AIM: To observe the comparison of vitrectomy combined drug therapy ( Ranibizumab injection ) and single vitrectomy for proliferatived diabetic retinopathy ( PDR ) and the influence of the curative effect and prognosis of patients.
METHODS:In this study, 112 cases (125 eyes) with PDR were selected and randomly divided into experimental group and control group ( n= 56 ) . Fifty-six cases ( 61 eyes ) in experimental group were injected by drug therapy of 0. 5mg ranibizumab and received vitrectomy;In control group, 56 cases ( 64 eyes ) were received single vitrectomy. The intraoperative and postoperative differences of clinical indicators were analyzed in two groups.
RESULTS: The average operation time, intraoperative electric coagulation hemostasis rate and iatrogenic hiatal incidence of the experimental group were lower than that of the control group:(95. 00±13. 00) min vs (133. 00±14.5) min, 11% vs 34%, 5% vs 20%, respectively (P<0. 05). The anterior chamber and vitreous body cavity hemorrhage rate within postoperative 1mo in the experimental group were lower than that of the control group:7% vs 23%, 5% vs 12%, respectively (P<0. 05). The postoperative visual acuity of experimental group was better than that of the control group:0. 375±0. 210 vs 0. 261±0. 170, respectively (P<0. 05).
CONCLUSION: Patients with PDR injected with ranibizumab in vitreous cavity before vitrectomy can effectively reduce the operation time, less intraoperative blood loss, the incidence of iatrogenic hiatus, and intraoperative and postoperative complications. The postoperative visual acuity was better than before.

Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Salvage Therapy ; Treatment Failure

Background Interleukin-17 (IL-17)is a potent pro-inflammatory cytokine and plays a pathogenic role in autoimmune disease.It was confirmed that IL-17 is implicated in allograft rejection of many transplanted organs.Recent studies have foensed on the effect of IL-17 antagonists on allograft rejection.Objective This study aimed to investigate the inhibitory effect of anti-mouse IL-17 monoclonal antibody (mAb) on corneal allograft rejection.Methods Twenty-five 8 to 10-week-old C57BL/6 mice and 50 BALB/c mice were collected.Donor cornea grafts with 2 mm diameter from 25 C57BL/6 mice was transplanted to 50 eye of BALB/c mice to establish a model of corneal transplantation.The recipients were randomized into 2 groups,and neutralizing mouse IL-17antibody or isotype control antibody was intraperitoneally injected immediately after transplantation for experimental treatment,respectively.Allografts were scored clinically at appropriate time points after treatment based on Plskova criteria,and ≥5 was confirmed as rejection.Infiltrating cells in corneal graft were detected qualitatively and quantitatively by immunohistochemistry and reverse transcription-PCR separately.The cytokine levels of T helper type 1 (Th1),Th2,and Th17 in recipients' spleen wer(c) analyzcd by ELISA.The use of the animals followed the Statement of ARVO.Results Compared with the isotype control antibody group,the survival of grafts was improved in the IL-17mAb group(P＜0.05).The levels of neutrophile granulocyte mRNA,CD4+ and CD8+ T lymphotes mRNA were 2.22±0.10,1.64±0.04 and 1.32±0.10 in the IL-17 mAb group,showing a significant decline in comparison with those of the isotype control antibody group(3.61 ±0.08,2.69±0.06 and 2.17±0.04) (P=0.000,0.000,0.000).Interferon-γ(IFN-γ),IL-12 p40 and IL-17 concentrations in recipients ' splenocytes were (529.80 ± 13.83) ng/L,(539.58 ±10.74) ng/L and(173.70±8.11)ng/L in the IL-17 mAb group,and thosc in the isotype control antibody group were (741.48± 10.51) ng/L,(1156.90 ± 69.93) ng/L and (366.13± 7.93) ng/L,with significant differences between them (P=0.000,0.001,0.000).Conclusions Neutralization IL-17 bioactivity inhibits mouse corneal allograft rejection to a certain extent.

Objective A scientific evaluation of hospital culture with the Dimension organizational culture model, in view of features of China's general public hospitals.Methods Based on Denison model, according to the characteristics of the public general hospitals in China, the authors developed a tool for organizational culture assessment (TOCA) by using the survey data from 87 hospitals in three provinces from the East, Central, and West areas in China.Results This tool, an evaluation scale, comprises the four cultural characteristics of direction, consistency, participation, and adaptability, as well as 13 cultural dimensions of social responsibility and competitive consciousness. The tool is tested as having good internal reliability and validity.Conclusion The TOCA provides hospital administrators with a tool for hospital culture evaluation, diagnosis and improvement.

Based on the principle of management, evidence-based medicine, operational research and health economics, this essay addressed the theoretical basis of clinical pathway and its application of evidence-based Chinese medicine to practice. It could be taken as references for different health care institutions and organizations for development of clinical pathway.
Critical Pathways ; Evidence-Based Medicine ; organization & administration ; Humans ; Medicine, Chinese Traditional

Objective To study CD35on erythrocytes and erythrocyte chemokine recepter(ECKR)in patients with psoriasis in order to explore red blood cell(RBC)innate immune function and its possible role in the pathogenesis of psoriasis.Methods The rapid natural immune reaction on cancer cells was measured with RBCs isolated from fresh blood.Expression of CD35on erythrocytes was detected by flow cy-tometry.The level of IL-8,which was bound to isolated erythrocytes,was measured by enzyme linked im-munosorbent assay(ELISA)in the supernatant after centrifugation,which represented ECKR binding activity.Results Rosette formation rates of RBC adhering to cancer cells and expression of CD35on RBCs were significantly higher in psoriatic patients than those in control group(P

Objective To investigate the effect of a fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses. Methods A total of 91 primary hepatic carcinoma (PHC) patients undergoing elective hepatectomy were enrolled and were divided into two groups by admission time, namely the control group (48 cases) and the experimental group (43 cases). The patients in the control group received traditional perioperative nursing care of hepatectomy, while the cases in the experimental group participated in fast-track nursing pathway. Patient satisfaction and nurse job satisfaction were measured before and after implementation. Results Final analysis included 45 patients in the control group and 40 patients in the experimental group. In the experimental group, the total score of patient satisfaction and the scores of all dimensions (including services and techniques, concern and care, services and techniques and overall satisfaction) were (132.75 ± 13.71), (48.30 ± 6.53), (42.60 ± 4.62), (35.98 ± 3.85), (5.88 ± 0.94), while they were (122.89 ± 16.62), (44.53 ± 7.74), (39.49 ± 5.67), (33.53±4.40), (5.33±1.13) in the control group. And the scores of the experimental group were significantly higher than that of the control group (t=-2.961, t=-2.409, t=-2.753, t=-2.709, t=-2.389, P<0.05). Furthermore,after implementing the fast-track clinical nursing pathway,the total score of nurse job satisfaction and the scores of six factors were (143.23 ± 9.40), (28.45 ± 2.72), (24.82 ± 2.28), (23.05 ± 1.33), (13.91 ± 1.95), (15.05 ± 1.43), (16.64 ± 1.65) while they were (127.36 ± 13.14), (25.68 ± 4.16), (19.64 ± 2.75), (20.23 ± 2.35), (13.23 ± 2.22), (13.68 ± 2.01), (14.50 ± 1.95) before the implementation. The former was significantly better than the latter (t =-12.462,-7.743,-12.670,-6.560,-2.417,-1.483,-6.587,P<0.05). However, no differences were observed in the other two dimensions of wages and benefits andwork-family balance(t =-1.945,-1.312,P>0.05) since the scores after implementation were (13.86 ± 2.12), (7.45 ± 1.57), while that of (13.18 ± 2.30)、(7.23 ± 1.41) were obtained before performance. Conclusions Application of fast- track nursing pathway in perioperative patients with PHC can contribute to promoting the level of patient satisfaction and job satisfaction of nurses and improving nursing quality. It is suggested that this nursing pathway will have more potential value for PHC patients.

OBJECTIVESTo explore the role of fibroblasts derived from tumor in the tumor angiogenesis.

METHODSTwo-well co-culture system were used to detect the expression of MMP-9, TGF-beta1, TN and bcl-2 in L929-H22 cells, and their ability of promoting angiogenesis of ECV304 cells and invasion of MDA-MB-231 cells respectively, which were established in our laboratory before. Then their adhesion and the effect of their supernatant on H22 cells proliferation were analysed.

RESULTSCompared with L929 cells, the adhesion potential of L929-H22 cells increased (F>or=104.32, P<0.001), with the higher level of expression of MMP-9, bcl-2, TN, and TGF-beta1 in L929-H22 cells in creased (t>or=3.3055, P<0.01). L929-H22 and L929 cells enhanced the invasiveness of human mammary cancer MDA-MB-231 cells through artificial basement membrane (Matrigel) 1.21 and 0.48 times respectively (F=266.3, P<0.001). L929-H22 cells induced morphogenesis of ECV304 cells. L929-H22 stimulated endothelial cells to form more and longer tubes than L929 did (F>or=23.75, P<0.01). 25% CM of L929-H22 cells stimulated the growth of H22 cells (F=266.30, P<0.05).

CONCLUSIONThe results suggested that fibroblasts in tumors secrete more growth factors and angiogenic factors to promote the angiogenesis and invasion of solid tumors.

Animals ; Cell Line, Tumor ; Fibroblasts ; physiology ; Humans ; Matrix Metalloproteinase 9 ; analysis ; Mice ; Neoplasm Invasiveness ; Neoplasms ; blood supply ; Neovascularization, Pathologic ; etiology ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Transforming Growth Factor beta ; analysis

Objective To study the features of level Ⅵ lymph node metastasis in papillary thyroid cancer (PTC) and the distribution of metastastic lymph nodes in the neck levels, and to provide evidences for the treatments of cervical metastasis in patients with PTC. Methods Ninety-seven PTC cases were reviewed retrospectively. The tumors in all cases were limited to one side lobe. Of them, 72 patients were cN0 and 25 patients were cN +; 32 patients with tumors ≤ 1 cm and 65 patients with tumors ＞ 1 cm.Pathological examinations of frozen biopsies of level Ⅲ and Ⅳ lymph nodes were taken in the operation. The extent of lymph node dissection depending on pathological examination results of level Ⅲ and Ⅳ lymph nodes and the size and location of the tumor. For the patients with metastastic lymph nodes in level Ⅲ and Ⅳ, the modified neck dissection including level Ⅵ was performed. Ipsilateral Ⅵ lymph node dissection was performed for the patients with tumors ≤ 1 cm and bilateral Ⅵ lymph node dissection for the patients with tumors ＞ 1 cm or with extra-thyroidal invasion. Results In 97 patients, 122 sides of Ⅵ lymph node dissection were performed. Positive nodes in level Ⅵ were found in 45.1% (55/122) patients. The positive rates of nodes metastases in level Ⅵ were 45.8% (33/72)for 72 patients with cN0 and 76.0% ( 19/25 ) for 25 patients with cN + respectively, with a significant difference statistically ( x2 = 6.790, P = 0.009 ).Positive rates of node metastases in level Ⅵ were 65.0% ( 13/20 ) in 10 patients with extra-thyroidal invasion and 41.2% (42/102) in 77 patients without extra-thyroidal invasion respectively, with a significant difference statistically (x2 = 3.833, P = 0.047 ). Positive rate of node metastasis in level Ⅵ was 43.8%(14/32) in 32 patients with tumors≤1cm. Of 65 patients with tumors ＞ 1cm, ipsilateral and bilateral node metastasis rates were 69.2% (45/65) and 23.1% (15/65) respectively, with a significant difference statistically (x2 = 5.843, P=0.016). Conclusions Cervical lymph node metastasis in level Ⅵ can occur at early stage of PTC. The patients with extra-thyroidal invasion were prone to have lymph node metastasis in level Ⅵ. Ipsilateral positive nodes in level Ⅵ can exist in the patients with tumors ≤ 1 cm, while bilateral positive nodes in level Ⅵ can occur in the patients with tumors ＞ 1 cm. The cervical lymph node metastasis of PTC may take place in level Ⅵ alone or in level Ⅳ and in lateral neck levels simultaneously. Pathological examinations of frozen biopsies of level Ⅲ and Ⅳ lymph nodes should be taken for PTC patients, when the presence of positive lymph node, the modified neck dissection including level Ⅵ should be performed.

Objective To explore the NS gene structure and mutation of Chinese strains of human Parvovirus B19 (HPV B19). Methods NS genes of B19-XA17, XA18 and XA20 strains from three Chinese children with acute aplastic anemia were amplified by PCR, and then the amplified products were sequenced directly. Results Compared with the sequence of Au strain, four bases of NS genes of B19-XA17, XA18 and XA20 strains changed and their coding amino acids changed also. Conclusions Genetic diversity exists in mucleotide sequences of NS gene of HPV B19 isolated from the serum of Chinese children.