OBJECTIVE:To observe therapeutic efficacy and safety of tobramycin dexamethasone in the treatment of meibo-mian gland dysfunction(MGD). METHODS:108 MGD patients were randomly divided into control group(53 cases)and observa-tion group(55 cases). Control group was given eyelid cleaning with conventional physical cleaning method,at the same time,giv-en Doxycycline hydrochloride tablets 0.1 g orally after meal,twice a day. Based on control group,observation group was addition-ally given Tobramycin and dexamethasone eye ointment with length of 1.0-1.5 cm,smearing into conjunctival sac,4 times a day. Treatment courses of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed as well as eyelid observation score, symptom score,the levels of IL-6 and TNF-α,the occurrence of ADR before and after treatment. RESULTS:The total response rate of observation group was significantly higher than that of control group(89.1% vs. 77.4%),with statistical significance(P<0.05). Before treatment,there was no statistical significance in eyelid observation score,symptom score,the levels of IL-6 and TNF-α between 2 groups(P>0.05). After treatment,eyelid observation score of 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;symptom score and the levels of IL-6 and TNF-α in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the con-trol group,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Based on routine treatment,tobramycin dexamethasone shows significant therapeutic efficacy for MGD,and can improve clinical symptoms significantly but does not increase the occurrence of ADR.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Objective To investigate the operation timing of laparoscopic cholecystectomy (LC)after endoscopic sphincterotomy (EST).Methods A total of 240 patients with cholecystolithiasis and choledocholithiasis received EST combined with LC.They were divided into 3 groups by random digits table method with 80 cases each:3 days after EST(group A),7 days after EST(group B),and 30 days after EST (group C).Intraoperative and postoperative clinical data were compared among three groups.Results The operation time of LC in group B [(52.5 ± 6.4) min] was longer than that in group A and group C [(35.8 ± 5.7),(34.6 ± 2.6) min],and there was significant difference (P ＜ 0.01).The intraoperative conversion rate in group B [10.0 ％ (8/80)] was higher than that in group A and group C [1.3 ％ (1/80),1.3 ％ (1/80)],and there was significant difference (P ＜ 0.05).The amount of bleeding in group B [(51.7 ± 4.8) ml] was larger than that in group A and group C [(27.9 ± 6.4),(28.2 ± 3.6) ml],and there was significant difference (P ＜ 0.01).The cost of hospitalization in group C [(15 361.2 ± 1 007.8) yuan] was more than that in group A and group B [(10 085.1 ± 695.4),(10 632.4 ± 855.9) yuan],and there was significant difference (P＜ 0.01).Conclusion LC performed 3 days after EST can reduce the operation difficulty and conversion rate,and shorten the operation time,and this modality is safe and effective.

BACKGROUND:The aquaporin (AQP), mainly AQP1, AQP4 and AQP9, are expressed in mammalian brain, while the others are sporadical y expressed. There is no evidence concerning the distribution, function and regulation mechanism of AQP in the brain.
OBJECTIVE:To comprehensively analyze the research progress of the distribution, function and regulation mechanism of AQP in maintaining normal physiological function of the brain.
METHODS:An online retrieval of PubMed database and CNKI database between January 1980 and July 2013 was performed for articles on the distribution, function and regulation mechanism of AQP, with the key words of“AQP1, AQP4, AQP9, function, brain, adjusting mechanism”in English and Chinese. A total of 163 papers were screened out and 85 of them met the inclusive criteria.
RESULTS AND CONCLUSION:The existing studies about the expression, function and regulating mechanism of AQP1, AQP4 and AQP9 in the brain can be summarized as the fol owing three aspects: (1) AQP1 is expressed in the choroid plexus and participates in forming cerebrospinal fluid;in other types of cells, gas micromolecules CO 2 , NO, NH 3 and O 2 also cross through AQP1. (2) AQP4 is mainly expressed in the astrocytes, ependymal foot process and gelatin membranes, which can help the water in and out of the brain tissue, accelerate glial cellmigration and change neural activity. (3) AQP9 is mainly distributed in astrocytes and catecholamine neurons, the main function is involved in energy metabolism in the brain. Therefore, AQP is the key for water transport in the brain. Understanding the distribution, function and regulation mechanism of AQP wil play an important role in the treatment of brain diseases. The regulatory mechanism on the expression of AQPs in normal pathology and related disease remains unclear and related molecular signal pathway needs further exploration.

Objective To develop an indicator system for evaluating midwifery quality. Methods Guided by the latest evidence-based framework of midwifery quality,based on indicator selection principle,the indicator system for evaluating midwifery quality was preliminarily developed by literature review,expert meeting,theoretical analysis and expert consultation,for further validation through large-scale Delphi method. Results The indicator pool for mid-wifery quality evaluation was identified by literature review,including indicator name and definition of special indi-cator. The indicator system was finalized through comprehensive analysis and selection,and consisted of 45 indica-tors. The expert consultation questionnaire response rate was 100%,the rate of experts who provided written sug-gestions was 81.3%,the authority coefficient was 0.92,the coefficients of variation of indicators ranged from 0 to 0.29. Conclusion The preliminarily developed indicator system for midwifery quality evaluation guided by the lat-est evidence-based framework of midwifery quality was scientific,oriented and accessible,which could be further ex-amined through large-scale Delphi method.

Objective To determine prevalence of dementia in diabetics and non-diabetics, and in different age and gender groups. Methods A case-control study was conducted among participants aged 50 and over in Jing' an temple community in Shanghai. Subjects in diabetics group were matched to non-diabetics groups for age and sex with 1:1 matching. Personal information and case history were collected through questionnaire. The subjects were screened for dementia using the Mini Mental State Examination (MMSE). Subjects that screened positively (indicated by an MMSE score below 19, 21 and 24 among those with illiteracy, elementary school and above junior middle school education, respectively) were subsequently examined by a series of neuropsychological tests. Based on all available information, a diagnosis of dementia was defined according to the Diagnostic and Statistical Manual of Mental Disorders ( DSM )-Ⅳ criteria Results Prevalence of dementia of 4. 75% (23/484, 95% CI: 3. 03%-7.04%) in diabetics was higher than that of 2. 24% (11/490,95% CI: 1.13% -3.98%) in non-diabetics (X~2 = 4.54, P=0.03).Prevalence of dementia among diabetics in age groups of 60-69, 70-79 and 80 and above was 1.94% (2/103), 4. 43 % (9/203) and 14.12% (12/85, trend X~2 =18.04, P <0.01), and in non-diabetics was 1.43% (2/140), 2. 86% (6/210) and 5.00% (3/60, trend X~2 = 4.58, P=0.03), respectively.Prevalence of dementia among female and male in diabetics was 6.55% (19/299) and 2.06% (4/194) (X~2 = 5.18, P = 0.02), respectively, and in non-diabetics was 3.01% (9/299) and 1.05% (2/191).Conclusions Prevalence of dementia is significantly higher in diabetics than in non-diabetics, higher in women than men, and increases as age rises.

vides com-parable efficacy with medical castration in regard of decreasing PSA level and reducing prostate vol-ume. It is a safe and well tolerated treatment option as well.

Objective To establish a porcine model of liver failure after different percent hepatectomy.Methods The porcine models of liver failure 75%,85%,95% hepatectomy were developed and the living conditions and survival time were recorded.The blood samples of pre-surgery,post-hepatectomy d1,d3,d5 and post-hepatectomy 1 week,2 weeks,and 3 weeks were collected for hepatic function analysis.Histological examination of liver tissues was performed using HE staining.Liver injury histology was interpreted and scored in the terminal samples.Results The average survival time of pigs with post-hepatectomy liver failure after 75%,85%,95% hepatectomy was 19.0±5.6 days,17.3±5.5 days,1.3±1.5 days,respectively.Their pathological scores were 5.67±0.52,8.17±0.82 and 8.50±0.71,respectively.With the increase of percent hepatic resection,the incidence of hepatic failure was increasing.ALT,AST,ALP,LDH and TBA were dramatically increased in the pigs after 85% hepatectomy.Conclusions The pig model of acute liver failure by 85% hepatectomy is successfully established,which can cause typical acute liver failure in Bama miniature pigs.

Background:Recurrent acute pancreatitis(RAP)is a special type of acute pancreatitis(AP). Finding the cause is the key to avoid the recurrence of RAP. Aims:To investigate the risk factors of RAP. Methods:The clinical data of 43 patients with RAP and 130 patients with only one time AP(control group)were retrospectively analyzed. Risk factors of recurrence of RAP were analyzed. Results:Univariate analysis showed that no significant differences in etiology,severity, serum levels of cholesterol,calcium,white blood cell count,amylase,ALT,AST,total bilirubin,direct bilirubin and C-reactive protein were found between RAP group and control group(P > 0. 05). Serum triglyceride level,blood glucose level and CT score in RAP group were significantly higher than those in control group(t = 3. 260,P < 0. 05;t = 2. 720, P < 0. 05;t = 2. 162,P < 0. 05). Logistic regression analysis demonstrated that serum triglyceride level,blood glucose level and CT score were risk factors of RAP(oR = 1. 86,95% CI:1. 05-3. 68,P = 0. 03;oR = 1. 23,95% CI:1. 01-1. 50,P = 0. 04;oR = 2. 46,95% CI:1. 00-6. 03,P = 0. 04). Conclusions:The recurrence of RAP is related with serum triglyceride level,blood glucose level and CT score.

Objective To explore the most effective route of mesenchymal stem cell transplantation (MSCs) in D-galactosamine (D-gal) induced porcine model with acute liver failure (ALF) and the potential mechanism.Methods BA-MA mini-pigs with D-gal-induced ALF were transplanted with porcine mesenchymal stem cells (MSCs) through four routes:intraportal injection (InP),peripheral intravenous injection (PV),hepatic intra-arterial injection (AH) and intrahepatic injection (IH).The survival time was recorded.The blood samples before and after MSC transplantation were collected for detecting liver function.Liver histology was interpreted and scored.Hepatic apoptosis and regeneration were detected by Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling (TUNEL) assay and Ki-67 assay.The protein expression of cleaved caspase-3,survivin,AKT and ERK were analyzed by Western blot.Results The average survival time in each group was (10.7 ±1.6) days (InP),(6.0 ±0.9) days (AH),(4.7 ±1.4) days (PV),(4.3 ± 0.8) days (IH) when compared with D-gal group [(3.8 ± 0.8) days].The histopathological scores revealed a significantly decrease in InP group (3.17 ± 1.04,P ＜0.05) and AH group (8.17 ± 0.76,P ＜ 0.05) when compared with that in D-gal group (11.50 ± 1.32).The apoptosis rate in InP group (25.0 ± 3.4％,P ＜ 0.05) and AH group (40.5 ± 1.0％,P ＜ 0.05) was lower than that in D-gal group (70.6 ± 8.5％).The expression of active caspase-3 was inhibited,while the expression of survivin,AKT and ERK was elevated in InP group.Conclusions The intraportal injection was superior to other pathways for MSCs transplantation.Intraportal MSC transplantation could improve liver function,inhibit cell apoptosis,promote cell proliferation and prolong the survival in porcine ALF model.