AIM: To investigate the changes of first order kernel ( FOK ) and second order kernel ( SOK ) of multifocal electroretinogram( mf-ERG) in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy. ·METHODS: Totally 32 patients ( 58 eyes ) with type 2 diabetes mellitus ( DM ) without apparent diabetic retinopathy( DR) were detected by mf-ERG, from June 2014 to May 2015. Thirty cases ( 60 eyes ) of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups. ·RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased (t=3. 099, P=0. 012). The SOK b-wave latency in diabetes group was statistically delayed (t=2. 643, P=0. 025), and the SOK b-wave amplitude statistically decreased (t=4. 833, P<0. 01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus. ·CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

Disease Outbreaks ; prevention & control ; Humans ; Influenza A Virus, H5N1 Subtype ; Influenza Vaccines ; Influenza, Human ; prevention & control

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

In 2015 , policy reforms on centralized drug purchasing system have been released one by one , and the quality of medicines has been highly valued .Centralized drug purchasing system distinguishes different qualities of drugs mainly through bidding grouping , in order to achieve “uality priority”.However , there are yet some existing problems in group bidding policy at present , such as lack of a unified hierarchy , no scientific indicators and so on , which inevitably weaken the leading role of centralized purchasing policy over the quality of medicines .This paper , focuses on the study of group bidding , and the existing main problems are found through the statistical analysis of rel-evant policies introduced in different provinces .Finally, it explores some optimization strategies for “Group Bidding”which is of paramount importance .

Objective To understand the distribution of the genotypes of ?-lactamases in Chryseobacterium/Flavobacterium spp.Methods Minimum inhibitory concentrations (MICs) of 43 Chryseobacterium meningosepticum strains,22 Chryseobacterium indologenes strains and 10 Chryseobacterium gleum strains against 15 antibiotics were determined by agar dilution method.3-D test and modified 3-D test were used to identify carbapenamase.2-mercaptopropionic acid inhibitory test was used to confirm metallo-?-lactamases (MBL).Genes of ?-lactamases were amplified with 6 pairs of primers special for Chryseobacterium/Flavobacterium spp.and the amplified genes were sequenced.Results MIC_(50) and MIC_(90) of quinolones were lower comparing to other antibiotics.MICs of C.gleum against 15 antibiotics were lower than other Chryseobacterium/Flavobacterium spp.Among 43 C.meningosepticum strains,26 strains (60.5%) produce MBL,but all strains (100%) produced extended-spectrum ?-lactamases (ESBLs);12 C.indologenes strains (68.8%) produced MBL;6 (60%) C.gleum strains had MBL.Genotypes of MBL in C.meningosepticum strains were Bla-B 1,2,3,5 and 11,and Bla-GOB 2,4,6 and 8,respectively.Only one genotype,namely CME-1,was identified for ESBL in C.meningosepticum.The genotype of MBL in 3 C.indolgenes strains was IND-1,and the 6 C.gleum strains contained CGB genotype.Meanwhile,there were 8 C.indolgenes strains and 3 C.gleum strains were confirmed to produce ?-lactamase,but their genotypes were unable to be detected using the current primers,implying that there were possible novel genotypes.Conclusions Investigation of genotypes distribution of ?-lactamase in Chryseobacterium/ Flavobacterium spp.can provide theoretical evidences and rational in the selection of antibiotics,control of noscomical infection and development of novel antibiotics.

OBJECTIVE: To study the effect of bioactive glass (BG) on the dentin bond strength and the microleakage of hybrid layer. METHODS: In the study, 30 dentin planes were prepared from the third molars with no caries and equally assigned to the control group, BG group, and sodium trimetaphosphate (STMP)-polyacrylic acid (PAA)-BG group (S-P-BG group), randomly. After etched with 35% phosphoric acid, the dentin planes of BG group were pretreated with 0.5 g/L BG, and the dentin planes of S-P-BG group were pretreated with 5% STMP, 5% PAA and 0.5 g/L BG. No additional pretreatment was done to the dentin planes of control group. Then the dentin planes were bonded using 3M Single Bond 2 adhesive to 3M Z350XT composite resin, and cut into 0.9 mm×0.9 mm column samples, which were stored at 37 ℃ artificial saliva (AS). After 24 hours, 1 month, and 3 months, the microtensile bond strength test was performed. The data were analyzed using one-way ANOVA and LSD method. The morphology of the bond fracture interface was observed with scanning electron microscope. Other 27 teeth were collected and the enamel layer and roots cut off, with the pulp chamber exposed. 0.1% rhodamine B was added to the 3M Single Bond 2 adhesive, and then the adhesive was applied to complete the bonding procedures as above. The teeth were stored in 37 ℃ AS for 24 hours, 1 month, 3 months, and then 0.1% sodium fluorescein solution was placed in the chambers and stained for 1 hour. Confocal laser scanning microscopy was used to observe the interface morphology and microleakage of the hybrid layer. RESULTS: At the end of 24 hours and 1 month, there was no significant difference in the microtensile bond strength among the three groups (P>0.05). After 3 months of soaking, the S-P-BG group [(36.91±7.07) MPa] had significantly higher microtensile bond strength than the control group [(32.73±8.06) MPa] (P=0.026); For the control group and the BG group, the microtensile bond strength significantly decreased at the end of 3 months compared with 24 hours (control group: P=0.017, BG group: P=0.01); The microtensile bond strength of S-P-BG group af the end of 3 months had no significant difference in compared with 24 hours [(37.99±7.98) MPa] (P>0.05). Observation of the fracture surface at the 24 hours showed no obvious mineralization in all the three groups. After 1 and 3 months, mineral formation was observed in BG group and S-P-BG group, and no obvious collagen exposure was observed in S-P-BG group. Confocal laser scanning microscopy revealed no obvious differences in the morphology and quantity of the resin tag in the control group, BG group and S-P-BG group. At the end of 24 hours, leakage was found in all the three groups. The microleakage of the control group increased at the end of 3 months, while the microleakage of the BG and S-P-BG groups decreased. CONCLUSION BG pretreatment of dentin bonding interface can induce mineralization at the bonding interface and reduce the microleakage of the hybrid layer; pretreating the dentin bonding interface with STMP, PAA and BG may enhance the maintaining of the dentin bonding durability.
Dentin ; Dentin-Bonding Agents ; Glass ; Resin Cements ; Tensile Strength

Adult ; Eccrine Glands ; pathology ; Female ; Hamartoma ; pathology ; Humans ; Sweat Gland Diseases ; pathology

Twelve flavonoids were isolated from an ethanol extract of Machilus wangchiana by a combination of various chromatographic techniques including column chromatography over silica gel and Sephadex LH-20 and reversed-phase flash chromatography and HPLC. Their structures were identified by spectroscopic data analysis (IR, MS, and NMR) as (+)-catechin (1), (-)-epicatechin (2), 3'-O-methyl-(+)-catechin (3), 3'-O-methyl-(-)-epicatechin (4), 3, 5, 7, 2', 5'-pentahydroxy flavan (5), (-)-naringenin (6), (-)-eriodictyol (7), (-)-liquiritigenin (8), (2R,3R)-(+)-dihydrokaempferol (9), (2R,3S)-(-)-dihydro- kaempferol (10), (2R, 3R)-(+)-taxifolin (11), and quercetin (12). Compounds 1-10 are isolated from the genus Machilus for the first time.
Drugs, Chinese Herbal ; chemistry ; Flavonoids ; chemistry ; Lauraceae ; chemistry ; Mass Spectrometry ; Molecular Structure ; Plant Roots ; chemistry

Ten glycosidic compounds were isolated from an ethanol extract of Machilus wangchiana by a combination of various chromatographic techniques including column chromatography over silica gel and Sephadex LH-20 and reversed-phase flash chromatography and HPLC. Their structures were identified by spectroscopic data analysis (IR, MS, and NMR) as icariside B1 (1), boscialin-3-O-β-D-glucopyranoside (2), pisumionoside (3), isolariciresinol-9'-O-β-D-xylopyranoside (4), 5'-methoxyisolariciresinol-9'-O-β-D-xylopyranoside (5), lyoniresinol-9'-O-β-D-xylopyranoside (6), (E) -4-hydroxyphenylprop-7-ene 4-O-β-D-glucopyranoside (7), (E) - 4-hydroxy-3-methoxyphenylprop-7-ene 4-O-α-L-rhamnopyranosyl-(1 --> 6) -β-D-glucopyranoside (8), 4-hydroxy-3-methoxyphenylprop-8-ene 4-O-β-D-xylopyraosyl-(1 --> 6) -β-D-glucopyranoside (9), and 4-hydroxy-3,5-dimethoxyphenylprop-8-ene 4-O-α-L-rhamnpyranosyl-(1 --> 6)-β-D- glucopyranoside (10), respectively.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Lauraceae ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

Aged ; Equipment Failure ; Foreign Bodies ; Humans ; Kyphosis ; Male ; Scoliosis ; Spine ; abnormalities ; Trachea ; Tracheostomy ; instrumentation