AIM: To comparatively analyze the application of laser confocal microscopy and corneal smear in the diagnosis of fungal keratitis.METHODS: Totally 77 patients (77 eyes) diagnosed as fungal keratitis were selected.Laser confocal microscopy and corneal smear examination were performed to observe the characteristics of the images, and the detection rate of fungus were compared between the two methods.RESULTS: Of the 77 patients, 66 eyes (86%) were positive and 11 eyes were negative detected by laser confocal microscopy;51 eyes (66%) were positive and 26 eyes were negative detected by corneal smear examination, the difference was statistically significant compared between two group (P<0.05).CONCLUSION: Laser corneal confocal microscopy is relatively safe and sensitive.If combined the application of laser corneal confocal microscopy and corneal smear examination in clinical, the diagnosis rate of fungal keratitis may be improved.

Objective To investigate the numbers and the expression of MHC-Ⅰpositive cells in hu- man ovarian epithelial carcinoma tissues and provide the experimental data in the futher biological therapy of ovarian carcinoma.Methods Thirty one samples of ovarian epithelial carcinoma were analysed with flow cy- tometry for MHC classⅠexpression.Results The number of MHC classⅠcells(25.22?21.23,4.37?3.63)was fewer in ovarian epithelial carcinoma than that in normal ovarian tissues(43.56?18.47,7.43?5.87),and was related with pathologic grades(P

Objective To investigate the effect of perioperative treatment and protection in human immunodeficiency virus (HIV) infected patients with osteoporotic vertebral compression fracture by percutaneous kyphoplasty (PKP).Methods From February 2010 to December 2015,206 cases with osteoporotic vertebral compression fracture treated by PKP were admitted,including 13 HIV infected patients.Blood routine,biochemical indexes,liver and kidney function,blood coagulation function,immune index and preoperative nutritional status were detected before operation.Highly active antiretroviral therapy (HAART),reasonable antibiotics,nutritional and immune support were given to the HIV infected patients.Standardized operation process and meticulous operative manipulation were applied during operation.The prevention of occupational exposure protection standardization process was strictly enforced.The postoperative complications,improvement of immune function and nutritional status,vertebral height,VAS,ODI and exposure occupation of medical personnel were observed.Results All 13 HIV infected patients had successful operations,without bone cement leakage and toxic reaction.One patient had perficial infection and the others had operative incisionprimary healing.There was no death.The levels of vertebral height,VAS scores and ODI scores were significantly improved after intervention and at the end of follow-up (P ＜ 0.05),but there were no significant differences between after the intervention and at the end of follow-up (P ＞ 0.05).Eleven malnutrition patients with HIV infected were received nutritional and immune support,and the levels of CD4 +,ALB and Hb were significantly improved:(289.00 ± 54.29) × 106./L vs.(237.25 ± 72.70) × 106/L,(38.04 ± 5.17) g/L vs.(33.73 ± 7.16) g/L,(112.87 ± 15.54) g/L vs.(100.68 ± 18.95) g/L,P ＜ 0.05.The levels of PLT and WBC had no significantly change (P ＞ 0.05).Two medical personnel had occupational exposure,and none had HIV infection.Conclusions Perioperative adjuvant treatment in HIV infected patients with osteoporotic vertebral compression fracture can achieve satisfactory outcomes.Strict implementation of protective standardization process should be focused.

Objective Because of the major trauma from thoracotomy , postoperative pain may arouse patients'psychological and physiological stress response and hence affected the treatment outcome and functional recovery seriously .We retrospectively studied the correlation between the staging of pain and nursing interference to investigate the effect of nursing interference on the pain intensity after thoracic surgery . Methods Five hundred and eighty cases of patients surviving thoracotomy between December 2013 and March 2014 in Nanjing Jingling Hospital were reviewed .Correlations between comfortable nursing measures such as effective analgesia , postural care , catheter care , environmental interventions , psychological intervention and the standard assessment of pain were analysed according to postoperative pain stage . Results With comprehensive nursing interference , the highest pain score occurred in the first 24 hour (2.89 ±0.39).The score was reduced gradually to 2.25 ±0.90 in stage Ⅱ, 1.58 ±0.57 in stage Ⅲ and 1.06 ±0.24 in stage Ⅳrespectively . Conclusion Comprehensive nursing interference according to pain staging may relieve pain effectively after thoracotomy .

Objective To find out the situation of Kashin-Beck disease and it's dynamic changes in Yan'an city, and provide basis for decision-making on prevention and control of the disease. Methods In accordance with the national monitoring program on Kaschin-Beck disease, 21 villages were selected from 6counties in Yan'an, clinical and X-ray inspection of 7 to 13 year-old children were made according to historical illness information from 2006 to 2008. Clinical monitoring on Kashin-Beck disease was made in 2008 for people over 16 years old from 5 villages in 5 counties. Results One thousand and one hundred eighty children were found positive with the illness from 2006 to 2008, with 7 cases of grade Ⅰ , the detection rate was 0.59%(7/1180).One thousand and one hundred sixty-two people were taken X-ray photo on right hand, with no positive case found.In 2008, 1444 adults were taken clinical examination, the detection of grade Ⅰ and over were 160 cases, the detection rate was 11.08%(160/1444), mainly in the age of 36 years[93.75%(150/160)]. Conclusion KashinBeck disease in Yan'an city is in stable condition, but surveillance and preventing measures are stilled needed.

Objective To create a model with simple expression of mechanical characteristics of the human chest for the development of a manikin. Methods A simplified Gruben-model was proposed based on the anatomical structure and physical characteristics of the materials, and perfect coefficients were computed. The model feasibility was proved by the coefficient of determination and residual analysis.Results The mathematic form of the model provided had three fewer terms than Gruben′s. The coefficient of determination approximated 1, the residue was small, and the perfect coefficients of "a typical human" were determined.Conclusion The hypothesis of the model makes the coefficients physically meaningful, which provides a new method to study the force-displacement relationship of the thorax. Also the simple form makes it easy to create the model and provide some guidance for the design of a manikin′s chest.

Objective: To explore the necessity of multi-slice CT (MSCT) and echocardiogram in diagnosing multiple cardiac myxoma or myxoma originated from special site of heart via analyzing medical imaging features. Methods: A total of 14 patients with multiple cardiac myxoma or myxoma not originated from left atrium fossa ovale were studied; the patients had operation conifrmed diagnosis in our hospital from 2003-02 to 2015-12, the imaging features of MSCT and echocardiography were analyzed and compared. Results: There were 12/14 patients diagnose by echocardiography with the accuracy of 85.7% and 11 patients diagnosed by MSCT with the accuracy of 84.6%. MSCT and echocardiography had similar pre-operative accuracy and complimentary advantages for diagnosing multiple cardiac myxoma or myxoma not originated from regular site of heart. Echocardiography was superior for examining the motion, pedicle position, shape and attachment point of cardiac myxoma; MSCT may exclude pulmonary embolism and coronary artery disease at meanwhile. Conclusion: Unconventional cardiac myxoma not only has similar image signs to typical single myxoma from left atrium, but also has the speciifc features; MSCT combining echocardiogram examinations could make more accurate diagnosis and provide a better condition for surgical treatment.

Objective To investigate the effect of all-in-one nursing intervention on esophageal carcinoma patients with bad emotion and immune function. Methods From the October, 2012 to the October, 2013, 102 patients with radical operation of esophageal carcinoma were divided into all-in-one nursing intervention group (research group, 52cases) and routine nursing group (control group, 50 cases) according to the random number table method.Two groups of patients were evaluated before and after operation of anxiety and depression emotion scores, with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) .At the same time, two groups of patients were detected the stress and immune index before and after the operation. Results Before operation, two groups of patients with anxiety, depression, stress reaction and immune index were not significantly different (P>0.05).After operation, the study group patients with anxiety and depression scores were significantly lower than those in the control group [(34.6+6.7) points vs. (44.8+7.5) points, (33.7+6.9) points vs. (40.6+7.3) points], the difference was statistically significant (t values were 7.234, 4.902, P<0.05). Eighth days after operation, patients in the control group FBG, CRP and Cor levels were significantly higher in the study group [(6.98±1.12)mmol/L vs.(6.09±0.85)mmol/L,(18.11±5.93) mg/L vs.(9.24±3.22)mg/L,(293.98±69.09)nmol/L vs.(221.97±67.94)nmol/L],the difference was statistically significant (t values were 4.532, 9.336, 5.307, P<0.05). Eighth days after operation, two groups of patients with IgA, IgM were higher than first days after operation [(2.41±0.46)g/L vs.(1.89±0.56)g/L,(2.51±0.58) g/L vs.(1.35±0.67)g/L and (2.36±0.53)g/L vs.(1.82±0.46)g/L, (2.34±0.62)g/L vs. (1.37±0.64) g/L], the difference was statistically significant (t values were 5.174, 9.439, 5.549, 7.850, P<0.05).The total number of patients blood lymphocytes (LYM) and cytokines (CD3, CD4, CD8, CD4/CD8) were significantly higher than the control group [(2.87±0.65)×109/L vs.(1.98±0.58)×109/L, 0.62±0.10 vs. 0.57±0.07, 0.41±0.08 vs. 0.35 ±0.08, 0.24 ±0.04 vs. 0.26 ±0.05, 2.06 ±0.44 vs. 1.65 ±0.46], the difference was statistically significant (t values were 7.286, 2.915, 6.942, 2.225, 4.601, P<0.05). Conclusion All-in-one nursing intervention can significantly improve the anxiety and depression in patients with esophageal cancer in bad mood, enhance the immune function of patients, conducive to the rehabilitation of patients.

Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.

OBJECTIVETo study whether zearalenone (ZEA), a fungal estrogen, can transcriptionally up-regulate the expression of cytochrome 450 3A4 (CYP3A4) transcription by activating human steroid hormone and xenobiotic receptor (SXR).

METHODTransient cotransfection reporter gene assays were performed with human SXR expression plasmid and a reporter plasmid containing the SXR in the CYP3A4 gene promoter in HepG(2) cells.

RESULTSThe transcriptional induction of CYP3A4 by ZEA with a dose, time-dependent manner. ZEA at the concentrations of 0.01, 0.10, 1.00 and 10.00 micromol/L, respectively, could induce CYP3A4 with (1.50 +/- 0.21), (1.66 +/- 0.27), (3.04 +/- 0.82) and (3.96 +/- 1.16) folds, as compared with 0.1% DMSO. Results from a time-dependent study show that 1.00 and 10.00 micromol/L of ZEA for 12 to 48 hours could enhance the transcription of CYP3A4 with (3.69 +/- 1.34) and (5.18 +/- 1.50) folds, and 10.00 micromol/L of ZEA for 48 hours could induce the CYP3A4 gene expression (5.18 +/- 1.50) folds, as compared with 0.1% DMSO by activating human SXR.

CONCLUSIONZEA could induce the expression of the CYP3A4 gene transcription through activating SXR, possibly by affecting the other substrates of the CYP3A4, especially affecting the metabolism of drugs in the body.

Carcinoma, Hepatocellular ; pathology ; Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; biosynthesis ; genetics ; Genes, Reporter ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Transcription, Genetic ; drug effects ; Tumor Cells, Cultured ; Zearalenone ; pharmacology