Objective To compare the efficacy and safety of vitrectomy combined with internal limiting membrane flap and vitrectomy combined with internal limiting membrane peeling for the treatment of idiopathic macular hole with different sizes.Methods A total of 127 consective patients (127 eyes)were divided into two groups according to the size of the hole diameter of the smallest split points by less than or equal to 500 μm (small diameter macular hole group) and more than 500 μm (huge diameter macular hole group).According to different surgical methods the patients were divided into non ILM flap coverage group (peeling 1 group and peeling 2 group) and ILM flap cover group (covering 1 group and covering 2 group).All the patients underwent vitrectomy combined with internal limiting membrane peeling or vitrectomy combined with limiting membrane flap.Preoperative and postoperative best correct visual acuity,closure ratio of macular hole and postoperative major complications were observed and followed up.Results The postoperative best correct visual acuity improved in all the groups,there was no significance difference between small diameter macular hole group and huge diameter macuiar hole group (t =0.112 2,0.750 8;all P ＞0.05).The closure ratio of peeling 1 group and covering 2 group at postoperative 6 months were all 100％,there was no statistical difference (P ＞ 0.05),which in peeling 2 group and covering 2 group were 84.85％ and 100.00％,there was statistical difference (x2 =13.292,P ＜ 0.05).There was no statistical difference in preoperative defect diameter of the inner and outer junction between peeling 2 group and covering 2 groups (P ＞0.05),there was also no statistical difference between peeling 2 group and covering 2 groups at postoperative 1 months (P ＞ 0.05),but there were statistical differences at postoperative 3 months,6 months and 12 months (all P ＜ 0.05),the covering 2 group were less than the peeling 2 group.Conclusion ILM flap coverage helps to heal macular holes greater than 500 μm diameter,and has no extra effect on healing of diameter less than 500 μm.

OBJECTIVETo summarize the pharmacological function of oleanolic acid.

METHODBased on the documents and related achievements, the pharmacological function and its mechanism including its clinical use were summed up.

RESULT AND CONCLUSIONOleanolic Acid is a natural chemical which has wide-ranging function and abundant source. But we should place the emphasis on improving its biotic utilization and effect on clinical treatment.

Adjuvants, Immunologic ; pharmacology ; Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Antiviral Agents ; pharmacology ; Hepatitis, Viral, Human ; drug therapy ; Humans ; Hypoglycemic Agents ; pharmacology ; Oleanolic Acid ; isolation & purification ; pharmacology ; Phytotherapy ; Plants, Medicinal ; chemistry

Background Whether ocular anterior and posterior chamber exist a blood-aqueous barrier is in controversy.Conventional method can not offer a good evidence because it is unable to detect the aqueous component in the posterior chamber.Objective This study was to investigate the distribution of Gadolinium-diethylene triamine pentaacetic acids(Gd-DTPA)after peripheral iridectomy with magnetic resonance imaging(MRI)in rabbit.Methods Monocular peripheral iridectomy was performed on the right eyes in 8 clean New Zealand white rabbits and the fellow eyes were as controls.0.2 ml/kg(0.5 mol/L)Gd-DTPA,a tracer of MRI,was injected into ear vein in vivo to scan the eyes with MRI for the observation of the permeability and distribution.The signal enhanced ratio of interest region associated with time were analyzed.Results The signal in ciliary body of both eyes showed an immediately sharp enhancement within 10 minutes following the injection of Gd-DTPA with a peak intensity at 30-40 minutes,and then the intensity was gradually weaken over time.The signal was stronger in the operative eyes than that in the fellow eyes.The signal in the posterior chamber was gradually increased after operation,however,that in posterior chamber of the control eyes was lower.The interest regions of Gd-DTPA were ciliary,anterior chamber and posterior chamber,and the enhanced signal intensities were consisted in the posterior chamber after operation.However,the increase of the signal was not seen in the posterior chamber in the control eyes.Conclusions The pathway of plasma protein entering into the anterior chamber is very different from that of aqueous secretion.There exists a barrier between the anterior and posterior chamber which might be an integral part of the blood-ocular barrier.

Abstract: Mycobacterium senegalense is one of the major pathogens causing bovine farcy, and reports of its infection in human are rare. Here is a report on a woman who had been taking hormones and immunosuppressants for a long time for SLE and underwent abdominal soft tissue infection with Mycobacterium senegalense after abdominal liposuction, to provide reference for clinical diagnosis and treatment. The patient, female, 32 years old, has a history of SLE for more than 2 years, and currently takes "methylprednisolone, hydroxychloroquine, and mycophenolate mofetil" regularly. Nine months before the patient was admitted to the hospital, she once performed abdominal, waist and buttock liposuction in a medical beauty institution. One month after the operation, several masses gradually appeared on the abdominal wall, accompanied by tenderness, one of the masses had obvious fluctuation on palpation and purulent fluid could be drawn out. The location of the abdominal wall mass was consistent with the insertion site of the liposuction needle. After the onset of the disease, the patient went to the medical beauty institution for puncture of the abdominal wall mass, and 5 mL of purulent fluid was pierced and sent for bacterial culture, and cultured "Mycobacterium Senegalense", after 3 days of treatment with "cephalosporin" antibiotics (specifically unknown), the symptoms did not improve, so she went to the second affiliated hospital of hainan medical college. After completing the relevant examinations during the hospitalization in our hospital, in order to clarify the etiology, another abdominal puncture to extract pus was performed, the mycobacterial culture + identification results: Mycobacterium senegalense. Consistent with the out-of-hospital results, the diagnosis of Mycobacterium senegalense infection was confirmed. After 3 months of treatment with "cefoxitin, azithromycin, amikacin, and levofloxacin", the patient's abdominal wall soft tissue infection was cured. Trauma or invasive procedures can lead to skin, muscle, or bone infection with nontuberculous mycobacteria (NTM), which can manifest as chronic painless nodules that progress to purulent folliculitis and abscesses. NTM infection should be suspected when the patient's wound has been exposed to water, there is a history of surgery, and empirical anti-infection is ineffective. This is the first case of Mycobacterium senegalense infection caused by medical beauty, which tell people that they should be cautious when choosing medical aesthetic projects and medical aesthetic institutions.

OBJECTIVETo study the influence of Xinqin tablets on guinea-pig nasal hypersensitivity.

METHOD2,4-Toluene Diisocyanate (TDI) was selected as antigen and used in nose to establish guinea-pig allergic rhinitis. The effects of Xinqin tablets on symptoms of nasal hypersensitivity in guinea-pigs, histamine content of nasal mucosa and activity of nitric oxide synthase (NOS) were examined.

RESULTXinqin tablets could significantly relieve the pathological symptoms of nasal hypersensitivity in guinea-pig, reduce histamine content of nasal mucosa and inhibit the activity of nitric oxide synthase.

CONCLUSIONXinqin tablets have significant effect on nasal hypersensitivity, and prevent the occurrence of allergic rhinitis.

Animals ; Asarum ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Guinea Pigs ; Histamine ; metabolism ; Male ; Nasal Mucosa ; drug effects ; metabolism ; pathology ; Nitric Oxide Synthase ; metabolism ; Phytotherapy ; Plants, Medicinal ; chemistry ; Rhinitis, Allergic, Perennial ; chemically induced ; metabolism ; pathology ; Scutellaria ; chemistry ; Toluene 2,4-Diisocyanate

Objective To investigate the efficacy of ranibizumab combined with pars plana vitrectomy (PPV) in treatment of patients with diabetic retinopathy together with neovascular glaucoma.Methods A retrospective analysis of 16 patients (16 eyes) with diabetic retinopathy accompanied by neovascular glaucoma underwent vitrectomy combined with ranibizumab between June 2013 and June 2017 was conducted.Data were collected on patients' intraocular pressure (IOP),best-corrected visual acuity (BCVA),iris neovascularization,chamber angle changes before and after surgery,and the postoperative complications were recorded.Results No significant difference was approached in IOP before surgery and 1 day after ranibizumab injection [(42.54 ± 16.52) mmHg vs.(38.78 ± 11.38)mmHg,1 kPa =7.5 mmHg] (P＞0.05).And there was also no significant difference in the IOP before surgery and 1 week after vitrectomy [(45.30 ± 12.20) mmHg vs.(42.54 ± 16.52) mmHg] (P ＞0.05);The IOP at 1 month,3 months and 6 months after surgery was (27.56 ± 19.38) mmHg,(20.49 ± 18.66) mmHg and (19.79 ± 16.53) mmHg,respectively,which were significantly different from preoperative IOP (all P ＜ 0.05).At the end of the follow-up,iris neovascularization completely disappeared in 10 eyes (62.5％) and iris neovascularization was significantly lessened in 6 eyes (37.5％).Conclusion Ranibizumab with PPV for diabetic retinopathy and neovascular glaucoma can effectively reduce intraocular pressure and postoperative complications as well as improve visual acuity slightly.

Given the poor prognosis of proliferative diabetic retinopathy (PDR),the morbidity of PDR has also increased recent years.Modern surgery has undergone a very impressive development over the last 10a due to the evolution of methods,techniques and extension of surgical indications.In this article,we will review the current choices of the surgery time,perioperative managements,as well as the methods of the vitrectomy.

BACKGROUNDAfter cardiac surgery, central venous oxygen saturation (ScvO 2 ) and serum lactate concentration are often used to guide resuscitation; however, neither are completely reliable indicators of global tissue hypoxia. This observational study aimed to establish whether the ratio between the veno-arterial carbon dioxide and the arterial-venous oxygen differences (P(v-a)CO 2 /C(a-v)O 2 ) could predict whether patients would respond to resuscitation by increasing oxygen delivery (DO 2 ).

METHODSWe selected 72 patients from a cohort of 290 who had undergone cardiac surgery in our institution between January 2012 and August 2014. The selected patients were managed postoperatively on the Intensive Care Unit, had a normal ScvO 2 , elevated serum lactate concentration, and responded to resuscitation by increasing DO 2 by >10%. As a consequence, 48 patients responded with an increase in oxygen consumption (VO 2 ) while VO 2 was static or fell in 24.

RESULTSAt baseline and before resuscitative intervention in postoperative cardiac surgery patients, a P(v-a)CO 2 /C(a-v)O 2 ratio ≥1.6 mmHg/ml predicted a positive VO 2 response to an increase in DO 2 of >10% with a sensitivity of 68.8% and a specificity of 87.5%.

CONCLUSIONSP(v-a)CO 2 /C(a-v)O 2 ratio appears to be a reliable marker of global anaerobic metabolism and predicts response to DO 2 challenge. Thus, patients likely to benefit from resuscitation can be identified promptly, the P(v-a)CO 2 /C(a-v)O 2 ratio may, therefore, be a useful resuscitation target.

Adult ; Aged ; Blood Gas Analysis ; Carbon Dioxide ; blood ; Cardiac Surgical Procedures ; Female ; Humans ; Hyperlactatemia ; blood ; therapy ; Intensive Care Units ; statistics & numerical data ; Lactic Acid ; blood ; Male ; Middle Aged ; Oxygen Consumption ; physiology ; Prospective Studies ; Resuscitation

Objective To explore the clinical value of portal exposure in laparoscopic treatment of children with type Ⅲ biliary atresia (BA).Methods From June 2013 to October 2017,30 infants with type Ⅲ BA who treated with laparoscopic portoenterostomy in Huai'an Women and Children's Hospital were selected.A percutaneous suture was used to snare the round ligament and retract the liver,other percutaneous stay sutures were then introduced and fundus and neck of gallbladder were sutured to elevate the liver to expose the portal hepatis.The fibro cord and hepatic vessels were mobilized,and then two rubber bands were put around the left and right portal veins and hepatic arteries.The portal hepatis was exposed by laterally stretching the two elastic rubber bands.The fibro cord was removed and then laparoscopic portoenterostomy was accomplished.In 20 cases,the liver was enlarged,part of hepatic lobus quadratus was removed laparoscopiclly for exposure of the portal hepatis.Results There were 30 cases in this group,2 cases were converted to open surgery by a micro transverse incision.There was no surgical death.Time of laparoscopic procedure varied from 210 to 280 min.All cases survived the surgery without any intraoperative complications.Blood loss during operation was minimal,without necessity for blood transfusion.One case died of respiratory failure one week after surgery.Two cases were lost follow-up.Twenty-five cases were followed up for 3～51 months(mean 22.4 months).Three cases died because of repeated cholangitis and liver failure at 10,16,35 months postoperatively.Nineteen patients' total bilirubin had dropped to normal,three others' bilirubin levels dropped significantly after surgery.Conclusion The technique of laparoscopic hepatic porta exposure can help to complete hepatic portoenterostomy successfully,reduce the conversion rate of laparoscopic surgery,and improve the surgical effect.

The surface layer of the sclerotia of Poria cocos, named Fu-Ling-Pi, is used as a diuretic in traditional Chinese medicine to treat edema and urinary dysfunction. Recent studies have showed that the triterpenes (lanostane and 3,4-secolanostane skeletons) and polysaccharides (beta-pachyman) are the main components of Fu-Ling-Pi and they exhibited various biological activities, such as anti-tumor, antibacterial and antioxidant, etc. This review was focused on the chemistry, pharmacology, and clinical uses of this drug and it may provide scientific foundation for further development and utilization of Fulingpi.
Animals ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Structure ; Poria ; chemistry ; Wolfiporia