The technique of amniotic membrane transplantation is developping rapidly in treating ocular surface disease recently. Amniotic membrane is widely used in this area due to its unique structure, procurment and graft puparation. The authors describe the methods of processing and preservation of human amniotic membrane, and the histological study and clinical application experiences as well.

Objectives: To observe the clinical course of diffuse lamellar keratitis(DLK) after laser in situ keratomileusis(LASIK) and to investigate the presentation and management of DLK. Methods:Among 3500 patients underwent LASIK in our center, 18 eyes in 10 patients received DLK were examined. All eyes were examined with slitlamp biomicroscope at the course of 3 days,7 days,14 days,1 month, 2 months and 6 months after the operation. Visual actuity was measured. Results:Symptoms were controlled after 1 week treatment of topical corticosteroids and antibiotics. Resolution of DLK occurred after 1 to 2 months. Uncorrected visual acuity is 1.0 to 1.5 in 16 eyes and 0.8 to 1.0 in 2 eyes. Conclusions:DLK is a complication after LASIK, it usually occurs in 1 to 7 days postoperatively, more likely in male. Topical corticosteroids and antibiotics can get a satisfied outcome. Systemic corticosteroids and antibiotics are needed in serious cases. Early stage of DLK must be distinguished from corneal epithelial implantation and interface infection.

Objective To learn the overall results of the final test paper in nursing undergraduates of Peking Union Medical College, and to provide the theoretical support for teaching quality assessment of nursing undergraduates.Methods The difficulty coefficient, the discrimination index, the reliability (Cronbach α coefficient) and the degree of coverage were analyzed based on education measurement and education statistical methods.Results The mean total score was 67.8±12.5, ranged from 38 to 95.The difficulty coefficient, the discrimination index and the Cronbach α coefficient were 0.68, 0.30 and 0.71 respectively.The rates of loss score were 33.8% for choice questions, 37.2% for completion questions, 22.5%for true or false questions and 24.8% for calculation questions respectively.Among the total 30 examination questions, the proportions of the most difficult ones, the difficult ones, the moderate ones, the easy ones and the easiest ones were 30.0%,13.3%,20.0%,20.0% and 16.7% respectively.28 examination questions (93.3%) had the best or better discrimination.Conclusions The test paper held the moderate difficulty and the good discrimination, reliability and the degree of coverage.The results of the examination accurately reflect the knowledge and ability of the students.In addition, more attention should be paidto improve the knowledge of nursing undergraduates on the importance of the medical statistics in medical scientific research.

Objective To observe the protective effect of the separate zinc gluconate oral and combined of Salvia injection on whole blood metal ion of calcium,magnesium,iron,copper and zinc concentration in noise-induced rats.Methods 50 female SD rats were randomly divided into a control group,a noise group,a zinc gluconate noise group (plus zinc group),a Salvia injection noise group (plus Salvia group) and a Zinc gluconate oral liquid and Salvia injection noise group (combined group),with10 rats in each group.Except the control group did not expose to noise,the rest groups were continuously exposed to high frequency steady noise for two weeks.Each group was compared for the concentration differences of whole blood metal ion of calcium,magnesium,iron,copper and zinc after the intervention of noise.Results ① In each group at the comparison of the calcium ion concentration: Calcium ion concentration of the control group(1.25± 0.16)mmol/L and the combination group(1.27 ± 0.10) mmol/L was significantly lower than the noise group (1.42 ± 0.18) mmol/L.The rest groups compared to each other were not statistically significant.②Magnesium ion concentration was highest in the noise group (1.53 ± 0.10)rmtmol/L),and lowest in the control group (130 ± 0.29) mmol/L,and the noise group was significantly higher than that of the control group.The mean of magnesium ion concentration in plus zinc group (1.42± 0.27) mmol/L,plus Salvia group (1.38± 0.15) mmol/L and combined group(l.37±0.11)mmol/L were lower than the noise group,but the difference was not significant (P＞0.05).③ The iron ion concentration of the noise group (5.47± 1.29)mmol/L was significantly lower than the other four groups (P＜0.05).The control group,plus zinc group,plus Salvia group,the combined group showed no significant differences.④ Whole blood copper ion concentration of the noise group (16.69 ± 4.18) μmol/L was significantly lower than the control group (21.53 ± 3.78) μmol/L and the combination group(19.53± 1.92)μmol/L with a statistical difference; compared with the control group,the concentration of copper ions in plus zinc group(16.19± 1.93)mμol/L was significantly lower (P＜0.05).⑤The whole blood zinc ion concentration in the noise group (50.83±7.99)μmol/L was significantly lower than the other groups,zinc ion concentration in the plus Salvia group (53.87±6.77)μmol/L was significantly lower than the control group (63.86± 8.83) μmol/L; the whole blood zinc ion concentration showed no difference between the plus zinc group (54.81 ± 5.90) μmol/L,plus Salvia group and combined group (59.21 ± 3.90) μmol/L.Conclusion Combined zinc gluconate oral solution and Salvia injection had protective effect on whole blood metal ion concentration affected by noise.The protection effect of zinc gluconate oral solution and Salvia injection combination was stronger than any individual.

Objective:To observe the flap complications after LASIK and analyze their clinical characters and treatment. Methods:The flap complications after LASIK in 35 eyes of 27 patients was reviewed.Visual acuity were measured at 3,7,15,30,60 days after the operation,at the same time, the eyes were examined with slit lamp. Results:After the therapy,diffuse lamellar keratitis of 10 eyes were recovered in 1 to 2 months,the visual acuity were 0.8 to 1.5.Flap slippage of 9 eyes were treated with replacement and the visual acuity were 1.0 to 1.2.One eye with trauma induced flap lose underwent allogeneic keratomileusis and the visual actity was 0.5 to 0.6.One eye with interface infection was treated by removing the infected flap and PTK.The corneal surface was healed but remained with little haze.The visual acuity were 0.8 to 1.0 after the therapy in three eyes with epithelial ingrowth.Three eyes with fiap breaking in the procedure were reoperated half a year later,and the visual acuity were 1.0 to 1.2. Conclusion:Flap complications after LASIK occurred at various period and are related with surgical technic,patient~(,)s eyes conditions and the treatment after the surgery.Early detection and therapy can obtain an comparatively excellent recovery.

Objective:To evaluate the therapeutic effects and value of preserved amniotic membrane combined with conjunctival autograft transplantation for recurrent symblepharon. Methods:A group of 38 eyes in 38 patients with recurrent symblepharon due to recurrent pterygium,chemical burn and other causes were undertaken preserved amniotic membrane combined with conjunctival autograft transplantation.The patients were followed for 6 to 36 monthes.Results:No infections occurred.The amniotic membrane changed into transparent 10 days postoperatively.The conjunctival epithelium emigrated to the surface of amniotic membrane.Impression cytology showed a stable conjunctival epithelium on the surface of amniotic membrane.Efficient movement ability was recovered in 34 eyes(89.5%).Four eyes(10.5%) were still restricted in movement due to partly recurrent symblepharon.Conclusion:The preserved amniotic membrane combined with conjunctival autograft transplantation for is effective recurrent symblepharon

Objective: To investigate the ultrastructural pathogenesis of retina injury by observing the ultrastructural changes under the transmission electron microscope(TEM) after ocular blast injury in rabbits.Methods: Ocular blast injury models were set up in 20 rabbits by the bow wave produced with a bioshock tube.The rabbits were sacrificed at scheduled times after injury,their retinas obtained and their ultrastructural changes observed by TEM.Results: The axonal ultrastructural changes of the retina induced by blast were summarized as follows.The microfilaments and microtubules were swollen and distorted in the early stage,followed by reactive swelling of the ganglion cells.The swollen mitochondria and endoplasmic reticula focally accumulated and the cytoskeleton was destroyed.Finally the intraaxonal cellular structure disappeared and the axon disconnected.Conclusion: Ocular blast injury may cause retinal ultrastructural changes.The pathological changes of ganglion cells in the optic nerve may be associated with the direct effect of the blast and/or ischemia and are possibly important factors in the pathogenesis of vision disturbance.

All the examination results of anesthesia interns from 1996 to 2003 were analyzed.The content and criteria of examination in anesthesia intern which was formulated by our university was evaluated.The cause of deficiency reflected by examination results and problems existing in education were analyzed to improve clinic training for anesthesia intern and cultivate excellent anesthesia specialist.

Acute Disease ; Adult ; Humans ; Male ; Occupational Diseases ; diagnosis ; therapy ; Phosphines ; poisoning ; Poisoning ; diagnosis ; therapy

Objective To evaluate the different cardioprotective function of transplantation of marrow mesenchymal stem cells(BMSCs) from coronary heart disease(CHD) patients with diabetes mellitus (DM) or not to myocardial infarction rats.Methods 45 adult male rats with acute myocardial infarction experimentally were randomized into three groups,15 rats in each group.BMSCs from CHD patients with DM or not were injected into the infarcted myocardium.In control group,culture medium was used.Echocardiography,Western-blot analysis,TUNEL were performed 4 weeks after transplantation.Results Proliferation of BMSCs in DM group was significantly lower than that in non-DM group.Transplantation of BMSCs in the infarcted border zone improved cardiac function,Bcl-2 protein level in DM and non-DM group compared with control group,moreover,BAX protein level and TUNEL positive cells were decreased.Furthermore,compared with non-DM group,cardiac function and Bcl-2 protein level were decreased,however,BAX protein and TUNEL positive cells were improved.Conclusion BMSCs from CHD patients have proliferative properties.Transplantation of BMSCs can improve cardiac function by inhibiting apoptosis.But DM may decrease apoptosis resistance,which might impair the cardioprotective function of cells transplantation.