Objective To collaboratively calibrate and finally assign the potency of the 9th national standard for human rabies vaccine for candidate.Methods Qualified laboratories for the production,research and development of human rabies vaccines were organized to determine the potency of candidate national standard for rabies vaccines by using NIH method,with the 7th international standard for rabies vaccines(NIBSC code:16/204)as the reference standard. The detection results were statistically analyzed,and the geometric mean of effective detection values was taken as the final potency value of the candidate standard. According to the requirements of the preparation of national drug reference materials,the candidate standard was destroyed by heat acceleration,and then detected for the glycoprotein antigen to investigate the stability.Results A total of 20 laboratories participated in the collaborative calibration,of which the two laboratories that did not strictly follow the collaborative calibration SOP were excluded,and the data of the remaining collaborative laboratories were valid. After statistical analysis,the final potency of the 9th national standard for rabies vaccine was 11. 4 IU/mL,the 95% confidence limit was 10. 9～11. 9 IU/mL,and the 95% reference range of ED_(50) was 2. 10～2. 75. There was no significant difference in the results of glycoprotein antigen detection under different time conditions(2,4,8 and 16 weeks)at 37 ℃.Conclusion The collaborative calibration research of the 9th national standard for human rabies vaccine(batch number:201906001)has been completed,the potency assignment is scientific and rigorous,the data was reliable,and the thermal stability meets the requirements. At present,this standard has been approved by the National Drug Reference Material Committee,which is of great significance to the quality control of human rabies vaccine,especially the quality control of effectiveness.

Objective To observe the effect of preoperative intravitreal ranibizumab injection (IVR) on the operation duration of vitrectomy and postoperative vision for the treatment of proliferative diabetic retinopathy (PDR).Methods A prospective study was carried out with the 90 PDR patients (90 eyes) who underwent vitrectomy.The 90 patients(90 eyes)were assigned to the vitrectomy only group(43 eyes) and the IVR combined with vitrectomy group (47 eyes).The IVR was performed 5-13 days prior to vitrectomy in the IVR combined with vitrectomy group.There were 15 eyes with fibrous proliferation PDR (FPDR),16 eyes with advanced PDR (APDR) without involving the macular and 16 eyes with APDR involving the macular in the vitrectomy only group.There were 14 eyes with FPDR,15 eyes with APDR without involving the macular and 14 eyes with APDR involving the macular patients in the IVR combined with vitrectomy group.All the eyes in the two groups were regularly operated by the same doctor to complete the vitrectomy.The start and end time of vitrectomy were recorded.The average follow-up time was 10 months.The changes of best corrected visual acuity (BCVA) before and 1,3 and 6 months after surgery were compared between the two groups.Results The duration of operation of the FPDR type (t=-8.300) and the APDR involving the macular type (t=-2.418) in the IVR combined with vitrectomy group was shorter than vitrectomy only group (P＜0.05).The comparison of duration of operation of the APDR without involving the macular type in the two groups has no statistically significant difference (t=-1.685,P＞0.05).At 1 month after surgery,the comparison of BCVA of the IVR combined vitrectomy group and the vitrectomy only group in APDR involving the macular type has no statistically significant difference (t=0.126,P＞0.05).At 3,6 months after surgery,the BCVA of the IVR combined vitrectomy group in APDR involving the macular type was significantly better than the BCVA of the vitrectomy only group (t=8.014,7.808;P＜0.05).At 1,3,and 6 months after surgery,the BCVA of the IVR combined vitrectomy group in FPDR type (t=3.809,1.831,0.600) and APDR without involving the macular type (t=0.003,1.092,3.931) compared with pre-treatment,the difference were not statistically significant (P＞0.05);the BCVA in APDR without involving the macular type compared with pre-treatment,the difference was distinctly statistically significant (t=2.940,4.162,6.446;P＜0.05);the BCVA in APDR involving the macular type (t =0.953,1.682,1.835) compared with pre-treatment,the difference were not statistically significant (P＞0.05).Conclusion Preoperative IVR of PDR can shorten the operation duration and improve the BCVA of APDR involving the macular type.

Objective To compare the clinical results of radial head resection with those of open reduction and internal fixation in treatment of Mason type- Ⅲ comminuted fracture of radial head. Methods 58 cases of Mason type- Ⅲ radial head fracture were treated in our department from January, 1983 to July, 2005. 28 cases had resection of the fractured redial head, while the other 30 cases had open reduction and internal fixation. The outcomes were assessed on the basis of pain, motion, strength, radiographic findings, and elbow functional rating score. Results The resection group had a mean follow- up of 5.5 years (2 to 6), while the internal fixation group had 10 years (3 to 13). The average pain VAS (visual analog scale) score was 18.7 (11 to 25) for the resection group and 23.5 (17 to 25) for the fixation group with a P value of 0.0023. The elbow extension averaged - 12.4? in the resection group and - 5.8? in the fixation group (P0.05) , but the decrease of elbow extension and forearm rotation differed statistically between the 2 groups (P

Objective To evaluate the techniques of controlling renal pedicle and dealing with incisional wound of kidney during retroperitoneoscopic nephron-sparing surgery for kidney tumors.Methods 9 patients with kidney tumors underwent retroperitoneoscopic nephron-sparing surgery from December 2003 to January 2007.Renal artery was blocked incompletely with silicone tube and the tumor was resected using an ultrasound scalpel 0.5-1.0 cm distant from the tumors.Incisional wound of kidney was sutured with absorbable stitch combined with biological fibrin glue and hemostatic gauze.Results All the procedures were successful without any converting to open surgery.The operative time was 2-3.5 h(mean,2.6 h).The blood loss was 50-400 ml(mean,150 ml).No complications such as perioperative haemorrhage and urinary leakage occurred.Pathological examination confirmed renal clear cell carcinoma in 8 patients and angiolipoleimyoma in 1 patient.Incisional margins were all of negative tumor cell.9 patients were followed up for 4 to 36 months(mean,13 months),and showed normal renal function and no local recurrence and organ metastasis.Conclusions With the command of techniques of controlling renal pedicle and dealing with surface of wound of kidney,retroperitoneoscopic nephron-sparing surgery is safe and effective.

Innate immune cells have a critical role in defense against infections and diseases.Central to this is the broad specificity with which they can detect pathogen-associated patterns and danger-associated patterns via the pattern recognition receptors (PRRs) they express.TLR is one of the most largely studied families of PRRs.Activation of TLR promotes both innate inflammatory responses and the induction of adaptive immunity.Given the characteristics of TLR,various Toll like receptor agonists are used in vaccine design to accelerate the immune response and produce long-lasting protection.

Background Intraocular neovascularization is a primary cause of visual reduce in proliferative diabetic retinopathy (PDR) , and intravitreal injection of ranibizumab is one of treating approachs.Researching the mechanism of intravitreal injection of ranibizumab for PDR is a new target for the prevention and management of PDR.Objective This study was to determine the levels of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of PDR eyes before and after intravitreai injection of ranibizumab.Methods Self-controlled observational study was designed.Fifteen eyes of 15 PDR patients with type 2 diabetes mellitus were included in Fuzhou General Hospital of Nanjing Military Command from January to August 2014, and 1 eye combined with neovascular glaucoma and iris rubeosis.Aqueous samples of 0.1 ml at each time were collected before and 7 days after the injection of ranibizumab from all patients under the informed consent.The changes of aqueous VEGF and PEDF concentrations were detected and analyzed by enzyme-linked immunosorbent assay.This study complied with Declaration of Helsinki and the protocol was approved by this hospital.Results The freeVEGF concentrations before and 7 days after intravitreal injection were (179.4±136.5) pg/ml and (27.1 ±23.5) pg/ml, respectively, showing a significant reduce after intravitreal injection of ranibizumab (t =4.172, P =0.001).PEDF concentrations before and 7 days after intravitreal injection were (394.0-±237.2) pg/ml and (267.7±199.6) pg/ml, respectively, showing a significant reduce after intravitreal injection of ranibizumab (t =5.443, P =0.000).Intraocular neovascularization vanished after intravitreal injection of ranibizumab and vitrectomy was carried out at the seventh day after intravitreal injection.Conclusions Free VEGF and PEDF levels in aqueous humor appear to be significantly decreased after intravitreal injection of ranibizumab, and ocular neovascularization disappears at same time,which avoids intraoperative bleeding during vitrectomy.

Objective To compare clinical efficacy of clobetasol propionate ointment and vitamin A acid cream in the treatment of skin papule type amyloidosis.Methods 100 cases of skin papule type amyloidosis were randomly divided into the observation group and control group,each had 50 patients.The control group was treated with Vitamin A acid cream while the observation group used clobetasol propionate ointment for treatment.Skin lesion area,infiltration,skin color,skin itching score as well as the cure rate and efficiency were compared after 4 weeks of treatment.Results The two groups' symptoms was improved,symptom scores was decreased gradually after treatment than before,the observation group's symptom scores at 1,2,3,4 weeks were (9.35 ± 1.88),(6.54 ±2.16),(4.08 ±1.32),(2.04 ± 0.95) points which was significant better than (10.86 ± 2.08),(7.98 ± 2.57),(6.25 ± 1.44),(4.56 ± 1.18) points of the control group,the difference of two groups was statistically significant (t =6.22,6.71,7.30,7.41,all P ＜ 0.05) ;4 weeks after treatment,the observation group's efficience and cure rates were 94％ and 34％,significantly higher than 70％ and 22％ of the control group,the difference was statistically significant (x2 =9.040,8.391,all P ＜ 0.05).Conclusion Clobetasol propionate ointment has a exact effect in treatment of skinpapule type amyloidosis than vitamin A acid cream,which is worthy of clinical application.

Objective To analyze the concentrations of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of patients with proliferative diabetic retinopathy (PDR) before and after intravitreal injection of ranibizumab.Methods Twenty-five eyes of 20 PDR patients were collected as the PDR group.Twenty-five eyes of 21 senile cataract patients were collected as the control group.There were no statistical significance in gender (x2 =0.223), age (Z=-1.555) and intraocular pressure (Z=0.225) between the two groups (P＞0.05).Samples of aqueous humor (0.1 ml) were collected just before and 7 days after the injection of ranibizumab in PDR group.Samples of aqueous (0.1 ml) humor were collected just before cataract surgery in control group.The concentrations of VEGF and PEDF in the aqueous humor were measured by enzyme-linked immunosorbent assay.Results The VEGF and PEDF concentration in the aqueous humor were reduced significantly after intravitreal injection of ranibizumab in PDR group (Z=-4.072,-4.319;P＜0.05).The concentrations of VEGF and PEDF in the aqueous humor before intravitreal injection of ranibizumab in PDR group were significantly higher than the control group (Z=-5.228, 4.706;P＜0.05).The VEGF concentration in the aqueous humor after intravitreal injection of ranibizumab in PDR group were similar to control group (Z=-1.557,P＞ 0.05).However, the concentration of PEDF in the aqueous humor after intravitreal injection of ranibizumab in PDR group still higher than control group (Z=-2.475, P＜0.05).The ratio of VEGF/PEDF before and after intravitreal injection of ranibizumab was statistically different (Z=-2.058, P＜0.05), but was the same between PDR group and control group (Z=-0.456,-0.844;P＞0.05).The aqueous humor concentrations of VEGF and PEDF were not significantly correlated with each other, neither in PDR group (r=-0.195,-0.174;P＞0.05) nor in control group (r=-0.286, P＞0.05).Conclusions Aqueous humor concentrations of VEGF and PEDF are significantly elevated in eyes with PDR.Intravitreal injection of ranibizumab significantly decreased the VEGF and PEDF in the aqueous humor after 7 days.

Ebola virus(EBOV)and Marburg virus(MARV),belonging to the Filoviridae family,emerged four decades ago and caused severe viral hemorrhagic fever in human and other primates.As high as 50-90% mortality,filoviruses can cause significant threats to public health.However,so far no specific and efficient vaccine has been available,nor have other treatment methods proved to be effective.It is of great importance to detect these pathogens specific,rapidly and sensitively in order to control future filovirus outbreaks.Here,recent progresses in the development of detection and diagnosis methods for EBOV and MARV are summarized.

Objective To study a improved technique by releasing the orbicularis retaining ligament in orbicularis oculi muscle supension blepharoplasty. Release of the orbicularis retaining ligament could cut off the contact between orbitomalar skin and periosteum at inferior orbital rim, and carry the point of tightening orbitomalar skin in orbicularis oculi muscle supension blepharoplasty. Methods There were 409 patients with apparent orbitmalar fold. The methods of releasing orbicularis retaining ligament and orbital septum fixation were added to improve the orbicularis oculi muscle supension blepharoplasty. Results 409 cases were treated using this method over the past 3 years. All results were satisfactory. No complications were observed. Conclusion This improved method of orbicularis oculi muscle supension blepharoplasty is useful for orbitomalar skin rolling, especially for orbitmalar fold. The release allows effective redraping and upward mobilization of the orbicularis of the lower lid and the premalar soft tissues. This method is a simple, safe and effective procedure for the correction of tear trough deformity and well-demarcated lid/cheek junction in lower eyelid belpharoplasty. It is one of the best choices for lower eyelid blepharoplasty.