OBJECTIVE:To observe the clinical efficacy and safety of different combination regimens of latanoprost combined with timolol in the treatment of primary open-angle glaucoma(POAG). METHODS:By 2×2 self-cross controlled regimen,a total of 50 POAG patients were selected from Sanya Municipal People's Hospital during Jan. 2014-Nov. 2016,and then divided into group A and B according to random number tablet,with 25 cases in each group. Group A received traditional regimens (Latanoprost eye drops,once every night,one drop each time+Timolol maleate eye drops,once in the morning and evening,one drop each time);after 8 weeks of treatment and 48 h washout period,group A was given modified regimen(Latanoprost eye drops,once every night,one drop each time+Timolol maleate eye drops,once every morning,one drop each time)for 8 weeks. Group B was given modified regimen;after 8 weeks of treatment and 48 h washout period,then was given traditional regimen for 8 weeks. The 24 h average intraocular pressure,peak and trough intraocular pressure before and after medication,ocular hemodynamics [end diastolic velocity(EDV),peak systolic velocity(PSV),resistance index(RI)] and ADR were recorded in 2 regimens. RESULTS:After received two regimens,24 h average intraocular pressure,peak and trough intraocular pressure, intraocular pressure fluctuation and RI were significantly lower than before treatment,while EDV and PSV were significantly higher than before treatment,with statistical significance(P<0.05). There was no statistical significance between 2 groups(P>0.05). The total incidence of ADR in patients receiving modified regimen was significantly lower than those receiving traditional regimen(4.0% vs. 22.0%),with statistical significance(P<0.05). CONCLUSIONS:In traditional combination regimen of latanoprost combined with timolol,the frequency of timolol use was changed from twice in the morning and evening to once in the morning,which doesn't influence therapeutic efficacy but reduce ADR.

This study performed to observe the effect of Yiqi Jianpi Shengjin recipe on Tfr/Tfh cell balance and autophagy expression in primary Sj?gren's syndrome(pSS)patients,and to explore the intervention mechanism of Yiqi Jianpi Shengjin recipe in treating pSS.We collected 60 cases of pSS with deficiency of both qi and yin from the Department of Rheumatology and Immunology of Anhui Provincial Hospital of TCM and randomly grouped them into experimental group and control group,with each group consisting of 30 cases.The control group was given a dose of hydroxychloroquine sulphate 0.2 g bid,the experimental group received an additional oral dose of Yiqi Jianpi Shengjin formula on top of the control group's treatment,and both continued to take it for 12 weeks.IL-10,IL-21 and IL-6 levels were measured by enzyme-linked immunosorbent assay,Tfh and Tfr cells ratios were measured by Flow cytometry,Western blot was used to detect the protein expression of Atg5,Beclin1 and LC3-Ⅱ/Ⅰ,and qPCR was used to detect the RNA expression of Atg5,Beclin1 and LC3.The indexes of inflammation,dryness,ESSPRI,ESSDAI and TCM syndrome integral before and after treatment were statistically analyzed.Data showed that the scores of corneal fluorescence stainin g in the experimental group were significantly lower and the static saliva flow rate was significantly higher compared with the control group.The experimental group showed a marked reduction in TCM,ESSPRI and ESSDAI score after treatment compared to control group.The expression of IL-21,IL-10 and IgG in the experimental group was markedly lower compa red with the control group.Tfr cells were significantly lower in the experimental group as compared to the control group.T he expression and ratio of autophagy protein and mRNA in the experimental group were significantly lower compared with t he control group.In conclusion,Yiqi Jianpi Shengjin recipe can effectively reestablish the balance of Tfr/Tfh cells,regulate cytokines,inhibit autophagy and activity,relieve clinical symptoms,delay disease activity,and improve the secretion of lacrimal gland and salivary gland.

Objective To explore the application and significance of intraoperative laparoscopic ultrasound( IOUS) in robot-assisted laparoscopic hepatectomy . Methods From February 2015 to February 2017 ,135 patients undergoing liver resection with robotic approach were enrolled in the study . All data about demographic ,surgical procedure and postoperative course were collected prospectively and analyzed . IOUS was routinely performed in these patients . To assist the localization and resection of liver tumor ,a four steps IOUS protocol in robotic liver surgery was proposed ,including exploration ,verification ,guidance , and confirmation . If necessary ,intraoperative laparoscopic ultrasound guided microwave ablation of liver tumor to complete the treatment . Results A total of 11 additional lesions in 11 patients were detected in 135 patients ,7 patients accepted strategic surgical modification : 4 cases were enlarged resection ,and 3 cases were treated with microwave ablation . There were only 17 patients lost blood more than 1000 ml in all patients . No patient suffered from any single or multiple organ dysfunctions ,and there was no mortality observed . Conclusions IOUS is indispensable to understand lesions and vessels ,confirm the complete resection of the tumor in robot-assisted laparoscopic hepatectomy . It is also a necessary tool for the microwave ablation of liver tumor .

Non-compaction of ventricular myocardium (NVM), a rare congenital and inherited cardiomyopathy, is characterized by prominent trabeculations and deep intertrabecular recesses in communication with the ventricular cavity.NVM has diverse clinical presentations without specificity, of which the major characteristics are cardiac insufficiency, arrhythmias and thrombosis.Echocardiography and cardiac magnetic resonance imaging are necessary technologies to diagnose NVM.Symptomatic therapy is the only choice for most patients.Furthermore, if medical treatment fails, the heart transplantation could be performed.As a whole, NVM has a high mortality and entirely different prognosis, however, the prognosis of asymptomatic patients is relatively good.

To investigate the feasibility ,safety and clinical effect of No touch liver pedicle microwave ablation . Methods T he clinical data of 229 patients with hepatocellular carcinoma treated in the Department of Hepatology ,Wuhan Tongji Hospital from M ay 2014 to October 2016 were retrospectively analyzed . T he patients were divided into 3 groups .In group A ,82 patients underwent ultrasound‐guided No touch liver pedicle microwave ablation ,69 patients in group B were treated with anatomical hepatectomy ,and 78 patients in group C underwent traditional microwave ablation . T he preoperative basic data ,intraoperative data ( treatment time , intraoperative blood loss ) and postoperative data ( postoperative liver function indicators ,complications ,hospitalization time ,local recurrence ,survival rate) were compared among the 3 groups . Results T he treatment time ,intraoperative blood loss ,postoperative liver function index and hospitalization time in group A and group C were significantly lower than those in group B( all P ＝0 .000) . T here was no difference in complete elimination rate ,between the two groups in group A and group B( P ＞0 .05) ,which was significantly better than those of group C ( P ＝ 0 .019 ) . T here was no significant difference in the local recurrence rate between the three groups after 1 year and 3 years . Conclusions No touch liver pedicle microwave ablation damage is safe and reliable ,in line with the principle of oncology treatment ,it worthes further promotion in the clinic .

To investigate the safety and feasibility of indocyanine green ( ICG ) fluorescence staining guided by laparoscopic ultrasound guiding portal branch puncture approach in anatomical segmentectomy of the liver . Methods The clinical data of 22 patients with malignant liver diseases underwent anatomical segmentectomy between February 2018 and M ay 2018 were retrospectively analyzed . ICG 0 .125～0 .250 mg was directly injected into the portal branches supplying blood flow to the tumor‐bearing hepatic segment , after puncturing of the target portal branch under intraoperative laparoscopic ultrasound guidance in all patients . T he fluorescence imaging system ( Pinpoint) was used for the resection procedure . Observation indicators :intraoperative conditions ( tumor diameter ,success rate of portal branches puncture ,success rate of staining the target hepatic segment ,intraoperative complications , time of operation ,volume of intraoperative blood loss , blood transfusion , and transit of laparotomy ) . Postoperative conditions :postoperative complications ,and length of hospital stay . Results Twenty‐two patients with liver tumors were all performed anatomical hepatectomy assisted by laparoscopic ultrasound guiding ICG injection for liver segment staining . All the liver tumors were hepatocellular carcinoma . ①Intraoperative conditions : T he portal branches puncture successful rate was 100% ( 22/22 ) . Eighteen patients achieved expected effect of ICG fluorescence staining ,with a satisfaction rate of 81 .8% (18/22) and 4 failed to get expected effect ,including 2 with uneven dying ,and 2 with adjacent hepatic segmental staining induced to unclear boundary . No complication such as allergy occurred in all patients after ICG injection . T he mean operation time was ( 209 ± 89 ) min ( range :97 ～ 325 min) and the target portal branches ICG puncture injection time under intraoperative laparoscopic ultrasound guidance was ( 11 ± 5) min ( range 3－25 min) . T here was no intraoperative blood transfusion or transit of laparotomy .Average tumor diameter was ( 3 .9 ± 1 .3) cm( range :2 .2－7 .0 cm ) . ②Postoperative conditions of 22 patients ,4 with grade Ⅰ － Ⅱ of Clavien‐Dindo classification were improved by drug treatments ( 1 with deep venous thrombosis of the lower extremities and 3 with pleural effusion ) , no patient had grade Ⅲ and above complications , and no perioperative death occurred . Average duration of hospital stay was ( 7 ± 2 ) days in 22 patients ( range :5 .0－14 .0 days) . Conclusions ICG fluorescence staining guided by laparoscopic ultrasound guiding portal branch puncture ,obtains accurate and lasting fluorescence markers on the liver surface and inside the parenchyma . ICG staining guides the selection of liver section in the operation of liver in real time ,and helps surgeons to perform laparoscopic anatomical segmentectomy of the liver .