Objective To observe the expression of DR5 in the ocular tissues of uveitis rats induced by endotoxin,and study the relationship between the apoptosis of inflammatory cells and expression of TRAIL / DR5.Methods SD rats were randomly divided into 3 groups:Blank control group,normal saline injection group and endotoxin injection group.The endotoxin injection group was injected with lipopolysaccharide into the rat posterior foot pad to make endotoxin-induced uveitis animal model.There were no operations in the blank control group,and the subgroups were divided into 6 hours,12 hours,24 hours and 48 hours groups according to the time of injection.The ultrastructural changes of inflammatory cells and endothelial cells in iris capillaries were observed by transmission electron microscopy (TEM).The expression of DtR5 protein on inflammatory cells at different time after endotoxin induction was detected by SABC method.Results TEM showed that the microvilli of the capillary endothelial cells in the iris tissue of the blank control group and saline injection group had more obvious vesicles with no obvious abnormal structure and shape.The number of swallowed vesicles in the capillary endothelial cells injected with endotoxin was decreased at 6 hours group,and the number of vesicles in the infiltrating neutrophils and lymphocytes decreased.Neutrophils and lymphocytes appear chromatin condensation,vacuolar changes in the expression of apoptosis.Immunohistochemistry showed that the DR5 protein was negative in the iridocular epithelium of the blank control group and saline injection group.In the endotoxin injection group,the DR5 protein was weakly colored in the iris pigment epithelium and appeared on the inflammatory cells.The number of staining and the intensity of coloring in the 24 hours group were significantly higher than those in the 6 hours group,and the color density was 0.085 9 ± 0.019 6,there were statistical differences compared with 6 hours group,12 hours group and 48 hours group (all P ＜ 0.05).Conclusion TRAIL and its receptor DR5 may be involved in the apoptosis of inflammatory cells in endotoxin-induced uveitis.

Objective To explore the multiple risk factors for family lifestyle of children with congenital heart defects (CHDs) in Shaanxi Province, China. children and their parents. The univariate and multivariable logistic regression models were used to analyze the influence of risk factors related to parents' lifestyle on CHDs. Results Several possible risk factors were found for CHDs, including fever (OR=4.465, P=0.017), pesticides contact (OR=2.234, P=0.083), passive smoking during pregnancy (OR=20.529, P=0.007) and father's smoking (OR=3.342, P=0.005); fever (OR=2.428, P=0.012) and passive smoking during pregnancy (OR=1.201, P=0.037) were also correlated with ventricular sepal defect (VSD). Conclusion Fever, pesticides contact and passive smoking are associated with CHDs during pregnancy. We should focus our attention on health care during pregnancy to avoid the above-mentioned risk factors and call on parents to hold on to a good healthy lifestyle.

Background Lowing intraocular pressure (IOP) is the only effective treating method in glaucoma.Making sure the change of optic disc parameters and retinal nerve fiber layer thickness(RNFLT) in primary open-angle glaucoma (POAG) patients after IOP reduced can provide objective evidence for evaluating the effect of lowing-IOP on the function of optic nerve.Objective The present study was to evaluate the change of optic disc parameters and RNFLT in POAG patients after trabeculectomy,and analyze the affecting factors of image parameters.Methods A serial case-observational study was adapted.Forty eyes of 39 patients with POAG underwent trabeculectomy were recruited in the study.IOP was examined and perimetry was performed before operation and 2 weeks,1 month,3 months,6 months and 1 year after surgery.Optical parameters and RNFLT were measured using Heidelberg retina tomography (HRT) and optical coherence tomography (OCT) in above-mentioned time points.The correlations between lowing-IOP range or disease severity and optical disc parameters or mean RNFLT (mRNFLT) were analyzed by Pearson linear correlation.Results Mean IOP of the 40 eyes was (32.77±8.64) mmHg before operation and (12.45 ±3.65) mmHg,(13.05±3.90) mmHg,(13.42± 3.33) mmHg,(14.22± 2.60) mmHg and (14.74±2.46)mmHg 2 weeks,1 month,3 months,6 months and 1 year after operation,with a significant difference among various time points (F=13.73,P =0.00).However,no significant difference was seen in the mean defect of perimetry among the different time points (F=1.02,P=0.41).The cup area (CA),cup/disc area ratio (C/DAR),cup volume (CV),mean cup depth (MCD),cup shape measurement (CSM),horizontal C/D,vertical C/D,rim area (RA),rim/disc area ratio (R/DAR),height variation contour (HVC),rim volume (RV),mRNFLT,RNFL cross sectional area (RNFLA) were gradually improved after operation in comparison with before operation.One year after operation,RV,CSM,mRNFLT,RNFLA were still increased,but vertical C/D was reduced after operation than that of before (P＜0.05).No significant differences were found in the whole mRNFLT and superior quadrant mRNFLT,inferior quadrant mRNFLT,nasal quadrant mRNFLT and temporal quadrant mRNFLT among before and after operation (F=1.63,P=0.16; F=0.51,P=0.77; F=1.44,P=0.20;F=1.02,P=0.32; F=1.31,P=0.30).Positive correlations were found between lowing-IOP range and the improvement of RV,CSM,vertical C/D (r =0.45,P =0.02; r=0.41,P=0.04; r=0.58,P=0.00),and negative correlations were seen between absolute value of MD and the improvement of RV,CSM 1 year after operation (r=-0.43,P=0.03; r=-0.62,P=0.00).Conclusions Reduction of IOP after trabeculectomy results in the reversal of optic disc parameters.The improvement of the optic disc parameters may be a protective factor for progression of glaucomatous optical nerve damage.

Adult ; Bronchoalveolar Lavage ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Respiration, Artificial ; methods ; Ventilators, Mechanical

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Objective To provide a quantitative summary estimate on the efficacy and safety measures of the combination therapy.Methods We searched databases(Medline and Embase)from January 1997 to December 2009 using‘ Fluticasone and salmerterol' or‘ Seretide' or‘ Advair' or‘ budesonide/formoterol' or‘ Symbicort Turbuhaler' in combination with ‘ Randomised controlled trial'.The databases of GlaxoSmithKline Clinical Trial Register and Cochrane Controlled Trials Register,or relevant original studies and review articles were approached for additional studies or details of all relevant studies.Results Morning peak expiratory flow(PEF),evening PEF and clinic FEV1 were 17.59L/min,14.95L/min and 0.08L/min higher with combination therpy than with increasing ICSs by two fold or more at endpoint,respectively.The risk of asthmatic exacerbation was reduced in the combination therpy group compared with the increased doses of ICS groups,with OR being 0.61(95 ％ CI 0.53 ～ 0.70,P ＜ 0.01).Significantly increases in the percent of symptom-free days 6.30(95％ CI 3.52 ～9.10),asthma-control days 9.49(95％ CI 4.74 ～14.25)and relieve-free days 6.59(95％ CI 6.10 ～ 7.08)were observed in patients treated with ICS/LABA compared with increased doses of ICSs at endpoint.Reduction in reliever medication use(inhalations/day)0.22(95 ％ CI 0.11 ～0.33)with significant difference was also observed at endpoint.Conclusion Combination products of ICS/LABA were more effective than a high dose of ICSs in improving lung function,reducing asthmatic exacerbation and use of reliever medication and improving control of asthma.

Intrauterine growth retardation (IUGR) is one of the most commonly encountered developmental toxicity, which could lead to perinatal morbidity and mortality, be also extended from the fetus to adulthood, and seriously affect the quality of the population. Caffeine widely exists in a variety of daily beverages and some drugs. Its consumption is increasing year by year. Caffeine intake during pregnancy is one of the risk factors for IUGR. However, its mechanism of adverse outcome based on embryonic research is still unclear. In this paper, the possible mechanisms of caffeine-induced IUGR focusing on 3 important factors-the mother, placenta and fetus were explored. Caffeine's impact on the mother is the chronic activation of renin-angiotensin system; on the placenta, caffeine induces cell damage or the failure of the cell proliferation/apoptosis balance, leading to blockage of blood supply to the placenta; caffeine is also capable of directly affecting fetal development through interfering its neuroendocrine.

ObjectiveTo explore the features of the cleanliness change with time during the use of laminar operating rooms in order to establish reliable quality assurance system. MethodsTwo grade 3 lami-nar operation rooms were chosen to be tested after one and a half year and two and a half years, laser counter was used to detect the static particulates after cleaning for 30 minutes and 45 minutes. ResultsAfter the laminar operation room was used for one and a half years the amount of 0.5 μm particulates in indoor air was less than 350 per liter, and after two and a half years it's above 350 per liter after cleaning for 30 minutes, an obvious difference than the previous one. The anaount of 1 μm and 2 pan particulates also increase obviously, but ff cleaning for 45 minutes the amount of 0.5 μm particulates in indoor air will fulfill the qualification. Al-though the amount of 0.5 μm, 1 pan and 2 μm particulates after 2 years using was higher than the one and a half yesrs'using after cleaning for 45 minutes, but the difference had no statistic meaning. CondusionsThe elesnliness of laminar operation rooms will drop as time prolonged, Amount of particulates in indoor air will in-crease too but the cleanliness can be ensured by extending cleaning time. After the quality assurance sys-tem was established the amount of smile particulates is still within the standard level

Bronchoalveolar Lavage ; methods ; Humans ; Pneumoconiosis ; therapy

Adolescent ; Adult ; Aged ; Bronchoalveolar Lavage ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult