AlM: To evaluate the clinical efficacy of canalicular intubation combined with external dacryocystorhinostomy ( ext-DCR ) for treatment of chronic dacryocystitis and upper lacrimal duct stenosis.
METHODS:Thirty-three patients (33 eyes) with chronic dacryocystitis and upper lacrimal duct stenosis who underwent canalicular intubation combined ext-DCR were retrospective analyzed. The silicon tube was indwelt for 6mo. All cases were re-examined 1wk;1, 3, 6, 9mo post-operation, flow of tears, pus excretion and lacrimal duct clearance were observed.
RESULTS: Clear lacrimal duct ratio was 100% in all cases during 1wk~6mo post-operation; Silicon tube was removed 6mo post-operation, 3mo after tube removal, rechecking reported 32 cases with clear lacrimal duct (97%) and 1 case with resistant duct (3%). Two cases ( 6%) with minor lacerations, no other complications were observed.
CONCLUSlON: Canalicular intubation combined ext-DCR is an effective treatment for chronic dacryocystitis and upper lacrimal duct stenosis.

Objective To investigate the bacterial infection status,etiology distribution and drug resistance of neurological rehabilitation hospitalized patients,to guide the clinical rational use of drugs,to provide a scientific basis for the development of effective prevention and control measures.Methods From January 201 1 to December 201 4,the clinical data of 334 hospitalized patients in department of neurological rehabilitation of our hospital were ret-rospectively analyzed.The pathogenic culture results were analyzed.Results There were 334 strains of pathogenic bacteria,83.53% of gram negative bacteria,47 gram positive bacteria(1 4.07%),8 fungi(2.39%).The top three infected gram negative bacterias were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa.The main Gram positive bacteria was enterococcus.The detective gram negative bacterias were mainly sensitive to piperacillin penicillin/tazobactam and cefoperazone /sulbactam and imipenem,meropenem,cefepime,amikacin.The resistance rate of Escherichia coli to gentamicin,piperacillin and levofloxacin was more than 50%.The resistance rate of Kleb-siella pneumoniae to gentamicin and piperacillin was more than 50%.Conclusion The infection rate of urinary tract and respiratory tract is higher in patients with neurological rehabilitation ward,and the infection rate is higher,and the main part of gram negative bacilli,should be aimed at high risk patients and key links,strengthen the implementation of infection prevention and control measures,rational use of antimicrobial agents.

Objective To investigate the effect of 1,25-(OH)2D3 and salvia miltiorrhiza on T cell subsets and cytokines in rats after allogeneic bone marrow transplantation.Methods Female Wistar rats were used as recipients and male SD rats were used as donors.All Wistar rats were divided into aGVHD group and intervention groups at random,and the intervention groups were further divided into 1,25-(OH)2D3 group,salvia miltiorrhiza group and combination group.The changes of T cell subsets (CD4+ and CD8+) and cytokine (IL-2,IFN-?,IL-4 and IL-10) in every group were detected and measured.Results When the presentation of aGVHD was relatively conspicuous,CD4+ and CD8+ were increased,and the increase of CD4+ was predominant.Compared with the difference prior to transplantation,the difference was statistically significant (P

Objective:To investigate frequencies of microsatellite instability(MSI)and loss of heterozygosity(LOH)in renal ceil carcinoma(RCC),and to discuss the relationship of clinicopathological characteristics of RCC with MSI and LOH. Methods:Twelve microsatellite markers located at chromosomes 3p,9p and 14q were selected to investigate microsatellite alterations(MSI and LOH)in 31 RCC specimens and their paired metastasis specimens by polymerase chain reaction- polyacrylamide gel elect rophoresis-ethylene dibromide(PCR-PAGE-EB)staining and sequencing.Results:The frequency of MSI could reached 61.3% and that of LOH could reach 54.8%.The highest frequency of MSI was at locus of D9S168(32.3%);the highest frequency of LOH was at locus of D3S1289(21.4%).No correlation was found between MSI or LOH and the patients' age,sex,pathology type and metastastis,except that MSI was correlated with TNM stage of RCC(P

Objective To explore the differences in health care quality,scale,output,efficiency,cost and financial condition between freestanding secondary hospitals and system-affiliated secondary hospitals in Shanghai,and analyse the determinants of hospital integration. Methods Eleven upper secondary hospitals in Shanghai integrated between 2000 and 2004 were selected,and another 40 secondary hospitals (including 30 upper secondary hospitals and 10 middle secondary hospitals) without integration were served as controls. Using related data of 1999,Mann-Whitney U test was performed to analyse the differences between these two groups,and Logistic regression analysis was conducted to explore the determinants of hospital integration. Results There were significant differences in health care quality,scale,and output between these two groups (P0.05). It was revealed by Logistic regression analysis that health care quality,scale,output,and financial condition were determinants of integration. Conclusion System-affiliated secondary hospitals have advantages over freestanding hospitals in health care quality,scale,output and financial condition,and those with better health care quality,larger scale,larger output and better financial condition are more likely to be integrated by tertiary hospitals.

AlM: To study the clinical effect of the application of microscopic pterygium resection combined with different concentration of mitomycin C ( MMC) .
METHODS:A total of 110 cases of pterygium patients (120 eyes) were randomly divided into control group (58 eyes) and observation group (62 eyes) according to the odd and even number method. The control group adopted the pterygium resection combined 0. 3mg/mL MMC, and the observation group was given pterygium resection combined 0. 2mg/mL MMC. The cure rate and the recurrence rate, eyesight before and after the treatment, two groups of cornea and sclera wound healing situation, the incidence of postoperative complications were compared.
RESULTS: The cure rate and recurrence rate of the control group was 84. 5% and 15. 5% respectively, and the observation group was 93. 6% and 6. 5% respectively, the differences were statistically significant (P<0. 05). There were statistical differences of vision of the two groups before and after treatment (P<0. 05), and there were no statistical differences of the two groups between the two groups after treatment (P>0. 05). The cornea, sclera, wound healing time of the observation group were less than the control group, and there were statistical differences between the two groups ( P < 0. 05 ). The incidence of complications was 13. 8% in the control group and 3. 2% in observation group, with statistically significant difference (P<0. 05).
CONCLUSlON: The application effect of microscopic pterygium resection combined with MMC is remarkable, and the joint of 0. 2mg/mL concentration of MMC is more safe and effective, and is worth popularizing in clinical application.

Objective To discuss the clinical value of interventional transcatheter arterial chemoembolization(TACE)combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer.Methods According to the therapeutic scheme,195 patients with phase Ⅱb or beyond advanced cervical cancer were divided into two groups: (1)study group(n=99),treated with TACE combined with subsequent pelvic radiotherapy(I.e.combination group);(2)control group(n=96),treated with radiotherapy alone(I.e.radiotherapy alone group).The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups.Results Different degrees of the tumor shrinkage were found in patients of both groups after treatment.The short-term remission rate of the study group was significantly higher than that of the control group,and the difference between two groups was statistically significant(P=0.012).After the procedure,the anaemia in patients of study group was markedly corrected.The difference in hemoglobin between preoperative levels and postoperative ones was significant(T-test,P＜0.01).Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group(P=0.032).Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group(P＜0.05).No significant difference in one-year,five-year survival rate and in five-year recurrent rate existed between two groups.The main short-term complications included digestive untoward reaction,bone marrow depression,hepatic and renal toxicity,etc.,which could be well relieved after active symptomatic medication.The longterm complications included radiodermatitis,radiocystitis and/or radioproctitis.The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group(P＜0.05).Conclusion TACE combined with subsequent pelvic radiotherapy is an effective therapy for advanced cervical cancer,its clinical result is superior to simple radiotherapy.This therapy tan enhance both the short-term and the tong-term effects,relieve the clinical symptoms,reduce the occurrence of long-term complications,thus,improve the quality of life and prolong the survival time of patients.

Objective To summarize the perioperative characters of femoral neck fractures in patients aged at over 80 years by analyzing the surgical treatment procedures. Methods A retrospective study was done on data of patients with femoral neck fractures treated surgically from June 2000 and June 2008. There were 25 males and 36 females, at average age of 83.4 years (80-94 years). Of all, there were 53 patients with fresh fractures including six with type Garden Ⅰ or Ⅱ fractures and 47 with type Garden Ⅲ or Ⅳ fractures, eight with old fractures ( all type Garden Ⅳ). Fifty-one patients (84%) were accompanied with preexisted internal medical or neurological diseases. Six patients with type Garden Ⅰ or Ⅱ fractures were treated with cannulated screw fixation (CSF). Among 55 patients with type Garden Ⅲ or Ⅳ fractures inclu-ding 47 fresh fractures and 8 old ones, 53 patients were treated by hip hemiarthroplasty (HHA) but the other two by cemented total hip arthroplasty (THA) because of preexisting hip osteoarthritis. Results The average operation duration and blood loss were 51 minutes and 50 ml in CSF group, 81 minutes and 180 ml in HHA group, 105 minutes and 350 ml in THA group. Fifteen patients (25%) had postoperative com-plications, mostly hypotension, cardiac insufficiency and atrial fibrillation, accounting for 12%. Postoperative hemoglobin was decreased by 11.9%, 17.1% and 18. 1% on average respectively in CSF group, HHA group and THA group, and postoperative albumin decreased by 10.8%, 18. 1% and 20.2% on average respectively in CSF group, HHA group and THA group. There were 17 patients (28%) with hemoglobin below 100 g/L and four (7%) with albumin below 30 g/L after operation. Conclusions The patients aged ≥80 years with femoral neck fractures are usually accompanied with preexisted internal medical or neurological diseases and have high risk in operation. Adequate preoperative preparation and active prevention and treatment of perioperative complications are important for successful operation and good postoperative results.

Objective To investigate the effect of echinococcus granulosus antigen B on the severity of streptozotocin induced diabetes mellitus.Methods Thirty male BALB/c mice were randomly divided into 3 groups:echinococcus granulosus antigen B group (group A,n =10),normal saline group (group B,n =10),control group (group C,n =10).Mouse in group A was injected by echinococcus granulosus antigen B and mouse in group B was given normal saline,Type 1 diabetes was induced.After 3 weeks,mice were executed and pancreases were scored on insulitis by HE staining.Serum IFN-γ and IL-4 levels were measured by ELISA.Results After 3 weeks of the establishment of diabetes model mouse body weight in group B and C decreased significantly compared with that in group A.Mouse mean blood glucose level in group A was significantly lower than that in group B and C.There were less than 40％ of islets with lymphocytic infiltration in group A,compared with 80％ in group B.The average Ridit was 0.423,0.519,and 0.561 in group A,B and C respectively,P ＜ 0.05.IL-4 level in group A was significantly higher than that in group B and group C [(71.6 ± 12.4) ng/ml,(12.6 ± 5.6) ng/ml,(14.2 ± 7.2) ng/ml,P ＜ 0.05].IFN-γ level in group B and group C were higher than that in group A [(276.1 ± 41.7) ng/ml,(352.2 ± 52.2) ng/ml,(358.1 ± 53.4) ng/ml,P ＜ 0.05].Conclusions Type 1 diabetes is organ specific T lymphocyte mediated autoimmune disease.Echinococcus granulosus antigen B has protective effects on diabetes mellitus in mice couteracting autoimmune injury to the islets by streptozotocin,probably by a mechanism related to immune deviation of Th1 to Th2.

Objective To increase externally-assigned response, improve energy response of CR39 and develop positive fast/thermal neutron personal dosimeter applicable for occupational exposure in oil and gas field logging by using pre-recoil layer.Methods The externally-assigned response of CR39 detector was improved through increasing the track density by using the α particle induced by the reaction of 10B(n,α) 7Li with the BN as pre-recoil layer, and the increase was vilified by using both Monte-Carlo simulation and experiment exposed by standard neutron source.Results Fast/thermal neutron personal dosimeter's neutron flux sensitivity and neutron dose equivalent sensitivity were 3.46 × 10-4 track per 0.013 and 52.8 mSv.According to theoretical derivation and experiment of standard 241 Am-Be neutron source, detecting efficiency and energy response of CR39 were effectively improved, and quantitative measurement of dose contributed by thermal neutron was realized.Conclusions CR39 fast/thermal neutron personal dosimeter of high sensitivity is applicable to oil and gas field logging environment and of potential development.