Objective To evaluate the effects of small dose of dopamine on the renal blood flow in the elderly patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Sixty elderly patients,of ASA physical status Ⅱ or Ⅲ,aged 65-74 yr,weighing 52-77 kg,scheduled for elective cardiac valve replacement under CPB,were randomized to receive either normal saline (group C,n =30) or dopamine (group D,n =30).After beginning of surgery,CPB was established routinely.In group D,dopamine was continuously infused for 20 min at a rate of 2 μg· kg-1 · min-1 starting from 10 min after the hearts were perfused with cardioplegic solution for the first time,while the equal volume of normal saline was given in group C.The left renal blood flow velocity was measured by transesophageal echocardiography and mean arterial pressure was recorded before and after dopamine infusion.Blood samples were obtained before surgery and at 24 h after surgery for determination of blood urea nitrogen concentrations.Results Blood urea nitrogen concentrations were significantly increased at 24 h after surgery than that before surgery in the two groups.There was no significant difference in mean arterial pressure and the left renal blood flow velocity before and after dopamine infusion between the two groups.Conclusion Small dose of dopamine (2 μg· kg-1· min-1) dose not increase the renal blood flow or improve the postoperative renal function in the elderly patients undergoing cardiac valve replacement under CPB.

AIM: To investigate effect of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer.
METHODS: A total of 83 cases ( 83 eyes ) with severe fungal corneal ulcer treated in our hospital from Jan. 2013 to Jan. 2016 were selected. Among them, 36 cases ( 36 eyes) were treated with drug therapy, and 47 patients(47 eyes ) were treated with autogenous conjunctival flap transplantation, two group did fungal culture and identification, observed the two groups treatment effect.RESULTS:The effective rate of surgical treatment group was 89%, significantly higher than that of drug treatment group, the difference was statistically significant ( P <0.05 ); The effective rate of surgical treatment of filamentous bacteria was 92%, which was significantly higher than that of drug treatment, the difference was statistically significant(P<0. 05). The effective rates of surgical treatment and drug treatment of yeast were 80%and 78%, the difference was not statistically significant( P<0. 05).
CONCLUSION: Autologous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer has good curative effect. The operation is simple, worthy of recommendation method. Filamentous bacterial corneal ulcer without good drug therapy effect, surgical treatment should be performed in a timely manner to improve the curative effect.

Objective To investigate the effects of cobalt chloride(COCl2)induced rat alveolar epithelial cell apoptosis and the significance of related apoptosis protein hypoxia inducible factor-lalpha(HIF-1 a)expression. Methods Alveolar epithelial cells were cultured in vitro and divided into four groups with 6 samples in each.Hypoxia 4 h group:added 500μmol/L COCl2 for 4 hours inducing alveolar epithelial cell hypoxia;hypoxia 24 h group:co-cultured with COCl2 for 24 hours;hypoxia 48 h group:co-cultured with CoCl2 for 48 hours;control group:no CoCl2 added.The apoptosis rates were detected by fluorescent microscope and flow cytometry.The apoptosis morphological changes of the cell were observed by transmission electron microscopy.The protein expression of HIF-la was detected bv Western Blot. Results (1)Fluorescent microscope results showed that apoptosis rate in hypoxia 4 h、24 h、48 h group[(5.83±0.76)%,(15.00±3.28)%and(51.50±3.00)%],were higher than control group[(1.50±0.50)%](P＜0.05).(2)Flow cytometry analysis reached the same results as with fluorescent microscope.(3)Typical morphological changes of apoptosis were observed in hypoxia 24 h group.(4)HIF-1α expression in hypoxia 4 h、24 h and 48 h groups[0.69±0.035,1.02±0.044 and 0.71±0.046],were higher than control group(0.21±0.026)(P＜0.01).(5)Positive correlations were found between relative amount of HIF-1αprotein and apoptosis rate by fluorescent microscope and flow cytometry analysis(r=0.484,P=0.016;r=0.713,P=0.009).Conclusions Hypoxia could induce apoptosis of alveolar epithelial cells,which may participate in the pathogenesis of hypoxia-induced lung injury.

Humans ; Noise, Occupational ; Occupational Exposure

Animals ; Brain Ischemia ; complications ; physiopathology ; Excitatory Amino Acid Antagonists ; pharmacology ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; etiology ; Receptors, N-Methyl-D-Aspartate ; antagonists & inhibitors ; physiology ; Signal Transduction ; physiology

ObjectiveThe investigate the action of self-care in geriatric type 2 diabetes patients.Methods96 geriatric type 2 patients were investigated through questionnaire. Results47 patients determined their blood sugar once or twice a week. 68 cases took medicine strictly.56 cases were good on alimentary control. 52 patients did exercise more than 1.5 h every day. The patients below 75 age old understood more about diabetes than that upward of 75.ConclusionTo improve the level of self-care on geriatric type 2 patients, the health care education must be done.

This study is undertaken to modify the chitosan nanoparticles (CS-NPs) with wheat germ agglutinin (WGA), and investigate the conjugation between WGA-CS-NPs and N-acetylglucosamine (NAG). CS-NPs were prepared by ionotropic gelation process and then conjugated with WGA under the activation of glutaricdialdehyde. The mean diameter of the CS-NPs was approximately 113.5 nm and the poly-dispersity index (PDI) was 0.18. The binding yield of WGA to CS-NPs was comprised between 27.8% and 87.9% depending mostly on the addition of 0.3% (w/v) glutaraldehyde solution. A competitive inhibition experiment of WGA-CS-NPs to bovine submaxillary gland mucin (BSM) was taken to illuminate the binding activity of WGA-CS-NPs to the sugar of N-acetylglucosamine. After the addition of NAG, the binding rates between CS-NPs and BSM almost didn't change, while the binding rates between WGA-CS-NPs and BSM dropped down significantly, which confirmed the specific binding characteristics of WGA to NAG.

Background Cataract surgery with replacement of the natural lens with an artificial intraocular lens(IOL) has developed into refractive surgery.Visual acuity is not the only evaluation criterion,but more focus has been put into the visual quality postoperatively.Aspherical IOL could improve the visual quality by decreasing the aspherical aberration.Objective This study was to investigate the short-term visual acuity,aberration alteration and clinical application of unsteady aberration aspheric IOL.Methods A retrospective case-controlled study was designed.Forty-two eyes of 30 patients with age-related cataract were included and divided into two groups.Phacoemulsification combined with unsteady aberration aspheric IOL implantation was performed in 21 cataractous eyes of the ZO group,and phacoemulsification combined with spherical IOL implantation in the other 21 eyes of the ADAPT group.Visual acuity,best corrected visual acuity (BCVA),contrast visual acuity,spherical aberration of the whole eye,contrast sensitivity (CS),dare sensitivity,modulation transfer function (MTF) and apparent accommodation were measured three months after surgery.All the parameters were compared between the two groups.The correlation of CS with the root mean square of spherical aberration,root mean square of comatic aberration and age was analyzed by multiple linear regression analysis.Written informed consent was obtained from each patient prior to operation.Results No significant differences were found in unconnected visual acuity,BCVA and spherical degrees between the ZO group and ADAPT group 3 months after surgery(P＞0.05).The CS value in the ZO group was significantly higher than that of the ADAPT group under scotopic background condition with spatial frequencies of 6,12,18 cpd,low glare the spatial frequencies of 6,12 cpd,as well as high glare with 12,18 cpd(P＜0.05).Under a scotopic background with 100％ contrast or a photopic background with 5％ contrast,the contrast visual acuity of the ZO group was significantly higher than that of the ADAPT group (t =20.217,P =0.000 ; t =4.568,P =0.039).At pupil diameters of 3,4 and 5 mm,the Z4 value was significantly lower in the patients of the ZO group than that of the ADAPT group (U =63.000,P =0.000 ; U =52.000,P =0.000 ; U =36.000,P =0.000).However,no significant differences were seen in the Trefoil aberration (Z6)value at 3 mm and 4 mm of pupil diameter(U =204.000,P =0.678;U =215.000,P =0.890) and coma aberration (Z7,Z8) value at 3,4 and 5 mm of pupil diameter between ZO group and ADAPT group(Z7:U=156.000,P =0.159 ; U =196.000,P =0.538 ; U =199.000,P =0.587 ; Z8:U=163.000,P =0.148 ;U=214.000,P =0.870;U =143.000,P =0.061).When the pupil diameter was 5 mm,Z6 value was significantly lower in the patients of the ZO group than that of the ADAPT group (U =4.000,P =0.000).The higher-order aberration MTF was significantly elevated in the ZO group compared with the ADAPT group from 5 through 20 cpd at a pupil diameter of 4 mm (P＜0.05) and 10,20,25,30 cpd at a pupil diameter of 5 mm (P＜0.05).A slightly lower objective accommodation was found in the ZO group compared with the ADAPT group without statistically significant difference(t =0.003,P＞0.05).Multiple linear regression analysis showed that the change in CS was associated with the root mean square of the spherical aberration and IOL type(β=0.544,R2=0.519,P =0.000)rather than with the root mean square of the comatic aberration and age.Conclusions The postoperative visual quality in the unsteady aberration aspheric IOL implanted eye is superior to that in the spherical IOL implanted eye due to a reduction in spherical aberration.

Objective To analyse the clinical efficacy of methotrexate (MTX) combined with intrauterine embryo sac garrotte injection in the treatment of cesarean scar pregnancy (CSP), and discuss its clinical significance. Methods A total of 77 patients with CSP treated in our hospital during June 2013 to December 2016 were selected in this study. Forty patients treated with embryo sac destruction and methotrexate injection were included in the observation group, while 37 cases treated by uterine artery embolization combined with curettage were used as the control group. The time of vaginal bleeding, the time of postoperative blood level of human chorionic gonadotropin (HCG) returned to the normal level, average hospitalization cost and the curative rate were recorded in two groups. All patients were followed up by the outpatient visit. Results In the observation group, the vaginal bleeding time [(22.1±6.7) days vs. (29.5±10.8) days] and treatment cost [(8774.2 ± 714.5) yuan vs. (15258.3 ± 1084.2) yuan] were less than those of the control group (P<0.001). There were no significant differences in the recovery time of HCG [(26.4±9.0) days vs. (25.1±10.4) days] and treatment success rate (87.5%vs. 91.9%) between the two groups (P>0.05). No bleeding or threatened rupture of scar were found in two groups of patients. Conclusion In this study, we take the embryo sac puncture combined with methotrexate injection in the treatment of scar pregnancy. This method has the advantages of low operative difficulty, definite clinical curative effect and low cost