Neuro-ophthalmology,as an interdisciplinary,covers ophthalmology,neurology and neurosurgery.In China,the development of neuro-ophthalmology has just started,therefore how to train neuro-ophthalmological specialists in China is a problen.This paper analyzed the medical education and current situation of neuro-ophthalmology of China and America,discussed the differences between them,and then put forward some problems existing in the neurological ophthalmology physician training and solutions,aiming at improving the specialist physician train program of Neuro-ophthalmology by learing from foreign medical education development experience,and promoting the development of neuro-ophthalmology in China.

BACKGROUND: The tissue engineered corneal epithelium can be constructed with limbal stem cells of healthy rabbit cornea cultured in vitro, and its transplantation may promote the repair and healing of corneal alkaline burn.OBJECTIVE: To probe the effect and opportunity of treating corneal alkaline bum by tissue-engineered corneal epithelium transplantation.DESIGN, TIME AND SETTING: Controlled observational animal experiment was performed in the Department of Experimental Animal at the First Affiliated Hospital of Chinese PLA General Hospital between July 2007 and June 2008.MATERIALS: Twenty-one New Zealand female white rabbits, weighing 2.0-2.5 kg, were divided into control group (n=8, 16 eyes) and transplantation group (n=13, 26 eyes) at random. The transplantation group was further assigned into early transplantation group at 1 day (n=2, 4 eyes), 3 days (n=3, 6 eyes), 6 days (n=6, 12 eyes), and 9 days (n=9, 18 eyes); and mataphase transplantation group at 14 days (n=3, 6 eyes).METHODS: The tissue-engineered corneal epithelium was prepared on 21 rabbits with limbal stem cells cultured in vitro, and reforming comeel alkaline burn models of double eyes were induced by 1 mollL NaOH. The autotogous or allogenic tissue-engineered comeal epithelium transplantation was conducted on early time points (1, 3, 6, 9 days) or metaphase (14 days) after alkaline burning. In the control group, the burns were observed for 4 consecutive weeks.MAIN OUTCOME MEASURES: The ocular surface integrity and histopathology in the transplantation group and control group were observed on several time points within 4 weeks.RESULTS: At 1 weak after corneal alkaline burning, large corneal epithelial dasquamation occurred, 72% incidence of epithelial desquamation or corneal ulcer at 2 weeks, and continued to 4 weeks, while only 25% were observed at 4 weeks in transplantation group, most gained ocular surface integrity; cell infiltration and vascularization of corneal stroma had not bean suppressed in metaphase transplantation group, while they were suppressed obviously in the deep comeal stroma in early transplantation groups; Within 4 weeks, immunological rejection induced by allogenic transplantation was not greater than that of autologous transplantation.CONCLUSION: Cultivated autologous or allogenic tissue-engineered corneal epithelium transplantation could recover ocular surface integrity as soon as possible, and the effect of early transplantation surpasses that of mstaphase.

BACKGROUND: Up to now, the research on the mortality rate of hip fracture after operation mainly focuses on 30 days to 1 year and longer. However, there are few studies on early postoperative mortality of hip fracture. OBJECTIVE: To compare the differences between survived and dead patients at 72 hours after surgery, and to explore the risk factors associated with 72-hour postoperative mortality in hip fracture patients. METHODS: Clinical data of 2 811 hip fracture patients admitted to Zhujiang Hospital of Southern Medical University from January 2013 to December 2018 were retrospectively analyzed, including surgical treatment and conservative treatment. The patient's age ranged from 15 to 101 years old. This study compared the differences between the survival group and death group within 72 hours after surgery. According to the outcome, the patients were divided into survival group and death group. The patient's medical records were collected, including gender, age, preoperative ASA classification, preoperative walking ability score, preoperative cognitive level, whether to take anticoagulants orally, fracture classification, operation mode, internal plant species, operation time, blood transfusion volume, anesthesia mode, and postoperative complications. The diagnosis of each observation factor was based on the clinical diagnosis of medical records. The survival status, cause of death, intraoperative and postoperative complications were recorded within 72 hours after operation. The patients were followed up by telephone within half a year after operation. RESULTS AND CONCLUSION: (1) Forty-seven patients received conservative treatment, and 1 patient died 24 hours after admission; totally 2 764 patients were included in the study. (2) The average age was 72.5 years, including 2 035 females and 729 males. The mortality rate within 72 hours after operation was about 0.90% (25 patients). (3) In the 72-hour postoperatively death group, the proportion of patients with advanced age, ASA grade 3 or above, pre-traumatic walking ability limitation and cognitive impairment was higher (P < 0.05). (4) In the 72-hour survival group, more patients received surgical treatment within 48 hours of injury (P < 0.05). (5) The incidence of implant-related complications was higher in the death group than in the survival group, but the difference between the two groups was not statistically significant (P > 0.05). (6) In conclusion, great attention has been paid to the optimization of the management of patients undergoing hip fracture surgery and its concomitant effect on survival. Our study found that the increased risk of death within 72 hours after hip fracture surgery is associated with advanced age, ASA grade 3 or above, limited walking ability before injury, cognitive impairment and more than 48 hours after injury; however, it is not related to the type of implant of the patient. The information provided in this study can be used to assess patients with the highest risk of death within 72 hours after surgery. On the basis of this study, it may be necessary to further collect multi-center, more detailed data to assess the impact of various factors on the postoperative mortality of hip fracture patients, and to identify high-risk factors affecting the early postoperative mortality.

OBJECTIVE：To de termine unknown impurities in Cefprozil suspension ，and to identify its structure. METHODS ： LC-HR-MS/MS method was used to detect and identify unknown impurities in Cefprozil suspension. The determination was performed on Thermo HyPURITY TM C18 with mobile phase consisted of acetonitrile- 0.013％ formic acid solution （gradient elution ） at the flow rate of 1.0 mL/min. The detection wavelength was set at 230 nm，and column temperature was 40 ℃. The sample size was 20 μL. ESI+ full scanning was carried out with electrospray ion source scanning range was mass-charge ratio （m/z）100-1 500 with spray voltage of 3.8 kV，metal capillary temperature of 320 ℃，sheath gas pressure of 60 Arb，auxiliary gas pressure of 10 Arb，spray temperature of 280 ℃. RESULTS ：Under this condition ，the detection limit of impurity K was 0.202 μg/mL. RSDs of precision and reproducibility tests were both lower than 4％. Three unknown impurities were found around impurity K ，which were isomers of each other. The retention time of ions were 17.83-19.31 min，and the secondary parent ion were all m/z 436.150 0[M+ H]+，which may be the product of ring opening and dehydration of cefpropene. CONCLUSIONS ：Three unknown impurities near impurity K in Cefprozil suspension were detected by this method.

Animals ; Hypoxia ; classification ; metabolism ; Male ; Oxygen Consumption ; Rats ; Rats, Sprague-Dawley

Objective To explore the correlation between the expression of protease activated receptors-2 (PAR-2) and intestinal mucosal barrier injury of acute necrotizing pancreatitis (ANP) in rats.Methods The ANP rat model was created.The expression of PAR-2 in rat's intestinal mucosa of sham-operated group and ANP group at six,12 and 24 hours after model established was detected by immunohistochemistry (IHC),reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.The difference between groups was analyzed by one way analysis of variance.Results The results of IHC indicated that PAR-2 expression in rat's intestinal mucosa of sham-operated group was weak.The number of PAR-2 expression positive cells and immunostaining intensity increased significantly after ANP model established.The IHC score was 4.88±0.33,5.87±0.32 and 11.17±0.27 at six,12 and 24 hours after model established respectively.Compared with those of shamoperated group (2.86 ± 0.31),the differences were statistically significant (F=747.08,P＜0.01).The expression of PAR-2 at mRNA and protein level in intestinal mucosa of sham-operated group was very low.As time extended after ANP model established,both expression increased gradually.The PAR-2 mRNA was 0.56±0.03,0.69±0.03,1.05±0.05,and the protein was 0.28±0.02,0.35±0.03,0.69±0.04 at six,12 and 24 hours after model established respectively.Compared with shamoperated group,the differences were statistically significant at each time point (F=785.69,1177.82,both P＜0.01).Conclusions PAR-2 is activated in the inflammatory progress of ANP,and may play an important role in the pathogenesis and development of intestinal mucosa barrier injury in ANP.

Objective To investigate an economic and practical modality for the all-round rehabilitation of children with cerebral palsy(CP).Methods The six-in-one rehabilitation approach was designed according to the principal of modern rehabilitation and conductive education.It was mainly conducted through physical therapy,occupational therapy,speech therapy,sensory integration,supplemented with individual education and a self-originated "movement rehabilitation exercise".50 CP children were treated with this approach.Results After one period of treatment by six-in-one approach,the movement function,language ability and cognitive ability of those CP children improved tremendously.The children also got much progress in sociality and activities of daily living(ADL).The effective rate of rehabilitation reached 90%～96%.Conclusion The CP children have benefited variously in areas of language,movement,cognition,behavior,sociality and ADL from six-in-one approach,which requires small financial contribution from family and is cost-effective to the rehabilitation center.It is a new approach for all-round CP children rehabilitation,which can be adopted by small and middle sized rehabilitating institution and community rehabilitation,especially for those poor families CP children more than 3 years old.

Animals ; Hepatitis B virus ; physiology ; Humans ; Liver Cirrhosis ; virology ; Peroxisome Proliferator-Activated Receptors ; classification ; metabolism ; physiology ; Transcription Factors ; metabolism ; Virus Replication

OBJECTIVETo observe the effect of natural type ginsenoside Rg2 (Rg2) and its stereoisomers [20 (R)-Rg2 and 20 (S)-Rg2] at different concentrations on oxygen-glucose deprivation/ reperfusion (OGD/R) induced cortical neuronal injury model in vitro, and to explore the mechanism, and compare their differences of action.

METHODSCortical neurons after 7-day culture were randomly divided into 5 groups, i.e., the control group, the model group, the Rg2 group, 20 (R) -Rg2 group, and 20 (S) - Rg2 group. Cortical neurons in the Rg2 group, 20 (R)-Rg2 group, and 20(S)-Rg2 group were pretreated with 20, 40, and 80 μmol/L Rg2, 20 (R) -Rg2, and 20 (S) -Rg2 for 24 h to prepare OGD/R model. The cell survival rate, the activity of Caspase-3, the intracellular Ca2+ concentration, contents of superoxide dismutase (SOD) and malondialdehyde (MDA) were detected 24 h later.

RESULTSCompared with the control group, cell survival rates and activities of SOD obviously decreased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly increased with statistical difference (P < 0.05). Compared with the model group, cell survival rates and activities of SOD obviously increased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly decreased in 20 μmol/L Rg2 group, 40 μmol/L 20 (R) -Rg2 group, and 80 μmol/L 20 (S) -Rg2 group (P < 0.05). Compared with 20(S)-Rg2 group, cell survival rates increased and contents of MDA significantly decreased in 20, 40, and 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). The activity of Caspase-3 decreased and contents of SOD increased in 80 μmol/L 20 (R)-Rg2 group, and 40, 80 μmol/L Rg2 groups (P < 0.05). Ca2+ fluorescent optical gray value decreased in 40, 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). Compared with 20 (R)-Rg2 group, Ca2+ fluorescent optical gray value decreased in 80 μmol/L Rg2 group (P < 0.05); contents of SOD increased in 40 and 80 μmol/L Rg2 groups (P < 0.05); contents of MDA decreased in 20, 40, and 80 μmol/L Rg2 groups (P < 0.05).

CONCLUSIONSRg2 and its stereoisomers could improve cell vitality of cortical neurons against OGD/R induced injury. This might be related to improving anti-apoptotic capacities and antioxidant abilities, and reducing Ca2+ inflow. Besides, the neuroprotective effect of 20 (R) -Rg2 was better than that of 20 (S) -Rg2, but inferior to that of Rg2.

Antioxidants ; metabolism ; Apoptosis ; Calcium ; metabolism ; Caspase 3 ; metabolism ; Cell Survival ; Cells, Cultured ; Ginsenosides ; pharmacology ; Glucose ; Humans ; Malondialdehyde ; metabolism ; Neurons ; drug effects ; Neuroprotective Agents ; pharmacology ; Oxygen ; Random Allocation ; Reperfusion Injury ; Stereoisomerism ; Superoxide Dismutase ; metabolism

OBJECTIVETo observe the coronary vessel lumen diameter and bifurcation angle in subjects with normal CT coronary angiography (CTCA) imaging.

METHODS64-row CT coronary angiography imaging from 526 adult people with excellent image quality and normal vascular image were analyzed in this study. The lumen diameter from the origin to distal with 2 mm lumen of left main coronary artery (LM), anterior descending branch (LAD), left circumflex branch (LCX) and right coronary artery (RCA) was measured at 1 cm interval in CPR image. The vascular tapered ratio was calculated. The bifurcation angle in the diagonal branch, obtuse marginal branch, posterior descending branch, acute marginal branch as well as the origin diameter was also measured in VR image.

RESULTSThe LAD average length was 13 cm and lumen diameter was 3.92 mm at origin and 2.10 mm at distal. The average decremented ratio of LAD was 7.7% (male 7.0%, female 8.4%). The maximal decremented ratio 8.0% - 10.0% occurred at 3 - 5 cm apart from the origin of LAD. The LCX average length was 13 cm and lumen diameter was 3.57 mm at origin and 2.10 mm at distal. The average decremented ratio of LCX was 9.7% (male 9.6%, female 9.7%). Lumen decremented ratio was less than 3.0% between origin and proximal 3 cm and 8.3% - 10.7% in the rest portion of the LCX. The RCA average length was 18 cm and lumen diameter was 3.97 mm at origin and 2.15 mm at distal. The average decremented ratio of RCA was 5.1% (male 4.9%, female 5.3%). The decremented ratio of RCR was less than 4.0% between origin and proximal 10 cm and 6.1% - 15.2% in the rest portion. The bifurcation angle was 50, 55, 66 and 76 degree for LAD with diagonal branch, LCX with obtuse marginal branch, RCA with posterior descending branch and RCA with obtuse marginal branch respectively.

CONCLUSIONCoronary artery length, lumen diameter and decremented ratio as well as bifurcation angel could be identified in 64 row CTCA image in vivo. This information could help us to understand the in vivo coronary artery anatomy.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Stenosis ; diagnostic imaging ; Coronary Vessels ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed