Objective To study the efficacy of different anti-adhesion agents used in preventing tubal obstruction after recanalization.Methods Five hundred and eight patients with tubal obstruction were divided into 245 cases in control group,108 cases in chitosan group;113 cases in sodium hyaluronate group and 42 cases in lipiodol group.The patients in control group were injected with anti-inflammation agents after recanalizatian,while other groups were injected with chitosan,sodium hyaluronate or lipiodol at dose of 2-3 ml in every therapeutic group.The rate of location of tubal obstruction and tubal recanalization were recorded during operation.Then patients in every group were followed up on tubal patency after 3 months,and pregnancy rate after 12 months.Results Among 1016 fallopian tubes in 508 patients,there were 330 tubes occlusion at isthmus portion and 563 tubes occlusion at interstitial portion of fallopian tube.Thirtyseven fallopian tubes were ablated because of ectopic pregnancy,86 fallopian tubes were unobstructed.(1)The recanalization rate were 95.7% (179/187) in chitosan group,97.9% (191/195) in sodium hyaluronate group,98.7% (75/76) in lipiodol group and 97.7% (425/435) in control group,which did not show statistical difference (P＞0.05).(2) The rates of tubal patency after 3 months of 91.7% (99/108) in chitosan group and 88.5% (100/113) in sodium hyaluronate group were significantly higher than 71.4% (30/42) in lipiodol group and 74.3% (182/245) in control group (P ＜0.05).(3)The rates of intrauterine pregnancy after 12 months were 48.1% (52/108) in chitosan group and 41.6% (47/113) in sodium hyaluronate group,which were significantly higher than 23.8% (10/42) in lipiodol group and 24.1% (59/245) in control group (P ＜ 0.05).Conclusion Chitosan and sodium hyaluronate could be effective to prevent tubal obstruction after interventional recanalization and increase pregnancy rate.

Objective To investigate the risk factors of acute respiratory distress syndrome (ARDS) occurrence in intensive care unit (ICU) traumatic patients. Methods Clinical data of traumatic patients in ICU of the People's Hospital of Liangping in Chongqing from January 1st, 2012 to June 30th, 2018 were retrospectively analyzed. According to the outcomes, the patients were divided into ARDS group and non-ARDS group. The differences of demographic indexes (gender, age), time of admission, type of injury, atrial fibrillation, trachea cannula, multiple injury, open injury, shock, surgery, blood transfusion, central venous indwelling catheter, infection, and blood routine indexes [white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), plateletcytocrit (PCT), hematocrit (Hct)], biochemical indexes [total bilirubin (TBil), albumin (Alb), serum creatinine (SCr), blood sodium, blood calcium, blood potassium, blood glucose], arterial blood gas analysis indexes [partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), blood pH], coagulation indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), fibrinogen (Fib)], injury severity score (ISS), new injury severity score (NISS), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), Glasgow coma scale (GCS) within 24 hours of admission, and the length of ICU stay between the two groups were analyzed, and the possible influencing factors were screened out. Logistic regression model was used to analyze the risk factors of ARDS in patients with severe trauma, and receiver operating characteristic curve (ROC) was drawn to evaluate its predictive value. Results A total of 303 patients with severe trauma, including 223 males and 80 females, were enrolled. The average age was (52.98±17.03) years old. ARDS occurred in 149 cases (49.17%), including 114 males and 35 females. Compared with the non-ARDS group, the ARDS group had older age, higher rates of traffic injuries, endotracheal intubation and infection, higher blood sugar, PaO2/FiO2, TT, ISS, NISS and SOFA, lower GCS and longer the length of ICU stay. Logistic regression analysis showed that hyperglycemia, PaO2/FiO2anomalies and increased SOFA score were independent risk factors for ARDS in ICU trauma patients [blood glucose > 6.10 mmol/L:odds ratios (OR) = 2.72, 95% confidence interval (95%CI) = 1.20-6.19, P = 0.017; PaO2/FiO2< 400 mmHg (1 mmHg =0.133 kPa): OR = 7.40, 95%CI = 1.59-34.37, P = 0.011; SOFA > 5: OR = 2.92, 95%CI = 1.63-5.21, P < 0.001]. ROC curve analysis showed that blood glucose, SOFA and PaO2/FiO2could predict ARDS in ICU trauma patients, with the area under ROC curve (AUC) were 0.65, 0.70 and 0.75, respectively (all P < 0.01). The predictive value of PaO2/FiO2was better, when the cut-off value was 275 mmHg, the sensitivity was 85.89% and specificity was 70.29%. Conclusion The traumatic patients on admission with hyperglycemia, abnormal PaO2/FiO2and increased SOFA score are more susceptible to ARDS occurrence.

Ocular diseases include various anterior and posterior segment diseases. Due to the unique anatomy and physiology of the eye, efficient ocular drug delivery is a great challenge to researchers and pharmacologists. Although there are conventional noninvasive and invasive treatments, such as eye drops, injections and implants, the current treatments either suffer from low bioavailability or severe adverse ocular effects. Alternatively, the emerging nanoscience and nanotechnology are playing an important role in the development of novel strategies for ocular disease therapy. Various active molecules have been designed to associate with nanocarriers to overcome ocular barriers and intimately interact with specific ocular tissues. In this review, we highlight the recent attempts of nanotechnology-based systems for imaging and treating ocular diseases, such as corneal d iseases, glaucoma, retina diseases, and choroid diseases. Although additional work remains, the progress described herein may pave the way to new, highly effective and important ocular nanomedicines.