Objective To investigate the risk factors of the intraocular pressure (IOP) elevation after pars plana vitrectomy (PPV). Methods Eighty eight patients (88 eyes) of postoperative ocular hypertension in a series of 339 patients who had undergone PPV with normal ocular pressure before operation were retrospectively studied. The ocular pressures in both preoperative and postoperative periods were detected by NCT examination, and the ocular hypertension was decided on the level of ≥25 mm Hg. The relationships of occurence of the time of onset and duration of persistence of postoperative ocular hypertension with the different kinds of primary diseases, the techniques of operation, and the condition whether or not the affected eyes had formerly accepted surgical intervention, were analyzed. Results The IOP elevation occures mostly within 1 to 2 weeks postoperatively (77 eyes, 87.5%). In 65 cases (65 eyes) IOP returned to normal in 1 week, and in another 14 cases (14 eyes) in 1 month after treatments. Six patients' (6 eyes ) IOP was under 25 to 30 mm Hg with the medicine. With sustained elevation of IOP over 4 to 6 months, 3 cases (3 eyes ) lost or almost lost their vision finally. The probability of postoperative IOP elevation in the patients suffered from the retinal detachment with proliferative vitreoretinopathy (PVR) ≥grade C 2 was the highest in all the patients in our study (38.2%, P

Objective To explore the application of propofol combined with midazolam intrave-nous anesthesia in pediatric upper gastrointestinal endoscopy, Methods A total of 497 ASA Ⅰ～Ⅱ patients who received sedative upper gastrointestinal endoscopy were assigned to a children group (2～14 years) and an adults group (18～65 years). The 2 groups were treated with midazolam (0.02～0.03 mg/kg, iv) and propofol (0.6～0.7 mg/s, iv) with an interval of 3～5 minutes. Enterseopy was inserted at light sleep, relaxing muscles, and disappearance of eyelash relaxation. Combining of pro-endoscopy, reaction to intravenous administration, dose of propofol, reaction to en-doscopy, time of returning to consciousness, changes of SpO2, R, HR, and BP, and sedative quali-ty were evaluated. Results Good sedation of the 2 groups after intravenous administration was ob-served. Rate of combining of pro-endoscopy in children was lower (42%) than that in adults (100%). The incidence of restlessness, hyperphasia, temporary decreasing of SpO2, dose of propofol of per kilogram weight, time of returning to consciousness in the children were 82.7%, 17%, 2.4 mg/kg, and (17.5±3.2)min, respectively, which were all higher in the adults [9%,4%,1.4 mg/kg, and (9.5±1.3)min, P<0.01]. HR and BP decreased in the 2 groups, and recovered rapidly after the endoscopy. There was no significant difference between the 2 groups (P>0.05). Conclusion It is safe and effective to use propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy.

Objective To explore the safety and the efficacy of the two-stage sedation administration method for the elderly in gastroscopic examination. Methods 128 elderly patients were divided into two groups according to age and body mass index (BMI), and were given sedation treatment before gastroscopic examination by two-stage administration method(group TSAM, n= 64)and continual administration method (group CAM, n= 64) of analgesics respectively. The following major data were recorded : ( 1 ) mean artery pressure (MAP) ;( 2 ) Blood oxygen saturation ( SpO2 ) ;(3)sedation level;(4) recovery time;(5) the amount of propofol used for sedation;(6) electrocardiogram (ECG) ;(7)the degree of pharyngeal malaise;(8) the oblivion degree of malaise. Results There was no significant difference in MAP alteration between two methods(P>0. 05). Compared with group CAM, the decreased degree of SpO2 was slighter and no patient's SpO2 was lower than 90% in group TSAM (P<0. 05). Fifty-seven patients in group TSAM fell into sedative state for gastroscopy with OAA/S score 2, while sixty patients in group CAM with OAA/S score 2, which represented a deeper sedation level in group CAM (P<0. 01). The recovery time was shorter and the amount of propofol used was significantly less in group TSAM than in group CAM (P<0. 01). During the process of gastroscopic exmaination, ST-T change and arrhythmia in ECG were not seen in either of these two groups. The pharyngeal malaise of patients in group TSAM was more severe than in group CAM (P<0. 01). However, there was no difference in the oblivion degree of malaise between two methods(P>0.05). Conclusions The two-stage sedative administration method is safer and more effective for gastroscopic examination for the elderly.

OBJECTIVE To realize the timeliness of the mobile phone and network during the application of the infectious disease reporting and supervision,and the preciseness of the infectious disease forecast,thus build the automatic reporting and supervision system of the infectious disease in hospital with the military and local features.METHODS Using the existing iatrical data and computer resources with telecommunication wide band network and the special mobile phone resources to construct the reporting and supervision system of the epidemic situation.Adopting B/S framework,the downstage supporter adopted the comprehensive technology with Net,J2EE,and Java,the backstage supporter adopted the large scale database of Oracle,using software and NTFS with code technology to make epidemic situation reporting and supervise the network.RESULTS This system might realize the most important function of the infectious disease with timely reporting,precise filling,automatic alarming,dynamic supervision and automatic statistical calculation.CONCLUSIONS This system may provide the important practical value for the epidemic situation reporting and supervision and the abrupt public medical accidents forecast.

OBJECTIVE: To investigate the efficacy and security of different administrations of propofol on the sedation in upper gastrointestinal endoscopic procedures in snoring patients. METHODS: A total of 1,117 patients with snoring in ASA I-II level, who underwent gastroscopy and received propofol as sedation, were assigned to Group A, Group B, and Group C.These groups had different administration methods of propofol. The dose of propofol, response to endoscopic procedures, changes of oxygen saturation of arterial blood (SPO₂), incidence of severe respiratory depression and sedation quality assessed by operators were observed. RESULTS: The incidence of transient decline in SPO₂ in Group A, B, and C were 50.4%, 3.1%, and 18.5%, respectively. The doses of propofol of Group A, B, and C were (108.50±18.02) mg, (57.50±7.50) mg, and (79.80±10.02) mg, respectively, with significant difference (P<0.05). The incidence of severe respiratory depression in Group A was 1.2%, but Group B and C were 0%. Compared with Group A(100%) and C(100%), the satisfaction rate of sedation quality in Group B was 74%, with significant difference (P<0.05). CONCLUSION During the upper gastrointestinal endoscopic procedures, snoring patients are premedicated with propofol in various uses by steps or one slow administration. Both methods are safe and effective to reduce the incidence of severe respiratory depression, and patients have no memory of the procedure.
Adult ; Endoscopy, Gastrointestinal ; methods ; Female ; Gastrointestinal Diseases ; complications ; diagnosis ; Humans ; Hypnotics and Sedatives ; administration & dosage ; adverse effects ; Male ; Middle Aged ; Propofol ; administration & dosage ; adverse effects ; Snoring ; complications

OBJECTIVE: To determine the efficiency and safety of capsule endoscopy for patients with intestinal diseases. METHODS: Given M2A capsule endoscopy (CE) was performed on 81 patients with obscure gastrointestinal bleeding and obscure abdominal pain, and the clinical data were analyzed. RESULTS: In the 81 patients, 9 showed negative finding, CE didn't reach the small intestine in 1 patient. In the other 71 patients, 132 intestinal lesions were detected, and the total positive rate of CE for intestinal diseases was 88.75%. The findings consisted of 36 intestinal inflammation, 24 angiopathy, 16 protuberant lesions, 15 mutipolypi in the intestine, 12 blood in the intestine, 11 single or multiple ulcers, 6 ascarid in the intestine, 5 diverticula, 1 ankylostomiasis, 1 intestinal dysplasia with internal fistula, and the 5 intestinal Crohn's disease. Ten patients with protuberant lesion were verified by surgical operation and pathology, and the 5 stromal tumors diagnosed by CE were confirmed by pathological examination, while no one of Crohn's disease, lymphoma and angioma was diagnosed correctly by CE. All images of CE were good. All the patients had no complications. CONCLUSION Capsule endoscopy is a safe and effective procedure, with a high positive rate, but the diagnostic yield is limited, which can be used for intestinal diseases.
Abdominal Pain ; diagnosis ; Adult ; Aged ; Aged, 80 and over ; Capsule Endoscopy ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; Humans ; Inflammatory Bowel Diseases ; diagnosis ; Intestinal Diseases ; diagnosis ; Intestine, Small ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

OBJECTIVE: To investigate the efficacy and risk of midazolam and propofol for sedation during colonoscopy procedures in adults of different age groups. METHODS: A total of 180 patients undergoing colonoscopy were allocated to 3 groups: a young adult group (n=45, 18-44 years), a mid-aged group (n=78,45-64 years) and an elderly group (n=57, 65-80 years). All patients were premedicated with midazolam 0.02-0.03 mg/kg and propofol 0.5-2.5 mg/kg. The pulse rate, arterial pressure, and oxygen saturation for each patient were monitored continuously before, during and after the procedure. RESULTS: The doses of midazolam and propofol for the young adults were significantly higher than that for the mid-aged and the elderly (P<0.01). Based on the view of gastroenterologists, the satisfied rate of sedation quality was significantly higher in the elderly group than that in the young or the mid-aged group (P<0.01). There were significant changes in the arterial pressure in all groups compared with the baseline level (P<0.01), but there was no significant difference among the 3 groups. Other parameters such as heart rate, saturation of O2, and the rate of severe adverse reaction among the 3 groups were not significantly different (P>0.05). CONCLUSION Higher dose of midazolam and propofol is needed to obtain the sedation quality in young adults. Whereas for the elderly, properly reducing the dose of midazolam and propofol may still keep the sedation quality during colonoscopy procedures.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Colonoscopy ; methods ; Conscious Sedation ; methods ; Drug Synergism ; Female ; Humans ; Hypnotics and Sedatives ; administration & dosage ; Male ; Midazolam ; administration & dosage ; Middle Aged ; Propofol ; administration & dosage ; Young Adult

OBJECTIVE: To evaluate the curative effect and safety of endoscopic full-thickness resection (EFR) in the treatment of gastric tumor originated from the muscularis propria.
 METHODS: Clinical data were collected from 34 patients, who underwent EFR of gastric tumor originated from muscularis propria, to observe the resection rate and complications from November 2012 to August 2014.
 RESULTS: Of the 34 patients, 15 were male, 19 were female, with the age of 38.3-70.6 (52.3±4.3) years old. The lesions of 25 patients located in the fundus of stomach and the rest was in the gastric body. EFR was successfully performed in the 34 patients with no need for surgery. The complete resection rate was 100%. Lesion diameter ranged from 1.0 to 5.0 (2.8±1.2) centimeters. The operation time was 50-100 (76.5±18.2) min. Patients with pneumoperitoneum were relieved after abdominal puncture exhaust, without post-operation bleeding and perforation. The hospitalization duration was 3-5 (3.6±0.8) days. Except 1 case, the remaining 33 cases were spindle cell tumors, consistent with the results of immunohistochemistry. The risk for two lesions with 4.5 cm and 5.0 cm was moderate. The risk of invasion was low or very low in the remaining 31 cases. Among them, 2 stromal tumors near the cardia showed a differentiation tendency toward smooth muscle. No lesion residual or recurrence happened during the follow-up period (range 5-23 months) in 34 cases. 
 CONCLUSION EFR is a safe and effective method for gastric tumor originated from muscularis propria.
Adult ; Aged ; Cardia ; Female ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Humans ; Immunohistochemistry ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Stomach Neoplasms

ObjectiveTo prepare matrine lipid-based cubic liquid crystalline nanoparticle （MAT-LLCN） gels and investigate its in vitro release and transdermal absorption behavior. MethodTaking entrapment efficiency as the index， the optimal formulation of MAT-LLCN was screened by extreme vertex mixture method based on the optimal ratio of glycerol monooleate （GMO） to poloxamer 407 （P407）， and its drug loading was investigated. MAT-LLCN gels was prepared by mixing MAT-LLCN with pre-swelled carbomer 940 as the gel matrix. The structure of MAT-lipid-based cubic liquid crystalline （LLC） was characterized by polarized light microscopy （PLM） and small angle X-ray scattering （SAXS）. The in vitro release and transdermal absorption properties of MAT-LLCN gels and MAT ordinary gels were compared by modified Franz diffusion cell method， skin structure changes caused by them were observed by hematoxylin-eosin （HE） staining. ResultThe optimal formulation of MAT-LLCN gels was 5.5% of GMO-P407 （9∶1）， 1%-6% of MAT， 0.6% of carbomer 940， adding water to sufficient amount. The prepared MAT-LLC was confirmed as body-centered （Im3m） LLC. The in vitro release behavior of MAT-LLCN gels was in accordance with the Weibull equation （R²=0.954 0）， and the release mechanism was the Fick diffusion. In vitro transdermal test showed that all the parameters of MAT-LLCN gels were higher than those of MAT ordinary gels （P<0.05）， including cumulative release rate， steady-state release rate and the amount of drug retention in skin. HE staining results showed that MAT-LLCN gels could loose the cellular arrangement of skin stratum corneum， and maintain the stability of the cell structure of the dermis. ConclusionThe prepared MAT-LLCN gels can accelerate the transdermal drug transport and form drug storage in the dermis by rapidly opening the skin stratum corneum barrier， suggesting that LLC has good application prospects in the field of transdermal drug delivery.