Retrospective analyses of clinical data were performed for 518 elderly cataract patients (856 eyes) of Disabled Persons' Federation in Hangzhou,Zhejiang Province.For 69 eyes (8.06％),corneal edema was a major factor of low vision during early postoperative period; for 23 eyes (2.69％),delayed cataract was an important cause of low vision during long-term postoperative period.The best corrected visual acuity of 120 eyes caused by nonsurgical factors was diabetic retinopathy (48 eyes,48.00％),senile macular degeneration (25 eyes,20.80％),high myopia retinopathy (17 eyes,14.20％),optic never injury in glaucoma (16 eyes,13.30％),macular membrane & hole (5 eyes,4.20％) and amblyopia & corneal leucoma (9 eyes,7.50％).Retinal disease is the most important reason of low vision after cataract surgery.And surgery remains the most effective treatment for cataract.

Objective To study the diagnosis and treatment in patients of esophagus carcinoma and esophagogastric junction carcinoma after operation with paralysis gastroparesis syndrome (PGS).Methods From March 1996 to December 2013 in the Affiliated Hospital of Putian University,the clinical data of PGS in 42 patients with esophagus carcinoma and esophagogastric junction carcinoma after operation were selected, and retrospectively analyzed.Results All the patients were presented with gastric retention, no obvious abdominal pain,and anal exhaust has been restored.Enteron radiography shows anastomosis and pylorus were unobstructed and gastric motility was weaken or disappear.All patients were treated with gastrointestinal decompression, nutritional support, maintaining water electrolyte metabolism balance, promoting gastrointestinal peristalsis and reducing stomach wall edema.The stomach function recovery of 40 cases was within 10-15 days, respectively.Two patients cured by pyloroplasty when they were not improved by conservative treatment for 2 months.And the stomach function recovery were within 28 days and 35 days.Conclusion Gastroparesis syndrome is a functional disease,the cure rate is high, the treatment of first choice was conservative treatment, however, for the intractable gastroparesis, pyloroplasty maybe another good choice.

Cancers of the digestive system account for a large portion of malignant tumors in humans,and the trend is on the rise.The formation of neovascularization is the dominant factor in the metastasis of tumors.The vascular endothelial growth factor(VEGF) is well documented as the most potent inducer of angiogenesis.It promotes the formation of new blood vessels in several aspects,such as proliferation of endothelial cells,endothelial cell migration and increased vascular permeability.So VEGF is regarded as an important factor in the development of digestive system tumors.The purpose of this review is to investigate the relationship between VEGF and digestive system tumors.

To evaluate the effects of tetramethylpyraze (TPZ) on the collapsed lung during one lung ventilation (OLV), 2.4 adult patients with esophageal cancer,ASA grade Ⅰ-Ⅱ,undergoing esopha-goesophagostomy, were randomly allocated to receiving intravenous infusion with TPZ 4mg?kg~(-1) (group T,n=12) or equivalent volume of normal saline (group C,n=12) in 5 mins before onset of OLV respectively. The ultrastracture of collapsed lungat 90th min following OLV showed that in group C mitochondia swelled, the cristae disappeared, and large vecule appeared, but in group T those remained normal. As compared with those in group C,the Ca~(2+) content in erythrocyte decreased significantly 30 and 60 mins following OLV (P

Objective: To investigate the relationship between the plasma concentration of nitric oxide (NO) and prognosis of the hemorrhagic shock. Method:The blood levels of NO and Lactate (LA) were measured with fluorophotometry and colorimetry in 30 hemorrhagic shock patients,and another 30 patients for elective surgery served as a control. Result :Concentration of NO was significantly lower and that of LA was significantly higher in hemorrhagic shock group than that of control group. NO level had a negative correlation with LA level and injury index. NO level in the patients complicated by sepsis were still lower than the control. Conclusion:Decrease of NO level may result in disturbance of microcirculation and increase of LA. So nitroglycerin should be used as early as possible in the hemorrhagic shock patients.

To investigate the inhibiting effects of ketamine on arterial plasma TNF-? concentration and lung injury in septic shock rat. Method: 40 Wister rats were divided into five groups. 15mg?kg~(-1) endotoxin (LPS) was intravenously injected alone (group Ⅰ)or ip ketamine 50,100 and 200mg?kg~(-1) before LPS, then ketamine was infused at 10mg?kg~(-1)?min~(-1) (Ⅱ, Ⅲ and Ⅳgroup). TNF-? was assessed with ELISA, and at the same time the arterial blood oxygen tension and lung water content were measured. Result: In contrast to normal control level, arterial plasma TNF-? levels and lung water content increased and arterial oxygen tension decreased after LPS in group Ⅰ, but in the rats of giving ketamine, plasma TNF-? level decreased more than that in the rats of giving LPS alone (group Ⅰ), change of arterial blood oxygen tension and lung water content in former groups were better than that of later, in dosage-dependent way. Conclusion: Ketamine can dose-relatedly decrease TNF-? concentration and lung injury degree induced by endotoxin.

Objective To compare the influences of propofol and ketamine on mean pulmonary arterial pressure (MPAP), Ca 2+ content and the ultrastrcture of lung tissues during acute hypoxia Methods Twenty one Wistar rats were randomly divided into 3 group: infusion with propofol 8mg kg -1 h -1 in P group and ketamine 8 mg kg -1 h -1 in K group ,21% O 2 gas was inhaled in 15 min followed by inhalation of mixture gas of 10% O 2 and 90% N 2 for 20 min in the both groups ; continuous infusion with normal saline with 21% O 2 inhalation for 35 min in C group Carotid blood gas was analysed, pulmonary Ca 2+ content was measured with absorption spectrophotometry and the lung ultrastructure was detected with electron microscopy at the end of the experiment Results Compared with those in C group, MAP and PaO 2 decreased significantly and MPAP increased markedly in P and K groups , with MPAP in P group being lower than that in K group (P

Objective The purpose of this study was to assess the effects of heat stress response (HSR) on i of pulmonary arterial endothelium cells (PAEC)incubated with TNF-?. We tried to illustrate the mechanism of injury to PAEC caused by TNF-? and the effects of HSR.Methods The study consisted of four groups.In group Ⅰ confluent monolayer of calf PAEC were directly incubated with TNF-? at final concentrations of 500, 1 000 and 2 000 u/ml for 24 h.In group Ⅱ PAEC were first bathed in 42℃ water for 20 min and then allowed to recover for 24 h.In turn they were incubated with TNF-? at the same concentrations.In group Ⅲ PAEC were not heated and incubated with TNF-?.In group Ⅳ PAEC were heated but not incubated with TNF-?.i of PAEC was assayed by fluorospectrophotometry and i of four groups were compared.The change in i before and after incubation of PAEC with TNF-?(?i) was calculated.Results (1) i was considerably higher in group Ⅰ than that in group Ⅲ at different concentrations in dose-dependent way.(2) Although i was higher in group Ⅳ than that in group Ⅲ, HSR could inhibit the further increase in i of PAEC incubated with TNF-?.Conclusions HSR may decrease the i in PAEC incubated with TNF-?.It indicates that HSR can prevent PAEC from calcium overload and provide protection on PAEC against injuries.

ve When a new drug is introduced for intrathecal (IT) administration, its effect on spinal cord should be studied for safety reason. The aim of this study was to determine the ultra-microstructure of spinal cord and Ca2+ content in spinal cord after IT administration of ropivacaine in dogs. Methods Eighteen mongrel dogs of either sex weighing about 10kg were randomly assigned to one of three groups according to the dose of ropivacaine administered IT: group A received normal saline 2ml IT and served as control; group B received 0.5% ropivacaine 2ml(10mg) IT; group C received 1% ropivacaine 2ml(20mg) IT. Anesthesia was induced with intramuscular ketamine 20mg.kg-1 and atropine 0.05mg?kg-1 and maintained with intermittent iv boluses of ketamine 3mg?kg-1 and fentanyl 5?g?kg-1 Left internal jugular artery was cannulated for intra-arterial pressure monitoring. An incision was made in the back at L3-4 and lumbar puncture was confirmed by aspiration of cerebral-spinal fluid (CSF). Normal saline or ropivacaine was then injected over 20 seconds. 3 hours after IT administration the animals were sacrificed and L1-2 segment of spinal cord and nerve roots were immediately removed for Ca content determination and electron microscopic examination. Results The Ca2+ content of spinal cord was significantly higher in group C than that in group A and B. Electron microscope revealed that in group A and B neurolemma of the nerve root and mitochondria and endoplasmic reticulum of the neurons in spinal cord were intact, while in group C neurolemma was stratified and partly disrupted and mitochondria and endoplasmic reticulum underwent swelling and there was vacuole degeneration. Conclusions Ropivacaine of high concentration or at high dose may be injurious to spinal cord.

BACKGROUND:Drug eluting stents(DESs)has been applied in treatment of saphenous vein grafts,but few reports are present.OBJECTIVE:To retrospectively compare the late loss and major adverse cardiac events(MACE)between DES and bare mental stents(BMS)in patients with diseased saphenous vein grafts.DESIGN,TIME AND SETTING:The experiment,a grouping control study and follow-up observation,was performed from January 2002 to February 2007 in Beijing Luhe Hospitat and Beijing Anzhen Hospital.PARTICIPANTS:Ninety-seven consecutive patients with saphenous vein graft lesions were treated with DESs (DESgroup.n=50)or BMSs(BMS group,n=47).METHODS:All patients underwent percutaneous coronary implantation and received clinical follow-ups immediately.They were scheduled to undergo 12-month coronary angiography.MAIN OUTCOME MEASURES:The cardiac events including death,myocardial infarction,target lesion and/or target vessel revascularization.Late lumen loss was recorded and compared between the two groups.RESULTS:There were no significant differences on the gender,age,history of bridge vessels and complication between the two groups(P>0.05).A total of 97 patients with 118 lesions localized in 105 diseased saphenous vein grafts were included:50 patients received 71 DESs for 59 lesions,whereas 47 patients received 62 BMSs for 59 lesions.Procedural success was achieved in 94.0%of patients in the DES group and 93.6%in BMS group(P=0.43).At 12 months,the cumulative incidence of MACE was significantly lower in DES group than in BMS group(1 2.0%vs.29.8%.P=0.03).Angiographic follow-up was available for 54 patients,26 patients in DES group and 28 in BMS group.Late lumen loss was significantly reduced in DES group[(0.32±0.65)mm vs.(0.79±1.23)mm,P=0.01].The DES group had a significantly lower incidence of target lesion revascularization compared with BMS group(6.0%vs.19.1%.P=0.05).By Cox regression analysis,independent predictors for MACE at 12-month follow-ups were diabetes (OR:2.37;CI:0.95 to 5.88;P=0.064),BMS(OR:2.86;CI:0.98 to 8.34;P=0.05),and stent per lesion(OR:2.92;CI:1.25 to 6.82;P=0.01).CONCLUSION:DES is superior to BMS in diseased saphenous vein grafts,and it can significantly reduce late lumen loss and MACE.