Objective To observe the clinical characteristics and surgical methods of strabismus following external approach for retinal detachment,and explore the common factors related to deviation angles of strabismus.Methods Twenty-five cases of secondary strabismus following external approach for retinal detachment underwent strabismus surgery were recruited,and the follow-up time was from 5 months to 41 months.Ophthalmic examinations were performed before operation.Clinical characteristics of these cases were observed by intraoperative exploration,including preoperative and postoperative eye position and ocular movement (at 1 week and further followup).The preoperative and postoperative deviation angles of strabismus were evaluated according to the times of retinal detachment operation,postoperative BCVA and the surgery procedure of hang-back recession.Results Before strabismus operation,all cases underwent abnormal eye-movements,8 cases suffered from diplopia,and scar adhesions were observed in all involved ocular muscles during operation.Seven cases underwent weakening procedure of extraocular muscle,18 cases underwent weakening procedure plus strengthening procedure.Ten cases underwent hang-back recession among them.At 1 week and the final follow-up,the eyeball in21 cases and 15 cases were in position,4 cases and 9 cases were in undercorrection,5 cases and 7 cases were in limitation,and 2 cases and 1 case were in diplopia.The more operations were performed in retinal detachment,the more scar adhesions were presented,and statistical significance existed with the mean deviation angles before and after operation(in a week) between cases that had one-time and over-one-time of retinal detachment surgery (P =0.01,0.00).No difference of mean deviation angles was found at one week after operation and at follow-ups between the cases with and without hang-back recession (P =0.26,0.63).Conclusion Abnormal eyemovements,diplopia and scar adhesion are the most common clinical characteristics of strabismus following retinal detachment surgery.Times of retinal detachment operation and postoperative BCVA can influence the deviation angles of strabismus,and hang-back recession seems the safe and effective method of strabismus surgery.

Objective To evaluate the significance of serum matrix metalloproteinase-3 (MMP-3) and joint ultrasonography in assessing the activity of rheumatoid arthritis (RA) by comparing MMP-3 level and the ultrasonic 7 joints (US7) score in RA patients.Methods Serum MMP-3 level and US7 score were measured in 133 RA patients by immune turbidity and Doppler ultrasound.Synchronous 53 healthy subjects were recruited as controls.Clinical data were collected.Erythrocyte sedimentation rate (ESR),serum level of anti-cyclic citrullinated peptide (CCP) antibody,health assessment questionnaire (HAQ) and disease activity score 28 (DAS28) were measured.The level of disease activity is interpreted as remission(DAS28 ＜2.6),low(DAS 28≥2.6-＜3.2),moderate(DAS 28≥3.2-＜5.1),high(DAS28≥5.1).The discriminating validity of MMP-3 and US7 score in disease was evaluated using receiver operating characteristic (ROC) curve analysis with DAS28 as the reference standard.Results Compared with that in healthy controls [35.20(25.90,48.90) μg/L] and remission patients[33.40(22.60,678.40) μg/L],the MMP-3 level in moderate [105.1 (61.70,172.70) μg/L] and high [363.1 (161.50,475.90) μg/L]groups increased dramatically.US7 score in patients with high disease activity was significantly higher than that in other groups.The level of MMP-3 was significantly correlated with DAS28,HAQ,US7 score,yet did not have correlation with anti-CCP antibody.Serum level of MMP-3 was positively correlated with US7 score (r =0.566,P ＜ 0.001).In evaluating the disease activity,US7 score combined with MMP-3 (AUC 0.863 2) was not superior to MMP-3 alone (AUC 0.854 3),but significantly better than single US7 score (AUC 0.7643,P ＜ 0.05).Conclusions MMP-3 is an effective and simple index in evaluating RA disease activity.The combination of MMP-3 and US7 score does not further improve the efficacy to evaluate disease activity than MMP-3 alone in patients with RA.

Objective To study transmission characteristics of Acinetobacter baumannii (A.baumannii )clone and clinical features of infected patients in a respiratory intensive care unit (RICU),so as to guide the effective pre-vention and control of A.baumannii transmission.Methods 40 A.baumannii strains isolated from RICU patients were performed homology analysis by pulsed-field gel electrophoresis (PFGE)and cluster analysis,relationship of strains was determined,antimicrobial resistance and clinical data were analyzed.Results 40 A.baumannii strains were divided into 11 genotypes(A-K),the main epidemic strains were type A,B and E.The resistant rate to imipen-em was the lowest(70.00%),the next was levofloxacin (77.50%).The average age of 40 infected patients was 67 years old,the average length of hospital stay was 41 days,12 patients died because of invalid treatment.There was overlapping hospitalization among patients infected with type A and E strains;among patients infected with type B strain,there was no overlapping hospitalization among the last 6 and first 6 infected patients.Conclusion The main epidemic strains of A.baumannii were type A,B and E,antimicrobial resistant rate is high;the infected patients are with high average age and long length of hospital stay.It is important to reduce the transmission of A.baumannii through rational use of antimicrobial agents,strict aseptic operation,and intensified disinfection and sterilization of hospital environment and medical devices.

Objective:To develop a method for the determination of palladium in bendamustine hydrochloride by GFAAS. Meth-ods:The sample was destroyed by heat, and the content of palladium was determined by GFAAS with the detection wavelength of 247. 6 nm. Results:The absorbance and the content of palladium showed a good linear relationship within the range of 20-60 ng· ml-1(r=0. 998 4). The average recovery of palladium was 102. 9%(RSD=1. 7%, n=9). Conclusion: The method is sensitive and simple, which can be used for the determination of palladium in bendamustine hydrochloride.

Objective To investigate the effect of Smo siRNA on the aggressive capability of human esophageal carcinoma EC9706 cells.Methods EC9706 cells were transfected by Smo siRNA.The expressions of Smo and Glil protein in experimental and control groups were detected with immunocytochemistry.The expressions of Smo and Gli1 mRNA in experimental and control groups were detected with in situ hybridization.The change of aggressive capability in all groups was detected by Boyden chamber in vitro.Results Compared with control group,there was a significant decrease in the protein and mRNA levels of Smo and Gli1 in every specific siRNA transfection group with three different concentration (P ＜ 0.05).The aggressive capability of EC9706 cells was significantly weakened after the transfection (P ＜ 0.05).Conclusions Smo siRNA can inhibit the expressions of Smo and Gli1 genes in EC9706 cells,and can also weaken the aggressive capability of EC9706 cells.

Objective To establish fingerprint and mutual mode of aqueous extracts of Eucommia ulmoides Oliv.from different regions by high performance liquid chromatography ( HPLC). Methods The column of SinoChrom ODS￣BP (250 mm×4.6 mm, 5 μm) was used.The mobile phase consisted of acetonitrile￣0.1% phosphoric acid with gradient elution.The flow rate was 1.0 mL.min-1 , the detective wavelength was 230 nm, and the column temperature was 25 ℃ . Results The fingerprint consisted of 14 common peaks.The overall similarity for ten batches of Eucommia ulmoides Oliv.from different regions was 0.592-0.986.The standard fingerprint of Eucommia ulmoides Oliv.was established by HPLC. Conclusion This fingerprint method is simple and repeatable, and it provides a scientific basis for the quality control of Eucommia ulmoides Oliv.

Objective: To explore risk factors for complicated cardiovascular and cerebrovascular diseases in patients with refractory hypertension (RH).Methods: Clinical data of 536 RH patients, who were treated in our hospital from Jun 2010 to Jul 2015, were retrospectively analyzed.According to presence of cardiovascular and cerebrovascular diseases or not, patients were divided into complication group (n=217) and pure RH group (n=319).Results: Compared with pure RH group, there were significant rise in percentages of drinking and smoking, hypertension course, mean arterial pressure (MAP), mean systolic blood pressure, pulse pressure, serum uric acid (SUA), creatinine (Cr), total cholesterol and low density lipoprotein cholesterol (LDL-C), and significant reductions in high density lipoprotein cholesterol (HDL-C) mean diastolic blood pressure and mean heart rate in complication group, P<0.01 all.Multi-factor unconditional Logistic regression analysis indicated that hypertension course, SUA,MAP, Cr and LDL-C levels were independent risk factors for complicated cardiovascular and cerebrovascular diseases in RH patients (OR=1.014~3.217, P<0.05 or <0.01).Conclusion: Hypertension course,MAP,Cr,SUA and LDL-C are independent risk factors for refractory hypertension.Enhancing their monitor, prevention and treatment are important to reduce incidence rates of cardiovascular and cerebrovascular complications in patients with refractory hypertension.

The influences of the calmodulin antagonist chlorpromazine (CPZ), and calcium chanmel blocker nimodipine (NLMO) and their combination on cadmium (Cd) poisoning of mice were studied.A series of biochemical parameters including urinary enzyme activities, blood and urine Cd levels, metallothionein (MT) contents in liver and kidney, hepatic ultrastructure and Ca2+ -Mg2- AT Pase activitv in erythrocyte membrane were determined. Animal models for Cd poisoning were established by peritoneal injection of 1/5 LD50 CdCl2. The experimental groups were protected by administration of CPZ, NIMO and CPZ and NIMO in combination I h before the injection of CdCl2. Five days later, samples were collected for analysis. The data showed that CPZ could protect kidney tissue against Cd-induced damage, as the urinary y-glutamyl-traspeptidase (γ-GT) and N-acetyl-β-D-glucosaminidase (NAG) activities were reduced significantly. There was neither evidence of the protective effect of NIMO on kidney tissue nor an indication of a synergistic effecf of CPZ and NIMO.Both CPZ and NIMO showed a considerable protective effect against the decrease in Ca2+ -Mg2+ AT-Pase activity, and a synergistic action was observed. Cd content in blood was reduced significantly by CPZ or the combination of CPZ and NIMO, but elevated by NIMO. Both CPZ and NIMO considerably increased MT contents in livers and kidneys and ameliorated damaged to the hepatic ultrastructures caused by Cd. The results indicated that these inhibitors could protect mice against the toxic effects of Cd in liver and kidney tissues, while CPZ was more efficient than NIMO. The combination of CPZ and NIMO excrted a synergistic action. The protective action of these two drugs might be relevent to the function of MT.

Objective To investigate factors that influence the subjective well-being of nurses in a secondary hospital in Shenzhen Special Economy Zone (SSEZ). Methods A total of 122 nurses in the hospital were assessed using Fazio' s General Well- Being (GWB) schedule and a self-designed data collecting questionaire. Results The difference of GWB were no significant in following factors: education level,administrative appointment, maritial status, years of residence in the SSEZ, whether the nurse pocesses any real estate properties or does any night shifts. There are significant links between the GWB and the age, department of work, professional title, length of service, employment contract type and whether the nurse has any children.Conclusions The findings suggest that age, department of work, professional title, length of service, employment contract type and whether the nurse has any children are the major influential factors of GWB among the nurses in the secondary hospital in SSEZ.

Objective To study early changes in biochemical markers of bone turnover for prodicting the bone mineral density(BMD) response to alendronate therapy in Chinese men with osteoporosis. Methods Seventy-eight men aged 60 to 82 years with osteoporosis [mean age (69.8 ±11.8) years]were treated with alendronate sodium 70 mg/week for 12 months. Serum bone gla-protein (BGP) and serum pyridinoline-eross-linked earboxyterminal telopeptide of type I collagen (ICTP) level were measured by chemiluminescence (equipment is Roche E170). Serum BGP, ICTP and BSALP levels were measured before and 3 months and 12 months after treatment. BMD in lumbar spine and femoral neck were measured with dual energy X-ray absorptiometry (GE PRODIGY Inc. ) at L1-4 and at the left hip(total hip,trochanter,Ward's area and femoral neck)before and 12 months after treatment. Results After 3-months and 12-months treatment, the percent reductions of serum ICTP levels were 45.8% and 51.6%, serum BGP level 32.0% and 37.5%, serum BSALP level 35. 3% and 39.9% ,respectively. After 12-months treatment, the percent increase of lumbar BMD was 11.8%, femoral neck BMD 11.4 %. The percent reductions of serum ICTP level at months 3 and 12 after treatment were positively correlated to the percent increase of lumbar BMD (r=0.28, 0.295,P <0.05 and P<0.01)and of fermoral neck BMD at 12 months after treatment(r=0.262, 0.333, P＜0.05 and P<0.01)respectively. The percent reductions of serum BGP level at months 3 and 12 after treatment were positively correlated to the percent increase of lumbar BMD (r=0. 322, 0.401,all P<0.01) and of fermoral neck BMD at 12 months after treatment (r=0.277,0.284, all P＜0.05)respectively. The percent reductions of serum BSALP level at months 3 and 12 after treatment were positively correlated to the percent increase of lumbar BMD (r=0.133,0.231,all P＜0.05) and of fermoral neck BMD at 12 months after treatment(r=0.248, 0.317, all P＜0.01)respectively.Conclusions Early changes in biochemical markers of bone turnover rates can predict BMD response to alendronate in Chinese men with osteoporosis.