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 ensure the quality of field operation materials, and enhance rescue ability of medical corps in field condition. Methods Materials for package and sterilization were tested and selected for new way of package and sterilization instead of the traditional cotton. Results Sheet package was preserved in normal condition. Every month the microorgarism in sheet package was sampled. There were no bacteria in the operation items in the half-year sampling. So the period of validity was prolonged from one week to half year. Conclusion With the new package sterilization method, the work load of nurses is alleviated and the expenses on repeated sterilization due to short term of validity are also reduced. At the same time, operation infection rate and death rate are decreased so that the battle injury rescue level was raised.

BACKGROUND: Lentivirus-mediated RNA interference technology has been widely used in the study of gene function because of its specificity, high inhibition efficiency and persistent effects. Virus packaging, transfection, as well as small hairpin RNA (shRNA)-coding sequence could affect the inhibition efficiency. Therefore, impact factors of RNA interference for human Bax inhibitor 1 (BI-1) was studied in this experiment.OBJECTIVE: To find the valid small interference RNA (siRNA) targeting human BI-1 gene by Lentivirus.DESIGN, TIME AND SETTING: Single sample observation was completed in Department of Medical Genetics, Basic Medical College, Peking University Health Science Center from September 2007 to December 2008.MATERIALS: 293T cell and SH-SY5Y cells were preserved in this laboratory; 4 shRNAs were designed through a use of online design tool by Ambion (www.ambion.com). METHODS: Several recombinant plasmids which expressed shRNAs targeting different regions of the BI-1 gene and labeled enhanced green fluorescent protein as a fusion gene were constructed. Four types of shRNA-expressing virions were obtained by cotransfection of shRNA-expressing plasmid and package protein-expressing plasmids into 293T cells. Green fluorescent protein expression was determined using flow cytometry to search the optimal package conditions. Real-time PCR and beta actin mRNA was used as an internal control, four types of recombinant viral supernatant and control viral supernatant were added on the SH-SY5Y cells, knock-down efficacies of the endogenous BI-1 gene were determined, and the RNA interference effective sequences were optimized. MAIN OUTCOME MEASURES: Intracellular green fluorescent protein expression rate of the cells infected with different packaging virus. RESULTS: The optimal infective packaging virus could be obtained when the ratio of plasmids pLentiLox3.7, REV, VSVG and RRE was 2:1:1:1 and the supernatants were collected 48 hours after transfection. Replacement of culture media 24 hours after transfection could increase the infection efficacy of the virions. shRNA targeting-2-17nt (start coding region) of BI-1 gene was most valid interference efficiency and could decrease the gene expression to 40%. CONCLUSION: Influencing factors of Lentivirus-mediated RNA interference technology virus packages were investigated in this study, which could be a foundation for constructing stable BI-1 knocked down neuronal cell model and for studying the abnormal expression of BI-1 related to the neuron apoptosis disease.

Objective To evaluate the effect of propofol on postoperative cognitive dysfunction induced by preoperative sleep deprivation in the rats.Methods A total of 126 healthy adult male SpragueDawley rats,weighing 200-250 g,were randomly divided into 3 groups (n =42 each) using a random number table:control group (group C),sleep deprivation group (group SD),and sleep deprivation + propofol group (group SD+P).The rats were kept for 96 h on a treadmill that moved for 3 s on/12 s off in SD and SD+P groups.Intramedullary nailing for right femoral shaft fractures was performed in the 3 groups.Propofol 20 mg · kg-1 · h-1 was infused for 2 h via the contralateral femoral vein starting from the end of operation in group SD+P,while the equal volume of normal saline was infused for 2 h starting from the end of operation in C and SD groups.The animals underwent Morris water maze test at 1-5 days after operation to assess the cognitive function,and the escape latency and time of staying at the original platform position were recorded.At 1,3 and 7 days after operation,hippocampal tissues were obtained,nissl staining was performed to determine neuron count in hippocampal CA1 area,and Golgi staining was performed to measure the density of dendritic spine in hippocampal CA1 area.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform position was significantly shortened,and the neuron count and density of dendritic spine in hippocampal CA1 area were significantly decreased at each time point after operation in group SD (P＜0.05),and no significant change was found in each index mentioned above in group SD+P (P＞0.05).Compared with group SD,the escape latency was significantly shortened,the time of staying at the original platform position was significantly prolonged,and the neuron count and density of dendritic spine in hippocampal CA1 area were significantly increased at each time point after operation in group SD+P (P＜0.05).Conclusion Propofol can ameliorate postoperative cognitive dysfunction induced by preoperative sleep deprivation in the rats.

The content of optical isomerism is the difficult point of organic chemistry teaching, and so case-based learning (CBL), theoretical-experimental integration teaching method and micro class teaching methods are tried to be used in classroom teaching according to the actual teaching situations. For CBL teaching method, the course is guided by the step of introduction-question-discussion and summary-exten-sions; For theoretical-experimental integration teaching method, combined with the theory class, the two experiments including the determination of optical rotation and organic molecular model are set for the opti-cal isomer content, to enhance the students' understanding of theoretical knowledge through the hands-on operation;For micro class teaching method, the key and difficult points of this chapter are dug out and about 10 minutes of video are recorded by using common video software before class, which are introduced in the classroom or provided to students after class for repeated watching, to deepen the students' understanding of the concept and phenomenon of optical isomers. In brief, it is important to combine various teaching method to improve the classroom instructing effectively and stimulate the students' interest in organic chemistry.

Objective To investigate the changes of excitatory amino acids (EAAs) of cerebrospinalfluid (CSF) in patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Method The EAAs levels of CSF including glutamate (Glu) and aspartate (Asp) in 24 patients with DEACMP and 20 controls with migraine were measured by high performance liquid chromatography( HPLC ).Results Glu and Asp levels in patients with DEACMP were significantly higher than those of the controls [(3.76 ± 1.52) μmol/L vs ( 1.55 ± 1.03 ) μmol/L, (0.73 ± 0.44) μmol/L vs (0.38 ± 0.33 ) μmol/L, P all <0.01]. Glu and Asp levels in moderate and severe DEACMP patients were higher than those in mild DEACMP patients. Conclusion It suggests that EAAs participated in the pathogenesis of DEACMP. The Glu and Asp levels in CSF may be regarded as indicator of DEACMP.

Objective To understand the status of the blood safety in Handan region to provide the basis for recruiting blood do-nors in our region and the data support for meeting clinical blood use.Methods The detection results of 5 legal indicators among unpaid blood donors in Handan region during 2002-2012 were investigated and analyzed.Results The total positive rate of indica-tors detection was 5.52%,in which alanine aminotransferase(ALT)was 4.06%,hepatitis B surface antigen(HBsAg),hepatitis C virus antibody(anti-HCV)was 0.54%,human immunodeficiency virus(HIV)antibody(anti-HIV)was 0.24% and treponema palli-dum antibody(anti-TP)was 0.12%.Conclusion This survey is conducive to the blood donor recruitment work and strengthening the screening of blood donors is helpful for safety of clinical blood use.

Combined transplantation of fetal pancreas and thymus was performed in 10 patients suffering from severe diabetes I. They were closely followed for over one year, and it was found that among them 7 showed spectacular clinical improvement, including 2 with total discontinuation of insulin, and 5 with average reduction of insulin by 82%. In 3 patients, the dosage of insulin was reduced by an average of 56.9%. The average reduction of insulin for the 10 patients in 2 months, 6 months and one year after the transplantation was 68.3%, 74.5%, and 78.4%, respectively. The effect of warm ischemia of different durations on the donor tissues was studied with electron microscopy. The significance of combined transplantation and the relationship of the techniques of procuring the donor tissues and transplantation is discussed.

Objective To study the clinical feature of ciguatera fish poisoning.Methods Thirty-nine patients with ciguatera fish poisoning were observed.Results The clinical symlptoms of ciguatera poisoning usually began to appear 2～10 hours after eating a poisonous fish and could be classified into three broad groups:neurological,gastrointestinal cardiovascular symptoms.Gastrointes tinal symptoms were the most common complaint.Neurological symptoms generally stayed for 1～2 weeks.The clinical picture was characterized by temperature reversal.Conclusion Ciguatera poisoning can be differentiated by unique features affecting the neurological system.

Employed staffs in military hospital are the basic power in the development of hospital, and they are playing an im-portant role in the military medical security.The article gives a detailed elaboration on the innovation and practice of employed staff man-agement in our hospital.In order to improve the efficiency and scientific management level of employed staffs, the innovative measure-ments in employment pattern, post management, education development, policy system, promotion passage are put forward in combination with current situation of employed staff in order to promote the construction of employed staffs and the development of the hospital.