Age-related maculadegeneration (AMD) ione of majoretinal diseaseleading to central vision loss.Apresent,the pathogenesiof AMD ibelow understood.Ovethe pasdecade years,dysmetabolism of extracellulamatrix (ECM) regulated by matrix metalloproteinase(MMPs) and tissue inhibitoof metalloproteinase(TIMPs) system play an importanrole in the pathogenesiof AMD.The imbalance of MMPand TIMPleadto differenpathological changeof Bruch 'membrane,which involvein drusen formation and regulatechoroidal neovascularization (CNV).The level of elastin-derived peptides(EDPs) reflectthe level and activity of M MPs,and the elevated level of EDPincreasethe risk of early AMD to advance neovasculaAMD.Thiarticle reviewthe research progression of MMPs,TIMPand the elastin-derived peptideand in AMD.

BACKGROUND:It has been generally accepted that polypropylene mesh tension-free hernia repair may repair the inguinal hernia,but the clinical application is not wide.OBJECTIVE:To analyze retrospectively the effect of polypropylene mesh plug tension-free hernia repair versus the traditional herniorrhaphy for inguinal hernia.DESIGN,TIME AND SETTING:Case analysis was performed among 115 cases who underwent inguinal hernia in Department of General Surgery,Affiliated Xinhua Hospital of Hainan Medical College from March 2003 to October 2007.PARTICIPANTS:The involved patients were 76 males and 39 females,aged 26-81 years with a mean of 61.3.There were 78 cases with lateral indirect hernia,11 direct hernia,2 femoral hernia,and 12 bilateral indirect hernia.35 of 115 patients were operated with polypropylene mesh tension-free hernia repair and 80 patients were provided at traditional repair method.Mesh cone hernia ring and patches were offered from Bard Company(USA).RESULTS:The size of hernia ring was selected based on the pattern number and amount of mesh plug.Transfixing suture was performed along the center and tip of hernial sac.Subsequent to the mesh plug implantation,the flap was processed into interrupted suture with hernia ring at a interval of 0.5-0.8 cm.Traditional herniorrhaphy was chiefly consisted of Bassini,McWay and Shouldice operative types.MAIN OUTCOME MEASURES:Operative duration,out of bed activity time and average hospitalization time were observed.Utility of anodyne,uroschesis and scrotal swelling were detected after operation.RESULTS:All patients were cured.There were 35 patients operated with mesh tension-free repair of inguinal hernia.The operation mean time was 42 minutes.The mean time of getting out of bed was 8 hours after operation.The mean hospitalization time was 6.2 days.There were 2 patients with uroschesis,3 patients utilizing the anodyne,and 1 patient with scrotal swelling after operation,without complications about wound infection and scrotal hydrocele.No recurrence occurred by follow-up visit of 6-36 months after operation.Eighty patients operated with the traditional herniorrhaphy.The operation mean time was 56 minutes.The mean time of getting out of bed was 68 hours after operation.The mean hospitalization time was 11.6 days.There were 9 patients with uroschesis,37 patients utilizing the anodyne and 1 patient with scrotal swelling after operation,without complications about wound infection and scrotal hydrocele.Nine patients were recurrent by follow-up visit of 6-36 months after operation.CONCLUSION:Polypropylene mesh plug tension-free repair for inguinal hernia is suitable to repair and enhance the pectineus porose area,with great histocompatibility.Thus,it is obviously ascendant to the traditional herniorrhaphy.

Currently,higher education has entered into a profound reform period,and it is an inevitable trend to strengthen humanities and sociology education in scientific and technological universities and colleges.On the basis of the practice of offering the course of literature appreciation in medical college,we will discuss the actuality,necessity and the way of offering the course in this paper.

Objective To explore the differences between the conservative treatment and the operative treatment in the management of cervical spinal cord injury, and the timing of the operation. Methods The therapeutic effectiveness o f the 45 cases who were treated from October 1996 to January 2002 was analyzed. 21 of them underwent conservative treatment and 24 operative treatment. The corr elation between the therapeutic effects of the operation and its timing was expl ored. Results The myeloid functional recovery was poor in the patients who had b een treated with conservative means but good in those who had been given an oper ation. The earlier the operation, the more effective it could be, and the higher the probability of the myeloid functional recovery. Conclusions The operative treatment promises better outcome than the conservative treatment. To get the be st effects, the operation should be done within one month after the injury, for the longer the lapse between the injury and the operation, the worse the effect.

Corresponding author:PAN Cong-qing,E-mail:cq.pan@163.com Objective The prevalence of diabetic foot was 2.3% for out-patients and 8.6% (208/2428) for in-patients with amputation rate of 17.3% in our hospital from May 1997 to Dec 2000, more often seen on right than left extremity and in patients over 50 years old than in the younger.

The polymorphisms of paraoxonase 1 ( PON 1 ) and ApoE gene in 192 patients with type 2diabetes mellitus (DM group) , 116 cases of atherosclerosis (AS) without DM (AS group), and 105 normal subjects (NC group ) were detected by means of PCR-restriction fragment length polymorphism. The serum concentration of Ox-LDL was determined by enzyme linked immunosorbent assay. The results showed that plasma Ox-LDL level in DM group was higher than those in AS and NC groups[(754.2±279.9 vs 526. 1±186.2 and 421.1 ± 163.2 )μg/L, P<0.01]. Ox-LDL level in the patients with QQ genotype of PON 1 was higher than those in QR and RR genotypes in type 2 DM[(846.6±147.5 vs 763.4±126. 7 and 7 1 3.2 ±132.4 ) μg/L, P<0. 0l],and Ox-LDL level in the patients with ε3/4+ ε4/4 genotype of ApoE was also higher than those in ε3/3 and ε2/2 + ε2/3 geneotypes in type 2 DM[( 824.3 ± 173.5 vs 741.6± 182. 5 and 718.3 ± 167.5 ) μg/L, P<0.05], but the difference was not found in atherosclerosis without DM. Multiple regression analysis showed that disease duration, PON1 and ApoE genotypes were the independent predictors of plasma Ox-LDL level in patients with type 2 DM.

[Objective]To investigate the clinical treatments of perioperative complications in patients with cervical cord injury.[Method]Totally 155 cases of cervical cord injury associated with fracture of the cervical spine were enrolled in this study from January 1997 to December 2007.Eighty-five cases were treated with anterior internal fixation,66 with expansive open-door laminoplasty of the cervical spine,and 4 with one stage anterior and posterior approach operations.[Result]Forty-five cases were complicated with hyperpyrexia,31 with respiratory dysfunction,43 with pulmonary infection,70 with hyponatremia,25 with urinary system infection,3 with stress ulcer,10 with deep venous thrombosis,5 with palsy of the C5 nerve root,3 with injury of superior laryngeal nerve or recurrent nerve,1 with leakage of cerebrospinal fluid,2 with cervical hematoma,1 with loosening of interal fixation,1 with esophageal fislula,and 10 died.[Conclusion]There are many perioperative complications from cervical cord injury.To pay attention to the treatments of perioperative complications will bring a satisfactory clinical effect.

ObjectiveTo sum up the experience on diagnosis and treatment for patients of hyperthyroidism complicated by thyroid cancer. MethodsBetween 1994 and 2000, 300 hyperthyroidism patients were admitted, among them 12 suffered concomittent thyroid carcinoma and received surgical therapy and pathologic examination. ResultsIn this series thyroid carcinoma occurred in 4%(12/300) in patients with hyperthyroidism, but correct preoperative diagnosis was obtained in only one (3%) of the 300 cases. Bilateral subtotal thyroidectomy was initially performed in all 12 cases with 7 cases undergoing additionally ipsilateral total thyroidectomy when a cancer was identified. Two cases underwent functional cervical clearance of lymph nodes. Postoperative follow-up of 9 mos to 6 years found no recurrence. ConclusionIn patients of hyperthyroidism a thyroid cancer may develop on the background of immunodeficiency and endocrine dysfunction. In patients with hyperthyroidism, a thyroid nodule found perioperatively must be biopsied for frozen section to guide the surgical modality.

Based on the intension as well as extension of campus culture,this paper discusses how to construct campus culture in the medical school.

Objective To retrospectively evaluate effects of early dynamization of interlocking intramedullary nail on union of tibial shaft fractures.Methods From January 2002 to Septemher 2004,75 patients with tibial shaft fractures were treated in our department with internal fixation using static interlocking iutramedullary nails.Early dy- namization(6 to 10 weeks postoperative)was adopted in 32 patients (the dynamic group) according to the fracture con- ditions,while the other 43 patients were treated without early dynamization (the non-dynamic group).The healing time of fractures and the rate of delayed union in both groups were documented.Results All the cases were followed up for a mean duration of 6.5 months (range,4 to 13 months).The mean healing time was 115.6 days (range,105 to 126 days) in the dynamic group and 124.5 days (range,119 to 133 days) in the non-dynamic group.The difference was statistically significant between the two groups (P＜0.05).There were two cases (6.2%) of delayed union in the dynamic group and four (9.4%) in the non-dynamic group.The difference was not significant (P＞0.05). Conclusion Early dynamization of interlocking intramedullary nail can promote union of tibial shaft fractures.