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 explore the clinical efficacy and safety of Leukotriene receptor antagonist combined with Gluco-corticoid nasal spray(called“intranasal steroid”for short)in the treatment of different degree of adenoidal hypertrophy(AH)com-plicated with allergic rhinitis (AR). METHODS:240 AR children with AH were randomly divided into control group,intranasal steroid group and drug combination group,with 80 cases in each group. Control group was given physiological seawater,3 presses each nostrile,in the morning and evening. The intranasal steroid group received Momestasone furoate nasal spray,one press each nostrile,qd. Drug combination group was additionally given leukotriene receptor antagonist Montelukast sodium chewable tablet,4 mg for under 5 year-old and 5 mg for 5-year-old or above,qd,at bedtime. Treatment course of 3 groups lasted for 12 weeks. The change of clinical symptoms and signs(such as nasal obstruction,snore,mouth breathing,etc)and adenoid/pharyngeal ratio(A/N ratio)were compared among 3 groups after treatment as well as the occurrence of ADR. Each group was divided into two sub-groups (medium and severe) according to the severity of AH so as to evaluate therapeutic efficacy. RESULTS:21 children withdrew from the study,including 11 cases in control group,6 in intranasal steroid group and 4 in drug combination group. After treatment,clinical symptom score and A/N in subgroups of drug combination group and intranasal steroid group were all lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in clinical symptom score and A/N between drug combination group and AR complicated with medium AH subgroup from intranasal steroid group(P>0.05). Clini-cal symptom score and A/N of AR complicated with severe AH subgroup from drug combination group were lower than intranasal steroid group,with statistical significance (P<0.05). No obvious ADR occurred in 3 groups. CONCLUSIONS:Intranasal steroid alone and intranasal steroid combined with leukotriene receptor antagonist can improve clinical symptom of AR patients with AH, and reduce adenoid volume. It is suggested to use intranasal steroid firstly for medium AH complicated with AR,and additionally use Leukotriene receptor antagonist for severe AH complicated with AR.

[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.

Objective To investigate the application of CUSUM (cumulative sum control chart) curve in cardiac clinical teaching of resident surgeon education.Methods We chose a surgeon of 10years work experience of attending the preparation operation of internal mammary artery as control reference (standard group,28 patients) and a resident engaged in professional clinical cardiac work no more than 5 years as group 1,a professional training physician engaged in cardiac surgery clinical work more than 5 years as group 2 and took 40 patients' data respectively from the two groups' preparation of internal mammary artery operation.And then we recorded the postoperative mammary artery flow,internal mammary artery preparation time and adverse events data and made statistics analysis with SPSS 19.0,and CUSUM curve with Matlab R2012b polynomial curve.Results When the density of operate interval and the operate numbers came to about 25 cases,the polynomial eurve's slope rate went up to 0,regardless the surgeons' experience,CUSUM value was accumulated from 66 to 76,and overcame the learning curve successfully.However,when the density of operate interval did no reach the standard,the surgeon's CUSUM ploynomial cmwe slope rate never reached to 0,and can't overcome the learning curve.Conclusion CUSUM curve gives a clear quantitative indicator to the cultivation of clinical physician,and makes teaching teachers can understand the young physicians' learning process,so as to change the teaching plan,help young physicians cross the learning curve as soon as possible.

Objective To study the effect of abnormal blood pressure (BP) circadian rhythm on subtypes of acute ischemic stroke (AIS) in hypertensive patients .Methods Ninety-seven AIS pa-tients with hypertension were divided into arterothrombosis (AT)group (n=66)and small artery disease (SAD)group (n=31)according to the modified TOAST classification .Their 24 h ambula-tory BP was monitored .The 24 h BP ,daytime and nighttime BP ,morning BP surge and BP circa-dian rhythm were compared between the two groups .Results The nighttime SBP was significant-ly higher in AT group than in SAD group (133 .86 ± 18 .17 mm Hg vs 124 .42 ± 16 .06 mm Hg , P<0 .05) .The absent rate of BP circadian rhythm was higher in AT group than in SAD group (84 .8% vs 64 .5% ,P<0 .05) .However ,no significant difference was found in morning BP surge between the two groups (37 .9% vs 19 .4% ,P>0 .05) .Conclusion Absent BP circadian rhythm and elevated nighttime BP are related with AT type ischemic stroke .

Objective To observe the effect and safety of modified Yishen Zhuyang Huoxue Huazhuo Formula for polycystic ovarian syndrome (PCOS) in the TCM pattern of deficiency of spleen and kidney with phlegm-dampness. Methods Totally 123 cases were recruited into this study and randomized to two groups by central random approach, 64 cases in the observation group and 59 cases in the control group. Patients in the observation group were given the modified Yishen Zhuyang Huoxue Huazhuo Formula, while those in the control group were given compound cyproterone acetate tablet, for two treatment courses, three months for one course. The changes of ovarian volume and the number of follicles before and after treatment were observed. Adverse reactions were also evaluated. Results Bilateral ovarian volumes in both groups decreased after treatment (P<0.05, P<0.01), while the control group showed a significant better improvement (P<0.05). The number of follicles in the two groups decreased, but no significant difference were observed between the two groups (P>0.05). The rate of adverse reaction in the observation group was lower than the control group. Conclusion Modified Yishen Zhuyang Huoxue Huazhuo Formula is effective for PCOS patient by reducing the ovarian volume with a low incidence of side effect.

[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.

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.

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.