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

Objective To investigate the incidence,treatment and prognosis of neonatal respiratory failure (NRF) in the Neonatal Intensive Care Unit of Children's Hospital of Hebei Province.Methods The medical data of 626 NRF newborns admitted to the Neonatal Intensive Care Unit of Children's Hospital of Hebei Province from January 1st,2008 to December 31st,2008 were collected,and the pathogenesis of NRF,management,risk factors of their deaths and cost for the disease were studied.The results were compared with the national study in the same period and the local study of 2004-2005 by Chi-square test.Results During the 12 consecutive months,the incidence of NRF in neonatal intensive care unit was 38.9％ (626/1608).The mortality in hospital was 22.5％ (141/626),among which,most deaths (134,95.0％) occured after early discharge required by the parents.The mortality decreased by 14.7％ compared with that during 2004 2005 (37.2％,113/304),and was also lower than that (24.7％,1683/6864) in the national study at the same period.Pneumonia/sepsis ( 34.8 ％,218/626 ),neonatal respiratory distress syndrome ( 31.6 ％,198/626 ),and meconium aspiration syndrome (10.7％,67/626) were leading primary causes of NRF.The major complications were pneumonia/sepsis (5.4 ％,34/626),intracranial hemorrhage (4.6 ％,29/626) and persistent pulmonary hypertension (3.2％,20/626 ).The percentage of NRF babies requiring pulmonary surfactant rose from 14.1％ (43/304) during 2004-2005 to 23.6％ (149/626) in 2008,which almost reached the national level of 26.8％ (1840/6864).Pulmonary surfactant treatment was accepted by 70.2％ (139/198) patients with neonatal respiratory distress syndrome.12.1％ (24/198)of neonatal respiratory distress syndrome infant was administered immediate intubation-surfactant-extubation.Seventeen (2.7％) patients accepted nitric oxygen treatment.Nasal continuous positive airway pressure was given to 76.5％(479/626) patients,which was higher than before (47.1％,143/304).Conventional mechanical ventilation rate decreased from 72.7％ (221/304) to 49.8％ (312/626),and high frequency oscillatory rate increased from 0.7％ (2/304) to 10.5％ (66/626),which were similar to the national level.Of the 480 patients discharged after recovery,the mean time of hospital stay was (15.1 ± 4.0) days,and the mean medical cost was (12752 ± 5148) CNY.Conclusions The patient number increases and the medical skills and treatment methods of our hospital improve a lot.Utilization of pulmonary surfactant,nasal continuous positive airway pressure and high frequency oscillatory ventilation increase significantly.However,the burden of NRF is still heavy.

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.

Pancreatic cancer is a common malignant neoplasm of the pancreas with an extremely high mortality.Currently,the early diagno-sis of pancreatic cancer is still not ideal.Attention should be paid to some clinical warning symptoms,such as unexplained abdominal and back pain,jaundice,and unexpected diabetes.Additionally,the combined use of CA19-9,CEA,and other tumor markers,the attention to biochemical indicators,the detection of mutation in KAI1 or p53 gene,and the exploration of the value of miRNA in clinical diagnosis are of great significance.On the other hand,ultrasound,CT,MRCP,ERCP,PET-CT,and other imaging methods,as well as effective col-lection of cytology specimens,should be performed.Thus,there is hope for the early diagnosis of pancreatic cancer.

The paper analyzed the necessity of the testing items for blood transfusion compatibility.By means of a comprehensive evaluation of the testing requirements of blood transfusion labs,and a basis on characteristics of blood transfusion profession and technical specifications in clinical transfusion,the paper probed into building appropriate lab examination techniques in terms of ABO blood type testing item,RhD blood type testing item and screening test,and cross-matching testing items,for the purpose of achieving the safety and effectiveness of clinical blood use.

Objective To investigate the protein and mRNA expression of NF-κB and zinc finger protein A20 in the keloid and normal skin and to explore its underlying molecular biological mechanism.Methods The protein and mRNA expression of NF-κB p65 and zinc finger protein A20 in keloid and normal skin was detected by immunohistochemistry and real time quantitative reverse transcription-polymerase chain reaction (RT-PCR).Results The protein and mRNA expression of NF-κB p65 in keloid tissues was higher than those in normal skin tissues (P＜0.05).The protein and mRNA expression of zinc finger protein A20 in keloid tissues was lower than those in normal skin tissues (P＜0.05).Conclusions NF-κB signal pathways and zinc finger protein A20 could play a role in keloid pathogenesis.

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.

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.

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.