Corneal refractive surgery has been the major solution for the correction of ametropia.With the standardization of preoperative examination,intraoperative procedure and perioperative drugs,corneal refractive surgery has become much safer.Meanwhile,patients can get not only good visual acuity,but also favorable visual quality.However,the patient satisfaction has not been improved dramatically with the enhance of effectiveness and safety after surgery.Increase of the satisfaction degree to corneal refractive surgery is related to multiple factors such as experienced and highly skilled operation,operative safety,lessening operative complication,good postoperative visual and life quality of patients.Comprehensively analyzing existing problems in corneal refractive surgery in China and further obtain satisfaction of patient will be of an important significance for the healthy development of laser corneal refractive surgery.

Objective To investigate the reliability of Berg Balance Scale (BBS) applied in patients with Parkinson's disease (PD). Methods 121 PD inpatients from March to December, 2011 were assessed with BBS by 2 raters, and the testing procedure was videoed. One of the raters assessed with BBS via video 4 weeks later. The intraclass correlation coefficient (ICC) and Kappa coefficient between raters and between tests were investigated. Results The ICC was 1.00 of the total score between raters and 0.99 between tests, while the Kappa co-efficient were 0.66 to 0.93 and 0.69 to 0.99 of the items. Conclusion BBS is reliable in interrater and test-retest as applied in PD patients.

Objective Toexploreinfluencingfactorsoftheulinastatin(UTI)onmyocardialprotection.Methods 120casesofa-cute myocardial infarction(AMI) patients were given UTI at the base of conventional treatment for heart failure like thrombolysis , resistance to shock .The patients were divided into group A (within 12 hours) and group B (after 12 hours) ,and than each group was divided into subdivision small dose (250 kU) ,medium dose (500 kU) ,large dose (1 000 kU) groups .The patients were re-ceived echocardiogram examination ,determination of left ventricular contraction end-diastolic diameter(LVESD ,LVEDD) testing , left ventricular ejection fraction(LVEF) testing ,each stroke output(SV) ,peak concentration of creatine kinase isoenzyme(CK-MB) after treated for one week .Results Compared with the small dose and after 12 hours groups ,large dose and within 12 hours group caused an increase of cardiac function and density loss of CK-MB peak concentration (P<0 .05) .Conclusion The same cause of myocardial injury ,dose and administration timing will affect the clinical efficacy of UTI .

Objective To measure the learning passion of medical students and evaluating its in-fluencing factors. Methods Taking 879 medical students as research subjects to conduct a questionnaire survey according to specialty and grade stratified sampling. The questionnaire contained two parts, includ-ing learning passion scale and general situation questionnaire. The effective recovery rate was 69.28%, 609 valid questionnaires were recovered. SPSS 22.0 and AMOS 21.0 software were used for statistical analysis of data, analyzing the reliability and validity of the questionnaire with internal consistency reliability coeffi-cient and confirmatory factor analysis. The factors of learning passion of medical students were analyzed by logistic regression analysis. Results The questionnaire of learning passion of medical students contained 12 measurement items, including 2 dimensions: harmonious passion and obsessive passion. The questionnaire was of fine reliability (Cronbach's Alpha=0.916) and validity (χ2/df=3.401,RMSEA=0.073,GFI=0.958). The
learning passion of medical students was at upper middle level (4.390±0.934). The influence of achievement level (OR=1.691, 95%CI=1.415 to 2.021), school satisfaction (OR=0.586, 95%CI=0.402 to 0.854) and profession plan (short-term plan OR=2.121, 95%CI=1.310 to 3.434;long-term plan OR=3.822,95%CI=1.972 to 7.405) on learning passion were statistically significant. Conclusion The questionnaire of learning pas-sion of medical students has fine reliability and validity. Achievement level, school satisfaction and profes-sion plan are factors affecting the learning passion of medical students.

Thymosin β4 exists in most human tissues and cells, involved in many physiological and pathological processes in the human body, such as anti-inflammation, wound healing, angiogenesis, and tumor metastasis. In recent years, thymosin β4 has been found to play an important role in the development and progression of liver diseases. This article reviews the relationship between thymosin β4 and the development and progression of liver diseases, indicating that further exploration of thymosin β4 would make it a new biomarker in diagnosing and treating liver diseases.

The traditional Chinese medicine (Tripterygium wilfordiiHook.f.,TWH) has been clinically used to treat primary and secondary renal diseases and proteinuria for nearly 40 years.However,there is a rare literature about the effect of triptolide (the main active ingredient of TWH) on the expression of oxidative carbonyl protein (OCP) in diabetic nephropathy (DN).This study aimed to provide experimental evidence for triptolide treatment on DN through its effect on the expression of OCP,in order to investigate the effects of triptolide on the expression of OCP in rats with DN.Sixty SD rats were randomly divided into five groups:control group,high-dose triptolide (Th) group,low-dose triptolide (T1) group,DN model group,and positive control (benazepril) group.The DN model was established using streptozotocin.Urinary protein excretion,fasting blood glucose (FBG),superoxide dismutase (SOD) in renal homogenate,malondialdehyde (MDA) in renal homogenate and renal nitrotyrosine by immunohistochemistry,and the expression of OCP by oxyblotimmune blotting were detected.In the DN model group,rat urinary protein excretion and renal MDA were significantly increased,while renal SOD significantly decreased and nitrotyrosine expression was obviously upregulated in the kidney.After triptolide treatment,24-h urinary protein excretion (61.96±19.00 vs.18.32±4.78 mg/day,P＜0.001),renal MDA (8.09±0.79 vs.5.45±0.68 nmol/L,P＜0.001),and nitrotyrosine expression were decreased.Furthermore,renal OCP significantly decreased,while renal SOD (82.50±19.10 vs.124.00±20.52 U/L,P＜0.001) was elevated.This study revealed that triptolide can down-regulate the expression of OCP in the renal cortex of DN rats.

Objective To explore the abilities and personal qualities that medical undergraduates need for their future clinical work, and develop their competency model. Methods The self-made ques-tionnaire survey on medical undergraduates' competencies was conducted among the 1326 medical under-graduates in a medical university by using the cluster sampling method, and the 1099 effective question-naires were collected with effective rates of 82.88%. The exploratory factor analysis was used to analyze the internal structure of competency item and to build the competency model. The rating method was used to calculate the weight of each competency item. Results The overall Cronbach's alpha coefficient of the competency questionnaire was 0.965, and the coefficient of each dimension was above 0.832. The KMO statistic value was 0.970, and the probability associated with Bartlett test statistic was P=0.000, showing that the questionnaire has high reliability and validity. The competency model of medical undergraduates covers six aspects, namely, craftsmanship, personal qualities, professional learning, interpersonal communication, psychological adaptation and the pursuit of excellence, which contain 49 factors. The cumulative variance contribution rate was 54.729%. The weights of these six aspects in the model were 0.204 4, 0.202 1, 0.175 3, 0.158 8, 0.137 6 and 0.121 8 respectively. Conclusion The competency model of undergraduate medi-cal students has a certain scientific and practical value, which can provide new evaluation methods and ideas for medical education objectives, quality assurance, teaching evaluation, medical personnel selection and training.

Fibrolase is a non-hemorrhagic zinc metalloproteinase isolated from southern copperhead snake venom (Agkistrodon contortrix contortrix) and is capable of degrading fibrin clots resulting from purified fibrinogen or from blood plasma. Alfimeprase, a truncated form of fibrolase, as a clinical agent was successfully completed PhaseII clinical trials.The cDNA of alfimeprase was amplified by recursive PCR, digested with BamHI and HindII, and cloned into pET43.1a, pMALp2X and pMALc2X vectors to generate fusions with NusA, MBP and sMBP(with signal peptide), respectively. Nus/alfimeprase was expressed in soluble form by co-expressing with chaperone FkpA and inducing with1mmol/L IPTG. The fusion protein accounted for about 25 % of total protein following cell lysis. Alfimeprase was successfully purifiesd by Ni-NTA affinity chromatography and cleaved by enterokinase. The results demonstrate the fibrinolytic activity of recombinant alfimeprase using fibrin plate assays and fibrinogen hydrolysis.

Objective To evaluate preoperative multislice CT angiography (MSCTA) in guidance for laparoscopic right colon cancer the complete mesocolon resection (CME).Methods From September 2014 to May 2016 data of 24 patients undergoing laparoscopic CME right colon cancer surgery,were reviewed for the guidance of MSCTA over operative surgery.Results Preoperative MSCTA clearly showed superior mesenteric vascular anatomical variation and its branch,which was in closely consistent with that seen during the operation.The superior mesenteric arteries and veins (SMA/SMV) and the ileum colon arteries and veins (ICA/ICV) were seen in all the 24 cases.There are four main types anatomic variation of gastrocolic trunk (Henle trunk),of which most often consisting of three branchs (type B),accounting for about 46％.The time of completely dissecting anatomical Henle trunk was significantly longer than that for the ileum colon vessels and the middle vessels dissection (P ＜ 0.05).Conclusion Preoperative MSCTA can clearly present anatomic variation of SMV/SMA and its branch,precisely navigate the laparoscopic right colon cancer CME surgery,reducing the incidence of intraoperative vascular complications and improving the quality of surgery.

OBJECTIVETo study the effect of aqueous extracts of Polygonum multiflorum (AEPM) on bile acid synthesis, metabolism and transfer-related molecules in rat liver and the hepatotoxicity-related mechanism of P. multiflorum.

METHODSprague-Dawley rats were orally administered with 30, 60 g x kg(-1) APEM once everyday for consecutively 28 days. At the end of the experiment, mRNA and protein expressions of hepatic MRP3, MRP2, BSEP, FXR and CYP7A1 were detected by Real-time PCR and Western blot

RESULTCompared with the normal group, the AEPM high dose group showed significant increases in mRNA expressions of hepatic MRP3 and BSEP of male rats (P < 0.05); AEPM high and low dose groups revealed a notable decrease in mRNA expressions of hepatic FXR (P < 0.05) and remarkable rises in mRNA expressions of hepatic MRP3, MRP2, BSEP, CYP7A1 among female rats (P < 0.05). According to the test results of western blot assay, AEPM high and low dose groups showed consistent changes in protein and mRNA expressions hepatic MRP3, MRP2, BSEP, FXR, CYP7A1.

CONCLUSIONThe 28 oral administration with AEPM in rats showed a certain effect on expressions of bile acid synthesis, metabolism and transfer-related proteins, as well as cholestatic or choleretic effects in the mRNA expression.

Administration, Oral ; Animals ; Bile Acids and Salts ; metabolism ; Cholestasis ; chemically induced ; Fallopia multiflora ; Female ; Liver ; drug effects ; Male ; Plant Extracts ; toxicity ; Rats ; Rats, Sprague-Dawley