Here we reviewed the applications of laser scanning confocal microscope in biomedical field. The reformation and improvement based on this technique were also summarized. After analyzing the defects, we highlighted its potential applications in the future.

Objective To investigate the blood transfusion paths in elderly patients in order to ensure the blood transfusion safety in the elderly.Methods Clinical data of elderly patients (aged 60 and over) receiving blood transfusion were selected from January 2008 to December 2013.Data of blood transfusion in different clinical department were analyzed.Results From 2008 to 2013,the number of elderly patients receiving blood transfusion and transfusion volume showed the rising trends.Patients in Department of Cardiothoracic Surgery had the most blood transfusion volume among all surgical departments (9.3U/person),and plasma transfusion accounted for the most with plasma and red blood cells in a 3 ∶ 1 ratio.Patients in Department of Internal Medicine had the most blood transfusion volume among all non surgical departments (15.9U/person),and platelets transfusion accounted for the most with platelets and red blood cells in a 3 ∶ 1 ratio.The oldest patients on average receiving blood transfusion in the top 10 was from Department of Emergency (aged 77 years),and the most common cause was gastrointestinal hemorrhage.The youngest patients receiving blood transfusion in the top 10 was from Department of Cardiothoracic Surgery and Department of Gynecology (aged 69 years),and the most common cause was huge pleural mass and ovarian cancer.Conclusions Blood transfusion for elderly patients should be restrict the indications for transfusion strictly,choose the reasonable transfusion time,blood components and volume.Physiological and functional changes and clinical features of elderly patients should be paid attention to at the same time in order to reduce unnecessary transfusions,particularly the dependence on plasma transfusion and unnecessary collocated blood transfusion,to avoid the overload and adverse transfusion reactions.

Aim To establish a new,multi-parameter,real time and qualitative cell migration evaluation method.Methods Lung cancer cell line A549 was cultured on the glass bottom dish.After treated with different dosages of berberine or Rg3 for 24 hours,several scratching lines at the same dimension were made and observed by Living Cell Working Station.8 observation areas were selected randomly and imaged continuously for 24 hours.Transferred Area(TA),Transferred Distance(TD),Single Cell Transferred Speed(SCTS)and the Cell Division Number among defined area(CDN)were analyzed after getting sequence images.Results The focus stage and the incubation system were sufficient to keep cell proliferation and made it possible for long term observation.Berberine at 25 μmol·L~(-1) and 12.5 μmol·L~(-1) could inhibit the migration of A549(P<0.01).The analysis results of TA,TD,SCTS and CDN were basically coincident.Rg3 at 0.1 mmol·L~(-1) could inhibit SCTS and promote CDN in 6,12 and 24 h(P<0.01),while decrease both TA and TD in 24 hs.Conclusion The method is sensitive,rapid and simple to be applied in the research of tumor metastasis,wound healing and inflammatory response with real time,in-situ and multi-parameters.

Objective To explore the application of evidence-based medicine in rehabilitation therapy in clinical teaching. Methods 45 interns were divided into 2 groups. The interns during July, 2011 to April, 2012 as the control group (n=23) received the traditional teaching method and the interns during July, 2012 to April, 2013 as the test group (n=22) accepted the evidence-based medicine teaching method in addition. They were assessed with the test scores of theory and operation, and questionnaires. Results The operation scores and the total scores were higher in the test group than in the control group (P<0.05). The satisfaction was better in the test group than in the control group in the items of improving the ability of self-study, taking the initiative, developing clinical thinking, improving the ability of obtaining information, improving the ability of selecting literature, improving the ability of analyzing and summarizing, improving their overall level and degree of satisfaction with this teaching method (P<0.05). Conclusion The evidence-based medicine teaching method can facilitate to improve the practical skills, cultivate the clinical thinking and improve the overall level for students in rehabilitation therapy in clinical practice.

Objective To evaluate the precision and accuracy of blood glucose meter(BGM ) for community home use testing . Methods According to the In Vitro Diagnostic Test Systems‐Requirements for Blood Glucose Monitoring Systems for Self‐Testing in Managing Diabetes Mellitus in DIN EN ISO15197 :2013 .Capillary blood and venous blood were tested by BGM and the laborato‐ry biochemical analyzer respectively .The measurement results of each BGM were compared with the results of the biochemical ana‐lyzer for conducting the bias analysis .Results In evaluated 20 BGM ,none of them met the requirements of ISO15197 :2013(when blood glucose concentrations < 5 .5 mmol/L ,the bias in 95% of detection results is within the range of ± 0 .83 mmol/L ;when blood glucose concentrations ≥ 5 .5 mmol/L ,the bias in 95% of detection results is within the range of ± 15% .Only 11 imported BGM (55% ) met the state standard .Conclusion The bias of 20 BGM ranged - 28 .7% - 3 .8% ,with the average bias of - 12 .2% . These detection results will bring the large risk of therapy in the diabetic patients .The regular and standardized evaluation of BGM performance may ensure the quality of blood glucose self - monitoring .

OBJECTIVE To find a way of reserving high quality phonation function after phonomicrosurgery for premalignant lesions of the larynx.METHODS There were 77 cases with leukoplakia or atypical hyperplasia of the vocal cord included in this study.They were all treated with phonomicrosurgical techniques as mucosal epithelium ablation or mucosal stripping by using CO_2 laser.Ten patients with laryngeal papilloma were excised by CO_2 laser.RESULTS Twenty three patients with leukoplakia or mild atypical hyperplasia of the vocal cord achieved a normal phonation within 2 months.The 44 patients with moderate and advanced hyperplasia need 3～5 months to recover the normal phonation.Phonation recovery of the 10 patients with laryngeal papilloma treated with CO_2 laser was better than patients treated with transcervical approach.CONCLUSION The CO_2 laser assisted phonomicrosurgery is a reliable method for management the premalignant lesions of the larynx, which not only can remove the lesions and also can restore good voice function.

Objective To explore the effect of goal-oriented repetitive training on motor function of upper limb in patients with stroke. Methods From March, 2014 to February, 2016, a total of 60 stroke patients were randomly divided into experiment group (n=30) and con-trol group (n=30). Both groups received routine rehabilitation, while the experiment group received goal-oriented repetitive training in addi-tion, 30 minutes once a day, 5 days a week for 4 weeks. They were assessed with simple Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel index (MBI) before and after training. Results There was no difference in the scores of FMA-UE and MBI between two groups before training (Z<1.153, P>0.05). The scores of FMA-UE and MBI significantly improved in both groups after treat-ment (Z>5.645, P<0.001), in which the scores were higher in the experiment group than in the control group (Z>2.275, P<0.05), as well as the D-value of scores before and after training (t>5.770, P<0.001). Conclusion Goal-oriented repetitive training could promote the recovery of upper limb motor function in patients with stroke.

Objective To compare the dosimetric difference among plans designed by 4-field,6-field TomoDirect and TomoHelical techniques in Tomotherapy system for left-breast cancer patients with radiotherapy after breast-conserving surgery.Method A total of 16 patients with left-breast cancer following breast-conserving surgery and intensity-modulated radiation therapy were enrolled in this retrospective study.The 4-field TomoDirect (TD4),6-field TomoDirect (TD6),and TomoHelical (TH) techniques were applied to design simulation plans in tomotherapy system for each patient,respectively.The differences of dose distribution and treatment parameters were analyzed in this study.Results Three plans all met the clinical requirement.Thereinto,TD4 was superior to TH in the dose limitation of organs at risk (OARs),especially the max dose of cord and right-breast,thc 5 Gy radiation volume of lung,and the mean dose of heart(F =595.60,129.24,60.44,65.37,P ＜ 0.05),but inferior to TH in dose homogeneity (HI) and conformity (CI) (F =2.78,60.93,P ＜ 0.05).However,TD6 improved TD4's HI and CI when delivered the lower OARs dose compared to TH.Meanwhile,the number of monitor units was less in TD technique and reduced the treatment times (F =24.89,3.75,P ＜ O.05).Conclusions For the radiotherapy of left-breast cancer patients after breast-conserving surgery,TD6 technique appeared to be superior,with the lower radiation dose of OARs compared to TH technique,and the better target's HI and CI in comparison with TD4 technique,especially in patients with early stage breast cancer.

OBJECTIVE To evaluate the therapeutic effect of intranasal endoscopic surgery on inverted papilloma of the nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ. METHODS According to the staging system developed by John H.Krouse,30 cases with inverted papilloma in the nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ were analyzed retrospectively. All patients were treated by intronasal endscopic surgery and were followed up for 24 months. RESULTS The inverted papilloma was removed completely and no serious complications occurred. One case recurred at 10 month after surgery and pathologically proved to be cancerated. Another 2 case recurred at 6 and 7 month after surgery respectively. Recurred tumors were removed again, no recurrences occurred in the following up period. The recurrence rate was 10 % and canceration rate was 3.3 %. CONCLUSION Endoscopic surgery is an effective method in management of the inverting papilloma in nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ.

Objective: To investigate the effects of Trimetazidine on mitochondrial proteomic alterations in heart failure rats with qi- deficiency and blood- stasis syndrome after myocardial infarction. Methods: Heart failure models were established by ligating the left anterior descending coronary artery of SD rats. Rats were randomly divided into sham group, model group, Trimetazidine group. 8 weeks after drug intervention, the mitochondrial proteomic alterations of myocardial tissue were detected by two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ ionization time- of- flight mass spectrometry (MALDI- TOF- MS). Furthermore, expression levels of part of the differentially expressed proteins were verified by western blot. Results: Compared with model group, 18 differentially expressed protein spots were detected in Trimetazidine group, 10 of which were successfully identified by MALDI-TOFMS. Bioinformatics analysis showed that these differential proteins were mainly associated with energy metabolism, stress reaction, oxidative damage, cyto-skeleton, cell differentiation and proliferation. Western blot results showed that the expression of Stress-70 protein and Nucleophosmin increased and the expression of ATP-αdecreased in model group. The expression of Stress- 70 protein and Nucleophosmin decreased and the expression of ATP- αincreased in Trimetazidine group, which showed the same results in proteomics. Conclusion: Trimetazidine can partly adjust proteomic alterations of myocardial mitochondrial in HF rats with qi-deficiency and blood-stasis syndrome, and its intervention mechanism may involve improving energy metabolism, relieving stress reaction and oxidative damage, as well as regulating cell differentiation and proliferation. The results of comparative proteomic analysis performed by using 2-DE and MALDI-TOF-MS are accurate, stable and reliable.