventy-two male Sprague-Dawley rats were randomly divided into 3 groups: sham-operated group(n=24),operated group(n=24) and silymarin treated group(n=24).Renal tubulointerstitial fibrosis model was established via UUO.Silymarin was given by gavage with 30 mg/(kg?d) in silymarin treated group,and the same volume normal saline was given by gavage in operated group and sham-operated group.In each group,8 rats were killed at 7,14 and 21 d after operation.Histological changes were observed in tubulointerstitial injury under microscope.The expressions of NF-?B and ICAM-1 in renal tissue were determined with immunohistochemical method.Results Tubuloin-terstitial injury scores in operated group at 7,14 and 21 d were 1.168?0.108,1.776?0.064 and 2.301?0.157,respectively,and Tubulointerstitial injury scores in the treated group at 7,14 and 21 d were 1.043?0.114,1.677?0.083 and 2.084?0.201,respectively.Tubulointerstitial injury scores in silymarin treated group were significantly lower than those in operated group(Pa

Good clinical practice should be based on evidence. Evidence quality should be based on critical appraisal in evidence based medicine (EBM). Evaluation of evidence quality plays an important role in evidence level clarifying, which is the core of EBM. Different recommendations for clinical practice often derive from evidence levels. Thus evidence quality evaluation is the first and most important step in EBM. There are lots of standards to evaluate evidence quality in the world. However there are two aspects of the evaluation, one is methodological evaluation and the other is reporting evaluation. This article collected a series of standards for clinical trials quality evaluation according to different research designs. It is hoped that the resource and introduction about the quality evaluation of clinical trials be helpful for medical researchers in China. Only being familiar with all kinds of standards of methodology and reporting, researchers could publish high quality scientific papers.
Biomedical Research ; Evidence-Based Medicine ; Guidelines as Topic ; Humans ; Meta-Analysis as Topic ; Randomized Controlled Trials as Topic

AIM:To compare the higher-order aberrations between implantations of AcrySof and AcrySof ReStor multifocal aspherical intraocular lens(IOL) with various pupil diameters.METHODS:Fifty-four patients(62 eyes)with bilateral senile cataracts were retrospectively selected.Patients were operated with phacoemulsification and IOL implantation.They were divided into two groups based on the IOL implantation of AcrySof IQ and AcrySof ReStor.Wave front aberration:spherical aberration(C12)and the root mean square of the total higher-order aberration(RMSh)were observed 3 months after surgery.RESULTS:The larger the pupil was, the higher the C12 and RMSh were in the eyes (P<0.01).There were no statistical differences in C12 or RMSh between two groups at 5, 6 or 7mm pupil diameters (P>0.05). CONCLUSION:There are no differences between AcrySof IQ group and AcrySof ReStor group at 5, 6 or 7mm pupil diameters.

ObjectiveTo assessment the value of strain ratio(SR) in differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.MethodsElastosonography was performed on 64 patients with breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.SR (strainnormal neighboring tissues /strainbreast lesion) was calculated by the software equipped with the ultrasonic machine.Pathology of the lesions after biopsy or operation was considered as standard,SRs of benign and malignant breast lesions were compared with independent-samples t test.The diagnostic value of SR was evaluated by receiver operating characteristic (ROC) curve analysis.Results SRs of 34 benign breast lesions and 30 malignant breast lesions were 2.85 ± 1.30 and 5.03 ± 2.50 respectively,there was significant difference between them( t =- 4.29,P =0.000).Area under the curve of diagnosing benign and malignant of breast lesions was 0.875 for SR( P ＜0.0001).If the cut-off point of SR was 3.26,the sensitivity in differentiating breast lesions was 83.33％,while the specificity was 82.35％.Conclusions SR is a helpful elasticity parameter for differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.

Objective To study the change of the level of serum leptin in children with primary nephritic syndrome(PNS)treated with glucocorticosteroid.Methods Totally 30 PNS patients and 26 healthy children in whom were a matchable age,sex and body mass index(BMI)with the PNS patients were recruited in this study.The PNS patients were treated with prednisone in middle-term or long-term coure of treatment.Serum leptin and BMI of PNS patients were abserved before treatment,after 2,6 months treatment and in the end.The se-rum total cholesteroc(TC)and triglyeride(TG)were abserved in PNS patients after 2,6 months treatment and in the end.Results The se-rum leptin level was(2.75?2.29)?g/L in the PNS patient before treatment and control group was(2.65?2.22)?g/L.There was not significantly different between the PNS patient and control group.The level of serum leptin after 2 months treatment was(9.29?7.19)?g/L and BMI was(18.12?1.90)kg/m2.They were higher than that in control group,6 months treatment and in the end(Pa

OBJECTIVE To investigate the drug resistance of clinical isolates of Streptococcus pneumoniae and molecular epidemiology with BOX-PCR in Nanchang. METHODS Antibiotic susceptibility was determined by the Etest methods or K-B disk diffusion test. Twenty-nine Penicillin-resistant S. pneumoniae(PRSP) clinical isolates were molecularly typed by BOX-PCR to detect the clonal relationship of them. RESULTS 85.7% were resistant to erythromycin,57.1% were PRSP. The resistant rates to tetracycline,clindamycin,trimethoprim-sulfamethoxazole and chloramphenicol were 88.1%,79.8%,60.7%,and 28.6%. Amoxicillin/clavulanic acid,levofloxacin and ceftriaxone retained activity against most of the isolates. All of strains were susceptible to vancomycin. Twenty-nine S. pneumoniae strains were divided into 14 distinct types,and 19 subtypes with subtype A (n=4) as the predominant type. CONCLUSIONS The resistance rate of S. pneumoniae to penicillin is very high,BOX-PCR typing demonstrats a high discriminatory potential and easy to be accurately analyzed.

Objective To evaluate the possible interactions among different impact factors possibly affecting the treatment efficacy of 131I in Graves′ disease (GD). Methods Six hundred and thirty two GD patients that had been treated by 131I, with or without antithyroid drugs (ATD), were included in this study. The impact factors were pre-defined as age (x1), sex (x2), mass of thyroid (x3), course of disease (x4), initial symptom (x5), condition of disease (x6), ATD treatment duration (x7), effective half life time (x8), maximum 131I uptake rate (x9), total dose of 131I (x10), dose of 131I per gram of thyroid (x11), TRAb (x12), TSI (x13), TgAb (x14), and thyroid microsomal antibody(TMAb) level(x15). Interactions among different impact factors were studied by t-test, χ2 test and multi-variant logistic regression. Results Age, mass of thyroid, ATD treatment duration, maximum 131I uptake rate, dose of 131I per gram of thyroid tissue and TSI level were identified as independent impact factors affecting the 131I treatment efficacy on GD (χ2=6.908, t=-4.063, χ2=13.558, t=-2.553, t=4.528, χ2=9.716, all P<0.05) by uni-variant and multi-variate analyses. Loglinear and general linear model analyses showed that there existed multiple multiplicative and additive interactions among the factors of age, mass of thyroid, ATD treatment duration and maximum 131I uptake rate (likelihood χ2=8.176, P>0.05; F=2.928, 1.992, 2.629, 2.215, all P<0.05), which indicated that the treatment efficacy with co-existing multiple factors was not equal to simple summation of single factors. Conclusions The interactions among multiple factors can cause indi-rect effect on 131I treatment, which might guide the prescription of 131I dosage for GD treatment.

AIM: To explore the predisposing factors, population characteristics and clinical features of severe fungal keratitis.
METHODS:The data of 233 cases 233 eyes of severe fungal keratitis in my hospital from January, 2008 to November, 2013 was retrospectively reviewed. The predisposing factors, population characteristics and clinical features were analyzed.
RESULTS: In 233 cases of severe fungal keratitis, the number of male patients was 153 ( 65. 7%) and the number ratio of male to female was 1. 9:1. The average age of them was (52. 7±11. 3), and most of them were middle-aged and elderly people living in the rural area (78. 1%) and were farmers ( 66. 1%) with low literacy (59. 7%). In 233 cases, 188 cases (80. 7%) possessed a clear history of ocular trauma, mainly caused by plant-based trauma (60. 9%). 90 cases (57. 3%) were infected with Fusarium, and 47 cases ( 29. 9%) by Aspergillus. The main treatment of severe fungal keratitis was surgery (87. 9%). 83 cases ( 52. 9%) were treated with penetrating keratoplasty, and in Fusarium and Aspergillus infected patients with severe fungal keratitis, 58. 4% ( 80/137 ) were performed with penetrating keratoplasty. In addition, patients treated with eye enucleation or evisceration, 68. 4% (13/19) were infected with Fusarium species.
CONCLUSION: Patients with severe fungalkeratitis in our hospital are mainly elderly male farmers living in rural, because of low economic condition and poor diagnosis consciousness. The main pathogens are Fusarium and Aspergillus species, and the major treatment is penetrating keratoplasty. Most of patients with poor clinical outcomes are infected with Fusarium species.

AIM: To study caspase-9 expression on rat retina in the process of chronic elevation of IOP and the changes with the application of amino guanidine (AG), thus to investigate potential protective function of AG to rat retina with chronic elevation of IOP.METHODS: Immunohistochemistry, RT-PCR and Western blot were used to observe retinal morphology and expression of caspase-9 at different time points of rat with chronic IOP elevation, both affected or not affected by the application of AG.RESULTS: Compared with control group, as time passed retina of experimental group gradually had detectable morphological changes. On 21st day of chronic IOP elevation, retinas became thinner and the quantity of retinal ganglion cells (RGCs) decreased; caspase-9 expression increased, consistent with the morphological changes. The group using AG presented relatively smaller morphology changes and less expression of caspase-9.CONCLUSION: Apoptosis-related gene caspase-9 played a part in the process of chronic IOP elevation; AG protects retina by down-regulating expression of caspase-9.

Objective To determine whether cleavage developmentally retarded embryos have not cleaved during a 24 hour period could develop into blastocysts and produce hESC cell lines.Methods A total of 120 such embryos were cultured to blastocyst stage by sequential culture.Blastocysts formation rate and quality of blastocyst were detected under microscope.The relation between blastocyst formation rate and blastomere number,the fragment of blastomere and blastomere symmetry were analyzed by stepwise Logistical regression analysis.Inner cell masses(ICMs)were isolated by immunosurgery.Colonies derived from the ICMs were passed every 4-7 days and the derivatives were passaged and identified.Results A total of 22 blastocysts were obtained from 120 embryos.The blastulation rate was 18.7%.Early blatocyst, blastocyst,full blastocyst,expanded blastocyst,hatching blastoeyst and hatched blastocyst accounted for 5.9%,23.5%,35.3%,23.5%,5.9%,and 5.9% respectively.The grade of ICM and trophoblast was mostly scored C or B.Blastocyst formation rate was related to cell number and blastomere symmetry but not fragment.Immunosurgery resulted in the formation of 7 ICMs and 3 primary colonies,which produced 2 cell lines.The cell lines satisfied the criteria that characterize pluripotent hESC cells.Undifferentiated cells were positive for AKP,SSEA-4,TRA-1-60,and TRA-1-81.It could continue to proliferate in vitro and form embryoid bodies when cultured in suspension.It had capability to form teratoma in SCID mice.Both cell lines had normal karyotypes after 45 and 34 passages respectively.Conclusions Our results suggest that a subset of developmentally retarded embryos can form blastocysts and give rise to hESC cell lines.