AIM: To analyze the common causes and treatments methods of high intraocular pressure (>21mmHg) after trabeculectomy.
METHODS: Twenty-four eyes of glaucoma patients with high intraocular pressure after trabeculectomy in our hospital from July 2010 to September 2014 were retrospectively studied. The common cause and processing methods were analyzed.
RESULTS:The causes which lead to early postoperative high intraocular pressure included high filtering bleb scar in 11 eyes ( 46%) , filtration obstruction in 4 eyes ( 17%) , malignant glaucoma 3 eyes ( 12%) , iris resection of malignant glaucoma unreasonable 2 eyes ( 8%) , hyphema 2 eyes ( 8%) , wrap cystic filtering bleb 2 eyes (8%), etc. After proper treatments, intraocular pressures of all patients were bellowed 21mmHg.
CONCLUSION: High intraocular pressure with surgery for glaucoma is caused by multiple factors, preoperative and intraoperative avoid as far as possible, postoperative early detection for symptomatic treatment is the key to successful operation.

Objective To investigate the correlation of epidermal distribution of lamellar bodies and expression of ceramidase with skin barrier dysfunction in polymorphous light eruption.Methods Forty-seven patients with polymorphous light eruption and 40 healthy volunteers were recruited into this study.Noninvasive instruments were used to measure skin sebum content,transepidermal water loss(TEWL)and water content in stratum corneum in all of the subjects.Then,tissue specimens were obtained from the lesions at sunexposed sites in the patients and normal skin of the healthy volunteers.The ultrastructure and distribution of lamellar bodies were observed with transmission electron microscopy in five lesion and control specimens.Immunohistochemistry was performed to detect the expression of ceramidase in the tissue specimens.Results Compared with the normal skin from healthy volunteers,the lesions from patients showed decreased number of lamellar bodies in the granular layer and prick cell layer with a disorganized arrangement.Ceramidase was positively expressed in 20 lesion specimens and 36 normal control specimens,weakly expressed in 21 lesion specimens and 4 normal control specimens,and negative in 6 lesion specimens; there was a significant difference in the expression of ceramidase between the lesion specimens and normal control specimens(P ＜ 0.01).The lesions also showed high TEWL(34.2191 ± 12.70 vs.16.8350 ± 6.50,P ＜ 0.01),lower water content in stratum corneum(22.7319 ± 8.71 vs.29.4250 ± 5.08,P ＜ 0.01)and similar skin sebum content compared with the normal skin.Conclusions There is a disturbance in the synthesis of ceramide in patients with polymorphous light eruption,which may contribute to the impairment of skin barrier.

Although the type of XHD150B-IO 800mA X-ray machine possesses a damage protection electric circuit for the main thyristors, with the first switch of photographic hand valve pressed, abnormal instant exposure still appears when double (in different phase) or more than three main thyristors are broken through, short-circuited or mis-energized, and consequently the high voltage element or X-ray machine will break down. Therefore the original electric circuit must be improved. Material: A few of leads. Method: We exchange the conjunction sequence of three NO (normal open) contacting points of radiograph high voltage preparing work relay--MAG SW- R with three reverse parallel connection of main thyristors. Conclusion: The normal procedure of radiographic exposure won't be disturbed after the improvement. When whichever one or more than two main thyristors is broken through, short-circuited or mis-energized, the spoilage can be detected instantly and the protection circuit works correspondingly, which guarantees the safety of X-ray machine.

Objective:To explore the resource of rice bran by comparing antioxidative activities and growth promotion of Bacillus bifidus between supernatant of formented rice bran(RBF) by Bacillus natto and water extract of rice bran(RBW) . Method:The reducing capacity the?OH and ??O 2 scavenging capacity and the inhibitory effect to oxidize lard were determined in vitro. The growth promotion for Bacillus bifidus by photodensity with simulated condition was investigated in vivo. Results:RBF and RBW had antioxidant activity in vitro. The IC50 of scavenging?OH and ??O 250 of RBF was 3.55 mg/ml and 23.5 mg/ml,0.3 and 10 folds higher than that of RBW respectively. In inhibiting oxidation of lard,RBF had a little higher antioxidative activities than RBW,near VE. RBF and RBW could promot growth of Bacillus bifidus by 65.2% and 17.8% respectively. By enzymatic digestion,the promotive rate of RBF was still 51.6%. Conclusion:RBF had higher antioxidant activity and growth promotion to Bacillus bifidus.

Background Trans-corneally subretinal injection in rodent model is a useful method for genetic therapy,stem cell transplantation and the study on the ophthalmic research.Standarized operation process is critical for the successful treatment.However,there is no literature to report the detailed procedure and the influence of this technique on morphology and function of retina.Objective This sudy was to introduce a method of trans-corneally subretinal injection and evaluate its influence on the morphology and function of retina.Methods Trans-corneallly subretinal injection was performed on the left eyes of 2-month-old SPF C57BL/6J mice after dilation of pupils.A 301/2G disposable needle was used to puncture the cornea within the pupil area near limbus and avoid touching the lens and irises under eye surgery microscope.Then,a 33G blunt needle was used to insert into the vitreous and toward subretinal space via corneal puncture.Normal saline with 0.1％ fluorescein sodium of 1 μl was slowly injected into the space,and 2.5％ hydroxypropyl methylcellulose was dropped on ocular surface for the observation of the fundus clearly.According to the percentage of the retina filled with subretinally injected solution,the experimental eyes were divided into 80％-100％ area group,50％-70％ area group after injection,and the mice in the pseudo-injected group,in which injection procedure stopped just before the solution was pushed in to the subretinal space did not inject any solution after punctured.The right uninjected eyes of the mice served as normal control group.Four eyes were selected for each group.The structural changes were evaluated by optical coherance tomograpby (OCT) 1 day,2 days,3 days and 5 weeks after injection,and retinal function was assessed by the recored of electroretinography (ERG) 5 weeks after injection.The retinal sepcimens were prepared to examin the morphological changes by hematoxylin and esosin staning.The use of care followd the Regulations for the Administration of Affair Concerning Experimental Animals of Zhejiang Province.Results About 70％ of the injected eyes showed that retinal blebs filled with injected green fluorescein solution occupied 50％ or more retinal area with minimal damages.The focal detachment between neurosensory retinal layer and retinal pigment epithelium (RPE) was exhibited 1 day postinjection,and almost all the retinas retached 2 days after injection.In the fifth week after injection,the amplitudes of ERG b wave were (386.25±37.88),(357.50±41.03),(324.25±53.45) and (410.50±14.88) μV in the sham operation group,50％-70％ area group,80％-100％ area group and normal control group,respectively,showing a significant difference among the 4 groups (F=3.574,P=0.047),and the amplitudes of b wave in the normal control group were higher than those in the 80％-100％ area group (all at P ＜ 0.05).The detachment between retinal neuroepithelium layer and RPE layer,cell proliferation and transposition in the outer nuclear layer were dispalyed under the light microscope in the sham operation group,50％-70％ area group and 80％-100％ area group,and the disordered outer segment of photoreceptors at the injecting area was seen in the 50％-70％ area and 80％-100％ area groups at five weeks after injection.However,retinal sructure and morphology were normal at the non-injection area.Conclusions Trans-corneally subretinal injection is an effective and safe way for subretinal injection.

It is necessary to medical student to take the elective course of pharmacy.This paper put forward several viewpoints and concrete methods about teaching methods,means and contents of elective course of pharmacy.

Objective Toinvestigatetheprevalenceofurinaryincontinenceanditseffectonlifequalityamongfemale adultsinHangzhou,andtoprovideevidencetothecontroloffemaleurinaryincontinence.Methods Aquestionnaire survey was performed in Gongshu and Xiacheng districts in Hangzhou from October 2013 to June 2014,and 4 563 women aged over 20 years were interviewed through a questionnaire including International Consultation on Incontinence Questionnaire Lower Urinary Tract,IQ-FLUTS and demographic information.Single and multi factor logistic regression analysiswereusedtoanalyzetheriskfactorsofurinaryincontinence.Results Atotalof4785questionnairesweresent, and 4 563 effective questionnaires were recovered,with a recovery rate of 95.4%.The prevalence of urinary incontinence was 33.5%(1 530/4 563),and female with older age tended to have a higher prevalence of UI(P<0.01).Among which stress urinary incontinence (SUI ),urge incontinence (UUI )and mixed urinary incontinence (MUI ) were accounted for 20.2%(922/4 563),3.0%(135/4 563)and 10.3%(473/4 563)respectively.UUI and MUI had a greater effect on quality of life.According to the multi factor logistic regression analysis,gravidity,age,constipation,pelvic surgery and fat (BMI>24)wereriskfactorsforurinaryincontinence(P<0.05).Conclusion Becauseofthehighprevalenceofurinary incontinence among female adults,more attention should be paid to urinary incontinence suffers in order to improve the quality of life of female adults.

OBJECTIVETo investigate the effects of the plasma containing Qianlongtong Capsule (QLT)-containing plasma on the expression of the Smad4 gene in prostate stromal cells in vitro and provide some experimental evidence for the treatment of benign prostatic hyperplasia (BPH) with Chinese medicinal compound.

METHODSFifteen cases of BPH were equally randomized to three groups to be treated with QLT at a high dose (6 capsules once), a medium dose (3 capsules once), and a low dose (1.5 capsules once), tid, for 7 days consecutively. QLT-containing plasma was collected from the patients. Prostate stromal cells were identified by immunofluorescence when they became monolayered and cultured in the QLT-containing plasma for 24 hours, followed by detection of the expression of the Smad4 gene by real-time quantitative PCR and that of the Smad4 protein by Western blot.

RESULTSAfter treatment with the QLT-containing plasma, the expression of the Smad4 gene in the stromal cells was significantly increased in a dose-dependent manner as compared with the blank control and no-QLT groups (P < 0.01). The expression of the Smad4 protein was also markedly elevated after treatment. The differences were statistically significant between the blank control and medium-dose groups (P < 0.01), low-dose and medium-dose groups (P < 0.05), and high-dose and the other groups (P < 0.01), but not between the blank control and low-dose groups (P > 0.05).

CONCLUSIONQLT-containing plasma could inhibit the proliferation and improve the apoptotic index of prostate stromal cells in vitro, which was related to the elevation of the mRNA and protein expressions of Smad4.

Apoptosis ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Male ; Prostate ; drug effects ; metabolism ; RNA, Messenger ; genetics ; Smad4 Protein ; genetics ; metabolism ; Stromal Cells ; drug effects ; metabolism

BACKGROUND: Primary studies suggest that coronary artery stenosis is highly exactly shown by 16-slice spiral CT coronary artery imaging.OBJECTIVE: To compare the accuracy and limitation between coronary angiography and multi-slice computed tomography (MSCT) coronary artery imaging to diagnose moderate and severe coronary artery stenosis. DESIGN, TIME AND SETTING: Clinical diagnostic study based on gold standard, which was carried out in the Department of Cardiology, Xuanwu Hospital, Capital Medical University from June 2005 to March 2006. PARTICIPANTS: Twenty-eight patients with suspected coronary arteriosclerotic heart disease were examined by 64-slice spiral CT coronary artery imaging and coronary artery angiography during the 1-month hospitalization in the Department of Cardiology, Xuanwu Hospital, Capital Medical University from June 2005 to March 2006. METHODS: 280 segments of 28 patients were quantitatively analyzed coronary artery stenosis by selective coronary artery angiography and multi-slice spiral CT imaging based on eye-measurement diameter method. MAIN OUTCOME MEASURES: True positive, true negative, false positive, false negative, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of coronary artery stenosis were measured by multi-slice spiral CT imaging.RESULTS: All 28 patients were included in the final analysis. Multi-slice spiral CT imaging showed that the sensitivity, specificity, positive predictive value, and negative predictive value were 46.5%, 97.6%, 86.8%, and 84.3%, respectively. If excluding the effect of 31 coronary segments with severe calcification, the sensitivity, specificity, positive predictive value and negative predictive value were 66.7%, 98.6%, 90.3% and 93.6%, respectively.CONCLUSION: Multi-slice spiral CT imaging is simple, reliable, noninvasive and safe; moreover, it has a good potential for diagnosing especially excluding coronary arteriosclerotic heart disease, but still some limits.

ObjectiveTo explore the effects of epidermal proteins and lamellar bodies on skin barrier in glucocorticoid-dependent dermatitis.MethodsTotally,60 patients with glucocorticoid-dependent dermatitis and 40 normal human controls were eligible for this study.A noninvasive method using TewameterTM was applied to determine transepidermal water loss (TEWL) value in these subjects.Tissue specimens were obtained from the lesions of 13 patients with glucocorticoid-dependent dermatitis and normal skin of 10 human controls.Subsequently,haematoxylin and eosin(HE) staining was performed to observe the histopathological changes,immunohistochemistry to detect the protein expressions of K6,K10,K14,K15,loricrin,filaggrin,involucrin in epidermis,and electron microscopy(EM) to estimate the density of lamellar bodies in tissue specimens.ResultsCompared with the normal controls,the patients displayed an elevated TEWL value (P ＜ 0.05),which suggested an impaired epidermal barrier.Histopathology of lesions revealed nonspecific inflammatorychanges withmarkeddifferencesbetweendifferentclinicaltypesofglucocorticoid-dependentdermatitis.Immunohistochemistry revealed an attenuated expression of K10,K14,loricrin,filaggrin,involucrin and abnormal expression of K15 in lesional epidermis compared with the normal epidermis (all P ＜ 0.05),hinting a suppression of epidermal differentiation and proliferation as well as an impairment of cornified envelope structure.The number and density of lamellar bodies were also reduced in lesional epidermis compared with the control epidermis.ConclusionsCompared with normal skin,the structure of skin barrier is impaired in lesions of glucocorticoid-dependent dermatitis,to restore skin barrier is essential for the treatment of this entity.