Objective To investigate the relationship between the change of HDL level and the severity in patients with sepsis.Methods The levels of HDL were measured in 68 patients with sepsis who were divided into light,middle and heavy group by APACHEⅡscore after final diagnosis of 0,1,2,3,7,14.28 days.Results The levels of HDL in patients with sepsis were lower than those of the normal:the levels of HDL began to decrease at 0 day,got to lowest point after 3 days,and up-regulated gradually after 7 to 28 days.The levels of recovery were the highest in light group,and the lowest in heavy group.Conclusion The levels of HDL in patients with sepsis are low,which is related with the severity of sepsis.

Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.

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.

Technologies for the trans-institutional sharing of scientific data were studied with the sharing of nucleic acid sequence data as the study object , such as leaving a flexible space for implementation of the unified standards in working out the criteria for data sharing , implementing regular point to point data sharing and updating in agree-ment of institutional league , and providing multiple data services according to the unified working process by giving considerations to the local demands .The significance of trans-institutional sharing of scientific data under the insti-tutional league model was summarized for the reference in constructing the scientific datasharing platform.

Objective To discuss the modern surgical treatments for congenital choledochal cysts complicated with anomalous junction of pancreaticobiliary ductal system through analyzing data in 30 cases. Methods The 30 cases were diagnosed with ERCP, MRCP, cholangiography or dissection, respectively. Then 28 of them were treated with external drainage (n=2), internal drainage (n=9) and Roux-en-Y hepaticojejunostomy (n=22), respectively. Of the 28, 5 received operations twice. Results External drainage was helpful in emergency cases while internal drainage frequently resulted in recurrent cholangitis, choledocholith, anastomotic stenosis or cyst malignancy that needed to be operated on again. Choledochocyst resection and pancreaticobiliary shunt achieved satisfactory results. Conclusions Congenital choledochal cyst is usually complicated with anomalous junction of pancreaticobiliary ductal system (88.2%). As for its treatment, choledochocyst resection, pancreaticobiliary shunt and hepaticojejunostomy should be of the first choice.

Objective To investigate the expression of activating receptors (NKG2D and NKp46), inhibitory receptors (NKG2A and KIR) as well as costimulatory molecules (OX40, 4-1BB and ICOS) on peripheral blood natural killer (NK) cells from patients with recurrent genital herpes (RGH). Methods Four-color immunofluorescence staining with flow cytometry was used to detect the expression of NKG2D, NKG2A, KIR and NKp46 in 44 patients with RGH and 40 normal human controls, and to detect the expression of OX40, 4-1BB and ICOS in 29 patients with RGH and 29 normal human controls. Results The proportions of NKG2D-positive and NKp46-positive NK cells significantly decreased in patients with RGH than those in the normal human controls [(93.3 ± 5.4)% vs (96.9 ± 2.5)%, (88.9 ± 8.7)% vs(93.4 ± 4.1)%, respectively, both P < 0.01]. Between the patients and controls, no significant difference was observed in the expression of NK cell inhibitory receptors, NKG2A [(41.8 ± 14.4)% vs (46.0 ± 14.7)%, P > 0.05] or KIR [(68.3 ± 19.1)% vs (69.1 ± 17.6)%, P > 0.05]. A lower expression of costimulatory molecule OX40 was noted in NK cells from patients with RGH compared with those in normal controls [(1.0 ± 1.1)% vs (1.8 ± 1.7)%, P < 0.05]. Conclusions Herpes simplex virus infection could down-regulate the expression of NK cell activating receptors and costimulatory molecules, subsequently suppress the activation of NK cells, and lead to the escape of virus-infected cells from the killing of NK cells.

Objective To investigate the clinical effects of continuous 3-in-1 femoral nerve block with stimulating catheters for patient controlled regional anesthesia(PCRA) in elderly patients after unilateral total knee replacement (TKR)surgery.Methods Thirty ASA Ⅰ - Ⅱ elderly patients wererandomly divided into two groups: FB group and Ⅳ group.FB group received continuous 3-in-1 femoral nerve block for postoperative analgesia with 0.2% ropivacaine plus 0.1 μg/ml sufentanil continuous infusion at 5 ml/h plus PCA boluses (1.0 ml/15 min).Ⅳ group received continuous intravenous analgesia with 1 μg/ml sufentanil plus 0.04 mg/ml tropisetron hydrochloride at 2 ml/h plus PCA boluses (0.5 ml/15 min).All patients were maintained analgesia for 48 hours.Results In FB group, the visual analogue scale(VAS) scores were 1.3 ±1.1, 1.2 ± 1.0, 1.1±0.9, 1.1 ± 1.0,1.0±0.9 at 4, 8, 12, 24, 48 hours after surgery under rest status respectively and were 3.04±1.4,2.3±1.3 at 24, 48 hours after surgery in active function training.These parameters in Ⅳ group were 4.0±1.6, 3.5±1.6, 3.2±1.4, 3.0±1.3, 2.5±1.2, 4.7±1.5 and 3.3±1.5 respectively, which were significantly different compared with FB group (t=5.358, 4.707, 4.852, 3.784, 3.743, 3.254,1.932,all P<0.05 or P<0.01).The incidence of nausea was higher in IV group than in FB group(P = 0.0022).Postoperative satisfaction ratings was higher (χ2 =41.1 ,P<0.01) and the total morphine use for 48 hours after operation was less(uc=2.412, P<0.01) in FB group than in Ⅳ group.Conclusions After TKR surgery, the continuous 3-in-1 femoral nerve block with stimulating catheters is an effective method with better pain relief,fewer side effects and higher satisfaction ratings in the elderly.

Diabetic peripheral neuropathy (DPN) is a common complication of diabetic mellitus. The treatment is so difficult that doctors have not found reliable methods to cure this disease. The research progress both in TCM and western medicine of this disease were reviewed in terms of aspects of etiology, pathogenesis and differential treatments.

BACKGROUND:At present,new drug and dosage form to treat diabetes mellitus has emerged continually,but it has toxic reaction,side effects,and contraindication or unindication.Especially that it cannot prevent the natural proceeding of diabetes mellitus from aggravation.Based on theory and experience of traditional Chinese medicine,and combining modern methods of pharmacology and pharmaceutical chemistry,it has become one of the hotspots in researches on diabetes mellitus at present to investigate and empolder preparation of pure traditional Chinese medicine that has good effect and little toxicity.OBJECTIVE:To investigate the pharmacological effect of Chinese compound of Qiangyi Jiangtang capsules on diabetic rat models induced by high-fat forage and streptozotocin.DESIGN:A comparative observation of animal trial.SETTING:Staff Room of Pharmacology,Yunnan College of Traditional Chinese Medicine.MATERIALS:Totally 100 2-month-old Wistar rats of common degree,weighing(180±25)g were used.There were 50 males and 50 females,14 rats were randomly selected as the blank control group,and the other 84 rats were used in model establishment.The treatments of the animals in the experiment were accorded with the ethical standard.METHODS:The experiment was carried out in the Staff Room of Pharmacology,Yunnan College of Traditional Chinese Medicine from March to April in 2004.Diabetic models were induced by high-fat forage and streptozotocin.The successful model rats (n=54) were randomly divided into the model group,positive control group and the high,middle and low dosage of Qiangyi Jiangtang capsules groups.The dosages in the low,middle and high dosages treated groups were 0.4,1.2 and 2.0 g/kg respectively. The rats in the blank control group and model group were given isovolume of saline,and those in the positive control group were administrated intragastrically with metformin (0.5 g/kg).After administration,blood glucose,glycosylated hemoglobin and serum fructosamine were determined at 1 month,and the amounts of water drinking and food intake were determined at the 2nd and 4th weeks.MAIN OUTCOME MEASURES:Results of blood glucose,glycosylated hemoglobin and serum fructosamine;amounts of water drinking and food intake.RESULTS:Totally 100 Wistar rats were used,32 of them were excluded due to failure in the model establishment,and the other 68 were involved in the final analysis of results.The blood glucose,glycosylated hemoglobin and serum fructosamine in the high,middle and low dosages of Qiangyi Jiangtang capsules groups were all significantly lower than those in the model group(P＜0.01).The amounts of water drinking at the 2nd and 4th weeks in the high,middle and low dosages of Qiangyi Jiangtang capsules groups were significantly lower than those in the model group (P＜0.01),and the amounts of food intake were also lower than those in the model group (P＜0.05 or 0.01).CONCLUSION: Qiangyi Jiangtang capsules could remarkably decrease the levels of blood glucose, glycosylated hemoglobin and serum fructosamine,and the amounts of water drinking and food intake of rat models of diabetes mellitus.It was proved that traditional Chinese medicine for diabetes mellitus is worthy of further development and research.

Objective To evaluate the efficacy and safety of emergency percutaneous coronary intervention(PCI) in patients with non-ST-segment elevation acute coronary syndrome(ACS).Methods A total of 233 patients(emergency group) were treated with emergency PCI within 48 h of heart attack and another 152 patients(delayed group) were treated with PCI after 3-14 days of medical therapy.All culprit lesions were treated.Procedural success rate,the time from admission to angina relief,the length of hospital stay and cardiac events incidence in 30 days were observed.Results The procedural success rates for the emergency group and the delayed group were similar(98.1% vs 95.5%),but cardiac events incidence in 30 days was significantly lower in the emergency group than that of the delayed group(2.9% vs 14.1%,P