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AIM: To study the roles of tumor necrosis factor alpha ( TNF-α) , interferon gamma ( IFN-γ) in pathogenesis of primary pterygium and to explore the mechanism of tears in pterygium.?METHODS: Concentrations of TNF-α and interferon gamma IFN - γ were quantified by enzyme - linked immunosorbent assay ( ELISA ) in asymptomatic control group (30 eyes of 30 healthy volunteers) and 60 primary pterygium patients ( 30 eyes of the 30 progressive cases, 30 eyes of the 30 quiescent cases) . The data was analyzed by analysis of variance.?RESULTS:The concentration of TNF-αand IFN-γin the patients with primary pterygium were statistically significant (P<0. 05), compared with the normal control group. Tear concentration of TNF-α was significantly higher in primary pterygium compared with the control group. Tear concentration of IFN - γ was significantly reduced in primary pterygium compared with the control group (P<0. 05).?CONCLUSION:TNF-α and IFN-γmay be important in the pathogenesis and development of pterygium tissues.It can provide some new directions and ideas for the treatment of primary pterygium.
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AIM:To observe the sustained-release effect of compound betamethasone by subconjunctival injection on immunological rejection after ostrich-rabbit lamellar keratoplasty.METHODS:Sixteen healthy New Zealand white rabbits with 6wk old received corneal lamellar keratoplasty,and the corneal graft was ostrich acellular corneal stroma.After surgery all subjects were divided into two groups,Group A (experimental group) were administrated with subconjunctival injection of compound betamethasone injection (once every 7d),and Group B (control group) were administrated with subconjunctival injection of dexamethasone sodium phosphate (once every 7d).At 1,2wk,1,2mo after the surgery,rabbit corneas were taken for paraffin sections,and were observed with H-E staining,in the meantime changes of CD4+ and CD8+ T lymphocytes were observed by immunofluorescence.RESULTS:Two months after surgery,in Group A corneal grafts remained transparenct,and showed little neovascularization;HE staining and indirect immunofluorescence showed that only a few neutrophil infiltration,no CD4+ and CD8+T lymphocytes.In Group B,the inflammatory reaction was observable at different time points,the corneal graft was turbid;and the tissue sections and indirect immunofluorescence staining showed that neutrophil infiltration was predominant,and CD4+,CD8+T lymphocytes were also seen.CONCLUSION:Compound betamethasone is able to inhibit the ostrich-rabbit corneal transplantation immune rejection,prolong the survival time of the grafts.The present study lay the foundation for further research and clinical application.
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Background Keratoconus is a bilateral,noninflammatory,gradually progressive corneal disorder characterized by progressive thinning and steepening of the central cornea.It is significant to investigate keratoconusrelated pathogenic gene for elaborating the pathogenesis and establishing early diagnosis standard and taking clinical measurement.Objective The aim of the study was to explore the relationship of visual system homeobox gene (VSX1) polymorphism and the risk of sporadic keratoconus.Methods This study was approved by Ethic Commission of First Hospital of Xi' an.Written informed consent was obtained from each subject prior to enrollment.A case-controlled study was conducted.One hundred and one Han nationality patients with sporadic keratoconus were included in this study.These keratoconus patients were clinically diagnosed by slit lamp examination and corneal tomography.Single nucleolide polymorphism (SNP) of VSX1 gene was assayed and classified using the MassARRAY SNP technique.Demography and relevant risk factors were collected from each subject by questionnaire.Eighty healthy volunteers served as controls.Chi-square test and Binary logistic regression were used to evaluate the difference in the distribution of allele frequency and genotype frequency and to analyze the association with keratoconus risks.Results SNP of two genes was found in the Chinese Han population (rs743018 (c.843+140 C＞T) and rs6138482(R217H C＞T)).There were no significant differences in the genotype frequency and allele frequency of the SNP of two genes in the keratoconus group in comparison with the normal control group (P＞0.05).After adjustment by age and sex,SNP of two genes was not significantly associated with the risk of keratoconus (regression model:rs743018 (C＞T) adjusted:P=0.35,OR=0.72,95％ CI:0.37-1.43 ;rs6138482 (C＞T) adjusted:P =0.48,OR=0.76,95％ CI:0.35-1.64).Conclusions Gene polymorphisms of rs743018(c.843+140 C＞T) and rs6138482(R217H C＞T) in the Chinese Han population is not associated with the risk of keratoconus.Due to the racial difference in genotype and allele frequency,the role of the VSX1 gene in the pathogenesis of keratoconus still remains controversial,and further study needs to be developed.
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<p><b>OBJECTIVE</b>To understand the use of lipidemia related assistant examinations and lipid-lowering agents, the clinical ability among physicians in district and community hospitals in Beijing, and to evaluate the capability of dislipidemia diagnosis and treatment in these hospitals.</p><p><b>METHODS</b>A survey was carried out in 42 hospitals in Chaoyang and Haidian district, including 9 district level hospitals, and the rest were at the community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals. A total number of 632 physicians in those hospitals were investigated, using a close book examination.</p><p><b>RESULTS</b>100% of the hospitals could perform TC and TG tests; 87.5% and 72.5% of the hospitals had medications as statins and bile acid, respectively; 100% of the hospitals could test ALT and 40.0% of the hospitals could test CK. The correct rates of selecting treatment strategy and determining the appropriate treatment goals were 53.7% and 17.6%, respectively.</p><p><b>CONCLUSION</b>The hardware condition of community hospitals seem to have satisfied the implicit requirements of dyslipidemia evaluation and treatment but it was essential to improve the knowledge and ability among physicians in community hospitals.</p>
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Humans , China , Data Collection , Dyslipidemias , Diagnosis , Therapeutics , Hospitals, Community , Practice Patterns, Physicians'ABSTRACT
Objective:The recombinant human retinal pigment epithelium-derived factor(PEDF)protein to be obtained and the angiogenesis of the rPEDF to be identified.Methods: PEDF gene gene was amplified by PCR and cloned into pET32a,rPEDF protein was expressed in E.coli BL21 and confirmed by SDS-PAGE and Western blot.The rPEDF was purified by Ni-NTA on denature condition.The concentration of the rPEDF was determined by Bradford method.The angiogenesis of the rPEDF was determined by chick chorioallantoic membrane(CAM) method.Results: The expression plasmid pET32a-PEDF was constructed successfully.The rPEDF was expressed with stable efficiency in E.coli BL21.The results of the CAM experiment showed that the rPEDF had notable angiogenesis effect in the concentration 0.4、0.04 ng/ml,but had no effect in 4 ng/ml.Conclusion:The PEDF gene was cloned and expressed efficiently,the angiogenesis of the rPEDF to be identified and the activity was worked in certain range.The results can facilitate studying its function and spreading its application.
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<p><b>OBJECTIVE</b>To compare the impact of two different continuing education models: traditional model and a new model entitled "problem-oriented and case-based" mutual pattern and "train the trainer" course, on improving hypertension diagnosis and treatment competence of community physicians.</p><p><b>METHODS</b>A total of 632 physicians from 22 district and community hospitals in Haidian district (new model) and 20 district and community hospitals in Chaoyang district (traditional model) in Beijing were trained during July to October 2002. The survey was carried out before and 2 years after training with examination questionnaire.</p><p><b>RESULTS</b>The competence evaluated as a score (maximal 100) for hypertension diagnosis and treatment of physicians was similar in physicians before training from the two districts. Post training, the score significantly increased from 40.0 to 47.4 (P < 0.01) in physicians from Chaoyang district and from 40.5 to 70.5 (P < 0.01) in physicians from Haidian district and the final score for physicians from Haidian district is significantly higher than that for physicians from increased from Chaoyang district (P < 0.01).</p><p><b>CONCLUSION</b>The new model is more efficient for improving community physician's competence for diagnosing and treating hypertension.</p>
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Adult , Female , Humans , Male , Clinical Competence , Education, Medical, Continuing , Methods , Hospitals, Community , Hypertension , Diagnosis , Therapeutics , Physicians , Practice Patterns, Physicians' , Surveys and QuestionnairesABSTRACT
· AIM: To study the clinical characteristics of metastatic bacterial endophthalmitis.endophthalmitis were retrospectively studied.manifestation was found in 17 cases (77%), iridal purulent nodules in 2 cases and retinal purulent embolism In 3 cases. The total number of leucocytes and neutrophilic granulocytes was elevated markedly, while lymphocyte count was reduced significantly in early stage. Positive rate of bacterial cultivation was 36%.dophthalmitis often have apparent extraocular infected situation before eye Is involved. Ocular appearance and laboratory examination have some specificity in early stage, while bacterial cultivation, as a golden standard,needs to be further improved.
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<p><b>OBJECTIVE</b>To study the use of hypertension related physical examinations, laboratory tests and anti-hypertension drugs among district and community based hospitals in Beijing and to analyze the possible hardware (examination, test, drug) problems under the application of the "China Hypertension Guide" in those hospitals.</p><p><b>METHODS</b>The survey was carried out in 40 hospitals in Chaoyang and Haidian districts, including 9 district level hospitals, and the rest at community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals.</p><p><b>RESULTS</b>(1) The hardware condition of district hospital satisfied the implicit requirements of hypertension evaluation and treatment in "China hypertension Guide". (2) 64.5% of the community level hospitals had the basic equipments and routine laboratory tests for diagnosis and treatment on hypertension, but 35.5% of them lack of tests on blood chemistry (potassium, sodium, creatinine) and urine protein. (3) 71.0% of community level hospitals could not judge the patient's "target organ damage" independently. (4) Both district and community level hospitals had all major types of anti-hypertension drugs in there pharmacy except ARB.</p><p><b>CONCLUSION</b>When necessary laboratory tests for both district and community level hospitals were provided, they could accomplish the tasks of hypertension treatment and management. However, the community level hospitals should cooperate with hospitals at higher level to have a comprehensive clinical understanding of patients with high blood pressure.</p>
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Humans , China , Clinical Laboratory Techniques , Cross-Sectional Studies , Diagnostic Services , Hospitals, Community , Hypertension , Diagnosis , Drug Therapy , Pharmaceutical Services , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To analyze the influence of knowledge about hypertension and clinical competence among physicians in district and community hospitals on management of hypertensives.</p><p><b>METHODS</b>Questionnaire investigation was used in 9 district and community hospitals in Chaoyang and Haidian district, including 181 physicians and 204 patients with hypertension.</p><p><b>RESULTS</b>(1) The hospitals involved were divided into two groups according to our evaluation on the knowledge of hypertension and clinical competence of physicians. Four hospitals were graded as high-score group and 5 hospitals as low-score group. (2) There was no significant difference on physicians' evaluation between district and community hospitals. There was higher proportion of hypertensives with instructed physical exercises, reducing salt ingestion, psychological balance and weight reduction in district hospitals than those in community ones. (3) The proportion of hypertensives who were examined with funduscopy, ambulatory pressure and instructed with physical exercises, reducing salt ingestion and weight reduction in high-score group was obviously higher than that in low-score group. The control rates of blood pressure, on the days of examination during lastest check-up or the past three months, were significantly higher in high-score group than in low-score group (P < 0.05).</p><p><b>CONCLUSION</b>Knowledge of hypertension and clinical management competence among physicians in district and community hospitals did influence the management of hypertension and education of physicians and thus should be increased.</p>
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Humans , Clinical Competence , Reference Standards , Delivery of Health Care , Reference Standards , Directive Counseling , Reference Standards , Education, Medical , Reference Standards , Hospitals, Community , Classification , Reference Standards , Hypertension , Diagnosis , Therapeutics , Patient Care , Reference Standards , Physicians , Reference StandardsABSTRACT
<p><b>OBJECTIVE</b>To estimate the knowledge level and clinical ability of hypertension treatment among physicians in district and community hospitals in big and moderate cities.</p><p><b>METHODS</b>43 district and community hospitals were selected by non-random sampling in Beijing and Baotou inner-Mongolia municipality. A total of 754 physicians in those hospitals were investigated, through an examination.</p><p><b>RESULTS</b>The correct rates on blood pressure stages, risk stratification and treatment strategy were 64%, 28% and 54%, respectively. The knowledge level on non-pharmacologic treatments was insufficient among physicians. The knowledge level of special indications on the common antihypertensive drugs (such as diuretics, beta-blockers, ACE inhibitors) was even worse.</p><p><b>CONCLUSION</b>Physicians in district and community hospitals did not have enough knowledge and ability to fulfill the task of hypertension treatment and management.</p>