Background Anti-scarring is a focus following glaucoma filtering surgery.It has been verified that expression of heat shock protein 47 (HSP47) is always correlated with that of various types of collagens and closely related with the collagen-related diseases including fibrosis in various organs.However,the relationship between the expression of HSP47 and fibrosis of filtering bleb is unclear.Ohjective Present study was to investigate the dynamic expression of HSP47 in subconjunctival filtering bleb after anti-glaucomatous filtering surgery.Methods Filtering surgery was performed on the right eyes of 10 SPF male Spargue-Dawley(SD) rats.Then the operative eyes were randomized into the postoperative 7-day group and 14-day group according to the randomized number table,and the left eyes of the rats served as the normal control group.The shape of filtering blebs and the ocular anterior segment response were examined under microscope daily.The animals were sacrificed by excessive anesthesia on day 7 and 14 after operation,respectively,and the specimens were prepared of the eyes.Regular histopathological examination was performed to observe the collagen fibrosis change,and immunohistochemistry was carried out to assay the dynamic expression of HSP47 depended on the fibrosis.Percentage of positive cells for HSP47 were calculated.The use and care of the experimental animals complied with the Regulation for the Administration of Affair Concerning the Experimental Animals by State Science and Technology Committee.Results Diffuse subconjunctival blebs were seen postoperatively in t0 eyes after surgery with mild inflammatory response in ocular anterior segment.Hematoxylin-eosin staining showed that compared with the specimens of the normal control group,fibroblasts obviously proliferated and collagenous fibers increased in the specimens of operative group.The HSP47 protein was less expressed in cytoplasm of many fibroblasts and less vascular endothelial cells in the normal rat specimens.The expressing intensity of HSP47 protein was enhanced.However,the expression intensity was weaker in the postoperative 14-day group in comparison with the 7-day group.The percentage of positive cells for HSP47 in the filtering blebs 7 days after operation was (56.40±1.12)％,that in the normal control group was (13.70±0.74)％,with a significant difference between them (P=0.000).In the postoperative 14-day group,the percentage of positive cells for HSP47 reduced from (56.40± 1.12) ％ to (23.90±0.76) ％ (P =0.000),but it was still higher than that of the normal control group (P =0.000).Conclusions Expression intensity of HSP47 alters as the activity of fibroblasts in filtering bleb,suggesting that HSP47 plays a role in collagen-fibrosis following filtering surgery in SD rats.

OBJECTIVETo observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week. In the control group, midodrine tablets were prescribed orally,three times a day. All the treatment was given for 9 weeks. The clinical effects of the two groups were observed, and the levels of luteinizing hormone(LH), testosterone(Tes) and estra4 diol(E2) were compared between the two groups.

RESULTSThe total effective rate of the observation group was, 89. 47%(17/19), which was better than 47.06% (8/17) of the control group(P<0. 05). The LH and Tes were obviously increased and E2 was decreased compared with those before treatment in the observation group(all P< 0. 01). Tes was raised(P<0. 05) and E2 was apparently declined in the control group(P<0. 01). After treatment, the differences of serum LH and Tes were statistically significant between the two groups(both P<0. 01).

CONCLUSIONNeedle-pricking therapy has advantages for functional retrograde ejaculation probably in that stimulating lumbosacral nerves can strengthen the function of pelvic floor muscles and urethral expansion muscle and regulate sexual gland axis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Needles ; Sexual Dysfunction, Physiological ; physiopathology ; therapy ; Treatment Outcome

Objective:To compare the efficacy of phacoemulsification+ goniosynechialysis (Phaco-GSL) and Phaco alone for chronic primary angle-closure glaucoma (CPACG) patients with peripheral anterior synechia (PAS)≤180° combined cataract.Methods:A cohort study was performed.Fifty-two eyes with CPACG in 40 patients who underwent Phaco-GSL and Phaco-alone in Peking Union Medical College Hospital from February 2014 to October 2018 were enrolled.The patients were divided into Phaco-GSL group (22 cases, 29 eyes) and Phaco-alone group (18 cases, 23 eyes) according to different surgeries.Goldmann applanation tonometer was used to measure intraocular pressure (IOP) before operation and 1 day, 1 week and 1, 3, 6, 12, 18 months after operation.Best corrected visual acuity (BCVA) was examined with a standard logarithmic visual acuity chart.The number of anti-glaucoma drugs was calculated in the follow-up duration.The change of PAS was observed by ultrasound biomicroscopy and indentation gonioscopy.The intra- and post-operative complications and their management were analyzed and compared.This research protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Peking Union Medical College Hospital (No.S-K1352). Written informed consent was obtained from each subject prior to any medical examination.Results:There was no significant difference in IOP between the Phaco-GSL group and the Phaco-alone group ( Fgroup=1.569, P=0.223). A significant difference was found in IOP among various time points in different groups ( Ftime=7.762, P<0.01). The IOP of the eyes were significantly reduced at various time points postoperatively in comparison with the preoperative IOP in each group (all at P<0.001). There was no significant intergroup difference in BCVA ( Fgroup=1.996, P=0.172), however, a significant difference was found in BCVA among different time points in both groups ( Ftime=95.737, P<0.01). The postoperative 6- and 18-month BCVA was significantly improved in comparison with before surgery in both groups (all at P<0.001). The number of anti-glaucoma medicines used was significantly decreased at postoperative 1, 6, 12, 18 months in comparison with preoperation in both groups (all at P<0.05), and the anti-glaucoma medicines used in the Phaco-GSL group was less than that in the Phaco-alone group at 6, 12 and 18 months after surgery (all at P<0.05). The ranage of PAS at 18 months after surgery was 45 (0, 90)° and 100 (90, 140)° in the Phaco-GSL group and Phaco-alone group, respectively.The range of PAS in the Phaco-GSL group at postoperative 1, 3, 6, 12, 18 months was significantly smaller than preoperation in the Phaco-alone group (all at P<0.05). The incidence of intra- and post-operative complications in the Phaco-GSL group was significantly higher than that in the Phaco-alone group ( P<0.001). Conclusions:Both Phaco-GSL and Phaco-alone can reduce IOP and improve visual acuity in CPACG with PAS≤180° combined cataract patients.Phaco-GSL can maintain the gonio open and reduce the use of anti-glaucoma medicines and show a good safety.

Objective: This study aimed to measure the morphological parameters of the internal acoustic meatus(IAM) and its adjacent structures using temporal-bone thin-section CT(computed tomography). Methods: CT images were obtained from 50 Chinese adult patients (25 males and 25 females, 100 sides) which had no visible lesion in the petrous part of the temporal bone and inner ear, the morphological parameters of all inner ear parts were sectionally measured on the specified plane using SPSS 22.0 software for statistical analysis. Results: The integral morphological characteristics of the IAM were observed. These results revealed that anterior-posterior diameter of the internal acoustic poer(IAP)(CD) was (6.93±1.85)mm, the superior-inferior diameter of the IAP(EF) was (4.40±0.86)mm, the length of the IAM(AB) was (9.30±1.60)mm, the superior-inferior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (4.13±0.83)mm, the superior-inferior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (4.61±1.02)mm, the anterior-posterior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (6.62±1.92)mm, the anterior-posterior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (6.28±1.65)mm, the depth of transverse crest (superior wall) was (3.10±0.75)mm, the depth of transverse crest (interior wall)the was (1.46±0.59)mm, the distance from transverse crest vertex A to the superior wall of the IAM was (2.05±0.42)mm, the distance from transverse crest vertex A to the interior wall of the IAM was (2.93±0.41)mm, the thickness of the superior bone wall of the IAM (the intersection of inner 1/3 section and middle 1/3 section) was (4.45±1.34)mm, the thickness of the superior bone wall of the IAM (the intersection of middle 1/3 section and outer 1/3 section) was (4.32±1.12)mm, the thickness of the superior bone wall of the IAM (the intersection of outer 1/3 section and transverse crest vertex) was (4.37±1.28)mm, and the appearance ratio of the cells in the whole IAM superior wall was 32%.The whole IAM assumed the shape of short cylinder, inclining about 1 cm outward, with the upper-lower diameter and anterior-posterior diameter about 5 mm. Conclusion It is necessary for carrying out preoperative the temporal-bone thin-section CT to obtain the morphological parameters of the IAM, determine its basic morphology, and provide references to avoid damaging the other important structures during IAM surgeries.