Background Development of corneal tissue engineering creates a new therapeutic method for severe corneal diseases.However,ideal seed cells and scaffold for corneal surface reconstruction have not yet been investigated well.Adipose-derived stem cells (ADSCs) are varified to have a self-renewal ability and epithelioid features,and temperature-responsive scaffolds (TRSs) can offer technical support for stem cell sheet.Objective This study was to investigate the characteristics of ADSCs cultured on TRSs and compare these features to typical oral mucosal epithelial cells (OMECs),and therefore to explore the feasibility of reconstruction of ocular surface with ADSCs as seed cells.Methods Self-made TRSs were prepared by adding isopropyl alcohol dissolved poly-Nisopropylacrylamide (PNIPAAm) to each polystyrene tissue culture dish and then irradiating using an election beam.Subcutaneious fatty tissue of rabbit neck was obtained to culture ADSCs,and 4 pieces of oral cavity mucosal tissue were digested and cultured to obtain OMECs.Then the ADSCs and OMECs were incubated on TRSs,and cell morphology,growth rate,detached duration and survival counts were compared between ADSCs and OMECs.The ADSCs sheet and OMECs sheet were stained with hematoxylin and eosin for morphological examination.Immunochemistry was used to observe the expressions of stem-cell biomakers and epithelioid-cell biomakers in the cells.The ultrastructure of cell surface was observed under the scanning electron microscope.Results Self-made TRSs were similar to ordinary culture dish in the transparancy and smoothness.The water contact angle of 4 in 5 samples were ＞10° with the effective rate upto 80％.A DSCs showed the elongated fusiform in shape,while OMECs showed a cobblestone appearance.The growth cycle,detached duration and cell number of ADSCs were 12-14 days,(46.0 ±9.6) minutes and (7.9 ±1.1)×105/sheet,and those of OMECs were 14-16 days,(91.9 ±10.9) minutes and (45.8 ±26.5)×105/sheet,respectively,showing statistically significant differences in the detached duration and cell counts between ADSCs and OMECs (P=0.002,0.028).Hematoxylin and eosin staining showed that ADSCs sheet comprised only 1-3 layer cells,while OMECs showed 4-5 layer cells.ATP-binding cassette superfamily G member 2 (ABCG2),p63 and cytokeratin 12 (CK12) were positively expressed in both ADSCs sheet and OMECs sheet.Closely packed cells and typical eithelial microvilli in the cell surface were exhibited in both ADSCs sheet and OMECs sheet under the scanning electron microscope.Conclusions Self-made TRSs can be used as scaffold of ADSCs.The ADSCs sheet on the TRSs appears to have a good cell vitality and therefore is a new seed source of ocular surface reconstruction.

Dry eye is a most common external eye disease in clinic and it can cause ocular discomfort and visual disturbance. The conventional examinations for dry eye have some shortcomings, for example, high variability and insufficient association with symptoms. Recently, routine ophthalmic technologies play more extending roles in evaluation of dry eye, including corneal topography, wavefront aberrometer, optical coherence tomography (OCT) and confocal microscope. Corneal topography and wavefront aberrometer could be used to evaluate the stability of tear film and visual function. OCT could image tear meniscus directly, and confocal microscope could observe histopathology of ocular surface in vivo. The studies on ophthalmic technologies in dry eye make us deepen the understanding of pathophysiology of dry eye and also provide new diagnostic approaches.

OBJECTIVE:To evaluate the effects of pharmaceutical care in PIVAS of our hospital,and to improve the quality and level of pharmaceutical care. METHODS:Combined with the actual situation of our hospital,various measures which had been carried out in PIVAS of our hospital were analyzed retrospectively,and the effects of pharmaceutical care were also analyzed. RESULTS & CONCLUSIONS:Through strengthening safety awareness,formulating effective management system,continuous op-timization process to guarantee the quality of drug dispensing,and focusing on the ability to improve the quality of the team,an ef-fective improvement has gained in the quality of pharmaceutical care. The proportion of irrational medical order of anti-tumor intra-venous drug use has decreased from 0.62% in 2008 to 0.09% in 2012. 1 363 irrational medical orders have been checked out dur-ing Jul.-Dec. of 2014,accounting for 0.39% in total. The satisfactory degree of clinical staff has increased from 80.0% to 98.5%. PIVAS has a positive role in promoting pharmaceutical care.

Objective To investigate the clinical characteristics and surgical treatment for primary presacral tumors.Methods The clinical data of 42 patients of primary presacral tumors from January 2013 to May 2015 were analysed retrospectively.Results Of the 42 patients,16 cases were asymptomatic while 26 patients had discomfort at the sacral or abdominal region,or difficulty in urinating or defecation.90％ of the cases were digital rectum examination (DRE) positive.Among the 42 patients 36 cases underwent surgical treatment,1 case underwent radiotherapy,5 cases refused surgical treatment.Among those receiving surgical resection,28 cases had trans-abdominal surgery and 4 cases had trans-sacral surgery,while 3 cases had trans-abdominal & trans-sacral surgery,1 case had trans-abdominal and perineal surgery.Tumors were completely resected in 31 cases,and palliatively resected in 5 cases.3 cases suffered from intra-operative presacral hemorrhage.1 case with delayed hemorrhage required surgical intervention.2 cases from incision infection recovered after wound disinfection and dressing.3 cases had postoperative hip or leg numbness;1 case with high fever was cured by intensive antibiotics treatment.Conclusion The low incidence of presacral tumors makes early detection difficult.A diagnosis can be obtained by a positive DRE combined with CT or MRI results.Resection is a therapy of choice after biopsies.

OBJECTIVE:To discuss the role of clinical pharmacist participating in drug therapy for severe ulcerative colitis (UC)during late pregnancy. METHODS:Clinical pharmacists participated in the therapy for a UC patients during late pregnancy, assisted the doctors to optimize and improve drug therapy plan from antidiarrheal,anti-intestinal inflammation,regulating intestinal flora,recovering damaged mucosa;suggested regimen was as follows:montmorillonite powder 3 g,pr,qd,to avoid drug interac-tion;hydrocortisone 100 mg,ivgtt,bid to resist intestinal inflammation;prednisone 30 mg,po,qd+20 mg,po,qn,instead after symptom relieved;stopping taking Bifid triple viable capsules,supplementing Human serum albumin injection,Nutrients,Potassi-um chloride injection,Concentrated sodium chloride injection,etc. RESULTS:The suggestion provided by clinical pharmacists was adopted by doctors,and the patient was recovered. There was no significant difference in the intelligence development,body weight and height charge between born baby boy and infants with same month age. CONCLUSIONS:Clinical pharmacists assist physician to optimize and improve drug therapy plan to promote rational drug use in the clinic and guarantee the safety of drug use.

BACKGROUND: The application of adipose derived stromal cells to tissue engineering has been more and more popular around the world. Compatibility of scaffold material is the key point for its further research.OBJECTIVE: To determine the growth rules of rabbit adipose-derived stromal cells with polylactic-co-glycolic acid (PLGA).DESIGN, TIME AND SETTING: An in vitro study was performed at the Institute of Ophthalmology, Otolaryngology Hospital,Fudan University and Shanghai Tissue Engineering Center from September 2007 to March 2009.MATERIALS: Six female New Zealand rabbits aged six months were used for extraction of adipose-derived stromal cells. PLGA was provided by Sigma, USA.METHODS: Adipose tissue was harvested from the nape fat pad of the rabbits following anesthesia. Primary cultured cells were established using type I collagenase and cell cultures were maintained with DMEM containing 10% volume fraction of fetal bovine serum. Cells were passaged when 80% was confluent. The fourth passages of cells were utilized for the study. PLGA consisted of polylactic acid and polyglycolic acid as the ratio of 7:3, and the relative molecular mass was 104900.MAIN OUTCOME MEASURES: Initially, the adherent rate of cells to scaffold was detected. After one week co-culture, the scaffold bearing adipose-derived stromal cells labeled with Dio agent were investigated by fluorescence inverse microscope,scanning electron microscopy and laser scanning microscope.RESULTS: The best adherent rate of adipose-derived stromal cells with PLGA reached 99%. After one-week-incubation in vitro,cells of fiber-shaped or ovule-shaped proliferated well and exhibited stratified growth on the surface of PLGA scaffold. In addition,it also secreted visible extracellular matrices, which could be examined by scanning electron microscopic examination.Meanwhile, the adipose-derived stromal cells grew well and distributed equably inside the PLGA in terms of the investigation with laser scanning microscope.CONCLUSION: The compatibility of adipose-derived stromal cells to PLGA in vitro was well.

Objective:To discuss the application of antithrombotic drugs in myocardial infarction patients with thrombocytopenia. Methods:The therapy for one myocardial infarction patient with primary thrombocytopenia was discussed and summarized. Based on the related literatures, the characteristics of case, application status and adverse reactions of antithrombotic drugs and anticoagulant drugs were summarized. Results: The adjustment of antithrombotic drug treatment regimen for the patient was reasonable. Conclu-sion:Antithrombotic drugs applied in acute myocardial infarction patients with thrombocytopenia are safe. If patients complicate with other diseases, individualized antithrombotic therapy should be carried out according to particular case.

Objective To explore the safety and applicability of a temporary protective ileostomy that closes itself in the prevention of anastomotic leakage following anterior resection after chemoradiation for rectal cancer.Methods From Oct 2010 to Oct 2013,54 cases of middle or low rectal carcinoma were admitted.Protective ileostomy was created to prevent anastomotic leakage.Patients were divided into two groups receiving respectively intubation ileostomy (group A,28 cases),and conventional ileostomy (group B,26 cases).Results The mean time for anus to restore defecation was identical in the two groups.The period of protection of the anastomosis,was 21 d (15 ～ 35 d) in group A.The rate of spontaneous closure of the stoma after removal of the tube was 100％.The stoma was reduced after 3 to 6 months in group B and major complication developed in one case in this group.Conclusions Temporary ileostomy prevents anastomotic leakage of anterior resection in patients of rectal carcinoma receiving preoperative neoadjuvant chemoradiotherapy.Intubation ileostomy is effective and safe in prevention of anastomotic leakage saving stoma reduction procedures.

OBJECTIVE:To study the effects Weide'an tablet on gastric function and the expressions of epidermal growth fac-tor(EGF)and its receptor(EGFR)in gastric tissue of model rats with stress-induced gastric injury,and investigate its mechanism in the treatment of gastric ulcer. METHODS:Rats were randomly divided into normal group (normal saline),model group (nor-mal saline),positive group (ranitidine hydrochloride,0.015 mg/kg) and Weide'an tablet high-dose,medium-dose,low-dose groups (1.7,0.87,0.43 g/kg),10 in each group. Except for normal group,rats in other groups were given fasting swimming in cold water to induce gastric ulcer model. After modeling,all rats were intragastrically administrated once a day,for 2 weeks. The body mass of rats in 0,7,14 d of administration was recorded. After 12 h of last administration,gastric juice secretion,gastric juice pH,gastric ulcer area and gastric mucosal damage index of rats were detected,and the expressions of EGF and EGFR in gas-tric tissue were detected. RESULTS:Compared with normal group,body mass and gastric juice pH in 7,14 d in model group were declined;gastric juice secretion and gastric ulcer area were increased,gastric mucosal damage index was increased;and the expressions of EGF and EGFR in gastric tissue were enhanced,with statistical significances(P<0.05 or P<0.01). Compared with model group,except that the body mass,gastric juice secretion,gastric juice pH and gastric ulcer area in Weide'an medium-dose group in 7 d,and body mass,gastric juice secretion,gastric juice pH,gastric ulcer area and the expression of EGF in gastric tis-sue in Weide'an low-dose group in 7,14 d were not significantly improved,above indexes were significantly improved in other ad-ministration groups(P<0.05 or P<0.01);and the effect of Weide'an tablet showed a certain dose-effect relationship. CONCLU-SIONS:Weide'an tablet can significantly improve the gastric function of model rats with stress-induced gastric injury;and the mechanism may be related with enhancing the expressions of EGF and EGFR and promoting ulcer healing.

Objective To investigate the correlation between the use density of antibiotic and antifungal drugs and the positive rate of aspergillus in our hospital from 2009 to 2013,in order to provide a scientific basis for rational use of antibiotic and antifungal drugs. Methods The use density of carbapenems,two third-generation cephalosporins,and antifungal drugs,and the positive rate of aspergillus in our hospital from 2009 to 2013 were studied retrospectively. Their correlation was analyzed using SPSS software. Results There was significantly positive correlation between the use density of imipenem and that of fluconazole (r=0.913,P<0.05).The use density of biapenem was positively correlated with that of voriconazole (r=0.915,P<0.05).The use density of biapenem and that of voriconazole was positively correlated with positive rate of aspergillus,respectively ( r=0.918,r=0.955,both P<0.05).The other antibiotic and antifungal drugs were not significantly correlated to the positive rate of aspergillus.