AlM: To compare the effects of external approach microsurgery and conventional external approach surgery for retinal detachment ( RD) .METHODS: From January 2010 to January 2013, 60 patients (60 eyes) in our hospital were randomly divided into experimental group (29 cases, 29 eyes) and control group ( 31 cases, 31 eyes ) , the external approach microsurgery and conventional external approach surgery were performed respectively ( by the same skilled doctor ) . Retinal reattachment rate, visual acuity improvement rate and operative time were compared between two groups.RESULTS:lt cost shorter time for the external approach microsurgery than that of conventional external approach surgery ( P = 0. 0087 ). The once successful retinal reattachment rate in experimental group was 93% ( 27 cases ) , which was higher than that in control group (90%, 28 cases), there was no statistical difference. The vision improvement rate in control group was 86% ( 25 cases ) , compare to 90% ( 28 cases ) in experimental group, there was no statistical differences. CONCLUSlON: No statistical differences showed in visual acuity improvement and the once retinal reattachment rate between the two groups for rhegmatogenous retinal detachment. However, it is believed that external approach microsurgery could be faster, easier to learn with satisfactory effect.

Objective To examine the caregivers' burden and quality of life (QOL) of main caregivers of patients with Parkinson's disease by analyzing caregiver and patient-related factors. Methods A total of 53 cases with Parkinson's disease seen from October 2012 to December 2013 in Yantaishan hospital of Yantai City were selected. Assessments: (a) EuroQol-5 questionnaires, including: EQ-5 dimensions (EQ -5d) and visual analogue scale (VAS). (b) Unified Parkinson's Disease Rating Scale. (c) Hoehn-Yahr(H-Y) stage; (d) Parkinson's disease sleep scale (PDSS), 15 items; (e) Hamilton Anxiety Rating Scale (HAMD-14), Hamilton Depression Rating Scale (HAMA-24); (f) Chinese version of Zarit caregiver burden interview. Results Spearman correlation analysis showed that the EQ-5D index and EQ-VAS negatively correlated with HAMD-14 of caregivers of Parkinson diseasepatients (r=- 0.318, - 0.046) (P<0.05), and negatively correlated with H-Y staging (r=-0.592, -0.531), UPDRSI (r=-0.434, -0.316) , UPDRS Ⅱ (r=0.521, 0.513) , UPDRS Ⅲ (r=0.520, 0.534), UPDRS Ⅳ (r=0.564, 0.509), PDSS in patients with Parkinson's disease (r=0.547, 0.490), HAMD-14 (r=0.315, 0.350), HAMA-24 (r=0.413, 0.401) of Parkinson's disease patients (P<0.05). Caregiver burden was related with HAMD-14 (r=0.496), HAMA-24 (r=0.551),H-Y stage (r=0.697), PDSS (r=0.659), UPDRS Ⅰ-Ⅳ (r=0.538, 0.668, 0.696, 0.600), EQ-5D index of Parkinson disease patients (r=0.682), EQ-VAS of Parkinson disease patients (r=0.670) (P<0.05); and positively related with anxiety of caregivers (r=0.275) , and a negative correlation with the caregivers' quality of lives (r=0.665) (P<0.05). Bivariate analyses showed significant correlations between caregiver burden and patients' sleep, scores of Parkinson's motor symptoms, and caregivers' depression. Based on multiple regression analysis, Zarit score proved to be the main predictor of caregivers' QOL. Caregivers' age, total numbers of caregivers and H-Y stage also proved to be a relevant factor. Conclusion Improvement of patient's sleep, motor symptoms anddepression might alleviate caregivers' strain. There is a correlation between caregivers' burden and QOL. QOL of caregivers can be improved through reducing their care-burden.

Excessive and fast rise of medical expenses in China recent years has worsened the financial burden of both the government and individuals alike,making it a hotspot issue countrywide.To alleviate the difficulties of "accessibility to medical services" and "poverty or repoverty resulting from sickness" faced by the Chinese people at large,we built a multi-factor analysis model to identify key factors contributing to such a fast rise of medical expenses based on an analysis of the medical expenses in Shandong Province.In addition,we discussed the causes for GDP and headcount of medical staff in relation to the rise of medical expenses,and the strategies to curb expenses.

Objective To investigate the role of receptor for advanced glycation end - products nuclear factor - κB(RAGE - NF - κB)signaling pathway in the lipopolysaccharide - induced acute lung injury(ALI)in neo-natal rats. Methods Thirty - two SD rats were divided into 4 groups by complete randomization method(8 cases in each group).(1)Lipopolysaccharide(LPS)group was given intraperitoneal injection of 9 g/ L saline and 3 mg/ kg LPS 1 h later.(2)Bortezomib group was given intraperitoneal injection of Bortezomib(0. 2 mg/ kg)and 3 mg/ kg LPS 1 h later.(3)Anti - RAGE mAb group was given intraperitoneal injection of anti - RAGE mAb(15 mg/ kg)and 3 mg/ kg LPS 1 h later.(4)Control group was given 9 g/ L saline was given at each time point. All the rats were sacrificed and observed 24 h later. Levels of tumor necrosis factor(TNF) - α in the plasma and bronchoalveolar lavage fluid(BALF) were detected by enzyme linked immunosorbent assay. RAGE and NF - κB levels in tissue homogenates were detected by Western blot and mRNA levels were detected by reverse transcription - polymerase chain reaction. The pathological assessment of the lung tissues was performed by HE staining. Results (1)Among 4 groups,there were significantly differences in TNF - α in serum and BALF(F = 150. 70,P ﹤ 0. 001;F = 165. 83,P ﹤ 0. 001). Levels of TNF - α in LPS group were significantly higher than those of two pretreatment groups(all P ﹤ 0. 05).(2)Western blot figures il-lustrated that the concentrations of RAGE mRNA and NF - κB in anti - RAGE mAb group and bortezomib group were lower than those of the LPS group.(3)Reverse transcription - polymerase chain reaction analysis showed that there were significant differences in the expression of RAGE mRNA and NF - κB mRNA among 4 groups(F = 175. 14,P ﹤0. 05;F = 188. 65,P ﹤ 0. 05). Levels of RAGE mRNA and NF - κB mRNA in the LPS group were significantly higher than those of two pretreatment groups(all P ﹤ 0. 05).(4)Lung injury score differences among 4 groups were statistical-ly significant(F = 106. 01,P ﹤ 0. 001). Pathological changes in two pretreatment groups reduced compared to those of the LPS group(all P ﹤ 0. 05). Conclusions RAGE - NF - κB signaling pathway regulates the LPS - induced ALI in neonatal rats. Anti - RAGE mAb and Bortezomib both have a protective effect on LPS - induced ALI.

OBJECTIVE: To optimize the extraction process of total flavonoids from flos lonicerae. METHODS: The time and temperature of extracting, the amount of solvent and the extraction times of total flavonoids from flos lonicerae was optimized using the uniform design. With the yield total flavonoids as markers to conduct U11(116) experiment and optimize the technology. RESULSTS: The optimum extraction process was adding 10 times 5% alcohol extracting for 1 h (only one time) at 85 ℃. CONCLUSION: This extraction process is simple, reliable and serves as a theoretic basis for the extraction process of total flavonoids from flos lonicerae.

OBJECTIVE: To study the in vitro antibacterial activity of the crude extract of total flavonoids from Lonicera japonica against the main pathogenic bacteria.METHODS: With DM130 macroporous resin as stationary phase,the different components(component A contained more sugar,and content B less sugar;C,D and E components were eluted by 20%,40%,and 60% ethanol,respectively) were obtained by gradient elution of the aqueous extract from Lonicera japonica using different concentration of ethanol,then the MIC of different components on main pathogenic bacteria were detected.RESULTS:The antibacterial activity of component B against staphylococcus aureus was more ponent with its MIC at about 1 mg?mL-1.CONCLUSION:Component B has ponent antibacterial action on main pathogenic bacteria.

Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer.Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2-II B cervical cancer patients were divided into observation group(n=43) and control group(n=37),the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer,patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect,operation time,intraoperative blood loss,postoperative pathological risk factor differences of two groups of patients were compared.Results (1)Evaluated the curative effect of neoadjuvant chemotherapy,squamous cell carcinoma group complete remission(CR) 4 cases,partial remission(PR) 22 cases,stable disease(SD),6 cases of disease progression(PD) in 0 cases,in adenocarcinoma group CR 1 cases,PR 3 cases,SD 5 cases,PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group,the difference was statistically significant(z=2.4968,P=0.0063).(2)The operation time((215±57) min) and intraoperative blood loss((682±145) ml) in the observation group were significantly lower than those in the control group(((259±62) min,(758±193) ml)),the difference was statistically significant(t=3.8780,2.2528,P=0.0002,0.0263).(3)The two groups of patients with ureteral fistula(P=0.5039),vesicovaginal fistula(P=0.3639),wound healing(P=0.5182),lower extremity deep venous thrombosis(P=0.4818) complications had no significant difference.(4)The positive rate of the observation group of lymph nodes(χ2=8.2005,P=0.0000),parametrial infiltration rate(χ2=8.1553,P=0.0000) was significantly lower than the control group,the difference was statistically significant.Two groups of patients with deep myometrial invasion rate(χ2=0.0991,P=0.7516),the incidence of cancer embolus(χ2=0.0130,P=0.9176) compared to no statistical significance.Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer,neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer,operation time and blood loss are lower,node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect.

Objective To investigate the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases(Akt) signal transduction pathway in EphB receptor-mediated neuropathic pain in rats.Methods Forty-eight pathogen-free male SD rats aged 2-3 months weighing 150-180 g were randomly divided into 6 groups (n =8 each):groups sham operation (groups S1 and S2 ); groups chronic constrictive injury (CCI) (groups C1and C2 ) and groups EphBI-Fc (EphB receptor antagonist) + CCI (groups E1 and E2 ).Neuropathic pain was induced by placing 4 ligatures on left sciatic nerve at 1 mm intervals with 5-0 silk thread in groups C1,C2,E1 and E2.EphBI-Fc 0.5 μg in 5 μl normal saline was injected intrathecally 1 h before operation and at 1 and 2 d after operation (group E1 ) or on 5th day after operation (group E2).Normal saline 5 μl was injected intrathecally instead of EphBI-Fc 1 h before operation and at 1 and 2 days after operation (groups S1 and C1 ) or on 5th day after operation (groups S2 and C2 ).Pain withdrawal latency to noxious thermal stimulation (PWL) and pain withdrawal threshold to noxious mechanical stimulation (PWT) were measured before operation and at 1,3 and 5 d after operation.The animals were sacrificed at 5 d after operation after measurement of pain threshold.The lumbar segment of spinal cord (L4-6) was removed for determination of c-Fos,PI3K and phosphorylated Akt(p-Akt) expression.Results CCI significantly reduced PWL and PWT and up-regulated spinal c-Fos,PI3K and p-Akt expression in groups C1 and C2 as compared with groups S1 and S2.EphB1-Fc significantly decreased hyperalgesia and the upregulated spinal Fos,PI3K and p-Akt protein expression induced by CCI in groups E1 and E2 as compared with groups C1 and C2.Conclusion Spinal EphB receptor is involved in the development and maintenance of neuropathic pain through PI3K/Akt signal transduction pathway.

Medical consumable is widely used in disease diagnosis,treatment and health care,but its multifarious classifications show its weakness in management.Based on the research and analysis on the existing kinds of classifications,this article unifies practical application in hospital and proposes"null-stock"classification method under the management plan,which seems more scientific and reasonable.

An analysis method for requirement of medical consumptive materials on Kalman filter is put forward.An analysis mathematical model is established at first,its solution process is carried out at same time,and then an example using this solution is given according to the working practice.At last,the shortcomings using classical Kalman filter were discussed and a new method using adaptive Kalman filter was proposed.