Objective To research the clinical effect of complex trabeculectomy in the treatment of glaucoma. Methods 80 patients with glaucoma were selected in the study.They were randomly divided into two groups. 40 patients in the control group were given traditional trabeculectomy technique,and 40 patients in the treatment group were given composite trabeculectomy.The incidence of shallow anterior chamber,intraocular pressure,one year after the formation of a functional follicles were analyzed and compared in the two groups.Results The incidence rate of shallow anterior chamber in the treatment group (6.98%)was lower than the control group(23.81%).6 months, 12 months after operation,the IOP of the treatment group was lower than the control group,and less than 21mmHg. After 1 year,the formation rate of functional follicles of the treatment group (90.70%)was higher than the control group (71.43%),the difference between the two groups was significant(χ2 =5.16,P <0.05).Conclusion The treatment effect of composite trabeculectomy for glaucoma is significant.

Tubulointerstitial fibrosis is the final common pathway of most progressive renal diseases, and also is the pathological basis that leading to chronic renal failure. In recent years, the biological effect of tissue transglutaminase in the progressive tubulointerstitium fibrosis attracts more and more attention. Tissue transglutaminase belongs to a group of calcium-dependent mammalian enzymes that have the capacity to irreversibly cross-link proteins through the formation of e (γ-glutamyl)lysine bonds, and lead to the excessive deposition of extracellular matrix, then functions markedly in the tubulointerstitial fibrosis.

Unfolded protein response(UPR) is a protective response in cell endoplasmic reticulum(ER) under stress condition.Three ER transmembrane proteins,IRE1,PERK,and ATF6,coordinately regulate the UPR function in mammalian cells through their signaling pathways.In addition,some proteins and transcription factors during the UPR can provide negative and positive feedback loops to maintain the normal function of ER.UPR can trigger cell death or apoptosis and eventually cause related diseases if the ER stress persists.Several key mediators of UPR are candidates for therapeutic targets in many studies.Up to now progress has been made in the area,which provides new ideas for clinical practice and holds a great potential for future application.

OBJECTIVE:To investigate the utilization of aztreonam in perioperative patients in order to promote rational use of antimicrobial agents. METHODS: 215 discharged surgery cases were collected in Mar. 2009 and analyzed retrospectively to evaluate the rationality of drug use. RESULTS: Of 215 cases, preventive use accounted for 122 cases, among which rational use 29 cases and irrational use 93 cases; treatment use accounted for 93 cases, among which reasonable use 54 cases and unreasonable use 39 cases. CONCLUSION: Perioperative use of aztreonam was not in line with Guiding Principles for Clinical Use of Antibacterial Drugs, Notice for Further Strengthen Management of Clinical Use of Antibacterial Drugs Issued by General Office of the Ministry of Health. Unreasonable utilization require to arouse attention of medical personnel and strengthen management.

To investigate the relationship between esophageal motility and GI hormones in patients suffering from gastroesophageal reflux disease (GERD), the esophageal motility in 20 GERD patients with esophagitis and 25 GERD patients without esophagitis was examined by means of SGY-3 Digestive Tract Motility Measuring Instrument. Meanwhile,Serum gastrin,motilin,glucagon,estradiol were measured with RIA.The data from 15 healthy volunteers served as control.The results showed that ①GERD patients without esophagitis had lower LESP(2 12?1 00kPa) than control(3 23?0 72kPa P

Objective To determine the endogenous metabolites in blood of rats with Xiaoqinglong Decoction Syndrome by using GC-MS;To provide evidence for researches on the essence of Xiaoqinglong Decoction Syndrome. Methods Totally 36 male Wistar rats were randomly divided into blank control group (10 rats), model group (13 rats), and Xiaoqinglong Decoction group (13 rats). Model group and Xiaoqinglong Decoction group were used to make the models of exogenous cold and internal fluid syndrome (Xiaoqinglong Decoction Syndrome). Rats in Xiaoqinglong Decoction group received gavage with Xiaoqinglong Decoction, while rats in blank control group received nothing. Blood of rats in the three groups was taken from the abdominal aorta and detected by GC-MS 15 days later, and analyzed by multivariate statistical analysis with PLS-DA. Results 13 kinds of biomarkers were found:lactic acid, 3-hydroxy-butyric acid, glycine, serine, lysine, dextrose, arachidonic acid and other metabolites. Conclusion Expressions of biomarkers, such as lactic acid and glycine, are energy metabolism, immune function, and inflammation, which provide material basis for researches on the essence of Xiaoqinglong Decoction Syndrome.

Objective To investigate the relationship between the pathogenesis of leukemia and Flt3 gene by detecting the point mutations in juxtamembrane domain coding by Flt3. Methods The exons 14, 15 of Flt3 gene were detected using PCR, PCR/SSCP and gene sequence in 60 leukemia patients with peripheral blood and bone marrow samples. Results We found Flt3-L576P point mutation in 3 cases in juxtamembrane domain in 60 patients, including 1 patient had a deletion of intron 14. Conclusion Flt3-L576 was a new point mutation site, which way be associated with the pathogenesis and development of leukemia.

BACKGROUND:The mechanism of differentiation and proliferation of bone marrow-derived mesenchymal stem cells remains unclear. In addition, issues such as how signal pathways such as Ca2+and bone marrow-derived mesenchymal stem cellproliferation and differentiation signals form complex signal network remain poorly understood.
OBJECTIVE:To investigate the effect of Ca2+in the induced differentiation of bone marrow-derived mesenchymal stem cells into hepatocytes.
METHODS:Bone marrow-derived mesenchymal stem cells were isolated from rat bone marrow using whone bone marrow adherence method, purified, amplified, and induced with hepatocyte growth factor. [Ca2+]i in the directional differentiated bone marrow-derived mesenchymal stem cells and control bone marrow-derived mesenchymal stem cells were detected with flow cytometry. Bone marrow-derived mesenchymal stem cells induced with hepatocyte growth factor were mixed with nimodipine of different concentration, and cells were divided into three groups:hepatocyte growth factor+nimodipine 10 mg/L, 50 or 100 mg/L groups. cellgrowth was observed with inverted phase contrast microscope and alpha 1-antitrypsin expression of the cells was confirmed by immunocytochemistry. The calcineurin M and the activation of extracellular signal regulated kinase pathway was detected by reverse transcription-PCR and western blotting, respectively.
RESULTS AND CONCLUSION:[Ca2+]i in the directional differentiated bone marrow-derived mesenchymal stem cells was higher than in the control group (P<0.05). After addition of a larger dose of nimodipine, no differentiation of cells was obeserved and growth of bone marrow-derived mesenchymal stem cells was getting worse. There were few alpha 1-antitrypsin positive cells in the nimodipine groups. Calcineurin Mexpression was significantly increased in directional differentiated bone marrow-derived mesenchymal stem cells and smal dose of nimodipine than the controls (P<0.05). However, no significant difference was found among middle, high dose nimodipine and control groups (P>0.05). These findings indicate that Ca2+could participate in the differentiation of bone marrow-derived mesenchymal stem cells into hepatocytes incuded with cytokines, and also maintain the survival and proliferation of bone marrow-derived mesenchymal stem cells.

BACKGROUND: Chinese medicine Gukang prescription has a clear effect on clinical treatment of osteoporosis, but the therapeutic pathway is stil unclear.
OBJECTIVE:To investigate the effects of Chinese medicine Gukang on the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin by regulating core binding factor alpha 1 expression to control the growth and development of osteoblasts.
METHODS:Sprague-Dawley neonatal rats within 24 hours after delivery were used for the separation and culture of osteoblasts. Adult Sprague-Dawley rats were used to prepare drug-containing serum, and then divided into two groups randomly:normal control group and Gukang group. Rats in the normal control and Gukang groups were intragastrical y administrated with extract of Gukang prescription and normal saline based on rat’s body surface area, for 1 consecutive week. Two hours after the last administration, blood samples were taken from the heart. Then the serum was col ected. Osteoblasts at passage 3 were confirmed with alkaline phosphatase assay and digested. After counting and planting, al osteoblasts were divided into two groups and treated with col ected
serum for 72 hours. Proliferative rate of osteoblasts was detected by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test. Secretion of alkaline phosphatase was detected by using enzyme linked immunosorbent assay and corrected with the corresponding absorbance value. mRNA expression of core binding factor alpha 1, receptor activator of nuclear factor kappa B ligand and osteoprotegerin were detected by using reverse
transcription-PCR in al groups.
RESULTS AND CONCLUSION:mRNA expression of osteoprotegerin and core binding factor alpha 1 in the Gukang group was significantly higher than that in the normal control group, but protein and mRNA expression of receptor
activator of nuclear factor kappa B ligand were dramatical y lower in the Gukang group compared with the normal control group (P<0.01). These findings indicate that Chinese medicine Gukang prescription can modulate the expression of
core binding factor alpha 1, thereby adjusting the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin, which may be one of the mechanisms underlying Gukang treatment for osteoporosis.

Objective To evaluate the assessment index system of internal medicine, and to analyze the factors of practical effects on internal medicine. Methods The assessment index system of clinical skills was developed by expert group based on the clinical syllabus and objectives. Internal medicine index system was divided into four items such as history-taking, physical examination, hos-pital records and case questions. 49 five-year clinical interns who took internal medicine exams were researched. Reliability, validity, discrimination, difficulty were used to analyze the quality of assess-ment index system. Gender, teaching hospital and the preparation of postgraduate examination were used to explore the influencing factors of practical effects with independent t-test and Wilcoxon signed rank tests. Results The reliability, discrimination, difficulty of the assessment index system were 0.50, 0.15 and 0.85, respectively. The removing item coefficient of history collection, physical ex-amination, hospital records, case questions were 0.38, 0.26, 0.47 and 0.53, separately, and the discrimination were 0.18, 0.17,0.27 and 0.37, separately, and the difficulty were 0.87, 0.89, 0.79, and 0.78, respectively. The scores of assessment index system of girls were higher than those of the boys(P<0.05). Moreover, the girls scored higher in history collection and physical examination, compared with the boys(P<0.05). The discrepancy scores were not statistically significant among teaching hospitals (P>0.05). The students who prepared the postgraduate examination scored lower than the others(P<0.05). Conclusions The assessment index system of internal medicine is reason-able and reliable, but the assessment of case questions still needs to be standardized. Teaching hospi-tals have little effect on internship while gender and the preparation for postgraduate examination influence practice effects in internal medicine.