Objective To investigate surgical methods of treating secondary glaucoma due to tumescent senile cataract.Methods Sixty two inpatient cases(62 eyes)who suffered from secondary glaucoma due to tumescent senile cataract underwent extracapsular cataract extraction(ECEE)or phacoemulsification combined with intraocular lens implant.The changes of the eye axis,intraocular pressure(IOP),anterior chamber angle and the depth of anterior chamber were observed.Resuls The mean eye axis length of patients suffering from secondary slaucoma due to tumescent senile cataract was significanly longer than controls.The mean iotraocular pressure of inpatients had reduced from(26.02±4.38)mm Hg preoperatively to(14.46±4.54)mm Hgpostoperatively.Anterior chamber angle was opening and depth of anterior chamber was increased after operation.Conclusioo The tnain reason of secondary glaucoma due to tumescent senile cataract is that cataract inflation leads to structural change of anterior chamber angle.This kind of glaucoma patients can be treated by purely extracapsular cataract extraction(ECCE)or phacoemulsification combined with intraoctdar lens implant without slaloms operation.

Objective To analyze the relationship between plasma copeptin level and prognosis in patients with severe acute pancreatitis(SAP).Methods The clinical data of 48 SAP patients from January 2010 to October 2014 were collected and another 48 patients who accepted healthexamination dur-ing the same period were selected as controls.Difference in plasma copeptin level was compared between groups.The results of APACHEⅡ,Ranson and modified Marshall scores were also collected to evaluate the severity of disease and the existence of MODS.The prevalence of pancreas and peripancreatic tissues effusion,necrosis,pancreas and peripancreatic abscess,pancreatic pseudocyst and mortality of the experi-mental group were recorded to analyze the relationship among plasma copeptin,complications and mortali-ty.Results The plasma level of copeptin of the experimental group was 0.83 ~5.49ng/ml,with a mean of(3.48 ±1.32)ng/ml;while in the control group,it was 0.09 ~1.46ng/ml,with a mean of(0.23 ± 0.06)ng/ml.There was significant difference between the groups(P <0.05).Patient with a high plasma copeptin level may have a higher risk for local complication,MODS and mortality,and there was significant difference between the groups(P <0.05).A ROC curve identified that a plasma copeptin level >4.02 ng/mL predicted in-hospital mortality of patients,with a sensitivity of 72.7%and a specificity of 81.0%(AUC =0.831,95%CI =1.051 ~1.679,P <0.001).Conclusion SAP patients have elevated levels of plasma copeptin,and higher copeptin levels predict high risks of complications and mortality.

Background It is determined that the patients with thyroid-associated ophthalmopathy (TAO) often occur dry-eye related symptoms due to increasing tear evaporation caused by exophthalmos.However,more than half of thyroid dysfunction patients without TAO appear ocular surface inflammation.It is very important for us to understand the association of thyroid dysfunction patients without TAO with ocular damage.Objective This study was to observe the ocular surface changes in thyroid dysfunction patients without TAO.Methods A prospective cohort study was performed.Thirty-one patients who were initially diagnosed as thyroid dysfunction without TAO were included in the Second Hospital of Tianjin Medical University from January 2015 to May 2016 as the thyroid dysfunction group,and 16 helthy subjects were simutenniously selected as the control group under the informed consent of all the individuals.The peripheral blood was collected to detect the thyroid function-related indexes.Then the patients with thyroid dysfunction were divided into thyroid stimulating hormone (TSH) reduced group (18 patients) versus TSH elevated group (13 patients) and thyrotrophin receptor antibody (TRAb)+ group (20 patients) versus TRAb-group (11 patients).Exophthalmos degree,Schirmer I test (S I t),tear film break-up time (BUT),fluorescent integral,ocular surface disease index (OSDI) and corneal inflammation index were examined and intergrouply compared.The correlations of thyroid function indexes with ocular surface examination results were analyzed.Results There were no significant differences in exophthalmos degree and S I t values between thyroid dysfunction group and control group (t =0.037,P =0.971;t =0.815,P =0.419).The BUT values were (7.74 ± 1.45) seconds and (10.56± 1.40) seconds,fluorescent integral scores were 5.00 (1.50) and 2.50 (2.38),OSDI scores were 45.58 ± 9.23 and 19.47 ± 6.25,and corneal inflammation index scores were 0.11 (0.22) and 0.00 (0.06) in the thyroid dysfunction group and the control group,respectively,showing significant differences between the two groups (all at P＜0.01).There were not significant differences in exophthalmos degree,S I t,BUT and corneal inflammation index scores between the TSH elevated group and TSH reduced group (t =0.473,P =0.640;t =0.650,P=0.521;t=1.634,P=0.l13;Z=0.270,P=0.787).The fluorescent integral scores were 4.00 (2.00) and 5.00 (1.00),and OSDI scores were 40.08±9.91 and 47.11±9.75 in the TSH elevated group and TSH reduced group,repectively,with statistically significant differences between these two groups (all at P＜0.01).The exophthalmos degrees,S I t,BUT and corneal inflammation index scores were not considerably different between TRAb-group and TRAb+ group (all at P＞0.05);and significant differences were seen in fluorescent integral scores (4.00[1.50] vs.5.50 [1.50]) and OSDI scores ([39.18±6.25] vs.[46.78±8.76]).Corneal inflammation index scores were positive correlated with serum TSH (R2 =0.520,P =0.000),and fluorescent integral scores,OSDI scores and corneal inflammation index scores were positive correlated with serum TRAb (R2 =0.587,P =0.000;R2 =0.329,P =0.024;R2 =0.400,P=0.005).Conclusions Thyroid dysfunction patients without TAO have ocular surface dysfunction,which probably is associated with abnormal serum TSH and TRAb.

The expression of microRNAs (miRNAs) alters obviously in ovarian cancer.Through miRNA profile based on a microarray platform and further research on individual one,they are found to be closely related to pathogenesis,progression,recurrence,and drug resistance of ovarian cancer and have a good prospect in applying it in the early diagnosis,detection recurrence,prognosis and therapy of ovarian cancer.

Objective: To establish a determination for Ricinus communis L.and Carthamus tinctorius L.could in Anchan Emulsion. Methods: The determinations were carried out by GC. Chromatographic conditions were: using Chromosorb DEGS as a stationary phase column temperature 180 ?C , flame ionization detecter.Rusults:The content limit of Linoleic acid wasn't lower than 20%, The content limit of Ricinoleic acid wasn't lower than 20%.Conclusion: The established methods is simple, feasibl and reproducible. This study provides a method for the quality control of Anchan Emulsion.

Objective To investigate the protective effect of hypoxia-inducible factor-1α(HIF-1 α) on the neurovascular unit in rats with traumatic brain injury (TBI).Methods The fluid percussion model was applied to induce TBI in rats.A total of 600 rats were divided into sham operation group,TBI group,TBI + HIF-1 α silence group and TBI + control virus group according to the random number table,with 150 rats in each.Virus-mediated HIF-1 α silence gene and control virus were delivered 24 h before the fluid percussion injury.After 3,7 and 14 d,brain injury area and morphological changes in injured region were detected by HE staining,expressions of vascular endothelial cell markers (vWF) and HIF-1 α were detected by Western blot method,and expressions of vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9),tumor necrosis factor-α (TNF-α),interleukin 6 (IL-6) and nuclear factor-κB (NF-κB) in peripheral blood and brain tissue were detected by ELISA method.Rat neural function was dynamically assessed using the modified neurological severity score (mNSS).Results (1) Brain injury area and edema area in TBI + HIF-1 α silence group were higher than those in TBI group at all time points (P ＜ 0.05).(2) Compared with sham operation group and TBI + control virus group,expression of HIF-1α in TBI group gradually increased and remained high at 7 and 14 d postinjury (P ＜ 0.05).Compared with TBI group,expression of vWF in TBI + HIF-1αsilence group decreased at all time points (P ＜ 0.05) and inhibited angiogenesis.(3) TBI + HIF-lα silence group versus TBI group showed remarkably decreased VEGF at all time points,increased expressions of TNF-α,IL-6 and NF-κB at all time point,and increased expression of MMP-9 at 7 and 14 d postinjury (all P ＜0.05).(4) TBI + HIF-1α silence group versus TBI group showed significant difference in mNSS at 7 and 14 d postinjury (all P ＜ 0.05).Conclusions After TBI,high expression of HIF-1αcan facilitate vascular formation and inhibit inflammatory reaction related factor expression,inducing the mitigation of brain edema and brain injury.Therefore,promoting HIF-1α expression may become a new means to improvement of neurovascular function after TBI.

OBJECTIVE Toillustratethepharmacokineticsandpharmacodynamicsofdifferentdos-agesofsustained-releaseimplantofgoserelininrats.METHODS Theratsreceivedasingledoseof sustaineed-release i mplant of goserelin 0.3,0.6 and 1 .2 mg per rat by subcutaneous injection,respec-tively.Concentrations of goserelin and testosterone in plas ma were determined by HPLC-MS/MS.The pharmacokineticparameterswerecalculatedbyWinNonlin6.3.RESULTS Themainpharmacokinetic parameters of the 0.3,0.6 and 1 .2 mg per rat were as fowllows:the area under the concentration-time curve(AUC0-t)was 770 ±96,1534 ±299 and (3233 ±777)μg·L-1·h,and the maximum plasma con-centration(cmax)was 3.7 ±0.3,6.8 ±2.2 and (1 7.6 ±5.4)μg·L-1 ,respectively.Regression analysis was applied to analyze the relationship between AUC0-t and cmax at different doses and those relative coefficients were 0.942 and 0.923 respectively.AUC0-t and cmax increased with the dose in the range of 0.3-1 .2 mg per rat.As for other main pharmacokinetic parameters (peak time,half life,mean resi-dence time,clearance and apparent volume of distribution),there was no significant difference between the three groups.Testosterone plasma concentration reached the highest level following administration and then kept decreasing to low concentrations.Between 28 d and 35 d,testosterone plas ma concentra-tionslowlyincreasedtothenormallevel.CONCLUSION Pharmacokineticcharacteristicsofsustained-release implant of goserelin in rats show a linear relationship,within the dose range of 0.3-1 .2 mg per rat.The results from pharmacodynamic data show that testosterone does not change in a dose-depend-ent manner at a dose ranging from 0.3 to 1 .2 mg per rat.Testosterone plasma concentration decreases to theoretical castrate level (0.5 μg·L-1 )after 4 d following a dose of 0.6-1 .2 mg per rat.

Objective To investigate the clinical and electroencephalogram (EEG) features of patients with idiopathic generalized epilepsy in adults with phantom absences.Methods Six patients were referred to the clinic of epilepsy from April,2007 to December,2011.They all had clinical assessment,EEG,or video EEG confirming absences seizure.Results Six patients showed the following similar clinical-EEG features:(1) mild ictal impairment of consciousness associated with generalized 3.0-3.5 Hz spike and slow wave discharges; (2) late-onset generalized tonic-clonic seizures; (3) absence status epilepticus with or without secondary generalized tonic-clonic seizures; (4) generalized discharges were mostly seen in three types in the awaking stage:fragmented discharge (＜4 s),brief discharge (4-10s) and long-time discharge (＞ 10 s).None of the patients had myoclonic jerks or photosensitivity.One patient' s mother had a history of generalized tonic clonic seizures.One patient had a history of children absence epilepsy and one patient had a history of febrile convulsion in the age of 1-3.Conclusion Idiopathic generalized epilepsy with phantom absences has distinct clinical and EEG features and may become a new idiopathic generalized epilepsy syndrome in adults.

Objective To analyze retrospectively the risk factors and predictors of post-encephalitic epilepsy (PEE) and refractory epilepsy in patients with encephalitis.Methods In a hospital based study,the patients with encephalitis were reviewed retrospectively between the January of 1995 and December of 2010.Related factors were evaluated including age,sex,seizure types,neuroimaging,electroencephalogram(EEG) in intermittent period,clinical symptoms,consciousness level,initial seizure and steroid hormone therapy,etc.Results 237 patients with encephalitis were enrolled,whose median age was 26.3 (range 15-57) years old.PEE occurred in 103 (43.46％) patients; and 67 of whom had partial seizure.Significant risk factors for PEE included age (OR =3.72,95％ CI 2.70-5.25,P =0.018),disturbance of consciousness level(OR =5.37,95％ CI 2.43-13.03,P =0.012),cortical lesion in imaging (OR =11.42,95％ CI 5.94-31.27,P =0.000),spike discharges in EEG (OR =18.04,95％ CI 7.30-48.38,P =0.000) and initial seizures in acute phase (OR =32.68,95％ CI 9.62-97.59,P =0.000).The refractory epilepsy occurred in 6t patients.The significant risk factors of refractory PEE included focal seizures(OR =4.09,95％ CI 2.14-9.10,P =0.021),status epilepticus (OR =4.48,95％ CI 1.89-8.07,P =0.017) and poor controlled seizure (OR =6.17,95％ CI 3.52-11.34,P =0.001) during acute phase,multifocal spikes discharge in EEG(OR =5.53,95％ CI 2.91-10.07,P =0.006),cortical lesion in neuroimaging(OR =2.33,95％ CI 1.37-7.72,P =O.028),however,early steroid hormone therapy (OR =2.19,95％ CI 1.11-4.87,P =0.037) and longer time to initial seizure (OR =4.40,95％ CI 3.19-11.62,P =0.014) could significantly reduced the incidence of refractory epilepsy in PEE patients.Conclusion Our data indicated that PEE occur in 43.46％ patients especially in younger patients with disturbance of consciousness level,cortical lesion in imaging,spike discharges in EEG and initial seizures in acute phase.And the risk factors for refractory PEE are also discussed.

Objective To develop a multivariate logistic regression model , and to predict the risk of ma-lignant partially cystic thyroid nodules .Methods 470 patients(662 nodules)treated with surgery and confirmed by pathological diagnosis were screened out .Their ultrasonographic morphology and vascularity of thyroid nod-ules, thyroid stimulating hormone(TSH)and clinical information were collected and analyzed retrospectively .The model was developed to calculate the individual risk and ROC curve was used to evaluate the predictive index . Results The regression model was:Z=-3.60+1.40X2+2.47X3+1.05X4+0.57X9+0.07X10+1.02X12 ( X2 represents eccentric acute-angle configuration , X3 represents microcalcification , X4 represents cystic-solid margin,X9 represents echogenecity of solid portion , X10 represents TSH,X12 represents gender );M=eZ/1+eZ (M represents probability of malignancy , e represents natural constant 2.72).When applied the model to the ver-ification group, the accuracy, sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, negative likeli-hood ratio(LR-)and positive likelihood ratio(LR+)was 96.95%,100%, 96.68%, 3.32%, 0%, 0 and 30.12 respectively.The largest area under the receiver-operating characteristics curve (AUC)was 0.88,which proved the model has high diagnostic value .Conclusions The model has high accuracy to predict the risk of malignan-cy.M is closely related to malignant risk of partially cystic thyroid nodules .