AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Drug reservation wag investigated in 2077 community residents.We found that most drugs were obtained from the hospitals(83.78%),kept at a relatively lower place(69.23%),packed in box(75.25%),and did not meet the storage requirement(72.60%).Half of the overdue drugs(median time,12 months)were used for internal treatment.This study suggests that there might be unsafe drug storage in communities.

Objective To investigate the effect of diabetes on clinical efficacy of transcatheter arterial chemoembolization (TACE) in the treatment of non-viral hepatitis hepatocellular carcinoma (HCC). Methods Retrospectively analyzed the clinical data of 367 non-hepatitis virus HCC patients treated by TACE, included 153 diabetes mellitus cases (test group) and blood glucose of 214 patients was normal (control group). To assess the treatment effect after 1 month of TACE based on response evaluation criteria in solid tumors, include complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), and calculate the disease control rate. Through 6 to 75 months follow-up to observed long-term efficacy, record the time to progression (TTP) and overall survival (OS) time. Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis by SPSS 16.0. The single-factor analysis was used to analyze variables which variables that differed were analyzed by Cox regression. Results The disease control rate of test group was 69.9%(107/153) and control group was 74.3%(159/214), the difference was no statistically significant (P=0.125). The median time to progression (mTTP) and median overall survival (mOS) of test group were 10.0 and 15.0 months;and the mTTP and mOS of control group were 14.0 and 19.0 months, the difference were statistically significant (P=0.023 and P= 0.026). Tumor diameter ≥4.5 cm, numbers of tumor ≥3, invasion of blood vessels, α-fetoprotein≥200 μg/L, Eastern Cooperative Oncology Group score and diabetes were risk factors for OS of HCC patients. Conclusion Diabetes is unfavorable factors for overall survival of non-hepatitis HCC tread by TACE.

Objective To study the deformation and stress distribution of femur after total hip arthroplasty (THA) and its influence on the vibration mode and natural frequency of femur. Method Two finite element models of natural femur and femur after THA were developed on the basis of computed tomography (CT) scans from a normal young man to investigate the biomechanical behavior of the subjectunder gait condition and make the modal analysis. Results (1) After THA, obvious stress concentration was obtained around the prosthesis neck, and the stress shielding was observed; (2) The peak stress of femur model after THA increased to 4.36 times of the original one; (3) The natural frequency for constrained mode was much higher than that of free mode; (4) With the increase of vibration mode, the differences in natural frequency between two models became larger; (5) Bending and twisting were the main vibration mode of femur, and there were no significant changes in vibration mode before and after THA. Conclusions The prosthesis could change the mechanical and structural properties of the original femur. In order to avoid prosthesis loosening derived from sympathetic vibration, the vibration property of femur must be taken into consideration in the design of prosthesis.

Objective To investigate the influence of acetabular morphology on contact mechanics of the human hip joint. Methods One anatomical finite element (FE) model of natural hip joint and three simplified FE models with different acetabular geometry were established to study the contact mechanics of hip joint under gait loads. Results (1) Contact predicted by the anatomical model was mainly distributed in the acetabular medial-superior area, from anterior to posterior, with the peak contact pressure occurred in the anterior-superior area; (2) Compared with the anatomical model, the rotational ellipsoid produced similar contact behavior, while the sphere and the rotational conchoids predicted that contact was distributed in the medial-lateral direction; (3) The rotational ellipsoid predicted the largest contact area and the lowest peak contact pressure and Von-Mises stress; (4) The sphere and rotational conchoids had similar contact mechanical behavior. Conclusions Compared with the sphere and rotational conchoids, the rotational ellipsoid could be more preferable to represent the anatomical morphology of the acetabulum and its contact mechanics.

OBJECTIVETo investigate the epidemiological features, genetic drift in the epitopes of hemagglutinin (HA) of the novel influenza A (H1N1) virus and oseltamivir-resistant variants characterized by H275Y and N295S mutations in children in Shanghai since the outbreak.

METHODBetween June 2009 and May 2012, a prospective surveillance study was carried out in Shanghainese children who attended the outpatient clinic of Children's Hospital of Fudan University for influenza-like illness. One-step real-time fluorescence quantitative RT-PCR was performed to detect seasonal influenza A and influenza B virus and the novel influenza A (H1N1) virus in the respiratory samples. Genetic drift from the vaccine strain in HA epitopes of the novel influenza H1N1 virus and the molecular markers associated with oseltamivir resistance in neuraminidase (NA) were analyzed.

RESULTOut of 3475 enrolled cases, the novel influenza A (H1N1) virus was confirmed virologically in 222 (6.4%) otherwise healthy children with 133 (59.9%) being boys and 89 (40.1%) girls. The median ages of children with the novel influenza A (H1N1) virus infection during the first wave from August 2009 to February 2010 and the second wave from December 2010 to February 2011 were 53.5 months and 32.0 months, respectively (Z = -4.601, P = 0.000); 119 (46.9%) had the close contact with persons suffering from fever or respiratory infection, of whom, 68 (57.1%) contacts were family members and 47 (39.5%) contacts were classmates. During the outbreak in 2009-2010 season, 66 (40.9%) were exposed to primary index cases, school students were the major exposure subjects, accounting for 50.0%. The nucleotide sequences of HA1 gene were highly homologous between the vaccine strain A/California/07/2009 and Shanghai circulating novel influenza A (H1N1) strains and only S83P mutation in epitope E of HA was detected inclusively in the circulating strains. The H275Y and N295S amino acid mutations associated with oseltamivir resistance were not found in the circulating novel influenza (H1N1) strains.

CONCLUSIONTwo major waves of the novel influenza A (H1N1) outbreaks occurred in Shanghainese children during 2009-2011. Institutional children were the major affected individuals during the 2009 pandemic wave. Households and schools were the main sites of transmission among children during influenza pandemic. Influenza vaccination should be enhanced in children and their close family contacts. The novel influenza A (H1N1) virus in Shanghai has not undergone significant genetic changes. Oseltamivir is effective for the treatment of the novel influenza A (H1N1) virus.

Adolescent ; Amino Acid Sequence ; Antiviral Agents ; pharmacology ; Child ; Child, Preschool ; China ; epidemiology ; Drug Resistance, Viral ; Female ; Hemagglutinins, Viral ; genetics ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; classification ; genetics ; isolation & purification ; Influenza, Human ; drug therapy ; epidemiology ; pathology ; virology ; Male ; Molecular Epidemiology ; Molecular Sequence Data ; Neuraminidase ; genetics ; Oseltamivir ; pharmacology ; Pandemics ; Viral Vaccines ; genetics ; immunology

OBJECTIVETo establish a real-time reverse transcription-polymerase chain reaction (RT-PCR) for quantitative detection of E2A-PBX1 fusion gene mRNA in acute lymphoblastic leukemia (ALL) children and to explore its clinical significance in minimal residual disease monitoring and prognosis evaluation.

METHODSReal-time RT-PCR was used to quantitatively detect the mRNA expression of E2A-PBX1 gene in 11 newly diagnosed ALL patients at diagnosis (11 cases), complete remission (11 cases) and periods of relapse (3 cases). Ten children with normal bone marrow cell morphology and without hematopathy or tumor diseases were used as the control group.

RESULTSThe median expression levels of E2A-PBX1 fusion gene in the ALL group at diagnosis and the relapse group were significantly higher than in the control and complete remission groups (P<0.01). Compared with E2A-PBX1 negative patients on day 33 during induction of remission, the recurrence rate increased and disease free survival rate at 3 year decreased significantly in E2A-PBX1 positive patients decreased (P<0.05).

CONCLUSIONSMeasurement of E2A-PBX1 levels by real-time RT-PCR is useful for monitoing minimal residual disease, prediction of relapse and individual treatment. The expression level of E2A-PBX1 gene on day 33 during induction of remission can be used for prognosis evaluation.

Adolescent ; Child ; Child, Preschool ; Female ; Homeodomain Proteins ; genetics ; Humans ; Male ; Neoplasm, Residual ; diagnosis ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; Prognosis ; Real-Time Polymerase Chain Reaction ; methods

The total leaves saponins of panax notoginseng decoloring by adsorption with exchange resins was studied and the decoloring capacity of six anions resins as adsorbent material was evaluated. The decoloring capacity of the selected resins (D296 and Dt) was compared by the dynamic adsorption decolorization experiments. Removel of coloured compounds in rew solution takes place in two serially coupled different ionic exchange columns, one packed column was D72 cation resin, another anion resin. The results showed that macroporous anion exchange resin Dt was the best resin to decolorization of the total leaves saponins of panax notoginseng. The total saponin products with higher purity and quality were obtained. The results of this work shows that the method proposed is convenient, high efficcient and steady one.
Ion Exchange Resins ; chemistry ; Panax notoginseng ; chemistry ; Plant Leaves ; chemistry ; Saponins ; chemistry ; isolation & purification

Objective To investigate the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in endometriosis (EMS) and its diagnostic value.Methods The information of EMS gene expression was collected from Gene-Cloud of Biotechnology Information (GCBI) and analyzed,in which MALAT1 gene was screened out accordingly.The total RNAs were extracted from tissues and serum samples of the patients with ovarian endometriosis and non-endometriosis and the expression of MALAT1 was detected by real-time quantitative PCR.The correlation between MALAT1 expression level and menstrual cycle was analyzed.The differential diagnostic efficacy of serum MALAT1 levels was analyzed by receiver operating characteristic (ROC) curve.Results Compared with the non-EMS group the expression of MAL4T1 gene was down-regulated by 1.35-fold (t =-3.27,P ＜ 0.01) in EMS group according to gene information analysis of GCBI.The relative expression levels of MALAT1 in ectopic and eutopic endometrium of patients with ovary endometriosis (0.41 ±0.18 and 0.61 ± 0.12) were significantly lower than those in non-endometriosis patients (1.05 ±-0.34,t =5.87 and 4.48,P ＜ 0.01).However,the expression level of MALAT1 was not related with menstrual cycle of the patients with ovarian endometriosis and non-endometriosis (t =1.54 and 1.52,P ＞ 0.05).The expression of MALAT1 in ectopic ovarian cysts was significantly lower than that in eutopic endometrium of ovary endometriosis (t =3.77,P ＜ 0.01).The relative expression of serum MALAT1 in ovary endometriosis (0.60 ±0.18) was significantly lower than that in non-endometriosis (1.05 ± 0.32,t =5.18,P ＜ 0.01).The area under the curve (AUCsOc) was 0.88.When the cut-off value of serum MALAT1 level was set as 0.74,the sensitivity and specificity of expression level of MALAT1 were 82.4％ and 92％ respectively,and Youden's index was 74.4％.Conclusion Low expression of MALAT1 in endometriosis may be related with occurrence and development of endometriosis.Serum MALAT1 level may have certain differential diagnostic value for EMS.

Comprehensively and continuously improving the ability is the goal of continuing medical education for practicing general practitioners (GPs). It is urgent to carry out systematic planning for improvement of the training content, training methods and evaluation methods in current continuing education system. Therefore, based on the survey of the training requirements of the community GPs in Shanghai Changning District, this study proposed a pathway of establishing continuing education mechanism for community GPs in regional medical centers. This continuing education mechanism planned to build a talent evaluation system reflecting the competency of the community GPs, to develop training contents based on the community situation and the needs of the GPs, to establish the practice support and the collaboration platform of science, education and research, to promote the sustaining improvement of GPs.