Accompanying with the development of technological level,optical coherence tomography plays a more and more important role in predicting the surgical outcome for idiopathic macular hole.Preoperative morphologic parameters like minimum diameter,base diameter,maximum height,macular hole index,hole form factor,tractional hole index,macular hole closure index,photoreceptor inner-outer segment junction,cone outer segment tips line,central subfield retinal thickness and macular hole inner opening diameter were proved correlated to postoperative visual acuity and anatomical results.It has important application value to know these predictors to judge the surgical outcome and deepen understanding of idiopathic macular hole.

· AlM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability.
· METHODS: A total of 120 pterygium patients ( 120 eyes) were divided into three groups, each 40 cases (40 eyes).Data including SchirmerⅠtest (SⅠt), tear break-up time ( BUT) , corneal fluorescein staining ( CFS) were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.
·RESULTS:There were no significant differences in BUT in group A before the operation and one month after operation.Groups B and C showed significant difference before and after operation, but differences were not statistically significant ( all P<0.05 ); One month after operation, there was significant difference in CFS among group A, B and C (P<0.05), but the difference was not satistically significant between groups B and C; After 3mo, BUT in group A was not significant difference compared with the preoperative; but there was significant difference in groups B and C (P<0.05).When
compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative (P<0.05), but no significant difference between the two groups;After 3mo, CFS of preoperative group A and group B and group C had no significant difference. After 10mo follow - up, there was axsignificant difference ( P<0.05 ) in recurrence rate in group A comparing with groups B and C, there were differences between groups B and C, but no statistically significant.Surgery is more likely to relapse in summer than in winter.
·CONCLUSlON: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.

The medical staff's ability to apply medical statistics is deficient at present.In order to bring up eligible students and improve the teaching quality of medical statistics,the author has advanced his thoughts and opinions on teaching contents,teaching ways and examination ways.

Objective To evaluate the effective treatment for and prevention of complications. Methods The diagnosis and treatment of 32 patients with acute arterial ischemia of the lower extremity were analyzed (retrospectively). 4 cases were treated with thrombolytic therapy, 28 cases underwent emergency operation, of which 3 cases underwent amputation after embolectomy, and 25 cases were treated by arteriotomy of femoral artery and embolectomy with Fogarty catheter(7 cases underwent concomitant arterioplasty).Results One (patient) in the nonoperative group died; but there was no mortality in the operated group. Limb amputation was done in 3 cases, and limbs were saved in 28 cases. Conclusions For acute arterial ischemia of the lower (extremity), emergency arteriotomy of femoral artery plus embolectomy is the treatment of choice. This (therapeutic) approach can lower mortality and limb amputation rate.

Objective To investigate the significance of T‐SPOT .TB and real‐time quantitative Polymerase Chain Reaction (PCR) in the diagnosis of extrapulmonary tuberculosis .Methods Among the 125 cases of extrapulmonary tuberculosis group ,all the 125 cases were performed in accordance with the acid fast bacilli smear ,TB‐PCR and T‐SPOT .TB detection .87 cases of Non‐tuberculosis disease group were detected .Results Among 125 cases of extrapulmonary tuberculosis ,4 cases were positive for acid fast bacilli smear and the positive rate was 3 .2% ;57 cases were positive byTB‐PCR and the positive rate was 45 .6% ;96 cases were positive by T‐SPOT .TB and the positive rate was 76 .8% .wo methods were detected in104 cases of positive patients ,the positive rate was 83 .2% .3 cases were positive by TB‐PCR and the positive rate was 3 .4% in 87 cases with non tuberculosis disease group . 4 cases were positive by T‐SPOT .TB and the positive rate was 4 .6% .Conclusion Here is an important practical value in the diag‐nosis of T‐SPOT .TB detection technology in extra pulmonary tuberculosis ,and TB‐PCR joint detection could further improve the detection rate of pulmonary tuberculosis .

Objective To explore the expression of c-met mRNA in nasopharyngeal carcinomas(NPC) and its relation with clinical biological behavior. Methods In situ hybridisation was used to detect mRNA expression of c-met in 15 cases NP and 55cases NPC. Results The positive rate of c-met mRNA in NP and NPC cells were were 13.3 %(2/15) and 61.8 %(34/55) respectively. The expression of c-met mRNA was significantly correlated with lymphnode metastasis, local invasion(basilar destroying) (P 0.05). Conclusions The abnormality expression of c-met gene expression was well correlated with the biological behavior of metastasis and invasion. The expression of c-met mRNA could serve as an important index to estimate the prognosis of NPC. c-met may be a new diagnostic/therapeutic targert of NPC.

To study the related substances in nicergoline, electrospray positive ionization high resolution TOF/MS was used for the determination of the accurate mass and elemental composition of the related substances. Triple quadrupoles tandem MS/MS was employed for the determination of the fragmentations of the parent ions. 16 related substances were detected and identified to be eight synthetic by-products and eight degradation products, by using impurity references matching, product mass spectra fragmentations elucidation, and verified further according to synthetic processes and stress testing results. The results obtained are valuable for nicergoline manufacturing process control and quality assurance.

Objective To explore the prevalence and the relative factors of the overweight and the obese in a population of Gansu Province pre-pregnancy women.and the effects of pre-pregnancy maternal body mass index (BMI) on gestational weight gain and pregnant outcome.Methods We conducted a populationbased birth cohort study in Gansu Province Maternity and Child Health Care Hospital from February,2010 to December,2011.Single live term birth women who have complete anthropometry were enrolled this study.They were categorized into four BMI groups according to World Health Organization's BMI recommendations for Asian populations.We explored the prevalence and the relative factors of the overweight and the obese,and the effects of pre-pregnancy maternal body mass index on gestational weight gain and birth outcomes by Chi-square test,analysis of variance.Results A total of 6 400 cases included in this study.The BMI range is from 13.3 to 38.1,the average BMI is (20.6 ±2.7).Among 6 400 cases,636 cases(9.9％) and 416 cases (6.5％) were overweight and obese.The average age (unit:years) is increase gradually in low weight group (27.8±3.8),normal group (29.1 ±4.3),overweight group (30.3 ±4.7) and obese group (30.6±4.6),the difference was statistically significant (F=77.490,P＜0.01).The result prompt that the median BMI increased with the increasing of maternal age (r=0.18,P＜0.01).The BMI of multiparous women (21.22 ±2.63) is higher than nulliparous women (20.43 ± 2.64),the difference was statistically significant (t=-9.630,P＜0.01).The BMI has negatively correlated with education level and economic income level (r=-0.06,P＜0.01; r=-0.04,P=0.036).With the increase of BMI,the weight gain of early (13 weeks) pregnancy (F=8.892,P＜ 0.01) and the total weight gain during whole pregnancy (F=21.700,P＜ 0.01) gradually reduced in four groups.The neonatal birth weight in overweight group is largest,in turn higher than obesity group,normal group and low weight group,the difference was statistically significant (F=11.261,P＜0.01).With increasing BMI,the incidence of pre eclampsia (x2=85.758,P＜0.05),gestational diabetes mellitus (x2=58.913,P＜0.05),postpartum hemorrhage (x2=13.501,P＜0.05),neonatal hypoglycemia (x2=6.563,P＜0.05) and neonatal pulmonary hyaline membrane (x2=9.579,P＜0.05) was increased.The incidence of caesarean section (x2=125.442,P＜0.05),macrosomia (x2=62.963,P＜0.05) and birth defects (x2=9.087,P＜0.05) also increased.The incidence of abnormal umbilical cord in overweight group is highest,in turn higher than normal group,low weight group,and the obesity group (x2=15.82g,P=0.001).The incidence of neonatal electrolyte disorder in obesity group was higher than low weight group,normal group,and the overweight group (x2=12.092,P=0.007).The incidence of preterm birth in overweight group is highest,in turn higher than obesity group,normal group and the low weight group (x2=7.865,P=0.049).Compared with the normal group,the risk of caesarean section (OR=l.700,95％ CI:1.325-2.181),pre-eclampsia (OR=2.436,95％ CI:1.578-3.761),gestational diabetes (OR=3.182,95％ CI:1.049-9.653) and abnormal umbilical cord (OR=2.252,95％ CI:1.267-4.004) in overweight group was increased.the risk of pre eclampsia (OR=2.585,95％ CI:1.020-6.914),macrosomia (OR=2.484,95％ CI:1.017 6.070),neonatal electrolyte disorder (OR=4.430,95％ CI:1.290-t5.217) in obesity group was increased.Conclusions The median BMI before pregnancy increased with increasing maternal age,parity,but decreased with education level and income level.The weight gain of early (13 weeks) pregnancy and the total weight gain during whole pregnancy decreased with increasing BMI.Overweight and obesity before pregnancy increased the risk the caesarean section,preeclampsia,gestational diabetes,macrosomia and neonatal electrolyte disorder.

Objective To observe the changes of zymophagy during experimental acute pancreatitis (AP) induced by caerulein.Methods Pancreatic acinar cell line AR42J cells were cultured in 6-well plates till 90％ confluent and then divided into AP group and control group.Caerulein (1 × 10-8 mol/L) was added into AP group to establish AP cell model,and 1640 cell culture medium was added into control group.After caerulein treated for one,four,six,eight,12 and 24 hours,cells and cell culture supernatant were collected.The levels of cytokine interleukin (IL)-1,tumor necrosis factor (TNF)α,trypsinogen activation (TAP) and amylase were measured with enzyme-linked immunosorbent assay (ELISA) method.The expression of LC3 and Beclin1 at mRNA of each group were detected by reverse transcription-polymerase chain reaction (RT-PCR).The LC3B protein level of each group were detected by Western blotting.The changes of autophagosome and zymophagosome were observed by transmission electron microscopy.The difference between AP group and control group was analyzed by analysis of variance.Results The level of IL-1,TNFα,amylase and TAP in cell culture supernatant of control group was (18.83±7.10) pg/mL,(14.20±3.79) pg/mL,(10.03±2.85) U/L and (39.48±8.62) pg/mL,respectively.Those of AP group significantly increased at first hour ((62.13±11.25) pg/mL,F=3.32,P＜0.01 ; (30.98±7.11) pg/mL,F=3.05,P＜0.05; (25.06±6.82) U/L,F=2.90,P＜0.05 and (128.51± 18.30) pg/mL),F=2.62,P＜0.01,at fourth or sixth hour reached peak (IL-1 at fourth hour:(71.96± 15.82) pg/mL,F=7.25,P＜0.01;TNFα at sixth hour:(39.92±8.94) pg/mL,F=4.93,P＜0.05; amylase at fourth hour:(28.83 ± 8.31) U/L,F=2.06,P＜0.05; TAP at fourth hour:(146.29± 29.36) pg/mL,F=0.14,P＜0.01) and then gradually decreased.At fourth and sixth hour,the expression of LC3 at mRNA level in AP group was 3.18±0.82,1.71±0.14,respectively,while the expression of Beclin-1 rnRNA at first,fourth hour was 2.44±0.34 and 4.13±0.30,all of them were significantly increased compared with those of control group (0.21±0.04 and 0.30±0.08,LC3 mRNA F=0.79、0.06; Beclin mRNA F=2.31、0.36,all P＜ 0.05).There were no significant differences at other time points.The numbers of autophagosome and zymophagosome of AP group were significantly higher than those of control group under transmission electron microscopy.Conclusion Zymophagy occurred during AP cell model induced by caerulein,which suggested that zymophagy might involve in the mechanism of AP.

Background:Damage of intestinal mucosal barrier is a key factor in the development and progress of acute pancreatitis(AP),and is closely related with the prognosis of the disease. Aims:To investigate the protective effect and possible mechanism of mucoprotective agent teprenone on intestinal mucosal barrier in rats with experimental AP. Methods:Forty-five adult male Sprague-Dawley rats were randomly divided into normal control group(n = 5),AP model group(n = 20)and teprenone treated group(n = 20). AP model was established by subcutaneous injection of cerulein at abdominal wall. Rats in treated group were intervened with teprenone intragastrically before and after model establishment. ELISA was used for measurement of serum interleukin-1(IL-1),IL-6,tumor necrosis factor-α(TNF-α)and amylase;histopathological and ultrastructural changes of small intestinal mucosa were observed by light microscope and transmission electron microscope;Western blotting was used to detect the expressions of tight junction protein occludin and ZO-1. Results:Serum levels of IL-1,IL-6,TNF-α and amylase in AP model group were significantly higher than those in normal control group(P < 0. 05),accompanied by necrosis and exfoliation of small intestinal villus,widening of intercellular tight junctions and downregulation of occludin and ZO-1 expression. While in teprenone treated group,serum levels of proinflammatory cytokines and amylase were significantly decreased as compared with AP model group(P < 0. 05),the villus of small intestine remained intact,and dense tight junctions were observed. Expressions of occludin and ZO-1 in teprenone treated group were upregulated. Conclusions:Teprenone may protect against intestinal mucosal barrier injury in AP model rats by upregulating tight junction protein expression.