To study the heritability (h~2) of pterygium, the morbidity of pterygium in the first degree relatives of 123 patients was found to be 8.04％ h~2=49.9％ and that of the control group was 2.24％. However, for subjects under 40 years of age, the h~2 was 42.3％, while for subjects over 40 years of age, h~2=54.36％. It was concluded that the genetic factor plays an important role in the pathogeny of pterygium and the age factor also exerts some effects.

ve To evaluate the performance of the target controlled infusion (TCI) system of midazolam for sedation during operation in terms of safety and ease of use in the elderly and the young. Methods Forty-four unpremedicated ASA I - II patients scheduled for elective surgery under epidural or combined spinal-epidural (CSE) anesthesia were included in this study. The patients were divided into two age groups: the elderly group aged 61-82 yr ( n = 22) and the young group aged 19-43 yr (n = 22) . Patients with neurological or severe cardiopulmonary diseases or abnormal liver or kidney function were excluded. The block height was maintained below T4. The TCI system consisted of Intel Pentium III 450 MHz computer and Graseby 3500 computerized infusion pump. The software we used was Stelpump Version 1.05 written by Pina and Coetzee and the pharmacokinetic model and parameter were described by Arram and Buhrer. The effect site concentration of midazolam was targeted and started from 50ng?ml-1, then increased in increment of 50 ng?ml-1 (in the young group) or 25ng?ml-1 (in the elderly group) until the patient did not respond to light shaking (defined as unconsciousness) . Each incremental increase was maintained for 15 min. Arterial blood samples were taken in ten patients randomly selected from each group at 10 and 15min after each incremental increase of midazolam concentration for determination of plasma midazolam concentration by high performance liquid chromatography ( HPLC) .Results The bias (median performance error) of the TCI system of midazolam was 7.9% in the elderly group and 11.6% in young groups. The precision (median absolute performance error) was 20.0% in both groups. They were clinically acceptable. Conclusions The TCI system of midzolam can provided sedation for patients undergoing surgery under spinal and/or epidural anesthesia safely and efficiently in both the old and young.

Objective To assess the changes in heart rate variability (HRV) during midazolam sedation with TCI in the elderly and young patients. Methods Thirty-eight ASA I - Ⅱ patients scheduled for elective surgery on lower abdomen or lower extremities under epidural or combined epidural-spinal anesthesia were divided into two groups of 19 patients each: the young group (18-40 yr) and the elderly group (60-89 yr). Radial artery was cannulated for intra-arterial pressure monitoring and blood sampling. HRV was monitored by HXD-1 monitoring system. HRV parameters included total power (TP), low frequency(LF), high frequency(HF), LF/HF, nuLF(LF/TP ?100%) and NuHF(HF/TP ? 100%) . The height of block was maintained below T5. TCI was used to achieve a rapid induction and maintenance of a stable target blood midazolam concentration. Target blood midazolam concentration was started from 50 ng/ml and gradually increased with increment of 25 ng/ml in elderly group or 50ng/ml in the young group until loss of consciousness (OAA/S =1). Arterial blood samples were taken at each target blood midazolam concentration for determination of blood midazolam concentration. HRV parameters were recorded at different OAA/S scores during both the induction of and recovery from sedation. Results With increasing depth of sedation, most of the HRV parameters (LF, nuLF, LF/HF and TP) decreased progressively, while nuHF increased and HF remained unchanged. During recovery from midazolam-induced sedation, HRV parameters returned gradually to the baseline values. OAA/S scores and HRV parameters were well correlated(r = 0.502-0.719). The trend of changes in HRV was consistent in both groups. At the same OAA/S score, most values of HRV parameters were not significantly different between the two groups. Only during deep sedation (OAA/S=1), values of all HRV parameters were significantly lower in the elderly group than those in the young group, except LF/HF. Conclusions During profound sedation (OAA/S=1) midazolam depresses the activity of the autonomic nervous system more markedly in the elderly than in the young, but the elderly without cardiovascular and autonomic nervous system disorders has the same ability to keep the balance between the sympathetic and parasympathetic nervous system as theyoung.

[Objective]To investigate the biomechanical effect of mid-upper fibular fracture on ankle joint.[Method]From January 2005 to June 2006,20 cases of mid-upper fibular fracture were collected.Normal anterior film of bilateral ankle joint was photographed,ankle mortise width and distal fibula upper shift were measured to observe the effect on stability of ankle joint.Foot-scan pressure analyzer was used to detect the central track of footplate pressue,subtalar joint angle,in order to compare the difference between normal ankle and the sick.[Result]Dislocated mid-upper fibular fracture could lead to ankle mortise widening,lateral malleolus up shift ( averaged,1.260?0.339mm,1.045?0.276mm).the central track of footplate pressure offset and the fracture sides subtalar joint angle were larger than those in normal feet(P

Objective To compare the effects of different dose aprotinin on cardiopulmonary bypass induced inflammation and myocardial injury Methods Eighteen adult patients undergoing cardiopulmonary bypass (CPB) were divided into three groups (n=6): control,low dose aprotinin and full dose aprotinin Plasma levels of tumor necrosis factor ?(TNF?), interleukin 6(IL 6), interleukin 10(IL 10), intercellular adhesion molecule 1(ICAM 1), troponin T(TnT) and neutrophil integrin cluster of differentiation 11b(CD11b) were measured at following points: before CPB(T1);1 h of CPB (T2) ;30 min after weaning from CPB (T3); 4 h after weaning from CPB (T4) ; and 24 h after weaning from CPB(T5) Results TNF?: the values in two aprotinin using groups were lower than the control levels at T2, T3 and T4 , furthermore, in full dose group was lower than in low dose group at T4 , and lower than two other groups at T5 (P

Objective To observe the changes of calcitonin gene related peptide (CGRP) in rat spinal motoneuron after upper motoneuron injury. Methods Thirty six adult male Wistar rats were selected. Spinal cord transection was made at the lower thoracic segment. The lumbar regions of spinal cord were removed immediately, 1, 2, 4, 7 and 14 days after surgery to be divided into dorsal and ventral sections. The content of CGRP in ventral section was detected using radioimmunoassay method.Results The level of CGRP in spinal motoneuron of the lumbar region was decreased significantly after transection of spinal cord, reached the lowest level on the 2nd day after surgery and then maintained at the low level.Conclusions The upper motoneuron injury can result in the decrease of CGRP content in spinal motoneuron.

Objective To investigate the relationships between incidence of post-stroke depression(PSD)and sex,lesion sites and stroke severity,as well as the treatment of anti-depression in elderly patients.Methods 112 stroke patients were assessed by Self-rating Depression Scale(SDS)and Hamilton Depression Scale(HAMD)to evaluate the severity of depression,and the related features were analyzed in 42 diagnosed PSD patients.Results The incidence of PSD was 37.5% in elderly patients,90.5% of which were mild-and moderate-depression(P<0.01).The incidence of PSD was significantly different between genders(P<0.01).PSD incidence in patients with basal ganglia lesion was significantly different compared to that with lesions of cerebral cortex,cerebellum or brainstem(P<0.01).PSD incidence in patients with left cerebral hemisphere lesion was similar with that in those with right or both sides of cerebral hemisphere lesions(P>0.05).PSD incidence was different between patients with mono-and poly-lesions.PSD incidence in patients with severe degree of neurological dysfunction was significantly different compared to that with moderate or mild degrees of neurological dysfunction(P<0.05,P<0.01).Based on the treatment of stroke,the HAMD scores decreased significantly after mind-cure and anti-depression medication treatments(P<0.01).Conclusion PSD incidence is high in elderly patients,and most of PSD are mild and moderate.Females are susceptibility with PSD than males.PSD incidence is higher in patients with basal ganglia lesion,but is not correlated with the infracted area.The more lesions in cerebral,and the severer degree of neurological dysfunction,the PSD incidence is higher.The treatments of mind-cure and anti-depression medications based on the treatment of stroke are safe and effective for PSD patients.

Objective To determine the factors contributing to the development of deep vein thrombosis (DVT) in the lower extremity in patients after hip or knee arthroplasty and hip fracture internal fixation.Methods One hundred and forty-seven consecutive patients receiving hip or knee arthroplasty and hip fracture internal fixation from 2004 to 2005 were included in this study. Their age ranged from 33 to 92 years. Duplex color ultrasonic inspection was performed on veins of the bilateral lower extremities before operation and 2 weeks after operation for detection of DVT. The patients were divided into a DVT group and a DVT-free group based on the development of DVT after operation. Detailed perioperative clinical information about the patients, surgery and anesthesia was collected.Results Lower extremity DVT was found in 42.2% of the patients after operation, while the incidence of proximal DVT was 2.7%. Compared with the DVT-free group, the usage rate and dosage of ephedrine increased significantly, the duration of anesthesia was significantly longer, and the white blood cell count (WBC) on the 1st postoperative day and the highest WBC count were significantly higher in the DVT group(P＜0.05). Logistic regression analysis indicated that the above factors were closely related to DVT.Conclusion Duration of anesthesia ＞ 3 h, ephedrine administration and a marked increase in WBC count after operation are the risk factors for DVT in the lower extremities in patients after hip or knee arthroplasty and hip fracture internal fixation.

Oligosaccharides are one of the essential physiological constituents of glycoproteins and glycolipids on mammalian cell surfaces and microbial metabolites. They have considerable potential as therapeutics but are only now slowly assuming this important role. One of the reasons for their slow development has been the considerable difficulty in synthesizing oligosaccharides on the scale necessary for their clinical evaluation. Classical chemical and enzymatic methods both have limitations in synthesizing large-scale oligosaccharides. In recent years, the rapid progress on molecular biotechnology has promoted the development of retaining glycosidases in oligosaccharides synthesis, which led to the production of a novel class of enzymatic activities termed the glycosynthases. These new enzymes are retaining glycosidase mutants in which the catalytic nucleophile has been converted to a non-nucleophilic residue,synthesizing oligosaccharides in high yields ( the highest yields reach 99%) without any hydrolysis. Furthermore thioglycoligases and thioglycosynthases have been developed subsequently in the past three years. Glycosynthases can be screened in high-throughput assay by the two-plasmid system and the yeast three-hybid system respectively. Their activity can be significantly enhanced by substituting alternative residues for nucleophile, additional random mutations and optimizing reaction conditions. Their regioselectivity can be modified through changes in receptors.

OBJECTIVE:To compare Paliperidone sustained-release tablet and Paliperidone palmitate injection in the treatment of schizophrenia in respects of medium-term and long-term efficacy,safety,insight,medication compliance and social function of patients,so ad to provide reference for drug selection in the clinic.METHODS:Eighty-four schizophrenia patients selected from our center during Mar.2015-Jun.2016 were divided into Paliperidone sustained-release tablet group (group H,44 cases) and Paliperidone palmitate injection group (group Z,40 cases).Group H was given Paliperidone sustained-release tablet orally with initial dose of 3 mg/d,gradually increasing to 9 mg/d 2 weeks later according to disease condition;the drug dose was adjusted and ranged 3-12 mg/d according to disease condition.Group Z was given Paliperidone palmitate injection intramuscularly,150 mg on 1st day,100 mg on 8th day,and then given injection once a month,drug dose was adjusted according to disease condition (75,100,150 mg).Treatment course of 2 groups lasted for 12 months.Before treatment,1,2,3,6,9,12 months after treatment,Positive and Negative Syndrome Scale (PANSS) was used to evaluate therapeutic efficacy;Scale to Assess Unawareness of Mental Disorder (SAUMD) was used to evaluate the cognition of patients to disease;Medication Adherence Rating Scale (MARS) was used to evaluate medication compliance;Personal and Social Performance Scale (PSP) was used to evaluate patient's social function.The occurrence of ADR was observed during treatment.RESULTS:3,2 patients withdrew from group H,Z during treatment.Before treatment,there was no statistical significance in PANSS,SAUMD,MARS,PSP scores between 2 groups (P＞0.05).1,2,3,6,9,12 months after treatment,PANSS and SAUMD scores of 2 groups were decreased significantly,while MARS and PSP scores were increased significantly,compared to before treatment,with statistical significance (P＜0.05).9,12 months after treatment,PANSS and SAUMD scores of group Z were decreased significantly,while MARS and PSP scores were increased significantly,compared to group H,with statistical significance (P＜0.05).There was no statistical significance in the occurrence of ADR between 2 groups (P＞0.05).CONCLUSIONS:For schizophrenia,Paliperidone palmitate injection is better than Paliperi done sustained-release tablet in respects of medium-term and long-term efficacy,patient's insight,medication compliance,social function recovery;the longer the time,the more prominent the superiority.There is no significant difference in safety between them.