AIM: To investigate the incidence of trachoma in children aged 1 to 9y in Hainan Province and determine high-risk trachoma endemic and non-endemic areas in Hainan, and thus provide evidence for developing trachoma control and prevention therapy.METHODS:The areas of investigation were chosen on the basis of past literatures, expert interviews and survey on the spot.In 2013, Hainan Provincial Office of Blindness Prevention carried out the survey in 7 counties including Dongfang City, Wuzhishan City, Ledong County, Baisha County, Baoting County, Lingao County and Changjiang County.In these districts, 356 pupils including 192 boys and 164 girls were examined, their age ranging from 1 to 9 and their average age being 7 years old.The targeted students received the trachoma rapid assessment by the adoption of simplified trachoma classification system which was recommended by the World Health Organization.RESULTS: No case of active trachoma was found among the 356 students.CONCLUSION:The prevalence rate of trachoma in children under 9 years is less than 5% in Hainan Province.Active trachoma is not a public health issue in Hainan Province.

Advances in mechanism and application of the heating effect in breeding of microorganism are reviewed in this paper. Heat produces mutagenesis effect and screening effect. Heating mutagenesis effect is occurred through the substitution of G-C base pair induced by heat, and heating screening effect produces higher forward mutation rate induced by other mutagens.

Objecfive To investigate antibiotic resistance,carbapenemase genotype and the molecular epidemiology of multidrug-resistant Acinetobacter baumannii (Aba) collected from 3 military hospitals in China.Methotis The minimum inhibitory concentrations (MIC) were examined by ager dilution method.Genotypes of carbapenemases were amplified by multiplex PCR and its products were sequenced.PCR was used to detect per gene,Homology of the resistant isolates was analyzed by pulse-field gel electrophoresis(PFGE).Results Among the 64 MDRA strains,78.1%(50)strains possessed blaOXA-23 gene,89.1%(57) carried Class 1 integrase gene,39.1% (25) with blaPER-1 gene,and 1 strain with blaOXA-58-like gene.PFGE showed that 13(A,B,C,D,E genotype) different clones were identified in these strains.A,B,and U clones were the predominant clones in three hospitals,respectitively.Conclusion OutbreaEs of muitidrug-rcsistant Aba occurred at 3 military hospitals with the most prevalent carbapenemase as OXA-23 enzyme.OXA-58 type of carbapenemase and per-1 in Aba were also isolated.

?AlM: To investigate repeatability and accuracy of a latest Keratograph for evaluating the tear film stability and to compare its measurements with that of traditional examination methods.
?METHODS: The results of noninvasive tear film break-up time ( Nl-BUT ) including the first tear film break-up time ( BUT-f ) and the average tear film break-up time ( BUT - ave ) were measured by Keratograph. The repeatability of the measurements was evaluated by coefficient of variation ( CV ) and intraclass correlation coefficient ( lCC) . Wilcoxon Signed-Rank test was used to compare Nl-BUT with fluorescein tear film break-up time ( FBUT) to confirm the correlation between Nl-BUT and FBUT, Schirmer l test values. Bland-Altman analysis was used to evaluate consistency.
?RESULTS: The study recruited 48 subjects ( 48 eyes ) (mean age 38. 7±15. 2 years). The CV and lCC of BUT-f were respectively 12. 6% and 0. 95, those of BUT-ave were 9. 8% and 0. 96. The value of BUT-f was lower than that of FBUT. The difference had statistical significance ( 6. 16±2. 46s vs 7. 46±1. 92s, P<0. 01). There was significant positive correlation between Nl-BUT and FBUT, Schirmer l test values ( P< 0. 01 ). The scope of 95% limits of agreement (LoA) was 4. 46s in BUT-f and FBUT, while the scope of LoA was 3. 64s in BUT-ave and FBUT.
?CONCLUSlON: Keratograph can provide Nl-BUT data that has a better repeatability and reliability, which has great application prospects in diagnosis and treatment of dry eye and refractive corneal surgery.

OBJECTIVETo study the mode of transmission and molecular characteristics on carbapenem-resistant Acinetobacter baumannii strain. Strains were isolated from different parts of samples in various patients.

METHODSClinical information of carbapenem-resistant Acinetobacter baumannii isolates were stored and analyzed by WHONET 5.4 software. The transmission and pathopoiesis of the strains were learned through case file review. Genotypes of isolates were identified by pulse-field gel electrophoresis (PFGE) and genes of carbapenemase were detected by multiple PCR, in order to find molecular characteristics and relatedness between strains.

RESULTS29 stains of Acinetobacter baumannii resistant to carbapenem were isolated from 2 or more kinds of samples among 13 patients'. Two genotypes were identified by PFGE: genotype A was obtained from 22 isolates in 11 patients and genotype B was obtained from 7 isolates in 4 patients. PCR amplification showed that all strains possessed OXA-23 gene except 1, and all strains possessed Integrase gene I except 3.

CONCLUSIONThere were 2 different genotypes from 29 strains of carbapenem-resistant Acinetobacter baumannii with Genotype A as the main type. OXA-23 carbapenemase gene and integrase gene I were detected from most of the isolates. All the strains could be easily transmitted in the body of the patients and among patients, hence becoming the epidemic pathogen of iatrogenic infection.

Acinetobacter Infections ; microbiology ; transmission ; Acinetobacter baumannii ; classification ; drug effects ; genetics ; Carbapenems ; pharmacology ; Cross Infection ; microbiology ; transmission ; Drug Resistance, Bacterial ; genetics ; Genotype ; Humans

OBJECTIVEThe history of clinical application of extracorporeal membrane oxygenation (ECMO) has been more than 30 years. But in China, there were only a few ECMO centers with limited successful cases reported by the end of twentieth century. The high morbidities and mortalities in current pediatric ECMO practice are noted in China. Therefore, it is necessary to review the experience on rescue use of ECMO in critically ill pediatric patients.

METHODA retrospective analysis was done for patients who had been receiving ECMO treatment to rescue refractory cardiorespiratory failure from different causes in a hospital between July 2007 and May 2011.

RESULTA total of 12 patients were treated with ECMO; 7 of them were male and 5 female, they aged 6 days to 11 years, weighed 2.8 - 35 (17.21 ± 11.64) kg. The underlying causes of cardiorespiratory failure were as follows: two cases with acute respiratory distress syndrome (ARDS) leading to respiratory failure, 4 with failure of weaning from cardiopulmonary bypass, 3 with fulminant myocarditis, 1 with right ventricular cardiomyopathy leading to repeated cardiac arrest, 1 with preoperative severe hypoxemia, and 1 with anaphylactic shock complicated with massive pulmonary hemorrhage and severe hypoxemia. Of the 12 cases, 3 were established ECMO (E-CPR) while underwent chest compression cardiopulmonary resuscitation (CPR). The mean ECMO support time was 151.75 (15 - 572) h. Seven patients (58.33%) were weaned from ECMO, 6 patients (50.00%) were successfully discharged. Six cases had bleeding from sutures, 2 cases with severe bleeding underwent thoracotomy hemostasis, 2 presented with acute renal failure. Infection was documented in 3 cases, hyperbilirubinemia in 2 cases, lower limb ischemia in 1 case, hyperglycemia in 3 cases, disseminated intravascular coagulation in 1 case, membrane lung leakage in 2 cases, systemic hemolysis in 3 cases, oxygenator failure in 2 cases and oxygenator thrombosis in one case. During the follow-up between 6 months and 4.5 years, 5 patients survived with good quality of life, without any documented central nervous system disorders. One case survived with the right lower extremity disorder from ischemic damage. His motor function has been improved following orthopedic operation at one year after discharge.

CONCLUSIONECMO is a justifiable alternative treatment for reversible severe cardiopulmonary failure in critically ill children.

Cardiac Output, Low ; etiology ; therapy ; Cause of Death ; Child ; Child, Preschool ; Critical Illness ; mortality ; therapy ; Extracorporeal Membrane Oxygenation ; adverse effects ; Female ; Heart Failure ; etiology ; mortality ; therapy ; Hemorrhage ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; mortality ; therapy ; Respiratory Insufficiency ; etiology ; mortality ; therapy ; Retrospective Studies ; Survival Analysis ; Thrombosis ; epidemiology ; etiology ; Treatment Outcome

OBJECTIVETo evaluate the application of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB).

METHODSClinical data of 29 patients with type 2 diabetes mellitus (T2DM) undergoing side to side anastomosis of the lesser curvature of stomach and jejunum in LRYGB from May 2012 to November 2012 in Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University were analyzed retrospectively.

RESULTSAll the procedures were successfully completed without conversion to laparotomy. The side-to-side anastomosis of the lesser curvature of stomach and jejunum avoided the laparoscopic suture. No gastrojejunostomy anastomotic bleeding, fistula, obstruction and other complications occurred after operation and no complications of gastrojejunostomy anastomosis were found during a follow up of 1 to 7 months.

CONCLUSIONSSide-to-side anastomosis of the lesser curvature of stomach and jejunum in LRYGB can manipulate the size of anastomosis accurately and avoid the laparoscopic suturing. It is simple and easy to learn.

Adult ; Aged ; Diabetes Mellitus, Type 2 ; surgery ; Female ; Follow-Up Studies ; Gastric Bypass ; methods ; Humans ; Jejunum ; surgery ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Stomach ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the bone-implant interfaces of two kinds of implants with different surfaces in different time in vivo.

METHODSCDIC and ITI-TPS solid-screw cylinder pure titanium implants were selected and implanted in the regions of posterior molars of rhesus monkeys. 1 month, 2 months, 3 months and 1 year after surgery, the bone-implant interfaces were evaluated respectively through oral examination, X-ray inspection, light microscope and scanning electron microscope (SEM) observation.

RESULTSNone of the implants was loose. Soft tissue around implants appeared no inflammation. There were no apparent transparent shadow around the implants interfaces in X-ray photos except little angle-shaped absorption was showed in neck region of CDIC implants of one-month. New bone was observed around implants of one-month through light microscope and SEM. More bone growing around ITI implants were seen than that around CDIC implants except the interfaces of one-year.

CONCLUSIONThe osseointegration of ITI implants are better than that of CDIC implants during three months after implanting without loading. The bone formation at the interfaces of ITI and CDIC implants has no significant difference after one year without loading.

Animals ; Dental Implants ; Macaca mulatta ; Molar ; Osseointegration ; Titanium

OBJECTIVETo observe the collagen spatial distribution, collagen volume fraction (CVF) and Cx40, Cx43mRNA expressions in rapid atrial pacing dogs post vagal denervation by removing fat pad located between the medial superior vena cava and aortic root (SVC-Ao fat pad).

METHODSTwenty-four dogs were randomly divided into unpaced sham operation group (S group, n = 8), Keeping SVC-Ao fat pad group (K group, n = 8) and Removing SVC-Ao fat pad group (R group, SVC-Ao fat pad was removed by surgical excision before pacing, n = 8). K and R groups were paced for six weeks. Six weeks later, all dogs were sacrificed, left atrium (LA), right atrium (RA), left atrial appendage (LAA), right atrial appendage (RAA) and atrial septum (AS) were collected and stained with HE or Masson Trichrome or frozen in liquid nitrogen for quantifying the expression of Cx40, Cx43 mRNA by Real-time quantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR).

RESULTSSpatial distribution of collagen fibers as well as CVF between S and R group were similar (all P > 0.05). CVF was significantly higher in K group compared to R group, especially at LAA and AS locations (all P < 0.05). Cx40mRNA expression in K group was significantly decreased in LA, RA, and significantly increased in LAA, RAA and AS compared those in S group (all P < 0.05), significantly lower in LA and RA while significantly higher in LAA and RAA compared to R group (all P < 0.05). Cx43mRNA expression in K group was significantly reduced in LA, RA, LAA and RAA while significantly increased in AS compared to S group (all P < 0.05), significantly higher in LA, RA, RAA and AS while significantly lower in LAA compared to R group.

CONCLUSIONPacing induced collagen remodeling and modulation on Cx40mRNA and Cx43 mRNA expressions could be partially attenuated by removing SVC-Ao fat pad suggesting vagal denervation plays a key role in the initiation and preservation of atrial fibrillation.

Animals ; Atrial Fibrillation ; metabolism ; pathology ; Cardiac Pacing, Artificial ; Collagen ; metabolism ; Connexin 43 ; metabolism ; Connexins ; metabolism ; Dogs ; Heart Atria ; metabolism ; pathology ; RNA, Messenger ; genetics

The diffusion coefficient ((4. 11±0. 78)×10-11 m2/s) and hydrated radius ((6. 12±1. 21) nm) of FITC-DSA ( fluorescein isothiocyanate conjugate dog albumin ) were investigated and measured by combining Taylor dispersion analysis with laser induced fluorescence in microchip. The influence of size of gold nanoparticles (15, 30 and 50 nm) on the interactions between FITC-DSA and gold nanoparticles was studied. The preliminary result demonstrated that the binding of protein and gold nanoparticle displayed a size-dependent relationship. It was interesting that the 50-nm gold nanoparticles could enhance the FITC-DSA fluorescence in microchannel driven with pressure. This method was simple, fast, low sample consumption and high throughput and could be used to study the interaction of nanoparticles and proteins. Systematical study using this method would enable us to have a deep understanding of the toxicity of nanomaterials, and promote the development of safe nanomedicine.