AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication.
METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.
RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P< 0. 01 ). The visual acurity of all cases increased in different degrees from handle move to 0. 3 to 0-1-1. 0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes (52. 4%), mild iritis in 21 eyes (100%). No cornea burn was encountered.
CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.

Exposure to traffic-related air pollutants(TRAP)has been implicated in airway allergic diseases.Recent findings include epidemiologic and mechanistic studies that shed new light on the impact of TRAP on allergic rhinitis(AR)and the biology underlying this impact.These studies have found that oxidative stress induced by TRAP could affect the axis of epithelial cell-dendritic cell-T cell towards a T-helper 2 immune response,which is the major mechanism between TRAP and AR.Further,epigenetics and microRNA might be involved in this process.Our review will summarize the most recent findings in each of these areas.
Air Pollutants ; toxicity ; Air Pollution ; Humans ; Oxidative Stress ; Rhinitis, Allergic ; etiology ; Vehicle Emissions ; toxicity

Vascular endothelial growth factor receptors ( VEGFR ) belong to the receptor-type tyrosine kinase ( RTK ) super family and play important roles in tumor angiogenesis.Abnormal activation of VEGFR results in several disorders including cancer.VEGFR-2 is the major signal transducer for angiogenesis, and therefore, it becomes a good target for the inhibition of tumor development and metastasis.Nowadays, the VEGFR-based antiangiogenic therapy becomes one of the most powerful clinical strategies for cancer treatment.In this review, small molecular VEGFR-2 inhibitors are classified according to their structural features, their biological activities and current statue are briefly introduced.

Objective To observe the therapeutic effect of phloroglucinol combined with diazepam in prolonged or protracted active phase of first stage of labor,and the outcome of perinatal phase.Methods Two hundred vaginal delivery primipara with prolonged or protracted active phase after dilatation of cervix 2-3 cm were selected.The patients were divided into 2 groups by random digits table method with 100 cases each,the patients in observation group were given phloroglucinol 80 mg and diazepam 10 mg,and the patients in control group were given diazepam 10 mg.The cervical dilatation,the degree soft hardness and edema of cervix,time of active phase,time of second stage of labor,mode of delivery,vaginal bleeding in 2 h postpartum and outcome of perinatal phase in the 2 groups were observed.Results In observation group,the cervical dilatation rate was (2.31 ± 0.27) cm/h,the time of active phase was (187.27 ± 33.22) min.In control group,the cervical dilatation rate was (1.82 ±0.48) cm/h,the time of active phase was (251.32 ± 45.33) min,there were statistical differences between 2 groups (P ＜ 0.05).The rate of uterineincision delivery in observation group was significantly lower than that in control group [18.0％(18/100) vs.32.0％ (32/100)],there was statistical difference (P ＜ 0.05).There were no statistical differences in time of second stage of labor,vaginal bleeding in 2 h postpartum,rate of neonatal asphyxia between 2 groups (P ＞0.05).Conclusion The effect of phloroglucinol combined with diazepam in prolonged or protracted active phase is remarkable,it can promote the progress of labor,speed up delivery progress,improve the rate of vaginal delivery and decrease the rate of uterine-incision delivery,and no adverse effects on the outcome of perinatal phase,it is worth popularizing.

Objective To investigate the clinical status of massive transfusion in elderly patients in general hospital in order to improve the clinical use of blood and ensure the security of blood transfusion in elderly patients.Methods 100 patients who required massive transfusion were divided into 2 groups:elderly group (patients aged 60 years and over,n=32) and non-elderly group (patients aged under 60 years,n=68).Clinical blood transfusion indications in all patients met the Technical Criterion of Clinical Blood Transfusion issued by Ministry of Health of the People's Republic of China in 2000.Clinical data were analyzed and compared between the two groups.Results Elderly patients with massive transfusion were mainly in department of surgery,including department of orthopedics,general surgery,hepatobiliary surgery,cardiac surgery and urology surgery and gastroenterology,and the mean age of patients in these departments was 71.5 years,69.9 years,72.0 years,66.0 years,65.5 years,70.8 years respectively,accounting for 50.0％,70.0％,20.0％,75.0％,20.0％ and 66.7％ in all patients who required massive blood transfusion respectively.The mean blood transfusion volumes were higher in patients in department of gastroenterology,general surgery,hepatobiliary surgery and orthopedic,in which the mean units of red blood cell components transfusion were 14.0 U,7.0 U,5.2 U and 4.1U respectively,the mean units of plasma components transfusion were 23.3 U,8.4 U,8.0 U,0.5 U respectively,and the mean uint of platelet components transfusion was 1.6 U in hepatobiliary surgery.Conclusions The risk of blood transfusion is higher in the elderly than in the non elderly.We should select the effective blood components reasonablely,reduce the unnecessary blood transfusion and decrease the dependence on plasma transfusion to avoid the transfusion overload and adverse reactions.

To review the outcome of the endovascular treatment of aortoiliac occlusive disease,the recent literature concerning endovascular treatment as well as aortoiliac occlusive disease was extensively reviewed,and the research and development were summarized.The results are:(1) In most cases,endovascular invention is better than surgery ; (2) Stent placement has a higher technical success rates and a better longterm outcome than percutaneous transluminal angioplasty,primary or selective stent placement,which is better,is controversial; (3)Covered stents perform better than bare stents in longer-term patency and clinical outcome ; (4)Endovascular treatment of complex AIOD provides excellent early and long-term results,similar to those obtained in the treatment of simple lesions.So,in general,endovascular treatment of aortoiliac occlusive disease provides excellent clinical results,further research is needed.

BACKGROUND:The treatment of diabetic foot has become a“bottleneck”. The transplantation of autologous bone marrow or peripheral blood endothelial progenitor cells is a new way for the treatment of diabetic foot in recent years.
OBJECTIVE:To review the effects of vascular endothelial growth factor receptor 2 and the integrin in treatment of diabetes foot by transplantation of endothelial progenitor cells.
METHODS:The first author searched PubMed database and Chinese periodical ful-text database for related articles published between January 1998 and December 2012, withdiabetic foot, endothelial progenitor cells, VEGFR-2, integrin, synergistic effectin English and Chinese, respectively. A total of 98 articles were searched, and 60 were included after excluding repetitive articles.
RESULTS AND CONCLUSION:In the diabetic foot treatment, autologous bone marrow or peripheral blood endothelial progenitor cells has around increasing attention, and gradual y become the focus of this field. Therapy with endothelial progenitor cells has gradual y developed into a new method for diabetic foot. Vascular endothelial growth factor receptor 2 and the integrin may exhibit synergistic effects in the treatment of diabetes foot. However, the mechanism remains poorly understood. Further studies are needed to wel understand their mechanism of action.

The genes of P53,retinoblastoma (Rb),C-myc and human papilloma virus (HPV) were determined by PCR method in specimens of 33 patients with laryngeal carcinoma and 4 normal laryngeal tissues as a control group.There were 23 males and 10 females,ranging in age from 40 to 11 years old.Results showed that the mutation rate of P53 and Rb gene were 69.69%(23/33) and 48.48%(16/33),respectively;c\|myc gene amplification rate and HPV insertion rate were 58.62% (17/29) and 72.72%(24/33),respectively.There were significant difference(P＜0.05)in comparison between positive and negative expression above these genes.The expression rate were 50.00%(12/24),45.83%(11/24)and 66.67%(16/24)of C-myc,Rb and P53 genes respectively in 24 cases who were HPV positive of laryngeal carcinoma.The positive rates were 73.68%(14/19),63.16%(12/19),57.89%(11/19)and 84.21%(16/19) of HPV,C-myc,Rb and P53,respectively in 19 cases who have heavy smoking (20/day,20 years smoking history).Above results suggested that there were closed relationship in the C-myc gene activation and P53,Rb genes inactivation with smoking and HPV infection.It was believed that carcinogen factors on laryngeal carcinoma was the result of factors,genes and stages interaction.

Graves' ophthalmopathy (GO) is an autoimmune disorder representing the commonest and most important extrathyroidal manifestation of Graves' disease.GO can be a debilitating component of the disease,resulting in impaired quality of life.Although therapeutic methods appear to be widespread,the optimal treatment remains challenging.This article reviewes recent studies on therapy pattern and evidence-based medicine,to provide practical information for managing patients with GO.

Exendin-4,a peptide analogue of glucagon-like peptide-1(GLP-1),is presently in clinical trials as a therapy for type 2 diabetes mellitus.Exendin-4 selectively acts on GLP-1 receptors,which are coupled to the cAMP nucleotide second messenger pathway to enhance the survival and plasticity of neurons in the brain.Exendin-4 has potent effects on homeostasis of Ca2+,on multiple targets to block apoptotic signaling pathways,and on neuronal proliferation and differentiation.It has also been demonstrated to possess properties against oxidative stress and excitotoxicity.In this review the functions of exendin-4 on central nerve system and the potentia therapeutic effects on neurodegenerative diseases will be involved.