Objective To study trabeculectomy with adjustable sutures on the ocular function score in pa-tients with angle-closure glaucoma .Methods 98 cases ( 134 eyes ) were randomly divided into the two groups , the control group(n=49 cases,66 eyes) and the observation group (n=49 cases,68 eyes).The patients in the control group were operated through trabeculectomy ,while the patients in the observation group were operated through trabe-culectomy with adjustable sutures .The occurrence of the two groups of patients intraocular pressure changes , and recovery of sight,shallow anterior chamber before and after surgery three months were observed .Postoperative 1d,3d, 1m and 3m ocular function score were compared .Results Postoperative 3 months IOP were significantly lower ( t=3.921,5.746,all P<0.01),and compared with the control group ,the observation group significantly decreased (t=2.680,P<0.05).Postoperative 3 months visual acuity significantly improved in patients (t=2.460,2.976,all P<0.05),and compared with the control group,the observation group improved more significantly (t =2.062,P <0.05).The incidence of postoperative shallow anterior chamber were 12.1% in the control group and 2.9% in the observation group Shallow anterior chamber in observation group was significantly less than that in the control group (χ2 =7.98,P<0.01).The two groups of patients after ocular surface scores were decreased in the observation group after 1d,3d,1m and 3m and ocular scores were lower than that of the control group ( t =2.1901,2.680,3.172, 3.013,all P<0.05).Conclusion Trabeculectomy with adjustable sutures can promote the recovery of angle-closure glaucoma,ocular function.

The method, established for analysis of paeoniflorin in blood plasma, appeared a good linear relationship(r=0.9998). Using meta-hydroxybenzoic acid as internal standard and calibration factor combined, the quantitation precision of method could be raised. The result of determination of calibration factor conformed with the chromatography prescriptions in "Pharmacopoeia of China" (edited in 1990). The average recovery reached up 97.13％. The minimum detection amount was 5.6ng. The coefficients of within-day and between-day variation were 0.39％ and 1.17％, respectively. This method is suitable for paeoniflorin analysis of in vivo sample . At present,the in vivo absorption of Baihegujintang Granules (containing Radix Paeoniae alba or Radix Paeoniae rubra) by rabbit is preliminarily investigated utilizing this method.

Objective To explore the CT manifestation and the diagnostic value of leiomyomatous tmnor of gastrointestinal tract in 8 patients.Methods 8 patients with gastrointestinnal tract leiomyoma tumor were scaned with GE HISPEED CT/I.proceeding to scan with contrast agent when detected and ascertained the nidus.Results There were 4 eases gastric smooth muscle tumors in 8 patients,and 1 case was leiomyosarcoma of stomach,1 case was duodenal muscle tumors,1 case as jejuna muscle tumors and another is leiomyosarcoma of jejunum.Conclusion The location,contour and characteristic of imaging is important standard of leiomyomatous tumor of gastrointestinal tract.

Objective To observe the expression of neuroglobin in brain of rat with septic shock,and study the protective effect of neuroglobin.Methods Sixty male SD rats were randomly di-vided into two groups,30 rats in each.The rats in group M were injected LPS 10 mg/kg through tail vein to establish septic shock model,the success standard of septic shock was systolic blood pressure dropping to 60% of the basic values;the control group were given equal volume of NS.The levels of rat TNF-α,IL-6 and NGB in serum at the time points of before LPS injection (T0 ),1 h (T1 ),2 h (T2 ),4 h (T3 )and 6 h(T4 )after LPS injection were measured using ELISA kits.NGB and caspase-3 protein expression in brain were determined using Western blotting.Results Compared with group C and T0 ,the TNF-α,IL-6 concentrations in serum and caspase-3 in brain were increased significantly at T1-T4 (P <0.05),NGB protein content in serum and brain at T3 and T4 were increased significantly (P <0.05).Conclusion Cell apoptosis and inflammatory response are discovered in the brain during septic shock.NGB is over-expressed in brain of rats with septic shock,which may play a role of pro-tective function.

Objective To observe the effect of Radix astragali (RA) on myocardial connexin-43 in rats with dilated cardiomyopathy (DCM). Methods The dilated cardiomyopathy model in rat was established through intraperitoneal injection with adriamycin. The rats in the model group were randomly divided into RA group and the model control group according to different methods of administration. Rats in RA group were gavaged with Astragalus particles and double-distilled water, and rats in model control group and normal control group were gavaged with an equal amount of double-distilled water daily for four weeks. At the end of 12 weeks, the left ventricular ejection fraction (LVEF) was measured with echocardiogram. The Cx43 mRNA level was tested by reverse transcriptase polymerase chain reaction (RT-PCR). Immunohistochemical method was used to observe myocardial Cx43 expression and distribution. Results Compared with the model control group, the Cx43 mRNA and protein expressions and LVEF were increased signiifcantly in RA group (P<0.05). The disorders in distribution of myocardial Cx43 improved in RA group in contrast to the model control group. Conclusions Radix astragali can improve myocardial Cx43 expression and distribution in DCM rats, and can further improve the cardiac function.

OBJECTIVE:To observe the efficacy and safety of Guizhi fuling capsule combined with mifepristone in treatment of uterine fibroids. METHODS:116 patients with uterine fibroids were randomly divided into control group and observation group. Control group was orally given Mifepristone tablet 25 mg,2 h before meal in the first day of menstrual period,once a day,for con-tinuous 10 d;observation group was additionally given Guizhi fuling capsule 3 pills in non-menstrual period,3 times a day. 3 months was regarded as a treatment course,it lasted 2 courses. Clinical efficacy,and E2,FSH,SHBG,uterine volume,menstrual blood volume,uterine fibroid volume and incidence of adverse reactions in 2 groups before and after treatment were observed. RE-SULTS:Total effective rate in observation group was significantly higher than control group,the difference was statistically signifi-cant(P<0.05). After treatment,the FSH,E2,uterine volume,menstrual blood volume and uterine fibroid volume in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically signifi-cant(P<0.05);but there were no significant difference in the SHBG and adverse reactions between 2 groups(P>0.05). CONCLU-SIONS:The clinical efficacy of Guizhi fuling capsule combined with mifepristone in treatment of uterine fibroids is more signifi-cant than mifepristone alone,with good safety.

Objective To investigate the optimal time of termination of pregnancy for patients with hemolysis elevated liver enzymes and low platelet (HELLP) syndrome Methods 57 patients with HELLP syndrome admitted from October 1992 to September 2001 were enrolled According to the length from the time diagnoses confirmed to the time of delivery,patients were divided into 3 groups; group Ⅰ,within 24 hours, group Ⅱ,24 to 48 hours and group Ⅲ,over 48 hours Complications,maternal and perinatal mortality were analyzed retrospectively between different groups Results Maternal and perinatal mortality were 7% and 11% in group Ⅰ, 16% and 21% in group Ⅱ, 64% and 73% in group Ⅲ with significant differences between group Ⅲ and group Ⅰ or group Ⅲ and group Ⅱ ( P

Objective To discuss nursing care of patients underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy. Methods 22 patients who underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy accepted strengthened psychological care, perfect preoperatively preparation, to sleep in face-up supine position, meanwhile complications were observed and treated carefully. Results 22 patients could persist in sleeping in face-up position for 4days postoperatively. Graft shift occurred in two cases. And after gas reinjection the grafts adhered very well. Intraocular pressure rose in 7 cases .After timely treated these 7 patients were cured and discharged. Conclusions Careful preoperative evaluation and preparation could reduce postoperative complication. Strict measures to keep patients sleeping in face-up supine position, timely observation and treatment of complications should be important to ensure the success of the operation.

Objective To evaluate the significance of the mannose-binding lection (MBL) gene polymorphism at code 54 of exon 1 and MBL serum level and C-reactive protein (CRP) in the severity of community acquired pneumonia (CAP) in adults.Methods A prospective observation was conducted.104 adults Han patients with CAP hospitalized in Tianjin People's Hospital were enrolled.Frequencies of MBL54 alleles and genotypes were measured.The patients were evaluated by pneumonia severity index (PSI) score and were graded.Serum MBL was determined by enzyme linked immunosorbent assay (ELISA),and serum CRP was detected by immunoturbidimetry before and 4 days and 7 days after the treatment.100 healthy control subjects with the same region,age,gender,nationality were enrolled as control group.Serum MBL and CRP levels were compared between CAP group and the control group or among different grades of PSI,and the correlation was analyzed.Results The variation of GGC→GGC in MBL54 was found in CAP patients and controls.Similar frequencies of genotypes (x2=0.018,P=0.893) and alleles (x2=0.019,P=0.903) of MBL54 with wild type and mutant type were found between two groups.The serum MBL level (mg/L) before and 4 days and 7 days after the treatment in CAP group was increased followed by the reduction and they were 3.75 ± 1.78,4.53 ± 1.99 and 4.04 ± 1.91,respectivelv,which were significantly higher than those in control group (2.84 ± 1.41,all P＜0.01).The serum CRP levels (mg/L) in CAP group were gradually declined,and they were 66.88 ± 40.47,51.21 ± 37.54,36.91 ± 36.02,respectively,which were significantly higher than those in control group (6.96 ± 2.19,all P＜0.01).There were 12 cases with PSI grade Ⅰ,32 cases with grade Ⅱ,20 cases with grade Ⅲ,22 cases with grade Ⅳ and 18 cases with grade V in CAP patients.There was no significant difference in frequencies of MBL54 genotypes among different grades of PSI (x2=1.210,P=0.876) and between general ward and intensive care unit (x2=0.569,P=0.451).No differences in the serum MBL level before (F=1.313,P=0.279) and 4 days (F=1.705,P=0.165) and 7 days (F=1.684,P=0.170) after the treatment were found among different PSI grades.The serum MBL level 4 days after the treatment was significantly higher than that before treatment,then decreased to the level before treatment on the 7th day after treatment in CAP patients with grade Ⅱ-Ⅳ.There was significant difference in serum CRP level before (F=23.179,P=0.000) and 4 days (F=26.601,P=0.000) and 7 days (F=10.358,P=0.000) after the treatment among different PSI grades in CAP patients.The serum levels of CRP in patients with different PSI grades were gradually decreased with time prolonged,the higher the PSI grade,the more obscure the serum CRP decrease.No correlation was found between PSI grade and serum MBL before and 4 days and 7 days after the treatment (before treatment:r=-0.205,P=0.145; 4 days after treatment:r=-0.062,P=0.662; 7 days after treatment:r=-0.063,P=0.656),and positive correlation between PSI grade and serum CRP was found (before treatment:r=0.809,P=0.000; 4 days after treatment:r=0.842,P=0.000; 7 days after treatment:r=0.702,P=0.000).Conclusions The MBL54 codon genotypes had no effect on the susceptibility of CAP.The serum MBL was elevated and dynamic changes with increasing treatment time in CAP patients were shown.MBL can be used as a reaction of CAP in acute stage.But it cannot be used as an inflammatory marker for the severity of CAP.

Objective To study the regularity changes in serum levels of C-reactive protein(CRP)and mannose-binding lectin(MBL)in patients of community acquired pneumonia(CAP)with different syndrome patterns of traditional Chinese medicine(TCM),and to explore the new objective markers to differentiate the syndrome patterns of TCM. Methods According to The Guideline on TCM diagnosis and treatment of CAP(2011 edition),104 patients with CAP were selected and their syndromes were cassified into 3 classes and 8 patterns of syndrome:excessive class〔including following patterns:wind-heat invading lung(fengrexifei),exopathic cold and interior heat(waihanneire), accumulation of heat in lung(tanreyongfei),accumulation of phlegm-dampness in lung(tanshiyongfei)〕,deficient vital QI leading to lingering of pathogen class〔qi deficiency of lung and spleen(feipiqixu),both qi and yin deficiency (qiyinliangxu)〕,TCM critical class〔heat falling into pericardium(rexianxinbao),pathogen invasion and vital qi deterioration(xiexianzhengtuo)〕. In the same period,after physical examinations,100 healthy volunteers were chosen as healthy control group. The serum levels of CRP and MBL were detected before treatment and after treatment for 4 days and 7 days. Results Among the 104 CAP patients,the most popular class of syndrome was the excessive one(63.5%),followed by deficient vital QI leading to lingering of pathogen(19.2%)and TCM critical class(17.3%). The serum CRP level in CAP patients at each time point was higher than that in healthy control group,which had a different tendency to change over time in different syndrome patterns of TCM. With the prolongation of treatment time,the serum CRP levels in fengrexifei and waihanneire patterns returned to a normal level on the 7th day(mg/L:13.51±11.48,7.07±1.84 vs. 6.96±2.19,both P>0.05),in feipiqixu and qiyinliangxu patterns the CPR levels were higher,but its descent rate was relatively fast,and on the 7th day it was approximately normal in spite of being higher than the level in healthy control group(25.25±25.90,18.17±23.19 vs. 6.96±2.19,both P<0.05);in tanreyongfei and tanshiyongfei patterns,although the CPR levels were decreased,they still maintained at relatively high levels on the 7th day after treatment(51.70±27.33,49.28±30.57),and no downtrend of CPR was seen in rexianxinbao and xiexianzhengtuo patterns. Before treatment,the serum MBL levels in CAP patients with fengrexifei,waihanneire, tanreyongfei,tanshiyongfei,feipiqixu and qiyinliangxu patterns were higher than the level in healthy control group, and in rexianxinbao and xiexianzhengtuo patterns,the levels were lower than those in other patterns and kept being at relatively lower levels along with the prolongation of the therapy. Conclusion Serum CRP can be used as a reference marker for different syndrome patterns of TCM in patients with CAP,and low serum MBL level was a risk factor of severe syndrome patterns of TCM and a poor prognosis in CAP.