Objective To evaluate the effect of stereotactic radiotherapy combined with conventional radiotherapy for non-small cell lung cancer(NSCLC)patients with positive stump at the resected bronchial margin. Methods From June 1996 to November 2000, 41 NSCLC patients in whom microscopic residual disease found pathologically at the resected bronchial margin were treated by: conventional radiotherapy followed by stereotactic radiotherapy ( RT+SRT group 18 patients), while the other 23 patients received routine radiotherapy alone (RT group). Results The 1-,2-and 3-year local disease-free rates were better in RT+ SRT group (92.3%,~83.1% and 83.1%) than those in RT group (80.2%,60.2% and 39.5% ). However, no significant difference was found in the complication rate or survival rate between the two groups. Conclusions Stereotactic radiotherapy is effective as a boost irradiation to patients with non-small cell lung cancer with microscopic residual disease at the resected bronchial margin by improving the local control.

Aim To investigate the effect of tanshinol on bone mineral density and microstructure of proximal tibias in rats with bone loss induced by glucocorticoid. Methods Sixty 7-month-old female SPF SD rats were randomly divided into 6 groups with 1 0 rats per group:control group(saline:5 ml·kg -1 ·d -1 ),glucocorti-coid group (prednisone acetate:6 mg·kg -1 ·d -1 ), glucocorticoid +low dose of tanshinol group(1 2.5 mg ·kg -1 ·d -1 ),glucocorticoid +medium dose of tan-shinol group (25 mg·kg -1 ·d -1 ),glucocorticoid +high dose of tanshinol group (50 mg·kg -1 ·d -1 ), glucocorticoid +(positive control drug)calcitriol group (0.045 μg · kg -1 · d -1 ).Rats were gavaged with prednisone acetate continuously for 1 4 weeks to estab-lish the bone loss model.Meanwhile,tanshinol and calcitriol were orally administered to the rats which were treated with prednisone acetate for intervention. At the end of the experiment,the left proximal tibias were collected for Micro-CT scanning and three-dimen-sional reconstruction of cortical and trabecular bone re-
spectively to observe the changes of bone microstruc-ture and test related parameters.Results Bone min-eral density was decreased and bone microstructure was destroyed in proximal tibias of rats after treatment with glucocorticoid.Both tanshinol (25 mg·kg -1 ·d -1 ) and calcitriol(0.045 μg·kg -1 ·d -1 )could increase bone mineral density and improve bone microstructure in proximal tibias without significant differences be-tween each other.Tanshinol (50 mg · kg -1 · d -1 ) could improve bone microstructure to some extent,but it had no significant effect on bone mineral density. Tanshinol(1 2.5 mg·kg -1 ·d -1 )had no significant effect on bone mineral density or microstructure.Con-clusion Oral administration of tanshinol (25 mg · kg -1 ·d -1 )to the rats treated with glucocorticoid can increase bone mineral density and improve bone micro-structure in proximal tibias.

Objective To study the relationship between HAI and HBsAg, HCV in HCC, pericarcinomatous tissues. Methods The patterns of HBsAg and HCV in 100 cases of hepatocellular carcinoma(HCC) and their surrounding liver tissues were studied on paraffin-embeded sections with immunohistochemistry technique, and pericarcinomatous tissues were scored in Knodell’s histological activity index(HAI). Results The score of HAI in the group of co-infection of HBV, HCV is the highest in the four groups(12.62?3.88). The score of HAI in the group which is not infected by HBV, HCV is the lowest in the four groups(6.67?2.58). HBV, HCV virus infection were positively correlated with HAI(rs=0.39,P=0.0001). HBsAg and HCV were detected both in HCC and pericarcinomatous tissues. The positive rate of HBsAg in Pericarcinomatous Tissues(79%) was higher than that of in HCC tissues(23%). HCV expressions in HCC(15%) and pericarcinomatous tissues(23%) had no differences. Conclusions As for the tissues of liver cancer with virus infection background, the HAI is obviously higher than that without virus infection background. HBV, HCV virus infection were correlated with HAI significantly, perennial virusemia will aggravate pathological changes of liver tissue.

Objective To evaluate the causes of the metamorphopsia in patients with reattached retina after scleral buckling surgery. Methods Amsler grid test, ophthalmoscopic examination, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were performed on 79 patients (79 eyes) with reattached retina at the 2nd week, 2nd, 6th month and 1st year after scleral buckling operation. Results Two weeks after the operation, 51 patients (51 eyes, 64.56%) complained of metamorphopsia, and 44 patients (44 eyes, including 35 with and 9 without metamorphopsia) were examined by OCT and FFA. In patients with metamorphopsia, the results of OCT in 31 (88.57%) revealed abnormal macula with seven kinds consisting mostly of stratum neuroepithelium detachment (74.29%), while of FFA in 6 patients showed abnormal macular (17.14%) including 4 with neuroepithelium detachment (66.67%). In patients without metamorphopsia, abnormal macula could be found in 2 by OCT while nothing special was seen in FFA. Most abnormal macula in patients followed-up 2 months, 6 months and 1 year postoperatively meliorated as time went by, with alleviative or disappeared metamorphopsia; while the patients with persistently existing macular membrane had aggravating metamorphopsia. Conclusions Abnormal macula is the main reason for metamorphopsia after scleral buckling surgery. Neuroepithelium detachment and macular membrane are the main causes of metamorphopsia at the early and terminal stage after operation.

Objective To investigate the possibility that transplanting the full-thickness neonatal piggy retinas that are completely differentiated but immature improves the retinal function after light-induced retinal degeneration in pigs.Methods Retinas from normal Guangxi Bama pigs aged 1-6 days were used as donor tissues.Neuroretina-RPE cografts were obtained from newborn pigs by using excimer laser for microablation of choroidal tissue and transplanted into the subretinal cavity of adult Bama pigs after light-induced retinal degeneration through vitrectomy and retinotomy.On days 5-7 and in 1st to 5th month after retinal transplantation,the survival of the cografts in the recipients and whether the host retinas have rejection were observed by ophthalmoscope,colour fundus photography and fundus fluorescein angiography,and the amplitude and lantency of N1,P1 waves between different periods were measured by mfERG.Results The retinal transplantation was performed in 15 eyes of 8 Bama pigs after light-induced retinal degeneration.The subretinal transplantation of the cografts was performed successfully in 11 eyes,with the operation success rate of 84.6%(11/15).In host retina,the gray-black graft inside transplantation bed could be seen clearly in 1st to 2nd month after transplantation and the leaked fluorescence in transplants was checked with FFA.The vertical comparison between different periods showed the amplitude of N1,P1 waves of retinal transplants rose with the extension of the survival time,and the areas where active response was observed were ring 2 and ring 3;but the latency of N1,P1 waves was shortened significantly in each ring as compared with that before operation,especially in late survival period.Conclusion The function measurement and the observation of living body together confirm the transplantation of completely differentiated retina from newborn pigs improves the retinal function of pigs after light-induced retinal degeneration.

Objective To analyze the causes and pathogens of infectious endophthalmitis in ourhospital.Methods The clinical data and laboratory findings of 282 inpatients with infectiousendophthalmitis were retrospectively reviewed.There were 206 males(73.05%)and 76 females(26.95%)with a mean age of(36.0±11.2)years(range from 2 to 79 years).Except 14 patients who lost theireyeballs as of serious conditions.pathogen examinations of vitreous specimen had been performed for allremaining 268 cases.The clinieal and laboratory data were statistically analyzed by Chi-square and Kappaconsistency tests,when P<0.05 the difference should be considered as statistically significant.ResultsThe 4 major causes of infectious endophthalmitis of those 282 patients included ocular trauma(177cases,62.77%),infectious keratitis(61 cases,21.63%),eye surgery(32 cases,11.35%),andendogenous endophthalmitis(12 cases,4.25%).19.21% of the patients in ocular trauma group was 2-13years old,55.74% of the patients in infectious keratitis group was 14-50 years old,and 60.61% of thepatients in eye surgery group was 51-79 years old.The major pathogens were fungus and staphylococcieach accounted for 30.63% of all cases.Most of the pathogenic bacteria were sensitive to ciprofloxaein(81.81%)and gentamicin(77.92%).Conclusions The major reason of infectious endophthalmitis wasocular trauma,and the major pathogens were fungus and staphylococci.Those findings may help us totreat infectious endophthalmitis patients appropriately.

Objective To investigate the effects of dexmedetomidine on global cerebral ischemia-reperfusion (I/R) injury in rats.Methods Fifty-four adult male SD rats weighing 200-250 g were randomly divided into 3 groups (n =18 each): shame operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was produced by occlusion of bilateral common carotid arteries combined with hypotension (MAP maintained at 35-45 mm Hg).In group D dexmedetomidine 3 μg/kg was injected iv immediately after I/R,followed by infusion of dexmedetomidine at a rate of 3 μg· kg- 1 · h- 1 until 2 h of reperfusion.The neurological deficit score (NDS) was assessed (0 =normal,100 =brain death) at 6 h (T1),24 h (T2)and 72 h (T3) of reperfusion.Then six rats were sacrificed in each group and brain tissues were removed for microscopic examination of hippocampus CA1 region and determination of activity of myeloperoxidase (MPO),contents of TNF-α and IL-1β and expression of glial fibrillary acidic protein ( GFAP).Results Compared with group S,NDS,MPO activity and the contents of TNF-α and IL-1β at T1-3 were significantly increased,the expression of GFAP was up-regulated at T2,3 in groups I/R and D ( P ＜ 0.05 or 0.01).Compared with group I/R,NDS,MPO activity and TNF-α concent were significantly decreased at T1-3,IL-1β concent was decreased at T1,2,the expression of GFAP was down-regulated at T2,3 in group D (P ＜ 0.05 or 0.01 ).The pathologic changes were significantly attenuated in group D as compared with group I/R.Conclusion Dexmedetomidine can attenuate global cerebral I/R injury in rats,and the inhibition of inflammatory response may be involved in the mechanism.

Objective To evaluate the effects of dexmedetomidine on the permeability of blood-brain barrier in rats subjected to global cerebral ischemia-reperfusion (I/R).Methods Thirty-six male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was induced by occlusion of bilateral common carotid arteries combined with hypotension (MAP was maintained at 35-45 mm Hg) in anesthetized rats.In group D,dexmedetomidine was infused at a rate of 3μg· kg-1 · h-1 until 2 h of reperfusion after a loading dose of dexmedetomidine 3 μg/kg was injected intravenously immediately after onset of I/R.The rats were sacrificed at 24 h of reperfusion and their brains were immediately removed for microscopic examination of hippocampal CA1 region and for determination of the cell apoptosis,brain water content,Evans blue content and aquaporin 4 (AQP4) expression.Results The number of apoptotic cells was significantly larger,and brain water content,Evans blue content and AQP4 expression were higher in groups I/R and D than in group S (P ＜ 0.05 or 0.01).The number of apoptotic cells was significantly smaller,and brain water content,and Evans blue content and AQP4 expression were lower in group D than in group I/R (P ＜ 0.05 or 0.01).Global cerebral I/R-induced pathological changes were significantly attenuated in group D.Conclusion Dexmedetomidine can decrease the permeability of blood-brain barrier and attenuate global cerebral I/R injury in rats,and down-regulation of AQP4 expression may be involved in the mechanism.

Objective To understand the current state of staff for Plasmodium microscopy examinations in Changzhou City in the early stage of eliminating malaria action,so as to provide the evidence for achieving the target of malaria elimination. Methods The staff for Plasmodium microscopy examinations from medical institutions and centers for disease control and prevention at differ-ent levels were investigated by questionnaires and tests of the malaria related theory and microscopic operation. Results Totally 95 people were investigated,and among them,40.0%had college degree and 45.3%were university educated. There were 18.9%of them working on Plasmodium microscopy examinations for less than 1 year,40.0%for 2-5 years,18.9%for 6-10 years and 22.1%for more than 10 years. The numbers of person-time of provincial and municipal level training,district-level training,and unit-level training in the last year were 0.57,0.59,and 0.14,respectively. Totally 18.9%of them had the experience of finding Plasmodium at work,and 97.9% of them considered it was necessary or very necessary to do Plasmodium microscopy examina-tions. However,57.9%and 8.4%of them considered Plasmodium microscopy examinations increased their work load and work dif-ficulty,respectively. The average correct rates of knowledge tests on malaria before and after training were 72.5%and 91.6%re-spectively(P<0.05). The average mark of Plasmodium microscopic tests was 25.3 points(full mark being 50 points),and the passing rate(≥30 points)was 58.9%. Conclusion The working experience of staff for Plasmodium microscopy examinations in Changzhou City is relatively poor,and the related training should be enhanced.

Objective To evaluate the role of evidence-based nursing in clinical ophthalmology teaching. Methods Fifty nursing interns in department of ophthalmology in Southwest Hospital were randomized into control group and observation group in accordance with the principle of equal number of junior college students and undergraduates. Traditional teaching was applied in control group while clinical ophthalmology teaching combined with traditional teaching was used in observation group. Teaching effect was evaluated at the end of internship by questionnaire and examination. Data were analyzed by SPSS 13.0 using χ2 test and independent sample t test(taking students with score ≥60 as effective indicator). P<0.05 indicated significant difference. Results Scores of questionnaire and examination were higher in observation group than in control group, with statistically significant differ-ence( χ2=6.818, P=0.018). Theoretical exam score was 67.12±11.53 in control group and 84.96± 9.27 in observation group; practical score was 65.68±8.0 in control group and 80.28±10.65 in observation group with significant differences between two groups (P=0.000). Conclusions Adoption of evidence-based nursing intervention in ophthalmic clinical teaching help students learn to think, consult literature and use critical thinking to raise questions during the internship. It also makes stu-dents regard the results of scientific research and personal experience as the basis for mastering pro-fessional and scientific expertise, thereby enhancing the ability of nursing practice.