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

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 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.

[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.

Objective To evaluate the operative results of 542 patients underwent mitral valve repair and the results of 20-years follow-up.Methods A total of 542 patients [306 males,236 females;mean age (38.75?19.38) years) underwent mitral valve re- pair between 1985 and 2006.Mean follow-up was (41.03?40.40) months (1～240 months),and follow-up was 90.8% complete. Results The post-operative mortality was 3.7 %,and 96.3 % of patients were in NYHA class Ⅰ and Ⅱ after surgery.During fol- low-up,there were 20 deaths and 23 reoperations.Survival at 7-year,10-year and 15-year was 91%,88% and 70%,respectively. Freedom from reoperation at 7-year and 10-year was 94% and 86%,respectively.Conclusion Valve repair in mitral leaflet disease is a standard technique,with a good operative results.

Eligible 112 children aged 4-12 years old were recruited and assigned to 2 groups with block random design.For the first treatment session,the subjects in group 1 received computer-controlled anaesthesia(CCA) with autiovisual distraction of video-eyewear system(ADVS) intervention based on the routine therapy,those group 2 received only CCA and routine therapy.For the second session,a crossover of intervention methods were conducted for the 2 groups.Before and after each session,pain intensity and dental anxiety of each group were evaluated.Results showed that the group receiving CCA-ADVS presented significantly lower pain intensity and dental anxiety than the group receiving CCA only(P＜0.05).Evident differences were detected in the assessment outcomes in each treatment session (P＜0.0001).The combination of CCA and ADVS can effectively reduce pain perception and dental anxiety of children in pediatric endodontic treatment.

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 assess the curative effect of acupuncture therapy to chronic mesenteric lymphadenitis. [Methods] Al 120 children patients are ran-domly divided into two groups, 60 cases each. Control group is treated with cefuroxime sodium for infections, and treatment group with acupuncture at Sifeng(EX-UE 10), Neiguan (PC06), Zhongwan(RN 12),Zusanli(ST 36) and etc. [Results] Markedly effective rate of treatment group was 91.7%,and total effective rate was 98.3%; markedly effective rate of control group was 86.7%, and total effective rate was 95%, which showed significant difference in curative effects.The two groups symptoms were decreased compared with before treatment, the difference was significant( P<0.01);after treatment, symptom scores were lower than the control group, with significant difference. The recurrence rate of treatment group after three months was 3.6%. The recurrence rate of treatment group after six months was 1.9%, evidently lower than control group ’s 57.7%,54% respectively. [Conclusion] Acupuncture therapy to chronic mesenteric lymphadenitis has unequivocal short-term effect, a stable long-term effect, and low recurrence rate,deservers clinical applications.

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.