Mathematics ; Models, Theoretical ; Occupational Health Services ; organization & administration ; Risk Assessment ; methods

Background and purpose:Studies have shown that ribosomal protein L8 (RPL8) is shared by melanomas, gliomas and ovarian carcinomas. A peptide of RPL8 signiifcantly stimulated proliferation and cytokine expression of the hepler T cell clone and lymphocytes in melanoma patients. RPL8 may stimulate anti-tumor immunity, making RPL8 an attractive candidate for therapeutic intervention. In this study, we prepared DC pulsed by RPL8 (RPL8-DC) and investigate the anti-tumor effect of RPL8-DC on melanoma in mice.Methods: The recombinant protein was achieved through IPTG induction in E. coli and identiifed with Western blot. Bone marrow-derived DC was loaded with RPL8 protein. RPL8 and CD11c, CD80, MHC-Ⅰ, MHC-Ⅱmolecules on dentritic cells were monitored by lfuorescence microscope and FACS analysis, respectively. The anti-tumor effect of T cells in vitro was detected by MTT assay. Subcutaneous tumors were induced in C57BL/6 mice using B16 cells. The tumor volumes were measured after injection with RPL8-DC. Results:The puriifed protein was combined with speciifc antibodies. DCs pulsed by RPL8 were visualized under lfuorescent microscopy. CD11c, CD80, MHC-Ⅰ, MHC-Ⅱmolecules on DCs were up-regulated after stimulation with RPL8 and LPS. B16 cells were inhibited by T cells stimulated with RPL8-DC. The inhibition rate of tumor cells was 70%in RPL8-DC group when effector-to-target ratio was 30∶1, which was higher than PBS and DC groups. Inhibition of growth could be observed more signiifcantly in mice after the treatment with RPL8-DC. The mice receiving the therapy of RPL8-DC were able to survive much longer than the mice receiving control therapy. Conclusion:The DC pulsed by RPL8 protein can inhibit the growth of melanoma.

A bacterium that contains a chitin deacetylase has been isolated from ocean soil. It has been identified Baciluus .The best suitable condition of producing this enzyme is that pH is 4.0,35℃,and the incubate time is 80 hours in the present of Ca 2+ as well as having no chitosan. The best temperature of this enzyme when it acts is 40℃～50℃ and the best pH range is 4.5～5.0.

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

Objective:Acute retinal necrosis syndrome(ARNS) is a rare disease with high blinding rate.The surgery of vitrectomy,endolaser photocoagulation and silicone oil injection is considered an effective treatment of ARNS.The study investigated the effect of vitrectomy,endolaser photocoagulation and silicone oil injection treating ARNS.Methods:A consecutive 16 eyes of 16 patients with ARNS were treated with vitrectomy,endolaser photocoagulation and silicone oil injection.The 5 eyes without retinal detachment were photocoagulated from the posterior border of necrosis to the ora serrata.The 11 eyes with retinal detachment were treated with subtotal retinal photocoagulation,air/fluid exchange and silicone oil injection.The follow-up time were 6 months at least,16 months in average.Results:The final best-correcting visual acuity was counting fingers in 3 eyes(18.8%),0.02-0.3 in 7 eyes(43.8%),0.4-0.6 in 5 eyes(31.3%),0.7 in 1 eye(6.3%).The silicone oil was uneventfully removed in 14 patients(87.5%) from 3 to 12 months.No one had a recurrent retinal detachment.Conclusion:There is a favorable effect in ARNS with the treatment of vitrectomy,endolaser photocoagulation and silicone oil injection.

Objective Deletion detection of Duchenne muscular dystrophy(DMD).Methods Totally 135 patients were tested through polymerase reaction of amplification with 12 dystrophin exons,polyacrylamide gel electrophoresis make gene analysis.Results The deletion of different region was found in 54 patients.Conclusion The deletion region is concentrated in 45～53 exons,the deletion of 48 exons is the peak.

Objective To investigate the effect and mechanism of exogenous leptin on liver injury in severe acute pancreatitis rat .Methods Thirty male SD rats were randomly divided into the sham operation group ,SAP group and leptin intervention group . The SAP rat models was established by retrograde injection of 3 .5% sodium taurocholate into the biliopancreatic duct .The leptin intervention group was intraperitoneally injected with leptin 20 μg/kg .The rats in each group were sacrificed at 12 h after model‐ing .The pancreas and liver tissues were taken for HE staining and detecting the nuclear factor kappa B (NF‐κB) .The cell apoptosis in situ labeling method was adopted for detecting the liver tissue cell apoptosis index .ALT ,AST and AMY were detected . Results Compared with the sham operation group ,the liver tissue pathology score in SAP group and leptin intervention group were significantly increased(P<0 .05) .The liver tissue pathology scores in the leptin intervention group were lower than those in the SAP group(P<0 .05) .The NF‐κB expression of liver tissue in the SAP group and leptin intervention group was obviously increased compared with the sham operation group ,the expression in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .The liver cell apoptosis index in the leptin intervention group and SAP group was significantly higher than that in the sham operation group (P<0 .05) ,and which leptin intervention group was decreased compared with the SAP group (P<0 .05) . The results of ALT ,AST and AMY in the SAP group and leptin intervention group were increased significantly compared with the sham operation group(P<0 .05) ,while which in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .Conclusion The exogenous leptin may play the protective effect on SAP complicating liver damage by lowering the liver tis‐sue NF‐κB expression and reducing the liver cell apoptosis index .

High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.