?AIM:To observe the clinical effect of Ahmed glaucoma valve ( AGV ) implantation for teenagers with refractory glaucoma.?METHODS: Twenty-seven patients ( 27 eyes ) with refractory glaucoma were treated with AGV implantation in our hospital from October 2012 to October 2014. The patients were followed up for 12mo. The success rate of the operation, postoperative intraocular pressure, the best corrected visual acuity, as well as complications were recorded.?RESULTS:The success rate of the operation was 85%. The intraocular pressure of the 27 patients decreased from 48. 3 ± 8. 3mmHg before operations to 21. 4 ± 8. 1mmHg(P<0. 05). Visual field defect was -23. 7±4. 1dB before operations, - 27. 5 ± 4. 7dB at 12mo after operations, and the difference was statistically significant (P<0. 05). There was 85% patients with improved or unchanged vision. Early postoperative complications included shallow anterior chamber ( 5 eyes, 19%) , transient high intraocular pressure ( 3 eyes, 11%) and anterior chamber hemorrhage ( 4 eyes, 15%) , drainage tube obstruction (1 eye, 4%), anterior chamber silicone tube in poor position ( 1 eye, 4%) . There was no ambiopia, drainage erosion and exposed, plate leaked out, choroidal detachment, immune rejection of graft and other complications. Long - term complications included dyscoria ( 8 eyes, 30%) , the back of the plate packed(3 eyes, 11%).?CONCLUSION:AGV implantation is characterized by a high success rate, simple operation, less complications and is an effective treatment for refractory glaucoma in adolescents.

This study is to investigate the effects of paeoniflorin on cerebral blood flow and the balance of PGI2/TXA2 of rats with focal cerebral ischemia-reperfusion injury. A total of 72 SD rats (3) were randomly divided into 6 groups: sham operation group, cerebral ischemia-reperfusion model group (I/R gourp), low (10 mg.kg-1), middle (20 mg.kg-1) and high (40 mg.kg-1) doses of paeoniflorin groups and nimrnodipine group. Focal cerebral ischemia in rats was made by inserting a monofilament suture into internal carotid artery for 90 min and then reperfused for 24 h. The effects of paeoniflorin on neurological deficit scores and the infarction volume of brain were detected. Relative regional cerebral blood flow (rCBF) was continuously monitored over ischemic hemispheres by laser-Doppler flowmetry (LDF). The expression of COX-2 in hippocampal CAl region was estimated by immunohistochemistry and the contents of prostacyclin I2 (PGI2), thromboxane A2 (TXA2), and ratio of PGIJ2/TXA2 in serum were measured by ELISA kits. Paeoniflorin significantly ameliorated neurological scores, reduced the infarction volume, and increased regional cerebral blood flow relative to the I/R group. In addition, paeoniflorin could inhibit COX-2 expression and the release of TXA2 and prevent the downregulation of PGI2 induced by I/R injury. The neuroprotective effects of paeoniflorin against focal cerebral ischemia-reperfusion rats might be attributed to improve the supply of injured hemisphere blood flow and adjust the balance between PGI2/TXA2.
6-Ketoprostaglandin F1 alpha ; blood ; Animals ; Brain ; blood supply ; CA1 Region, Hippocampal ; metabolism ; Cyclooxygenase 2 ; metabolism ; Glucosides ; isolation & purification ; pharmacology ; Infarction, Middle Cerebral Artery ; blood ; metabolism ; pathology ; physiopathology ; Male ; Monoterpenes ; isolation & purification ; pharmacology ; Neuroprotective Agents ; isolation & purification ; pharmacology ; Paeonia ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Regional Blood Flow ; drug effects ; Reperfusion Injury ; metabolism ; physiopathology ; Thromboxane B2 ; blood

To explore the measures of nursing management in the treatment of large number of infants with urinary calculi. The nursing management measures included launching the preparedness and response project for sudden public health events, formulating scientific and standardized nursing management system,optimizing work flow,strengthening nurse training,focusing on the details in nursing management,implementing disinfection and isolation system seriously,and paying close attention to health education for the parents of minority infants. Scientific nursing management can ensure the treatment effectiveness and nursing safety for the infants with urinary calculi.

Objective:To analyze the accuracy of the digital imaging fiber optic transillumination (DIFOTI) on diagnosis of caries lesions depth using DIAGNOcam system.Methods:This experiment adopted self-matching design.Seventy-four extracted teeth (molar:sixty-six,premolar:eight) with one caries lesions in proximity which were not damaged in surface marginal ridge were selected.Dental calculus and dental stains were removed from the extracted teeth for standby application.A sign was marked in the middle of the occlusal surface edge at the side of decay.Then the teeth were fixed in the standard model of dentition and cavities were adjacent with the sound tooth surface.Sticky wax was applied to seal the level of 2 mm beyond cemento-enamel junction (CEJ) in the direction of occlusion and interproximal space to imitate gingival margin and gingival papilla.The standard models of dentition was seated in imitation head mold.The lesions depth degree was looked into and checked with DIAGNOcam system.Besides,the pictures on the occlusal surfaces were recorded and saved.The sign above could be seen on the picture.The measuring tool in DIAGNOcam system was used to measure the depth of the caries from the sign (as starting point) to the deepest point of caries in the pictures and its length was recorded for a.The line a was lengthened to the contralateral edge of occlusal surface in the photo and the length was recorded for b.A line from the marked point on the occlusal surface edge of the extracted teeth was draw parallel to the line b on the corresponding photo and its length was recorded for c.The depth of the cavities on the projected images was recorded for d,and calculated d/a =c/b (digital optical fiber measured decay depth/caries damage depth of the image =actual tooth width/tooth width of the image),and d =c/b × a inferred.At last,the teeth were taken out from the standard model dentition.The decay of the tooth was removed completely.The actual depth of the cavity was recorded for D.The difference between d and D was recorded for Δd.The software of SPSS 20.0 was used to test the consistency of the results,and the MedCalc 14.8.1.0 software was used for Bland-Altman analysis.Results:The intraclass correlation coefficient (ICC) between d and D was 0.951 (ICC ＞ 75 ％),P =0.263.There was a function relationship y =0.23 ± 0.9 1x between d (x) and D (y).Bland-Altman analysis method showed that the mean of Δd (Δd) was 0.05 mm,the standard deviation of Δd (ΔdsD) =0.308,and the 95％ confidence interval was (-0.55 to 0.65).The amplitude of difference was clinically acceptable.So the consistency of the two measurement modes was high.Conclusion:There was no significant difference between the depth of caries lesions checked with DIAGNOcam system and the depth of the actual cavity,and the consistency was very good.The vitro study suggests that the DIAGNOcam system may be used to assess the depth of caries cavity as a useful tool in diagnosis and treatment.

OBJECTIVE: To study preparation technology and properties of a new kind of iron-supplement of alginate-iron (III) complex. METHODS: The preparation parameters of polysaccharide iron (III) complex with sodium alginate and ferric trichloride were optimized by means of the single factor and response surface design. Alginate-iron (III) complex was characterized by IR and DSC. Its reducibility and drug release percentage were determined in simulated gastrointestinal liquid. RESULTS: Optimum condition follows; alginate sodium to ferric trichloride with mass ratio of 1:3.2 and alginate sodium to sodium citrate with mass ratio of 1:1.4, which were reacted in pH 6.95 of reaction liquid and at 80℃ of water bath lasting for 3. 29 h and generated alginate-iron (III) complex with the 19.57% of iron content. The IR and DSC indicated that the hydroxyl groups of alginate was combined with Fe(III). The alginate-iron (III) complex could be dissolved and reduced easily by vitamin C in physiological pH conditions. And the cumulative release percentage was more than 80% within 60 min in stimulated gastrointestinal liquid. CONCLUSION: The preparation technology of alginate-iron (III) complex was feasible. The product is high iron content and the solubility. And it can meet with the fundamental functions as a new kind of is supplement source.

Objective To investigate the efficacy and safety of surgical treatment for internal carotid artery atheromatous pseudo-occlusion (APO).Methods Clinical data of patients with carotid artery stenosis treated by carotid endarterectomy from Dec.,2011 to Jun.,2016 in Zhongshan Hospital Affiliated to Fudan University were analyzed retrospectively.Carotid endarterectomy were performed in 32 patients with pseudo-occlusion of the internal carotid artery (APO group).And 124 patients with traditional severe stenosis (70％-99％) served as control group.Perioperative major and minor complications,recurrence rate of ipsilateral ischemic stroke,restenosisrate and mortality in follow-up were compared between the two groups.Results Perioperative major complications:one patient (3.1 ％) developed myocardial infarction in the APO group,no ischemic stroke,cerebral hemorrhage and death cases;2 (1.4％) ischemic stroke cases,6 (4.2％) myocardial infarction cases and 1 (0.7％)death case was found in control group.Perioperative minor complications:1 (3.1％) incision bleeding case,2 (6.3％) pulmonary infection cases,2 (6.3％) cerebral hyperperfusion syndrome cases were found in APO group;3 (2.1％) incision bleeding cases,2 (1.4％) incision infection cases,4 (2.8％)pulmonary infection cases,2 (1.4％) cranial nerve injury cases,2 (1.4％) cerebral hyperperfusion syndrome cases were found in control group.Patients were followed up for 6-60 months,with mean follow-up period of (35.3 ± 17.5) months.During follow-up,1 (3.1％) ipsilateral ischemic stroke recurrence case,4 (12.5％) restenosis cases,and 3 (9.4％) death cases were found in the APO group.And 8 (5.6％) ipsilateral ischemic stroke recurrence cases,9 (6.3％) restenosis cases,8 (5.6％)death cases were found in control group.There were no significant differences in perioperative major and minor complications,recurrence rate of ipsilateral ischemic stroke,restenosis rate and mortality between the two groups.Conclusions Surgical treatment for atheromatous pseudo-occlusion of the internal carotid artery is safe and effective.Perioperative and follow-up results are satisfactory.

Objective To investigate a new method of improving design of the skin flap pedicled with descending hranch of lateral femoral circumflex artery,in order to increase the accuracy of preoperative Doppler location.Methods Six fresh cadavers underwent a whole body,intra-arterial injection of a lead ox- ide and gelatine preparation.Observe the perforators of anterolateral thigh by dissection,measured their diam- eter;course,branches and location for there were showed up by angiography and photography.A specific pro- gram,3D-doctor,was used for the detection of the regions of interest in angisome and its 3D-reconstructive.In addition to the average area supplied by a single perforator within that territory was calculated from digital an- giograms using Scion Image.Results There were 16 perforators that the diameter≥0.5 ram,20%were septocutaneous,80%were musculocutaneous.Their average external diameter was 0.8 ram.The average ped- icle length from the deep fascia was(3.15?1.43)ram;the perforators from descending branch of lateral cir- cumflex femoral artery walk length average about 2.63 cm in superficial fascia.The area of each perforator supplied blood was average 45.61 cm~2.Conclusion Modified lead oxid-gelatine technique provides high quality angiograms for the study of cutaneous artery and perforator falp.Based on our data,the maximum di- mension of the anterolateral thigh perforator flap can be 30 cm?20 cm in with only a single dominant perfora- tor.The perforator flaps deviced by perforators from the anterolateral thigh are transplanted to the lower limbs and the other part of the body.

Objective To observe the expression of heparanase(HPA)in kidney of diabetic nephropathy(DN)rats and to investigate the role of HPA in the pathogenesis of proteinuria in DN rals. Methods DM rat models induced by intraperitoneal injection with streptozotocin were constnmted.Twenty-six rats were randomly divided into heahhy control group(n=6),DM6-week group(n=10)and DM 12-week group(n=10).Relative kidney weight(RKW),blood glucose,BUN,Scr,24-hour urine volume and(t 24-hour proteinuria quantilation were measured,and renal morphology was observed after 6 and 12 weeks.The expression of HPA was examined by immunohistochemistry and reverse transcription PCR. Results (1)Conq)ared with the control group,RKW,blood glucose,BUN,24-hour urine volume and 24-hour proteinuria quantitation of DM groups increased markedly(P＜0.05 orP＜0.01).(2)Compared to the control group,the expression of HPA mRNA and protein in DM groups increused significantly(P＜0.01).(3)HPA protein and mRNA were positively correlated with the quantification of urinary prolein (r=0.783,P＜0.01;r=0.793,P＜0.01). Conclusion The increased expression of HPA maybe parlicipate in the pathogenesis of proteinuria in DN.

Objective To explore the clinical value and typing characteristic of prenatal ultrasonography for fetal cystic adenomatoid malformation of the lung(CAML).Methods Ultrasonographic features and typing of fetal CAML in 41 cases detected by prenatal ultrasonography were analyzed retrospectively.All cases were followed up until to the induction of labor or birth.Results (1)Site of tumor: in the 41 cases,there were 22 cases on the left side,15 on the right side and 4 on bilateral.(2)Typing diagnosis of prenatal ultrasonography: three cases were CAML type Ⅰ,14 were type Ⅱ,and 24 cases were type Ⅲ.(3)Pathology diagnosis: thirty two cases were induced abortion.CAML was confirmed in 29 cases by autopsy and the classifications were consistent with the prenatal diagnosis of ultrasonography.Three pulmonary sequestration cases were prenatally misdiagnosed as CAML type Ⅲ by ultrasonography.(4)The other nine cases were followed up to birth.Three masses decreased gradually and then disappeared.Six newborns were confirmed as CAML by CT.Their typings were consistent with the postnatal diagnosis.(5)The diagnostic accuracy rate of prenatal ultrasonography for CAML was 92.7%(38/41).Its misdiagnostic rate was 7.3%(3/41).Conclusions Prenatal ultrasonography has a high accuracy rate for the diagnosis and classification of CAML and is the first choice to detect CAML early in pregnancy.It has an important clinical value.Pulmonary sequestration should be distinguished from CAML type Ⅲ because they tend to be confused.

Objective To investigate the anatomy of the superficial epigastric artery perforator flap , and to provide anatomical basis for harvesting flap .Methods Of 27 SD rats, 7 were used for gross anatomy observation and anatomic characteristics and 20 rats for lead oxide-gelatin injection followed by computer picture processing , measurements and the related parameters recording .Results The superficial epigastric artery originated from femoral artery , and gave off its first branch when passed through the superficial fascia .The trunk branched into a lateral perforator and a medial perforator , which anastomosed with thoracodorsal artery and lateral thoracic artery , respectively .The average external diameter of superficial epigastric artery was (0.46 ±0.02)mm at its starting point,and(0.46 ±0.02)mm at the superficial fascia level . The nutritive area of superficial epigastric artery was (18.37 ±3.67) cm2 .The anastomosed area with thoracodorsal artery and lateral thoracic artery was(5.34 ±0.86)cm and(6.28 ±0.29)cm, respectively, away from the horizontal line through axillary,and (4.38 ±0.38)cm and(2.04 ±0.33)cm, respectively, away from the ventral median line.Conclusion The position and external diameter of superficial epigastric artery are constant , and the superficial epigastric artery perforator flap is a ideal flap model for research on free flap transplantation , flap supercharging , and hemodynamics .