Objective To investigate the effects and mechanisms of immunosuppressants on in- duction of apoptosis of peripheral T lymphocytes.Methods T lymphocytes were derived from healthy donors and activated by super antigen SEB.The rest or activated T lymphocytes were incubated with immunosuppressants such as myophenolate mofetil (MMF),cyclosporine A (CsA),FK506,azathio- prine (Aza),sirolimus (SRL),prednisone (Pred),and daclizumab (Dac,anti-CD25mAb),alone or combined,for 3 days.The incidence of apoptosis was determined by the methods of confocal microsco- py,flow cytometer,DNA-ladder fragmentation electrophoresis,and reverse transcription-polymerase chain reaction (RT-PCR) gene amplification profiles.The quantitive assay of IL-2 and Fas in the cul- ture medium was also performed using the enzyme linked immunosorbent assay kit.Results Apoptosis in rest T lymphocytes was just induced by Pred among various immunosuppressants.MMF,Aza,and Pred promoted apoptosis in activated T lymphocytes (P＜0.05,P＜0.01),but it was blocked by CsA,FK506,SRL,and Dac (P＜0.01).After adding two or three kinds of immunosuppressants, the incidence of apoptosis in activated T lymphocytes was apparently lower than in control group (P＜0.01).The expression of Fas and IL-2 by activated T lymphocytes was inhibited by FK506 and CsA (P＜0.05).Conclusion MMF,Aza,and Pred may induce apoptosis of activated T lymphocytes via the signal pathway of Fas/Fasl.CsA and FK506 could inhibit the apoptosis of activated T lymphocytes by blocking the production of IL-2.Also,SRL and Dac can block the apoptosis of activated T lympho- cyte by interfering with the effect of IL-2 on T lymphocytes activation process.

Objective To investigate the incidence of needle stick injuries of nursing students in different stages of clinical practice and occupational protective education to provide evidence for developing education strategies. Methods One hundred and forty-one nursing students were surveyed retrospectively by a self-designed questionnaire. Results A total of 75.9%(107/141) nursing students had been injured in clinical practice. The incidence of needle stick injuries varied in different stages of clinical practice. Compared with the middle and late stage of clinical practice, the incidence of needle stick injuries was highest in the early stage of clinical practice:53.9%(76/141) vs. 38.3%(54/141),7.8%(11/141),and there was significant difference, χ2=216.14, P<0.05.About 64.2%(88/141)-78.0%(110/141) nursing students had not received protective education on the needle stick injuries. Only 48.9%(69/141)-55.3%(78/141) of nursing students were given protective training on needle stick injuries in their practice hospitals. Before clinical practice, 63.1%(89/141) nursing students had not been vaccinated to prevent infective diseases. Conclusions To reduce the incidence of needle stick injuries and related potential risks of infection caused by injuries, it is necessary to strengthen pre-practice education on occupational protection among nursing students. Perfect supervision system should also be established in practice hospitals and clinic wards.

Objective:To explore the correlation among risk factors of hypertension and waist-to-height ratio (WHtR) in officers of regiment and above in troops stationed in Zhejiang .Methods :A total of 2641 officers of regi-ment and above from troops stationed in Zhejiang ,who participated in annual physical examination in our hospital from 2012 to 2013 ,were selected .Correlation among body mass index (BMI) ,waist circumference (WC) ,WHtR , waist/hip ratio (WHR) and blood pressure were analyzed ;receiver operator characteristic curve (ROC) was used to compare and analyze the predictive value of above four indexes on hypertension and judge the optimal cut-off point . Results :(1) Pearson correlation analysis indicated that WHtR was positively correlated with WC ,BMI ,WHR ,sys-tolic and diastolic blood pressure (r=0.25~0.94 ,P<0.005~ <0.001);(2) Among above four indexes ,WHtR had the largest area under the ROC curve 0.697 (95% CI 0.676~0.718) and the optimal cut-off point was 0.51 ;and it's 0.651 (95% CI 0.639~0.662) for BMI ,0.689 (95% CI 0.664~0.751) for WC and 0.685 (95% CI 0.672~0.698) for WHR ;for morbidity risk of hypertension ,compared with BMI ,WC and WHR ,WHtR possessed the most balanced sensitivity (60.68% ) and specificity (70.74% ) ,and the largest OR 4.12 (3.71~4.59) .Conclusion:(1) Among officers of regiment and above in troops stationed in Zhejiang ,anthropometric indexes are closely relat-ed to blood pressure ,which can be regarded as simple indexes for predicting and assessing morbidity risk of the popu-lation ;(2) Waist-to-height ratio may be the best anthropometric index evaluating risk of hypertension in these popu-lation and its optimal cuf-off point is 0.51 for predicting hypertension .

One hundred and sixteen patients with lower limb fracture were screened by Doppler ultrasound for deep vein thrombosis(DVT) of bilateral lower extremities within the first 72 h, d7 and d21 after fracture. Results showed that DVT was detected in 31 (26. 7% ) out of 116 cases within 72 h; at d7 and d21 DVT was detected in 3 and 1 patient respectively with a cumulated DVT rate of 30. 2% in 3 weeks.Serial Doppler ultrasonography is of value in screening for DVT of the lower extremities in patients with lower limb fracture at early stage.

Objective:To learn the effect of personality in the course of cognitive decline.Methods:106 aged people from two districts were selected randomly.Arithmetic,digit span,picture filling,block patterns,digit symbol,visual attention span,spatial reasoning were used to learn the cognitive ability,“Kartaier's 16 personality factors test”were used to explore the personality of aged people.Results:16 personality factors test shows that old people are more deferential and self-assured.The relation between reasoning and arithmetic,rule-consciousness and arithmetic,abstractedness and digit span,reasoning and block design,dominance and digit symbol,sensitivity and special reasoning,apprehension and visual attention span,openness to change and visual attention span reach the statistical significance.Conclusion:Age is the most important reason to the cognitive impairment in aged people, education can prevent the cognitive impairment in a large degree.Personality can affect the cognitive ability although different personality factor affect different cognitive fields.

OBJECTIVETo compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation.

METHODSFrom January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups.

RESULTSAll patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence.

CONCLUSIONFor patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

AIM:To evaluate the application and effect of bandage contact lens in pterygium excision combined with conjunctival transplantation (CAT).METHODS:In a prospective, randomized, controlled clinical study, 110 patients (110 eyes) diagnosed with primary pterygium were collected in PLA NO.474 Hospital from January 2015 to January 2016.The 110 patients enrolled in the study in turn, and divided into two groups by the odd and even number.The odd number divided into bandage contact lens group (CAT + bandage contact lens, n=55), while the even number divided into control group (CAT, n=55).Visual analog scale (VAS) and corneal irritation were evaluated on 1, 3 and 7d after operation.Cornea fluorescent staining testing was carried out on 3d after operation.Following-up all the patients with 1a at least observed the recurrence of pterygium.RESULTS:The score of VAS in bandage contact lens group less than that in control group on 1d (4.13±2.06 vs 5.80±1.93, t=4.391, P<0.001) and 3d (2.09±1.36 vs 3.65±1.65, t=5.422, P<0.001) after operation, while there was no significant difference between two groups on 7d (t=1.295, P=0.198) after operation.The corneal irritation in bandage contact lens group less than that in control group on 1d and 3d after operation (P<0.05), while there was no significant difference between two groups on 7d after operation (P=0.052).Cornea fluorescent staining testing area in bandage contact lens group was less than that in control group on 7d after operation (0.33±0.37mm2 vs 2.73±2.21mm2, t=7.921, P<0.01).There was no significant difference in recurrence rate between two groups after 1a operation (P=1.000).CONCLUSION:Bandage contact lens could significantly release pain and corneal irritation, promote the healing of the corneal epitheliums in the defected area, and increase the postoperative comfort level in patients after operation.

AIM: To discuss the single application on iris localization technology in excimer laser for the treatment of astigmatism.
METHODS:Totally 203 cases (406 eyes) of laser in situ keratomileusis ( LASIK ) in the treatment of compound myopic astigmatism patients were operated from November 2011 to November 2012 in our hospital. They were divided into two groups. One was observation group using iris localization and the other was control group using routine operation. Patients in the observation group of 100 cases ( 200 eyes ) , aged 18-43 years old, spherical diopter was - 1. 25 to - 8. 75D, astigmatism was -1. 0 to -3. 25D. In control group, 103 patients ( 206 eyes ) , aged 19-44 years old, spherical diopter was -1. 75-9. 50D, astigmatism was -1. 0 to -3. 25D. The patients in the observation group before the application of WaveScan aberrometer check for iris image, spherical lens, cylindrical lens and astigmatism axis data operation, only single application of iris location, without using wavefront aberration guided technology, laser cutting patterns for conventional LASIK model, spherical, cylindrical mirror and astigmatism axis  RESULTS: Postoperative residual astigmatism, the observation group was significantly better than the control group. Astigmatism axial measurement after operation, the observation group was significantly less than that of the control group. Postoperative visual acuity at 6mo, the observation group was better than that of the control group. The difference was statistically significant.
data source to preoperative wavefront aberration results. The control group received routine LASIK. It was applicated comprehensive optometry optometry respectively to examine astigmatism and axial, based on the computer analysis during the preoperative, 1wk after the operation, and 6mo. Analysis of using SPSS 17 statistical software, it was independent-sample t test between the two groups of residual astigmatism and astigmatism axis.
CONCLUSION: For patients who cannot complete the wavefront aberration guided treatment of astigmatism, can separate the application of wavefront aberration analyzer automatic iris recognition technology to improve precision of astigmatism treatment, give full play to advanced technical performance of equipment, which has good application value.

ObjectiveTo explore the relationship between chronic kidney disease (CKD) and cerebral small vessel disease (SVD) in elderly patients. MethodsOne hundred and fifty-two elderly male CKD patients for experimental group and 158 elderly male for control group were recruited. Demographic data and vascular risk factors were recorded. White matter lesion (WML) was semi-quantitatively assessed by cerebral magnetic resonance imaging (MRI), and lacunar infarction (LI) was also calculated. Results(1) The prevalenees of hypertentsion and diabetes mellitus were higher in elderly CKD patients than those in control group (30. 9% vs. 19.0%, 23.7%vs. 14.6%;both P～0. 05). (2) The percentages of grade 2 and grade 3 WMLs were higher in elderly CKD patients than those in control group (34.9% vs. 24.1%, 25.7% vs. 16.5%;both P<0.05). Prevalence of LI was higher in elderly CKD patients than that in control group (45.4% vs.25.3% ,X2= 13. 70, P<0. 05). The similar Resultswere also obtained except for control subjects with hypertension and diabetes mellitus. (3) The logistic regression analysis showed that age, hypertension and low glomerular filtration rate (GFR) were closely associated with SVD in elderly CKD patients. ConclusionsHypertention and diabetes mellitus are risk factors for CKD in elderly patients. SVD is associated with CKD, and age, hypertension and low GFR may be risk factors for SVD in elderly CKD patients.

Objective To detect the level of plasma miR-155 in patients with pancreatic cancer and evaluate its diagnostic value for pancreatic cancer. Methods Sixty-two cases of pancreatic cancer patients, 61 patients of chronic pancreatitis and 36 normal controls were included in the study. miR-155 in the total RNA extracted from the plasma was measured using real time PCR. The diagnostic parameters and relationship of the miR-155 with clinical characteristics in pancreatic cancer patients were analyzed. Results The relative abundance of plasma miR-155 in pancreatic cancer, chronic pancreatitis and normal controls were 5.41 ±3.14,2.59 ±2.49 and 0.77 ± 1.17, and the value was significantly higher in pancreatic cancer group compared with those of chronic pancreatitis and normal group (P ＜ 0. 01 ). No significant correlation between the level of plasma miR-155 and age, sex, tumor size in pancreatic cancer patients was found. But there was a negative correlation between the level of plasma miR-155 and TNM staging (r = -0. 323, P = 0.01 ). For discriminating pancreatic cancer from normal control, the AUC ROC of miR-155 was 0. 943 (95% CI 0.902-0.985), and the sensitivity and specificity were 87.1% and 83.3%, respectively. For discriminating pancreatic cancer from chronic pancreatitis, the AUC ROC of miR-155 was 0.762 (95% CI0. 678-0. 846),and the sensitivity and specificity were 64.5% and 73.8%, respectively. For discriminating pancreatic cancer from chronic pancreatitis and normal, the AUC-ROC of miR-155 was 0. 829(95% CI0. 767-0.892), and the sensitivity and specificity were 62.9% and 84.5%, respectively. Conclusions Plasma miR-155 was significantly increased in patients with pancreatic cancer, and can be used for diagnosis of pancreatic cancer.