Twenty-one eyes of 13 patients with juvenile glaucoma confirmed by ocular tension, vision, eye ground and gonioscope underwent trabeculectomy combined with amniotic membrane transplantation. The posttransplant intraocular pressure significantly decreased compared to pretreatment (P

5 cm).The survival rates and the diminished rates of tumors in size were analysed comparatively.Results For small hepatocellular carcinoma,the diminished rates of tumor's size were higher in group PEI than that in group TACE and group CST,and higher in group RF than that in group TACE(P0.05).For large hepatocellular carcinoma,the diminished rates of tumor's size were higher in group TACE and group CST than that in group RF(P

We measured Plasma endothelin 1 (ET-1) concentrations in 110 normal pregnant women (NPW) and 23 normal non pregnant women (NNPW), that of maternal venous (MV), umbilical artery (UA) and umbilical vein (UV) in 20 normal parturient women at term (vaginal), and the tissue ET-1 concentrations of the placenta, fetal membrane, decidua and myometrium in 12 normotensive women at term (caesarean section) by radioimmunoassay. Results: compared with NNPW, plasma ET-1 levels were significantly decreased in NPW, and the lowest levels was in the second trimester. The plasma ET-1 levels were significantly increased in the labour, and were similar to that in NNPW. There were significant positive correlations between plasma ET-1 levels and mean arterial pressure in NNPW and NPW during the first, second and third trimester. UA and UV (ET -1) were 3.7 and 6.5 times of MV (ET 1), the UV (ET 1) was higher than UA (EF-1) significantly. The ET-1 concentrations of fetal membrane, placenta, decidua and myometrium were 38, 26, 19 and 11 times of MV (ET 1). Conclusions: ET 1 may play an important role in the initiation and process of labour and the regulation of blood pressure.

[Objective] To review the treatment of metabolic syndrome from phlegm and stasis, so as to provide effective ideas for the treatment of metabol-ic syndrome.[Method] Through searching for literatures related to Chinese medicine treatment of metabolic syndrome in the last decade, we can summarize the role of phlegm and blood stasis in the metabolic syndrome and its relationship with various components of metabolic syndrome. We can also research the application of the resolving the phlegm and removing blood stasis in the metabolic syndrome. [Results] Phlegm, blood stasis consistently run through the metabolic syndrome, and have a close relationship with each component of metabolic syndrome. The prescription of resolving the phlegm and remov-ing blood stasis can not only improve the clinical symptoms, but also can improve obesity-related indicators, reduce blood glucose, increase insulin sensitiv-ity, improve endothelial function and so on. [Conclusion] Treating metabolic syndrome from phlegm and stasis is safe and effective, which can reverse dia-betes, insulin resistance and prevent cardiovascular events through multi-channel, multi-level, multi-target. It has a broad application prospect and is worth further in-depth study.

Cerebral small vessel disease (CSVD) refers to the syndromes of clinical,cognitive,radiographic and pathological manifestations caused by intracranial small vessel disease.Due to the insidious onset of CSVD,unknown etiology,diverse clinical manifestations,and better short-term prognosis,it is easily ignored,resulting in misdiagnosis,missed diagnosis,and non-standard diagnosis and treatment.This article reviews the advances in research on clinical manifestations,imaging features,diagnosis and treatment of CSVD.

Objective To study the effect of abnormal blood pressure (BP) circadian rhythm on subtypes of acute ischemic stroke (AIS) in hypertensive patients .Methods Ninety-seven AIS pa-tients with hypertension were divided into arterothrombosis (AT)group (n=66)and small artery disease (SAD)group (n=31)according to the modified TOAST classification .Their 24 h ambula-tory BP was monitored .The 24 h BP ,daytime and nighttime BP ,morning BP surge and BP circa-dian rhythm were compared between the two groups .Results The nighttime SBP was significant-ly higher in AT group than in SAD group (133 .86 ± 18 .17 mm Hg vs 124 .42 ± 16 .06 mm Hg , P<0 .05) .The absent rate of BP circadian rhythm was higher in AT group than in SAD group (84 .8% vs 64 .5% ,P<0 .05) .However ,no significant difference was found in morning BP surge between the two groups (37 .9% vs 19 .4% ,P>0 .05) .Conclusion Absent BP circadian rhythm and elevated nighttime BP are related with AT type ischemic stroke .

Objective To investigate the application of CUSUM (cumulative sum control chart) curve in cardiac clinical teaching of resident surgeon education.Methods We chose a surgeon of 10years work experience of attending the preparation operation of internal mammary artery as control reference (standard group,28 patients) and a resident engaged in professional clinical cardiac work no more than 5 years as group 1,a professional training physician engaged in cardiac surgery clinical work more than 5 years as group 2 and took 40 patients' data respectively from the two groups' preparation of internal mammary artery operation.And then we recorded the postoperative mammary artery flow,internal mammary artery preparation time and adverse events data and made statistics analysis with SPSS 19.0,and CUSUM curve with Matlab R2012b polynomial curve.Results When the density of operate interval and the operate numbers came to about 25 cases,the polynomial eurve's slope rate went up to 0,regardless the surgeons' experience,CUSUM value was accumulated from 66 to 76,and overcame the learning curve successfully.However,when the density of operate interval did no reach the standard,the surgeon's CUSUM ploynomial cmwe slope rate never reached to 0,and can't overcome the learning curve.Conclusion CUSUM curve gives a clear quantitative indicator to the cultivation of clinical physician,and makes teaching teachers can understand the young physicians' learning process,so as to change the teaching plan,help young physicians cross the learning curve as soon as possible.

Objective To evaluate the efficacy of ketamine in preventing postpartum depression in patients undergoing cesarean section.Methods One hundred and twenty ASA physical status Ⅰ patieuts,aged 18-38 yr,with body mass index ＜35 kg/m2,scheduled for elective cesarean section,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ketamine group (group K).Postoperative analgesia was performed with sufentanil 100 μg in 100 ml of normal saline,and sufentanil was infused at 2 ml/h (bolus dose 5 μg,lockout interval 15 min) in both groups.In group K,ketamine 4 mg/kg was added to analgesic pump.VAS score was maintained＜3.Before surgery and at 1,3,5 and 42 days after surgery,depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS),and postpartum depression was defined as EPDS score ≥ 13.Postpartum depression and ketamine-related complications occurred within 3 days after surgery in group K were recorded.Results Compared with group C,EPDS scores were significantly decreased at 1,3 and 5 days after surgery,and the incidence of postpartum depression was decreased in group K.Ketamine-related complications were not found in group K.Conclusion Ketamine (infused starting from the end of operation,lasting for 48 h,total amount 4 mg/kg) for postoperative analgesia can prevent postpartum depression to some extent in patients undergoing cesarean section.

Objective To observe the effect and safety of modified Yishen Zhuyang Huoxue Huazhuo Formula for polycystic ovarian syndrome (PCOS) in the TCM pattern of deficiency of spleen and kidney with phlegm-dampness. Methods Totally 123 cases were recruited into this study and randomized to two groups by central random approach, 64 cases in the observation group and 59 cases in the control group. Patients in the observation group were given the modified Yishen Zhuyang Huoxue Huazhuo Formula, while those in the control group were given compound cyproterone acetate tablet, for two treatment courses, three months for one course. The changes of ovarian volume and the number of follicles before and after treatment were observed. Adverse reactions were also evaluated. Results Bilateral ovarian volumes in both groups decreased after treatment (P<0.05, P<0.01), while the control group showed a significant better improvement (P<0.05). The number of follicles in the two groups decreased, but no significant difference were observed between the two groups (P>0.05). The rate of adverse reaction in the observation group was lower than the control group. Conclusion Modified Yishen Zhuyang Huoxue Huazhuo Formula is effective for PCOS patient by reducing the ovarian volume with a low incidence of side effect.

ObjectiveTo investigate the effects of alpha-lipoic acid on serum soluble intercellular adhesion molecule-1 (sICAM-1) and high sensitive-C reactive protein (hs-CRP) levels in patients with early diabetic nephropathy (DN).MethodsA total of 61 patients with early DN were randomized into treatment group (n =31 ) and control group ( n =30 ).The two groups were both treated with dietary control and oral hypoglycemic drugs or insulin.Meanwhile,the treatment group was additionally given alpha-lipoic acid 300 mg/d by intravenous infusion for 20 days.The levels of sICAM-1 and hs-CRP in each group were detected.Results The levels of sICAM-1 and hs-CRP were decreased significantly in alpha-lipoic acid treatment group after 20 days of therapy ( [ 198.03 ±23.67] μg/L vs [271.17 ±34.66] μg/L,[5.16 ±0.43] mg/Lvs [7.95 ±0.88]mg/L,P ＜0.01 ).Conclusion alpha-lipoic acid may decrease the expression of slCAM-1 and hs-CRP,and that may be one of the mechanisms to postpone the progress of early DN.