The prevalence of age-related macular degeneration (AMD) is increasing yearly,and AMD has become the first cause of elderly vision irreversible loss.In China,an aging society is developing,so the prevention and therapy for AMD is faced with a new challenge.Thc multi-faceted study on AMD has become a focus of fundus disease in ophthalmology.AMD is thought to be a multifactorial-induced disease,and it is closely related to age,genetic and environmental factors.But its pathogenesis is not understood enough up to now.In recent years,epidemiological study revealed that the chromosome 10q26 has multiple polymorphic loci.Age-related maculopathy susceptibility 2 ( ARMS2,rs10490924 ) is reported to be a major risk factor of AMD in the yellow race.In this paper,the ARMS2 gene epidemiology,cell positioning and related treatment were reviewed.

OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperation period in our hospital.METHODS According to the designed table with unified contents and standards,a retrospective investigation was made in 325 patients who had been discharged from our hospital.RESULTS Of the 325 patients in our study,antimicrobials use in 281 patients was rational,44 patients had irrational antimicrobials use.CONCLUSIONS The results show that it is very important to strengthen and improve the management of the antimicrobials use in a normal and standard way in our hospital.

Objective To investigate the effect ofglycesylated hemoglobin(GHbA,c) on tissue-type plasminngen activator (t-PA)and level of serum plasminogen activator inhibitor-1 (PAI-1) in patients with early diabetic nephropathy (DN).MethodNinety patients with early DN from April 2004 to May 2005 were divided into 3 groups according to the level of GHbA1c,which was respectively less than 7% (group A),between 7% and 9% (group B),and more than 9% (greup C).Thirty healthy adults were chosen as control group.The levels of serum GHbA1c,t-PA and PAI-1 were detected on empty stomach in the morning.Results The level of serum t-PA was lower,the activity of PAI-1 was higher in groups of DN than those in control group (P＜0.05 or＜0.01),and those were changed with the level of GHbA,c.There were significant differences between group C and group A[t-PA:(0.14± 0.06),(0.28± 0.11) U/ml; PAI-1 (3.25 ±1.01),(1.90q± 1.09) U/ml](P＜0.05).Conclusions The fibrinolytic system exists unbalance in patients with early DN.Continuous hyperglycemia in patients with early DN make unbalanced fibrinolytic system more serious.Controlling the level of GHbA1c strictly can play an important role in delaying DN progress.

OBJECTIVE To investigate the distribution and the drug resistance of pathogens in cerebral stroke patients with hospital infction and to provide a foundation for reasonabie application of antibacterials.METHODS Pathogenic bacteria were isolated from inpatients of burn department from 2003 to 2008,instruments assay or K-B disk diffusion method was taken to carry out the sensitive test.The drug resistance rate of the pathogenic bacteria was analyzed.RESULTS Totally 222 strains were isolated,among which 122 strains were Gram-negative bacteria,58 strains were Gram-positive ones,and 42 strains were fungi.The percentage of these three groups was 54.95%,26.13% and 18.92%,respectively.The main strains of Gram-negative bacteria were Pseudomonas aeruginosa,Escherichia coli,and Enterobacter cloacae,and that of the Gram-positive bacteria were Staphylococcus aureus,Enterococcus and S.epidermidis.The major strain of fungi was Candida albicans.The pathogenic bacteria tested showed high drug resistance.The detection rate of the meticillin-resistant S.aureus(MRSA)was 73.68%.The detection rate of the ESBLs from the K.pneumoniae and the E.coli was 60.00% and 33.33 %.CONCLUSIONS The pathogenic bacteria are multidrug-resistant.Inspecting pathogens and strengthening susceptibility tests are very important in reducing drug abuse,decreasing the resistance rate and raising the cure rate in hospital.

Objective To explore the isometricity of grafts in ACL(anterior cruciate ligament)recon- struction under bone tunnel shifting condition.Methods Knee specimens from ten fresh frozen cadavers were used. Femoral tunnels of 2 mm were drilled at three points on the medial aspect of the lateral condyle.The first was“anterior bundle point”(located at the 11 o'clock position in the right knee and 1 o'clock position in the left knee).The second was“error point”(located at the place 5 mm anterior and distal to the“anterior bundle point”).The third was“posterior bundle point”(located at the crossing point of the long axis of the ACL attachment and a vertical line drawn across the femoral-tibial contact point with the knee flexed at 90?).Moreover,tibial tunnels of 2 mm were drilled at three points on the tibial plateau.The first was“central point”(located at the center of original insertion of ACL).The second was“5 mm posterior point”,located at the place 5 mm posterior to the“central point”.The third was“10 mm posterior point”,located at the place 10 mm posterior to the“central point”.Changes in distance between each pair of tibial and femoral tunnels were measured during passive knee flexion-extension.Results The anterior-posterior shifting of the tibial tunnel was found to have little influence(P＞0.05)on the isometricity after the femoral tunnel had been chosen.However,the shifting of the femoral tunnel was found to have significant influence(P＜0.01)on the isometricity.Changes in distance related to the“anterior bundle point”led to lengths within the physiologic isometric range.Changes in distance related to the“error point”led to lengthening(ligament stretching)beyond the physiologic isometric range.Changes in distance related to the“posterior bundle point”led to shortening(ligment relaxing)beyond the physiologic isometric range.Conclusion Anterior-posterior shifting of the tibial tunnel between the center of original insertion and posterior edge of inter-tibial eminence area has little influence on the isometricity of grafts in ACL double bundle reconstruction.

Objective: To investigate the circadian ryhthm v ariation of 2-125I-iodomelatonin (125I-Mel) binding sites in the human peripheral leukocytes in patients with acute cerebral infarction. Methods: Melatonin binding sites in the human peripheral leukocytes were studied using 125　I-Mel as a radioligand (radioligand binding assays).A ll patients ［age: (70.18±11.70) years］ were diagnosed by CT according to the standard ［Chin J Nerv， 1996,29(6):379］. We also studied 15 age-match ed healthy old people as the control ［age: (68.33±7.76) years］. Resul ts: The circadian ryhthm variation of 125　I-Mel specific binding in control remained significant (P<0.01) with a higher value at midlight ［ (0.16±0.049) fmol/106］ than at middark ［(0.078±0.035) fmol/106］ with one point analysis. There was no significant variation in the patient grou p (P>0.05). The specific binding in the peripheral leukocytes at midlight in the patients with acute cerebral infarction were lower than that of the control . Conclusion: The expression of Mel receptor decreases in the pa tients wit h acute cerebral infarction and the circadian ryhthm variation of 2-125I -Mel appears abnormal.

Objective Objective TO investigate the potential association between matrix metalloproteinase-9 (MMP-9) gene polymorphisms and risk of ischemic stroke in Western Guangdong population.Methods This hospitalbased case-control study recruited 251 patients with ischemic stroke and 96 controls.Using Multiplex SNaPshot method was used to detect the genotype of MMP-9 gene rs3787268、rs3918241 and rs3918242 polymorphisms.The association between MMP-9 gene polymorphisms and risk of ischemic stroke was analyzed.Results ① There were significant differences in the genotype distribution of rs3787268 between ischemic stroke group and the controls (P=0.042).In the recessive model,the individual risk of A/A genotype was higher (OR=2.21,P=0.046) than that of the G/G+G/A genotype.② Compared with the controls,the genotype and allele distribution of rs3918242 in the ischemic stroke group were significantly different (P=0.007,P=0.038).In the dominant model,the risk of individuals carrying the T genotype was significantly elevated (OR=2.14,P=0.009) compared with individuals with the C/C genotype.③ The genotype distribution of rs3787268 polymorphisms in the LAA but not in no-LAA subgroup was significantly different from that in the controls (P =0.039).The genotype distribution and allele frequency of rs3918242 polymorphisms in the LAA subgroup were significantly different from that of the control group (P=0.009,P=0.047).There was no significant difference in the genotype distribution and allele frequency between no-LAA subtype and the control group.Conclusions The MMP-9 gene rs3918242 and rs3787268 polymorphisms may be the risk factors of ischemic stroke in Han population in the western part of Guangdong province,China.The MMP-9 gene rs3918242 and rs3787268 polymorphisms may be the risk factors of large-artery atherosclerotic stroke.

AIM: To evaluate the relationship between damages of visual field and retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma (POAG)with highly myopia. POAG with highly myopia group (21 eyes of 17 cases), POAG with non-highly myopia group (17 eyes of 16 cases), highly myopia without POAG group (25 eyes of 20 cases) and normal control group (19 eyes of 17 cases).automated perimeter and thickness of RNFL was measured by optical coherent tomography(OCT). Main outcome mean deviation (MD), pattern standard deviation (PSD) and mean sensitivity at superior, inferior, nasal and temporal sectors in total deviation probability plots. Thickness of RNFL at superior, inferior, nasal and temporal sector.total deviation probability plots of the early POAG with highly myopia than that of POAG without highly myopia,and the early visual field defects of glaucoma in pattern deviation probability plots of this group. MD of POAG with highly myopia was more than those of others (P＜0.05).The differences of MD, PSD and mean sensitivity between POAG with highly myopia and others were significant(P＜0.05).Mean sensitivities in each sector of POAG without highly myopia were similar to those of highly myopia(P＞0.05). The thickness of RNFL of POAG with highly myopia was thinner than that of others and the thickness of RNFL of normality was thicker than that of others. The relationship between mean sensitivity and the thickness of RNFL in each quadrant was significant(P＜0.05).judgment of the visual field changes in POAG with highly myopia. The relationship between RNFL thickness by OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with highly myopia. Field; optical coherent tomography

Background Researches determined that the alteration of A69S locus of age-related maculopathy susceptibility 2 ( ARMS2 ) gene is closely associated with the pathogenesis and progression of age-related maculopathy ( AM D ).However,the location of ARMS2 protein in normal eye tissue is still in controversy,therefore,its function is below understanding up to now.Objective The goal of this laboratory work was to investigate the distribution,expression and location of ARMS2 protein in normal adult retina and choroid as well as in retinal pigment epithelial (RPE) cells and lay a basis for exploring further its function in the protein level.Methods Ten donor eyeballs of normal adult male with the age from 28-42 years were collected in eye bank of Qingdao Eye Hospital.The frozen sections of the retina and choroid were prepared for the detection and location of ARMS2 in 3 eyes by immunofluorescence under the confocal laser microscope.The retina was isolated for the primary culture of RPE cells using explant culture method.The cells were then identified by CK32 antibody by immunofluorescence.The distribution and expression of the ARMS2 protein in retina,ehoroid and RPE cells were determined by immunofluorescence technique.Results ARMS2 protein was strongly expressed in retinal vessel,RPE cell layer,Bruch membrane and choroidal vessel,but weak expression was in retinal ganglion cell layer,inner nuclear layer,outer plexiform layer,outer nuclear layer and inner plexiform layer in the normal eyes.The primarily cultured cells appeared the polygon shape with the abundant pigment in cytoplasm.The immunofluorescence of the cells showed the positive response for CK32,exhibiting the green fluorescence granules in the cytoplasm.The positive expression of ARMS2 protein also was seen in the cytoplasm of RPE cells,appearing the red fluorescence.Conclusions ARMS2 protein mainly distribute and locate retinal and choroidal vessels,RPE cells and Bruch membrane in normal eye.

OBJECTIVETo testify the feasibility of management through contract system between general practitioners and patients.

METHODSIn Sichuan province contract was made between general practitioners and hypertension patients in "community health service center-family of hypertension patients" in Yulin community in Chengdu city. After half a year, we analysed the effects of community-based intervention on hypertension.

RESULTSGeneral means of both SBP and DBP remarkably decreased (P < 0.05) with SBP remarkably decreased by 8.94 mm Hg while DBP decreased by 3.61 mm Hg. After interfered by the model, people whose blood pressure were above normal had a remarkable decrease than before by 14.06 mm Hg (P < 0.05). Rates of hypertension being under control increased from 38.39% to 64.29% (P < 0.001). Rates of awareness on fatness and heredity in hypertensive patients were increasing from 58.06% to 74.19% (P < 0.001). Rate of awareness on risk factors for hypertension was also higher than that of 6 months back (P < 0.05).

CONCLUSIONThe model of management by signing contract between general practitioners and patients in community, proved to be a successful way in the treatment to control high blood pressure.