?AIM:To study the clinical value of non-steroidal anti-inflammatory drug in adjuvant treatment of intravitreal triamcinolone acetonide ( IVTA ) for macular edema caused by retinal vein occlusion ( RVO) .?METHODS: Forty - eight eyes in 48 patients were randomly divided into trial and control group ( 24 eyes each ) in this prospective study. In the trial group, additional pranoprofen drops was administered from 1d before IVTA to 30d after injection. Central foveal thickness ( CFT ) was measured with optical coherence tomography ( OCT ) . Available documents of best corrected visual acuity ( BCVA ) , CFT, intraocular pressure and complications pre- and post-injection at 3d, 1,2wk, 1 and 3mo were evaluated.?RESULTS: After IVTA, BCVA was improved in both groups at different levels; but there was no statistically significant between two groups at each time point ( P>0. 05). The CFT values were 629 ± 43μm vs 605 ± 57μm before IVTA in the trail vs control groups (P>0. 05). The values were 432±74μm vs 511±32μm (t=7. 533, P<0. 05), and 275±54μm vs 379±29μm (t=13. 212, P<0. 05) of the trial vs control groups at 1 and 3mo after IVTA, respectively. Ocular hypertension occurred in 5 eyes after injection in trail group, and was controlled with anti-glaucoma medication and one eye with filtration surgery. Progression of cataract was noted in 3 of 35 phakic eyes and cataract surgery was performed in 2 eyes at 4-12mo after injection in trail group. Progression of cataract was noted in 4 eyes and cataract surgery was performed in 2 eyes at 4- 12mo after injection in control group. No retinal detachment and endophthalmitis happened during the whole period of follow-up.?CONCLUSION: Application of non - steroidal anti -inflammatory eye drops in perioperative period can be useful to improve the outcome of IVTA for macular edema, which needs further evaluation.

Constipation ; prevention & control ; therapy ; Dietary Fiber ; therapeutic use ; Humans ; Surveys and Questionnaires

The cupping spot is considered as one kind of skin change due to cupping treatment. With literature regarding cupping spot, the influencing factors and value of cupping spot in clinical diagnosis and treatment were analyzed, which could make a further exploration on the action mechanism of cupping treatment. The literature showed that the formation of cupping spot was related with cupping temperature, pressure, cup-retaining time, cupping area, individual difference and health condition, etc; cupping spot had the ability to assist diagnosis, prevent disease, cure disease and evaluate clinical efficacy. Previous studies on cupping spot have already made some progress, and played a positive significance on finding cupping rule and studying its mechanism. However, the research for this area is still in the primary stage, which needed deeper study to reveal scientific connotations of cupping spot.
Acupuncture Therapy ; instrumentation ; Humans ; Skin ; anatomy & histology ; blood supply

OBJECTIVETo determine if multi-detector CT (MDCT) characterization of plaque is correlated with the classification of acute coronary syndrome (ACS).

METHODSAltogether 1900 patients were examined by MDCT from December 2007 to May 2009, of whom 95 patients fulfilled the criteria of ACS. Those patients were divided into the discrete plaque group ( n=61) and diffuse plaque group ( n=34) based on the findings in MDCT. The clinical diagnosis of ACS and CT results were analyzed, including segment stenosis score, segment involvement score, 3-vessel plaque score, left main score, calcification score, and remodeling index. The incidences of major adverse cardiac events in follow-up period were also recorded.

RESULTSThe patients of the diffuse plaque group were older than those of the discrete plaque group ( Pü0.0001). The diffuse plaque group presented more cases of hypertension, peripheral artery disease, diabetes, and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardial infarction were found in discrete plaque group. The segment stenosis score of the discrete plaque group was lower than that of the diffuse plaque group(5.15±3.55 vs. 14.91±5.37, Pü0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of thediscrete plaque group was higher (1.12±0.16 vs.0.97±0.20, Pü0.05). Follow-up data showed that major adverse cardiac events occurred more frequently in diffuse plaque group than in discrete group (29.41% vs. 11.48%, P=0.0288).

CONCLUSIONSCharacteristics of discrete and diffuse plaques may be significantly different among different classes of ACS. The diffuse plaque may present higher risk, correlated to higher mortality. The diagnosis of discrete and diffuse plaques by MDCT would provide a new insight into the prognosis and treatment of ACS.

Acute Coronary Syndrome ; classification ; Adult ; Aged ; Coronary Artery Disease ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVETo discuss the change of blood supply pattern in visceral arteries of Stanford B dissection. The visceral arteries include celiac trunk (CA), superior mesenteric artery (SMA) and renal artery (RA).

METHODSBy retrospectively analysing the clinical data of 52 cases with Stanford B dissection, the blood supply pattern of visceral arteries was confirmed by aortography and the changes before and after endovascular repair were compared.

RESULTSAfter repair: the stenosis lesions disappeared in 7 cases supported by true channel completely but one. Twenty-two visceral arteries supported by true and false channel simultaneously recovered true channel chiefly but one. One recovered true channel chiefly and one had no change in 2 visceral arteries supported by false channel completely. Four recovered true channel chiefly and one had no change in 5 visceral arteries without blood support. 88.9% blood support got better and 11.1% blood support had no change in 36 damaged visceral arteries after endovascular repair.

CONCLUSIONBlood support from true and false channel simultaneously is the chief pattern in the injured visceral arteries before repair; Endovascular repair technique is benefit to recovering the blood support of true channel.

Adult ; Aged ; Aneurysm, Dissecting ; physiopathology ; surgery ; Aortic Aneurysm ; physiopathology ; surgery ; Celiac Artery ; physiopathology ; Female ; Humans ; Male ; Mesenteric Artery, Superior ; physiopathology ; Middle Aged ; Regional Blood Flow ; Renal Artery ; physiopathology ; Retrospective Studies

OBJECTIVETo investigate the expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h in lung of guinea pigs with bronchial asthma, and to explore the roles of them.

METHODSForty adult male guinea pigs were randomly divided into 4 groups: the control group (group A), asthmatic group ( group B), dexamethasone group (group C) and rogridone group (group D), 10 guinea pigs in each group. The asthmatic model was established by the ovalbumin challenge method. Expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h mRNA in lung tissue were assayed by in situ hybridization. Expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h protein were detected by immunohischemistry and by Western blot.

RESULTSIn situ hybridization showed that the expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h mRNA in lung tissue were the lowest in group B and the comparison among groups showed statistical significant (all P < 0.01). Immunohistochemistry and Western blot indicated that the value of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h protein in lung tissue were the lowest in group B, and expressed primarily in nucleus, the differences being statistically significant (all P < 0.01). There was positive correlation between PPAR-gamma and PGC-1. gamma-GCS-h mRNA also positively correlated between PPAR-gamma/PGC-1alpha and Nrf2 in nucleus, and the expression of Nrf2 was also positively correlated with PPAR-gamma/ PGC-1alpha.

CONCLUSIONIn acute asthmatic models induced by ovalbumin, the expressions of PPAR-alpha/PGC-1alpha and Nrf2/gamma-GCS-h were decreased, and PPARgamma/PGC-1alpha could up-regulate the expressions of Nrf2/gamma-GCS-h to increase the antioxidant defense of tissues, thus being implicated that PPARgamma/PGC-1alpha might play important roles in the pathogenesis and prevention of asthma.

Animals ; Asthma ; chemically induced ; physiopathology ; Glutamate-Cysteine Ligase ; genetics ; metabolism ; Guinea Pigs ; Lung ; metabolism ; Male ; NF-E2-Related Factor 2 ; genetics ; metabolism ; Ovalbumin ; PPAR gamma ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism

OBJECTIVETo discuss the safety, feasibility, efficacy and problem of endovascular repair (EVR) for ruptured aortic aneurysm (RAA).

METHODSFourteen patients with RAA were obtained diagnosis and anatomic data of proximal and distal neck through magnetic resonance imaging and CT. The patients with hypotension were accepted anti-shock treatment. Stent-grafts were deployed in proper position of RAA under X-ray fluoroscopic.

RESULTSThe time from rupture to operation was 50 min to 21 d. Three cases had plenty of blood in left pleural cavity and 2 cases were done under bleeding shock condition. Five cases with RAA were fixed by bifurcated stent-grafts and others by straight stent-grafts. Follow-up term was 1 month to 38 months. One with ruptured thoracic aortic aneurysm died 4 h later after operation, another one died of left thoracic cavity infection 9 months later, and others lived well without complication.

CONCLUSIONThe EVR is a safe, efficient and feasible method. It will be a potential alternative to treat RAA in future, but more suitable for RAA with better proximal and distal landing zones.

Adult ; Aged ; Aortic Rupture ; diagnosis ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

OBJECTIVETo discuss the safety, feasibility, efficacy and problems of endovascular repair for aortic dissection.

METHODSFrom June, 1998 to Dec, 2004, 178 aortic dissections were treated by stent-grafts, including 76 acute cases and 102 chronic cases, 19 cases with Stanford A and 159 cases with Stanford B. Under local or general anesthesia, every stent-graft was deployed at the proper position of first tear entry through femoral artery under X-ray fluoroscopic. The changes of hemodynamic in true and false lumen, visceral and limbs blood supply were investigated after operation.

RESULTS10 cases combined with left common carotid artery or left subclavian artery or hepatic artery and superior mesenteric artery bypass. 36 left subclavian arteries were covered simultaneously without bypass and the average blood pressure of left brachial artery was (61.6 +/- 23.7) mm Hg. The stent-grafts were deployed above thoracic 8 in 159 cases and below thoracic 8 in 19 cases. This group included 3.4% 30-day death rate, 12.9% endoleak rate after deployment, and without misplace of stent grafts, migration, rupture, conversion to open surgery and paraplegia complication. The average operation time 1.5 h (0.5-4.3 h), blood loss 140 ml (30-500 ml), movement recover time 1.8 d (0.5-21.0 d), food recover time 1.5 d (0.5-9.0 d). The true lumen blood supply in most of damaged visceral arteries were improved. Follow up between 1 month to 76 months, the endoleak rate was 6.4% one month later.

CONCLUSIONThe endovascular repair is a safe, efficacy and feasible method to aortic dissection. The long term results keep in follow up.

Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; methods ; Catheterization, Peripheral ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.

Aged ; Diabetes Mellitus, Type 2 ; complications ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; etiology ; pathology ; Retrospective Studies