Vitreous retinal interface abnormalities are associated with many macular diseases.The main approach of treatment is to release the vitreomacular adhesion with pars plana vitrectomy.Because of its complication and limitation,researches of pharmacologic posterior vitreous detachment (PVD) were undertaken.Gene recombinant ocriplasmin was proved by several experiments and clinical trials by inducing a complete PVD,showing its promising prospect.This article reviewed the literatures of ocriplasmin,including pathobiology in treatment of vitreomacular adhesion,pharmacokinetics,vitreodynamics,experimental studies and clinical trials and adverse events.

Objective To study the genes of a carbapenem-resistant Klebsiella pneumoniae strain isolated from a patient. Methods The antibiotic sensitivity test of a multidrug-resistant Klebsiella pneumoniae strain was done according to K-B and MIC method. Metallo-β-lactamase was detected by Modified Hodge Test and EDTA-disk synergy test. Both nine genes encoding β-lactamases, including blaKPC, blaIMP , blaVIM , blaSME , blaCTX-M , blaSHV, blaDHA , blaACT, Class Ⅰ integrase and Class Ⅰ integron were detected by PCR. Positive products were sequenced. Results The Klebsiella pneumoniae was resistant to carbapenems, cephalosporins, cefoxitin, ampicillin and trimethoprim/sulfamethoxazole. Only susceptible to aztreonam, gentamicin, tobramycin, amikacin, ciprofloxacin and levofloxacin. The blaIMP-1 and Class Ⅰ integron were positive. The blaIMP gene was identified by PCR and DNA sequencing confirmed that the gene belong to IMP-1 type Metallo-β-lactamase gene. The strain also carried Class Ⅰ integron and IMP-1 was located in Class Ⅰ integron 5'. Conclusions It is the first detection of IMP-1 Metallo-β-lactamase in Klebsiella pneumoniae. The production of IMP-1 carbapenemase is the main mechanism of carbapenem-resistant in Klebsiella pneumoniae, and multidrug resistance is related to ClassⅠ integron.

Objective To discuss the way of treatment of bile duct stone with laparoscope and choledochoscope. Methods Forty six patients with bile duct stones admitted in our hospital from July 2001. to July 2008 were selected in this study. The 46 cases were divided into two groups:the control and observation group.The control group included 22 patients who were performed cholecystectomy and choledochotomy with T tube drainage. The obeservation group included 24 patients who were performed laparoscope and choledochoscope operation.We used the Mann-Whites statistics and compared the incidence of complications, the amount of bleeding and hospitalized days in patients between two groups. When P<0.05, the difference between the two groups was considered statistically significant. Results The incidence of complications after operation, amount of bleeding and hospitalized days in patients had no statistically significant difference between two groups. The time of operation in observation group was longer than control group. The bile stones eradication rate in observation group was higher than control gourp. and the bile stones recurring rate in observation group was lower than control gourp. Conclusion It is better to treat the bile duct stones by using laparoscope with choledochoscope than the way of traditional cholecystectomy and choledochotomy with T tube drainage, the former has advantages such as higher bile duct stones edarication rate, lower recurring rate, safer and more reliable operation and fewer complications.

Objective To explore the change of the activities of peroxisome ?-oxidation in T2DM patients with the lipid disorders.Methods We analyzed the changes of the activities of peroxisome ?-oxidation and fatty acyl-CoA oxidase and its mRNA expression in 112 cases of T2DM patients.Results We found that there was compensatory increase in activity of peroxisome ?-oxidation of T2DM patients.As compared with control group,the activity of fatty acyl-CoA oxidase of T2DM group was increased by 5%(P

BACKGROUND:Electrospinning preparation for the tissue engineering scaffold materials is an extremely promising technology.
OBJECTIVE:To review the progress of electrospinning technology in different fields and its main problems in the current application.
METHODS:We searched Medline and CNKI databases for articles published from 2000 to 2013 using the keywords of“electrospinning, tissue engineering”in English and Chinese.
RESULTS AND CONCLUSION:The structure of non-woven cloth materials made by this technology is similar to the extracel ular matrix, which has high surface area and control able mechanical properties. Electrospinning materials have been widely applied in the tissue engineering field, especial y in the biodegradable materials and high biocompatibility molecular polymer synthesis process. Electrospinning has been developed rapidly in tissue engineering applications, especial y in the choice of materials or electrospinning technique combined with different technologies. Different morphological structures and properties of the materials can be wel combined by using electrospinning technology. A series of new polymers were successful y incorporated into a tissue engineering scaffold as the matrix for cel proliferation and regeneration, but there are some important issues to be solved, including how to control the interaction between the scaffold and the biological system that is to achieve the infiltrative growth of cel s, how to control the pore size, mechanical properties and toxicity. This technology clinical y applied in biomedicine stil requires further research, especial y in vivo studies.

Objective The epidemiology of Acinetobacter baumannii isolates from bloodstream infections,their antibiotic resistance profiles and virulence-associated factors were studied.Methods A total of 90 isolates from 17 hospitals were collected from the patients with bloodstream infections during July 2013 and July 2014.Vitek-2 Compact system was used for identification of the strains and antibiotic susceptibility testing.The epidemiology was studied by pulsed-field gelectrophoresis(PFGE).Drug-resistant genes and associated virulence genes were amplified by PCR.Results According to antimicrobial susceptibility testing,75 isolates are multi-drug resistant Acinetobacter baumannii.PFGE results showed that 75 multi-drug resistant Acinetobacter baumannii isolates belonged to eight clone types(A to H),with the A (n=51)and B (n=14)clone being the dominant PFGE clone types.Different clone isolates spread in different hospitals.Most of the hospitals were given priority to with clone A.Clone A only maintaining high sensitive rate to cefoperazone/sulbactam、amikacin and tigecycline.Virulence gene abaI,cusE,ompA,bap,bfms detection rates are 93.3% (84/90),92.2% (83/90),100.0% (90/90),84.4% (76/90),92.2% (83/90),respectively.There were 7 mucoid isolates,which are all multi-drug resistant Acinetobacter baumannii,all belong to clone B and all associated virulence genes can be detected.Conclusions The dominant clone type of multi-drug resistant Acinetobacter baumannii from bloodstream infections is clone A.The abaI-,bap-and bfms-positive strains are associated with a higher incidence of antibiotic resistance in most types of antimicrobials.The acquisition of mucous type may indicate the emergence of virulent strains,which should be paid attention to during clinical treatment.

Objective To investigate the early diagnostic value and prognostic significance of serum procalcitonin (PCT) in patients with sepsis. Methods Ninety cases between December 2008 and April 2009 were collected. According to the 1991 ACCP/SCCM and 2001 SCCM/ESICM/ACCP/ATS/SIS sepsis diagnosis criteria,they were divided into sepsis group (50 cases), nonbacterial systemic inflammation syndrome group (SIRS group, 17 cases) and control group (23 cases). Sepsis group was divided into two subgroups (survival group and death group) according to 28-day prognosis Dynamic changes of serum PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), and neutrophil count percentage (N) on the 1st, 4th day after admission was monitored,meanwhile, the maximal body temperature was recorded. Results The serum PCT level of sepsis group on the 1st day was higher than that in SIRS group and control group,and the difference was statistically significant [6.68 μg/L(1.16-12.46 μg/L) vs 0.22 μg/L(0.05-0.54 μg/L) vs 0.05 μg/L(0.05-0.27 μg/L), P < 0.05]. The serum PCT level of death group was higher than that in survival group,and the difference was statistically significant[11.89μg/L (10.00-28.67 μg/L) vs 2.44 μg/L(1.11-10.00 μg/L),P<0.05]. In sepsis group,serum PCT was positively correlated with APACHE Ⅱ score(r = 0.511, P = 0.000). The area under the ROC curve of PCT was bigger than that of CRP,WBC,N and ESR. The serum PCT level of survival group gradually decreased to normal level after the therapy,but the serum PCT level of death group didn't decrease significantly. Conclusions Serum PCT is a better biomarker in the early diagnosis of sepsis,and its sensitivity and specificity is superior to other inflammation parameters. It positively correlates with the severity of sepsis and can predict the prognosis.

Aim To study the effect of adiponectin ( APN) on myocardial ischemia reperfusion( IR) injury in diabetic rats and to explore the role of oxidation-an-tioxidation system. Methods Male Sprague Dawley rats were randomly divided into control group( NS) , IR group ( NIR ) , diabetes group ( DS ) , DS + IR group (DIR), DS +APN +IR group(APN). Experimental diabetes was induced in the animals by a single intrap-eritoneal injection of streptozotocin at a dose of 55 mg ·kg-1 . The IR and NIR group were subjected to myo-cardial I/R injury. APN group was administered APN through intravenous injection 10 min before the reper-fusion, the others were administered normal saline. The rats were considered diabetic and used for the study only if their glucose levels were higher than 15 mmol·L-1. Results All the diabetic rats exhibited increased levels of blood glucose and reduction of body weight ( P <0. 05 ) . Compared with those of NS and DS groups, the myocardial infarct size, cardiomyocyte apoptosis, MDA concentration and ROS in NIR and DIR groups were remarkably increased, activities of SOD and NO were decreased(P<0. 05 or P<0. 01). APN decreased oxidative stress product generation and myocardial apoptosis induced by diabetic myocardial I/R injury ( P <0. 05 ) . Conclusion APN exerts pro-tective effect on myocardial I/R injury in diabetic rats through anti-oxidative mechanism.

Objective To investigate the carbapenemases and integrons in imipenem-resistant Acinetobacter baumannii. Methods One hundred and three Acinetobacter baumannii were collected from Janurary 2008 to March 2010 in Tianjin Medical University General Hospital. The identification of strains and antimicrobial susceptibility test were performed by using Vitek-2 compact automatic system. Isolates of imipenem-resistant A. baumannii were screened for carbapenemases by modified Hodge test, improved threedimensional test and 2-mercaptopropionic acid synergy test. Isolates were then subjected to the multiplex PCR targeting genes encoding for OXA type carbapenemases, metallo-β-lactamases (MBLs) and integrases. The variable regions of integrons were amplificated and sequenced. Results Among the 103 isolates, 75 (72. 8% ) demonstrated positive in the modified Hodge test, 80 (77.7%)were positive in the improved three-dimensional test. No MBLs was found in the 2-mercaptopropionic acid synergy test. Eightyfour isolates were positive for blaOXA-51-like, blaOXA-23-like, and intI1; five were positive for blaOXA-51-like and blaOXA-23-like ;eight were positive for blaOXA-51-like and int11 ;two were positive for blaOXA-51-like and blaOXA-24-like ;four were only found positive for blaOXA-51-like. The blaOXA-58-like, IMP-1, VIM-2 and intI2 genes were all negative. Eighty-nine(96. 7% )of the intI1 positive strains owned the variable region. Two different cassettes arrangements were identified within class 1 integrons:81 isolates harbored aacA4-catB8-aadAI (2 300 bp) and 8 harbored aacCl-orX-orfX-orX'-aadAla (3 000 bp ) . Conclusion The presence of OXA-23 carbapenermase and class Ⅰ integrons are correlated with Acinetobacter baumannii resistant to carbapenems and multi-drug resistance.

Objective To compare different susceptibility testing methods of tigecycline against Acinetobacter baumannii and Klebsiella pneumoniae.Methods Fifty carbapenem-resietant A.baumannii (CRAB) strains and 49 K.pneumoniae strains were collected from Tianjin Medical University General Hospital during January and March 2012.Minimum inhibitory concentration (MIC) and inhibitory zone diameters for tigecycline were determined by broth microdilution,Vitek-2,MTS and disk diffusion methods.The results of Vitek-2,MTS and disk diffusion methods were compared with those of broth microdilution method.Results According to FDA standards,the susceptibilities of CRAB and K.pneumoniae to tigecycline determined by broth microdilution,Vitek-2 and MTS were 94.0％/91.8％,68.0％/91.8％ and 90.0％/91.8％,respectively.For CRAB isolates,the essential agreement (EA) and categorical agreement (CA) produced by Vitek-2 and MTS were 94.0％/72.0％ and 92.0％/90.0％.MICs determined by Vitek-2 were 1-2 dilutions higher than the reference method in 33 (66.0％) strains,and those determined by MTS were higher in 16 (32.0％) strains and lower in 11 (22.0％) strains.For K.pneumoniae isolates,the EA/CA produced by Vitek-2 and MTS were 95.9％/98.0％ and 83.7％/91.8％,respectively.MICs determined by Vitek-2 were 1-3 dilutions lower than the reference method in 17 (34.7％) strains,and those determined by MTS were 1-3 dilutions lower than the reference method in 39 (79.6％) strains.None of thetwo methods produced very major error (VME) and major error (ME) against two kinds of isolates.The results were determined by disk diffusion method using different breakpoints according different isolates.For CRAB,using ≥14 mm/≤ 10 mm as breakpoint,CA was 94.0％,which was higher than the breakpoint recommended by Jones et al (≥16 mm/≤12 mm,CA was 82.0％) ; and for K.pneumoniae,using the ≥ 14 mm/≤ 10 mm as breakpoint,CA was 93.9％,higher than the FDA Enterobacteriaceae breakpoint (≥ 19 mm/≤ 14 mm,CA was 67.3％).Conclusion For CRAB strains,MTS produces better consistence with broth microdilution,with several higher or lower MIC results.For K.pneumoniae strains,Vitek-2 has better correlation with reference method,with several lower MIC results.The consistence between disk diffusion method and broth microdilution is comparatively lower,and the breakpoint should be adjusted according to different bacteria.