Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.

Objective To evaluate the clinical results of phacoemulsification combined with pars plana vitrectomy for eyes with cataract and proliferative diabetic retinopathy. Design Non-controlled retrospective case series study. Participants 123 eyes with proliferative diabetic retinopathy (PDR) and cataract. Methods Phacoemulsification,posterior chamber intraocular lens (PCIOL) implantation combined with pars plana vitrectomy were done in 123 eyes with proliferative diabetic retinopathy (PDR) and cataract. Postoperative vision,number of secondary procedures and surgical complications were analyzed. Main Outcome Measures Postoperative visual improvement and associated complications. Results All 123 eyes underwent combined surgery. The average follow-up was 10 months. 99 eyes (81%) experienced postoperative vision improvement of varying degrees. Vision improved by 2 lines or more in 93 eyes (76%). No apparent corneal edema or corneal decompensation were encountered. One patient with type 1 diabetes developed neovascular glaucoma 6 months after surgery. Retinal detachment occurred in 1 eye and reoperated. Vitreous hemorrhage requiring secondary procedure happened in 4 eyes. All 24 eyes (19%) without vision improvement were found to be with diabetic maculopathy. Conclusions Phacoemulsification combined with pars plana vitrectomy can be used as an effective surgical tool to improve visions in patients with PDR and cataract. Diabetic maculopathy is the major cause of poor visual improvement. (Ophthalmol CHN ,2006,15: 198-201)

Objective To investigate the factors related to negative conversion of HBsAg in patients with acute hepatitis B (AHB).Meth-ods A total of 106 AHB patients who were admitted to the Department of Infectious Diseases,Zhoukou Central Hospital from February 2007 to February 2013 were recruited.Liver function,five serological markers of HBV infection (HBsAg,HBeAg,anti-HBs,anti-HBe,and anti-HBc),and HBV-DNA were measured every three months.All patients were followed up for 12 months.The major HBV genotypes (A through D)were determined by type-specific primer nested PCR.Categorical data were expressed as rates and compared with χ2 test;continuous data were expressed as mean ±SD and analyzed by t-test.Results When just admitted to our hospital,compared with the pa-tients with negative conversion of HBsAg,AHB patients with HBsAg persisting for more than 6 or 12 months had a significantly lower peak level of alanine aminotransferase (ALT)(718 ±696 vs 1282 ±913 U/L,622 ±514 vs 1203 ±924 U/L,P<0.05)and a significantly high-er level of HBV-DNA (6.8 ±1.4 vs 5.2 ±1.5 log10 copies/ml,7.3 ±1.6 vs 5.4 ±1.5 log10 copies/ml,P<0.05).The HBsAg clear-ance rate in patients with HBV genotype A was significantly lower than that in patients with HBV genotype B or D (75.0% vs 89.5% or 100%,83.3% vs 97.4% or 100%,P<0.05).Conclusion The HBsAg clearance rate in AHB patients may be associated with HBV genotypes,peak level of ALT,and HBV-DNA.

Objective To accelerate retrieve of mammogram database by using improved M-tree index. Methods M-tree index was analyzed in the reliability and effectiveness for indexing mammogram database.An algorithm called "Slim-down" was employed in design to minimize possible overlaps. Results The improved M-tree index enhanced the efficiency of retrieving mammogram database 25 times than traditional way. Conclusion The efficiency of retrieving mammogram database by using improved M-tree was accelerated remarkably.

Background Sugar cataract is one of the major diabetic complications in the eye,but there is not effective medicine to prevent or delay development of cataract. Objective The goal of this study was to investigate the effects and the potential mechanism of aldose reductase (AR) inhibitor,AL-1576 on prevention of galactose cataract in rats. Methods Forty-two SD rats were randomly and equally divided into 7 groups.The cataracts were induced by feeding with 50％ galactose.At the day of feeding galactose and the day 5,10 and 15 after feeding galactose,AL-1576 was added into the feeds.The rats were divided AL-1576 prevention group and early-,intermediate-or late-stage intervention groups.For another group,the withdrawing AL-1576 group,AL-1576 was added into the feeds at the day of feeding galactose,then was removed after 10 days.The lenses of the rats were examined under the slit-lamp microscope before and after given AL-1576 every 5 days.At the day 35,the lenses were obtained.The wet and dry weight of the lenses were weighted,respectically,to calculate the water content of the lenses.Activities of AR and superoxidedismutase (SOD) and contents of glutathione (GSH) of the lenses were measured by their commercial detecting kits.The care and use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission. Results In AL-1576 prevention group,all lenses maintained clear.Opacification of the lenses were significantly attenuated in all three AL-1576 intervention groups and withdrawing AL-1576 group compared with the cataractous model group ( P＜0.05),but the inhibiting role was weaken with late intervention.The water contents and the activities of AR of the lenses were decreased,the contents of SOD and GSH were dramatically increased in all different AL-1576 treated groups compared with the cataractous model group (P＜0.05).Moreover,AL-1576 prevention group showed the best effect on all indexes (P＜0.05). Conclusions The activity of AR can be inhibited by AL-1576 at the different stages of development of cataract induced by galactose.By blocking and attenuating formation of the edema and elevating antioxdative capacity in the lenses,AL-1576 prevents and delays the formation of galactose cataract.

Background A stable diabetic cataract animal model is a premise for screening and evaluating the drug for cataract therapy.Galactose cataract model is widely used in relevant experimental study,but the onset,extent and the type of lens opacification may be different due to different modeling way.Objective This study was to investigate the manifestations and pathological characteristics of cataract induced by D-galactose.Methods Fifty-six SPF SD rats were randomly divided into cataract-model group and control group and 28 rats for each group.50% D-galactose feed was given daily in model group,and regular feed was given in control group.Lenses of rats were examined under the slit lamp through the 30-day period at a 2-day interval,and then the opacity of lenses was graded on the modified Suryanarayana criteria.The body weight of rats was recorded and compared between two groups at day 5,10,15,20,25 and 30.The lenses samples were obtained for the histopathological examination by hemotoxylin and eosin staining.The wet weight,dry weight of the lenes and their ratio were detected and compared between these two groups.The use of animals followed the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The body weight was reduced in model rats compared with control rats with the statistically significant difference from 10 days through 30 days(P＜0.05).The different grades of opacification of lens cortical and nuclear progressed in model rats throughout the experiment duration,but the lenses were clear in control rats.The slit-lamp microscopy and pathological examinations revealed that lenses opacity in model rats started from the cortex at the equator zone and developed towards central zone gradually with the lapse of experimental time.Following the entire opacity of lens cortex,lens nucleus were cloudy and expanded.The swelling and degeneration of the fiber cells in lens cortex,the differentiation,migration and denuclearation delay of lens epithelial cells were seen in model rats under the light microscope.The wet weight of lenses was increased and the dry weight was decreased in model rats in comparison with control rats in experimental 30 days,showing significant difference between two groups(t=138.571,t=52.468,P＜0.05).Conclusion The development of galactose-induced cataract animal model resemble one of age-related cortical cataract in human with the similar generating mechanism.This cataract model is reproducible and classifiable.

Objective To investigate the role of autophagy in radiation-induced death process of human esophageal squamous carcinoma Eca-109 cells.Methods Esophageal carcinoma cell line Eca-109 was divided into 6 groups of control,5 mmol/L 3-Methyladenine treatment,10 mmol/L treatment,6 Gy irradiation,irradiation + 5 mmol/L drug,and irradiation + 10 mmol/L drug.Some cells were transferred with GFP-LC3 plasmid and the changes of autophagosome were obserred.After each treatment,the expression of autophagy marker LC3B was measured by Western Blot,cell viability was detected by MTT,morphological characteristics of apoptosis cells were stained with a fluorescein of Hoechst 33342 and the percentage of apoptotic cells and cell cycle distribution were measured by flow cytometry.Clonogenic survival were used to evaluate the cell radiosensitivity.Results Autophagy level was increased after radiation,and the LC3B Ⅱ expression and LC3B Ⅱ/LC3B Ⅰ ratio were significantly decreased by autophagy inhibitor 3-Methyladenine (F =25.64,P ＜ 0.05).The number of autophagosome fluorescent foci were significantly increased in the GFP-LC3 transfected cells after radiation,but reduced by 3-Methyladenine (F =127.36,P ＜ 0.05).Compared with radiation alone group,autophagy inhibition combined with radiation significantly decreased cell viability (F =129.54,P ＜ 0.05) and colony formation,increased apoptosis and the percentage of G2/M-phase cells.Conclusions 3-Methyladenine enhances the radiosensitivity of esophageal squamous carcinoma Eca-109 cells,suggesting that inhibition of autophagy could be used as an adjuvant treatment of radiotherapy in esophageal squamous carcinoma.

10.3969/j.issn.2095-4344.2013.25.009

BACKGROUND:High-dose antibiotics for bone infection have many adverse reactions, and its outcomes are not perfect. Thus, to explore a degradable material as a vector to prevent bone infection is valuable. OBJECTIVE:To study drug release characteristics of gatifloxa-poly sebacic anhydride local control ed release system in vivo. METHODS:A 3 mm × 6 mm bone window was made at right knee joint of New Zealand rabbits. The gatifloxacin-poly sebacic anhydride sustained release preparation was implanted. Heart blood, bone tissue and myeloid tissue specimens were obtained at 1, 2, 3, 6, 9, 12, 15, 18, 25 and 30 days after surgery. High-performance liquid chromatography was utilized to determine gatifloxacin concentration. Scanning electron microscope was employed to observe the structural changes before and after implantation of gatifloxacin-poly sebacic anhydride sustained release preparation. RESULTS AND CONCLUSION:After implantation of gatifloxacin-poly sebacic anhydride sustained release preparation, drug concentration gradual y decreased in the myeloid tissue, peaked at 1 day, stabilized at 3-15 days, gradual y reduced at 15-30 days. However, the drug concentration was stil higher than the minimal inhibitory concentration 0.1 mg/L against Staphylococcus aureus at 30 days. The peak of drug concentration in the bone tissue occurred at 3 days, and stabilized at other days, which was higher than 0.1 mg/L. At the same time point, drug concentration in the blood specimen was lower than that in the myeloid tissue and bone tissue. The degradation of gatifloxacin-poly sebacic anhydride sustained release preparation was surface erosion, and the shape of the degradation residue is smal globular. The change of the internal structure of gatifloxacin-poly sebacic anhydride sustained release preparation was not found. In the drug release procedure, gatifloxacin-poly sebacic anhydride sustained release preparation did not show disintegration or fragmentation. These results indicated that
gatifloxacin-poly sebacic anhydride local sustained release preparation has good abilities of drug load and drug release.

0.05).[Conclusion]The stability of the single - level anterior cervical intervertebral decompression and fusion with plating Uniplate is satisfactory.Uniplate is valuable in clinic,furthermore,it is relatively simple to operate.