AIM:To observe the efficacy, complications and ocular surface tear dynamics of the treatment for pterygium combined with conjunctivochalasis by inferior limbal-stem-cell transplantation.
METHODS: All 30 patients ( 46 eyes ) diagnosed as pterygium combined with conjunctivochalasis in our hospital from December, 2010 to December, 2012 with a mean age of 61. 2y (SD 7. 2, range 49-75) were subjected to observation. After excision of nasal pterygium, an equivalent size of conjunctival flap linked with corneal limbal stem cell from inferior limbus was transplanted to the exposed sclera. Afterwards, the inferior bulbar conjunctiva was trimmed and fixed onto surface of sclera and inferior corneal limbus. After one-year follow-up, the comparisons regarding vision acuity between pre-operation and post-operation ( 1mo later ) as well as ocular-surface tear dynamics changes including several indexes like altitude and integrity of tear meniscus, break-up time ( BUT ) , corneal fluorescein staining and chloramphenicol gestation test before and 3mo after surgery were made. The operative complications and the recurrence rates 1y after operations were recorded.
RESULTS: Median visual acuity was 0. 2 (0. 04-0. 6) before the operation and median visual acuity was 0. 4 (0-04-1. 0) 1mo after the operation. Of total 46 eyes in 21 eyes ( 45. 7%), visual acuity improved. No vision changes were found in other 25 eyes ( 54. 3%). Significant difference ( P<0. 01 ) of vision acuity before and after surgery was found. In addition, break-up time ( BUT) , corneal fluorescein staining and chloramphenicol gestation test and altitude and integrity of tear meniscus show better results 3mo after surgery than that of pre-operation, which showed statistically significant ( P <0-05). After 1y follow-up, 33 eyes (71. 7%) healed while problems in 11 eyes ( 23%) were relieved. The total efficacy rate was 95. 6%. Nonetheless, invalid surgeries were noticed in two eyes ( 4. 4%) that affected by recurrence of pterygium. The 33 eyes (71. 7%) affected by conjunctivochalasis was cured in terms of subjective evaluation and improved in 9 eyes (19. 6 %), but 4 eyes (8. 7%) exhibited no evident improvement in terms of subjective complains. Total efficacy was 91. 3%. The 41 eyes (89. 1%) were reported to be normal while 5 eyes ( 10. 9%) were revealed to be abnormal in terms of objective therapeutic evaluation. And this condition was so-call conjunctivochalasis recurrence with a recurrence rate of 10. 9%. No proliferation of granulation, narrowing inferior fornix and malfunction of eye movements was found.
CONCLUSION: Inferior - limbal - stem - cell transplantation to treat pterygium combined with conjunctivochalasis obtains better results. It proves to eradicate or relieve symptoms of patients effectively and ameliorate ocular-surface tear dynamics.

Objective To study the clinical characteristics and effects of surgical treatment of children with thalamic tumors.Methods The clinical data of 22 cases were retrospectively studied and followed-up 6 months to 9 years.Results There were 13 boys and 9 girls,their ages ranging from 3 to 13 years.The average duration of symptoms before diagnosis about 2 months.Headache and papilledem were the most symptoms and signs,respectively.Most children′s thalamic tumors were low grade tumors with clear verge.In this group,good results were obtained that total remove 9 cases,subtotal remove 8 cases,partial remove 3 cases,biopsy 2 cases and no surgical death.Conclusions Clinical character of children thalamic tumors is distinct and good surgical results in the nearly future.The long results are determined by type of pathology.

OBJECTIVE To explore urinary tract infection.METHODS Totally 750 clinical isolates of urinary tract infection were collected from patients who were cured in our hospital from 2001 to 2003,then analyzed the kinds of these bacterials and sensitive rate to antibiotics.RESULTS The percentage of Gram-negative bacilli was 53.60%,in which Escherichia coli was 38.13%;The percentage of Gram-positive cocci was 35.20%,in which Enterococcus were 16.53%;the percentage of fungi was 11.20%.The resistance rate of Escherichia coli to ampicillin,amoxicillin/clavulanic acid,quinolones,nalidixic acid and SXT was 80.54%,57.69%,45.00-71.00%, 71.23% and 65.14%,respectively,and the resistance rate to amikacin was lower than to gentamicin(5.82% vs 39.11%,P

Objective Serum indicators of oxidative protein damage (OPD) were analyzed to explore the effect on renal MMP/TIMP system of OPD in diabetic nephropathy. Methods AOPP levels and PCO levels were measured by modified Witko-Sarsat's method and 2, 4-dinitrophenylhydrazine spectrophotometric method, expression of serum MMP-2 were determined by ELISA, and MMP-2 activity were detected by zymography . Results AOPP levels of group DN1, group DN2 were higher than those of group DM(78.23±19.30 vs 61.25±12.13,101.59±30.22 vs 61.25±12.13,F＝41.988,P＜0.01). PCO levels of group DN1 and group DN2 were higher than those of group DM (0.84±0.03 vs 0.66±0.02,1.05±0.05 vs 0.66±0.02,F＝205.763,P＜0.01). Pearson correlation analysis indicated AOPP and PCO were positively correlated with the expression (r＝0.460,0.480,P＜0.05) and activity (r＝0.385,0.560,P＜0.05) of serum MMP-2. Multiple stepwise regression analysis showed that AOPP and PCO were major influential factors of serum MMP-2 expression (P＜0.05,P＜0.01) and activity(P＜0.01,P＜0.05). Conclusions OPD might be involved in the imbalance of renal matrix metabolism, which was correlated with the development of diabetic nephropathy.

OBJECTIVE:To investigate the variance of antimicrobial resistance of Klebsiella.spp isolated in our hospital during the recent 5 years.METHODS:Disk diffusion test was used to study the anti microbial resistance.The results were evaluated based on the criteria recommended by American Clinical and Laboratory Standards Institute.The data analysis was performed using WHONET-5software.RESULTS:Atotal of 840 strains of Klebsiella.spp were collected fromour hospital during2003～2007,of which,59.3% were fromrespiratory secretion speci men,12.0%fromblood speci men,and10.1% from secretions.The detection rate of ESBLs-producing Klebsiella.spp was from51.0% to65.1%.No I mipenem-and Meropenem-resistant Klebsiella.spp strain was detected.Susceptibility test showed that Klebsiella.spp-producing ESBLs was multiple resistant,and the anti microbial resistance of Klebsiella.spp has increased year on year.CONCLUSION:Monitoring of the drug resistance of Klebsiella.spp should be strengthened.The variation of the anti microbial resistance of Klebsiella.spp should be noted so as to direct rational drug use in the clinic and prevent spreading of drug resistant strains.

Objective To develop a reliable scale for evaluating medication compliance among patients with chronic diseases in China.Methods An initial item pool was generated by literature review,based on the definition of compliance generally accepted in China.The items were then subjected to item selections by using item answer distribution and other four methods,which resulted in a primary scale with 16 items.The reliability and validity of this scale was examined.Results Common factors extracted by factor analysis were well explained,there being a close correspondence between the scale construction and the theoretical construction. Convergent validity with the patients' self-ratings on medication compliance ranged from 0.55 to 0.59,and the correlation coefficient with the score of Morisky questionnaire was 0.58.The Cronbach ?,0 and ? coefficients were 0.717,0.751,0.893 respectively,and test-retest reliability was 0.95.Conclusion The newly developed scale appears reliable and may be a useful tool for measuring drug compliance among patients with chronic diseases,but there are still areas where further improvements may be needed.

Objective To investigate the linearity on testing creatinine in various assay instntments,in order to evaluate creatinine testing ability of clinical laboratories. Methods Statistically standard linearity and nonlinearity were judged via polynomial regression analysis recommended by EP6-A guideline. The imprecision of analytical data were analyzed and the average deviation of best fitting curve from linearity were determined by Dr. Kroll's EP6-A extended methods. In accordance with the instruments used, the testing data were divided into four groups: Beckman LX (28 Labs), Beckman CX ( 14 Labs), Hitachi (62 Labs)and Olympus (72 Labs) groups. Results This research found that in samples analyzed by Beckman LX,Beckman CX, Hitachi and Olympus instruments, the imprecision ranged from 0. 30%-3.01%, 0.09%-3.46%, 0. 14%-4. 91% and 0. 17% -16. 44%, respectively. The imprecision in one laboratory in Olympus group exceeded the acceptable limit, while the imprecision in the remaining laboratories were precision for linear survey. The average deviations of best fitting curve from linearity ranged from 0%-2. 38%, 0%-2. 51%, 0% -5.46% and 0% -4. 66%, respectively. The linearity with statistical significance were 21.4% (6/28), 35.7% (5/14), 11.3% (7/62) and 18. 1% (13/72), respectively. The linearity with clinical significance were 78.6% (22/28), 64. 3% (9/14), 88. 7% (55/62) and 80. 6% (58/72), respectively.The percentages of laboratories whose creatinine testing met the linearity criteria were 100% (28/28),100% ( 14/14 ), 100% ( 62/62 ) and 98. 6% ( 71/72 ), respectively. Conclusion Majority of the laboratories involved in the linearity survey present good capability for creatinine testing.

Objective To perform calibration verification for the blood glucose test in Hitachi and Olympus automatic biochemistry analyzers and present a method of calibration verification and evaluate the results.Methods The glucose test results were divided into two groups:Hitachi and Olympus groups according to the different analytical instruments.The calibration verification was performed following the current College of American Pathologists strategies.The slope and intercept of the calibration line were tested by one-sample t test and the percentage differences were calculated.The percentage differences were compared with allowable errors.If the slope and intercept had no statistically significant difference from 1 and 0 respectively and the percentage differences were within the limits of allowable errors,the calibration line was evaluated as verified 1 ; if the slope and intercept had no statistically significant difference from 1 and 0 respectively and at least one of the percentage differences exceeded the limits of allowable errors,the calibration line was evaluated as different 1 ; if the slope or intercept had statistically significant difference from 1 and 0 respectively and the percentage differences were within the limits of allowable errors,the calibration line was evaluated as verified 2; if the slope or intercept had statistically significant difference from 1 and 0 respectively and at least one of the percentage differences exceeded the limits of allowable errors,the calibration line was evaluated as different 2.Results In Hitachi group,verified 1,different 1,verified 2 and different 2 were 5.4％ ( 4/74 ),0.0％ ( 0/74 ),68.9％ ( 51/74 ) and 25.7％ ( 19/74 ),respectively.In Olympus group,verified 1,different 1,verified 2 and different 2 were 16.4％ (12/73),0.0％ (0/73),58.9％ (43/73) and 24.7％ ( 18/73 ),respectively.Conclusions The current College of American Pathologist strategies could be performed as a reasonable and feasible method for calibration verification.Most of participating laboratories ( 74.8％,110/147 passed the assessment of calibration verification.

ObjectiveTo evaluate creatinine proficiency testing data by robust Z-score analysis.MethodsThe data were collected from three proficiency surveys of routine biochemical test in 2009,to which 1 179,1 169 and 1 168 laboratories participated respectively.Creatinine data were divided into Jaffe group and enzymatic group based on the analytical method used.The results tested by both methods were compared using Mann-Whitney test.The outliers were deleted using the TUKEY fence established by quartile values.The normality of raw data and trimmed data was tested using one-sample Kolmogorov-Smirnov test.The performance of the laboratories was assessed using robust Z-score,whose values were considered satisfactory when ｜ Z-score｜ ≤2,questionable when 2 ＜ ｜ Z-score ｜ ＜ 3 and unsatisfactory when ｜ Z-score ｜ ≥3.Results86.7％ results tested using Jaffe and enzymatic methods were not comparable.The raw data in all research groups were not normally distributed.After deletion of outliers,73.3％ trimmed data in most research groups were normally distributed.For the three proficiency tests in 2009,in Jaffe group,the satisfactory rates were 89.8％( 495/551 ),87.2％( 468/537 ) and 89.5％( 476/532 ) respectively,unsatisfactory rates were 3.3％ ( 18/551 ),6.5％ (35/537) and 4.5％ (24/532) respectively; while in enzymatic group,the satisfactory rates were 88.8％ (558/628),89.3％ (564/632) and 88.1％ (560/636) respectively,unsatisfactory rates were 5.6％( 35/628 ),5.2％ (33/632) and 6.6％(42/636) respectively.Conclusion It is reasonable to choose robust Z-score as a proficiency testing assessment index,because it avoids the influence of the outliers on evaluation results.

Objective To investigate the effects of transforming growth factorβ1(TGFβ1)and β3 (TGFβ3)gene transfer on MMP-2,MMP-9 and TIMP-1 expression in hepatic stellate cells(HSC-T6).Methods TGFβ1 and TGFβ3 expression plagmids were constructed.The recombinant expression plasmid pcDNA3.1(+)-=TGFβ1 and pcDNA3.1(+).TGFβ3 were transfected or cotransfected into HSC-T6.At 24,48 and 72 h after transfection,the expression of MMP-2,MMP-9 and TIMP-1 mRNA were detected by real-time quantitative PCR,and the expression of MMP-2,MMP-9 and TIMP-1 protein were detected by Western blot.The recombinant expression plasmid pcDNA3.1(+).TGFβ1 was transfected into HSC-T6,and positive clones were selected by G418.The positive clones were transfected by the recombinant expression plasmid pcDNA3.1(+).TGFβ1,and the expression of MMP-2,MMP-9 and TIMP-1 were detected at 48 h after transfection.Results After transfection with peDNA3.1-TGFβ1,MMP-2 and TIMP-1 increaged remarkably in HSC-T6 cells(P＜0.05),but MMP-9 remained at the sanle level;After transfection with pcDNA3.1-TGFβ3,expression levels of MMP-2,MMP-9 and TIMP-1 mRNA were not changed,but TIMP-1 protein increased remarkably(P＜0.05);in cotransfection group,the expression of MMP-2 was higher than that in the blank and the control groups(P＜0.05),but MMP-9 level was not changed and TIMP-1was decreased compared with that in the TGF-β1 transfection group(P＜0.05).After TGFβ3was transfected into positive clones,the change of MMP-2 wag not significant(P＞0.05).but MMP-9 increaged and TIMP-1 decreased significantly at 48 h after transfection(P＜0.05).Conclusions TGFB3 may inhibit liver fibrosis by increase the activity of MMP-2 and MMP-9,and decrease the activity of TIMP-1.