Objective To investigate the curative effect of different time of irrigating after endolacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing. Methods Seventy-five cases (75 eyes) of lacrimal duct obstruction, which received endo-lacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing were divided into three groups by random digits table with 25 cases in each group. Group A received irrigating: the first day postoperative, consecutive 3 days,followed by once a week till a month. Group B received irrigating:the third day postoperative, consecutive 3 days,followed by once a week till a month. Group C received irrigating:the sixth day postoperative, consecutive 3 days, followed by once a week till a month. Followed-up survey for 12 months at the ophthalmologic outpatient clinic,the curative effect in each group was compared. Results In 6 months after surgery, the comparison of the curative effect was no statistical difference between group B and group C (P＞ 0.05), while the curative effects in group B and group C was superior to that in group A (P ＜ 0.05). In 12 months after surgery, the curative effect in group C was better than that in group A and B, the difference were statistically significant (P＜0.05). But there was no statistical significance compared with group A and group B (P＞0.05). Conclusions Properly delayed irrigating may improve the curative effect after endo-lacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing, while easier irrigating can increase the incidence of re-blockage of lacrimal duct and reduce the efficacy.

Objective To study effect of diclofenac sodium on content of prostaglandin E 2 KC/MC ratio and hyperpigmentation of the full-thickness skin autografts. Methods Content of PGE 2 was determined by radioimmune analysis method, and kinetic changes of KC/MC ratio were observed with histological and histochemical methods. Results In the operation control group, increase of KC/MC ratios was accompanied by of PGE 2 content at the early stage of the experiment; and the KMR became smaller than that in normal control group at the end of the experiment. While in the diclofenac soduim group, KMR was reduced due to the less damage of MC at the early stage, with decrease of PGE 2. Accordingly, KMR became larger at the late period of the experiment, and color of the autografts became lighter. Conclusion Application of diclofenac sodium on the grafts just after transplantation may reduce the damage of inflammation to the epidermal melanin units, control their proliferation and decrease the value of KMR, which lightens the color of the grafts.

Objective To explore the risk factors of Pseudomonas aeruginosa infection in diabetic foot .Methods 136 patients with diabetic foot were divided into infection group (n=12) and control group(n=124) according to whether Pseudomonas aerugi-nosa infection existed .Their age ,gender ,body mass index (BMI) and complications were recorded ,and their hemoglobin ,fasting plasma glucose (FPG ) ,two hours postprandial blood glucose (2hPBG ) ,glycosylated hemoglobin A1c (GHbA1c) ,cholesterol , triglycerides ,low density lipid(LDL) ,high density lipid(HDL) ,serum albumin(SALB) were detected .Logistic regression analysis was employed to analyze the risk factors of Pseudomonas aeruginosa infection .Results Incidence of Pseudomonas aeruginosa infec-tion in diabetic foot was 8 .8% .Among them ,the infection incidences of elderly patients and patients with diabetic nephropathy were 11 .6% and 12 .7% ,respectively .Univariate analysis showed that male ,advanced age ,BMI ,duration of diabetes ,history of heart disease ,diabetic nephropathy ,FPG ,2hPBG ,GHbA1c ,low hemoglobin and low SALB were associated risk factors of Pseudomonas aeruginosa infection(P<0 .05) .After correction of confounding factors such as male ,BMI ,history of heart disease ,2hPBG and low hemoglobin ,advanced age ,duration of diabetes ,diabetic nephropathy ,GHbA1c and low SALB were independent risk factors for Pseudomonas aeruginosa infection(P<0 .05) .Conclusion Advanced age ,duration of diabetes ,diabetic nephropathy ,GHbA1c and low SALB are independent risk factors for Pseudomonas aeruginosa infection .

The aim of the study is to evaluate the feasibility and safety of Bispectral index (BIS) monitoring in pediatric radio frequency catheter ablation. One hundred and six children aged 0. 6-12 years, scheduled for radio frequency catheter ablation, were randomly divided into two groups. In group A patients received BIS monitoring during the operation (n = 50), and the group B received modified Observer's Assessment of Alertness/Sedation (OAA/S) scaling (n = 56). The anesthesia was maintained with propofol target-controlled infusion. The intraoperative propefol target concentration was adjusted to maintain the BIS values between 55-65 in group A and OAA/S scale about 1 in group B respectively, The heart rate (HR), mean arterial pressure (MAP) and pulse oximetric saturation (SpO2) were measured before anesthetic induction, 1 min after induction, catheter puncturing and the end of operation respectively. The requirements of propofol, the times of supporting ventilation and recovery, the respiratory depression, nausea and vomiting postoperatively were also recorded. The intraoperative HR, MAP and SpO2 showed no differences between two groups, but the requirements of pmpofol, the times of supporting ventilation and recovery were less in group A than that of group B (P<0.05). All children didn't have nausea, vomiting and respiratory depression. The results suggest that in pediatric radio frequency catheter ablation, BIS monitoring has the advantages of timely adjustment of anesthetic depth, reducing anesthetic requirements, shortening the time of recovery, so as the perioperative safety can be improved.

Objective To study the relationship between cardiovascular diseases (CVD) and ischemia modified albumin (IMA) in patients with type 2 diabetes mellitus (T2DM).Methods Ninety-six patients with T2DM were selected as T2DM group retrospectively,and 60 cases of healthy physical examination were selected as control group,the patient' s medical history data were collected,the IMA was detected and Doppler ultrasound examination was performed.The relationship between serum IMA level and some laboratory parameters were analyzed.Results Twenty-eight cases (29.2％,28/96) occurred CVD among 96 cases of T2DM patients.The level of IMA in T2DM group was higher than that in control group [(58.25 ± 11.84) kU/L vs.(23.38 ± 6.41) kU/L],there was significant difference (P ＜ 0.05).The levels of IMA in T2DM combined with CVD group (28 cases) and T2DM not combined with CVD group (68 cases) were(91.46 ± 13.63),(47.91 ± 9.38) kU/L; the level of IMA in T2DM combined with CVD group was higher than that in T2DM not combined with CVD group and control group,there was significant difference (P ＜ 0.05).All patients completed echocardiography,Spearman correlation analysis between IMA and echocardiography indicators showed that the level of IMA was positively correlated with left ventricular end-diastolic diameter (r =0.546,P =0.031),interventricular septal thickness (r =0.427,P =0.039),posterior wall diameter of left ventricle at end-diastolic (r =0.582,P =0.026) and left venifieular mass index (r =0.339,P =0.042),and IMA was negatively correlated with ejection fraction of left ventricle (r =-0.561,P =0.024).Multivariable Logistic regression analysis showed that IMA,high-sensitivity C reactive protein,diabetes duration,fasting blood glucose levels were independent risk factors for CVD.Conclusions Serum IMA level is significantly higher in T2DM patients.IMA level is a related risk factor for CVD.

Objective To investigate the correlation between homocysteine(Hcy) and atheroscIerosis (AS) in type 2 diabetic patients.Methods A total of 98 type 2 diabetic patients in Donghua Hospital Affiliated to Sun Yet-Sen University were enrolled in this study and served as diabetic group.Meanwhile diabetic patients were divided into aged group(aged ＞65 years old) and young and middle aged group(＜65 years old).Fortynine healthy volunteers were used as control group.Intima-media thickness(IMT) and atherosclerotic plaqlles of the extracranial common carotid artery were detected by high-resolution B-mode ultrasoograph.Fasting plasma glucose (FPG),postprandial 2 h glucose (2 hPG),glycosylated hemoglobin (HbA1 c),total cholesterol (TC),total triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),creactive protein(CRP) and Hcy were measured.Correlation analysis of Hcy and IMT with other parameters was performed.Results Hcy level in patients with type 2 diabetes were (34.15 ± 10.25) μmol/L,significantly higher than those in healthy control group((8.46 ± 3.62) μmol/L,P =0.014).Hcy level in age group((40.63 ± 11.78) μmol/L) was significantly higher than that of young and middle aged group((26.54 ±9.38) μmol/L,P =0.028).IMT value and plaque detection rate in elderly patients were (1.28 ±0.26) mm and 66.1％ (20/41),significantly higher than that in the young and middle aged group((1.02 ±0.20) mm and 38.9％,P =0.041,0.027).Multiple stepwise regression analysis showed that age (OR =1.46,95％ CI:1.18-6.36,P =0.029),duration of diabetes (OR =2.62,95％ CI:1.78-7.43,P ＜ 0.001),LDL-C (OR =1.54,95％CI 1.19-6.27,P =0.028),CRP(OR =1.38,95％ CI 1.11-4.84,P =0.032),Hcy(OR =2.45,95％ CI 1.34-6.61,P =0.018)) were independent risk factors for carotid AS.Conclusion The Hcy level significantly increase in type 2 diabetic patients.Hcy,age,duration of diabetes,LDL-C,CRP are independently risk factors of neck AS.

AIM: To demonstrate the mechanisms underlying cardioprotection induced by ischemic postconditioning(I-postC) via studying the alteration of calreticulin(CRT)/calcineurin(CaN) signaling pathway in rat heart subjected to ischemia/reperfusion(I/R).METHODS: The model of myocardial I/R injury in vivo was made by occluding the left anterior descending artery for 45 min followed by 24 h of reperfusion in Wistar rats.Hemodynamics and activity of lactate dehydrogenase(LDH) and creatine kinase-MB(CK-MB) in plasma were measured.Myocardial infarct size was measured by 2,3,5-triphenyltetrazolium chloride(TTC) staining and cardiomyocyte apoptosis was detected using in situ TDT-mediated dUTP nick end labeling(TUNEL).The activity of CaN,the expressions of CaN and CRT in myocardium were detected by enzyme reaction phosphorus measurement and Western blotting analysis,respectively.RESULTS: Cyclosporin A,the inhibitor of CaN,limited significantly myocardial infarct size and cardiomyocyte apoptosis induced by I/R,but had no significant effect on cardiac function.I-postC ameliorated significantly the cardiac dysfunction induced by I/R.Compared with those in I/R group,the myocardial infarct size,the LDH and CK-MB activities in plasma and the cardiomyocyte apoptotic index were significantly reduced in I-postC group.In addition,I/R-induced upregulation of CaN activity,CaN and CRT expression were relieved by I-postC.No significant difference was found between I-postC and ischemic preconditioning groups.I-postC had stronger protective effect on the reperfused heart compared with cyclosporin A.CONCLUSION: The findings indicate that I-postC protects myocardium against I/R injury,at least in part,via inhibiting the CRT/CaN signaling pathway.

Objective: To investigate the possible mechanism of neuroprotection produced by taurine supplement on brain in young rats. Methods: In vitro, taurine treatment or co-treatment with sodium selenite that produced significant neuronal apoptosis was used in cultured cortical neurons to examine the neuroprotection effect using MTT assay and DNA fragmentation electrophoresis. In vivo, female weanling Sprague Dawley rats were divided into four groups, eight rats per group. The treated groups were fed on diets with different contents of taurine respectively, and the control group was fed on taurine unsupplemented diets. The experiment lasted five weeks. Results: Taurine significantly increased neuronal survival in dose-dependent manner. The typical DNA ladder pattern could be prevented by taurine. Taurine could elevate brain wet weight, and significantly increased the level of taurine, protein and AChE in brain. Conclusion: It is proposed that the neuroprotection effect of taurine could be achieved by modulating expression of related genes and blocking neuronal apoptosis.

Objective:To investigate the clinical value of ultrasonography combined with serum thyroglobulin (Tg) levels in preoperative N staging and therapeutic effect evaluation in patients with thyroid cancer.Methods:A retrospective analysis was conducted on the clinical data of 125 patients with thyroid cancer who underwent total thyroidectomy at The 903 Hospital of PLA Joint Logistics Support Force between January 2016 and December 2021. Based on the pathological results, the patients were divided into stages N0, N1a, and N1b. Consistency testing was performed to assess the consistency between ultrasonographic and pathological findings. The serological markers were compared between stage N0 and stage N1. A multivariate logistic regression analysis was conducted to investigate the correlation between antithyroid peroxidase antibodies (TPOAb) and Tg and lymph node metastasis. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum Tg, ultrasonography, and the combination of serum Tg with ultrasonography for lymph node metastasis.Results:Among the 125 patients, 51 cases were diagnosed with stage N1, including 36 cases of stage N1a and 15 cases of stage N1b. The pathological examination confirmed stage N0 in 74 cases. Ultrasonography results showed stage N0 in 96 cases, stage N1a in 7 cases, and stage N1b in 22 cases. The preoperative N staging of thyroid cancer patients by ultrasonography was moderately consistent with the pathological staging ( Kappa = 0.44, P < 0.001). Serum free triiodothyronine and Tg levels were higher in stage N1 compared with stage N0 ( P < 0.001), while serum TPOAb levels were lower in stage N1 than in stage N0 ( P = 0.017). Multivariate logistic regression analysis was performed with lymph node metastasis as the dependent variable and the factors FT3, TPOAb, and Tg levels as independent variables. The analysis revealed that Tg was associated with lymph node metastasis ( OR = 1.02, P < 0.001). The ROC curve analysis showed that the area under the ROC curve for serum Tg level and ultrasonography for the diagnosis of lymph node metastasis were 0.67 and 0.65, respectively, which were significantly lower than the area under the curve (0.76) for the combined detection ( P < 0.001). Conclusion:The combined utilization of ultrasonography and serum Tg levels in the preoperative staging of thyroid cancer patients holds distinct clinical relevance. Notably, this combined approach offers a more precise diagnosis of lymph node metastasis compared with ultrasonography alone. Consequently, when making clinical judgments regarding preoperative lymph node metastasis, it is advisable to consider the results of both ultrasonography and serum Tg testing to facilitate surgical planning and evaluate surgical outcomes.

The design of research protocol and quality control are the key to ensure the quality of clinical trial. A randomized clinical trial regarding the effects of medication combined with acupuncture on live birth rate in polycystic ovary syndrome (PCOS), which was initially designed as a comparative effectiveness research, then added with an acupuncture control group and finally became a factorial analysis, is taken as an example to explain the protocol design and optimization process, demonstrating the high level of methodology design and international recognization. By a series of measurements, such as unified purchase of acupuncture equipment, multiple trainings and assessments for acupuncturists' knowledge and operation standardization, in-site supervision of local center experts, the standard operation of acupuncture could be ensured and the credibility and scientificity of research results could be improved.