The purpose of this study was to observe the preliminary results of using automated lamellar keratoplasty with excimer laser intrastromal photoablation(LASIK technique)for correction of se- vere myopia.We report 58 eyes from 50 patients with extremely high myopia.The mean preoperative spherical equivalant refraction was-19.29?3.88 diop- ters(D),ranging from-15.37—-36.00D.We com- bined automated lamellar keratoplasty(ALK)micro- keratome with Ketacor 116 excimer laser techniques to create a nasally based corneal flap and then to ablate its underlying stroma with photoablation.The follow-up time was over 3 months.The results were: The mean postoperative uncorrected visual acuity (UCVA)was 0.61?0.27,in 39 eyes(67.24%), UCVA was≥0.5 and in 19 eyes(32.76%),UCVA≥0.8; the mean postoperative refraction was-0.49?3.01D, 51.72% of eyes were within?1.00D and 75.86%, within?2.00D of emmetropia.These results indicate this technique correct high myopia with greater corrective capability and predictability than other corneal refractive procedures.However,it's stability, potential capability and safety need long-term obser- vation and further research.

Objective To investigate the expression level and clinical significance of p53 ,C-myc and CerbB-2 in papillary thy-roid carcinoma patients .Methods The expression level of p53 ,C-myc and CerbB-2 were detected in 45 cases of papillary thyroid carcinoma tissue specimens and 45 cases of nodular goiter tissue specimens by using immunohistochemical staining .Their correla-tions with clinic pathological features in papillary thyroid carcinoma were analyzed further .Results The positive expression rates of p53 ,C-myc and CerbB-2 in the papillary thyroid carcinoma tissue specimens were significantly higher than that of the nodular goiter tissue specimens(all P< 0 .01) .The expression of C-myc and CerbB-2 significantly correlated with lymph node metastasis(P< 0 . 05) .The expression of CerbB-2 significantly correlated with tumor size ,local infiltration ,TNM stage ,differentiated degree and lymph node metastasis (all P< 0 .05) .p53 positive expression ,C-myc positive expression and CerbB-2 positive expression were the independent factors of cervical lymph node metastasis .Conclusion p53 ,C-myc and CerbB-2 were highly expressed in papillary thy-roid carcinoma and correlated with cervical lymph nody metastasis .The detection of p53 ,C-myc and CerbB-2 might be helpful for diagnosis of papillary thyroid carcinomas .

Energy conservation has become a problem needing to be immediately solved with the extensive con-struction of hospital information system. As a high computing technology, green computing uses resources economically and effectively and is characterized by energy conservation and environment friendship. Its concept and characteristics, and the status quo of hospital information system construction were described. A green computing framework model was established for hospital information system construction, which plays an active role in implementing the idea of green environment protection, low carbon and energy conservation, and sustainable development, thus laying a foundation for studying the mechanisms underlying energy conservation in hospital information system construction and for assessing and optimizing its strategic system.

Objective To investigate the correlation between Bispectral index (BIS) value and the prognosis of patients with coma in ICU.Methods A total of 208 patients with coma in ICU were divided into 4 groups according to the BIS value.In group I,BIS value was 0 to 20; groupⅡ,BIS value 21 to 40; group Ⅲ,BIS value 41 to 60; and group Ⅳ,BIS value greater than 60.Comparison of the difference in BIS value with the differences in prognosis of patients with coma was carried out between four groups,and the prognosis of patients with coma was stratified into consciousness,coma,vegetative state,and brain death.Subsequently,the best cutoff score of BIS value calculated for determining the correlation between BIS and mental state was proposed.Results There are no significant differences in the age and APACHE Ⅱ scores between four groups (P ＞ 0.05).It was inverse correlation between BIS value and mental state (r =-0.749,P =0.00).According to the ROC curve,as BIS value was greater than 42.5,there were higher sensitivity and specificity in Conscious-Coma patients.Conclusions BIS value is correlated with the prognosis of patients with coma in ICU,and BIS value can be a useful marker for estimating the prognosis of comatose patients.

Objective To study the feasibility of the acute gastrointestinal injury (AGI) classification standard for evaluation of gastrointestinal function in intensive care unit (ICU) patients,and to discuss its value in administration of early enteral nutrition (EN).Methods A perspective study was conducted.85 patients with AGI admitted to ICU of Tianjin First Center Hospital from January 2013 to June 2013 were enrolled.EN was conducted after ICU admission or within 12-24 hours after high catabolic state.The patients were divided into four groups according to the AGI classification,i.e.grade Ⅰ,Ⅱ,Ⅲ,and Ⅳ,and they were treated according to the treatment procedure for AGI.The primary end points were 7-day rate of intake of standard EN,the degree of disease and nutrition,and their correlation with AGI classification.Secondary endpoint was rate of giving EN within 48 hours.Results Gastrointestinal dysfunction patients accounted for 49.42％ (85/172) of the ICU patients,and number of patients in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 29,28,19,9 respectively.On the first day of ICU stay,there were no statistical differences in age,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,serum albumin (ALB) and prealbumin (PA) among four groups,and it was demonstrated that the baseline data were comparable.APACHE Ⅱ score on the seventh day of ICU stay was significantly lower than that on the first day in grade Ⅰ,Ⅱ and Ⅲ patients (grade Ⅰ:20.48 ± 2.45 vs.22.59 ± 2.06,t=-3.120,P=0.031 ; grade Ⅱ:19.34 ± 1.80 vs.21.65 ± 2.22,t=-4.316,P=0.012; grade Ⅲ:20.63 ± 1.34 vs.23.31 ± 1.70,t=-5.640,P=0.000),and serum PA (g/L) was significantly increased (grade Ⅰ:24.37 ± 6.54 vs.10.62 ± 7.24,t=-4.866,P=0.000; grade Ⅱ:19.79± 12.48 vs.11.57±8.94,t=-2.116,P=0.031; grade Ⅲ:19.15±8.43 vs.13.78 ± 6.59,t=-3.601,P=0.000).On the seventh day ofICU stay,the APACHE Ⅱ score was higher in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (22.87 ± 3.31 vs.20.48 ± 2.45,19.34 ± 1.80,20.63 ± 1.34,P＜0.05 or P＜0.01),and PA was obviously lower in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (g/L:14.02 ± 8.70 vs.24.37 ± 6.54,19.79 ±12.48,19.15 ± 8.43,P＜0.05 or P＜0.01).There was no statistically significant difference among four groups in respect of serum ALB (F=0.454,P=0.722).The rate of giving EN in 24 hours in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients was 95.4％,72.1％,52.0％ and 0,respectively (x2=8.310,P=0.016),and in 48 hours it was 100.0％,83.0％,76.0％,and 0 (x2=5.470,P=0.025).7-day standard EN intake rate was 100.0％,88.7％,84.0％ and 34.0％ respectively in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients (x2 =0.720,P=0.017).Correlation analysis showed that there was a negative correlation between AGI classification and rate of giving EN in 1 day (r=-0.62,P=0.04) and 7-day standard EN intake rate (r=-0.76,P=0.02).Conclusions AGI classification can be used to estimate the gastrointestinal function of patients with critical illness,and it has a significant correlation with early EN support.An early goal achieving intervention based on the AGI classification can improve the nutritional status and the general state of the patients.

Drug toxicology,as a discipline which studies drug toxicity mechanisms and evaluates comprehensive drug safety is of crucial importance for guiding sensible clinical drug use,reducing adverse drug reactions and reducing failures of new drug development caused by toxicity. This article summarizes the basic situation of Natural Science Foundation of China(NSFC)funded projects in drug toxicology between 2001 and 2015,involving the amount of approved grants,funding rate,funding category and supported faculty,and the change of NSFC guidelines. Research topics,ideas and contents of NSFC funded projects are generalized and characteristics,problems and future trends are also analyzed to provide reference for research on drug toxicology.

Objective To investigate the efficacy and safety of contrast enhanced ultrasound (CEUS)-guided local injection therapy in treatment of abdominal trauma. Methods CEUS was per-formed in 12 patients with abdominal trauma to determine the location,iniury severity and possible active bleeding. Then,all 12 patients underwent CEUS-guided local injection therapy with haemostat. Conven-tional ultrasound and CEUS examinations were performed at days 0,1,3,7,14 and 30 after the treat-ment. Results The bleeding was instantly controlled by using CEUS-guided local injection therapy without delayed rehemorrhage. Conclusion Compared with conventional ultrasound,CEUS Call more significantly elevate diagnostic accuracy of abdominal trauma and accurately guide local injection therapy, with satisfactory curative effect and safety.

Objective To investigate the change of serum cancer antigen(CA) 125 in patients with pleural effusion.Methods One hundred and twenty-eight patients with pleural effusion were admitted to the Naval General Hospital of People's Liberation Army from January 2010 to September 2012 were selected as our subjects.The level of serum CA125 was measured.The difference of serum CA125 positive rate and level were compared according to gender,pleural effusion nature,quantity and pleural effusion chest area; And the difference of patients with malignant pleural effusion tuberculosis,inflammatory,exudative pleural effusion based on above indicators.The correlation between serum CA125 level and pleural effusion depth were analyzed.Results The positive proportions of CA125 were 83.3％ (35/42) and 76.7 ％ (66/88) of patients with malignant and benign effusion respectively,and there was no significant difference (x2 =0.74,P ＞ 0.05).The serum CA125 level of patients with malignant pleural effusion was significantly higher than benign ones ((177.8 ± 31.4) U/ml vs.(110.6 ± 13.6) U/ml,t =31.24,P ＜ 0.05).There were no significant difference in the positive proportion of serum CA125 between malignant,tuberculous,inflammatory and transudative pleural effusion(75.8％ (25/33),70.0％ (20/29),87.5％ (21/24) and 83.3％ (35/42),P ＞ 0.05).Serum CA125 levels of patients with malignant pleural effusion were significantly higher than that with inflammatory ((177.8 ± 31.4) U/ml vs.(72.5 ± 12.8) U/ml,P ＜ 0.05),but the differences were not significant among malignant,tuberculous and transudative pleural effusion group((140.6 ± 28.2) U/ml,(154.3 ± 30.5) U/ml,P ＞ 0.05).The serum CA125 levels of patients with small,moderate and large effusions were (56.4 ± 18.2) U/ml,(120.2 ± 24.5) U/ml and (185.5 ± 34.6) U/ml respectively,and the difference among these groups were significant(F =296.03,P ＜ 0.05).Serum CA125 levels was positively correlated with pleural fluid depth (r =0.56,P ＜0.01).Different gender,pleural effusion parts serum CA125 positive rate and the different levels were not statistically significant (P ＞ 0.05).Conclusion Serum CA125 increased in patients with benign and malignant pleural effusion,and serum CA125 was not severed as the diagnosis biomarker in differentiating benign and malignant pleural effusion.Serum CA125 levels is helpful in monitoring the change of pleural fluid size due to the relation with depth of pleural fluid.

Objective To study the methods and value of emergency interventional therapy in digestive tract bleeding.Methods 61 cases with digestive tract bleeding accepted emergency angiography.According to find out positions and causes of bleeding during angiography,these patients accepted arterial embolization and /or perfusion of vasoconstrictor substance.Results In 29 cases accepted arterial embolization and 32 cases accepted perfusion of vasoconstrictor substance,the stoped bleeding immediately occured in 100% and 82.7% respectively.Bleeding recurrence was 3 cases in the patients with arterial embolization one week later and 25 cases of the patients with perfusion of vasoconstrictor substance forty-eight hours later.Conclusion To treat the digestive tract bleeding by arterial embolization or vasoconstrictor substance perfusion are safe and effective hemostatic ways during emergency angiography.Though the bleeding recurrent rate is high after vasoconstrictor substance perfusion,these ways can race against time for surgical operation.

BACKGROUND:Osteoarthritis animal models induced by papain are commonly used for studying osteoarthritis.
OBJECTIVE:To observe the morphology of articular cartilage surface during early osteoarthritis process in rats induced by papain and L-cysteine under scanning electron microscope.
METHODS:The right knees of Sprague-Dawley rats were given 0.15 mL mixed solution of 2%papain and 0.03 mol/L L-cysteine in the ratio of 2:1. The left knees were given injections of 0.15 mL 0.9%NaCl, as the control group. Another two rats (four knees) maintained untreated, as the normal control group. Al the rats were observed with scanning electron microscope at 2, 4, 6 weeks after injection, to explore the surface morphology of medial condyle of femur.
RESULTS AND CONCLUSION:The condyles of normal and control groups revealed numerous shal ow pits on the surface of articular cartilage. At 2 weeks after injection, the surfaces of condyles were unsmooth, presenting the shrinkage and distortion. The thinner articular cartilage and local tiny cracks were seen at 4 weeks. The deep and great cracks and cartilage defect were observed on the surface of cartilage at 6 weeks. The time of 4-6 weeks is a reference point for establishing early osteoarthritis model in rats through injections of 2%papain and 0.03 mol/L L-cysteine.