? 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.

AIM:To observe the clinical effects of 23-gauge (23G) transconjunctival sutureless vitrectomy for idiopathic macular hole.
METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23 - gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.
RESULTS:The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation (χ2=8-65, P=0. 003;χ2=10. 33, P=0. 001). The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases ( 18%) . There was no statistically significant difference in intraocular pressure between pre-operation and post - operation. No post - operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up.
CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

Objective To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol. Methods Mifepristone (150 mg) combined with misoprostol (600 ?g) 3 days later were given to 500 biochemical pregnancies (G_1),500 early clinical pregnancies (G_2) and 500 clinical pregnancies (G_3) which were classified according to amenorrhea days,serum human chorionic gonadotropin-beta subunit (?- hCG) and vaginal B-ultrasonic examinations.All were observed for 6 hours after taking misoprostol and returned for assessment per week.Results Expulsion of conceptus was G_1 123 (24.6%,123/500),G_2 438 (87.6%,438/500) and G_3 467 (93.4%,467/500).Failure rate was G_1 6 (1.2%,6/500),G_2 24 (4.8%,24/500) and G_3 79 (15.8%,79/500) for ongoing pregnancies,hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding.Bleeding cases during the administration of mifepristone were G_1 272 (54.4%,272/500),G_2 141 (28.2%,141/500) and G_3 87 (17.4%,87/500);the mean bleeding days were G_1 (5.8?1.5),G_2 (9.0?2.9) and G_3 (14.3?5.9) days.Other side effects including abdominal pain,nausea,vomiting and diarrhea were low and light in each group,increasing with advancing gestational age.Menses recovery was 486 (97.2%,486/500),452 (90.4%,452/500) and 433 (86.6%,433/500) for each group on scheduled time.Satisfaction was 499 (99.8%,499/500),485 (97.0%,485/500) and 369 (73.8%,369/500) respectively.Conclusion Mifepristone and misoprostol in combination is as safe,and effective for termination of biochemical pregnancies as ordinary medical abortion.It does not need to wait till ectopie pregnancy is excluded.

The external defibrillator is an emergency instrument used very widely in clinics. It plays an important role in rescuing ventricle fibrillation (VF) patients. We have designed an external defibrillator using the truncated exponential biphasic waveform. The system consists of three parts: the ECG collection module, the control module and the defibrillator module. They are introduced respectively, listing the main problems and the methods to solve them. Some experiments have been done and the corresponding results are given.
Animals ; Defibrillators ; Equipment Design ; Swine ; Ventricular Fibrillation

In this study, 120 patients with rheumatic heart disease undergoing valve replacement were randomly divided into the control group and the Qishen group, with 60 cases in each group. Before the operation, the control group was given routine heart and diuretic treatments and placebo of Qishen Yiqi dropping pills for seven days (0.5 g each time, three times a day); While the Qishen group was given Qishen Yiqi dropping pills for seven days (0.5 g each time after meal, three times a day) on the basis of the routine treatments. The right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (SV) and right ventricular ejection fraction (RVEF) were detected after the operation. The results showed that patients in the two groups showed significantly lower right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV) and stroke volume (SV) decreased than that before the operation, but with significantly higher Ejection fraction (RVEF) significantly than that before the operation. However, the Qishen group showed a significantly lower right heart function reduction than the control group, with the statistical significance in the differences (P < 0.05). This indicated that the pretreatment with Qishenyiqi Drop Pills showed a remarkable efficacy in the improvement of right ventricular function after valve replacement.
Aged ; Cardiac Valve Annuloplasty ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heart Valve Diseases ; drug therapy ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Perioperative Care ; Ventricular Function, Right ; drug effects

Objective To investigate the current status of moral distress in clinical nurses,and analyze its influential factors.Methods A total of 240 clinical nurses were recruited by stratified sampling method.They were investigated with general situation questionnaire and moral distress scale.Results The average score of moral distress was (2.66±0.41).Multiple linear regression analysis showed that department of work and qualification were influencing factors on moral distress of clinical nurses.Conclusions This study found that nurses' moral distress was above the middle level.Some targeted measures should be taken by nursing managers,in order to help decrease nurses' moral distress.

Objective To investigate the prevalence of low T3 syndrome in patients with acute myocardial infarction(AMI) and explore the effect of low T3 syndrome on outcome of AMI.MethodsThree hundred and thirty-eight patients with AMI admitted to cardiac care unit(CCU) underwent examinations of thyroid function and cardial ultrasound,and were further categorized according to thyroid hormone profile.The records of noninvasive bi-level positive airway pressure(BiPAP)ventilation utilization,length of hospital stay,mortality during hospitalization were evaluated,and the related factors were analysed.ResultsOne hundred and thirty-nine of the 338 patients(41.12%) with AMI complicated with low T3 syndrome.Free triiodothyronine(FT3) was the independent influential factor for length of hospital stay.Low FT3 was significantly correlated with noninvasive BiPAP ventilation utilization and mortality during hospitalization.The average time of follow-up was(21.4?8.1) months.It was revealed by multivariate Cox regression analysis that FT3 was the chief predictor for cumulative death(risk ratio,4.25;95% confidential interval,2.30-7.87),followed by age and left ventricular ejection fraction.ConclusionThe recognition of AMI complicated with low T3 syndrome plays an important role in predicting the disease severity and outcome.

Objective To identify and characterize uveal melanoma associated protein variants with two-dimensional electrophore- sis and mass spectrometry.Design Experiment study.Participants 4 cases of specimens of uveal melanoma and 4 cases of normal con- tributed uveal tissue.Methods Proteins from uveal melanoma and normal urea were separated with two-dimensional eleetrophoresis (2-DE)and visualized with Coomassie G-250.Gels were analyzed by Image Master 5.0 software.The mass spectra were measured by matrix-assisted laser desorption/ionizatian time-of-flight mass spectrometry(MALDI-TOF MS)and searched against NCBI database using Mascot software.Main Outcome Measures Differential proteins.Results A set of 30 proteins were differentially expressed in uveal melanoma compared to nomal urea.Twenty-four types of protein only expressed in uveal melanoma.Five types of protein were up-regu- lated and 1 type of one down-regulated.These proteins can be subdivided into groups according to cellular function,such as enzyme, signal transduction,signal regulation,cytoskehton,immune,etc.Conclusions There is significant difference in protein profilings be- tween uveal melanoma and normal uvea.The differentially expressed proteins may be associated with the development of uveal melanoma.

OBJECTIVETo research the process mechanism of Atractylodes macrocephala and conversion of sesquiterpenes from it.

METHODThe contents of atractylenolide I, II and III in the different processed herbal medicines were determined by HPLC. The conversion of the sesquiterpenes was proved by the separation of oxides of atractylone.

RESULTThe contents of atractylenolide I and III increased after frying, and at high temperature the content of atract ylenolide III decreased. After oxidation, atractylone converted to atractylenolide I, III and biatractylenolide, and atractylenolide III converted to atractylenolide II after dehydration when heated.

CONCLUSIONAtractylone can convert to atractylenolides during process of A. macrocephala, and the contents of each component are related to the level of process.

Atractylodes ; chemistry ; Desiccation ; Hot Temperature ; Lactones ; analysis ; chemistry ; Molecular Structure ; Oxidation-Reduction ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Sesquiterpenes ; analysis ; chemistry ; Technology, Pharmaceutical ; methods ; Temperature

OBJECTIVETo investigate the vascular supply of intrinsic muscles of foot and anatomic basis for muscular flap design.

METHODSA radiopaque injectate (lead oxide-gelatin mixtures, 26 ml/kg) was injected into 10 fresh cadavers. The dissected regions were photographed and each intrinsic muscles on the foot was removed and radiographed. The number, type, diameter of vascular branches of muscles and their distributions were observed. The area of the vascular territory supplied by each source vessel was calculated using Scion Image for Windows software.

RESULTSThere were significant architectural differences among the intrinsic muscles. The muscles length varied from 22.5mm to 116.2mm [average, (66.1 +/- 23.2)mm]. The measured fiber length were relatively consistent, ranging from 14.2 mm to 27.5 mm [average, (20.2 +/- 4.5)mm]. There are 63 vascular branches into the 23 foot muscles, each muscle having average branches of 3.2 +/- 0.8. The average diameter of branches, the length and width of each vascular territorial area is (0.8 +/- 0.3) mm, (2.2 +/- 0.8) cm, and (0.9 +/- 0.4) cm, respectively. Other findings included that some muscles were not present in some cadavers.

CONCLUSIONSThe blood supply of intrinsic muscles of foot is abundant with different diameter and distributions of branches. There is an anatomic basis for muscular or musculoosseous flap design. There are 7 intrinsic muscles with large and reliable vascular supply which can be chosen as muscular flaps.

Adult ; Foot ; blood supply ; Humans ; Muscle, Skeletal ; blood supply ; Surgical Flaps