?Pterygium is one of the most common ocular surface diseases. Its exact etiology and pathogenesis are not completely understood. At present, it is considered that its occurrence and development is the result of many factors. Current studies have indicated that the occurrence of pterygium is closely related to the environmental factors. Long time exposure to sunlight, dust, pollen and other long - term chronic stimulation are the main incentive factors. Various factors have caused limbal barrier dysfunction, induced the level of a variety of growth factors and inflammatory factors increased, so that the conjunctival tissue degenerate and proliferate to the cornea in the formation of pterygium. In this paper, the research progress of the pathogenesis of pterygium is reviewed.

Objective To investigate the antimicrobial resistance of Gram-positive cocci isolated from 17 hospitals located at different areas in China. Methods All the Gram-positive cocci isolated from 17 hospitals from October 1 st, 2004 to September 30th, 2005 were collected for susceptibility test using standard agar dilution method issued by The Clinical and Laboratory Standards Institute (CLSI,2004). The minimal inhibitory concentration (MIC)50 and MIC90 were detected for antibacterial activity in vitro of 35 antimicrobial agents. The rates of resistance, intermediate and susceptiblity of bacteria to the agents were calculated. Results Totally, 925 Gram-positive cocci strains were collected during the period, which included Staphylococcus 536, Enterococcus 249, Streptococcus 137 and other Gram-positive cocci 3; the rates of oxacillin resistant Staphylococcus aureus (ORSA) and oxacillin resistant Staphylococcus epidermidis (ORSE) were 62.9% and 82.9%, respectively. The penicillinnonsusceptible Streptococcus pneumoniae (PNSP) was 40.7 % including 10.5 % resistant and 30.2intermediate. All strains of Enterococcus were susceptible to teicoplanin. No Enterococcus was resistant to vancomycin. Five strains of Enterococcus were found intermediate to vancomycin, which were 1 E.faecalis, 2 E. faecium, 1 E. gallinarum and 1 E. avium. No glycopeptides resistant Gram-positive coccus was detected. Conclusions The antimicrobial resistance of Gram-positive cocci is increasing with higher isolate rate of penicillin-resistant Streptococcus pneurnoniae (PRSP) and methicillinresistant Staphylococcus aureus (MRSA). All the investigated Gram-positive cocci are highly resistant to macrolides. No glycopeptide resistant strains are detected during the surveillance.

Objective To evaluate the value of 64-slice spiral CT angiography in diagnosing diabetic leg arteriosclerosis obliterans(DLASO).Methods 64-slice spiral CT angiography was done in 90 patients with diabete and suspected vascular disorders of lower limb.Images were analyzed on the basis of the transverse CT source data including the maximum intensity projection(MIP),volume rendering(VR),multiplanar reconstruction(MPR) and curved planar reconstruction(CPR).Results 64-slice spiral CT angiography could exactly show the space relationship and anatomical detail of aortoiliac and lower extremity arteries.Arteriosclerostic obliterans was found in variant degree in 67 cases(67/90),of them,49(56.3%) were slight to medium arteriostenosis,18(20.7%) were obvious arteriostenosis and 7 were complete obstructed with collateral circulation.Conclusion 64-slice spiral CT angiography is of significant value in the assessment of arteriosclerosis obliterans of lower extremity arteries in the patients with diabetes.

Objective To assess the efficacy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the breast in the detection of residual lesions of early stage breast carcinoma after lumpectomy. Methods 53 patients with breast masses confirmed to be malignant tumors by pathology after lumpectomy underwent the dynamic contrast-enhanced breast MR imaging and then further surgical treatment by lumpectomy. The DCE MRI-based diagnoses were compared to the results of pathological analyses after the second lumpectomy. Results 17 (32%) cases were detected with abnormal enhancement. 8 cases presented mass-like enhancements , and 6 of them showed tumorous residuals (P < 0.01). 6 presented focal enhancements, taking up 35% and one of them was confirmed pathologically to have tumorous residuals (P < 0.01). 3 cases presented mass-like enhancement, taking up 18% and 2 of them were confirmed with cancerous residuals . MR dynamic enhancement showed 68% of the them presented no abnormal enhancements in the breast and 33 of themhad no residual cancer , taking up 92%. 3 of them were confirmed with tumorous residuals , taking up 8%. The The positive predictive value and negative predictive value of DCE MR imaging for diagnosing residual malignant lesion were 52% and 92%, respectively . Conclusion The dynamic contrast-enhanced MRI of breast is helpful for evaluating residual malignant lesion after lumpectomy and affects positively subsequent treatment.

Objective investigate the correlation between plasma soluble receptor for advanced glycation endproducts (sRAGE) and arterial stiffness in patients with different types of metabolic syndrome (MS).Methods A total of 180 subjects were drawn from a epidemiologic follow-up study,including 60 cases non-metabolic syndrome (NMS),60 cases metabolic syndrome without diabetes mellitus (NDMMS),60 cases metabolic syndrome with diabetes mellitus (DMMS).Carotid femoral arterial pulse wave velocity (CFPWV) was assessed by the French KangPuLe atherosclerosis measurement instrument,and plasma sRAGE levels were measured by ELISA.Comparison of mean in multiple groups was conducted by analysis of variance.Multivariate analysis was done with multiple linear stepwise regression analysis.P ＜ 0.05 was considered as statistically significant difference.Results Compared with NMS group,plasma sRAGE levels were significantly lower in DMMS and NDMMS groups [(635.07 ± 229.20) pg/mL vs.(671.17 ± 358.16) pg/mL vs.(992.99 ± 427.83) pg/mL,P =0.001].CFPWV of DMMS group was significantly higher than that of NMDMS and NMS groups (14.22 ±3.14) m/s vs.(12.15 ±2.79) m/s vs.(11.66 ± 2.52) m/s,P =0.002).Plasma sRAGE level was negatively correlated with CFPWV (r =-0.278,P =0.005).(3) Multiple linear regression analysis demonstrated that age (β =-0.091,95％ CI-0.096 ～-0.095,P =0.031),HDL-C (β =1.295,95％ CI 1.231 ～ 1.360,P =0.022) and sRAGE (β =0.119,95％ CI 0.118 ～ 0.130,P =0.032) had a significant effect on CFPWV.Conclusions The increased arterial stiffness is closely related to the discreased plasma sRAGE levels in MS.Plasma sRAGE maybe a novel target for vascular disease prevention and treatment in patients with metabolic syndrome.

Aim To explore the inhibitory effect of dexamethasone on the expression of SH2-B? in the lung and the visceral sensory afferent system(C7-T5 spinal ganglia and the corresponding posterior horn of the spinal cord)of asthmatic mice.Methods Murine model of asthma of BABL/c mice was induced by ovalbumin in vivo.By means of immunohistochemistry and Western blot,the expression of SH2-B? in the lung,C7-T5 spinal ganglia and corresponding spinal cord was detected and the inhibitory effect of dexamethasone on it was observed.Inspiratory airway resistance was measured with AniRes 2003 lung function system.Results The expression of SH2-B? in the lung,C7-T5 spinal ganglia and the corresponding spinal cord of the asthmatic mice was much higher than that of the control group and the dexamethasone group(P

Teaching the foreign students clinical medicine in English in the earlier period of foreign students education has played a vital role but also has such problems as teachers,difficulties in the later teaching and so on.Through practice we find that it is necessary to transit the mode from teaching in English to bilingual education,and finally teaching in Chinese in the internship to conform with the present medical foreign students education situation.Therefore ability of teaching in English and proficiency in Chinese are needed to improved as soon as possible.

AIM:To study the correlation of serum uric acid ( UA) level with carotid plaques and arterial stiff-ness in the patients with essential hypertension ( EH) , and to explore the predictive value of serum UA for evaluating EH preclinically .METHODS:A total of 92 patients with EH and 30 healthy individuals were enrolled .The value of UA and other indicators were detected .B-mode ultrasound examination was performed to measure the common carotid artery intima -media thickness ( IMT) and the sites of plaque in the internal carotid-artery, external carotid artery and carotid bifurca-tions.Carotid-femoral arterial pulse wave velocity ( CFPWV) was assessed by Complior?atherosclerosis measurement in-strument.RESULTS:The serum level of UA in the patients with EH was higher than that in control group [(361.51 ± 83.81) μmol/L vs (317.03 ±62.22) μmol/L, P<0.05].The mean value and abnormal rate of IMT between hyperten-sion group and control group were significant difference [(0.69 ±0.14) mm vs (0.60 ±0.12) mm, 42.39%vs 10.00%, P<0.05].In 92 EH patients, 45 cases had carotid plaques .These 45 cases were divided into 3 groups according to the plaque severity, among which the serum UA level had statistically significant differences [(285.25 ±78.41) μmol/L, (341.19 ±63.99) μmol/L and (401.33 ±88.49) μmol/L, P<0.05].Compared with rigid plaque group ( n=34), the serum UA level in soft plaque group (n=11) was significantly higher [(389.00 ±69.45) μmol/L vs (323.03 ± 72.71) μmol/L, P<0.05].A stepwise multiple linear regression analysis demonstrated that age ( r=0.414), systolic blood pressure (r=0.224), pulse pressure (r=0.270) and uric acid (r=0.219) were predisposed factors for higher CFP-WV (P<0.05).CONCLUSION:UA is one of the risk factors causing hypertension .Serum UA level may reflect the sever-ity and stability of carotid plaques .The increased arterial stiffness is closely related to the increased serum UA level in EH .

To state the importance of scientific research capability and general practitioners training for the poor scientific innovation conditions of general practitioner standardization training by the analysis of several ways to improve the scientific research capacity and the probe of the impact on strengthening the consciousness of scientific research to help general practitioner to better work in the areas of primary care and public health.