Repeatability of near visual acuity measurement at high and low contrast

Purpose: The aim of this study was to determine the repeatability of high‐ and low‐contrast visual acuity (VA) measurements at near. Methods: Fifty‐five normal subjects were recruited. Inclusion criteria included visual acuity of at least 0.00 logarithm of minimum angle of resolution (logMAR) on each eye at distance. One eye was selected for this study, either the one with a better acuity or randomly chosen if there was no difference between the two eyes. Near VA was measured in a random order with the PolyU high‐contrast (PolyU‐HC), the PolyU low‐contrast (PolyU‐LC), the Precision high‐contrast (P‐HC) and the Precision low‐contrast (P‐LC) charts at 400 mm. Measurements were repeated after one to two weeks. Repeatability was presented using the 95% limits of agreement between visits. Results: The between‐visit repeatability was ±0.063 logMAR for high‐contrast and ±0.141 for low‐contrast using the PolyU charts. The between‐visit repeatability was ±0.120 logMAR for high‐contrast and ±0.110 for low‐contrast using the Precision charts. Seventeen subjects had high‐contrast VA better than ‐0.10 logMAR using Precision chart, which could not be measured by PolyU chart. The mean difference between high‐ and low‐contrast VA was 0.108 from the Precision charts (median difference of 0.10 or one line). Conclusions: The Precision charts could measure high‐contrast near VA to threshold level. Practitioners should be aware of a VA difference of more than one line in repetitive measurement, at both high and low contrast. A difference in near high‐ and low‐contrast VA of more than one line may warrant further investigation.     

Lid margin split in the surgical correction of epiblepharon

Purpose: To describe the technique of splitting the lid margin combined with the excision of redundant skin and muscle during the surgical correction of epiblepharon and to report its clinical outcome. Methods: A combined procedure that included splitting the lid margin to repair lower eyelid epiblepharon was performed on 31 eyes of 19 consecutive patients. Lid margin splitting was performed along the grey line on the medial third or half of the lower eyelid by making a 1 mm‐deep incision. Having made a transverse subciliary skin incision and a dissection between the tarsus and the orbicularis oculi muscle, the subcutaneous tissue of the superior edge of the incision was secured to the tarsus with interrupted sutures to evert the cilia. An excision of the redundant skin and orbicularis tissue was made and the skin was closed. The patients were followed for direct inspection of the wound, the split lid margin, the direction of the lashes and the status of the cornea. Results: The mean postoperative follow‐up period was 29.4 weeks. Symptoms disappeared in all patients. In 30 eyelids of 19 patients the cilia did not touch the cornea, even in the down‐gaze. In one eyelid the cilium touched the medial conjunctiva, but not the cornea. The cosmetic outcome of the lower lid was satisfactory in all cases and the wounds of the split lid margin healed without scarring. To date, there have been no complications such as wound dehiscence, ectropion or eyelid retraction. Conclusions: The lamellar splitting of the lid margin is a beneficial addition to the repair of prominent lower lid epiblepharon, especially on the medial aspect of the eyelid. This simple technique ensures easier eversion of the cilia in epiblepharon repair, without disturbing the posterior lamella or causing unfavourable results.     

Eyelid mass secondary to injection of calcium hydroxylapatite facial filler

A 37-year-old woman presented with a 2-month history of fullness and ptosis of the left upper eyelid. Examination revealed a 6-cm x 2-cm mass in the left brow and upper eyelid, and a diffuse mass in the lower eyelid. Marked ptosis of the left upper eyelid and elevation of the left lower eyelid were noted. CT showed masses with a bone-like density in the left eyelid and periorbital soft tissue. A through history revealed that the patient had received calcium hydroxylapatite filler injection for nose augmentation 3 days prior to the development of the eyelid masses. The eyelid masses were excised and pathologically confirmed as calcium hydroxylapatite microspherules surrounded by collagen and histiocytes. Two months after surgery, the eyelid masses and ptosis of the left upper eyelid were completely resolved. To our knowledge, this is the first reported case of eyelid mass after injection of calcium hydroxylapatite facial filler for nose augmentation.     

Down‐regulatory effect of usnic acid on nuclear factor‐κB‐dependent tumor necrosis factor‐α and inducible nitric oxide synthase expression in lipopolysaccharide‐stimulated macrophages RAW 264.7

The purpose of this study was to investigate the molecular mechanisms that are responsible for the antiinflammatory effect of usnic acid (UA). UA is one of the most common and abundant lichen metabolites. The present study examined the effects of UA on the tumor necrosis factor‐α (TNF‐α) and nitric oxide (NO) production induced by lipopolysaccharide (LPS) in RAW264.7 macrophages and the underlying molecular mechanisms. UA decreased the TNF‐α level in LPS‐stimulated RAW264.7 macrophages in dose‐dependent manner, the IC₅₀ value was 12.8 µM. RT‐PCR analysis indicated that it inhibited TNF‐α mRNA expression. Furthermore, it inhibited NO production in LPS‐activated RAW264.7 macrophages, the IC₅₀ value was 4.7 µM. Western blot analysis showed that UA attenuated LPS‐induced synthesis of iNOS protein and nuclear translocation of NF‐κB p65 in the macrophages, in parallel. UA also inhibited LPS‐mediated I‐κBα degradation. Taken together, this suggests that UA has an antiinflammatory effect by inhibiting TNF‐α and iNOS expression, possibly through suppression of nuclear translocation of NF‐κB p65 and I‐κBα degradation. Copyright © 2008 John Wiley & Sons, Ltd.     

研究生《医学统计学》教学情况及效果的评价

目的 评价四川大学《医学统计学》研究生课程教学情况及其教学效果,针对教学结果提出进一步教学改革的建议。方法 采用自行设计的问卷,以《医学统计学》研究生课程选课学生为研究对象,在学期末最后一次课结束发放问卷,调查教学情况。结果 收到来自6个不同学院有效问卷258份,以临床医学院和公共卫生学院学生为主。不同学院的学生各章节课前课后掌握不同,学习需求不同。89.53%的学生认为自己本科阶段的医学统计学基础差,96.51%的学生能意识到本课程重要,82.56%的学生具有较高的学习兴趣;学生对教学态度和教学水平较为认可,实践教学水平满意度(76.74%)低于理论课(91.09%)。91.86%的学生对教学总体满意,在课程内容设置的前沿性(62.40%)和应用性(68.60%)上的满意度,比课程系统性(80.23%)的满意度低。结论 学生对本课程教学总体满意度较高,学生收获较多,但是在教学模式和教学内容上还有待进一步改革。     

扬州市餐饮具集中消毒服务单位消毒效果监测分析

目的：通过对扬州市餐饮具集中消毒服务单位消毒效果进行监测分析,了解目前扬州市餐饮具集中消毒服务单位现状及餐饮具集中消毒质量,从而提高餐饮具集中消毒安全水平。方法：通过随机采样,对消毒餐饮具进行检测。结果：共抽检33家餐具、饮具集中消毒服务单位,170个批次样品,其中152个批次合格,合格率89%,阴离子合成洗涤剂合格率为89%。筷子的不合格比例最高,为44%。结论：扬州市集中消毒的餐饮具消毒效果总体良好,餐饮具集中消毒服务单位基本符合要求,但仍有部分单位需要整改。     

肺癌多学科诊疗模式对学科建设的影响

目的：探讨肺癌多学科诊疗模式在医院学科建设中的作用,为今后多学科诊疗模式的发展提供依据。方法：比较开展多学科诊疗模式前后肺癌诊疗中心门诊量、以及各相关专科收治相应病种人数、患者平均住院日、人均住院费用和学术科研情况。结果：肺癌门诊人次大幅度上升,各专科相关住院患者人数均明显增加,且平均住院日呈下降趋势,人均住院费用也有不同程度的下降。结论：多学科诊疗模式改变了传统单一专科的就诊模式,对医院学科建设起到了重要的推动作用,社会效益明显增加。     

国际全科医生制度发展历程:影响因素分析及政策启示

全科医生制度建设的国际经验可以为中国全科医生制度的建立和发展提供借鉴。本文首先梳理了国民健康服务体制、社会医疗保险体制、商业医疗保险体制等部分典型国家的全科医生制度发展历程,重点分析了全科医生制度建设的影响因素。结果发现,建立和发展全科医生制度的主要影响因素有:经济社会因素、卫生保健体制对卫生体系的控制力、医师对卫生体系的控制力、全科医学服务的激励机制、全科医学的发展程度等。最后,结合近年我国全科医生制度建设的实际提出几点政策启示,一要以满足我国公众健康需求为目标,构建中国特色全科医生制度;二要普及全科医学服务核心价值,为建立全科医生制度提供公众民意基础;三要建立健全促进全科医生制度发展的激励机制,提高全科医生地位;四要积极推动全科与专科医学的专业分工,促进全科医学发展。     

牛蒡子提取物中牛蒡苷和牛蒡苷元的含量测定研究

目的建立牛蒡子提取物中牛蒡苷及其苷元的含量测定方法.方法采用HPLC,以牛蒡甘、牛蒡苷元为含量测定指标,测定了牛蒡了提取物中牛蒡苷和牛蒡苷元的含量.色谱柱为Kromasil C18 100A(150mm×4.6mm,51μm).流动相甲醇-水(采川梯度洗脱的方式0～7min,35%～45%甲醇;7～9[Bin,45%～48%甲醇;9～15min,48%～53%甲醇;15～24min,53%～80%甲醇;24～30min,80%～100%甲醇);检测波长为280nm.结果牛蒡苷及牛蒡苷元的平均回收率分别为97.7%,96.9%.RSD分别为1.3%,0.9%(n=5);线性方程分别为Y=782.6X-64.11(r=0.999 8).y=1 220.217X-35.26(r=0.999 8).结论该方法快速准确,可同时测定牛蒡提取物中牛蒡苷和牛蒡苷元的含量,可用作牛蒡子提取物的质量控制方法.     

Magnolol Attenuates Concanavalin A‐induced Hepatic Fibrosis,Inhibits CD4+ T Helper 17 (Th17) Cell Differentiation and Suppresses Hepatic Stellate Cell Activation: Blockade of Smad3/Smad4 Signalling

Magnolol is a pharmacological biphenolic compound extracted from Chinese herb Magnolia officinalis, which displays anti‐inflammatory and antioxidant effects. This study was aimed at exploring the potential effect of magnolol on immune‐related liver fibrosis. Herein, BALB/c mice were injected with concanavalin A (ConA, 8 mg/kg/week) up to 6 weeks to establish hepatic fibrosis, and magnolol (10, 20, 30 mg/kg/day) was given to these mice orally throughout the whole experiment. We found that magnolol preserved liver function and attenuated liver fibrotic injury in vivo. In response to ConA stimulation, the CD4⁺ T cells preferred to polarizing towards CD4⁺ T helper 17 (Th17) cells in liver. Magnolol was observed to inhibit Th17 cell differentiation in ConA‐treated liver in addition to suppressing interleukin (IL)‐17A generation. Hepatic stellate cells were activated in fibrotic liver as demonstrated by increased alpha smooth muscle actin (α‐SMA) and desmin. More transforming growth factor (TGF)‐β1 and activin A were secreted into the serum. Magnolol suppressed this abnormal HSC activation. Furthermore, the phosphorylation of Smad3 in its linker area (Thr179, Ser 204/208/213) was inhibited by magnolol. In vitro, the recombinant IL‐17A plus TGF‐β1 or activin A induced activation of human LX2 HSCs and promoted their collagen production. Smad3/Smad4 signalling pathway was activated in LX2 cells exposed to the fibrotic stimuli, as illustrated by the up‐regulated phospho‐Smad3 and the enhanced interaction between Smad3 and Smad4. These alterations were suppressed by magnolol. Collectively, our study reveals a novel antifibrotic effect of magnolol on Th17 cell‐mediated fibrosis.