To explore the changes of retrobulbar hemodynamics in diabetes via color doppler ultrasound.
●METHODS: Totally 80 patients ( 160 eyes ) with eye diseases in type 2 diabetes from June 2010 to May 2013 in our hospital were enrolled as research group. By fundus photography and direct ophthalmoscopy, patients were assigned to diabetes without retinopathy group ( DNR subgroup), non- proliferative diabetic retinopathy group (NPDR subgroup) and proliferative diabetic retinopathy group (PDR subgroup). Of 60 healthy patients (120 eyes) over the same period were chosen as control group. The doppler parameters of central retinal artery ( CRA ), posterior ciliary artery (PCA) and ophthalmic artery (OA) were measured.
●RESULTS: There were significant differences on circulatory parameters of CRA, PCA and OA between both groups ( P < 0. 05 ). Significant differences were also observed on peak systolic velocity ( PSV), end diastolic velocity ( EDV) and resistance index ( Rl) of CRA, PCA and OA among DNR subgroup, NPDR subgroup and PDR subgroup ( P < 0. 05). The EDV, Rl and PSV of control group differed from those of DNR subgroup, NPDR subgroup and PDR subgroup (P<0. 05).
●CONCLUSlON: The monitoring of retinal blood flow and analysis of blood spectrum morphology via color doppler ultrasound can effectively evaluate the degree of diabetic retinopathy lesions, especially before DR vascular disease. Early detection can reveal the hemodynamic change pattern of DR, facilitating the prevention of diabetic eye complications and improvement of the quality of life.

Objective To evaluate the performance of enzyme linked immunosorbent assay (ELISA) kit in detection of Hepatitis B virus(HBV) markers by using improved and optimized method ,so as to provide a practical and feasible method and reagents for clinical laboratory .Methods ELISA test was used for the detection of HBV markers .The gradient dilution method was used to e‐valuate the lower limit .The verifiation of cut off value was carried out based on clinical and laboratory standards institute (CLSI) EP12‐A2 document .Samples with cut off values were collected to evaluate the precision ,including repeatability and intermediate precision .The coincidence rates were counted through comparing the results of ELISA with those of external quality assessment and those detected by using Abbott i4000SR chemiluminescence instrument .Results The lower detection limit of HBsAg ,HBsAb , HBeAg ,HBeAb and HBcAb were 0 .2 IU/mL ,20 mIU/mL ,1 NCU/mL ,0 .75 NCU/mL and 0 .05 NCU/mL respectively .The cut‐off value(C50 )± 20% concentration included the concentration range between C5 and C95 .The within‐run coefficient of variation (CV)≤15% ,in sandwich method the between‐run CV≤25% ,in competition method the between‐run CV≤35% .The positive and negative coincidence rates in accuracy and comparing with i 4000SR all were more than 95% and all κ>0 .75 .Conclusion ELISA tests for HBV markers in our laboratory could meet the requirements of the detection performance and clinical needs .

Objective To evaluate the laparoscopic Palomo procedure in the management of varicocele in adolescent by assessment of the postoperative testicular growth and the changes of the biggest vessel diameter of varix. Methods From July 1999 to March 2004, laparoscopic high mass - ligation of testicular vessels according to Palomo procedure was performed on 31 boys who all presented with left varicocele Before and after operation at 1 month,3 and 6 months, the biggest vessel diameter of varicocele was measured by ultrasonography, testicular blood supply was evaluated by color Doppler flow imaging(CDFI) ,and fastis was recorded in length, width and thickness by ultrasonographic measurement, which volume was calculated by the formula V =?/6 ? length ? width ? thickness. Also the ratio of left to right testicular volume was calculated, and the left testicle was thought atrophy if the ratio was below 75% The biggest vessel diameter of varix, testicular blood supply, and the postoperative testicular increasing volume were compared before and after operation. Results The biggest vessel diameter of varicocele significantly reduced 1 month after operation(P

Spontaneous intracerebral hemorrhage (ICH) refers to primary non-traumatic parenchymal hemorrhage.Its mortality and disability are extremely high.A simple and easy clinical grading scale for ICH can not only evaluate the prognosis of patients,but also has an important guiding significance for clinical treatment and clinical research.This article reviews the contents of major intracerebral hemorrhage scales,external validation,advantages and disadvantages,and explains its scope of application and clinical application.

Objective Clinically, the anterior cruciate ligament ( ACL) can be reconstructed by either ligament advanced reinforcement system ( LARS) artificial ligament or hamstring tendon autograft ( HTAG) . This study aims to compare the early clinical outcomes of LARS versus HTAG in the treatment of ACL. Methods This study included 38 cases of ACL injury treated in our de-partment from March 2012 to August 2014, 18 by LARS artificial ligament and the other 20 by HTAG. Before and at 18 months after surgery, we evaluated the clinical outcomes of the tow strategies using the Lysholm knee scoring scale and International Knee Documen-tation Committee ( IKDC) scoring systems, and conducted statistical analysis on the follow-up findings. Results Statistically signifi-cant differences were not observed preoperatively between the LARS and HTAG groups either in the Lyshrolm scores (46.78±1.52 vs 46.80 ±1.89, P>0.05) or in the IKDC scores (42.83±1.47 vs 42.20±1.61, P>0.05), nor at 18 months postoperatively in the Lyshrolm scores (93.52±3.19 vs 94.10±1.37, P>0.05) or the IKDC scores (92.11± 1.45 vs 93.15±1.76, P>0.05). However, both the LARS and HTAG groups showed significant differences in the Lyshrolm and IKDC scores at the baseline as compared with those at 18 months after oper-ation ( P<0.05) . Conclusion Both LARS artificial ligament ham-string tendon autograft can achieve good early clinical outcomes in ACL reconstruction.

Objective To analyze the distribution and antimicrobial resistance of pathogenic bacteria in urinary tract infection (UTI)so as to provide evidence for appropriate selection of antimicrobial agents in clinical practice. Methods From January 2001 to December 2008 in Shanghai Ruijin Hospital,4683 strains of pathogenic bacteria isolated from urine samples were detected by ATB system;drug susceptibility test was performed with disk diffusion method and pathogenic bacteria distribution and drug resistance was analyzed with WHO NET 5.3 software. Results Among 4683 strains of pathogenic bacteria,most was gramnegative bacilli,accounting for about 77.8%,of which predominant strain was Escherichia coli (68.7%,3217/4683).The predominant strain of gram-positive bacteria was Enterococcus faecalis,accounting for 10.0%(468/4683).Escherichia coli showed hish resistance rotes to ampicillin,piperacillin and compound snlfamethoxazole(SMZ-TMP),which were 76.6%,61.7%and 57.4%respectively,while a low resistance to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,Enterococcus faecalis showed high resistance rates to erythromycin,gentamicin and levofloxacin,which were 65.8%,43.2%and 31.1%respectively,and were most susceptive to vancomycin and teicoplanin, both with resistance rates of 0. The susceptibility rate of Enterobacteriaceae to imipenem was 100%. From 2006 to 2008, the detection rate of extend-spectrum β-lactamases ESBLs -producing Escherichia coil in outpatient increased year by year, from 28.7% to 43.3% (P＜0.05), whereas no significant change was found in inpatients. The detection rate of (ESBLs)-producing Escherichia coil in inpatients was significantly higher than that in outpatients (P＜0.05).The detection rate of ESBLs-producing Escherichia coil was 23.6%. The antimicrobial resistance rate in elderly patients was significantly higher than that in overall antimicrobial resistance rote (P＜0.05). Conclusions The predominant bacteria of UTI are still gram-negative bacteria, main of which is Escherichia col. Bacteria are resistant to a variety of antibiotics. Approximate selection of antibiotics in clinical practice should be made on the basis of susceptibility test results.

Objective In order to explore the roles of TLR2 and TLR4 in the hepatocyte dam- age caused hy hepatitis B virus infection,and to find whether LPS can affect the damage of hepato- cytes pre-and pos-HBV infection,we detected the changes of TLR2 and TLR4 expressions in hu- man hepatocyte lines HepG2 cells and 2.2.15 cells.Methods HepG2 ceils are most similar to normal human hepatocytes and 2.2.15 ceils are HepG2 cells infected with HBV.We selected these two cell lines to study the differences of TLR2 and TLR4 expression between HepG2 cells before and after HBV infection.In this research,both HepG2 and 2.2.15 cells were stimulated with 0?g/ml, 1?g/ml,10?g/ml,100?g/ml,1 mg/ml and 10 mg/ml LPS.Then the expression of protein of TLR2 and TLR4 were examined by immuno-histochemistry(IHC).The cnRNA of HepG2 and 2.2.15 ceils stimulated with 0?g/ml and 10 mg/ml LPS were examined by reversal transcription-pol- ymerase chain reaction(RT-PCR).Thereafter,the apoptosis of HepG2 and HepG2.2.15 cells were examined by flow cytometry(FC),and the expressions of HBsAg and HBeAg of HepG2.2.15 cells tested with Abbott kits.Results IHC and RT-PCR analysis revealed that TLR2 and TLR4 expres- sions could he detected in both HepG2 and 2.2.15 cells.Moreover,without immune activation, TLR2 and TLR4 expressions were higher in the presence of higher concentrations of LPS.FC analy sis revealed that no apoptosis detected in HepG2 ceils stimulated with LPS in this research,but apop- tosis could be detected in 2.2.15 cells when treated with the same factors.Furthermore,the apoptosis ratios increased with the increase of LPS concentrations.When concentrations of LPS were 1?g/ml, 10?g/ml,100?g/ml,1 mg/ml and 10 mg/ml,the apoptosis ratios were 1.94%,3.03%,3.50%, 3.72%,5.30%,respectively.Abbott analysis revealed that expressions of HBsAg and HBeAg of 2.2.15 cells stimulated with LPS were lower than those not stimulated with LPS.Conclusion HBV can affect the expressions of TLR2 and TLR4 in HepG2 cell lines.LPS can lead 2.2.15 cells to apop- tosis but not HepG2 cells.Although LPS cannot damage normal hepatocytes,it might aggravate hep- atocytes damage when their microenvironment was changed by HBV infection.

Objective To investigate the relationship between OHSS and FSHR gene polymorphism. Methods Two hundred and two women were enrolled in this study. The FSHR gene polymorphisms at position 307 and 680 were detected. Results The distribution of the allele frequency and genotype frequency of the position 680 in FSHR gene were significantly different between women with OHSS or not. No significant differences of the position 307 in FSHR gene were observed. Conclusion Themutation of Asn680Ser in FSHR might be closely related with OHSS.

Objective To investigate the critical thinking ability of medical students and its related factors in order to provide evidence for higher medical education reform. Methods A total of 325 medical students were selected by cluster sampling method, and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was adopted for survery. Results The average total score of critical thinking ability of medical students was above 280, and 51.08% of students showed positive critical thinking ability. Among all the seven critical thinking dispositions, average scores of each item were all positive (>40) except that the significance of truth seeking (37.23) and systematicity (39.05) were indefinite. There were significant differences in critical thinking ability between medical students with different gender and academic years (P<0.05). Conclusion The critical thinking ability of medical students is positive, however, there still exist some shortages. An equal relationship between teachers and students should be established, the traditional course system be continuously reformed, a good environment for clinical training be created, and a variety of teaching methods be implemented to further strengthen the critical thinking ability of medical students.

Background Econazole nitrate is not effective as an antifungal eyedrop because of its poor intraocular permeability,therefore changing the formulation of econazole nitrate to improve its intraocular permeability become a critical point in the treatment of intraocular fungal infection. Objective The present study was to observe the penetration of 0.5％ econazole nitrate nanoparticles in the corneas and aqueous humors following its topicaladministration. Methods Econazole nitrate nanoparticles were prepared by quasi-emulsion solvent diffusion.Characteristics and size of nanoparticles were examined with transmission electron microscope and laser scatteringmethod,respectively.Econazole nitrate nanoparticles drops (0.5％ )was topically administered in 27 New Zealandwhite rabbits bilaterally,and aqueous humor and corneas were obtained after the application of the eye drops for 5,15,30,45,60,90,120,180,240 minutes respectively to detect the concentration of econazole nitrate with highperformance liquid chromatography (HPLC). The pharmacokinetic parameters were calculated with 3 p97pharmacokinetic computer software.The use of the animals followed the Regulation for the Administration of AffairsConcerning Experimental Animals by State Science and Technology Commission. Results The diameter of thenanoparticles was 50 nm with the round shape and encapsulation efficiency was 96.0％.Econazole nitrate nanoparticlesat the concentration of 0.5％ could be rapidly separated with other elements by HPLC with a lowest quantitativeconcentration of 0.1 mg/L.The mean recovery rates of econazole nitrate nanoparticles were 98.09％ in cornea and 99.66％ in aqueous humor,respectively after topical administration.The peak levels of econazole nitrate nanoparticles in cornea and aqueous humor were achieved at 5 minutes after application ( cornea:40.620 μg/g± 7.756 μg/g;aqueous humor:0.504 mg/L±0.153 mg/L),and its half-life( t1/2 )in cornea and aqueous humor was 23.5 minutes and 18.6 minutes,respectively. Conclusions Econazole nitrate nanoparticles at 0.5％ concentration can remain a feasible bioavailability in ocular tissue and therapeutic level in cornea and aqueous humor.