The goal of this work is to understand the difference between vertical structure and horizontal structure on data management. We take adverse event report as an example to find out the relationship between the storage space and the factors related to the trail. From the study we find out the difference of storage space between horizontal structure and vertical structure goes up with the increase of the storage space of each adverse event record and the number of adverse event allowed to record in the horizontal structure and goes down with the increase of the happening rate and the average times of the adverse event. When using the most widely used study design, vertical structure always takes less storage space than the horizontal structure. This vertical structure database is more suitable for the data management than the horizontal structure database.

Objective To compare the effect of one-site and two-site incision in glaucoma with cataract combined surgery.Methods Forty-two cases (58 eyes) of patients of glaucoma with cataract combined surgery were selected.One-site incision were 22 cases with 30 eyes (one-site incision group),and two-site incision were 20 cases with 28 eyes (two-site incision group).The postoperative intraocular pressure,ultrasound biomicroscope (UBM),filtering bleb and complications were compared in two groups.Results The postoperative visual acuity and intraocular pressure in two groups were better than preoperative [one-site incision group:0.82±0.11 vs.0.18±0.09,(17.32±4.52) mm Hg (1 mm Hg=0.133 kPa) vs.(31.98± 5.18) mm Hg,two-site incision group:0.79 ±0.20 vs.0.20 ±0.03,(16.98 ±4.65) mm Hg vs.(33.16 ±4.61) mm Hg],there were statistically significant differences (P ＜ 0.05),but there was no significant difference between two groups on postoperative (P＞ 0.05).There was no statistically significant difference in visibility of filtering routes under the scleral flap and reflectivity inside the blebs in two groups (P ＞ 0.05).Conclusions Ohe-site and two-site incision in glaucoma with cataract combined surgery has good intraoeular pressure control,can maintain a good filtering bleb function at the same time.The effects are similar between the two operative methods.

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.

Objective To investigate the therapeutic effects and the possible mechanism of fecal transplantation on rats with Clostridium difficile-associated pseudomembranous colitis. Methods A total of 40 Sprague-Dawley rats were divided into four groups including the healthy control group, model group, fecal transplant treatment group and vancomycin treatment group. Rats in three experimental groups were subcuta-neously injected with clindamycin phosphate (10 mg), followed by treatment with toxin producing Clostridi-um difficile (ACTT43255) enema 24 hours later. The rats in fecal transplant treatment group and vancomy-cin treatment group were respectively treated with fecal suspension and vancomycin one day after modeling. The rats were fasted for one day after the last administration and then executed. The levels of potassium ion ( K) , sodium ion ( Na) , albumin ( ALB) , white blood cells ( WBC) , C-reaction protein ( CRP) , interleu-kin-1β ( IL-1β) , interleukin-10 ( IL-10 ) , interleukin-12 ( IL-12 ) and interleukin-17 ( IL-17 ) as well as the percentage of neutrophils ( N%) in serum samples were detected. The colon tissue samples were collect-ed for pathology examination. Results The rat model of pseudomembranous colitis was successfully estab-lished by subcutaneous injection of clindamycin in combination with toxin-producing Clostridium difficile (ACTT43255) enema. The signs of intestinal inflammation including serious weight loss, remarkably short-ened colon length and significantly increased colon wet weight index were observed in rats from the model group (P<0. 05). Compared with the rats from model group, the rats received fecal transplant showed sig-nificantly increased levels of K, ALB, IL-10 and IL-10/IL-12 in serum and decreased levels of WBC, N%, CRP, IL-1β and IL-17 (P<0. 05). Conclusion Fecal transplantation was proved to be an effective ap-proach for the treatment of pseudomembranous colitis. The therapeutic mechanism might due to its impacts on serum inflammatory factors.

Objective To discuss the clinical results of lateral locking plate combined with bone grafting in the treatment of distal femoral fractures in the elderly.Methods Between January 2006 and December 2013,112 senile patients with distal femoral fracture were treated at our department by lateral locking plate combined with bone grafting.They were 16 men and 96 women,aged from 67 to 85 years (average,76.1 years).By AO classification,48 cases were type 33-A1,11 type 33-A2,3 type 33-A3,7 type 33-B1,4 type 33-B2,32 type 33-C1,and 7 type 33-C2.All of them had a previous history of osteopenia.By the Singh index classification,22 cases were rated as grade Ⅰ,74 as grade Ⅱ,13 as grade Ⅲ,and 3 as grade Ⅳ.Postoperatively,the patients conformed to regular follow-up,accepted functional rehabilitation and continued medication for osteopenia.Radiographic examinations were conducted to observe fracture healing.At the last follow-up,the function of involved knee was assessed according to the criteria by Karlstrom and Olerud.Results All the 112 patients completed their follow-ups,ranging from 10 to 48 months (average,16 months).All fractures united primarily after an average of 4.2 months (range,from 3.5 to 5.0 months).According to the criteria by Karlstrom and Olerud,93 cases were rated as excellent,10 as good and 9 as fair,giving a good-to-excellent rate of 92.0％.No such complications as nonunion,malunion,plate breakage,or screw loosening were observed during the follow-ups.Conclusion Lateral locking plate combined with bone grafting is effective for the treatment of distal femoral fractures in the elderly,if followed by postoperative anti-osteopenia therapy and early functional exercises.

Objective Human bone marrow mesenchymal stem cells were transfected by Smad7 and labeled with green fluores-cent mark.BMMSCs were implanted into rabbit glaucoma operational model and observed surviving condition.Methods Through BP and LR reaction,Smad7 with green fluorescent mark was inserted into human bone marrow mesenchymal stem cells by bacterio-phage,filtered positive colony and picked out cell line.15 New Zealand white rabbits were enforced trabeculectomy with BMMSC, then following up cell survival condition.Results Smad7 expressed stable in human bone marrow mesenchymal stem cells with sat-isfactory green fluorescent mark.BMMSC survived in rabbit trabecula with stable green fluorescent and effective ocular press.Con-clusion Smad7 with green fluorescent mark could be inserted into human bone marrow mesenchymal stem cells stably,and has ef-fective results in rabbit model.

Objective To observe the safety and efficacy of rocuronium rapid sequence induction in patient undergoing laparoscopic cholecystectomy(LC).Methods 100 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups(n =50):control group(group C)and rocuronium rapid sequence induction group (group R).Conventional induction of anesthesia was used in group C,rocuronium rapid sequence induction was used in group R and assisted ventilation was not implemented in the induction process.Oxygen saturation(SpO2 ),partial pressure of oxygen(PaO2 ),carbon dioxide partial pressure(PaO2 ),pH were recored at the condition of breathing air (T0 ),breathing pure oxygen 5 minutes(T1 ),after intubation(T2 )and mechanical ventilation five minutes(T3 ).The grade of the exposure in operation field,the operative time,indwelling of gastric suction tube,the time of no ventilation in group R were recorded,too.Results Compared to T1 time point,PaO2 and pH in group R decreased,but PaCO2 was significantly higher at T2 time point(P <0.05);PaO2 and pH in group R were lower,but PaCO2 was significantly higher than group C at T2 time point(P <0.05).After 5 minutes mechanical ventilation,the PaCO2 and pH in two groups were restored to the preoperative level(P >0.05),but SpO2 and PaO2 were higher than preoperative at every time point(P <0.05).The incidence of Indwelling gastric suction tube is higher in group C than in group R,the grade of exposure in the operation field were better in group R than in group C(P <0.05).Conclusion Application of rocuronium rapid sequence induction technique in laparoscopic cholecystectomy can improve the operative conditions and field,it can be safely used in clinical anesthesia.

Objective To explore the incidence rate and related factors of high intraocular pressure after vitro-retinal surgery for patients with diabetic retinopathy(DRP). Methods The 986 patients(1 326 eyes) with DRP arranged vitro-retinal surgery were studied. The inci-dence rate of intraocular pressure was analyzed between different types,grades,complicated with macular detachment,filled with silicone oil/C3F8,total/supplementary retina photo-coagulation and crystalline lens excision. Results The incidence rate of high intraocular pressure was 27. 8%(368/1 326). The incidence rate of high intraocular pressure of proliferative DRP (34. 0%) was obviously higher than non-pro-liferative DRP (17. 2%)(χ2 =30. 648,P=0. 000),and higher in DRP D grade than B grade(34. 1%,20. 8%)(χ2=8. 834,P=0. 003). The incidence rate of high intraocular pressure of proliferative DRP (34. 0%) was obviously higher in patients complicated with macular de-tachment(30. 4%,22. 7%)(χ2 =8. 834,P=0. 0030). The incidence rate of patients filled with silicone oil/C3F8(39. 1%,24. 0%) (χ2 =28. 088,P=0. 000),total/supplementary retina photo-coagulation(32. 8%,16. 8%) (χ2 =21. 159,P=0. 000),with/without crystal-line lens excision (40. 5%,25. 9%)(χ2=15. 532,P=0. 0001)was different obviously. Conclusion There is a high incidence rate and re-lated factors of high intraocular pressure after vitro-retinal surgery for patients with diabetic retinopathy,and it is related to different DRP types,grades,complicated with macular detachment,filled with silicone oil/C3F8,total/supplementary retina photo-coagulation,crystalline lens excision.

Objective Thoracic cavity fistula following esophagus carcinoma resection is a serious complication with a high mortality.This study aims at a better therapy for thoracic cavity fistula following esophagus carcinoma resection by summarizing the ex-perience with the four-tube strategy ( jejunal fistula tube, stomach tube, chest drainage tube, and nasal fistula tube) in the treatment of the complication. Methods We retrospectively analyzed the clinical data about 62 cases of thoracic cavity fistula following esopha-gus carcinoma resection, 35 treated with the four-tube strategy ( treatment group) and the other 27 with the three-tube ( stomach tube, chest drainage tube, and nasal fistula tube) method ( control group) .We compared the hospital days, wound healing time, mortality, and incidence of anastomotic stenosis at 6 months after operation between the two groups of patients. Results Compared with the controls, the treatment group showed remarkable decreases in the hospital days (P<0.05), wound healing time (P<0.05), and mortality (P<0.05), but no statistically significant difference was observed in the incidence rate of anastomotic stenosis at 6 months after operation between the two groups of patients ( P >0.05 ) . Conclusion Compared with the three-tube method, the four-tube strategy has the advantages of shorter healing time and lower mortali-ty, and therefore is preferable for the treatment of thoracic cavity fis-tula following esophagus carcinoma resection.

In this study, a novel tetrapeptide hydrophilic interaction chromatography (HILIC) material was synthesized, and corresponding enrichment method for glycopeptides was developed.The tetrapeptide modified silica gel materials (denoted as Poly-DAPD) were synthesized by atom-transfer radical-polymerization (ATRP) and characterized by N2 adsorption desorption and thermometer, thermal gravimetric analyzer (TGA) and X-ray photoelectron spectrometer (XPS).The characterization results indicated that tetrapeptide had been successfully synthesized on silica gel.Poly-DAPD materials showed high enrichment selectivity toward fetuin glycopeptides under solid-phase extraction (SPE) mode.Comparing with commercialized ZIC-HILIC in glycopeptides enrichment of fetuin digest which mixed with 5 mole ratio of albumin bovine (BSA), the as-prepared materials showed higher selectivity in both aspects of the identified number of glycopeptides and anti-interference property.The SPE results demonstrated that the tetrapeptide-based HILIC materials could be a potential tool in large-scale glycosylation analysis.