In complicated vitreoretinal surgery,vitreous substitutes play a major role in maintaining intraocular pressure.Air,expansion gases,perfluorocarbons liquid,and silicone oil are frequently used in modern vitreoretinal surgery.Long-term vitreous substitute has been attempted with collagen,hyaluronic acid,natural hydrogel polymers and so on.However,an ideal vitreous substitute is being requested for a long time.This review focused on the currently available vitreous substitutes,as well as those in the experimental phase.These compounds were classified based on their functionality,composition,and properties.The clinical use,advantages,and shortcomings of the various substitutes were discussed.Finally,the criteria for an ideal vitreous substitute was defined.

Allergic rhinitis is familiar in clinic,in recent years the incidence has the trend of increase annually and the modern medicine has no effective cure at present.How to seek a permanent solution to the problem? Chinese medical constitution has influence on the incidence,syndrome differentiation,treatment and prognosis of allergic rhinitis.It is necessary and possible to prevent it according to Chinese medical constitution.The constitution is the internal and crucial factor of allergic reaction.The external etiologic factors work through the internal etiologic factors,making people get ill through the imbalance of yin-yang.Therefore,treating allergic rhinitis on the basis of Chinese medical constitution has a positive effect on prevention,correct diagnosis and treatment,controlling the progress and improving the prognosis.

Objective To determine the therapeutic effect of IgA nephropathy treated with tonsillectomy, and investigate the indication and contraindication. Methods Thirty-five IgA nephropathy patients, who were diagnosed by renal biopsy treated with tonsillectomy, were in operation group. Twenty-four hours urine protein, one hour urine erythrocyte and serum creatine were detected before the operation, one week, two weeks, four weeks, six months after the operation. Compared with 40 IgA nephropathy patients, who were treated with medicine (control group). Results The effective power in operation group was 71.4% and in control group was 52.5%. There was significant difference between two groups. Conclusion Tonsillectomy is more effective in IgA nephropathy with chronic tonsillitis, especially when renal corpuscle is slightly impaired, conversely, when renal function is severely damaged, it belongs to surgical contraindication.

ObjectiveTo explore the influence of locus of control,self-efficacy and self-esteem on shame.MethodsTotal 924 students from six primary and middle schools in Chengdu were recruited by stratified sampling.They were assessed with locus of control,self-efficacy,self-esteem,and shame questionnaire.Results ( 1 ) Shame was significantly negatively related with self-efficacy (r =- 0.248 ) and self-esteem (r =- 0.318 ),and was significantly positively related with locus of control (r =0.185 ).Locus of control was negatively associated with self-efficacy(r =- 0.214) and self-esteem (r =- 0.254).Self-efficacy was positively related with self-esteem (r =0.440) ; (2) Self-esteem played partial mediating role between shame and locus of control as well as self-efficacy; ( 3 ) Self-efficacy played partial mediating role between locus of control and self-esteem as well as shame ; (4) High self-esteem group and low self-esteem group existed significant differences in whole structure equation model.Based on the whole model,the high self-esteem group reduced the path from locus of control to self-esteem ; and low self-esteem group reduced the path from locus of control to self-efficacy.ConclusionLocus of control and self-efficacy are not only directly but also indirectly associated with shame by self-esteem,and self-efficacy would be regulated by the level of self-esteem.

Patients with nonvalvular atrial fibrillation are the high-risk population of ischemic stroke.Anticoagulation therapy is mainly used to prevent the occurrence of stroke in clinical practice.However,there are some difficulties in the conventional administration of oral anticoagulant warfarin because of some restrictions.There are a number of novel oral anticoagulants with promising data for the prevention of stroke in nonvalvular atrial fibrillation,such as direct thrombin inhibitor and coagulant factor X a inhibitor.

BACKGROUND: Bilateral pedicle screw fixation combined with intervertebral decompression and fusion is a classic surgical approach in treatment of lumbar degenerative diseases, but it can cause ligament and other soft tissue damage of lumbar spine and degeneration of the adjacent segments. While translaminar facet screw fixation has its unique advantages.OBJECTIVE: To compare the clinical efficacy of unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation for lower lumbar degenerative diseases.METHODS: Forty-six patients with single-level lower lumbar degenerative disease were enrolled, and were then treated with bilateral pedicle screw fixation combined with intervertebral fusion (group A, n=24) or unilateral pedicle screw along with translaminar facet screw fixation and intervertebral fusion (group B, n=22). Afterwards, the clinical indexes and efficacy were compared between two groups.RESULTS AND CONCLUSION: (1) All operations were performed successfully. The length of incision, operation time,intraoperative blood loss, postoperative drainage volume and cost of hospitalization in the group B were significantly superior to those in the group A (P < 0.05). (2) There was no significant difference in the rate of fusion between two groups (P > 0.05). (3) The visual analogue scale and Japanese Orthopaedic Association scores in both groups at 1 week,3, 6, 12 and 24 months postoperatively were significantly improved compared with baseline (P < 0.05), but the scores had no significant differences between two groups (P > 0.05). (4) To conclude, unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation both exhibit satisfactory treatment outcomes,while the former holds little trauma, good stability, high fusion rate and less cost, which is a better choice for lower lumbar degenerative diseases.

Objective: To evaluate the clinical effect of individualized enteral nutritional (EN) support in severe stroke patients.Methods: Totally 120 severe stroke patients with nutritional risk were divided into two groups according to single or double admission number.The 60 patients in the intervention group received an individualized EN with different formula and concentrations according to the clinical status,and supplemented trace elements as occasion required.In the routine group, the patients received EN with standard formula.The energy supply was 83-125 kJ· kg-1·d-1 in both groups.Blood albumin(Alb), pre-albumin(PA), hemoglobin(Hb) and vitamin C(VC) were examined before and after the 21-day nutritional support.The lung infection and gastrointestinal (GI) complications were observed, and the hospital stay and cost were recorded as well.Results: After 21 day''s nutrition support, the serum levels of Alb, PA and VC in the intervention group were not statisticly significant than before (P＞0.05), and the serum levels of Alb, PA and VC were significantly higher than those in the routine group(P＜0.05).The incidence of complications in the in the intervention group was lower than that in the routine group (P＜0.05), and the length of hospital stay and hospitalization was shorter than that in the routine group (P＜0.05).Conclusion: Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammation reactions and GI complications in severe stroke patients, which is worthy of clinical use.

OBJECTIVE: To draw the attention of our country and the concerned party on the shortage of certain drugs. METHODS: Based on the drug shortage condition in our hospital in recent years, we analyzed the reasons for drug shortage, put forward the solution and summarized the clinically indispensable categories. RESULTS & CONCLUSIONS: We should draw experiences from US by solving shortage problem of certain drugs through the co-efforts of government, manufactures and medical institutions to satisfy patients' needs of disease prevention and treatment.

Objective To investigate the inhibitory effect of the mammalian target of rapamycin (mTOR) inhibitor, sirolimus on expression of hypoxia-inducible factor (HIF)1? protein and growth of ovarian carcinoma in an athymic mouse xenogeneic transplant model of ovarian cancer. Methods Four groups of female nude mice were inoculated subcutaneously with SKOV3 cells. After inoculation, mice were treated with saline, rapamycin alone, paclitaxel alone and sirolimus+paclitaxel. In each tumor protein expressions of HIF-1?,bcl-2 and apoptosis were determined by immunohistochemistry and RT-PCR. Results In sirolimus and sirolimus +paclitaxel groups protein expression of HIF-1? was inhibited. Tumor burden in rapamycin alone, sirolimus +paclitaxel, and paclitaxel alone was reduced by 47.9%( P 0.05) respectively compared with controls. Cell apoptosis inder in sirolimus alone(36), sirolimus +paclitaxel(40), paclitaxel alone(22),increased compared with control(15), while expression of bcl-2 decreased compared with control. Conclusion Sirolimus inhibited protein expression of HIF-1?, increased tumor apoptosis and decreased tumor growth.

Objective To investigate the correlation of hypoxia-inducible factor (HIF)-1? and va scular endothelial growth factor (VEGF) or micro-vessel density ( MVD). Methods The ovarian cancer cell line SKOV3 was transplanted into nude mice to form xenog eneic tumor. Mice were treated with rapamycin 4mg/kg,sulindac 100 mg/(kg.d) a nd saline 200 ?l respectively. Expression of HIF-1? and VEGF proteins and MV D were determined by immunohistochemistry. The mRNA of Glut1 and VEGF was studi ed by RT-PCR. Results The positive expression of HIF-1? and VEGF was moderate to strong, and MVD was high (31?8) in control group. In rapamycin treated group, the expression of H IF-1? was inhibited to weak positive or negative (P