AIM: To investigate the potential causes and management of the clusters of diffuse lamellar keratitis (DLK) after laser corneal refractive surgery.METHODS: The study enrolled 98 eyes (53 patients) complicated with DLK after receiving laser in situ keratomileusis (LASIK), FS-LASIK or small-incision lenticule extraction (SMILE) in our center from February 10th,2016 to February 22th,2016.They were given clinical classification treatments according to corneal layer inflammatory extent and then followed up after 1, 3, 5, 7, 10d and 1mo.RESULTS: The clusters of DLK occurred 5 times in the study period.The incidence and degree of DLK significantly decreased after changed the sterilization, surgical equipments, temperature and humidity of the operating room.There were 80 eyes (82%) had stage 1 DLK, 11 eyes (11%) had stage 2, 4 eyes (4%) had stage 3 and 3 eyes (3%) had stage 4.The incidence of DLK after FS-LASIK was 40% (79 eyes in 42 patients), that after LASIK assistant by Hastome keratome was 45% (10 eyes in 5 patients), that after SMILE was 20% (9 eyes in 6 patients).After intensive treatment, as glucocorticoid treatment and flap lifting flushing, all cases recovered within 1mo.CONCLUSION: The outbreak of DLK may be associated with the disposable item, flushing liquor, temperature and humidity of the operating room.Early diagnosis, prevention and treatment are the key of decreasing the incidence of DLK.

Objective To investigate the reversing effects on drug resistance of gastric carcinoma by suppressing PI3K/PKB signal pathway,and explore its implicated mechanism.Methods MTT assay was used to test the inhibitory effects of VCR alone or VCR in combination with PI3K/PKB inhibitor,LY294002 on SGC7901/VCR cells.The SGC7901 treated with or without LY294002 served as control.The protein levels of PKB and phospho-PKB in the above VCR cells were determined by Western blot analysis.The mRNA expressions of MDR1,Bax and Bcl-2 were evaluated by semi-quantitative PCR with ?-actin as the inner control.The apoptosis was detected by flow cytometry.Tumor volume on the tumor-bearing mice transplanted by SGC7901/VCR cells or cells treated by VCR,LY294002 and their combination respectively was measure for the in vivo effect of LY294002.Results LY294002 enhanced the sensitivities of SGC7901/VCR cells to VCR significantly,and promoted the apoptosis rate induced by VCR prominently,with their corresponding drug resistant index decreasing from 40.45 to 8.50.The protein level of phospho-PKB was reduced,and the mRNA expression levels of MDR1 and Bcl-2 were inhibited(P

Objective:To summarize the allergic mechanism caused by traditional Chinese medicine injection (TCMI) to provide some references for perfecting Good Laboratory Practice(GLP) of TCMI.Method:The related iteratures in data bases at home and abroad were reviewed,and the present experimental research methods about allergies were referred to to have a view of future studies.Result:The allergic mechanism of TCMI was mostly antigen-antibody reaction, part of which was anaphylactoid reaction.The method of the evaluation of allergy caused by TCMI only was animal experiments, but there were still some allergies caused by TCMI after the evaluation with this method.The present experimental research methods indicated that the detection of mediators of inflammation and FCM(Flow Cytometry) could be used to evaluate the allergies caused by TCMI.Conclusion:More attention should be paid to allergies caused by TCMI for its complicated mechanism and frequent occurrences in clinic.It may be an effective way to evaluate the allergies caused by TCMI with several methods including in vivo and in vitro.

AIM: To study regional cerebral blood flow (rCBF) and neuronal apoptosis in penumbra following focal cerebral infarction in rats.METHODS: To establish the model of focal cerebral infarction based on the principle of photochemical initiation of thrombosis.Laser Doppler flowmetry was used to measure rCBF in ischemic core and penumbra.The numbers and anatomic distribution of apoptosis cells were examined in situ histologically with terminal deoxynucleotidyl transferase(TdT)-mediated dUTP-fluorescein nick end-labeling(TUNEL) assay in adjacent sections.RESULTS: rCBF in penumbra decreased to the minimum at(6 h) in which it was 30.88%?7.11% of normal.From 9 h to 48 h,rCBF in penumbra increased gradually.At 48 h,91.90%?4.56% of normal cerebral blood flow was recovered which was significant differences than others.Terminal deoxynucleotidyl transferase(TdT)-mediated dUTP-fluorescein nick end-labeling(TUNEL) assay demonstrated that TUNEL-positive cells occurred at 6 h and were expending in a radial fashion only in penumbra.The numbers of apoptosis cells were progressively increased with time and to the maximum in penumbra after 48 h following focal cerebral infarction.CONCLUSION: There were delayed neuronal apoptosis following focal cerebral infarction.The mechanism may be related to ischemia-reperfusion injury induced by the recovery of rCBF in penumbra.

Objective To analyze allocation of health resources and utilization of health services,and evaluate the equity of health resources allocation and health services utilization.Methods Concentration curve and concentration index(CI)were used to evaluate the equity of health resources allocation in terms of health professionals,hospital beds,medical institutions,outpatient visits and hospitalizations in China.Results The CI for health professionals,hospital beds,and medical institutions is 0.038,-0.012,and-0.116 respectively.That for outpatient visits and hospitalizations is 0.111 and -0.023 respectively.Conclusion Health resources allocation in hospital beds and health professionals is fair,while the equity of medical institutions and outpatient service utilization needs to be improved.

Objective To evaluate the efficiency of health resources allocation of 31 provinces,autonomous regions and cities in China in 2011,identify the causes for low allocation efficiency and provide suggestions accordingly.Methods By ways of literature research and data envelopment analysis.Results The average efficiency value of these provinces and cities was 0.973.The health resources allocation of 18 provinces and cities were found efficient in general,and that of the other provinces and cities were found non-efficient.They respectively account for 58.1 ％and 41.9％.Conclusion To improve the efficiency of health resources allocation of the 13 provinces and cities,their policymakers should increase government funding support,attract private capital into medical institutions,optimize health investment scale,improve medical management and foster medical and health personnel development.

Objective To evaluate the preoperative nutritional status of the patients which were preparing for cardiac valves replacement using nutrition risk screening 2002 (NRS2002),and analyze the evaluation effect and bring forward the corresponding nursing interventions.Methods 226 patients who would carry out cardiac valves replacement in the context of extracorporeal circulation were evaluated by NRS2002 preoperatively.88 patients had nutrition risk.Those elective 88 patients were randomly assigned into the experimental group and the control group,each had 44 cases.Then different nursing measures were implemented in each group and the clinical outcome was contrasted in the two groups.Results In the patients who were preparing for cardiac valves replacement,88 cases had preoperative nutrition risk score ≥3 points and 138 cases ＜ 3 points.Preoperative nutrition risk score had positive correlation with heart function grade.Difference of the experimental group and the control group in length of stay,length of mechanical ventilation after surgery and incidence rate of general complications had statistical significance.Conclusions It is effective to analyze the preoperative nutritional status of the patients with cardiac valves replacement by NRS2002.It may improve prognosis effectively by providing preoperative nursing interventions for patients with nutrition risk.Besides,it provides theoretical basis for further studying the relation between nutrition support and clinical outcome of patients with nutrition risk.

Background One of the difficulties in identifying early glaucoma is the variability of perimetry performance.For this reason,a field defect have to be reproduced more than two consecutive examinations before it is confirmed.The relationship between visual field sensitivity and retinal nerve fiber layer (RNFL) thickness may give us a more efficient and objective assessment to the early diagnosis of glaucoma.Objective This diagnostic test was to evaluate the application of functional-structural relationship between automated perimetry and RNFL in the early diagnosis of open-angle glaucoma.Methods Sixty-four eyes of 64 patients with early open-angle glaucoma and 50 eyes of 50 normal volunteers with the matched age and gender were enrolled in Xiangya Hospital January to June 2007.Visual field examinations,including standard automated perimetry (SAP),short wave automated perimetry (SWAP),and imaging of scanning laser polarimetry with variable corneal compensation(GDxVCC),were performed on the subjects with the informed consent.The sensitivity and specificity of the joint or single measurement of GDxVCC,SAP and SWAP under the local diagnostic criteria,and overall diagnostic criteria were calculated.Results According to the overall diagnostic criteria,the sensitivity of GDxVCC,SWAP and SAP were 70％,63％,61％ respectively,and the specificity were 84％,80％,78％,respectively.According to the local diagnostic criteria,the sensitivity of GDxVCC,SWAP and SAP were 78％,86％,78％,respectively,and the specificity were 54％,40％,50％,respectively.With the local diagnostic criteria,the sensitivity and specificity of serial test of GDxVCC,SWAP and SAP were 86％ and 90％ respectively,and the positive likelihood ratio and negative likelihood ratio were 8.59 and O.16,respectively.Conclusions The functional-structural relationship between automated perimetry and RNFL which can provide valuable individual diagnostic information for patients,and serial test of GDxVCC,SWAP and SAP can reduce the false positive rate and improve the diagnostic performance significantly.

Objective: To investigate the effects of Rehannia glutinosa decoction (RGD)、 Rehmannia glutinosa polysaccharide (RGP) and Rehmannia glutinosa non polysaccharide (RGNP) on peripheral hemogram in mice. Methods: The first experimental group were continuously given RGD、RGP and RGNP for nine days, and then blood sample was taken from tails for determination of peripheral hemogram. The second group were given RGD、RGP and RGNP for five days, after making the blood difficiency model of cyclophosphamide. Determinating peripheral hemogram of the third group, after that those mice were given cyclophosphamide by 2 days, 4 days, 6 days, 8 days. Results: Peripheral hemogram of the every normal group has no difference. To compare the model of blood difficiency group and the control group, there were significant differences, RGNP can only enhance WBC. Both RGP and RGNP can reduce WBC of the mice model of anti cyclophosphamide, while RGP was superior to RGNP. Conclusion: Rehmannia glutinosa has dual directional adjustment function. RGP is tonifying blood active fraction of RG.

Objective: To explore the change of fractional exhaled nitric oxide (FeNO) and its correlation with forced expiratory volume in the ifrst second (FEV1), the ifrst second forced expiratory volume percentage of forced vital capacity (FEV1/FVC) in bronchial asthma and chronic obstructive pulmonary disease (COPD). Methods: FeNO, FEV1 and FEV1/FVC were measured in 57 suspected asthmatics (21 acute onsets, 12 non-acute and 24 non-asthma), 38 COPD patients (25 acute exacerbations and 13 stable stages) and 26 healthy subjects. Results: In the 57 suspected asthmatic patients, when the optimal cut off value of FeNO was 20.15 PPb, which was used to diagnose asthma and differentiate asthma and non-asthma, the positive predictive value, the negative predictive value, the sensitivity and the speciifcity was 94.1%, 95.7%, 97.0%, and 91.7% respectively. hTere was signiifcant difference in the FeNO level between the 33 asthmatics and 26 healthy subjects (P<0.05). There was also significant difference in the FeNO level between the acute onset and the non-acute (P<0.05), but not in the FEV1 and FEV1/FVC level (bothP>0.05). hTere was no signiifcant correlation between FeNO and FEV1, FEV1/FVC in patients with asthma (r=-0.186,-0.236, bothP>0.05). hTere was signiifcant difference in the levels of FeNO, FEV1 and FEV1/FVC between the 38 COPD patients and the 26 healthy subjects (all P<0.05), and also between the 25 acute exacerbations and 13 stable COPDs (allP<0.05), but not between the 13 stable COPDs and 26 healthy subjects (allP>0.05). FeNO was not correlated with FEV1 and FEV1/FVC level in COPD patients (r=-0.167,-0.285, bothP>0.05). Conclusion: FeNO level is increased obviously in patients with asthma. hTe optimal cut off value of FeNO at 20.15 PPb can differentiate asthma and non-asthma with high sensitivity and speciifcity. FeNO is higher for the acute onset than non-acute, which may be useful to evaluate the control degree. FeNO level is increased in COPD patients in the acute exacerbations, but there is no change in stable COPD patients compared with the healthy subjects.