Autologous blood patch pleurodesis (ABPP) was first proposed in 1987. Now it is mainly used to treat intractable pneumothorax and persistent air leakage after pneumonectomy, and also used to treat pneumothorax in children and other rare secondary pneumothorax. Persistent air leakage and pneumothorax of various causes are essentially alveolar pleural fistula. It can usually be treated by closed thoracic drainage, continuous negative pressure suction and surgery. Pleurodesis is a safe and effective alternative to surgery for patients who have failed conventional conservative treatment and can not receive operations. Compared with other pleurodesis adhesives, autologous blood (ABPP) is safer and more effective, and it is simple, painless, cheap and easy to be accepted by patients. But in the domestic and foreign researches in recent years, many details of ABPP treatment have not been standardized. For further research and popularization of ABPP, this article reviews the detailed regulations, efficacy and safety of this technology.

Objective To observe the effect of postoperative central vault on the anterior chamber after implantation of im-plantable contact lens V4c .Methods To carry out a retrospective study of 56 eyes with implantable contact lens V4c implantation in Chongqing Bright Eye Hospital from November 2 ,2014 to February 5 ,2015 ,examined anterior chamber angle before surgery ,the anterior chamber angular width (ACA) and anterior chamber volume (ACV) were measured by pentacam .the postoperative central vault and ACA and ACV during the first and third and sixth months after surgery were measured ,the pigment grade in anterior chamber after operation were recorded .The change of ACA and ACV of the 56 eyes was correlation analyzed .Results At first month after surgery ,the postoperative central vault was 250 ~ 765 μm ,the reduced amount of ACA was (13 .67 ± 1 .67)° ,the re-duced amount of ACV was (94 .23 ± 17 .02)mm3 .At the third month ,the postoperative central vault of the 55 eyes was 239 ~ 761μm ,the reduced amount of ACA was (13 .70 ± 1 .68)° ,The reduced amount of ACV was (93 .6 ± 17 .48)mm3 .At the sixth month , the postoperative central vault of the 51 eyes was 246 ~ 761 μm ,the reduced amount of ACA was (13 .60 ± 1 .69)° ,the reduced a-mount of ACV was(94 .29 ± 17 .80)mm3 .No case of pigment was found for grade Ⅱ .The statistical comparison of the amount of ACV and ACA decreased in different postoperative central vaults showed that the difference was statistically significant ,there were statistically significant differences in the amount of ACV and ACA between different central postoperative central vault(P< 0 .05) . Conclusion Anterior chamber angle was narrowed and anterior chamber volume decreased in the posterior chamber intraocular lensimplant-ation after implantable contact lens V4c implantation ,the postoperative central vault is related to the change of anterior chamber angle and ACV .Appropriate postoperative central vault has positive clinical significance for keeping anterior chamber angle open .

Objective To investigate the significance of fluorescence in situ hybridization (FISH) panel in detecting cytogenetic abnormalities in patients with chronic lymphocytic leukemia (CLL).Methods A panel of FISH probes [D13S25 (13q14.3),RB1 (13q14),ATM(1 1q22.3),CSP12(12p1 1.1-12q1 1.1) and p53 (17p13.1)] were performed in 21 cases with CLL.The cytogenetic features in correlation with clinical manifestation,other laboratory tests and prognosis were analyzed.Results Cytogenetic abnormalities were found in 13 of 21 patients with CLL (61.90 ％).The most frequent abnormality was del(13q14) (42.86 ％),followed by trisomy 12 (14.29 ％),del(11q22) (9.52 ％) and del(17p13) (9.52 ％).There was no significant relationship among cytogenetic abnormalities and sex,binet stages,expression of CD38,level of lactate dehydrogenase.Conclusion FISH with probe panel is a rapid,sensitive and accurate technique for detection of cytogenetic abnormalities in patients with CLL.

The M and S segment cDNAs of hantavirus Z5 strain was amplified by RT-PCR,and the purified PCR products were cloned into vector pGEM-T and then sequenced.It was demonstrated that the M genome segment of Z5 was found to be 3 616 nucleotides in length with a single open reading frame encoding 1 135 amino acids.And the S genome segment was 1700 nucleotides in length with a single open reading frame encoding 429 amino acids.As demonstrated by the homologous analysis of nucleotides and amino acids,it was showed that the Z5 strain belonged to hantaan viruses HTN type and was the same subtype of the Z10 strain.It is conclouded that difference in nucleotide sequence exists between Z5 strain with other Hantavirus strains but high level of homology in amino acid sequences is still present.

By analyzing the present development and reform experiments for public hospitals in Shenzhen,the author proposed the following directions for such a reform:1) Accelerating steps of the development strategy "One Large and One Small",to achieve a balanced deployment of local healthcare resources;2) Building a public hospitals group with reasonable resources deployment and information resources sharing;3) Advancing reforms of public hospitals,building an administrative system of public hospitals featuring separation between government functions and hospitals operations and that between hospital administration and hospital building;4) Improving the supervision mechanism for public hospitals featuring distinct rights and responsibilities and powerful regulatory practice;5) Building a scientific operation system of efficient incentives and self constraints;6) Building a service model for public hospitals featuring separation of medical service and pharmaceuticals sales and normalized system.

One strain of Hantavirus(HV) was isolated from patients with hemorrhagic fever with renal syndrome (HFRS) in Zhejiang province and its S-segment was cloned and submitted to nucleotide sequence analysis in order to determine the type of strain and extent of genetic variation for further study on its evolution and mutation .The HV antigen was detected from mouse lungs in endemic area by direct immunofluorescene test and the HV-positive sample of mouse lung was inoculated to Vero-E6 cells to isolate virus. The total cellular RNA was extracted from infected cell culture and the S segment gene was amplicated by RT-PCR. Then, the purified PCR product was cloned into T vector for sequencing. The result showed that the full-length sequence of the S segment was 1 700 bp with one open reading frame (ORF) encoding 429 amino acids. Comparison with Hantavirus HTN type showed 85.7%-91.9% homology at the nucleotide level. In comparison with the SEO type of viruses, the homology at nucleotide level was shown to be 71.2%-75%. This new HV strain may be typed as to HTN virus and may be a new subtype of this virus.

Objective To construct a new molecular biological method for the analysis of microbial species in lower respiratory tract infections based on 16S rRNA gene by denaturing high-performance liquid chromatograph(DHPLC).Methods The universal primer set was analyzed basing on the highly conserved regions of 16S rRNA gene.DNA amplicons of lower respiratory tract were analyzed by DHPLC to generate peak profiles respectively.The incorporation of 40-bpGC clamp into the amplification primet was essential to effectively discriminate genetic differences identification.Results The primers could only amplify bacterial 16S rRNA.Bacterial of amplicons which incorporation of a 40-bpGC clamp were effectively discriminated genetic differences in DHPLC.The results of clinical isolares identification showed 100%according with the traditional method.Conclusion DHPLC has not only high accuracy,but also is a convenient,rapid and high-through technique for the discrimination bacteria.It has potential value in the detection of lower respiratory pathogenic bacteria.

Objective To understand time-effect relationship in prehospital emergency care of trauma patients so as to cut down mortality. Methods The data of pre-hospital deaths of trauma pa-tients were collected from 67 Shenzhen Emergency Network Hospitals during 2002-2004 and input into a database established by using Foxpro 6.0.Then, the data were analyzed by software SPSS 11.0. Re-sults A total of 161 364 trauma patients received prehospital emergency call service during 2002-2004 and 3 967 patients died prehospital or in hospital.There were 360.528 and 645 trauma patients died pre-hospitsl in 2002, 2003 and 2004 respectively, accounting for 32.57%, 37.69% and 44.25% respec-tively of whole trauma emergency patients in corresponding year.In 2002, 2003 and 2004 respectively, pre-hospital mortality was 1.15%, 0.88% and 0.99%, ratio of male to female 79.17/20.83, 77.65/22.35 and 71.63/28.37, the death age(29.04 ±13.98), (27.84±18.54)and(29.25±17.06)years old, ratio of traffic trauma to non-traffic trauma 48.33/51.67.26.14/73.86 and 37.98/62.02, the median response time of ambulance in hospital 2, 2 and 1 minute, the median time of ambulance arri-ving at the accident scene 5, 8.5 and 7 minutes and the median time of ambulance to and fro was 15.35 and 30 minutes. Conclusions There is a tendency that the number of the pre-hospital deaths of trauma patients increases, but that the ratio of traffic to non-traffic trauma and mortality decrease.The average age of dead trsuma patients is 10 years younger than that of whole emergency patients in the city of Shenz-hen.The response time of ambulance in hospital shortens, but the time of ambulance arriving accident 8cene and to and fro time of ambulance prolong.

BACKGROUND: There are various reports on studies of tear secretion and tear film function in patients with diabetes mellitus over the past. In recent years, tear proteins have drawn more and more attentions on evaluation of tear film function.OBJECTIVE: To observe the contents of main tear proteins and basal tear secretion of patients with type 2 diabetes mellitus and normal persons so as to probe into tear secretion and tear film function of patients with diabetes mellitus.DESIGN: Case-control observation was designed.SETTING: Department of Ophthalmology, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 50 cases (100 eyes) of type 2 diabetes mellitus were employed, which were diagnosed in Department of Ophthalmology and Department of Endocrinology, Southwest Hospital of Third Military Medical University of Chinese PLA from December 2001 to December 2002. They were free from ocular surgical and laser treatment, local medication in recent period and contact lens. Of those, there were 25 cases (50 eyes) in proliferating diabetic retinopathy group and 25 cases (50 eyes) in nonproliferating diabetic retinopathy group. In addition, 25 cases (50 eyes) of normal persons with matched age and sex were taken as the control group.There was no significant difference in age and sex among 3 groups (x2=0.024,0.321 ;P ＞ 0.05). All of the participants were in the know before the experiment.METHODS: [1] Tear collection: 10 cases (20 eyes) were randomized from two diabetic groups and the control successively. Capillary pipette method was used to collect non-irritative tear 10 μL from lower lacrimal punctum that was preserved in refrigerator at -20 ℃ (＜ 1 month). [2] Determination of total tear protein amount: Lorry method was used to determine the concentration of total tear protein, in which, calf serum albumin was taken as the criteria. [3] Determination of contents of main tear proteins: SDS-PAGE (sod.dodecyl sulfate-polyacrylamide gel electrophoresis) was used and Coomassie brilliant blue staining and Bio-Rad imaging analyzing system were applied for the analysis of isolated protein strips in quality and quantity. [4] Determination of rupture time of tear film: glass rod was used to get 20 g/L fluorescein sodium and drop in conjunctival sac. The examined person was required to blink gently for several times and open the eyes naturally and stare forward. That the first ruptured "black hole" was discovered on the complete tear film was taken as the rupture time of tear film. [5] Experiment of basal tear secretion: No.41 Whatmann filtering paper was used, folded in 5 mm, and placed at 1/3 of conjunctiva in the lower eyelid. Five minutes later, the paper was removed and length of it after wetting was measured. [6]Experiment with rose Bengal staining: glass rod was used to get 10 g/L rose Bengal and drop in conjunctival sac. After eyes blinking for several minutes, the observation was performed with green light filter under slit lamp (evaluation criteria: corneal conjunctiva of palpebral fissure stained+, stained to the inferior bulbar conjunctiva++,stained to the superior bulbar conjunctiva). Dry eye disease was diagnosed indirectly with red-stained epithelial cells and mucin.MAIN OUTCOME MEASURES: [1] Concentration of total tear protein. [2]Concentrations of various main tear proteins. [3] Rupture time of tear film. [4]Value of basal tear secretion. [5] Positive rate of rose Bengal staining.RESULTS: Totally 50 cases (100 eyes) in diabetes groups and 25 cases(50 eyes) in the control group all entered result analysis. [1] Concentration of total tear protein: there was no significant difference among 3 groups (P＞ 0.05). [2] Concentrations of various main tear proteins: the results of lysozyme, lactoferritin and tear specific prealbumin in proliferating diabetic retinopathy group were lower remarkably compared with the control[ (0.94±0.21)vs ( 1.33±0.31 )g/L , ( 1.10±0.24)vs ( 1.67±0.43 )g/L, (0.98±0.22) vs (1.49±0.32)g/L, P ＜ 0.01]. Compared with non-proliferating diabetic retinopathy group, the results of lactoferritin and tear specific prealbumin were lower (P ＜ 0.05). There was no significant difference in human serum albumin among 3 groups (P ＞ 0.05). [3] Rupture time of tear film:compared with non-proliferating diabetic retinopathy group and the control, the rupture time of tear film in proliferating diabetic retinopathy group was reduced significantly [(7.68±2.21)s vs (9.92±2.37)s and(10.80±2.23)s,(P ＜ 0.01 )]. [4] Value of basal tear secretion: the value in proliferating diabetic retinopathy group was less significantly than that in non-proliferating diabetic retinopathy group and the control [ (8.00±2.10)vs( 11.02± 1.97 )mm and ( 12.17±2.08 )mm, P ＜ 0.05]. [5] Positive rate of rose Bengal staining: the positive rate in proliferating.diabetic retinopathy group was higher significantly than non-proliferating diabetic retinopathy group and the control (48% vs 24% and 14%, P ＜ 0.05, P ＜ 0.01).CONCLUSION: It is suggested in the results of this paper that abnormal tear secretion and tear film function are apt to present in patients with type 2 diabetes mellitus and the declined tear film function is more remarkably in the patients with proliferating diabetic retinopathy specially. SDS-PAGE benefits the discovery of changes in tear proteins in diabetic patients.

Objective To study the changes of central corneal thickness(CCT) and corneal endothelium morphology in type 2 diabetes mellitus. Methods The CCT and corneal endothelium morphology in 60 diabetic patients(60 eyes) and 60 healthy volunteers(60 eyes) as the age and gender matched control group were examined by pachymetry and non contact specular microscopy. Stepwise regression analysis was performed to assess the effects of systemic factors on CCT and the corneal endothelial cell density of diabetic patients. Results Compared with that in the control group, the endothelial cell density decreased, and the coefficient of variation of cell area increased significantly( P 0 05). Compared to patients with non proliferative diabetic retinopathy(NPDR), the patients with proliferative diabetic retinopathy(PDR) had a significant reduction in cell density( P