? Intraoperative floppy iris syndrome is a particular symptom in phacoemulsification, and it is often occurred in patients with the history of using alpha-1 adrenergic antagonist before cataract surgery. Although the pupil be fully mydriatic before the operation, the progressive constricting of the pupil, the relaxing of iris even the iridoptosis and the unstable anterior chamber still can be found during the phacoemulsification. If treated inappropriately, severe complications and terrible outcomes may happen, which would influenced the surgery effectives. This paper reviewed the epidemiological characteristics, pathogenesis, risk factors, clinical manifestations, complications, and coping strategies of the intraoperative floppy iris syndrome.

China ; Metals, Heavy ; Research Support as Topic ; statistics & numerical data

Objective Investigate the effect of applying clinical pathway on the patients undergoing leiomyoma of uterus. Methods As an experimental group of patients, 50 cases of uterine leiomyoma are treated with clinical pathway. By contrast, another 100 cases are treated with the traditional medical care as control group. Results Waiting time for surgery and hospital stay of the experimental group are less than the control group; and the average hospitalization cost of experimental group is lower than the control group (P< 0.01). Conclusions Application of clinical pathway management will regulate the activities of medical treatment, ensure the quality of health care, improve the feeling of patients, increase efficiency of hospital services, reduce the financial burden of patients, increase the hospital social benefits.

OBJECTIVETo explore the mechanism of natural moxibustion on regulating immune imbalance in asthma rats.

METHODSSeventy SD male rats were divided into a normal group, a placebo group, a dexamethasone group, a big-cake for long-course moxibustion group, a big-cake for short-course moxibustion group, a small-cake for long-course moxibustion group and a small-cake for short-course moxibustion group, ten rats in each one. The rat model of asthma was established by egg albumen sensitization and stimulation in all the groups except the normal group. The natural moxibustion was used in all moxibustion groups, in which big cake of 1 cmX 1 cm size was used in the big-cake groups and small cake of 0.5 cmX 0. 5 cm size was used in the small cake groups. According to relevant acupoints, the natural moxibustion was performed, 5 h per time, once a day. Four times of treatment was considered one course, and three courses were required in the long-course groups and one course was required in the short-course groups. Intraperitoneal injection of dexamethasone was applied in the dexamethasone group, which had the same course as long-course moxibustion group. After the treatment, changes of EOS in peripheral blood of asthma rats were observed; enzyme linked immunosorbent assay (ELISA) was applied to test the contents of IgE, IL-4 and IFN-gamma in the lung tissue; real-time Q-PCR method was adopted to measure the expression level of transcription factor T-bet and GATA binding protein 3 (GATA-3) in the lung tissue.

RESULTSCompared with the normal group, the EOS in whole blood as well as IL-4 and IgE in plasma were all increased in the placebo group (all P< 0. 01), IFN-gamma in plasma was obviously decreased (P<0. 01); while the levels of EOS, IgE and IL-4 were significantly reduced (all P<0. 01), the content of IFN-gamma was increased (P<0. 01) in all moxibustion groups and dexametnasone group. Compared with the normal group, the expression of T-bet mRNA in the placebo group was significantly reduced (P<0. 01). Each treatment group could significantly increase the expression of T-bet mRNA and reduce that of GATA-3 mRNA (P<0. 01). Compared with the short-course moxibustion groups, the expression of T-bet mRNA was obviously increased in the long-course moxibustion group and dexamethasone group (both P<0.01), and that of GATA-3 mRNA was reduced (P<0.01). There was no significant difference between long-course moxibustion group and dexamethasone group (P> 0. 05), and also no significant difference could be seen between big-cake moxibustion group and small-cake moxibustion group (P>0. 05).

CONCLUSIONThe natural moxibustion could obviously reduce airway inflammation in asthma rats. With time passing, the efficacy is enhanced, indicating evident timeliness, which has no apparent relationship with the size of moxibustion cake.

Animals ; Asthma ; genetics ; metabolism ; therapy ; Cytokines ; genetics ; metabolism ; Humans ; Male ; Moxibustion ; Rats ; Rats, Sprague-Dawley ; Transcription Factors ; genetics ; metabolism

Objective To investigate the efficacy and safety of different strategy of antithrombotic therapy in elderly patients with atrial fibrillation (AF) and coronary disease.Methods 224 inpatients and outpatients with AF and coronary disease whose mean follow-up time was 2 years,were divided into warfarin group,warfarin combined with antiplatelet drug(aspirin or clopidogrel) group,antiplatelet drug(aspirin or clopidogrel) group and control group.The thromboembolic event rate and adverse events incidence were observed in different groups.Results The risk of thromboembolic events,particular emerging risk of cerebral infarction in the control group(12.50 ％) was significantly higher than other groups (P＜ 0.05).Thrombotic event rates in warfarin + single joint group(2.78％) was lower than other groups(warfarin group 4.29 ％,single joint group 5.81％),but there was no significant statistical difference.The overall risk of bleeding in the control group (3.13 ％) was significantly lower than other antithrombotic group (P＜0.05).The incidence of skin bruising in single joint group was lower than other antithrombotic groups,the overall bleeding risk,especially gasfrointestinal bleeding in warfarin+ single joint group was significantly higher than other groups (P＜ 0.05).Conclusion Elderly patients with coronary heart disease and atrial fibrillation need antithrombotic therapy to prevent thrombotic events.Using warfarin alone or warfarin combined antiplatelet drug does not lead to serious bleeding events,but generally bleeding risk should be attracted more attention.

s Medicine is a kind of culture. The ideal settlement of practical medical problems must be built on medical cultural platform. The higher demand of modern medical practice to the talents is to cultivate their medical cultural quality. The medical cultural quality and its education is regular. Therefore, only by integrating medical humanistic education into medical cultural education can the medical humanistic education come into being and be enforced.

Objective To obtain the most effective diagnosis method for diabetic muscle infarction by using the evidence based medicine.Methods In March 2006 we attempted to find the guideline,systematic review,random controlled trials,clinical controlled trials and case reports for the diagnosis of diabetic muscle infarction by searching Cochrane Library(Issue 4,2005),Embase(1974—2005),Medline(1966—2005)and CNKI database(1949—2005),then critically appraised the quality of available evidences.Results According to the present evidence,when the the patient was suspected to have diabetic muscle infarction,we should choose the sonography to exclude some common diseases at first;the CT examination of all the patients showed no obvious manifestations;the normal MRI examination of 67 patients showed obvious manifestations;the patients who did the muscle biopsy or needle biopsy did not develop any complications.Conclusion The diagnosis of diabetic muscle infarction should be based on the clinical presentations and MRI outcome,but when the diagnosis is uncertain,we should use the needle biopsy to confirm the diagnosis at an early time.

ObjectiveTo study the outcome of renal transplantation in polycystic kidney disease (PKD) and its influencing factors.MethodsFrom 1978 to 2002, 46 PKD patients undergoing renal transplantation (PKD group) and 46 cases of other diseases (non-diabetic nephropathy;control group) were retrospectively analyzed. Patient/renal survival rate (1, 3 and 5 years after re nal transplantation) and postoperative complications were evaluated.ResultsA comparable overall patient (1, 3 and 5 years: 95.7?% , 91.3?% , 91.3 ?% PKD vs 97.8?% , 95.7?% , 93.5?% controls) and transplant sur vival rate (1, 3 and 5 years: 93.5?% , 89.1?% , 87.0?% PKD vs 95 .7?% , 89.1?% , 87.0?% controls) was found in both groups. Infectious complications with the exception of urinary tract infections (UTIs: PKD 43.4 ?% vs 10.9?% ) were diagnosed in similar frequency in the graft recipien ts. PKD patients were significantly more affected by UTIs than the control group (P

Objective Our study aimed at the role of p27 on the hypertrophy of mesangial cell (MC) cultured in high glucose. Methods The p27 protein of MC lysate was detected with western blotting analysis. The degree of cultured MC hypertrophy was estimated through [3H]-thymidine incorporation and [3H]-leucine incorporation. The effect of reducing p27 expression on cell hypertrophy was analysed with p27 antisense oligodeoxynucleotide (ODN) phosphorothioate. Results in MC cultured in high glucose (450mg/dl) serum-free DMEM compared with MC cultured in normal glucose (100mg/dl) serum-free DMEM, p27 increased, [3H]-leucine incorporation increased and[3H]-thymidine incorporation decreased;p27 antisense ODN transfection reduced [3H]leucine incorporation, increased [3H] thymidine incorporation of MC cultured in high glucose senumfree DMEM. Increasing medium osmolarity with D-mannitol failed to induce p27 expression of MC. Conclusion p27 protein increased in MC cultured in high glucose. High level of p27 played an important role in MC hypertrophy induced by high glucose. Because the cell cycle is controlled by the interaction between the positive cell cycle regulatory proteins(CCRP) and negative CCRP, further research is needed to study the expression of the positive and negative CCRP in MC in order to better understand the role of CCRP in MC hypertrophy.