Background Blepharitis is an induce factor for multiple ocular surface diseases.Research showed that bacteria play an important role in the pathogenesis of blepharitis.To make sure the pathogenic bacteria and effective antimicrobial agents are of clinical significance for the prevention and treatment of blepharitis.Objective The purpose of this study was 1o investigate the bacterial isolates of conjunctival sac secretion and meibomian secretion in the patients with blepharitis and study their in vitro antimicrobial susceptibility.Methods Forty-five patients with anterior blepharitis and 45 cases with posterior blepharitis were included in Beijing Chaoyang Hospital from December 2006 to December 2012,and 45 patients for laser in situ keratomileusis were enrolled in the same period as control group.The secretions of the conjunctival sac and meibomian were collected with sterile cotton swab,and bacterial isolates were cultured in bouillon culture-medium.The number of eyes with different bacteria was examined and calculated.Then the bacteria were switched to blood agar plates,and antimicrobial susceptibility test to erythromycin,gentamicin,tobramycin,rifampin,levofloxacin were performed by M ueller Hinton (M-H) medium paper method.Results The total germiculture positive rates were 81.1％,76.1％ and 65.0％ in the anterior blepharitis group,posterior blepharitis group and the control group,showing a significant difference among them (x2 =12.80,P=0.00).The germiculture positive rates in meibomian secretion were 84.4％ and 78.8％ in the anterior blepharitis group and the posterior blepharitis group,which were significantly higher than 67.8％ in the control group (x2=7.30,P =0.03).There was no statistically significant difference in the germiculture positive rate of conjunctival sac section among the three groups (77.8％,73.3％ and 62.2％) (x2 =5.60,P=0.06).The main bacteria in conjunctival sac secretion and meibomian secretion were staphylococcus epidermidis,staphylococcus aureus and corynebacterium in all the subjects,but streptococcus pneumoniae and gram-negative bacillus were not detected in the control group.Staphylococcus showed the highest susceptibility to gentamicin,tobramycin and rifampicin,with the sensitive rate ＞70％.Corynebacterium was susceptible to various drugs.Streptococcus pneumoniae had susceptibility to erythromycin and tobramycin.However,Gram-negative bacillus was not susceptible to all the drugs above.Conclusions Bacteria participate in the pathogenesis of blepharitis,but the germiculture positive rate,bacterial species and drug susceptibility of bacteria are obviously different between patients with blepharitis and normal population.Reasonable application of antimicrobial agents is important to blepharitis.

Objective To investigate the etiology and clinical features of transient global amnesia.Methods Seven patients diagnosed as transient global amnesia were analyzed by EEG,TCD,MRI or CT examination,five pa- tients analyzed by single photon emission computed tomography(SPECT).EEG and TCD examination were done within 24 hours during the attack.And SPECT,MRI or CT examination were done within 1 week during the at- tack.Results Six patients showed normal EEG,one patient showed a few slow waves;seven patients showed verte- brobasilar ischemia in TCD;six patients showed normal but one patient showed lacunar infarction in brain CT or MRI;five patients showed significant hypoperfusion in different encephalic region in brain SPECT.They were all fol- lowed up for three to tewty-four months respectively,six patients had no recurrence,but one patient recurred one time and the SPECT demonstrated a decreased cerebral blood flow in the left temporal lobe.Conclusion Transient global amnesia patients showed cerebral ischemia.Transient global amnesia may be related to the decrease of rCBF in the temporal lobe or the temporal hippocampus.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

Objective　To study the value of three-dimensional ultrasound imaging (3DUS) in uterus.Methods　The transvaginal 3D images were reconstructed in 32 patients.Results　The rate of satisfactory imaging is 96.6%,the accuracy of diagnosing uterine anomalies and localizing uterus leison is 100% and 96.6%,respectively.Conclusions　3DUS is of great value in diagnosing uterine anomalies and localizing uterus lesion.

Objective To study the curative efficacy of dydrogesterone in treatment of Climacteric syndrome and its effects on sex hormone, blood fat.Methods104 patients of Climacteric syndrome who received therapy from February 2014 to November 2016 in our hospital were selected as research objects, according to different divided into observation group and control group, treatment group used to bend progesterone therapy, the control group using a placebo.one month after treatment to observe the two groups of clinical curative effect, compare two groups before and after the treatment and testing level of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH),total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C).ResultsAfter treatment, the clinical total effective rate in the two groups to compare have no significant difference;Compared with before treatment, the control group in estrogen level and blood lipid levels in patients with no significant change, the observation group of patients with E2 and HDL-C level increased significantly, and significantly higher than the control group (P<0.05);FSH, LH, TC, TG, LDL levels significantly decreased, and significantly lower than the control group (P<0.05).ConclusionUsing of dydrogesterone short time the clinical curative effect of treatment of menopausal syndrome with placebo, but can effectively improve patient sex hormone levels, adjust blood lipid levels, to reduce the incidence of cardiovascular disease (CVD) patients, improve their quality of life.

Objective Sphingosine kinase 1 (SPK1) has been identified as a central mediator of ischemia preconditioning, and it has been shown to protect reactive oxygen species (ROS)-induced cardiomyocytes death. The present study aims at investigating the protective effects of adenovirus-mediated sphingosine kinase 1 gene (Ad-SPK1) transfer on ischemia-reperfusion induced cardiac injury. Methods Wistar rats were anesthetized and a left thoracotomy was performed. About 5?108 PFU of Ad-SPK1 in total volume of 100?l was injected intramyocardially into four separate sites of the left ventricular wall with a 30-gauge needle. The control rats received the same injection of adenovirus carrying green fluorescent protein gene (Ad-GFP). Three days later, hearts were isolated and subjected to ischemia/reperfusion (I/R) (30min/30min) ex vivo. Heart performance was evaluated by measuring the left ventricular systolic pressure (LVSP) and left ventricular end-diastolic pressure (LVEDP). The incidence of arrhythmia was recorded. Cardiomyocyte viability was detected by the detection of the release of creatine kinase (CK). The cardiac SPK1 activity was measured using an enzyme method. The forced and the total SKP1 expression was analyzed by immunoblotting with anti-FLAG and anti-SPK1 antibodies. Results The cardiac SPK1 activity was increased by about five-fold by injection of Ad-SPK1, compared to Ad-GFP control group. A more potent performance and a lower incidence of arrhythmia were observed in Ad-SPK1-injected hearts during the reperfusion period, compared with Ad-GFP-injected ones. Enzymatic activity assay showed that creatine kinase release was also less in Ad-SPK1-injected hearts. Conclusion Adenovirus-mediated SPK1 gene transfer efficiently protects heart from injury induced by ischemia-reperfusion.

Objective To investigate the refraction change and nursing character in myopic amblyopia during the perceptual learning treatment. Methods Refraction of 54 children (98 eyes) with myopic amblyopes were selected,which were selected from the amblyopia clinic between 2007 and 2009, the spherical diopter, astigmatism and spherical equivalent were collected before and after perceptual learning,the refractive dynamic was compared according to the degree of amblyopia. Results The spherical average annual growth of myopic amblyopia during treatment was 0.52D, the growth of astigmatism was 0.03D;the spherical equivalent average annual growth was less than 0.50D accounted for 57.14%. The dynamic changes of spherical or SE of mild, moderate and severe amblyopia had significant difference, but the cylinder had not significant difference in change. Conclusions The treatment of perceptual learning in patients has little effect on the growth of refraction in myopic amblyopia, however, it is still necessary to pay close attention to refraction changes of in myopic amblyopia in the course of treatment.

Brain Concussion ; complications ; Hearing ; Hearing Disorders ; prevention & control ; Humans ; Thioctic Acid ; therapeutic use

Objective:To conduct health economic evaluation of Chinese population-based screening and opportunistic testing strategies for the prevention of Helicobacter pylori ( H. pylori)-related diseases. Methods:The Markov models of H.pylori infection caused non-ulcer dyspepsia, peptic ulcer (PU) and gastric cancer were established. The cost and effects of the population-based screening, opportunistic testing, and non-intervention strategies in 100 000 population of our country were simulation calculated. Wilcoxon signed rank test was used for statistic analysis. Single factor sensitivity analysis was performed to analyze the impact of single parameter uncertainty on cost-effectiveness. Probability sensitivity was used to analyze the impact of common uncertainty of all parameters on cost-effectiveness. Results:Compared with opportunistic testing strategy and non-intervention strategy, the total cost of population-based screening strategy was reduced by 0.43 million yuan(-6.63 million yuan to 7.19 million yuan) and 4.45 million yuan(-8.60 million yuan to 27.93 million yuan), quality adjusted life years (QALY), life years and asmptomatic months were prolonged by 888.00 (479.86 to 1 574.10) and 3 032.78 (1 756.04 to 5 007.84), 651.82 (294.73 to 1 211.94) and 1 868.64 (1 045.88 to 3 148.34), 28 381.91 (19 109.54 to 43 736.72)and 102 537.13 (58 649.18 to 176 868.77) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 115 cases(52 cases to 232 cases) and 464 cases(266 cases to 803 cases), 74 cases(33 cases to 148 cases) and 260 cases(149 cases to 453 cases), 46 cases(25 cases to 72 cases) and 369 cases(210 cases to 710 cases), 80 cases(42 cases to 126 cases) and 501 cases(331 cases to 772 cases) respectively, and the differences were statistically significant ( Z=1.99, 10.54, 27.39, 27.39, 27.37, 27.39, 27.39, 27.39, 27.21, 27.28, 27.22, 27.28, 27.38, 27.39, 27.39 and 27.39, all P<0.05). Compared with the non-intervention strategy, the opportunistic testing strategy reduced the total cost by 3.89 million yuan(-2.79 million yuan to 18.18 million yuan), QALY, life years and asymptomatic months were prolonged by 1 764.77 (888.70 to 3 406.62), 1 044.16 (524.46 to 1 912.75) and 62 568.69 (30 054.07 to 129 892.76) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 311 cases(164 cases to 563 cases), 164 cases (87 cases to 301 cases), 325 cases(162 cases to 644 cases) and 399 cases(234 cases to 684 cases) respectively, and the differences were statistically significant ( Z=14.20, 27.39, 27.38, 27.39, 27.25, 27.25, 27.39 and 27.39, all P<0.01). The results of singlefactor sensitivity analysis showed that the uncertainty of any parameter did not affect the cost-effectiveness of three strategies. The results of probability sensitivity analysis indicated that the probability of cost-effectiveness advantage of the population-based screening strategy was 100% and the common uncertainty of all parameters had no effect on cost-effectiveness. Conclusions:For preventing H.pylori-related diseases, the population-based screening strategy has the lowest average cost and the best average effect. However, non-intervention strategy has the highest average cost and the worst average effect. Population-based screening strategy is worthy of promotion throughout China, and opportunistic testing strategy has a higher clinical practical value.

0.05). The morphological changes were observed in the cochlea. Moreover, the changes of cochlear tissues under the optical microscope wasa lot of akaryotes were found in the blood capillary of cartilaginous tissue in the rats of 30 minutes after rammed; a great quantity inflammatory cells were observed in the blood capillary of cartilaginous tissue in the rats of 1 day rammed. The changes of morphology coincided with the results of DPOAE. CONCLUSION Outer hair cells may be injured by cerebral concussion and the changes were showed by DPOAE and ABR.