This review snmmarized and estimated the management of cataract blindness in China recently,and introduced the purport of clinic medical economics.Based on it,it was proposed that our service system of cataract blindness could use the experiences of other countries as reference and engaged in more investigations in search of Chinese way for cataract blindness.

Objective The study aimed to evaluate the incidence rate and risk factors of early post-mastectomy pain syndrome (EPMPS) after surgery for breast cancer.Methods A retrospective study was carried out in 231 female patients with breast cancer who appeared EPMPS after surgery in the First Hospital of China Medical University from September 2012 to September 2014.They were followed-up for 3 months.Results Among 231 female patients with breast cancer,41.1％ (95/231) suffered from EPMPS.The incidence of EPMPS in women of 40-59 years old was 66.3％ (63/95),significantly higher than other age groups,RR=l.83,P＜0.05.Those who were submitted to axillary lymph node dissection and those without preservation of intercostobrachial nerve had shown a significantly increased risk of EPMPS compared with those with sentinel lymph node biopsy plus no surgery and preservation of intercostobrachial nerve patients (81 cases vs.14 cases,41 cases vs.18 cases,x2=19.921,P＜0.01;x2=11.045,P＜0.05).Conclusions The frequency of EPMPS in the middle-age women is high and possible explanations are unclear.Surgery of axilla affects the incidence of EPMPS,reassurance is key to coping with EPMPS in nursing and rehabilitation.

OBJECTIVE:To investigate the utilization and the economic value of the medicare drugs in our hospital. METHODS: The utilization of the medicare drugs in our hospital from 2001 to 2006 were analyzed statistically by sequencing drug consumption sum and DDDs. RESULTS: The consumption of medicare drugs represented 81.9% of the total drugs used in the clinic in our hospital. Both DDDs and consumption sum increased year on year. CONCLUSION: The utilization of medicare drugs was rational with good economic value, yet the application of new drugs was still on the high side in spite of their high prices.

Objective To morphologically observe the changes of cornea tissue a long period after myopic LASIK with confocal microscopy. Methods 34 patients (68 eyes) from April 1999 to July 2004, who had undertook LASIK in our Hospital, were involved in present study. The confocal microscopy was employed to examine the changes of cornea tissue. The average spherical equivalence was -6.81?2.88D (ranged from -3.0 to -16D). The average age of the patients was 24.17?5.93 (ranged from 18 to 42). The average follow-up time was 39?3 months (ranged from 6 to 73 months). Results The Micro-folds at the Bowman's layer were found in 68 eyes (100%), as well as variously reflectivity particles located at the interface in all eyes examined after operation. The density of high reflective particles did not decrease significantly with time. In the middle stroma, the mean depth of acellular area was 44.01?10.67?m in all 68 eyes (100%). The appearance of morphology of subbasel corneal nerve fiber bundles after operation recovered. Conclusions Morphologic changes were found in central cornea. Acellular area, micro-folds as well as variously reflectivity particles located at the interface in all eyes existed in the central cornea for long time.

Objective To measure ceftriaxone concentrations in aqueous humor of human eye after one gram of the drug was administered intravenously. Methods 75 subjects (75 eyes) were studied, 60 of whom were divided randomly into 4 test groups according to different time intervals between drug administration and extraction of aqueous humor (30min, 60min, 120min, 180min), and the rest 15 were controls. One-gram of ceferiaxone was administered intravenously before cataract operation. About 200-300?l aqueous humor was withdrawn from every patient during the operation at respective time point mentioned above and reversed phase high performance liquid chromatography (HPLC) was used to measure the concentration of the drug. Results The concentrations of ceftriaxone in aqueous humor were 0.235?0.121mg/L, 0.474?0.224mg/L, 0.453?0.162mg/L, and 0.534?0.202mg/L, respectively, after a time interval of 30min, 60min, 120min, 180min. The drug concentration in the 30 min group was lower compared with the other 3 test groups (P0.05), and the concentrations of ceftrixone in aqueous humor were all above the minimum inhibitory concentration for 50%(MIC 50 ) of ceftriaxone against most pathogenic bacteria. Conclusion Ceftriaxone may be an effective antibiotic for prophylactic use in ophthalmic surgery and also for the treatment of intraocular infection due to organisms susceptible to the drug.

AIM: To investigate the effect of mycophenolate acid(MPA) on hepatitis B virus(HBV) replication in vitro.METHODS: In the presence or absence of guanosine,the HepG2.2.15 cells were treated with different concentrations of MPA(1-20 mg/L) for 4 days.Hepatitis B surface antigen(HBsAg) and hepatitis Be antigen(HBeAg) in supernatant were detected by ELISA.Intracellular HBV core mRNA and HBV DNA were analyzed by reverse transcription-polymerase chain reaction(RT-PCR) and slot blot hybridization,respectively.RESULTS: MPA suppressed the expression of HBsAg and HBeAg,and inhibited the replication of HBV DNA.The effect of MPA on HBV replication was reversed by addition of exogenous guanosine.CONCLUSION: MPA suppresses the expression of HBsAg,HBeAg and replication of HBV DNA in HepG2.2.15 cells.Reducing the synthesis of guanosine nucleotides may be involved in the mechanism of the inhibitory activity of MPA on HBV replication.

Objective To evaluate the practicability and safety of 25-gauge (25G) transconjunctival sutureless vitrectomy system (TSV25G) and describe the preliminary experience. Methods Eighteen patients underwent TSV25G. The time of procedures of setting-up the three-port cannulae and closing the cuts were recorded. The pre- and post-operative ocular tension, visual acuity and complications were observed. Results The average time of setting-up the three-port cannulae and closing the cuts was 1 minutes 24 seconds and 32 seconds, respectively. The average preoperative ocular tension was 16.3 mm Hg(1 mm Hg=0.133 kPa); the average postoperative ocular tension at the first day, first week, and first month was 13.0, 15.9, and 16.4 mm Hg, respectively. The visual acuity before and one month after operation the was HM/20 cm～0.2 and HM/50 cm～0.6, respectively. No postoperative complication was found. Conclusion TSV25G may simplify the operation, minimize the surgical induced trauma, and decrease the operating time and the postoperative inflammatory response.

AIM: To investigate lymphotactin (Lptn) gene transcription during acute cardiac allograft rejection and the inhibitory effect of cyclosporine A (CsA). METHODS: Graft specimens were harvested at indicated time to determine morphological changes by pathological examination. The grade of acute cardiac allograft rejection was evaluated by using modified Banff scoring system. Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the Lptn mRNA expression in cardiac grafts. NFATc1 activity of splenocytes after transplantation was assessed by enzyme-linked immunoabsordent assay (ELISA). RESULTS: Prominent splenomegaly on day 3 posttransplantation was found in C57BL/6-Balb/c group. The extent of myocardial inflammatory infiltration was scored 2.667?0.577 at day 5 and 2.333?0.577 at day 7, respectively. Splenomegaly was ameliorated by CsA treatment, and the extent of myocardial infiltrate was scored 1.000?0.000 at day 5 and 1.333?0.577 at day 7, respectively. Lymphotactin mRNA was undetectable in cardiac isografts. Lymphotactin mRNA, which was inhibited partially by CsA, was upregulated strongly in acutely rejecting cardiac allografts at day 5 and day 7. Further studies demonstrated that NFATc1 activity in splenocytes, which markedly upregulated during acute rejection, was completely inhibited by CsA. CONCLUSION: Lptn appears to be a key chemokine of lymphocyte infiltration during acute allograft rejection. Inhibition of NFATc1 activity by CsA seems to decrease Lptn expression incompletely, suggesting that there was else mechanism to regulate Lptn expression other than NFAT pathway.

Objective To investigate the clinical features and the management of primary pigmented nodular adrenocortical disease PPNAD) and to evaluate its relationship with Carney complex. Methods One case of PPNAD reported. The patient was a 52 years oldmale. He was hospitalized because of hypertension for one year. The patient had a Cushing's face with elevated plasma and urine cortisone levels which could not be suppressed by both low dose and high dose dexamethasone tests. Ultrasonography howed normal bilateral adrenal glands. CT scan found a 1.6 cm × 2.0 cm mass in the left adrenal gland and normal on tralateral adrenal gland. Results The patient had accepted left laparoscopic adrenalectomy. The pathological examination onfirmed the diagnosis of PPNAD. Micro scopic study showed that there were black-gray spots in the center of the specimen. Hyperplasia was found in all the three adrenal zones. Lipofuscin was observed in the cytoplasm of reticular zone cells. The patient's blood pressure had returned to normal level after the surgery. Conclusions PPNAD is a rare type of ypercortisolism. As there is no specific feature in clinical manifestation and radiological examination of this disease, it is very easy to make a misdiagnosis in clinical practice. PPNAD itself can be the comorbidity of Carney complex, careful differentiation is needed.

AIM:To establish a rat hyperlipidemia model for studying the aortic expression of heat shock protein 22 (HSP22), tumor necrosis factor alpha (TNF-α) and endothelial nitric oxide synthase (eNOS) and the effect of atorvasta-tin intervention.METHODS:Hyperlipidemia model was established in SD rats.Afterwards, the rats were divided into nor-mal control group, high fat group and high fat+atorvastatin intervention group.The expression of HSP22 and TNF-αin the rat aortas was detected by immunohistochemical assay and the expression of eNOS was assessed by Western blotting.RE-SULTS:No detectable expression of HSP22 and TNF-αin the normal control group was observed.However, the expression of HSP22 and TNF-αwas positive in the high fat group and the atorvastatin intervention group.The mean densities of HSP22 and TNF-αpositive particles were significant lower in the atorvastatin intervention group as compared with high fat group ( both P<0.05) .The expression of eNOS protein in the high fat group and atorvastatin intervention group was significantly lower than that in normal control group (P<0.01).However, no marked difference of eNOS protein expression between high fat group and atorvastatins intervention group was observed.CONCLUSION:The expression of HSP22 and TNF-αin the rat aortas is increased in the hyperlipidemia rat model.This effect can be restored by atorvastatin treatment.The expression of eNOS in the rat aortas is decreased in the hyperlipidemia rat model, but this tendency could not be attenuated by atorvastatin.