AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Objective To approach the evaluative effect of respiratory variation of superior vena cava peak flow velocity measured using transthoracic echocardiography (TTE) on fluid responsiveness in patients with mechanical ventilation.Methods A prospective cohort study was conducted.All mechanical ventilated critically ill patients whose fluid therapy was planned due to hypovolemia in Department of Critical Care Medicine of Beijing Tongren Hospital of Capital Medical University from April 2011 to April 2013 were enrolled.Volume expansion was performed with 500 mL Linger solution within 30 minutes.Patients were classified as responders if pulse pressure variation (PPV) increased ≥ 13％ before volume expansion.The respiratory variation in superior vena cava peak velocity was calculated as the difference between maximum and minimum values of velocity in peak A,peak S and peak D over a single respiratory circle,and their variations (ΔA,ΔS,ΔD) were also calculated.The receiver operating characteristic curve (ROC curve) was plotted to assess the evaluative effect of respiratory variation of superior vena cava peak velocity on fluid responsiveness.Results Twenty-seven patients were enrolled in this study.Volume expansion increased PPV ≥ 13％ happened in 14 patients (responders).The velocity of superior vena cava in peak A,peak S,peak D was significantly increased after volume expansion compared with that before volume expansion in responders [peak A (cm/s):34.6 ± 2.2 vs.31.3 ±2.1,t=-2.493,P=0.027; peak S (cm/s):39.1 ± 1.3 vs.35.3 ±2.1,t=-2.564,P=0.024; peak D (cm/s):28.1 ± 1.2 vs.23.3 ± 1.4,t=-4.995,P=0.000],but there was no significant difference in ΔA,ΔS and ΔD between before and after volume expansion.The ΔA,ΔS and ΔD were positively correlated with PPV (r＝0.040,P=0.854; r=0.350,P=0.074; r=0.749,P=0.000).The area under ROC curve (AUC) of peak S was 0.36 [95％ confidence interval (95％CI):0.11-0.52],but the AUC of ΔS was 0.68 (95％CI 0.47-0.89),the AUC of peak D was 0.41 (95％CI 0.19-0.63),but the AUC of ΔD was 0.95 (95％CI 0.86-1.00),so the aberration rate of superior vena cava in respiration was better than the flow rate in superior vena cava.When the cut-off value of ΔS was 20.7％ for predicting fluid responsiveness,the sensitivity was 78.6％ and the specificity was 61.5％.When the cut-off value of ΔD was 12.7％ for predicting fluid responsiveness,the sensitivity was 92.0％ and the specificity was 92.3％.Conclusion Respiratory variations in superior vena cava peak velocity measured by TTE could assess fluid responsiveness in patients with mechanical ventilation.

Objective To analyze the factors that influence the family training compliance of THR,to provide a theoretical basis for the early rehabilitation of the patients' limbs function.Methods A questionnaire survey was used in this study,52 patients who received THR six months ago were given family visit.The survey including the scores of the patients' basic information,compliance of rehabilitation training and the rehabilitation of hip function,and statistical analysis was given to acquired data.Results The score of the postoperation family rehabilitation training compliance was (30.76±5.28).The order of the four dimensions was ranked as:the self-care capacity,the good habits,rehabilitation training skills and the relevant knowledge of the disease.The major related factors of the compliance were the education level,psychological condition,family and social support condition and economic condition.Conclusions Factors such as knowledge of rehabilitation,rehabilitation training skills,education level,psychological condition,family and social support and the economic condition are related to the compliance of family rehabilitation training.An effective rehabilitation training plan,postoperation visiting,recovery instruction and stable social support can play a positive influence on the compliance of family rehabilitation training and the recovery of limbs'function as well as the patients' quality of life.

Objective To evaluate the reliability and validity of informant questionnaire on cognitive decline in the elderly(IQCODE) in Chinese elderly patients and to estimate the efficacy of IQCODE in the screening of patients with cognitive impairment.Methods Ninety three patients with cognitive impairment and 128 community-dwelling healthy elderly over 60 years old were assessed.Informants were interviewed with the short version of the IQCODE.Results The internal consistency coefficient of IQCODE was 0.83.The correlation coefficient of test-retest reliability was 0.86.The validity coefficient of IQCODE with mini-mental state examination and activities of daily living were-0.78 and 0.71 respectively.The scores of IQCODE of the patients varied with the degree of cognitive deficits,and the differences had statistical significance.But there was no significant difference among different types of senile dementia.The scores of IQCODE of the patients with cognitive impairment were closely correlated with the degree of cognitive deficits.Conclusions IQCODE is a reliable and effective measurement for the patients with cognitive impairment.It could discriminate the cognitive impairment patients from the normal cognitive ones,and is practical in screening.But it can not distinguish different kinds of dementia.

Objective To evaluate the changes of macrophages and expression of Rac1 in the inflammatory site of Crohn's disease,and to investigate the effects of 6-thioguanine (6-TG) and peptidoglycan on apoptosis of human peripheral blood monocyte-macrophage by regulating Rac1 signaling pathway.Methods Ten patients with Crohn's disease and eight healthy controls diagnosed were enrolled at Department of Gastroenterology and Hepatology,Tianjin Medical University General Hospital from January 2013 to January 2014.The number of macrophages,apoptosis and expression of Rac1 in the inflammation sites and non-inflammation sites of intestinal mucosa were detected in both patients and controls.Peripheral blood mononuclear cells (PBMCs) were sorted by CD14 immunomagnetic beads.The apoptosis of monocytes,expression of Rac1 and related apoptosis signaling molecules were detected in patients treated with peptidoglycan,6-TG and Rac1 inhibitor NSC23766 and another 15 healthy donors.Results The number of macrophages and apoptotic cells significantly increased in the inflammatory group of Crohn's disease patients compared with the non-inflammatory group.The expression of PAK1,downstream molecular of Rac1 signaling pathway of macrophages was also significantly higher in the inflammatory group of Crohn's disease patients than that in healthy controls and non-inflammatory group.Compared with control group,anti-apoptotic signals (NF-κB,Bcl-xL and STAT-3) in PBMCs increased in the peptidoglycan group,while slightly decreased in 6-TG group.6-TG and NSC23766 significantly promoted peptidoglycan-related anti-apoptosis [peptidoglycan group (8.6±3.7)％,peptidoglycan + 6-TG group (42.0±2.7)％,peptidoglycan + NSC23766 group (58.5±6.9)％,P＜0.05].Conclusions Peptidoglycan plays a role in the pathogenesis of Crohn's disease by recruiting macrophages.However,6-TG inhibits peptidoglycan-induced activation of Rac 1 signaling pathway leading to macrophage apoptosis.

Objective To explore the relationship between pulse wave velocity(PWV)and blood pressure classification and cardiovascular risk factors stratification in patients with essential hypertension. Methods Totally,390 patients with essential hypertension were recruited in the study and their carotid- femoral PWVs were recorded by an automatic pulse wave velocity measurement system.The patients were stratified by their cardiovascular risk factors.PWVs were compared between patients with varied blood pressures or with and without cardiovascular risk factors.Results There was no significant difference in PWV between patients of phase 1 and phase 2 hypertension,[(10.8?1.7)m/s vs.(11.9?1.2)m/s,P =0.398].PWV in patients with more than one risk factor was significantly higher than that in those with hypertension alone,[(10.4?1.4)m/s vs.(11.7?1.4)m/s,P=0.018].Conclusions PWV in hypertensive patients with one or more than one other risk factors was significantly higher than that in those without other risk factors.Cardiovascular risk factor might play a more important role in arterial stiffness.

Aged, 80 and over ; Autoimmune Diseases ; blood ; diagnosis ; Humans ; Immunoglobulin G ; blood ; Lymphatic Diseases ; blood ; diagnosis ; Male ; Mikulicz' Disease ; blood ; diagnosis ; Pancreatitis ; blood ; diagnosis

Disease recurrence is a main challenge in treatment of hepatocellular carcinoma (HCC). There is no generally accepted method for preventing recurrence of HCC after resection.

To investigate the freshness, high molecular weight substances, the determination of polypeptide, haemolysis and agglomeration, biological activity of Cervus and Cucumis polypeptide injection; to provide the direction for improving the quality of products for enterprises; furthermore, to provide reference for the revision of the quality standards of Cervus and Cucumis polypeptide injection. Firstly, we investigated the factors affecting the freshness of the injection, including biogenic amines, aflatoxins, the acid value and peroxide value of the melon seeds. The method of dansyl chloride pre-column derivatization-HPLC was used to determine the content of 8 biogenic amines in Cervus and Cucumis polypeptide injection. The method validation results showed good specificity, precision, linearity and recovery rates, which was suitable for the determination of biogenic amines in Cervus and Cucumis polypeptide injection. The results of sample determination showed that relatively higher concentrations of cadaverine were detected in the products from company B. The results of aflatoxins, acid value and peroxide value showed that the melon seeds from some companies had rancidity, mildew and other problems, indicating that the quality standards of multi-component biochemical drugs containing animal- and plant-derived components should be controlled in terms of freshness. Secondly, the methods for the determination of high molecular weight substances and polypeptides in the quality standard were improved. Tricine-SDS-PAGE electrophoresis was used instead of gel chromatography to determine the high molecular weight substances, which improved the accuracy of determination. The kits were used instead of folin-phenol for the determination of peptide content, which is easy to operate, specific and suitable for high-throughput sample determination. Finally, the haemolysis, agglomeration, and biological activity of Cervus and Cucumis polypeptide injection were studied. The results showed that no haemolysis and agglomeration were found in all samples, and the inhibitory effect of samples on THP-1 proliferation in vitro from different companies was different to some extent. In conclusion, the optimized quality standard is more suitable for the detection of Cervus and Cucumis polypeptide injection, and can lay the foundation for improving the safety of multi-component biochemical drugs.

Objective To understand epidemiological characteristics of chronic obstructive pulmonary disease(COPD)in people aged over 40 years in a rural area of Tianjin.Methods Using cluster sampling,1 508 subjects over 40 years old at five villages in Xinkaikou Township,Baodi District,Tianjin were investigated with respiratory questionnaire,lung function test and physical examination.Confirmed patients with COPD were examined by chest roentgenography and electrocardiography.Results One hundred and forty-two subjects in that area suffered from COPD,with prevalence of 9.4%,24 of them (16.9%)were diagnosed as cor pulmonale.Prevalence of COPD increased with age,higher in men (13.5%)than that in women(6.2%),higher in smokers(12.2%)than that in non-smokers(7.2%), higher in those with family history(21.4%)than that in those without it(8.45%),and higher in those with coughing history during their childhood(75.0%)than that in those without it(9.2%),all with a P-value of less than 0.01.Univariate analysis showed that out-door air pollution,cooking,time length of burning firewood during cooking,smoking,coughing history during childhood,gender,age,family history all were predisposing factors for COPD.Multivariate analysis with logistic regression model showed that gender,age, family history were independently predisposing factors for COPD.Quality of life was better in non-COPD subjects than in those with COPD,with statistically significant difference.Conclusions Prevalence of COPD was relatively higher in people of rural Tianjin,with gender,age,family history and outdoor air pollution as main risk factors.