Objective To investigate the effect of extracapsular cataract extration by small incision after glaucomatous filtering surgery.Methods Non-phacoemulsificatinon extracapsular cataract extraction with posterior chamber intraocular lens implantation through temperal small tunnel incision was performed on 56 eyes of 48 glaucoma patients with preexisting filtering bleb.Results Visual acuity was improved in 56 eyes of 48 cases postoperatively.No severe complication was found intraoperatively and postoperatively.The postoperative IOP was (14.18?3.72)mm Hg.The functiond filtering bled had no apparently cicatrisation.Conclusion The operation is an effective method to treat cataract after glauconcatous filtering surgery.

The technique of transcervical chorionic villus sampling (TCVS) was studied in 155 cases for selected abortion in the first trimester of pregnancy, and 3 kinds of suction tube were compared. The ultrasonic mothod for the aspiration of chorionie villus sampling is more effective than the blind aspiration, giving a success rate of 99%. The modified suction tube with a stainless steel wire along-side as a supporter is simpler than the Portex's tube, giving a oneshot success rate of 85%. This shows that the TCVS is more satisfactory if the embryo is implanted into the posterior wall of the uterus. With the B-mode scanner, it gives the highest one-shot success rate and the amount of the obtained tissue is the greatest in the 7th and 8th weeks of gestation. Twenty cases were followed up for 3 to 7 days after the procedure before selective abortion. No complications occurred during and after the TCVS, indicating that this technique ia simple, safe and reliable.

Mother-Fetus ABO blood group incompatibility is one of the most common causes of hemolytic disease of newborns in China. To identify the blood group of the fetus in case of suspected mother-fetus blood group incompatibility in the first trimester of pregnancy, the author determined blood group substance (BGS) in 40 chorionic villi samples taken by the absorption-elution procedure during 6 to 12 weeks of gestation, with a simultaneous parental blood group determination as control. The BGS detected in those specimens were all in accordance with those of the blood groups of their coriesponding parents. Among the 40 samples of chorionic villi, 20 were redetermined, and the results were the same. This demonstrates the feasibility of the procedure to identify the fetal blood groups by the determination of BGS in the chorionic villi by transcervical aspiration. The study presents, apparently, a new and simple diagnostic method for detecting mother-fetus blood incompatibility in early pregnancy, thas giviing a prospectively preventive study on those types of blood group incompatibility.

Objective To investigate the safety of the application of dexmedetomidine in patients with heart failure .Methods The selective cardiac surgery 80 patients with heart failure were randomly divided into two groups ( n =20 each):group I:0.5 μg/kg dexmedetomidine intravenous injection in 10 min;and group II:control group.Systolic blood pressure (SBP), diastolic blood pres-sure (DBP), heart rate (HR), oxygen saturation (SpO2), and bispectral index (BIS) were recorded at 10, 20, 30 min after injec-tion.Cardiac output (CO) and stroke volume variation (SVV) were also recorded at the time after radial artery and internal jugular vein puncture , and Ramsay and visual analogue scale ( VAS) score were also given to each patients of two groups at 30 min.Results The SBP, DBP, HR, and BIS of group I were lower than group II at 10 and 20 min after injection ( P <0.05 ); the SBP, DBP, HR, and BIS of group I were also lower than group II at the time after radial artery and internal jugular vein puncture [ SBP:(124.9 ± 15.5)mmHg vs (138.7 ±17.8)mmHg;(128.9 ±17.8)mmHg vs (140.3 ±19.3)mmHg, P <0.05;DBP:(69.4 ±10.2)mmHg vs (80.1 ±11.2)mmHg;(70.5 ±11.8)mmHg vs (87.7 ±13.6)mmHg, P <0.05;HR:(65.3 ±9.4)bpm vs (78.8 ±10.9)bpm;(68.2 ±10.8)bpm vs (80.9 ±13.3)bpm, P <0.05;BIS:84.5 ±5.7 vs 95.4 ±3.7;87.8 ±7.7 vs 95.3 ±4.7, P <0.05]; The CO, SVV, and SpO2 were no difference between two groups;the Ramsay(3.4 ±1.5 vs 1.2 ±0.4;3.9 ±1.7 vs 1.4 ±0.5) and VAS (2.1 ±0.7 vs 3.8 ±2.1;1.9 ±1.5 vs 4.1 ±2.1)score of group I were lower than group II ( P <0.05).Conclusions A amount (0.5 μg/kg) of dexmedetomidine intravenous injection can be safely used in patients with heart failure .

Objectives To observe the effect of flurbiprofen as preemptive analgesic and it's relative adverse reactions in pa-tients undergoing selective craniotomy .Methods Sixty patients undergoing selective craniotomy were divided into two groups randomly by age,sex,location of craniotomy:observation group (Group-flurbiprofen) and control group (Group-saline).Monitored sonoclot signal and estimate bleeding amount during the operation .Evaluated the quality of emergence after operation .Recorded the VAS pain scores 2 hours,6 hours,12 hours and 24 hours after operation ,and the occurrence of adverse reactions as nausea , vomiting and respiratory de-pression.Results The concentration of prostaglandin E2(PGE2) in the serum of the observation group was lower than that of control group( P <0.05).There were no significant differences in ACT (activated coagulation time) and CR (clot rate) of the two groups( P>0.05),but the PF (platelet function) of observation group was lower than that of control group ( P <0.05).There were no signifi-cant differences in awakening time and extubation time of the two groups ( P >0.05).The 2 hours'pain scores of the two groups was of no significant difference( P >0.05),but the pain scores of observation group were lower than that of control group in 6 hours,12 hours and 24 hours after operation( P <0.05).The occurrence of nausea , vomoting and respiratory depression had no significant differences ( P >0.05) .Conclusions Flurbiprofen as preemptive analgesic can reduce the postoperative pain in patients undergoing cranioto -my,without increasing the occurrence of nausea , vomit and respiratory depression .It can effect the platelet function ,but could not in-crease the amount of bleeding .

Objective To investigate the effect of intrathecal injection (IT) of dexmedetomidine targeting Toll-like receptor 3 (TLR3) on neuropathic pain and spinal cord levels of TLR3 mRNA,interleukin-1β(IL-1β),tumor necrosis factor-alpha (TNF-α) proteins in rat model of chronic constriction injury (CCI).Methods Male Sprague-Dawley rats were randomly divided into five groups(n =10):the sham group(intrathecal normal saline,IT NS),CCI group (CCI + IT NS),DEX-pre group (CCI + IT DEX pre 2ds),DEX-post group (CCl + IT DEX post 7ds) and DEX + ATIP group (CCI + IT DEX + ATIP).The lumbar intrathecal catheters were implanted in L5_6 of rats and CCI models were established as previously described.The thermal and mechanical nociceptive thresholds were assessed by paw withdrawal latency(PWL) to radiant heat and yon Frey filaments.The DEX was administered intrathecally for 7 days starting from 2 day before surgery or 7day after surgery.The spinal cord expression of TLR3 mRNA was assessed by real-time polymerase chain reaction (PCR).Levels of IL-1β,TNF-α in spinal cord were detected by enzyme-linked immunosorbent assay (ELISA).Results Compared with the sham group,animals in CCI group had significandy lower mechanical (F =12.73,P ＜ 0.05) and thermal pain thresholds (F =14.65,P ＜ 0.05),higher expression of TLR3 mRNA (F =11.03,P ＜ 0.05) and levels of IL-1 β (F =9.67,P ＜ 0.05),TNF-α(F =8.78,P ＜ 0.05) in the spinal cord (P ＜ 0.05).Rats in DEX-pre group had significantly higher mechanical (F =11.03,P ＜ 0.05) and thermal pain thresholds (F =15.03,P ＜ 0.05) and significantly lower expression of TLR3 mRNA (F =14.65,P ＜0.05) and levels of IL-1β (F =12.51,P＜0.05,TNF-α (F =9.01,P ＜0.05) in the spinal cord compared with those in the CCI group (at any observed time points after ligation,but most significantly at 7 d).And the effects of DEX-pre group were abated by IT ATIP at the same time or 7days after surgery alone (P ＜ 0.05).Conclusions Intrathecal injection of DEX can decrease the levels of inflammatory factors by decreasing the TLR3 mRNA in the spinal cord of rats and prophylactic relieve the neuropathic pain induced by CCI.

Based on the organizational strategy,the balanced scorecard(BSC) is a kind of customized performance measurement system.Put forward by Robert Kaplan and David Norton in 1990,it has been using at several healthcare organizations and led to a great deal of innovation in organizing and management.This paper aims to introduce the composition,characteristics and successful cases of BSC,and analyze the feasibility of adopting this method in domestic healthcare organizations.

Objective:To explore the depressive symptom of nurses and its relationship with trait coping style,role perceive and personal control.Methods:425 nurses in the 2nd Hangzhou general hospital completed a battery of questionnaires consisted of part items of SCL-90,Trait Coping Style Questionnaire(TCSQ) and Role Perceive and Personal Control Scale.Results:There are significant correlation among the SCL-90 score,the coping styles,and the control feeling and role conflict.Based on depression factor ,factors of negative coping style,control feeling,role conflict and positive coping style were included in stepwise regression equation.Conclusion:Depressive symptom of nurses was related to trait coping style,role perceive and personal control.

Objective:To investigate the relationship among college student’s depression symptoms, problem solving appraisal and perceived stress.Methods:275 college students completed questionnaires, including CES-D, Chinese Perceived Stress Scale (CPSS) and Chinese Problem Solving Inventory (CPSI). Results: Among these students, 52% reported on the level of health risk stress (HRS), 55.3% had depression symptoms. There were significant correlation among depression symptoms, perceived stress and problem solving appraisal. The causal relationship between them were identified with the path analysis method, problem solving in special, seems to have both direct and indirect effect on the prediction of depression and on perceived stress. Conclusion:There is a high level of college student perceived stress and depression symptoms. Problem solving appraisal is an important factor for both of them.

Objective To investigate the correlation and risk factors between vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN).Methods A total of 121 cases of VAIN patients was retrospectively analyzed with examination results such as clinical manifestations,liquid based cytology (TCT),human papilloma virus infection,virus infection type,and clinical data of treatment and follow up.Results VAIN Ⅰ,VAIN],and VAIN Ⅲ] were accounted for 33.9％ (41/121),38.0％ (46/121),and 24.4％ (34/121) ; for 40 or less years old patients,VAIN Ⅲ was accounted for 10.7％ (3/28) ; for more than 40 years old patients,VAIN Ⅲ was accounted for 33.3％ (31 /93).Among 121 VAIN patients,77.7％ (94/121) patients had CIN history,15.7％ of which (19/121) had a history of cervical cancer; 27.3％ (33/121) with hysterectomy history,of which 75.8％ (25/33) was due to cervical intraepithelial neoplasia and cervical cancer resection of the uterus.Papilloma viral load in patients with VAIN Ⅰ was detected with a (HPV-HC2) positive rate of 87.8％ (36/41),while in VAIN Ⅱ and VAIN [patients,the positive rate was 100％,the infection of high risk type of HPV ratio was 95.9％ (116/ 121).of which the mixed infection was accounted for 56.9％ (66/116).There was 94.6％ in oatients with VAIN (114/121),and liquid-based cytology test results suggest abnormality; 88.4％ (107/121) in patients with VAIN lesions occurred in upper 1/3 of vaginal.After diagnosed cervical disease,the onset time of VAIN was (3.45 ± 2.02) years,non-total-hysterectomy was (3.24 ± 1.97) years,after hysterectomy to pathological diagnosis time for VAIN was (5.01 ± 3.95) years:for the diagnosis of VAIN disease after resection of cervical original time was (3.96 ± 2.99) years,and rather than non cervical disease resection was an average of (9.94 ±5.37) years.In the course of treatment of the 12l cases of CIN patients,6 cases of patients were progressed to invasive carcinoma.Conclusions The clinical manifestation of VAIN is similar to CIN,the principle of diagnosis and treatment of CIN can also apply to VAIN,high risk HPV infection virus,cervical intraepithelial neoplasia are the risk factors for VAIN.