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 situation of antibiotic resistance of S.pneumoniae(Sp)of clinical isolates from children in Guangzhou.METHODS:The authors cultured,isolated and identified the Sp strains from nasopharyngeal secretion of patients who visited Guangzhou children's hospitals because of upper respiratory tract infections in2000and2001.The paper strip method and E-Test of antibiotic susceptibility were done for157isolates.RESULTS:The penicillin resistant Sp(PRSP)isolates accounted for53.5%.PRSP isolates showed a higher resistance to other?-lactam antimcrobal,erythromycin and trimethoprim/sulfamethoxazole as compared to penicillin susceptible Sp(PSSP)isolates.More than90%of PRSP were mul?tidrug resistant strains.The strains of Sp were susceptible to amoxicillin/clavulamic acid and ceftriaxone.Strains had decreaced susceptibility(59%)to cefuroxime.In2001,the rate of cefaclor resistance was56%.The prevalence of erythromycin resistant Sp in this study was up to78%.The rate of tetra-cycline resistance were87.9%.Trimethoprim/sulphamethoxazole(TMP/SMX)resistant rate was as high as69%.The chloramphenicol resistant isolats were in stable low levels(33.3%).CONCLUSI_ ON:The resistant Sp isolated from children with respiratory tract infections in this area would be a severe problem.PRSP rate was increased and was characterized by a multi-resistance to erythromycin,tetracycline and TMP/SMX.

Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.

Objective To compare the anti-inflammatory effects between methotrexate(MTX) and Yangqixue Qufengshi Recipe(YQXQFSR) on mice arthritis induced by collagen II.Methods The model of rheumatoid arthritis was induced by using collagen II in C_(57)BL/6?DBA/1 mice.The rats with arthritis were treated with MTX or YQXQFSR respectively.The indexes such as the onset day of collagen induced arthritis(CIA),the level of CII-reactive antibodies and the pathological scores of CIA were assessed.Results The onset day of CIA and the level of CII-reactive antibodies were not influenced in the treatment of mice arthritis with MTX and YQXQFSR respectively.But MTX could alleviate the damage of cartilage [(1.60?1.51) vs(3.56?1.33) scores,P

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.

10.3969/j.issn.1000-3606.2013.06.015