AlM: To evaluate the clinical efficacy of canalicular intubation combined with external dacryocystorhinostomy ( ext-DCR ) for treatment of chronic dacryocystitis and upper lacrimal duct stenosis.
METHODS:Thirty-three patients (33 eyes) with chronic dacryocystitis and upper lacrimal duct stenosis who underwent canalicular intubation combined ext-DCR were retrospective analyzed. The silicon tube was indwelt for 6mo. All cases were re-examined 1wk;1, 3, 6, 9mo post-operation, flow of tears, pus excretion and lacrimal duct clearance were observed.
RESULTS: Clear lacrimal duct ratio was 100% in all cases during 1wk~6mo post-operation; Silicon tube was removed 6mo post-operation, 3mo after tube removal, rechecking reported 32 cases with clear lacrimal duct (97%) and 1 case with resistant duct (3%). Two cases ( 6%) with minor lacerations, no other complications were observed.
CONCLUSlON: Canalicular intubation combined ext-DCR is an effective treatment for chronic dacryocystitis and upper lacrimal duct stenosis.

Administration, Topical ; Ear, Inner ; pathology ; Humans ; Meniere Disease ; therapy

Objective To evaluate the prognostic factors of elderly patients with noscomial Candidemia in intensive care unit. Methods A retrospective study was carried out in 75 elderly patients with noscomial Candidemia from 2001 to 2008. Multivariate logistic regression analysis was performed to find the correlations of prognosis with clinical and biochemical parameters. Results A total of 75 Candida strains were isolated from blood. The proportion of non-albicans species reached to 70.7%. Fluconazole-resistant candidiasis was increased. Overall mortality rate was 48.0%.Multivariate logistic regression analysis showed that septic shock, comorbid bacteremia, higher serum creatinine and sequential organ failure assessment (SOFA) score more than 10 were independent predictors for in-hospital mortality (Ward=6.34, 5.15, 8.04, 6.82, all P＞0.05). Conclusions Noscomical Candidemia in elderly critical illness patients leads a high mortality, the proportion of nonalbicans species and fluconazole-resistant candidiasis increase. The blood culture and drug sensitive test should be performed routinely to provide proper evidence for antifungal therapy. Monitoring the high risk factors, effective and reasonable therapeutics are the guarantee for reducing the mortality induced by Candidemia.

Objective To study whether the measure of consumption of iodized salt to prevent iodine deficiency disorders could lead to residents excessive iodine intake in the coastal areas in China.Methods A large population-based cross-sectional study was carried out in four typical costal provinces along the coastline from north to south,including Liaoning,Shanghai,Zhejiang and Fujian.In addition to survey all of its area of Shanghai,the other three provinces' investigation was carried out at urban and rural levels,respectively,including 5 costal cities,5 costal villages and 3 inland rural areas(as a control point) in each province.In each investigated spot,the local water iodine,residents qualified iodized salt consumption rate,per capita daily intake of salt and urinary iodine levels in different populations were investigated.Results A total of 7552 copies of drinking water samples,7996 salt samples and 9873 urine samples of different populations(adults,lactating women,pregnant women and children) were collected from the 4 provinces.Except the coastal cities and counties of Zhejiang province,the qualified iodized salt consumption rates at household were all greater than 90％ in the investigated spots.The median urinary iodine(MUI) of adults and children investigated in the costal areas were in the range of 100 - 299μg/L.The MUIs of lactating women of all investigated areas were all greater than 100 μg/L.The MUI of pregnant women was at an insufficient iodine level which was lower than 150 μg/L in Shanghai,the costal cities of Zhejiang and the coastal counties of Fujian.Conclusions The overall level of iodine nutrition of coastal residents is appropriate; and it is insufficient among pregnant women in some coastal areas; coastal areas should adhere to the salt iodization measures to control iodine deficiency disorders.

A 42-year old man was admitted for treatment of a fracture of the medial condyle of the left femur. After 10 days of cast immbilization of the above mentioned extremity, erythematous papulo-vesicular eruption was noted under the external splintage. We concluded that this was an unusual allergic contact dermatitis which is caused by CaSO4.1/2H20, and proved it by patch test in our clinic.
Calcium Sulfate ; Dermatitis, Allergic Contact ; Extremities ; Femur ; Patch Tests

Objective To investigate the effects of acute hypervolemie hemodilution(AHH)combinedwith bypotension(CH)on hemodynamies and tissue perfusion and to evaluate the safety of the technique.MethodsForty-eight ASA Ⅰ-Ⅱ patients of both sexes(28 male,20 female)aged 41-63 yr weighing 47-85kg undergoingelective orthopedic operations were randomly divided into 4 group with 12 patients in each group:A control group;B CH group;C AHH group and D CH+AHH group.The patients were premedicated with oral diazepam 10 mgand intramuscular atropine 0.5 mg.Anesthesia was induced with midazolam 0.04 mg?kg~(-1),fentanyl 4?g?kg~(-1),propefol 1.5-2.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with inhalation of 1%-3 % isoflurane and50% N_2O in O_2 supplemented with intermittent i.v.boluses of vecaronium.The patients were mechanicallyventilated after tracheal intubation(V_T=8-10 ml?kg~(-1),RR 12 bpm).Radial artery and right internal jugular veinwere cannulated.The CVP catheter was inserted into right atrium and the blood obtained from right atrium was usedto replace mixed venous blood.ECG,MAP,HR,CVP,SpO_2 and urine output were continuously monitored duringoperation.Controlled hypotension was induced with sodium nitroprusside(NTP)at 0.1-2 ?g?kg~(-1)?min~(-1) andMAP was maintained at 70% of the baseline MAP during operation.NTP infusion was terminated 30 min beforethe end of surgery.AHH was induced with 6% HES 15 ml?kg~(-1) at 50 ml?min~(-1) after induction of anesthesia andbefore skin incision.Blood samples were taken from radial artery and right atrium before AHH(T_0,baseline),immediately after AHH or before CH(T_1),1h after AHH or 40 min after start of CH(T_2),at the end of surgeryor 30 rain after termination of NTG infusion(T_3)and 24h after surgery(T_4)for blood gas analysis and calculationof oxygen extraction ratio(ERO_2).Blood volume was maintained with infusion of colloid and lactated Ringer'ssolution.The amount of blood loss and blood transfusion were recorded.Hb was maintained above 70 g?L~(-1)Results CVP increassd significantly after AHH in group C and D as compared to baseline(P0.05).Conclusion AHH combined with CH can maintain stable hemodynamics,decrease blood loss andblood transfusion during operation and maintain the balance between oxygen delivery and oxygen consumption.

Objective To investigate the effects of simvastatin preconditioning on the pulmonary heme oxygenase-1 (HO-1) expression in rats with lung injury induced by ischemia-reperfusion (I/R) of hind limbs. Methods Forty-eight adult male SD rats weighing 250-300 g were randomly divided into 6 groups ( n = 8 each) : sham operation group (group S) ; I/R group; I/R + simvastatin 1,5, 10 mg/kg groups (S1 , S2, S3 groups) ; simvastatin control group (group SC) . I/R of hind limbs was produced by occlusion of bilateral femoral arteries for 2 h followed by 3 h reperfusion. Croups S1 , S2 , S3 received simvastatin 1, 5, 10 mg/kg respectively via an oro-gastric tube for 3 days before I/R. Group SC received simvastatin 10 mg/kg via an oro-gastric tube for 3 days. Arterial blood samples were taken at 3 h of reperfusion for blood gas analysis and PaO2 and PaCO2 were recorded. The animals were then sacrificed and the lungs removed immediately for pathologic examination and determination of the wet/dry lung weight ratio (W/D ratio), superoxide dismutase (SOD) activity and polymorphonuclear neutrophil (PMN) count . Hie expression of HO-1 mRNA and protein in lung tissues was detected using RT-PCR and Western blot analysis respectively.Results Alveolar edema, localized pulmonary atelectasis and large amount of PMN infiltration were found in I/R group and were ameliorated in S1, S2, S3 groups. Compared with group S, PaO2 and PaCO2 were significantly decreased in I/R group, W/D ratio and PMN count were increased and SOD activity was significantly decreased in I/R, S1 , S2 groups, and expression of HO-1 mRNA and protein was up-regulated in the other five groups ( P ＜ 0.05). PaO2, PaCO2 and SOD activity were significantly increased, W/D ratio and PMN count were significantly decreased, and HO-1 mRNA and protein expression was up-regulated in S1, S2 and S3 groups as compared with I/R group ( P ＜ 0.05 or 0.01). W/D ratio and PMN count were gradually decreased, SOD activity was gradually increased, and HO-1 mRNA and protein expression was gradually up-regulated in S1, S2 and S3 groups. Conclusion Simvastatin preconditioning has protective effect against lung injury induced by I/R of hind limbs in rats through up-regulation of HO-1 expression in the lung tissues and in a dose-dependent manner.

A rarely reported postoperative complication following biliary surgery,and to discuss its possible mechanism.This article summarizes I reported HSB case that developed after laparoscopic cholecystectomy in our department and 9 other cases reported in literature.HSB occurred most frequently after simple cholecystectomy in addition to post operative bile duct exploration with cholecystectomy or endoscopic retrograde cholangiopancreatography.The main clinical presentation of HSB was paroxysmal colic in the upper abdomen early in the postoperative period,which could be induced after a meal.Imaging revealed subcapsular hepatic fluid collection,and successful treatment involved placement of a percutaneous drain in the biloma.The mechanism of HSB still needs to be clarified even though it is a rarely reported postoperative complication following biliary surgery.We hypothesize,after analyzing these 10 cases,that sphincter of Oddi dysfunction after biliary surgery and the subsequent persistence of high biliary system pressure may be the root cause of HSB formation.More awareness should be paid to the changes of the sphincter's motility after biliary surgery and its related complications (biliary colic,HSB etc.).

Objective Comparison of three different molecular assays for the detection and molecular characterization of circulating tumor cells in breast cancer .Methods The retrospective study compared three different molecular assays to detect CTC in the peripheral blood of 30 healthy individuals and 71 benign breast disease patients and 83 early and 84 metastatic breast cancer patients .All samples were collected at the outpatient , inpatient and physical examination department of Sichuan Provincial People ′s Hospital from January 2011 to June 2014.The same cDNAs were analyzed by:singleplex RT-qPCR assay for BCL-2, multiplex RT-qPCR for BCL-2, HER-2, HMAM, and a commercially available molecular assay (AdnaTest BreastCancer ) for GA733-2, MUC-1, HER-2.The positive of CTC were compared among healthy individuals and benign breast disease patients and breast cancer patients .Chi square test was used to compare the expression of gene markers among the three groups , and the agreement of Kappa test was used to evaluate the method.Results (1) Detection rates of early breast cancer by single RT-qPCR, Adna kits and multiple RT-qPCR were 13.3%, 16.9% and 18.1%, respectively , and the detection of metastatic breast cancer were 31.0%, 42.9%and 35.7%, respectively.There were significant differences in the positive of CTC by three molecular assays between healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 4.235 and 4.301, 5.367 and 5.474, 5.894 and 6.023 respectively, P<0.05).There were no differences between benign breast disease patients and early breast cancer patients (The test values were 0.891,0.748 and 0.701 respectively,P >0.05) .There were significant differences between metastasis breast cancer patients and healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 8.429,7.553 and 7.061;10.24, 9.025 and 8.745; 9.658, 8.417 and 8.201 respectively,P<0.05).(2) In early breast cancer: The concordance between AdnaTest and single RT-qPCR was 79.5%while between AdnaTest and multiplex RT-qPCR was 77.1%.No agreement was found among them ( The test values were 1.065 and 1.871, P were 0.371 and 0.258 ) .The concordance between single RT-qPCR and multiplex RT-qPCR was 80.7%.No agreement was found between them (The test values was 2.814, P was 0.156).(3) In patients with overt metastasis:The concordance between AdnaTest and single RT-qPCR was 78.6%( The test values was 10.986).While between AdnaTest and multiplex RT-qPCR was 80.9%( The test values was 9.251 ) . Agreements were found among them ( P was 0.002 and 0.005 respectively ) .The concordance between single and multiplex RT-qPCR was 88.1%( The test values was 12.364 ) .Agreement was found between them (P was 0.001).Conclusions No correlations were found among different molecular methods to detect CTC in the early primary breast cancer , but correlations were found in the metastatic breast cancer , suggesting that different rate of CTC caused by the number of CTC and its heterogeneity should be considered to the clinical diagnosis and treatment of breast cancer while molecular method is used .

Objective:To study the influence of chemokine receptor blocker Met-RANTES upon endothelium adhesion and chemotaxis functions in response to T lymphocyte.Methods:In vitro,endothelium and T cell were mixed culture,which was used to observe endothelium adhesion and chemotaxis effect on T lymphocyte and expression of chemokine from endothelium,before and after using Met-RANTES.Results:When endothelium and T cell were mixed culture,endothelium expressed RANTES,MCP-1,MIP-1?,and the expression of RANTES was the largest.Met-RANTES could decrease endothelium adhesion and chemotaxis functions to T lymphocyte.Conclusion:Chemokines play an important role in endothelium adhesion and chemotaxis functions in response to T lymphocyte.Met-RANTES can decrease endothelium chemotaxis to T cell and then block endothelium firm adhesion with it.