Objective To investigate the mechanism of the toxic effect of N-methyl-N-nitrosourea (MNU) on photoreceptor cell apoptosis of rat′s retina. Methods Thirty 50-day-old female Sprague-Dawley ( SD ) rats were intraperitoneally injected with MNU (60 mg/kg) and were put to death by dislocation of cervical vertebra 12, 24, 48, and 72 hours and 7 days after the injection, respectively. The photoreceptor cell apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) and transmission electron microscope. The expression of proliferating cell nuclear antigen (PCNA), vimentin and glial fibrillary acidic protein (GFAP) was detected at different time after injection by immunohistochemical methods. Results The apoptotic index of the retina in the posterior pole was (33.6?2.3)%, (46.5?5.7)%, (20.1?5.3)%, (8.2?3.6)% and (2.5?1.3% at the 12th, 24 th, 48 th, and 72nd hour and on the 7th day, respectively, after injection. Karyopyknosis was found in most photoreceptor cells 24 hours after injection. The expression of PCNA was found in internal granular layer and between internal granular layer and choroid 24 hours after injection, reached the peak after 72 hours, and reduced obviously after 7 days. The positive expression of GFAP and vimentin was found in internal and external granular layer 24 hours after injection, reached the peak after 72 hours, and reduced obviously after 7 days. Conclusion MNU may selectively lead the photoreceptor cell apoptosis and proliferation of M?ller cells.

Objective To study the effect of Acanthopanax senticosus saponins (ASS) on organ blood flow and vascular resistance in anesthetized dogs.Methods The cerebral blood flow(CBF),cerebral vascular resistance(CVR),peripheral blood flow(PBF),peripheral vascular resistance(PVR),blood pressure(SDP and DBP) and heart rate(HR) were measured using the MF-27 electromagnetic flowmeter.Results ASS(15 and 30 mg?kg~(-1) iv perfusion for 60 min) augmented CBF and PBF,decreased CVR and PVR within 180 min and slowed down HR at 60-180 min.In addition,ASS(30 mg?kg~(-1) iv perfusion for 60 min) could obviously reduce SBP and DBP.Conclusion Protective effect of ASS on experimental cerebral ischemia may be related to improving cerebral circulation and increasing cerebral blood supplyment.

BackgroundExcessive conjunctival scar formation is a main cause of filtering surgical failure in glaucoma.It has been reported that the failure rate of filtering surgery is a tough problem in the research of glaucoma.Research showed that tetrandrine (Tet) suppress the proliferation of cultured human fibroblasts of Tenons capsule (TCFs) in vitro,but its possible mechanism is still unclear up to now.ObjectiveThe aim of this study is to investigate the inducement effects of Tet on the apoptosis of fibroblasts of Tenons capsule and mechanism.MethodsThe Tenon's capsule was obtained from donor eyes of Zhongshan Eye Center Eye Bank for further use.Human Tenon's capsule fibroblasts were cultured by explant culture method in mixed medium in vitro and the third to seventh generations of cells were collected for the experiment.The subcultured cells were identified by morphology observation and Vimentin staining.The apoptosis of cultured fibroblasts in Tet-treated group and control group was studied by using TUNEL (TdT- mediated dUTP nick end labling,TUNEL),flow cytometry (FCM) and transmission electron microscope.The cell number in different cellular cycle was calculated in Ted-treated group and control group.Results The cultured cells reached confluence in two weeks after cultured and presented the spindle or triangle shape with the radial-like or vortexin-like arrangement .The cells showed the positive staining for Vimentin.Apoptosis changes of cultured cell and apoptosis bodies were seen under the transmission electron microscope.Apoptotic cell nuclei were observed in Tet group by TUNEL.FCM result showed that the cells at G_0/G_1 phase decreased by 22.2%,and the cells at S and G_2/M phases increased by 20.53% and 1.6% in Ted-treated group.Significant differences in the numbers of cells in different cellular cycles and cell numbers of apoptosis were found between Tet-treated group and control group(P=0.000).ConclusionTet can inhibit the proliferation of human TCFs by inducing apoptosis in vitro.

Objective To investigate the effects of tropicamide and esculin-digitalisglycosides combination eye drops on low myopia of children (age ranging from 6 to 14). Methods Eighty children with 160 eyes of low myopia in the outpatient department of ophthalmology of our hospital were chose from July 2010 to April 2013, then the patients were equally divided into four groups:the control, esculin-digitalisglycosides eye drops,tropicamide,and tropicamide and esculin-digitalisglycosides combination groups. The naked vision and myopia correction of each group were compared before and after treatment for two weeks, and the treatment effects were compared among four groups. Results (1) The results showed there were no significant changes before and after treatment in the control, esculin-digitalisglycosides eye drops and tropicamide groups ( >0.05); (2) On the contrast, the tropicamide and esculin-digitalisglycosides combination have significantly improved naked vision and myopia correction after 2 weeks ( <0.05);(3) Prior to the treatment,there was no significant difference among four groups (<0.05);(4) After treatment,group under tropicamide and esculin- digitalisglycosides combined was statistical different from the other groups treated with other three eye drops ( <0.05);However, there was no statistical difference among groups in these three eyedrops. Conclusion Esculin-digitalisglycosides combined with tropicamide was the most effective treatment for low myopia of children.

Objective To study the effect of dexmedetomidine on perioperative stress reaction and postoperative cellular immunity of patients with breast cancer radical surgery.Methods We selected 108 cases of breast cancer patients undergoing elective radical surgery under general anesthesia in our hospital from Janu-ary 2012 to June 2015.These patients were divided into dexmedetomidine group (group D)and the control group (group C)by random number table method,54 cases in each group.Patients in group D were given dexmedetomidine 1.0 μg/kg by intravenous drip within 15 min before anesthesia and maintained 0.5 μg.kg -1 .h -1 after anesthesia induction intubation until operation finish.Patients in group C were given the same capacity of normal saline instead of dexmedetomidine,and the rest of the anesthesia was same as group D.The plasma norepinephrine (NE)and epinephrine (E)and cortisol (COR),serum interleukin-6 and T lymphocyte subsets (CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)and NK cells levels were determined before anes-thesia (T0 ),postoperative 4 h (T1 ),1 d (T2 ),3 d (T3 ),and 7 d (T4 ).Results The level of plasma NE, E,COR and serum IL-6 of the D group in different time had no statistical significance compared with T0 time (P ﹥ 0.05).The plasma level of E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the C group were increased significantly (P ﹤ 0.05).The level of plasma E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the D group were decreased significantly compared with C group (P ﹤ 0.05).The level of CD3 + and NK cells in T1 -T3 of the two groups decreased significantly compared with T0 (P ﹤ 0.05).The level of NK and CD3 + in T1 -T3 and CD4 +,CD4 +/CD8 + in T2-T3 of group D increased significantly com-pared with group C (P ﹤ 0.05).Conclusion Dexmedetomidine of intravenous drip during general anesthesia can effectively reduce stress reaction in perioperative period of breast cancer patients,and improve patients immune status.

Objective To evaluate the application of the lateral tarsal strip procedure for lower eyelid lesions. Methods We retrospectively analyzed 64 eyelids of 48 patients with lower eyelid laxity, ectropion, retraction, lagophthalmus and lateral canthus displacement from February 2010 to August 2013. All the patients were treated with the lateral tarsal strip procedure as the main surgical style, of which some combined with the surgery of lower-eyelid tarsal constrictor,some implanted with high porous polyethylene lower eyelid spacers (Medpor LES), and few cases of eyelid ectropion underwent transplantation or transposition of flap. The effect of relocation of lower eyelid and appearance improvement were evaluated after surgery. The degree of the low eyelid retraction, lagophthalmus and the lateral canthus displacement were examined quantitatively before and after operation, while the change of the low eyelid ectropion and laxity were done qualitatively. Results After two weeks of operation, eyelids of all the patients were relocated well except two cases of ectropion under mild correction. The quantitative evaluation showed there was significant difference between pre and post operation ( <0.001),while the qualitative effect of correction was satisfied after operation. Conclusion The lateral tarsal strip procedure had positive effects in the treatment of most sorts of lower eyelid diseases.

Objective To observe the serum and cerebrospinal fluid (CSF) levels of procalcitonin (PCT),matrix metalloproteinase-9 (MMP-9) in children with purulent meningitis and viral encephalitis,and evaluat the differential diagnosis value of PCT and MMP-9.Methods The clinical data of 73 patients with intracranial infection admitted to neurology of Qingdao Women and Children's Hospital from September 2014 to December 2015.Twenty-two patients with pumlent meningitis were se1ected as purulent meningitis group,51 patients with viral encephalitis as viral encephalitis group,and another 20 non-infectious convulsion children as a control group.Samples of 2 ml CSF and 3 ml venous blood from all the subjects were collected within 24 hours after admission.The levels of MMP-9 were detected by Enzymelinked immunosorbent assay (ELISA),and the PCT 1evels were measured by electrochemiluminescence immunoassay.The data in multiple groups were compared with analysis of variance,and by SNK-q test to carry on pairwise comparison among groups.The positive rate significance compared by Chi-square test.Linear correlation analysis was used for correlation analysis.Results Mean serum and CSF levels of PCT in the pumlent meningitis patients group were significantly higher than those in the viral encephalitis group as well as the control group (P ＜ 0.01),but the levels of serum or CSF there were no significant difference between the viral encephalitis group and the control group (P ＞ 0.05);Mean serum and CSF levels of MMP-9 in the pumlent meningitis patients group were significantly higher than those in the viral encephalitis group and control group (P ＜ 0.01),and the levels in patients with viral encephalitis were significantly higher than those in control group (P ＜ 0.01);The increased percentage of the serum and CSF PCT in pumlent meningitis group were significantly higher than in viral encephalitis group (P ＜ 0.01).,but there were no significant difference for MMP-9 (P ＞ 0.05);The PCT level of serum or CSF in pumlent meningitis patients was positively correlated with MMP-9 (r =0.498,P ＜ 0.01),but there was no significant correlation in viral encephalitis group (P ＞ 0.05).Conclusion Detection of PCT and MMP-9 level is valuable in differential diagnosis for the pumlent meningitis or viral encephalitis.

OBJECTIVETo investigate the effect of tetrandrine (Tet) on the expression of bax, bcl-2, and transforming growth factor-β2 (TGF-β2) mRNA in cultured human fibroblasts of Tenon's capsules (TCFS) and explore its possible mechanism.

METHODSThe third passage of TCFS cultured in vitro were exposed to 1×10(-5) mol/L Tet for 24 h, and real-time fluorescence quantitative PCR was used to detect the changes in the expressions of bax, bcl-2, and TGF-β2 mRNA.

RESULTSThe expression level of bax mRNA was obviously higher, while bcl-2 and TGF-β2 mRNA levels were significantly lower in Tet-treated TCFS than those in the control cells (P<0.05).

CONCLUSIONTet can inhibit the proliferation of TCFS possibly by reducing the expressions of bcl-2 and TGF-β2 mRNA, enhancing the expression of bax mRNA and inducing cell apoptosis, suggesting its potential in preventing fibrous scar formation after glaucoma filtration surgery.

Apoptosis ; Benzylisoquinolines ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix ; metabolism ; prevention & control ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Tenon Capsule ; cytology ; Transforming Growth Factor beta2 ; genetics ; metabolism ; bcl-2-Associated X Protein ; genetics ; metabolism

Driven by the two-wheel wheels of high-quality development of public hospitals and DRG/DIP payment reform,the operation mode of hospitals urgently needs to shift to the intensive mode of"cost reduction and efficiency increase".As the hub of hospital business operation and an important center of resource integration,the lean management of operating room affects the realization of high-quality development goals of"three transformations and three improvements".Based on the perspective of value chain,it discusses the difficult problems of operating room cost management in public hospitals from three aspects:operation cost motivation,execution cost motivation and structural cost motivation.Then,it puts forward corresponding management strategies to promote lean management of operating room,and help public hospitals to strengthen cost control and improve operational efficiency.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.