AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Animals ; Animals, Newborn ; Disease Models, Animal ; Enterocolitis, Necrotizing ; chemically induced ; Female ; Male ; Platelet Activating Factor ; toxicity ; Rats ; Rats, Sprague-Dawley ; Sulfalene ; toxicity ; Tumor Necrosis Factor-alpha ; toxicity

Objective: To investigate the effect of adhesion of Lactobacillus reuteri JCM1081 to enterocyte-like HT-29 cells on filamentous cytoskeleton.Methods:Cultured human intestinal enterocyte-like HT-29 cells were used.Cell permeability was examined in vitro by Evans blue labeled albumin and Examination of F-actin was conducted by direct immuno-fluorescence labeling using fluorescein labeled phalloidin.Results:Lactobacillus reuteri JCM1081 did not alter cell integrity and prevented the increase in permeability induced by enteropathogenic Escherichia coli infection.The distribution of F-actin were also not altered.Conclusion :Lactobacillus reuteri JCM1081 exerts a protective effect against the filamentous cytoskeleton rearrangement and permeability lesions promoted by enteropathogenic Escherichia coli infection.

Objective To study the adhesive characters of Lactobacillus to enterocyte-like HT-29 cells.Methods A HT-29 cell culture was employed to investigate the adherent ability of Lactobacillus.Bacterial suspension and HT-29 cells were co-incubated at 37℃ for 1h.The cells with adherent bacteria were Gram-stained,and then examined microscopically under oil immersion.The pH of the medium,bacterial growth phase,co-incubation time,bacterial concentration,D-mannose and type of host cells,which were involved in the process of adherence of Lactobacillus to enterocyte-like HT-29 cells,were also investigated.Results The adherent level increased substantially for Lactobacillus reuteri JCM1081 as the pH decreased from 6.0 to 4.0.Maximum adherence occurred within 90min and remained stable until the end of incubation.The bacterial concentration exerted a certain influence on the adherence of Lactobacillus reuteri JCM1081 to HT-29 cells,and it seemed to be concentration dependent.Maximum adherence occurred in the concentration of 109cfu/ml and remained stable until the end of incubation.Lactobacillus strain that grew into stationary phase showed higher ability to adhere to HT-29 cells than that in logarithmic phase.The addition of D-mannose dramatically decreased the level of Lactobacillus adherence.The Lactobacillus strain adhered in higher levels to the enterocyte-like cells or gastric epithelium cells than other cell origins,and the adhesion of Lactobacillus showed host cells specificity.Conclusion The adhesive characters observed with Lactobacillus suggested that adhesive properties are species and host specific.The pH,bacterial growth phase,co-incubation time,bacterial concentration and D-mannose may influence the adhesion of Lactobacillus to enterocyte-like HT-29 cells.

Objective To investigate bacterial spectrum characteristics and distribution of urinary tract infections with different time phase in intensive care unit(ICU).Methods From January 2012 to March 2013,the clinical data of 1330 cases in ICU,treated with urinary catheter indwelling,was retrospectively reviewed.Among them,705 cases were male and 625 cases were female.Their age ranged from 11 to 94 years old,mean (55.4 ± 19.2)years old.Acute physiology and chronic health scores (APACHE Ⅱ) were 1 to 69,mean 17.1 ±9.3.Duration of catheter indwelling ranged from 1 to 28 days,mean 23 days.The urine was collect through catheter via sterile syringe for bacterial culture.The incidence of urinary tract infection,bacterial infection spectrum,composition ratio and bacteria distribution in 1,2 and 4 weeks after admission were recorded.Results Total urinary tract infection cases were 36(2.7％).There were 15 urinary tract infection cases in 625 famale cases(2.4％),There were 21 cases in 705 male cases (3.0％).49 pathogens were obtained,including 32 gram-negative bacilli (65.3％),17 gram-positive cocci (32.7％) and 1 fungus 2.0％.Enterococcus faecium (30.6％),E.coli (22.4％),Acinetobacter baumannii(10.2％),and Klebsiella pneumoniae (10.2％) were the predominant species.According to hospitalized time,the bacteria spectrum distribution showed Gram negative bacilli were 50.0％ (8 pathogens),57.1％ (4 pathogens),76.9％ (20 pathogens) and Gram positive bacteria were 43.8％ (7 pathogens),42.9％ (3 pathogens),23.1％ (6 pathogens) in the differet observed time point,respectively.A fungus was only observed in the first week after admission 6.3％.Concluusions Gram-negative bacilli were predominant bacterial of urinary tract infections in ICU patients.The incidence of fungus infection was low.E.coli,Acinetobacter baumannii and Klebsiella pneumoniae were the predominant species in Gramnegative bacilli.And Enterococcus faecium was the predominant specie in gram-positive cocci.It was similar for gram-negative bacilli and gram-positive cocci in the first two weeks.After two weeks Gram-negative bacilli turned to the main species.

Objective To observe the short -term effect and safety of entecavir in the treatment of 50 patients with decompensated liver cirrhosis.Methods 92 patients with decompensated liver cirrhosis met the inclusion criteria in our hospital were selected as study subjects.The patients were randomly divided into the observation group (46 cases)and the control group(46 cases).The control group received routine treatment,including the liver,liver, diuretic,jaundice,symptomatic and supportive treatment and prevention of complications.The observation group was given entecavir for 48 weeks on the basis of the control group,0.5 mg /times,qd.The clinical effects were assessed after treatment.Results The HBV -DNA,ALT,TBIL,Child -Pugh score of the observation group and the control group after treatment were (2.05 ±0.32)log10 IU /mL and (3.11 ±0.36)log10 IU /mL,(32.1 ±8.5)U /L and (90.3 ±12.6)U /L,(27.8 ±7.1 )μmol/L and (35.3 ±8.2)μmol/L,(6.42 ±1.24)points and (9.20 ± 1.46)points,which were significantly lower than before treatment (t =6.563 and 5.341,11.266 and 7.044,7.346 and 6.013,6.252 and 4.423,all P <0.05).The ALB levels were (38.5 ±2.9)g/L and (34.4 ±3.0)g/L,which were significantly higher than before treatment(t =4.812 and 3.701,all P <0.05).The HBV -DNA,ALT,TBIL, Child -Pugh score of the observation group after treatment were significantly lower than the control group (t =3.335, 3.431,3.411,3.204,all P <0.05).The ALB of the observation group after treatment was significantly higher than the control group (t =3.034,P <0.05).There were two cases of deaths(4.45%)in the observation group,8 cases of deaths(17.39%) in the control group because of progressive deterioration,there was significant difference in treatment outcome between the two groups(χ2 =4.039,P <0.05).Conclusion Entecavir can delay progression, effectively reducing HBV -DNA,improve liver function and Child -Pugh score in the treatment of patients with decompensated liver cirrhosis,it can be used as first -line drug use.

Objective To explore the clinical character istics of bile reflux gastritis. Methods We observed 1328 patients with bile reflux gastritis(excluding gastritis of the remnant stomach),and selected 425 superficial gastritis as control group.All the patients took helicobacter pylori(Hp) rapid urease examination. 664 cases in observed group and all in patients of control group were examined for bile disease by UB. Results In 1328 patients,there were 797 male and 531 female,and the ratio of male and female was 1.5/1.The detecting rate of bile reflux gastritis was decreased along with aging. Among all the patients,there were 651 simple superficial gastritis(49%),86 gastric ulcer(6.5%),412 duodenal ulcer (31%),122 combined ulcer(9.2%) and 57 other disease(4.7%).In observed group,1030 HP(77.56%) were regative; 298 Hp(22.44%) were positive,and in control group,282 Hp(66.35%) were regative,147 Hp(33.65%) were positive.The amount of gallbladder disease resection was 221(33.3%),which was more than that of control group(16.9%). Conclusion The detecting rate of bile reflux gastritis was decreased along with aging.Bile reflux gastritis is more often combined with ulcer disease or gallbladder disease. The Hp infection rate of bile reflux gastritis is significant lower than that of non-bile reflux gastritis.

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head.After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed,commonly according to the staging of necrosis.Conservative therapy is suitable for stage 0 ～Ⅰ,interventional therapy is suitable for stage Ⅱ～Ⅲ,operation is adapted for stage Ⅱ～ Ⅲ and femoral head collapse or degenerative changes.Avascular necrosis of the femoral head is a chronic and dysfunctional illness.Comprehensive treatment according to different stage is now the most popular.Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile.(J Intervent Radiol,2006,15: 636-639)

Irritable bowel syndrome (IBS)is a commonly seen digestive system disease,and its pathogenesis is not fully clarified.The treatment of IBS includes change of life style and diet habit,medicine and psychotherapy,yet the therapeutic efficacy is not satisfactory.Studies have shown that peppermint oil is an effective drug for IBS,which can ameliorate symptoms of IBS and raise the patients'quality of life.This article reviewed the advances in basic science and clinical studies on peppermint oil in treatment of IBS.

Objective To study the clinical value of 64-slice spiral computed tomography(64SCT) contrast-enhanced scan and three-dimensional reconstructed techniques in the diagnosis of complex congenital heart disease(CCHD). Methods 39 patients with CCHD underwent CT angiography and transthoracic echocardiograms (TTE). Of them, the electrocardiographic-gating technique was used in 8 cases. The accurate rates in diagnosing CCHD with CT, TTE and CT with or without electrocardiographic-gating were analysed compared with that of operation and χ~2 test using SPSS13.0 tool. Results A total of 102 cardiac deformities con-firmed by operations,those included 47 intracardiac deformities,the diagnostic accuracys with CT and TTE were 85.1% and 95.7%, respectively, and there was no obvious difference among them (χ~2=2.68, P>0.05). 55 extracardiac deformities, the definite diagnos-tic rates with CT and TTE were 98.2% and 78.2%, respectively. CT was superior to TTE in the indentification of extracardiac de-formities(χ~2= 14.64 ,P<0.01). There was no obvious difference between with and without electrocardiographic-gating technique during CT scanning in diagnosis of cardiac deformities(χ~2=1.84, P>0.05). Conclusion 64SCT has significant value in diagnosis of CCHD,and there was no obvious difference in diagnosis of cardiac deformities by 64SCT between with and without electrocardio-graphic-gating technic.