Objective: To observe the clinical effects of combination of propofol,fentanyl and in surgical abortion. Methods: A total of 184 early-pregnant women were randomly divided into two groups.The women in group Ⅰ received propofol 2.5 mg/kg intravenously(n=92),the women in group Ⅱ received the combination of propofol,fentanyl and atropine intravenously(fentanyl 1 ?g/kg,atropine 0.5 mg,propofol 1 mg/kg)(n=92).To compare the efficacy of those two kinds of anesthesia,many measurements were taken, which included the total dose of propofol applied,induction time,recovery time,self-walking time,operative time,blood loss during the abortion,dilatation of the uterine cervix,blood pressure,heart rate,breathe,pain caused by injection and post-operation uterine contraction. Results: Many differences were found in the group who received the combination of propofol with fentanyl and atropine,when compared to those measurements in the group received propofol only.Significantly less(amount) of propofol was needed.The induction time was significantly shorter.The slowing of heart rate,dropping of blood pressure and reduction of breathing were significantly less.The dilation of the uterine cervix was more complete and took much less time.The pain caused by injection and post-operation contraction was significantly less frequent and less severe. Conclusion: Applying the combination of propofol,fentanyl and atropine has several clinical benefits which include less propofol need,less inhibition to the respiration and cardiovascular system,and less pain caused by injection and post-operation contraction.

Objectives:To observe the clinical effects of combination of propofol and misprostol in surgical abortion. Methods:240 women opting for voluntary surgical abortion were randomly allocated to 3 groups, receiving propofol plus misoprostol, lidocaine and routine menthods, respectively. Comparation was made on the effects of easing pain, cervical dilatation, surgical complications, bleeding amount, uterus contraction, patient satisfaction, etc. Results:The propofol and misoprostol group has higher efficacy and safety in surgical abortion than other 2 groups. Conclusions:Application of propofol and misoprostol in surgical abortion should be a recommended choice when patient can afford.

Objective To estimate the frequency of heart valvular involvement in Chinese patients with Takayasu arteritis (TAK) and its correlation with other clinical features. Methods Ninety-one patients with TAK were studied and their clinical manifestations, laboratory test, vascular images and echocardio - gra-phic findings were retrospectively reviewed. The data were compared between patients who had heart valvular involvement and those who had not. Mann-Whitney U-test or Student's t-test, Chi-squared test or Fisher's exact test were used for analysis. Results Aortic regurgitation and mitral regurgitation were both confirmed in 20 (22%) patients. Tricuspid regurgitation and pulmonary valve regurgitation were observed in 10 (11%) and 2 (2%) patients, respectively. Older age at onset, longer disease duration, hypertension and involvement of the ascending aorta were all significantly more frequent in TAK patients with aortic regurgitation (t=2.903, P<0.01; Z=-2.759, P<0.01; χ2=7.918, P<0.01; Z=-4.454, P<0.01) than those without. However, the constitutional symptoms and acute phase reactants [erythrocyte sedimentation rate (ESR) and C reactive protein (CRP)] were not statistically different between patients with and without valvular regurgitation (P>0.05). Aortic valvular pathology examination of the three TAK patients who had underwent aortic valve replacement showed no inflammatory cell infiltration. Conclusion This study has demonstrated that heart valve involvement is common in patients with TAK, mainly in the form of regurgitation, and which may be secondary to hypertension and other cardiovascular complications. We should pay more attention to the screening and treatment of heart valvular involvement in TAK patients.

Complaints of medical consumers are caused by a good many factors,which aim at distincting medical pur?pose further,asking for economic compensation and justice,and punishing complained individual or complained hospital.It’s a realistic proposition on howto treat,reduce and avoid complaints,and maintain a correct attitude by units which ac?cept the complaints.

OBJECTIVE:To compare the economic value between patent application and know-how,the two measures for intellectual property rights protection of traditional Chinese medicine.METHOD:The legal features of intellectual property rights protection for Chinese traditional medicine were analyzed and its economic value was evaluated with economic model.RESULTS&CONCLUSION:The know-how has a greater economic value to enterprises under the current intellectual property rights protection system.

Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.

Background Corneal confocal microscopy can denamically offer the morphological image of corneal cells at cellular level.To find out the dynamic change of corneal thickness and morphology of corneal cells with aging is very important for the design of corneal refractive surgery.ObjectivePresent study is to find out the important relevance of dynamic change of corneal thickness and morphology of corneal cells with aging and the design of corneal refractive surgery and investigate the influence of age on central corneal tissue and characterize precisely the anatomy of cornea by in vivo confocal microscopy.Methods122 eyes of 122 normal subjects were enrolled in this study with the age from 18 through 80 years old.The subjects were diagnosed as emmetropia in the Center of Tianjin Medical University from August 2003 to December 2007.All eyes were examined in vivo by confocal microscopy.The cell morphology,cell density and corneal thickness were measured by confocal microscopy.The relationship of central corneal tissue change and age was evaluated.ResultsThe density of corneal superficial basement epithelial cells showed a significantly negative correlation with age (r=-0.355,P=0.017).The keratocyte density in the anterior and posterior stroma indicated a significantly negative correlation with age (r_1=-0.462,P=0.001;r_2=-0.403,P=0.016).The thickness of corneal epithelium cells had a significantly negative correlation with age (P=0.02).The mean value of total corneal thickness and stromal thickness in high myopic eyes was (523.2±26.20)μm and (468.4±20.72)μm respectively,presenting a significantly negative correlation with age (r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).A significantly negative correlation was also found in endothelial cell areas and density with age (r_1=0.417,P=0.004;r_2=-0.598,P=0.002).The percentage of polymorphological corneal endothelial cells was considerably increased(r=0.417,P=0.004)but that of pleomorphism cells was significantly decreased in >60-year-old population compared with younger subjects (r=-0.598,P=0.002).The morphology of corneal basement cell,anterior stroma cytocyte and endothelial cell were normal in younger subjects,and enlargement of the cells in size,decreases of number and density of the cells were found in >60-year-old subject.ConclusionThe anatomy and histology of the central cornea in young subjects exist discrepancy from older ones.The corneal hisological changes with aging include thinner thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased size of endothelial cells.Corneal thickness is asymmetric and seems to undergo age-related anatomic changes.

Background Endoscopic cyclophotocoagulation(ECP) is a new approach to treat refractory glaucoma.But,the histopathological change of ciliary body after ECP has not been reported yet.ObjectivePurpose of the present study is to explore the histopathologic change of ciliary body after ECP and investigate the mechanism of lowing intraocular pressure(IOP) of ECP and compared with trans-scleral cyclophotocoagulation (TSCP).MethodECP was performed on the right eyes of 30 adult pigmented rabbits and TSCP was taken in the fellow eyes.Other two normal pigmented rabbits were as control group.The clinical examinations were performed in day 1,3,5,7,14,28,42 and 56 after operation under the slim lamp to evaluate the inflammatory reactions of conjunctiva,sclera and cornea,and the IOP was detected in the same time points.The animals were sacrificed and the eyeballs were extracted for the examination of structure of ciliary body under the light microscope in day 7,14,28,42 and 56 after surgery respectively.ResultsThe mild inflammatory response and local opacity of lens were seen under the slim lamp in the eyes after ECP,and severe inflammatory reaction was in the eyes received TSCP.No opacity of lens was found after TSCP through the observing period.The lowing-IOP extent was significantly higher in ECP group than TSCP group after operation(P＜0.01).The structure of ciliary body epithelium was normal in normal rabbit eyes.The disruption of ciliary body epithelium,especially for non-pigment epithelial layer,edema of ciliary process were seen in the early period after ECP.Fourty-two days later,the irregulation of ciliary body epithelium and atrophy of ciliary process were exhibited under the light microscope.In TSCP group,the edema,blooding and damage of ciliary process were seen,but slight inflammatory response was in the ciliary epithelium.After 42 days of surgery,atrophy of ciliary body,irregular proliferation of pigmental and non-pigmental epithelial cells,thinness of sclera and scarring of ciliary stroma were revealed.ConclusionCompared with TSCP,ECP can selectively destroy ciliary epithelium effectively and thoroughly and therefore reduce IOP.The adverse effect of ECP is the opacity of lens.Less damage of adjacent tissue is found in ECP compared with TSCP.

Objective To investigate the role of molecular allergen diagnosis in respiratory allergic diseases, and measure the prevalence and the allergen molecular mapping of the asthma and allergic rhinitic patients.Methods Totally 80 cases of asthma or allergic rhinitis patients with two or more inhaled allergens from First Affiliated Hospital of Guangzhou Medical University during 2013 January to 2014 December were tested for serum specific immunoglobulin E ( sIgE ) against 112 allergen components by ImmunoCAP ISAC.Results About 78.8% ( 63/80 ) patients is three or more allergen components sensitization, the most prevalence allergen components were house dust mites′Der f 1 67.5%(54/80), Der f 2 66.2%(53/80), Der p 1 and Der p 2 were 63.8%(51/80) and 61.2%(49/80), Der p 10 was only 12.5%(10/80), follewed by Fel d 1 22.5%(18/80), Cyn d 1 16.2%(13/80), Phl p 4 15.0%(12/80), Pen m 1,Pla a 2,Jug r 2 and Can f 1were all 11.2%(9/80), Lep d 2, Blo t 5, Bla g 7 and Ani s 3 10.0%(8/80).Other allergen components positive rates were low.Conclusions Molecular allergen diagnosis can provide more comprehensive diagnostic information for allergic patients, by providing allergen map.Allergen microarray can discover the neglected allergens such as bermuda grass, timothy grass and plane tree pollen allergens in southen China.

Objective To analyse distribution of age and gender characteristics of specific IgG(sIgG)antibodies and specific IgE (sIgE)antibodies of 13 types of food allergens in patients with food anaphylaxis,and to explore the relationship between sIgG and sIgE in food anaphylaxis.Methods 314 cases of patients from 2009 to 2012 were selected as subjects,and divided into underage group(1 63 cases)and adult group(1 5 1 cases).Serum sIgG of 13 types of food allergens were detected by using enzyme linked immu-nosorbent assay,serum sIgE of these food allergens were detected by using immune capture.Results 80.25% of the patients were sIgG-positive,and no obvious gender differences were found;while the positive rates of sIgG in the underage group(94.48%)were higher than that in the adult group(64.90%),there were statistically significant differences(P < 0.05 ).34.39% of the patients were sIgE-positive.The positive rates of sIgE in male patients(40.68%)were higher than that in female patients(26.28%),and that in the underage group(55.21%)were also higher than that in the adults group(1 1.92%),there were statistically significant differences(P <0.05).Conclusion The total positive rates and its distribution characteristics of sIgG and sIgE of same food aller-gens were obviously different.Food anaphylaxis might be associated with age,gender,food types and individual diversity.