Communicable Diseases ; transmission ; Decision Support Techniques ; Humans ; Models, Theoretical ; Risk Factors

Abdomen ; Acupuncture Therapy ; methods ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Vertigo ; therapy

Glaucoma,especially common primary open-angle glaucoma and primary angle-closure glaucoma,shows high genetic heterogeneity. The causing-disease genes known are difficult to explain some glaucomatous cases,and the study on the susceptibial gene of glaucoma do not achieve new breakthroughs. Combined with the newest progression in genetic study of glaucoma,some views were proposed in this paper in order to better understand the updating study of the pathogenesis mechanism.

Background Posterior capsular opacification (PCO) following cataract extracapsular extraction is a major cause of the reduction of visual acuity.Topical administration of eye drops is a research hotspot for the prevention of PCO.Objective This study was to evaluate the release of cyclosporine A-loaded chitosan nanoparticles (CyA-CS-NP) by ionic gelation in vitro and its feasibility of modification of the surface of polymethylmethacrylate intraocular lens (PMMA IOL) with CyA-CS-NP.Methods The CS-NP and CyA-CS-NP were prepared by ionic gelation of CS with sodium tripolyphosphate.The characteristics of CS-NP,such as the appearance and mean size,and drug entrapment efficient (EE),loading capacity (LC),and the drug release were studied ; the CyA content on the IOL surface was detected by high performance liquid chromatography (HPLC).The IOL surface modified with CyA-CS-NP was observed by scanning electron microscope and X-ray photoelectron spectroscopy technique (XPS),the changes of elements and chemical bond types between simple plasma processed IOL and CyA-CS-NP modified IOL were analyzed.The transmittance at the wavelength of 360-490 nm and refraction of IOL were detected using back focal length method and spectrophotometer,and the effective resolution of IOL was evaluated according to the instruction of ISO/CD 11979-2.Loops anti fatigue test of IOL referred to the criteria of ISO/CD 11979-3.Results The CS-NP and CyA-CS-NP showed monodisperse,uniform appearance similar to spherical shape with a mean size of (158±18) nm and (219±29) nm,respectively.The CyA-CS-NP had high CyA association efficiency and loading capacity (64.2％ and 7.6％).In vitro release study revealed a fast release on the first day followed by a increased drug release during an 11-day following up.The sustained release was approximately 46.6％ at day 1 and 77.7％ at day 12,respectively.The surface of IOLs with cling film was smooth without CS-NP;while the edge of IOLs appeared a layer of CyA-CS-NP after modification.XPS analysis displayed some elements such as phosphonium,CNH2 and O =CN that appeared on the modified surface,indicating that CyA-CS-NP existed on the surface of IOLs edge.The mean quality of CyA on three IOLs surface after modification was 171.88 μg.The diopter,distinguishing ability and transmittance of modified IOL were (16.64±0.23) D,(90.28 ± 0.25) ％ and (73.57 ±0.62) ％,and those of unmodified IOL were (16.62±0.29) D,(90.28±0.21) ％,(73.61±0.60)％,without significant differences between them (t =0.381,0.078,2.291,all at P ＞ 0.05).The antifatigue ability of loops complied with the criteria of ISO/CD 11979-3.Conclusions The optical property and antifatigue ability of loops of the edge-modified IOLs by CyA-CS-NP reach the normal standard and meet the requirement of clinic application.The edge-modified IOLs by CyA-CS-NP can be a delivery system for intraocular drug release.

AIM: To investigate the topography of the anterior surface of the human crystalline lens. ·METHODS: A Non-contact three-coodinate measuring system was utilized to scan the anterior surfaces of 8 human eye lenses in vitro. Acquired data were processed and computer models of the anterior lens surfaces were made using the program (Surfacer v 10.0). The to-pography of the anterior lens surfaces were established. Radii of curvature were measured at preset spots over the lens surfaces and two way analysis of variance was performed. The data were analysed to determine whether the radius of curvature varied systematically with the position on the lens surface from which the measurement was made. Lens surface asymmetric index (LSAI) was defined and calculated. The vertical and horizontal meridians of the modeled lens were calculated, and the best curve fit to any conic section was determined. ·RESULTS: The topography of the anterior lens surface indicated that the central zone (the central radius of curvature is (9.09±0.80)mm was steeper than that of the peripheral zone(17.05±2.20)mm. Two way analysis of variance of the radii of curvature at preset spots over the lens surfaces showed that the differences were statistically significant (P ＜ 0.05). Curve regression of radii of curvature at preset spots and their distances to the surface center revealed that the correlation of them was the third power function. LSAI increased steadily from the lens surface center(0.013±0.005) to the periphery(0.184± 0.065). The dots on the horizontal and vertical meridians were fit to four kinds of curves, and the determinate coefficient of hyperbola fit were the largest (0.9989-0.9999). ·CONCLUSION: The anterior lens surface is imperfectly rotational symmetric. Moreover, the nearer to the center, the more rotational symmetric it is. Radii of curvature increase nonlinearly from the surface center to the periphery. Anterior lens surface is typically hyperbolic.

BACKGROUND: Hyperbaric oxygen therapy has been considered as an effective therapy for prevention and cure of cerebral infarction traditionally.However, some scholars suggested that hyperbaric oxygen therapy could also result in cerebral infarction, although the mechanism is unclear.OBJECTIVE: To investigate the cause of cerebral infarction due to hyperbaric oxygen therapy.DESIGN: Case-control trial with patients as subjects.SETTING: Department of Hyperbaric Oxygen, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA.PARTICIPANTS: From December 1996 to March 1998, 192 inpatients receiving hyperbaric oxygen therapy were recruited into the trial from the Department of Hyperbaric Oxygen, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA. There were 127 males and 65 females aged 9-78 years. Patients admitted to the department of hyperbaric oxygen were eligible if they had hypoxia or ischemia induced disease and had no contraindication to hyperbaric oxygen therapy. Patients were recruited into the study regardless of the gender, and all patients and their family gave informed consent before enrollment. Patients were excluded if they did not receive hyperbaric oxygen therapy. According to the Diagnosis and Curing Criteria of Clinical Diseases, 6 patients developed into cerebral infarction during hyperbaric oxygen therapy, 3 males and 3 females, at the age of 51-76 years.METHODS: Patients were exposed to oxygen at 0.2 MPa in hyperbaric chamber used for many persons, and inhaled oxygen with a facemask once a day for 80 minutes with an interval of 10 minutes at the 40th minute. Ten days was considered as one course. Background and risk factors were analyzed in 6patients with cerebral infarction and 186 patients without cerebral infarction.MAIN OUTCOME MEASURES: Analysis of distribution of risk factors among cerebral infarction patients, and risk factor levels in patients without cerebral infarction.RESULTS: Among the 6 patients with cerebral infarction, hyperlipidemia was in all 6 cases, hypertension in 5 cases, primary cerebral infarction or hemorrhage in 5 cases, ≥ 60 years old or hyperviscosity in 4 cases, and diabetes mellitus in 1 case. Risk factor aggregation existed in the patients with over four risk factors. Of the 6 patients with cerebral infarction due to hyperbaric oxygen therapy, 5 cases had 4 risk factors and 1 had 5 risk factors. Of the 186 patients without cerebral infarction, 25 cases had 4 risk factors, and no case had 5 risk factors. The risk factor aggregation was relatively impossible (x2 = 54. 37, P ＜ 0. 05 ).CONCLUSION: Risk factor aggregation was found in all cerebral infarction patients, which is closely associated with the probability of cerebral infarction resulting from hyperbaric oxygen therapy.

Objective: To evaluate value of application of intravascular ultrasound imaging (IVUS) in diagnosing borderline lesions in left anterior descending artery (LAD) and left main coronary artery (LM). Methods: According to results of coronary angiography (CAG) in 60 cases with coronary borderline lesions, including 20 cases in LM, 20 cases in proximal segment of LAD and 20 cases in middle segment of LAD, the diagnostic value of IVUS in coronary borderline lesion was evaluated. Results: Compared with CAG, mean diameter stenosis rate of each coronary artery [LM: (65.3l±7.81) % vs. (75.28±8.89) %，proximal segment of LAD: (66.67±8.79) % vs. (78.89±7.88) %，middle segment of LAD: (71.55±6.83) % vs. (75.3l±7.81) %, P<0.01 all] significantly increased in IVUS. The differences of detection rate of plaque calcification and plaque rupture were no significant between CAG and IVUS（＞0.05）. Conclusion: Different degrees of underestimation of coronary artery stenosis exist in CAG, especially in proximal segment of LAD. IVUS can be an effective complement to CAG.

Objective To compare the therapeutic effects of hyperbaric oxygen (HBO) therapy at different time points on patients with spinal cord injury. Methods A total of 284 cases of spinal cord injury (SCI) were divided into an HBO group and a control group. The control group was treated with routine interventions (including a dehydrator, medication for neurotrophy, rehabilitation management, acupuncture and supportive treatment). The HBO group was treated with HBO in addition to the routine treatments, initiated at different time points after onset of SCI ( from less than 8 hours to longer than 1 week). All of the patients were evaluated in terms of scores on the American Spinal Cord Injury Association (ASIA) assessment and Barthel's index (BI) before and after treatment.Results Both groups had excellent effects when the treatment was initiated within the first 8 hours after the onset of SCI. There was no significant difference between the two groups. Average ASIA and BI scores in both groups improved significantly within the first 24 hours, and over the 1 st week after the onset of SCI. The recovery of neurological function and ability in the activities of daily living (ADL) was significantly better when HBO treatment was initiated within 8 hours after SCI compared with that initiated after 24 hour and 1 week. The therapeutic effects in the HBO group patients were significantly better than in the control group when HBO was initiated at 8 and 24 hours after onset of SCI. Neither the HBO group nor the control group had significant further improvement in ASIA scores or ADL performance when treatments initiated after 1 week. Conclusions HBO can significantly improve neurological function and ADL performance after SCI if it is administered within 1-8 hours.

Communicable Diseases ; epidemiology ; transmission ; Environmental Monitoring ; Epidemiologic Factors ; Forecasting ; Humans ; Models, Theoretical ; Risk Assessment

BACKGROUND: It is believed previously that hyperbaric oxygen(HBO)therapy can prevent stroke, but some scholars think HBO therapy on the contrary can induce stroke although its pathogen and prevention are unclear.OBJECTIVE: To study the reason of cerebral thrombosis induced by HBO and the preventive effects of the medicine.DESIGN: A retrospective study based on patients as subjects.SETTING: Department of HBO in a military area command hospital ofChinese PLA.PARTICIPANTS: Totally 192 hospitalized patients receiving HBO therapy in Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA were selected, in which there were 127 males and 65 females aged between 9 and 78 years old. A total of 6 cases including 3 male and 3 female cases aged between 51 and 76 years old developed cerebral thrombosis during therapy.METHODS: The background factors of 192 patients who received HBO therapy and the included 6 cerebral thrombosis cases were analyzed. Totally preventive effects of the medicine on a cluster level of different risk factor. Three groups of patients received different interventions under the prerequisites of routine medications including blood-activating and stasis-eliminating, neurotrophy, and vasodilator patients of nitric ether group received oral administration of isosorbide dinitrate or glycerin trinitrate; patients of calcium antagonist group received oral administration of Sibelium or Novarsc; and patients of no specific medication group did not receive any preventive medicine.MAIN OUTCOME MEASURES: Patients' symptoms, physical signs andhead CT or MRI.RESULTS: The risk factor of cerebral thrombosis induced by HBO was the basic disease of hyperlipidemia or hypertension, etc. A total of 115 cases had the cluster with less than 4 risk factors and none of them developed thrombosis. A total of 31 cases had the cluster with 4 or more than 4 risk factors and 6 of them developed thrombosis with greatly increased morbidity. Above the level of 4 risk factors, nitrate ether had effective preventive effect(0/13) while there was 33.3% of the patients(5/15) in calcium antagonist group developed thrombosis, and the difference between the above two groups was significant( P ＜ 0.05).CONCLUSION: The cluster level of risk factors has close relationship with the probability of thrombosis induced by HBO. Nitrate ether has significant preventive effects.