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

Objective To examine the effect of hydroxyethyl starch (HES 6%, 200/0.5) on reticuloendothelial system (RES) function in hemorrhagic shock. Methods Thirty 8 to 12-week-old Wistar rats weighing 250-350g were randomly divided into two groups: HES group ( n = 15) and control group ( n =15) . The animals were anesthetized with intraperitoneal 0.5% pentobarbital sodium 30mg ?kg-1 Bilateral common carotid arteries were exposed and cannulated for MAP monitoring and blood-letting. Blood was gradually removed until MAP dropped to 40mm Hg, which was maintained for 60min. Then same amount of HES (HES group) or Dextran (control group) was infused. The Kupffer cells were separated and purified before hemorrhagic shock (T0), at 12h (T1) 24h (T2) 48h (T3) and 72h (T4) after HES or DEX infusion, when the animals recovered from shock. Phagocytic activity of Kupffer cells (KC) was measured by counting the amount of Latex particles ingested by KC. Results At the same intervals (T1-4) there was no significant difference in phagocytic activity of KC between the two groups. There was no significant difference in phagocytic activity of KC between T0 (baseline) and T1-4 in both groups.Conclusions The phagocytic activity of Kupffer cells in not affected by removed of 20-30% blood volume which was replaced by same amount of HES.

Objective Valve replacement is a conventional therapy for the mitral insufficiency caused by IE. Mitral valve repair as an optional procedure for the disease has become feasible in recent years. However, concerns from surgeons about the recurrence of endocarditis after mitral valve repair remained. in this study we evaluated the long-term clinical outcomes of patients treated with surgery for the mitral insufficiency caused by infective endocarditis (IE). Methods Between July 1990 and July 2007, 83 consecutive patients (male 62, female 21) with mitral valve IE were enrolled in this study. Forty-one (49.4% )patients received mitral valve repair ( MVP,group A) and 42(50. 6% ) patients received mitral valve replacement ( MVR, group B). Thirty-seven cases had concomitant aortic valve replacement; 1 patient had aortic valve repair; 4 cases had ventricular septal defect repair; 1 case had atrial septal defect repair, 12 cases had bicuspid valve repair; 2 cases had coronary artery bypass graft and 1 case had femoral artery thrombus. Intraoperative transesophageal echocardiography were performed in 18 cases for the evaluation of mitral valve regurgitation. Mean cardiopulmonary bypass time, aortic clamping time and postoperative ventilation time were recorded and analyzed. Mid- and long-term clinical and echocardiographic outcomes were assessed.Results Preoperative left ventricular end systolic diameter, left ventricular ejection fraction and the classification of New York Heart Association in group A were significantly lower than those in group B (P ＜ 0. 05), but no difference was observed between the 2 groups in the cardiopulmonary bypass time and the crossclamping time. However, the intubation time and ICU time were shorter in group A than those in group B ( P ＜ 0.05 ). More vegetations were seen in the MVR group than in the MVP group. Three (3.6% ) patients died after the operation in group B. All patients were assessed as in NYHA Ⅰ-Ⅱ at discharge.A follow-up was done between 1 to 165 months (mean 39 months) with a mean follow-up rate of 95%. In the MVR group, peri-valvular leakage happened in 1 case, cerebral hemorrhage happened in 2 cases and repetitive pleura! effusion in 1 case. One death happened in the MVR group and none in the MVP group. The 10-year survival rate (100% ) in group A was nonsignificantly higher in group A than that (75% ) in group B(P =0.081). Conclusion Mitral valve repair is feasible for treating mitral valve lesions caused by endocarditis, and may provide an optimistic long-term outcome to the patients. The indication for mitral valve repair is mild to moderate mitral valve lesion. Experienced cardiac surgeons, use of antibiotics before and after the operations based on drug-sensitivity test and blood test, as well as follow-up the patients yearly, are important factors for the favorite outcomes.

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.

Objective: To determine the expression of Fas ligand (FasL) in the patients with esophageal carcinoma and its clinic significance. Methods: The expression of FasL was measured by immunohistochemical technique in 30 patients with esophageal cancer. The numbers of tumor infiltrationg (TIL) were accounted by immunohistochemically stained CD45. Results: 76.6% of specimen expressed FasL. The difference of FasL expression was significant between each TNM stage. There was a negative correlation between the number of TIL and the expression of FasL. Conclusion: The expression of FasL in esophageal carcinoma may correlate with its invasion and metastasis.

Objective To analyze the CT findings of acute cervical trauma (ACT) and evaluate the value and limitation of CT in the diagnosis of ACT. Methods 78 cases of cervical trauma were examined with X-ray film and thin slice CT. 3D reconstruction was performed routinely. Analysis and comparison of X-ray diagnosis with CT diagnosis were done. Results 60 cases of ACT were diagnosed by X-ray film while 59 cases were confirmed by CT simultaneously. 1 case was diagnosed by X-ray, while its CT findings were normal. Fracture detection rates of CT and X-ray film were 98.3% and 53.3%,respectively. The difference was statistically significant. Conclusion If the patient has the acute cervical trauma, CT can diagnose the fracture, luxation and spinal stenosis more safely and precisely. But CT scan has some limitations. Combining X-ray examination with CT scan is able to raise the diagnostic level.

It's very important to establish an evaluation system to match international standards for improving the medical education quality in China.This article reviews the global profile of evaluation process for higher education,and compares it with the current status in China.It introduces the characteristics and experiences from overseas as references to optimize our medical education evaluation system.

MicroRNAs (miRNAs) are small non-coding RNAs which are essential for posttranscriptional gene regulation and have important roles in physiology and pathology. The researches on function of miRNA will be a focus in the future. Several animal models have been built by transgenic technology, making important contributions to our understanding of gene function at the whole scale. Recently, the number of transgenic animal models for microRNAs and construction strategies have been increasing and diversifying. Some roles of miRNA in tumor and cardiovascular disease have been revealed by transgenic animals. Transgenic animals are becoming a kind of powerful tool in microRNA researches.

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.

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.