?AlM:To investigate the sensitive parameters of the anterior chamber changes with Pentacam anterior segment analysis system before and after laser peripheral iridectomy (LPl) in primary angle-closure suspetive (PACS).
? METHODS: Sixty eyes of 33 PACS patients were enrolled in this study. Pentacam examination was performed before and 1d after LPl to measure the central anterior chamber depth ( CACD ) , the peripheral anterior chamber depth ( PACD ) , the anterior chamber volume ( ACV) and the peripheral anterior chamber angle ( ACA) . Statistical analysis used paired t test.
?RESULTS: There was no statistical significance on the changes of ACD. PACD and ACV increased significantly between before and 1d after LPl. ACA was widened from (22. 26o±5. 18o) to (26. 42o±5. 20o), which were increased significantly between before and 1d after LPl.
?CONCLUSlON: LPl can deepen the PACD and increase the ACV in PACS. PACD and ACV are the sensitive parameters of the anterior chamber changes with Pentacam anterior segment analysis system.

Objective To compare the cellular immune responses induced by two different vectors,eukaryotic plasmid pcDN3.1(+) and attenuated typhia live vaccine Ty21a,-associated mimic epitopes of HCV hypervariable region 1,so to find a better way for vaccine immunization.Methods The DNA sequence based on the peptides' sequence of HCV hypervariable region 1 related consensus polymimotopes was synthesize and then inserted into plasmid pcDN3.1(+) to construct recombinant plasmid pcDN3.1(+)-SP,which then was transfected into live attenuated typhia vaccine Ty21a to construct Ty21a-SP.The mice were immunized orally with Ty21a-SP and intramuscularly with pcDN3.1(+)-SP,respectively,and then sacrificed by exsanguination.The splenocytes were separated and restimulated with pooled synthesized peptides,and then collected.Flow cytometry was employed to identify CD8+IFN-?+ T cells,and non-radioactive MTS method was adopted to test T cell proliferation,and non-radioactive LDH method was used to test cytotoxic T cytolytic reaction(CTL).Results Compared with control groups,the proliferation of splenocytes was apparently enhanced,the proportion of CD8+IFN-?+ cells obviously increased,and CTL responses also significantly increased after the spenocytes of mice immunized by pcDN3.1-SP and Ty21a-SP were restimulated with synthesized peptides.And the responses mentioned above in the mice immunized by Ty21a-SP were stronger than those mice immunized by pcDN3.1-SP.Conclusion Using attenuated typhia live vaccine Ty21a as DNA vector is an effective way to induce cellular immune responses.

Background Posterior capsular opacification (PCO)affects the pseudoaccommodation of 1CU accommodative intraocular lens (1CU AIOL).At present,few studies on the effect of PCO and Nd∶ YAG laser capsulotomy on intraocular shifting of 1CU AIOL are published.Objective The present study was to evaluate the effect of PCO and Nd∶YAG laser capsulotomy on the shifting of 1CU AIOL.Methods A respective serial caseobservational study was designed.Written informed consent was obtained from each patient prior to this study.Twentyfour eyes of 20 patients with PCO after phacoemulsification and implantation of 1CU AIOL were included in this study.Ocular examination was performed 3 months after IOL implantation,1 day before Nd:YAG laser capsulotomy and 3 months after Nd∶YAG laser capsulotomy to evaluate the distance corrected near visual acuity(DCNVA).The difference in the anterior chamber depths before and after administering 1％ pilocarpine topical eye drops was measured with the IOLMaster to determine the intraocular shifts of the IOL.The extent of IOL shifting was compared among 3 time points to assess the factors influencing IOL accommodation after 1CU AIOL implantation.Results The shifting amplitude of 1CU AIOL was(0.44±0.21)mm 3 months after implantation of 1CU AIOL,(0.27±0.11)mm 1 day before Nd ∶ YAG laser capsulotomy,and (0.34±0.10) mm 3 months after Nd ∶ YAG laser capsulotomy,showing a significant difference among them(F=7.180,P=0.001).The shifting amplitude of 1CU AIOL significantly declined 1 day before Nd∶YAG laser capsulotomy in comparison with 3 months after implantation of 1 CU AIOL(P =0.006).The shifting amplitude 3 months after Nd∶YAG laser capsulotomy increased slightly in comparison with 1 day before Nd∶YAG laser capsulotomy(P=0.059).DCNVA was(3.1±0.9)J 3 months after implantation of 1CU AIOL,(6.2±0.8) J 1 day before Nd ∶ YAG laser capsulotomy and(3.4±0.7) J 3 months after Nd ∶ YAG laser capsulotomy,with a significant difference among them (F =110.270,P =0.000).DCNVA was lower 1 day before Nd∶ YAG laser capsulotomy than 3 months after implantation of 1CU AIOL(P＜0.05).However,DCNVA was higher 3 months after Nd∶YAG laser capsulotomy than that of 1 day before Nd∶YAG laser capsulotomy (P＜0.05).There was no significant correlations between DCNVA and IOL movement 3 months after IOL implantation,1 day before Nd∶ YAG laser capsulotomy and 3 months after Nd ∶ YAG laser capsulotomy (r1 =-0.150,P1 =0.486,r2 =-0.320,P2 =0.122,r3 =-0.100,P3 =0.633).Conclusions The shifting amplitude of 1CU AIOL markedly declines due to PCO.No clinically significant influence of Nd ∶ YAG laser capsulotomy on the shifting amplitude of 1 CU AIOL is found.DCNVA can improve after Nd∶YAG laser capsulotomy.Multiple inter-related factors concerning pseudophakic accommodation may influence DCNVA.

50% and types 2 and 3 of plaque morphology) and mild lesion group (MG, narrowness of luminal diameter

Objective To establish a quantitative analysis of multi-components by single-marker (QAMS) for determination of four components (adenosine, uridine, guanosine, (R, S)-goitrin) in Isatidis Radix granules.Method The QAMS for Isatidis Radix granules was established and validated and adenosine was selected as the internal reference substance.The relative correction factor (RCF) of other three components were calculated.The contents of four components were determined by both external standard method and QAMS.The QAMS method was validated through comparison of the results obtained by the two different methods.Results The RCFs of uridine, guanosine and (R, S)-goitrin all showed good reproducibility within certain ranges.For Isatidis Radix granules, uridine, guanosine and (R, S)-goitrin, there was no significant difference between the quantitative results of the two methods.Conclusions The QAMS method is simple, feasible and credible to be used for comprehensive quality control of Isatidis Radix granules.

Objective To explore the immunomodulatory effects of seaweed polysaccharide(PSS)in aged mice induced by D-ga-lactose (D-gal).Methods D-gal was injected intraperitoneally to establish the aged mice model,meanwhile the aged mice was intra-gastricly administrated by PSS.Peritoneal macrophages were collected,and macrophage secretion of nitric oxide (NO),nitric oxide synthase (NOS)levels and expression levels of inducible nitric oxide synthase (iNOS)mRNA were detected.The spleen indexs of the agd mice were calculated,and effects of PSS on spleen microscopic structure of mouse were observed.The changes of spleen cell cycle in aged model mice were detected by flow cytometry assay.Results PSS could enhance macrophage synthesis of NO and NOS of the aged mice and up-regulate the expression of iNOS mRNA levels.And the spleen index of the aged mice increased obviously, the hyperplasia of spleen capsule was obvious.Moreover,PSS could increase the percentage of S phase and G2/M phase cells of the aged mice spleen.Conclusion PSS could enhance the immune function of aged mice induced by D-gal,which is worthy of further study,which development.

Purpose: The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. Methods: Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. Results: Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as “the guardians at the end of life” reflects the spirit of palliative care. Conclusion This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.

Purpose: The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. Methods: Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. Results: Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as “the guardians at the end of life” reflects the spirit of palliative care. Conclusion This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.

Optic nerve gliomas manifest either as a solitary form or a component of von Recklinghausen's neurofibromatosis. The reported incidence of coexistence with neurofibromatosis varies from 12% to 70%. Usually there are no significant cytological differences between the gliomas that accomapny the disease and those that are deemed to be solitary manifestations. The only possible difference between them is the apparently more common association, with the former, of extensive arachnoid hyperplasia and of a more florid local gliomatous infiltration into the leptomeninges, altogether resulting in perineural thickening. Our cases were 8 and 6 years old girls, respectively, presented with slowly progressive proptosis for 4 years and visual disturbance for 2.5 months. There were multiple cafe au lait spots on their trunks, and case 2 showed Lisch nodules in the iris. MRI of brain revealed unilateral optic nerve thickening with involvement of chiasm or multiple intracranial lesions. Resection of optic nerve tumor was performed. Microscopically, variable degree of tumorous change was seen. Most typically enlarged area was composed of intraneural and perineural portions surrounded by a layer of intact dura. Intraneural tumor revealed proliferation of elongated, spindle-shaped pilocytic astrocytes in intertrabecular spaces and distention of the pial septa with fibrovascular thickening. Another segment had areas with reactive gliosis. Perineural tissue was considerably thickened and, associated with proliferation of meningothelial cells and fibroblasts intermingled with astrocytes and Rosenthal fibers. There were increase of the optic nerve diameter and distention of the overlying dura. Foci of arachnoid cell hyperplasia were noted in both cases, although differed in degree. Immunohistochemically, the tumor cells expressed glial fibrillary acidic protein in intraneural and perineural portions particularly in case 2.
Incidence

Objective:To explore the efifcacy and safety for radiofrequency catheter ablation (RFCA) of left bundle branch guided by left bundle potential (LBP), X-ray image with EnSiteNavX System in canine model.
Methods:The RFCA of left bundle branch was conducted in 13 dogs. A mapping catheter was positioned in right atrium to record right-sided His-bundle (R-His) potential, and an ablation catheter via right femoral artery was retrograded to left ventriclefor LBP mapping and ablation. Meanwhile, EnSiteNavX System was used to identify R-His, L-His and LBP at the same time. The potential characteristics in dogs with successful ablation were observed, the PR interval, QRS shape and time limit, AH interval, HV interval, the A/V electro-gram ratio in ablationcatheter at before and after ablation were recorded. The procedural time and X-ray exposure time between LBP with X-ray image method and LBP, X-ray image with EnSiteNavX System method were compared.
Results: There were 9/13 dogs received successful left bundle branch ablation, 3 dogs failed and 1 suffered from complete A-V block. At the successful ablation target site, the LBP-V was (17.8 ± 2.6) ms with the range of (13-21) ms, and the A/V electro-gram ratio<1/10. The procedural time and X-ray expose time were signiifcantly decreased in LBP, X-ray image with EnSiteNavX System method than those in LBP with X-ray image method P=0.007 and P<0.001.
Conclusion:Under the LBP, X-ray image with EnSiteNavX System guidance method, left bundle branch could be safely and effectively ablated to establish left bundle branch block (LBBB) model in experimental canine.