Objective To investigate the effect of povidone iodine irrigation combined with levofloxacin eye drops on the inflammatory indexes, NO and antioxidant indices in serum and tear fluid of patients with diabetic cataract.Methods 50 cases of pati ents with diabetic cataract and admitted into the hospital during January 2013 to January 2015 were selected as the research objects all of whom received cataract surgery.According to the randomized double blind method, the patients were divided into two groups with 20 cases in each group.The control group received levofloxacin eye drops intervention before surgery while the observation group were treated withpovidone iodine irrigation, based on the control group.The inflammatory indexes (IL-2, sIL-2R, IL-6), NO, antioxidant indexes (TAC, SOD, CAT) and condition of postoperative infection were compared between the two groups before and after irrigation.ResuIts In the observation group, the sIL-2R, IL-6 and NO levels in serum and tear fluid after irrigation were significantly lower than those in the control group while IL-2, TAC, SOD and CAT were significantly higher than those in the control group.The differences were statistically significant (P<0.05).The postoperative infection rate of the observation group was 0.0% which was significantly lower than 16.0% of the control group.The difference was statistically significant ( P<0.05 ) .ConcIusion Povidone iodine irrigation combined with levofloxacin eye drops can significantly reduce the inflammatory reactions in patients with diabetic cataract and improve their antioxidant level.

Objective To investigate the protective effect of ǎn soup of Miao nationality on the intestinal barrier function in rats with acute liver failure ,in order to provide effective diet measures for hepatic failure patients .Methods A total of 50 male SD rats were randomly assigned to five groups :control group(group A) ,acute liver failure model group(group B) ,Bifidobacterium tri‐ple probiotics group(group C) ,high‐doseǎn soup group(group D) and low‐doseǎn soup group(E) ,10 cases in each group .The last four groups were subjected to the acute liver failure model by hypodermic injection with thioacetamide twice .In addition ,the last three groups were respectively intragastrically perfused with Bifidobacterium triple probiotics ,6 mL of ǎn soup and 1 .5 mL of ǎn soup before and during building the acute liver failure model .28 hours after the second injection ,femoral arterial blood to was drew to test serum endotoxin(ETX) ,diamine oxidase(DAO) ,D(‐)‐lactate(D‐lac) ,alanine aminotransferase (ALT) and aspartate amin‐otransferase(AST) .At the same time ,hepatic tissue and ileal tissue within 3 cm away from the ileocecal region were collected to do pathological examination .Results Pathological examination results showed that hepatic cord in hepar arranged mussily ,hepatic lob‐ules structure disordered ,hepatocyte focal necrosis or with large necrotic areas in which a large number of inflammatory cell infiltra‐tion in the acute liver failure model group .The pathology damage of liver in the other groups was almost in the same extent .The ile‐um mucosa in the group A was morphologically intact with clear structure of villi and lined up ,while that of group B was disorder with sparse villi ,epithelial cells in different degree of loss ,missing and necrosis ,lamina propria obviously hyperemia and there were large amount of inflammatory cellular infiltration .Intestinal mucosa injury in the other intervention groups was lighter than that in the group B .In particular ,levels of serum ETX ,D‐Lac ,DAO ,ALT and AST in the group B and other intervention groups were sig‐nificantly higher than that in the group A(P<0 .01) .Compared to the group B ,levels of serum ETX ,D‐lac ,DAO ,ALT and AST in other intervention groups were decreased to various degrees ,and there was significant difference between group B ,group C and group D(P<0 .01) ,and there was no significant difference between group B and group E (P>0 .05) .However ,there was no signif‐icant difference between group C and group D (P>0 .05) ,when obvious difference was observed between group C and group E(P<0 .05) .There was significant difference between group E and roup D (P<0 .05) .Conclusion Results demonstrated that ǎn soup protected intestinal barrier function of acute liver failure rats by reducing the production and release of serum endotoxin content in liver failure rats ,lowering intestinal endotoxemia (IETM ) ,which seems to prevent subsequent liver injury caused by IETM and have certain dietotherapy effect on liver failure .

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) in radical resection of hepatocellular carcinoma (HCC).Methods The propensity score matching (PSM) and retrospective cohort study were conducted.The clinicopathological data of 116 patients with HCC who were admitted to the Fuzhou General Hospital of Nanjing Command of PLA from June 2014 to January 2016 were collected.Fifty-eight patients using pre-,intra-and post-operative ERAS managements were allocated into the ERAS group and 58 using traditional perioperative managements were allocated into the control group.Observation indicators:(1) operation situations;(2) postoperative recovery:postoperative recovery time of bowel sound,time to initial anal exsufflation,time of drainage-tube removal,levels of alanine transaminase (ALT),total bilirubin (TBil),C-reactive protein (CRP) at 1,3 and 7 days postoperatively,postoperative complications (vomiting,abdominal distension,wound infection,intra-abdominal infection and pulmonary infection),duration of postoperative hospital stay,hospital expenses and satisfaction degree of patients;(3) follow-up situation.Followup using outpatient examination and telephone interview was performed to detect survival of patients up to March 2016.Measurement data with normal distribution were described as x±s.The comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).The comparison between groups was analyzed using the paried rank sum test.Repeated measurement data were evaluated by the repeated measures ANOVA.Results (1) Operation situations:all the patients underwent successful operations,without perioperative death.(2) Postoperative recovery:postoperative recovery time of bowel sound,time to initial anal exsufflation,time of drainage-tube removal,levels of ALT,TBil and CRP at 1,3 and 7 days postoperatively,duration of postoperative hospital stay,hospital expenses and satisfaction degree of patients were (49±10)hours,(60±10)hours,(3.3±0.7)days,(379±99)U/L,(222±65)U/L,(98±16)U/L,(20.4±4.7)μmol/L,(15.5±2.1)μmol/L,(13.4±1.8)μmol/L,(49±10)mg/L,(124±21)mg/L,(30± 5)mg/L,(9.7±0.9)days,(4.1±0.6) ×104 yuan,8.6±0.9 in the ERAS group and (53±5)hours,(64±7)hours,(6.2±1.6)days,(445± 114)U/L,(278±79) U/L,(116± 25) U/L,(18.6± 3.5) μmol/L,(17.0±2.7) μmol/L,(14.2±1.9)μmol/L,(53±11)mg/L,(135±35)mg/L,(34±6)mg/L,(10.0± 1.0) days,(4.3±0.5)x104 yuan,8.2±1.0 in the control group,respectively,with statistically significant differences between the 2 groups (t=2.537,2.479,2.065,F=20.075,14.357,13.460,t=2.060,2.197,2.370,P＜0.05).Number of patients with postoperative vomiting,abdominal distension,wound infection,intra-abdominal infection and pulmonary infection were 5,3,2,1,1 in the ERAS group and 6,6,7,5,3 in the control group,respectively,with no statistically significant difference between the 2 groups (x2=0.100,1.084,3.011,0.206,0.618,P＞ 0.05).(3) Follow-up situation:all the 116 patients were followed up for 1-20 months,with a median time of 11 months.During the follow-up,2 patients in the ERAS group died (1 dying of tumor recurrence and 1 dying of respiratory failure) and 3 in the control group died (1 dying of multiple organs metastasis,1 dying of lung metastasis of HCC and 1 dying of myocardial infarction).Conclusion ERAS in the perioperative management after radical resection of HCC is safe and effective,and it can quickly improve postoperative recovery of patients.

Objective To investigate the protective effect of aminoguanidine(AG),silymarin (Sil) and anisodamine (Ani) on retinal capillary pericytes cultured in glycosylation products. Methods MTT cololrimetric assay, thymidine incorporating and fluorescent indicator fura 2 acetoxy methyl ester (Fura 2AM) were used to study the influence of AG,Sil and Ani on the growth,DNA synthesis,and cytosolic free calcium([Ca 2+ ]i)changes of pericytes cultured in the medium contained early glycation products (EGs) or advanced glycation end products (AGEs). Results Cultured in the medium contained EGs,the A value by MTT assayed and amount of thymidine incorporating in AG group and Sil group were obviously elevated than those of control group(P

1 000 rnl were randomly divided into 2 groups : AHHD group ( n = 18) and control group ( n = 18). The patients were premedicated with intramuscular atropine 0.007-0.01 mg?kg-1 . Radial artery and right internal jugular vein were cannulated before induction of anesthesia for MAP and CVP monitoring, blood sampling and fluid administration. Anesthesia was induced with TCI of propofol. The target plasma propofol concentration was set at 3 ?g ? ml -1 . When the patients lost consciousness, fentanyl 2 ?g ? kg-1 was given intravenous and tracheal intubation was facilitated by vecuronium 0.1 mg? kg-1 , 10min after intubation additional fentanyl 2 ?g? kg-1 and vecuronium 0.08 mg? kg-1 were given. In AHHD group lactated Ringer's solution 10 ml ? kg-1 was infused over 30 min before TCI propofol was started. 10 min after start of TCI propofol 6% HES 20 ml? kg-1 was infused within 30 min. In control group the patients received only lactated Ringer's solution 10 ml?kg-1 . TCI of propofol was maintained for 1 h. Arterial blood samples were taken before and 2, 5, 10, 20, 30, 40, 50 and 60 min after TCI propofol was started, and at 2.5, 5, 10, 15, 20, 25, 30 min after termination of TCI propofol for determination of blood concentration of propofol by gas-chromatography - mass spectrometry (GC-MS) . The TCI system comprising Graseby 3 500 infusion pump controlled by Stelpump 1.07 software which included Tackley pharmacokinetic parameters. Results In AHHD group Hb was reduced from initial (130? 14)g?L-1 to (90? 15)g?L-1 and Hct from initial 38% ? 3% to 26% ? 4 % at the end of AHHD. The measured blood propofol concentrations were significantly lower in AHHD group than those in control group at the corresponding time points (P

Obuective To assess the population pharmacokinetic parameters and analyze thecharacteristics of pharmacokinetics of propofol given by target-controlled infusion (TCI) in Chinese using anoulinear mixed effect model (NONMEM) program. Methods Sixty-one ASA Ⅰ-Ⅱ patients (26 male, 35female) aged 18-64yr, weighing 41-83kg undergoing elective operation under general anesthesia were studied. TheTCI system consisted of (1 ) Stel pump Software 1 .07 designed by Coetzee, (2) cable R232 connector, (3)Graseby 3500 infusion pump, (4 ) pharmacokinetic parameters developed by Tackley. The patients werepremedicated with intramuscular phenobarbital sodium 1-2 mg?kg~(-1) and atropine 0. 5 mg. Anesthesia was inducedwith TCI of propofol. Target plasma concentration of propofol was set at 3?g?ml~(-1). Fentanyl 2?g?kg~(-1) andvecuronium 0. 1mg?kg~(-1) were given i. v. when the patients lost consciousness. TCI of propofol lasted 60 min. 976blood samples were obtained before induction of anesthesia and at 2, 5, 10, 20, 30, 40, 50, 60, 62. 5, 65, 70,75, 80, 85, 90 min ther TCI was started for determination of plasma propofol concentration by gas-chromatography-mass spectrometry (GC-MS). Population pharmacokinetic parameters were assessed and thecharacteristics of the pharmacokinetic profile was analyzed using NONMEM program. Results The pharmacokineticprofile of propofol given by TCI in Chinese was best described by an open two-compartment model. Thepharmacokinetic parameters for the final model: K_(10) was 0.111, K_(12) 0 .064 and K_(21) 0 .023 min~(-1); V_1 was 0 .205and V_2 0.404 L?kg~(-1); CL_1 was 22 .76 and CL_2 13 .24 ml?min~(-1). The estimated concentrations were well correlatedwith the measured concentrations in the final model. Weight was found to covariate significandy with V_1 and CL_1and age with K_(21). However gender had no significant effect on pharmacokinetic parameters.Conclusion Thepopulation pharmacokinetic profile of propofol administered by TCI in Chinese can be well described by an open two-compartment model. The volume of central compartment was smaller and the inter-compartmental transfer ratefrom central compartment to peripheral compartment was faster in Chinese.

Objective To investigate the effect of acute hypervolemic hemodilution (AHHD) on pharmacokinetics of propofol given by target-controlled infusion (TCI). Methods Thirty-six ASA Ⅰ-Ⅱpatients (18 male, 18 female) undergoing elective surgery were randomized to one of two groups: control group (n = 18) and AHHD group ( n = 18). The patients were premedicated with atropine 0.007-0.01mg?kg-1 and phenobarbital 1-2mg?kg-1 i.m. . Radial artery and right internal jugular vein were cannulated before induction of anesthesia. Anesthesia was induced with TCI of propofol. The target plasma propofol concentration was set at 3 ?g?ml-1. When the patients lost consciousness, fentanyl 2?g? kg-1 was given i.v. and tracheal intubation was facilitated by vecuronium 0. 1 mg?kg-1 . Ten minutes after tracheal intubation an additional dose of fentanyl 2 ?g?kg-1 and vecuronium 0.08 mg?kg-1 was given i.v.. TCI of propofol continued for 1 hour. In AHHD group lactated Ringer's solution 10 ml?kg-1 was infused over 30 min before induction of anesthesia. 10 min after TCI propofol was started, 6 % HES 20 ml ?kg-1 was infused within 30 min. In control group the patients received only lactated Ringer's solution 10 ml? kg-1 . All fluid infused was prewarmed to 35℃ Arterial blood samples were taken before and 2,5, 10, 20, 30, 40, 50 and 60 min after TCI propofol was started and 2.5, 5, 10, 15, 20, 30 min after termination of TCI propofol for determination of blood concentration of propofol by gas-chromatography-mass spectrometry (GC-MS) . The TCI system consisted of Graseby 3500 infusion pump controlled by Stelpump 1.07 software, which included Tackley pharmacokinetic parameters. Results The demographic data including sex, age, body weight and amount of propofol consumed were comparable between the two groups. The pharmacokinetic profile of propofol given by TCI was best described by a two-compartment open model during AHHD. The pharmacokinetic parameters tor the final model; K10 was0.116, K12 0.0907 and K210.024mm-1 ; V, was 0.311 and V2 0.446L?kg-1 ; Cl1 was 33.31 and Cl2 16.65 ml?min-1?kg-1 respectively. V1 and V2 were significandy larger, and transfer and clearance rates were significantly higher in AHHD group than those in control group. At the end of AHHD, Hb decreased by 31.0% and Hct by 31.3%; total plasma protein decreased by 30.1% and plasma albumin by 25.7% as compared with the baseline values before AHHD. Conclusion AHHD has significant effect on pharmacokinetics of propofol. Less propofol is bound to plasma protein and duration of action is relatively shorter. During AHHD the target plasma propofol concentration should be increased to some extent to achieve the same depth of anesthesia.

Objective:To discuss the effect of single low dose local radiotherapy and indomethacin to-gether in the prevention of recurrence of ectopic ossification around the elbow after resection.Methods:From Jun.2009 to Dec.2011,we performed excision of ectopic ossification around the elbow in 78 stiff elbows.For each case,we used both medial and lateral approaches,and we performed both anterior and posterior capsulectomies and removal of ectopic ossification.In the lateral approach,we started proximal-ly,the lateral supracondylar ridge of the humerus was exposed from the interval between extensor carpi radialis longus (ECRL)and triceps,and then distally passed the interval between ECRL and extensor carpi radialis brevis (ECRB).With the medial approach,after releasing the ulnar nerve,the pronator teres muscle origin was reflected from the medial epicondyle,and then the common flexor-pronator tendon was split longitudinally distally and the brachalis and the anterior portion of the flexor-pronator group were dissected off the anterior humerus.If there was forearm rotation dysfunction,we used extensive lateral ap-proach,the anconeus muscle was reflected from the ulna and the scar tissue and ectopic ossification around the proximal radioulnar joint were resected.The important structures,such as the lateral ulnar collateral ligament (LUCL)and the anterior part of the medial collateral ligament (AMCL),should be carefully protected,because they were important for the elbow stability.Anterior transposition of the ulnar nerve depended on the patients’condition.We performed low dose radiotherapy 4 hours before opera-tion,and we used indomethacin for 6 weeks after operation.In these patients,there were 46 males and 32 females,whose age averaged (35.8 ±7.9)years (16 -65 years).According to Hastings-Graham classification,there were 56 ⅡA,5 ⅡB,6 ⅡC and 1 1 Ⅲ before operation.Results:We followed up these patients for 26 months with an average of 24-36 months,all the patients improved their elbow func-tion,and no recurrence of ectopic ossification appeared except for 1 patient.For this patient,his elbow function was excellent,and according to Hastings-Graham classification,his ectopic ossification was of typeⅠ.Conclusion:Single low dose local radiotherapy and indomethacin together are effective in the prevention of recurrence of ectopic ossification around the elbow after excision.

Objective To investigate the effect of estrogen on expression of matrix GLA protein (MGP)in ovariectomized Sprague-Dawley(SD)rats and the role of estrogen in improving postmenopausal osteoporosis.Methods Thirty-six SD female rats were allocated into 3 groups randomly,every 12 rats in ovariectomized group(OVX group),estrogen group(E group)and control group(sham group).Rats in OVX and E group all underwent bilateral ovariectomy,those rats in E group were given by estradiol benzoate intramuscularly after 3 weeks of ovariectomy.Rats in sham group underwent bilateral lipectomy near the ovary.All rats were kept the urine and the serum every three weeks and were sacrificed after 15 weeks.The pathology changes of uterus,lumbar vertebral bones were observed by immunohistochemistry.Bone mineral density(BMD)of lumbar vertebra of rats was determined by dual energy X ray absorptiometry(DEXA).The content of MGP in serum and urine was determined by ELISA.Expression of underearboxylated matrix GLA Protein(MGP)was detected by immunohistochemistry.Relative quantification of MGP mRNA expression in lumbar vertebra bone was detected by Fluorescent real-time quantitative polymerase chain reaction.Results(1)After 15 weeks of ovariectomized,the endometrium of uterus and lumbar vertebra exhibit remarkable pathologic changes in OVX group.The serum estrogen of(454±66)pmol/L in OVX group were lower than in(527 ±77)pmol/L in sham group and(556 ±80)pmol/L in E group significantly (P ＜ 0.05).The BMD of lumbar vertebra of(0.263 ± 0.030)g/cm2 in OVX group were lower than (0.295 ±0.024)g/cm2 in sham group and(0.279 ±0.024)g/cm2 in E group significantly(P ＜0.01).(2)The serum MPG protein in OVX group and E group showed decreased trends after ovariectomized,which were(104 ±64)ng/L in OVX group and(134 ±6)ng/L in E group at 9 weeks,which reached statistical difference(P ＜ 0.05).However,MGP in urine in sham group did not exhibit significant difference after 15 weeks of surgery(P ＞0.05).The MGP in urine of E group showed increased trends after 12 weeks of surgery,which reached(110.0 ±3.4)ng/L at 15 weeks,in the mean time,it was found that(86.5 ±2.5)ng/L of MGP in urine in OVX group,which showed significant difference(P ＜ 0.05).(3)MGP could be observed in lumbar vertebra in OVX group by immunochemistry staining.In the other two groups,the expression of MGP was not dominant.(4)Relative quantification of MGP mRNA expression in lumbar vertebra was defined as 1 in OVX group,when compared with 0.289 ±0.260 in E group and 0.103 ±0.098 in sham group,the difference showed statistically significant(P ＜ 0.01).Conclusion Estrogen could increase the expression of MGP mRNA and protein in ovariectomized rats and might play an important role in improving postmenopausal osteoporosis.

Objective To investigate the characteristics of medicine taking,the type and ratio of long-term medication and treatment satisfaction in patients with gastroesophageal reflux disease (GERD),to analyze the effects of GERD combined with functional bowel disease (FBD) on the treatment satisfaction,and to compare the changes of type of medication and treatment satisfaction in patients with GERD in recent years.Methods From April to June in 2011,the questionnaire survey was conducted in gastroenterology clinic of People's Hospital of Peking University.The incidence of typical GERD symptoms was investigated by a validated reflux disease questionnaire (RDQ),the score between one and five was considered there might be reflux symptoms and the score over 12 was diagnosed as GERD.FBD was diagnosed according to Rome Ⅲ criteria.The information of GERD related medication taking within one year before the survey,long-term medication taking (≥ 1 year)and the treatment satisfaction of patients whose RDQ score over zero was recorded and compared with the data collected in the same method in 2004.The chi-square test was performed for data statistical analyses with SPSS 17.0 software.Results Among 1074 patients who completed questionnaire survey in 2011,the percentage of patients with reflux symptoms was 32.7％ (351/1074),the percentage of diagnosed GERD was 10.0％ (107/1074),and GERD combined with FBD was 25.2％ (27/107) of GERD.A total of 304 cases (86.6％) of patients with reflux symptoms had information of medication taking; 78.0％ (237/304) of whom had taken GERD related medication within one year before the survey.The rate of GERD related medication taking especially proton pump inhibitor (PPI) and antiacid medication taking increased along with RDQ score (x2 =24.2,13.1 and 18.2,all P＜0.05).A total of 104 cases of GERD patients had information of medication taking; 88.5 ％ (92/104) GERD patients had taken GERD related medication within one year before the survey,52.9％ (55/104) GERD patients had taken PPI medication,30.8％ (32/104) needed long-term medication and 20.2％ (21/104) needed longterm PPI treatment.There was no significant difference in treatment satisfaction between different RDQ score ranges (x2 =3.3,P＞0.05).Among GERD patients who appraised the effects of treatment,the percentage of satisfied,acceptable and not satified with the treatment was 37.1％(26/70),48.6％ (34/70)and 14.3％(10/70),respectively.There was no significant difference in treatment satisfation between GERD with and without FBD (x2 =3.1,P＞0.05).In 2011,the rates of medication taking (88.5％,92/104) and PPI taking (52.9％,55/104) in GERD patients significantly increased compared with those in 2004 (57.3％,98/171; 7.6％,13/171,x2 =29.4,71.4,both P＜0.05).The percentage of treatment satisfaction in 2011(37.1％,26/70) increased compared with that in 2004(25.7％,18/70,x2 =12.8,P＜0.01).Conclusions Some of patients with GERD symptoms need long-term medication,especially PPI treatment.In recent years,the rate of medication taking in GERD patients increased in outpatients department,PPI taking significantly increased and the treatment satisfaction also increased.Maybe the treatment satisfaction is not affected by GERD combined with FBD.