As a potent collagenase activator,ocriplasmin is a recombinant truncated form of serine protease that retains the protease activity of plasmin.Pre-clinical animal experiments,clinical trials and recent clinical studies all indicated a promising outcome of intravitreal injection of ocriplasmin to treat vitreomacular interface diseases,including vitreomacular adhesion (VMA),vitreomacular traction (VMT) and full-thickness macular hole.Ocriplasmin was approved by the Food and Drug Administration of USA in the management of symptomatic VMA,and by the European Medicines Agency in treating VMT-associated macular hole with less than or equal 400 pm.Further randomized controlled clinical trials are needed for further comprehensive observation and evaluation on its efficiency,safety and other noteworthy issues.

Objective:According to the existing problems on research instruments management in medical colleges, we proposed the reasonable purchasing and application advices and how to improve the efficiency. Methods: Aiming at the use and management of instruments of teaching and researching in universities, this paper expounds how to reasonably purchase and improve the use efficiency of large-scale instruments. Results:Five suggestions were proposed. Conclusion: To give full play to the investment benefit and its important role of large-scale instruments in the teaching and scientific research.

The content of carboxylate ions in marine sulfate polysaccharide 911 was determined by conductometric titration. In the mean while, the sample was transformed with cation exchange resin,the molar ratio of sufate ions to carboxylate ions was determined. The results showed that conductometric titration is a simple,rapid and accurate method.

Objective To evaluate surgical management of pancreatic duct stones.Methods From 1997 to 2007, 24 cases of pancreatic duct stones underwent surgical treatment, the clinical data were retrospectively analyzed. Results In this study, 17 cases underwent lithotomy by longitudinal pancreatic duct incision, Roux-en-Y anastomosis(side-to-side) of pancreatic duct to jejunum, extra drainageof the main pancreatic duct was done in two cases, hepaticojejunostomy in three cases, pancreaticcystojejunostomy in one case. One case suffered from postoperative bleeding at pancreatic ojejunostomy, one from stress ulcer, and both were cured by conservative treatment. Three cases underwent pancreaticeduodenectomy, anastomosis bleeding occurred in one patient, and was cured by conservative method. One case underwent duodenum-preserving resection of the head of the pancreas, 2 cases underwent distal pancreatectomy, one case underwent lithotomy by pancreatic duct incision and primary closure, no postoperative complications occurred among those patients. 21 cases were followed up, results were excellentin 17 patients. Conclusions Lithotomy by longitudinal pancreatic duct incision, Roux-en-Y anastomosisof pancreatic duct to jejunum is the main and effective surgical procedure, while duodenum preserving pancreatic head resection and lithotomy by pancreatic duct incision and primary closure are also rational for the treatment of pancreatic duct stones.

Objective To study miRNA expression differences in ovalbumin(OVA)- induced murine asthma models of mice and mast cells stimulated by inflammatory cytokines stimulation,and to better understand asthma deve-lopment so as to provide potential target for its prevention and treatment. Methods OVA - induced murine asthma models were validated by detecting cells in bronchoalveolar lavage fluid(BALF)and histopathology. And miRNA ex-pression differences in the lung tissues between the model group and the normal control group were detected by real -time polymerose chain reaction PCR . After tumor necrosis factor - α(TNF - α),interleukin 12(IL - 12)stimulation, miRNA expression differences in murine mast cells P815 were detected. Results The number of total cells and eosino-phil cells both increased in BALF of the model group[(12. 8 ± 2. 2)x 107 / L vs(5. 6 ± 2. 5)x 107 / L,t = 4. 760,P ﹤0. 05;(6. 6 ± 1. 9)x 107 / L vs(0. 8 ± 0. 8)x 107 / L,t = 8. 068,P ﹤ 0. 05]. In addition,histopathology showed more inflammatory cell infiltration in the model group than that in the normal control group,indicating that the models were validated. The expression of miRNA - 155 was up - regulated approximately 5. 0 - fold in the lung tissues of the model group(P ﹤ 0. 05),while miRNA - 192 showed no differences compared with the controls. After TNF - α and IL - 12 stimulated P815 mast cells,miRNA - 192 expressions in P815 were expression in P815 was up - regulated approximate-ly 1. 9 - fold and 1. 7 - fold after TNF - α and IL - 12 stimulation,respectively(P ﹤ 0. 05). Conclusions It is conclu-ded that miRNAs are differentially expressed in the presence of OVA - induced murint asthma models and mast cells stimulated by inflammatory cytokines. These differentially expressed miRNAs may regulate the function of mast cells and involved in the pathogenesis of asthma.

Background Choroidal thickness is closely associated with ametropia,and to study the influence of subfoveal choroidal thickness (SFCT) on refraction is very important for understanding the mechanism of refractive error more clearly.Objective This study was to investigate the relationship between SFCT and refraction.Methods A retrospective serial cases analysis was performed.Forty anisometrope patients were recruited in Zhongshan Ophthalmic Center from June 2012 to August 2012.The subjects were divided into 6-13 years group and 14-21 years group.Vision acuity was tested by the EDTRS visual acuity chart and ocular anterior segment was examined under the slit lamp microscope,and the fundus examination was performed by direct ophthalmoscope.Subjective and objective optometry was performed after pupils were dilated.EDI OCT was used to illuminate choroidal image.Ocular axial length (AL) was obtained by Lenstar 900.The difference in SFCT between myopic eyes and hyperopic eyes was compared using Student t test,and the correlations between SFCT and refraction were analyzed by Pearson linear analysis and linear regression analysis.Results The average SFCT was (307.82±88.47) μm in all the tested eyes,and the SFCT of myopic eyes and hyperopic eyes was (270.60±70.57) μm and (376.95±76.59) μm,respectively,with a significant difference between them (P =0.000).In the 6-13 years group,positive correlations were found between SFCT and diopters with the regression coefficient 18.60 and regression equation Y =18.60X +310.79 (r=0.345,F=21.110,P=0.000) as well as between SFCT and AL with the regression coefficient -31.76 and regression equation Y =-31.76X+1 039.97 (r=0.262,F=17.320,P=0.000).In the 14-21 years group,SFCT showed positive correlation with diopters,with the regression coefficient 23.38 and regression equation Y=23.38X+353.17 (r =0.430,F =27.210,P =0.000) and negative correlation with AL,with the regression coefficient-35.82 and regression equation Y =-35.82X+1 132.75 (r=0.237,F=15.650,P=0.000).Conclusions SFCT seems to be positive correlated with diopter.When the diopter shifts toward positive value,SFCT value increases,and whenever diopter increases-1 D,SFCT decreases 20 μm approximately.SFCT decreases with the increase of AL.

Objective To systematically explore students'perception of roles of clinical tutors and to identify different types of perception, so as to provide suggestions to promote the implementation of clinical tutorial system. Methods The study used Q-methodology, which was a combination of qualitative and quantitative research method. Through semi-structured interviews with 13 students, a Q discussion of 48 entries was formed. Forty undergraduate students majored in nursing who had participated in clinical tutorial system at least one year were asked to rank 48 statements according to their relative importance. Results Undergraduate nursing students′ cognition on the role of clinical tutors could be divided into four types. Type 1 "Lighthouse", types 2 "alienation", type 3 "help", type 4"experience type". There were differences and similarities between these types. They were in favor of clinical instructors in their professional specialty, also believed that the relationship between how to coordinate with the doctor,a clinical instructor did not give guidance. Conclusions There are four types of the cognition on clinical tutor role. The students generally accepted the role of clinical tutors. The degree of cognition are different.

The bile duct is the channel for bile transport in the liver, and the lining epithelial cells in the bile duct have functional and morphological heterogeneity and are the target of various bile duct diseases. In addition to bile metabolism and secretion, biliary epithelial cells are also involved in tissue damage and repair. Biliary epithelial cells have an immune barrier function and can secrete different proinflammatory factors and chemokines. Under the stimulation of endogenous and exogenous factors, biliary epithelial cells present immune reactivity and initiate immune response in the host. This article reviews the current status of research on bile duct lesions and related liver diseases.

OBJECTIVETo investigate the rationality and feasibility of primary closure of the common bile duct after choledochotomy for common bile duct calculi.

METHODSFrom January 1990 to June 2001, 386 patients with the evidence of stones in the common bile duct underwent choledochotomy. Among them, 215 received primary closure of the common bile duct (group A) and 171 T-tube drainage (group B). The patients with emergency operations were excluded. Intraoperative choledochoscopy or cholangiography was routinely performed to rule out the possibility of retained stones. The duct was meticulously stitched using 0/3 to 0/5 absorbent sutures for primary closure. A T-tube was placed in the subhepatic space in the patients of both groups.

RESULTSPostoperative bile leakage was seen in 9 patients of group A and in 5 of group B, respectively (P > 0.05), and no reoperations were necessary. After surgery, the average time and volume of transfusion was 4.9 days and 9.1 liters in group A, versus 7.3 days and 12.8 liters in group B (P < 0.01). The patients in group B had a longer postoperative hospital stay than the those in group A (average 17.6:10.0 days, P < 0.01). T-tube removal resulted in bile peritonitis in 5 patients at day 16, 17, 19, 21 and 22 after surgery in group B, and 3 patients required repeated surgery.

CONCLUSIONSPrimary closure of the common bile duct after choledochotomy is safe, effective, and inexpensive in selected patients with common bile duct calculi, and should be regarded as an alternative procedure.

Adult ; Aged ; Biliary Tract Surgical Procedures ; methods ; Choledocholithiasis ; surgery ; Common Bile Duct ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

ObjectiveTo explore the ideal minimally invasive surgical method for degenerative lumbar spine stenosis.MethodsFrom March 2008 to August 2010,73 cases with lumbar spinal stenosis underwent minimal invasive surgery were retrospectively analyzed.The patients were divided into different groups by clinical features,imaging manifestations,and concurrent diseases.The minimal invasive surgical methods were chosen according to the classification.Operation time,intra-operative bleeding,and complications were recorded.The lumbar function was evaluated by Oswestry disability index (ODI),and the clinical results were assessed by JOA pre- and postoperatively.ResultsMinimal invasive surgery was completed in all cases,which included 25 cases with bilateral decompression and 48 cases with unilateral approach for bilateral decompression.Twenty-three cases used interbody fusion and percutaneous pedicle screw fixation after decompression.Intraoperative blood loss and operation time were related to surgical methods.One case was complicated with dural tear.Cage was inserted into upper vertebral body during interbody fusion in 1case with osteoporosis,removed the cage and implanted bone fusion.Incisions of 3 cases were poor healing after surgery.The average follow up time was 13 months(range,10-35).JOA score and ODI before surgery were 9.2±5.1 and 62.3％±18.5％ respectively; while 6 months after surgery,JOA score and ODI were 23.5±7.2 and 18.4％±6.4％ respectively.JOA score and ODI showed statistically significant improvements after operation(P＜0.01).Twenty-two cases got solid fusion at the final follow-up.ConclusionTreatment of lumbar spinal stenosis by minimal invasive surgery has satisfactory surgical outcomes,but the proper minimal invasive strategy should be chosen according to specific patients,surgeons and hospitals.