Glaucoma is the first leading cause of irreversible blindness and the second leading cause of blindness worldwide. Numerous studies have shown that elevated intraocular pressure ( IOP ) is one of the major risk factors for the development and progression of glaucomatous optic nerve damage. However, there have been 50% of primary open-angle glaucoma ( POAG ) patients with typical glaucomatous optic neuropathy in whom the IOP measurements have always been in the normal range, and some patients develop typical glaucomatous optic neuropathy with the well controlled IOP. These phenomena cannot be explained by the theory of high intraocular pressure. The pathogenesis of glaucomatous optic nerve damage in these patients with normal IOP needs to be further discussed. Numerous studies at home and abroad have shown that: 1. the surrounding anatomy of the optic nerve including the IOP, the anatomy and biomechanics of the lamina cribrosa and retrobulbar orbital cerebrospinal fluid pressure may be of importance for the pathogenesis of the POAG;2. patients with normal tension glaucoma had significantly lower cerebrospinal fluid pressure and a higher trans - lamina cribrosa pressure difference compared with normal subjects; 3. patients with ocular hypertension had significantly higher cerebrospinal fluid pressure, however, there is no difference in trans -lamina cribrosa pressure compared with normal subjects. Based on the above research, now we make a review about the research advance of the relation between intracranial pressure and glaucoma optic nerve damage and the available measurements about noninvasive intracranial pressure in clinical in this paper.

Objective To assess the accuracy and safety of inserting K-wires by a spinal minimally invoive robot system into cattle spines. Methods With a program shown on the screen of a C-arm fluoroscopy system,194 nails were placed ino 17 cattle spines by a spinal minimal invasive robot system which had been developed jointly by Shenyang Institute of Autmation Chinese Academy of Sciences and our institute.Radiation frequency,radiation exposure time,operation time and deviation of drills were recorded and analyzed. Results The mean deviation in the lateral projections by the spinal minimally invasivc robot system was smaller than in the anteroposterior projections.In lateral projection,the deviations within 1 mm,2 mm and 3 mm accounted respectively for 91.6％,99.5％ and 100％.In anteroposterior projection.the deviations within 1 mm,2 mm and 3 mm accounted respecrvely for 71.1％,89.6％ and 94.8％.The mean drilling time,the mean radiation frequency and the mean radiation time per hole by the robot system were respectively 420 seconds (from 330 to 577 seconds),13 times (from 8 to 21 times) and 9 seconds (from 8 to19 seconds).There was a learning curve in mastering the system.Training for a period of time made the accuracy within 2 mm in both lateral and anteropsterior films 95.6％ of the deviations in lateral films and 92.1％ of the deviations in anteroposterior films were less than one mm. Conclusions Operators of the spinal minimally invasive robot system can avoid intraoperative X-ray radiation.The flexibility and accuracy of the system can completely satisfy the clinical needs of spinal surgeons,but there must be a learning curve.

OBJECTIVE: To investigate whether sodium magnesium fructose diphosphate(SM) could raise the contents of energy sustrates-ATP, ADP and AMP in the tissues of acute myocardial infarction.METHODS: 60 rat models of acute myocardial infarction were randomly divided into 6 groups(n = 10): Treatment groups(A, B, C) received SM(75mg/kg, 38mg/kg and 19mg/kg) in saline sulution respectively, and control groups (D, E) received 1,6 - fructose diphosphate (200mg/kg) or magnesium sulfate(10mg/kg), another control(F) received same volume of saline.Four hours after administration, the levels of ATP,ADP and AMP in the myocardial homogenate were determined by HPLC.RESULTS:The levels of ATP, ADP and AMP of treatment groups(A, B, C) were (612.8± 103.2)、 (538.0± 141.2) and (325.2± 113.2) nmol/g; (407.6± 113.4)、 (389.4±91.5)、 (306.1 ± 134.6) nmol/g and ( 1 637.6 ± 236.8)、 (1 366.8± 279.3)、 ( 1 186.1 ± 341.1) nmol/g; while those of control groups(F) were (119.0± 22.8)、 (146.5± 36.8)、 (436.7± 214.9) nmol/g, respectively(P＜ 0.01 of 0.05) .CONCLUSION: SM can raise the contents of energy substrates- ATP,ADP and AMP in the tissues of acute myocardial infarction.

Objective To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter.Methods A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test. The catheter was withdrawn step by step and the injection test was repeated until the presence disturbance wave presented, which indicated that the balloon had just entered the esophagus. The position where disturbance wave appears was named 0 cm. End-expiratory occlusions were performed at the positions of+15,+10,+5, 0, -5, -10 and -15 cm, respectively, and the changes of esophageal pressure (Pes) and airway pressures (Paw) were measured in the spontaneous breathing and passive ventilation, and the ratio between the changes (ΔPes/ΔPaw) was calculated.Results A total of 20 patients were enrolled, of which 15 patients finished both the spontaneous and the passive ventilation parts, and 2 patients finished only the spontaneous part and 3 patients finished only passive part. ① Disturbance waves could be induced by injection test in all patients. The average depth of disturbance wave in spontaneous breathing was deeper than that in passive ventilation (cm: 42.4±3.8 vs. 41.8±3.3), but there was no significant difference between the two ventilation settings (P = 0.132). No adverse events occurred during the study period. ② Pes increased with the stepwise withdraw of esophageal catheter, reached the maximal value at+5 cm, and then decreased when the catheter was further withdrawn, no matter in the spontaneous or the passive ventilation. In spontaneous breathing, the ΔPes/ΔPaw was within the ideal range (0.8-1.2) at the positions of 0, -5 and -10 cm. The ΔPes/ΔPaw was closest to unity at the positions of 0 cm (0.98±0.15). The ΔPes/ΔPaw at -15 cm (0.66±0.26) was significantly lower than that at 0 cm (P < 0.05). For passive ventilation, the ΔPes/ΔPaw was within the ideal range at the positions of -5 cm and -10 cm, and the ΔPes/ΔPaw was closest to unity at the positions of-10 cm (0.94±0.12). The ΔPes/ΔPaw at 0 cm and -5 cm was significantly higher than that at -10 cm (1.43±0.31 and 1.12±0.14, respectively); while the ΔPes/ΔPaw at -15 cm (0.68±0.23) was significantly lower than that at -10 cm (allP < 0.01).Conclusions Ideal position of the esophageal balloon catheter could be determined quickly and easily by using injection test. The method is safe and clinically feasible.Clinical Trial Registration Clinical Trials, NCT02446938.

Objective To study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients' survival rate.Methods From Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Log-rank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4-131 months.Results Single factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.Conclusion Independent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.

OBJECTIVE: To investigate whether sodium magnesium fructose diphosphate(SM) could raise the contents of energy sustrates-ATP, ADP and AMP in the tissues of acute myocardial infarction.METHODS: 60 rat models of acute my-ocardial infarction were randomly divided into 6 groups(n = 10): Treatment groups( A, B, C) received SM(75mg/kg, 38mg/kg and 19mg/kg) in saline sulution respectively,and control groups(D.E) received 1,6-fructose diphosphate(200mg/kg) or mag-nesium sulfate( l0mg/kg) ,another control(F) received same volume of saline.Four hours after administration, the levels of AT-P.ADP and AMP in the myocardial homogenate were determined by HPLC.RESULTS:The levels of ATP, ADP and AMP of treatment groups(A, B, C) were (612.8? 103.2), (538.0??141.2) and (325.2 ? 113.2) nmol/g; (407.6?113.4), (389.4 ? 91.5), (306.1??34.6) nmol/g and (1 637.6? 236.8), (1 366.8??279.3), (1 186.1 ??341.1) nmol/g; while those of control groups(F) were (119.0 ? 22.8), (146.5??36.8) , (436.7 ? 214.9) nmol/g, respectively(P

Objective To determine levels of nuclear factor (NF)-κB, interleukin (IL)-10, and visfatin in adipocytes treated by different degrees of intermittent hypoxia (IH), and to investigate the mechanism of IH leading to insulin resistance (IR). Methods The cell model of intermittent hypoxia/re-oxygenation (IH/ROX) in obstructive sleep apnea (OSA) was established. Differentiation mature 3T3-L1 adipocytes, were randomly divided into 10 groups including four different-frequency intermittent hypoxia groups(IH1-4, fixed intermittent hypoxia scheme for 1.5%O2 45 s and then re-oxygen 21%O2 for 2 min 15 s, 4 min 15 s, 5 min 45 s and 8 min 45 s, 60 times circulation), and their normal oxygen control groups (SC1-4, instead each IH group 1.5%O2 to 21%O2, the rest groups were treated as same as IH group), continuous hypoxia group (CH, 10%O2 for 6 h) and normal oxygen control group (CC, 21%O2 for 6 h). ELISA method was used to determine the levels of IL-10 and visfatin in the supematant of adipocytes. Western blot method was used to determine the protein levels of NF-κB p65 and visfatin. Real-time PCR method was used to determine the mRNA levels of IL-10 and visfatin. Results The protein and mRNA expressions of IL-10 were significantly lower in IH group and CH group than those of control groups (P<0.01). The levels of NF-κB p65 protein were significantly increased in IH group and CH group than those of control group. The protein and mRNA expressions of visfatin were significantly higher in IH1, IH2 and CH groups than those of control group (P<0.01). Conclusion As a prominent feature of OSA pathophysiology, IH may take part in insulin resistance of OSA patients by abnormally secreting NF-κB, IL-10 and visfatin in adipocytes.

Objective To analyze the effect of health education on recurrence of acute pancreatitis in discharged patients. Methods All patients with acute pancreatitis accepted health education during the first hospitalization.92 patients were randomly allocated to the trial group and the control group.The trial group was kept on being treated with health education for 18 months after discharged form the hospital but the control group didn' t.Results The recurrence rate of trial group was 8.50% but the control group was 24.44%(P

Objective To investigate the effect of atorvastatin on the expressions of long non-coding RNA (LncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1)and inflammation factors in human umbilical vein endothelial cells (HUVECs) stimulated by high glucose. Methods The expression of MALAT1 in HUVECs incubated with high glucose(30 mmol/L) for different time periods were detected by real-time PCR. Under high glucose condition, the expressions of MALAT1, interleukin-6(IL-6), and interleukin-8 (IL-8) in HUVECs were detected after MALAT1 was silenced by siRNA or atorvastatin was added. Results (1) After HUVECs were incubated with high glucose for different time periods, the expressions of MALAT1 were increased to some extent(P<0.05), with the peak at 12h (P<0.01). The levels of IL-6 and IL-8 expression and secretion were increased after HUVECs were stimulated by high glucose for 12h (P<0.05). (2)The silence of MALAT1 markedly suppressed high glucose-stimulated expression and secretion of IL-6 and IL-8 (P<0.05). (3) Atorvastatin significantly inhibited high glucose-stimulated expressions of MALAT1, IL-6, and IL-8(all P<0.05). Conclusions High glucose induces the secretion of inflammatory factors by stimulating MALAT1 expression in endothelial cells. Atorvastatin significantly inhibits high glucose-stimulated MALAT1 expression and decreases inflammatory reaction.

Objective To analyze risk factors and antimicrobial use for hospital-acquired pneumonia (HAP)due to multidrug-resistant organisms (MDROs)in an intensive care unit(ICU),so as to perform risk assessment and guide antimicrobial use.Methods From January 2012 to December 2013,HAP patients were conducted retrospective co-hort study,risk factors for MDRO-HAP and rationality of antimicrobial use were analyzed.Results A total of 110 cases of HAP occurred in ICU,63 cases (57.27%)were MDR-HAP.Logistic regression analysis revealed that re-cent hospital stay ≥5 days (OR=19.94),transference from other hospitals (OR =19.33),infection type of late-onset HAP (OR=7.98),and antimicrobial use in recent 90 days (OR =3.42)were independent risk factors for MDR-HAP.Initial empirical anti-infective treatment revealed that there were no significant difference in timing of antimicrobial administration within 24 hours after clinical diagnosis was confirmed,and rationality of antimicrobial selection between MDR-HAP group and non-MDR-HAP group (both P >0.05);The isolation rate of pathogens in MDR-HAP group was lower than non-MDR-HAP group (73.02% vs 91 .49% P <0.05 ).Targeted antimicrobial therapy revealed that there were no significant difference in selection,dosage,and frequency of antimicrobial use be-tween two groups(all P >0.05 );the rationality rate of therapy course in MDR-HAP group was higher than no-MDR-HAP group,but rationality rate of combination use of antimicrobial agents was slightly lower than the latter (both P < 0.05 ).Conclusion Patients in ICU should be conducted risk factor assessment,and according prevention and control measures should be formulated,so as to reduce the occurrence of MDR-HAP,health care workers should standardized the initial empirical anti-infective treatment.