Background The pathogenesis of allergic conjunctivitis has not been clearly established.Current researchers indicate that interleukin-4 (IL-4), IL-5 and IL-13 may play an important role in allergic conjunctivitis.But whether the roles of these inflammatory factors are same in different types of allergic conjunctivitis remains unclear.Objective This study was to investigate the expressions of IL-4, IL-5 and IL-13 in ocular surface with different types of allergic conjunctivitis.Methods A prospective cohort study was designed.Eighty individuals were recruited in Shanxi Eye Hospital from April 2013 to September 2014, including 20 patients with vernal keratoconjunctivitis (VKC), 20 patients with seasonal allergic conjunctivitis (SAC), 20 patients with perennial allergic conjunctivitis (PAC) and 20 normal healthy subjects.Surficial tissues were binocularly scraped using disinfected scraper from upper eyelid conjunctiva, and 4 μl of tear fluid was obtained with capillary tube.The expressions of IL-4, IL-5 and IL-13 protein and mRNA in the conjunctival epithelial cells were detected by immunohistochemistry and real-time fluorescence quantitative PCR.The IL-4, IL-5 and IL-13 concentrations in tear fluid were assayed by Luminex method.This study complied with Declaration of Helsinki and the research protocol was approved by the Shanxi Eye Hospital Ethics Committee.Written informed consent was obtained from each subject prior to entering the cohort.Results IL-4, IL-5 and IL-13 were positively expressed in cytoplasm of conjunctival epithelial cells in the VKC group,SAC group and PAC group,but the expressions of IL-4,IL-5 and IL-13 were absent in the normal control group.The relative expression levels of IL-4 mRNA were 4.11±1.24,2.71±0.71 and 2.00±0.80;the relative expression levels of IL-5 mRNA were 4.02±0.43,2.07±0.45 and 1.47±0.50;and the relative expression levels of IL-13 mRNA expression levels were 6.44±0.66,4.35±1.26 and 2.39±0.86 in the VKC group,SAC group and PAC group, showing significant differences among the 4 groups (F =51.32,220.18,162.49, all at P＜0.01).The relative expression levels of IL-4,IL-5 and IL-13 mRNA were significantly higher in the VKC group than those in the SAC group and PAC group;and those in the SAC group were significantly elevated in comparison with the PAC group (all at P＜0.05).No IL-4, IL-5 and IL-13 were detected in the tear fluid in the normal control group;while the concentrations of IL-4,IL-5 and IL-13 in the tear fluid were (14.06±3.50), (10.88±1.82) and (34.28±8.42) pg/ml in the VKC group,and (7.71 ±0.65), (5.10± 1.33), (23.77±6.29) pg/ml in the SAC group as well as (3.30± 1.50) pg/ml, (2.43± 1.28) pg/ml and (17.67 ± 4.28) pg/ml in the PAC group, showing significant differences among the 3 groups (F =200.29,260.49,128.23, all at P＜0.01).IL-4, IL-5 and IL-13 concentrations in the tear fluid were significantly higher in the VKC group than those in the SAC group and PAC group,and those in the SAC group were significantly raised in comparison with the PAC group (all at P＜0.01).Conclusions IL-4,IL-5 and IL-13 participate in the pathogenesis of multiple allergic conjunctivitis,but their expressions in the ocular surficial tissue are discriminatory in different types of allergic conjunctivitis.

BACKGROUND:Spiral acetabular prosthesis has good stability during total hip arthroplasty.
OBJECTIVE:To observe the early therapeutic effect of Zweymüler spiral acetabular prosthesis in total hip arthroplasty for patients with developmental dysplasia of the hip.
METHODS:Totaly 38 patients (48 hips) with developmental dysplasia of the hip received total hip arthroplasty with Zweymüler spiral acetabular prosthesis from January 2011 to June 2013 were selected. The clinical effect was observed after the operation.
RESULTS AND CONCLUSION: A total of 38 patients were folowed up for 21-46 months (averagely 42.3 months). One case suffered from deep venous thrombosis. Harris scores and Charnely scores apparently increased after surgery compared with that before surgery. The mean length of the osteotomy was 2.42±0.48 cm, and the mean extended length of the affected limb was 4.58±1.15 cm. X-ray films showed that there was no disunion of the osteotomy, no subsidence and loosening of prosthesis. The position of the acetabulum was suitable. The healing time of bone graft was 3-11 months (averagely 5.3 months). The coverage of the acetabular component was 92.5%, with a good initial stability, and the excelent rate of the operation was 90%. The satisfaction rate of patients was 84%. These results indicate that the Zweymüler spiral acetabular prosthesis has the advantages of reasonable design, good initial stability, low loosening rate and high satisfaction degree. However, the number of cases of this study was relatively smal, the folow-up time was short, and only the short-term effect was evaluated. Thus, the midterm and long-term effects need to be observed by the folow-up evaluation.

Selective estrogen receptor modulators (SERMs) is a class of estrogen-like non-steroid compounds that are able to bind to steroid hormone receptors .They can act as estrogen receptor agonist or antagonist depending on the target tissue and hormonal environment .Additionally , SERMs play an antioxidant role by scavenging oxygen free redicals , inhibiting lipid peroxidation , adjusting the level of NO and NOS , inhibiting mitochondrial permeability transition , improving the metabolism of free fatty acids in the mitochon-drial and regulating non-genomic transcription pathway .

By expounding the definition and application status quo of egg freezing with non-medical factors, this paper ethically analyzed the conflict between egg freezing with non-medical factors and assisted reproductive technology standard management. After systematic evaluation on effectiveness, safety, economy and ethics, it sug-gested that the egg freezing with non-medical factors required careful consideration.

Objective To evaluate the effect of dexmedetomidine on renal functions during the anesthesia of renal transplantation.Methods Sixty patients (36 males, 24 females, aged 25-45 years, ASA physical status Ⅱ or Ⅲ), were randomly divided into two groups (n=30 each).Patients in dexmedetomidine group received a loading dose of dexmedetomidine 1 μg/kg within 10 min)and a continuous infusion of dexmedetomidine 0.6 μg·kg-1·h-1 until 30 min toward the end of surgery, while patients in control group received 0.9% sodium chloride injection to maintain equal capacity until 30 min before the end of surgery.Artery systolic blood pressure and heart rate were recorded before anesthesia induction (T1), before vascular anastomosis opening (T2), immediately after vascular anastomosis opening (T3), 30 min after vascular anastomosis opening (T4), after the surgery (T5), venous blood was collected in T2, T4, 24 h after surgery (T6) and 48 h after surgery (T7) to detect the blood urea nitrogen (BUN), serum creatinine (Cr), IL-18 and Cystatin C (Cys C);fluid infusion and urine were recorded.Results Compared with control group, HR of dexmedetomidine group was reduced at T3, SBP of dexmedetomidine group was elevated at T2, T3(P<0.05).Compared with T2, Cys C, BUN, Cr of two groups decreased significantly at T6, T7, and Cys C of dexmedetomidine group was lower than that of control group (P<0.05).Compared with T2, IL-18 of the two groups reduced significantly at T6 and T7, and lowered amplitude in the dexmedetomidine group was greater than that in the control group (P<0.05).Perioperative urine volume in the dexmedetomidine group was more than that in the control group (P<0.05).There was no difference in perioperative fluid infusion between the two groups.Conclusion Perioperative continuous infusion of dexmedetomidine might effectively improve the renal function of renal transplantation patients.

Objective To describe the characteristics of organizational culture,to identify the level of quality of work life,and to explore the relationship between each dimension of organizational culture and quality of work life among nurses in tertiary hospitals in Yunnan Province,China.Methods The subjects were 416 nurses from six tertiary hospitals in Yunnan Province.Research instruments were the Organizational Culture Profile (OCP) and the Quality of Work Life Scale (QWLS).Results The results of this study showed that four dimensions of organizational culture including competitiveness (3.56 ± 0.49);performance orientation (4.08 ± 0.22);stability (3.68 ± 0.43) and social responsibility (3.95 ± 0.37) were prominent.The other 3 dimensions,namely supportiveness (3.19 ± 0.79);innovation (3.21 ±.0.62) and emphasis on rewards were perceived (2.42 ± 0.79) as less prominent.The overall mean score of quality of work life was at a moderate level (57.46 ± 15.17).Conclusion There are positive significant correlation between each dimension of organizational culture and quality of work life (P＜ 0.01).Improvement of organizational culture can enhance quality of work life among nurses,and then guarantee the nursing quality.

Through ethical analysis of the conflicts appearing in four special cases in the four steps of assisted reproductive technology implementations, this paper pointed out the measures to solve them in the perspective of le-gal protection, standardized management, ethical supervision, and self-regulation for making the research and ap-plication of assisted reproductive technology serve patients better and promoting the healthy development of assisted reproductive technology.

BACKGROUND:The post-core crown system is an effective method for dental defect repair, but its repair outcomes are influenced by various factors;thereby, a further study is needed to optimize this method.OBJECTIVE:To investigate the stress distribution in different degrees of dental defect after post-core crown restoration under different occlusal contacts. METHODS:Three-dimensional models of the mandibular first molar were established by CT images, and models of complete natural teeth, six different defected teeth (total maxil ofacial slight and severe defects, distal middle maxil ofacial slight and severe defects, proximal middle maxil ofacial slight and severe defects) and two different post-core crowns (fiber post and zirconia post) were created by software. These models were imported into ANSYS software to analyze the stress distribution in dentin and periodontium under stable occlusal contact (ABC) and unstable occlusal contact (AC), respectively. RESULTS AND CONCLUSION:The stress in dentin and the periodontium after post-core crown restoration under AC was obviously higher than that under ABC, and AC affected the restored teeth more markedly. The post-core crown material with higher elastic modulus could induce higher stresses, and severe defected teeth showed higher stress distribution. Different defected types made no overt effects on the stress distribution in the periodontium. These results suggest that the B area contact is critical in regulating occlusal contacts of restoration.

Objective To analyze the related factors in new born failed in hearing screening and its audiological characteristics . Methods From May 2009 to Febrary 2012 ,952 infants within the 3 to 6-month-old with detailed birth records and hearing screen-ing records were reviewed in the study .They were born in Chongqing and surrounding areas ,but failed in the first and second hear-ing screening .They were tested by auditory brainstem response (ABR) ,distortion product otoacoustic emissions (DPOAE) ,tympan-ometry and stapedius reflex .Results The normal ratio of tympanogram ,normal group(74 .25% ) was higher than the high-risk group(69 .61% )(P<0 .05);The pass proportion of DPOAE in normal group(34 .57% ) was higher than high-risk group(27 .94% ) (P<0 .05);In normal group ,ABR response threshold >30 dBnHL was 55 .80% ,60 .36% in high-risk group .High-risk group′s hearing abnormality rate was significantly higher than the normal group (P<0 .05);In normal group ,mean threshold of ABR was (47 .64 ± 22 .86)dBnHL .While it was(50 .58 ± 25 .02)dBnHL in high-risk group .The threshold was higher in normal group than high-risk group(P<0 .05) .Conclusion premature birth ,low birth weight(<1 500 g) ,hyperbilirubinemia ,neonatal asphyxia ,pal-ace the virus infection ,mechanical ventilation ≥ 5 days ,≥ 2 high-risk factors are risk factors for hearing loss .Newborn hearing screening is a long and arduous task ,We should enhance screening efforts in infant with high risk factors ,and actively prevent and treat neonatal perinatal risk factors and reduce the incidence of hearing loss .

Objective To observe the influence of Maixuekang therapy on hematoma absorption,cerebral edema and neural function in patients with acute intracerebral hemorrhage within 3 weeks.Methods A total of 89 patients with acute intracerebral hemorrhage were divided into control group (45 cases) and treatment group (44 cases) by random digits table method.The two groups were implemented routine therapy and individualized rehabilitation treatment.Furthermore,the patients in treatment group were treated with Maixuekang (1.0 g,thrice a day for 3 weeks),if reexamination result of cerebral CT showed no expanding hematoma after 24 h from the onset of intracerebral hemorrhage.Cerebral hematoma and edema volume was measured by brain CT before therapy and on the 7th,14th and 21st day after therapy,and neurologic impairment was scored at the same time points by neurological impairment scale(NIS).The results were analyzed with statistics.Results The cerebral hematoma volume,edema volume and NIS before therapy,on the 7th,14th and 21st day after therapy in two groups respectively was (22.4 ± 8.4) ml,(9.5 ±2.6) ml,(25.4 ±3.8) scores,(21.7 ±7.6) ml,(19.9 ±7.1) ml,(25.3 ±3.4) scores,(18.9 ±6.7) ml,(18.3 ± 5.7) ml,(23.8 ± 3.0) scores,(15.3 ± 5.4) ml,(14.5 ± 4.8) ml,(21.7 ± 2.5) scores in control group; (22.3 ± 8.6) ml,(9.4 ± 2.5) ml,(25.3 ±3.6) scores,(19.6 ± 7.0) ml,(17.3 ± 6.4) ml,(23.9 ± 3.2) scores,(15.5 ±5.9) ml,(15.1 ±4.5) ml,(20.5 ±2.8) scores,(11.2 ±4.5) ml,(10.7 ±3.3) ml,(17.4 ± 2.1) scores in treatment group.The cerebral hematoma volume and edema volume was significantly smaller in treatment group than that in control group after therapy (P ＜ 0.05 or ＜ 0.01),but did not show significant difference compared with that before therapy (P ＞ 0.05).Conclusion Maixuekang therapy can significantly reduce cerebral edema and contribute to hematoma absorption and nerve functional recovery in patients with acute intracerebral hemorrhage.