Refractory glaucoma is one of the main blinding diseases in ophthalmology.Glaucoma drainage device implantation has become one of the main methods of refractory glaucoma.It has been widely used in clinic because of its advantages of safety,effectiveness and less complications.After a large number of clinical applications and innovative development of minimally invasive glaucoma surgery,glaucoma drainage device implantation shows its good treatment prospects.In this paper,the structural features of glaucoma external drainage device (Molteno,Schocket,Baerveldt,Human aqueous drainage,Krupin,Ahmed,Joseph,Whites,Optimed drainage device) and microin vasive glaucoma surgery (MIGS) (Ex-PRESS drainage device,Xen Gel Stent,CyPass Micro-Stent,Ab interno trabeculectomy trabectome,Hydrus Schlemm canal scaffold,iStent trabecular micro-bypass stent,SOLX Gold Shunt) were summarized.The drainage device implantations for glaucoma in the role of the refractory glaucoma were reviewed.

Objective To study the natural history of HIV infection among paid blood donors(PBD).Methods Two thousand three hundred and sixty four individuals infected with HIV/AIDS via blood donation in twelve villages of Henan province were included in this study,Retrospective data were analyzed in combination with a cross-sectional survey.Results The number of deaths were 709 among these 2 364 subjects under study by the end of 2004,with a mortality rate of 30.1%.Among 712 deaths,32.8% were companied with serious lung infections,18.1% were complicated with serious diarrhea,8.2%-with central nervous infections,8.2%-with cirrhosis,6.6%-with various types of cancers,3% died of suicide and 23% died with unclear cause.Of them 544 AIDS patients died before the ARV treatment was available in rural areas of Henan at the end of 2002,with a mortality rate of 23.0%.The median survival period for individuals with HIV infection was 9.5 years,and the median incubation period was about 8.5 years.Conclusion The median aurvival period for individuals with HIV infection via blood donation in rural areas of Henan was 9.5 years and the median incubation period was about 8.5 years among them.

〔Abstract〕 Taking Wuxi People′s Hospital Affiliated to Nanjing Medical University as an example, the paper introduces the constitu-tion, software architecture and main functions of Clinical Decision Support System ( CDSS) .The system is integrated with Electronic Medical Records ( EMR) system, providing scientific and acurate information support for clinicians in the whole diagnosis process.It has positive significance to improve the work quality and reduce medical errors.

Objective To observe the curative effect of surgical treatment for eyelid basal cell carcinoma. Design Retrospective case series. Participants 33 cases with eyelid basal cell carcinoma. Methods 33 cases with eyelid basal cell carcinoma treated with surgery, standard excision in 17 case and Mohs micro excision in 16 cases were analyzed, postoperative appearance and function of re- eonstruetiiv eyelid, reeurence rate and survival rate were observed by follow-up survey. Main Outcome Measures Postoperative ap- pearance, function of reconstruetiiv eyelid, recurence rate and survival rate. Results After 6 month ~ 5 years follow-up survey with an average of 2.5 years, 28 of 29 cases obtained normal eyelid appearance, 1 case with lower eyelid gentle ectropium. 11 cases showed hy- perpigmentation in skin-grafting area in early stage, and became normal in half a year. Eyelid function of 29 cases were normal. Tumour relapse was seen in one case 2 years after standard resection,the cure rate was 94.12%. No tumor relapse was seen in group of mohs micro resection, the cure rate was 100%. Within five years postoperation, there was no death case caused by basal cell carcinoma re- lapse, except one dying from myocardial infarction and another dying of eerebrovaseular disease. Conclusions Operational excision is an effective approach for eyelid basal cell carcinoma. The effect of mohs micro resection is better than the one of standard resection. With dissociate skin grafting, fluctuate tarsal transmigration and dissociate skin grafting, eyelid appearance and function recover well.

Objective To analyze the curative effect used the common urokinase thrombolysis combined with topo-guide-wire fragmentation and low molecular heparin in the treatment of hemodialysis patients with arteriove-nous fistula embolization and explore the prospects of its application.Methods 30 hemodialysis patients with arterio-venous fistula embolization were divided into 15 cases of thrombolysis group and 15 cases of thrombectomy group ac-cording to the voluntary.The thrombolysis group was given simple urokinase thrombolysis,and the thrombectomy group was given thrombectomy combined with anticoagulant therapy.The curative effect and the difference in complication were compared.Results In curative effect,the recanalization rate,using time after recanalization,and dosage of uro-kinase of the thrombectomy group were better than those of the thrombolysis group[13cases vs.7cases,(22.13 ± 17.51)months vs.(11.05 ±10.55)months,(40.48 ±22.26)ten thousands IU vs.(60.29 ±15.81)ten thousands IU,χ2 =5.40,t=2.10,all P<0.05,t=2.81,P<0.01].In complication,there was no difference in the number of bleeding cases between the two groups(2cases vs.3cases,χ2 =0.24,P>0.05).For the thrombectomy group,there were fewer cases of re -embolization after recanalization (2 cases/13 cases vs.4 cases/7 cases,χ2 =3.85,P <0.05),but more cases of organ embolism(4 cases vs.0 cases,χ2 =4.62,P<0.05).Conclusion Compared with the traditional urokinase thrombolytic therapy,the guide wire fragmentation combined with low molecular weight hepa-rin anticoagulant therapy has a higher fistula recanalization rate and a lower re-embolization rate.It does not increase the incidence of bleeding complications.Besides,it can extend the use of internal fistula.However,it may cause the serious organ embolism,so it is necessary to strictly grasp the indications,applying only to the patients who are in the poor efficiency of thrombolytic and unable to have another operation.

Objective To explore the surgical indexes, therapeutic efficacy and prevention of complications in treatment of some blood diseases by splenectomy (including laparoscopic splenecto- my). Methods The clinical data of 27 patients with blood diseases receiving splenectomy in our hospi-tal were retrospectively analyzed. Results The effective rate of splenectomy was 100% in 4 cases of hereditary spherocytosis, 76.47% in 17 cases of ITP and low in 6 cases of Non-Hodgkin's lymphoma.The postoperative incidence of complications was 7.41% (2/27). Conclusion Splenectomy is of the first choice for treatment of hereditary spherocytosis. Meanwhile, it is effective for most of the patients with ITP. It is an important approach for comprehensive of malignant lymphoma. Proper choice of indications and perioperative management are helpful for decreasing incidence of postoperative complications.

Objective To assess the effects and side effects of ropivacaine combined with sulfentanyl in epidural anesthesia for caesarean section. Methods Two hundred ASA Ⅰ- Ⅱ patients scheduled for elective caesarean section were randomly divided into 2 groups (100 cases each):group S received 0.75% ropivacaine and 0.75 μg/ml sulfentanyl; and group R received 0.75 % ropivacaine. Epidural space L2-3 was punctured and the catheter was put upward 3 cm in all patients. Local anesthetic agents were administered until a complete sensory block was established extending upper T4-T6. In the operation, Bp, HR,SpO2, ECG were observed and the onset time, the upper spread and duration of sensory block were recorded.Assessed anesthetic efficacy and side-effects on newborn. Results The onset time [(4.5±1.2) min], the time needed to reach the highest sensory level [ ( 13±5) min ] were significantly shorter and the duration of sensory block [ (402±150 ) min ] was significantly longer in group S than those in group R (P < 0.05 ). There was no significant difference in the side effects such as tachycardia, nausea, vomiting, and shivering. Apgar score in newborn was not affected. Conclusion The anesthetic efficacy of epidural 0.75% ropivacaine is significantly enhanced which also has smaller local anesthetic requirements and low incidence of side-effects,in epidural anesthesia for caesarean section when sulfentanyl is added.

OBJECTIVE:To establish a method for the contents determination of volatile components in Huodan pill and study the effects of 60Co irradiation with different doses on the volatile components in Huodan pill. METHODS:GC-MS was used to de-termine the contents of patchouli alcohol and the ralative contents of β-patchouliene,α-guaiacene,seychellesene,α-patchouliene,α-bulnesene,5,11-diene guaiacyl,and unidentified objects in Huodan pill after 60Co irradiation with different doses. Column was HP-5MS by programmed temperature,volume temperature was 250℃,split ratio was 50:1,detector was triple quadrupole mass spectrometer detector,MS1 quadrupole temperature was 150℃,MS2 was 150℃,carrier gas was helium,flow rate of column was 1.2 ml/min,and the volume injection was 1 μl;ion source was EI,bombarding energy was 70 eV,temperature of ion source was 230℃,temperature of transmission line was 280℃ and scan range was 50-500 amu. RESULTS:The linear range of patchouli alcohol was 0.103 1-2.062 0μg(r=0.999 4);RSDs of precision,reproducibility and stability tests were lower than 1.0%;recovery was 98.05%-102.32%(RSD=1.8%,n=9). 60Co irradiation with different doses had little effects on the 8 volatile components in Huodan pill. CONCLUSIONS:60Co irradiation can be used for sterilization on Huodan pill,but irradiation dose should be controlled. The method is simple,good reproducibility,and can be used for the contents determination of volatile components in Huodan pill.

Objective To observe the anesthesia effect and safety of different doses of midazolam on operation in patients with lung cancer , to explore the appropriate dose.Methods 60 cases with lung cancer were divided into observation group and control group according to the dosage of midazolam,30 cases in each group.Hemodynamic changes, recovery time, extubation time, pain score and the dosage of anesthetic drug in the two groups were observed.Results There was no significant differences in hemodynamic indexes of each time point of the two groups .Compared with control group, recovery time, extubation time, pain score, the dosage of propofol and remifentanil dosage in the observation group were significantly lower than that of the control group, the difference was statistically significant (P <0.05).Conclusion Select the 0.075 mg/kg midazolam for lung cancer operation before anesthesia induction can reduce the operation to patients stimulation, make the operation smoothly.

The influence of anisodamine on the cerebral blood flow in the uncompletely ischemic brains was studied with radioactive biomicrosphere assay. After the bilateral carotid arteries were occluded the cerebral blood flow drawmatically decreased and middle part of the hemisphere had the most severe reduction. Anisodamine 10mg ? kg-1 iv selectively increased the cerebral blood flow in this area and 20mg ? kg-1 increased that in the whole hemisphere. When it was used in the dose of 40mg ? kg-, the increasing effect on the cerebral blood flow became weaker. While the cerebral blood flow decreased, the myocardial blood flow increased significantly after bilateral carotid artery occlusion. Anisodamine 20mg ? kg-1 iv made it further increase and 40mg ? kg-1 iv made it decrease. The cardiac index was not influenced by bilateral carotid artery occlusion and anisodamine 10~20mg ? kg-1 iv, but was significanntly increased by anisodamine 40mg ? kg-1 iv. These results suggested that anisodamine may be used in the treatment of ischemic cerebral diseases and should be used in different doses according to different purposes.