AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication.
METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.
RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P< 0. 01 ). The visual acurity of all cases increased in different degrees from handle move to 0. 3 to 0-1-1. 0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes (52. 4%), mild iritis in 21 eyes (100%). No cornea burn was encountered.
CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.

Exposure to traffic-related air pollutants(TRAP)has been implicated in airway allergic diseases.Recent findings include epidemiologic and mechanistic studies that shed new light on the impact of TRAP on allergic rhinitis(AR)and the biology underlying this impact.These studies have found that oxidative stress induced by TRAP could affect the axis of epithelial cell-dendritic cell-T cell towards a T-helper 2 immune response,which is the major mechanism between TRAP and AR.Further,epigenetics and microRNA might be involved in this process.Our review will summarize the most recent findings in each of these areas.
Air Pollutants ; toxicity ; Air Pollution ; Humans ; Oxidative Stress ; Rhinitis, Allergic ; etiology ; Vehicle Emissions ; toxicity

BACKGROUND:The treatment of diabetic foot has become a“bottleneck”. The transplantation of autologous bone marrow or peripheral blood endothelial progenitor cells is a new way for the treatment of diabetic foot in recent years.
OBJECTIVE:To review the effects of vascular endothelial growth factor receptor 2 and the integrin in treatment of diabetes foot by transplantation of endothelial progenitor cells.
METHODS:The first author searched PubMed database and Chinese periodical ful-text database for related articles published between January 1998 and December 2012, withdiabetic foot, endothelial progenitor cells, VEGFR-2, integrin, synergistic effectin English and Chinese, respectively. A total of 98 articles were searched, and 60 were included after excluding repetitive articles.
RESULTS AND CONCLUSION:In the diabetic foot treatment, autologous bone marrow or peripheral blood endothelial progenitor cells has around increasing attention, and gradual y become the focus of this field. Therapy with endothelial progenitor cells has gradual y developed into a new method for diabetic foot. Vascular endothelial growth factor receptor 2 and the integrin may exhibit synergistic effects in the treatment of diabetes foot. However, the mechanism remains poorly understood. Further studies are needed to wel understand their mechanism of action.

Objective To investigate the incidence,treatment and prognosis of neonatal respiratory failure (NRF) in the Neonatal Intensive Care Unit of Children's Hospital of Hebei Province.Methods The medical data of 626 NRF newborns admitted to the Neonatal Intensive Care Unit of Children's Hospital of Hebei Province from January 1st,2008 to December 31st,2008 were collected,and the pathogenesis of NRF,management,risk factors of their deaths and cost for the disease were studied.The results were compared with the national study in the same period and the local study of 2004-2005 by Chi-square test.Results During the 12 consecutive months,the incidence of NRF in neonatal intensive care unit was 38.9％ (626/1608).The mortality in hospital was 22.5％ (141/626),among which,most deaths (134,95.0％) occured after early discharge required by the parents.The mortality decreased by 14.7％ compared with that during 2004 2005 (37.2％,113/304),and was also lower than that (24.7％,1683/6864) in the national study at the same period.Pneumonia/sepsis ( 34.8 ％,218/626 ),neonatal respiratory distress syndrome ( 31.6 ％,198/626 ),and meconium aspiration syndrome (10.7％,67/626) were leading primary causes of NRF.The major complications were pneumonia/sepsis (5.4 ％,34/626),intracranial hemorrhage (4.6 ％,29/626) and persistent pulmonary hypertension (3.2％,20/626 ).The percentage of NRF babies requiring pulmonary surfactant rose from 14.1％ (43/304) during 2004-2005 to 23.6％ (149/626) in 2008,which almost reached the national level of 26.8％ (1840/6864).Pulmonary surfactant treatment was accepted by 70.2％ (139/198) patients with neonatal respiratory distress syndrome.12.1％ (24/198)of neonatal respiratory distress syndrome infant was administered immediate intubation-surfactant-extubation.Seventeen (2.7％) patients accepted nitric oxygen treatment.Nasal continuous positive airway pressure was given to 76.5％(479/626) patients,which was higher than before (47.1％,143/304).Conventional mechanical ventilation rate decreased from 72.7％ (221/304) to 49.8％ (312/626),and high frequency oscillatory rate increased from 0.7％ (2/304) to 10.5％ (66/626),which were similar to the national level.Of the 480 patients discharged after recovery,the mean time of hospital stay was (15.1 ± 4.0) days,and the mean medical cost was (12752 ± 5148) CNY.Conclusions The patient number increases and the medical skills and treatment methods of our hospital improve a lot.Utilization of pulmonary surfactant,nasal continuous positive airway pressure and high frequency oscillatory ventilation increase significantly.However,the burden of NRF is still heavy.

Vascular endothelial growth factor receptors ( VEGFR ) belong to the receptor-type tyrosine kinase ( RTK ) super family and play important roles in tumor angiogenesis.Abnormal activation of VEGFR results in several disorders including cancer.VEGFR-2 is the major signal transducer for angiogenesis, and therefore, it becomes a good target for the inhibition of tumor development and metastasis.Nowadays, the VEGFR-based antiangiogenic therapy becomes one of the most powerful clinical strategies for cancer treatment.In this review, small molecular VEGFR-2 inhibitors are classified according to their structural features, their biological activities and current statue are briefly introduced.

Objective To identify the patient satisfaction on follow-up service from the community health service (CHS) or West China hospital (WCH) and to compare the patient satisfaction on follow-up service from CHS and WCH.Methods A cross-sectional survey was used in this study to identify the patient satisfaction on day surgery.The questionnaires were self-made through literature review.Purposive sampling was used in collecting the data.Results Totally 758 qualified questionnaires were collected.The proportions of qualified questionnaires were 96.3％.Respectively,79.3％ of patients were completely satisfied with follow-up service from WCH,19.3％ of patients were partly satisfied,and 1.4％ of patients were completely dissatisfied.66.7％ of patients were completely satisfied with follow-up service from CHS,33.3％ of patients were partly satisfied with follow-up service from CHS,and no objects were completely dissatisfied.Conclusions Patient satisfaction on follow-up services from WCH was higher than CHS.It is essential to enhance follow-up services from CHS.

Objective To investigate the clinical status of massive transfusion in elderly patients in general hospital in order to improve the clinical use of blood and ensure the security of blood transfusion in elderly patients.Methods 100 patients who required massive transfusion were divided into 2 groups:elderly group (patients aged 60 years and over,n=32) and non-elderly group (patients aged under 60 years,n=68).Clinical blood transfusion indications in all patients met the Technical Criterion of Clinical Blood Transfusion issued by Ministry of Health of the People's Republic of China in 2000.Clinical data were analyzed and compared between the two groups.Results Elderly patients with massive transfusion were mainly in department of surgery,including department of orthopedics,general surgery,hepatobiliary surgery,cardiac surgery and urology surgery and gastroenterology,and the mean age of patients in these departments was 71.5 years,69.9 years,72.0 years,66.0 years,65.5 years,70.8 years respectively,accounting for 50.0％,70.0％,20.0％,75.0％,20.0％ and 66.7％ in all patients who required massive blood transfusion respectively.The mean blood transfusion volumes were higher in patients in department of gastroenterology,general surgery,hepatobiliary surgery and orthopedic,in which the mean units of red blood cell components transfusion were 14.0 U,7.0 U,5.2 U and 4.1U respectively,the mean units of plasma components transfusion were 23.3 U,8.4 U,8.0 U,0.5 U respectively,and the mean uint of platelet components transfusion was 1.6 U in hepatobiliary surgery.Conclusions The risk of blood transfusion is higher in the elderly than in the non elderly.We should select the effective blood components reasonablely,reduce the unnecessary blood transfusion and decrease the dependence on plasma transfusion to avoid the transfusion overload and adverse reactions.

To review the outcome of the endovascular treatment of aortoiliac occlusive disease,the recent literature concerning endovascular treatment as well as aortoiliac occlusive disease was extensively reviewed,and the research and development were summarized.The results are:(1) In most cases,endovascular invention is better than surgery ; (2) Stent placement has a higher technical success rates and a better longterm outcome than percutaneous transluminal angioplasty,primary or selective stent placement,which is better,is controversial; (3)Covered stents perform better than bare stents in longer-term patency and clinical outcome ; (4)Endovascular treatment of complex AIOD provides excellent early and long-term results,similar to those obtained in the treatment of simple lesions.So,in general,endovascular treatment of aortoiliac occlusive disease provides excellent clinical results,further research is needed.

Objective To analyze the onset, clinical manifestation, causation, complications of pediatric uveitis. MethodsOne hundred and two patients with uveitis under 16 year-old were retrospectively studied. They visited the clinic in Peking University First Hospital from November 1979 to December 2008. Their age ranged from 2.5 to 16 years old, with a mcan of 11.9 years. Routine exam was carried out, including visual acuity, slit lamp, fundus, and laboratory workup. The diagnosis and classification were made by the anatomic location according to the standard of The International Uveitis Working Group. The data of disease history, age of onset, manifestation, recurrence, causation, systemic diseases, complications, and lab examination were analyzed. Results A total of 102 patients (170 eyes)with pediatric uveitis were included in this study, 68 patients (66.6%) were bilateral cases. Anterior uveitis represented in 38 patients (37.3% ), intermediate uveitis in 19 (18.6%), posterior uveitis in 10 (9.8%),and panuveitis in 35 (34.3%). The disease duration was from five days to 2.4 years, with a mean of 3.6 months. The follow-up time was two weeks to more than ten years. The first three causes of pediatric uveitis were juvenile idiopathic arthritis, Vogt-Koyanagi Harada disease, and Behcet's disease. 36 patients were found with complications, and among them 19 had complicated cataract, seven had secondary glaucoma, five had corneal band dystrophy, 12 had iris synechia (both anterior and posterior), one had retinal detachment, two had eye atrophy, and one patient with juvenile idiopathic arthritis had bilateral femoral head necrosis because of the use of steroid and hip joint was replaced. There were ten children suffering more than two complications. Conclusions Pediatric uveitis is a possible blindness disease with variety of etiology and manifestations, and tends to cause complications. Early and special attention must be taken to avoid serious consequences.

Pancreatic cancer is a common malignant neoplasm of the pancreas with an extremely high mortality.Currently,the early diagno-sis of pancreatic cancer is still not ideal.Attention should be paid to some clinical warning symptoms,such as unexplained abdominal and back pain,jaundice,and unexpected diabetes.Additionally,the combined use of CA19-9,CEA,and other tumor markers,the attention to biochemical indicators,the detection of mutation in KAI1 or p53 gene,and the exploration of the value of miRNA in clinical diagnosis are of great significance.On the other hand,ultrasound,CT,MRCP,ERCP,PET-CT,and other imaging methods,as well as effective col-lection of cytology specimens,should be performed.Thus,there is hope for the early diagnosis of pancreatic cancer.