To observe the clinic effects and complication of Ahmed glaucoma valve(AGV) implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases ( 44 eyes ) of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure ( lOP ) , visual acuity, and complication of post - operation were contrasted with those of pre-operation.RESULTS:The success rate was 84. 1%, the mean preoperative lOP in research group was 52. 1±10. 1mmHg, and the last follow up mean lOP was 15. 6 ± 6. 9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber ( 4 eyes ) , choroidal detachment ( 3 eyes), drainage tube shift (1 eye), hyphema (6 eyes), drainage tube blockage ( 1 eye ) , expulsive choroidal hemorrhage (1 eye), and fiber wrap of drainage tray (5 eyes) .CONCLUSlON:AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. lt avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. lt is an effective procedure for refractory glaucoma.

Objective: To explore risk factors for complicated cardiovascular and cerebrovascular diseases in patients with refractory hypertension (RH).Methods: Clinical data of 536 RH patients, who were treated in our hospital from Jun 2010 to Jul 2015, were retrospectively analyzed.According to presence of cardiovascular and cerebrovascular diseases or not, patients were divided into complication group (n=217) and pure RH group (n=319).Results: Compared with pure RH group, there were significant rise in percentages of drinking and smoking, hypertension course, mean arterial pressure (MAP), mean systolic blood pressure, pulse pressure, serum uric acid (SUA), creatinine (Cr), total cholesterol and low density lipoprotein cholesterol (LDL-C), and significant reductions in high density lipoprotein cholesterol (HDL-C) mean diastolic blood pressure and mean heart rate in complication group, P<0.01 all.Multi-factor unconditional Logistic regression analysis indicated that hypertension course, SUA,MAP, Cr and LDL-C levels were independent risk factors for complicated cardiovascular and cerebrovascular diseases in RH patients (OR=1.014~3.217, P<0.05 or <0.01).Conclusion: Hypertension course,MAP,Cr,SUA and LDL-C are independent risk factors for refractory hypertension.Enhancing their monitor, prevention and treatment are important to reduce incidence rates of cardiovascular and cerebrovascular complications in patients with refractory hypertension.

Objective:To detect the clinical features of vulvar and vaginal intraepithelial neoplasias(VIN and VAIN,respectively).Methods:Total 148 women were performed vulvar or vaginal coloposcopy-directed biopsy pathology tests,from Sep.2004 to Dec.2007.Results:Among 148 women,vulvar or vaginal histologic results were vulvar cancer for 1,VIN or VAIN 2,3 for 23,VIN or VAIN for 16,condyloma for 61,vulvitis and vaginitis for 47.Eighty-five percent(33/39) women with VIN or VAIN 2,3 were more than 30 years old.Compared to women with cervical intraepithelial neoplasia(CIN),women with VIN or VAIN were older.The rate of high-risk HPV DNA in women with vulvar or vaginal lesions was 84%(84/100).VAIN occurred mainly in the upper vagina(90%,69/75).VIN or VAIN often accompanied or followed CIN or cervical cancer(79%,31/39),and VIN or VAIN 2,3 often accompanied or followed CIN 2,3 or cervical cancer(70%,16/23).Conclusion:Our data suggest that women with high-risk HPV infection are at risk of developing VIN or VAIN 2,3.The vulva and vagina should be carefully inspected by colposcopic examination at the time of colposcopy for any abnormal findings.

Objective To evaluate the role of 1-phosphatidylinositol 3-kinase (PI3K) signaling pathway in nerve growth factor-beta (NGF-β)-produced mitigation of cell apoptosis induced by endoplasmic reticulum stress during hypoxia-reoxygenation (H/R) in rat cardiomyocytes.Methods H9c2 cells were seeded in 96-well plates at a density of 5× 105 cells/ml (100 μl/well).The wells were randomly divided into 5 groups (n =15 each) using a random number table: control group (group C);group H/R;NGF-β group (group N);NGF-β+NGF receptor trkA antagonist K252a group (group N+K);NGF-β+ PI3K inhibitor LY294002 group (group N+L).The cells were exposed to 95％ N2-5％ CO2 for 4 h in an anaerobic incubator, followed by reoxygenation in a standard incubator for 4 h in H/R, N, N+K and N+L groups.In addition, the cells in N, N + K and N + L groups were incubated in a standard incubator containing NGF-β, the mixture of NGF-β and K252a and the mixture of NGF-β and LY294002, respectively, during reoxygenation, and the final concentrations of NGF-β , K252a and LY294002 were 50 ng/ml, 100 nmol/L and 50 μmol/L, respectively.The cell viability was detected by using CCK-8 assay, and the cell survival rate was calculated.The cell apoptosis was examined by flow cytometry, and apoptosis rate was calculated.The expression of glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), caspase-12, Akt and phosphorylated Akt (p-Akt) was detected by Western blot.The ratio of p-Akt to Akt was calculated.Results Compared with group C, the cell survival rate was significantly decreased, and the apoptosis rate was increased in H/R and N groups, and the expression of GRP78, CHOP and caspase-12 was significantly up-regulated in group H/R, and p-Akt/Akt was significantly increased in group N (P＜0.05).Compared with group H/R, the cell survival rate was significantly increased, the apoptosis rate was decreased, the expression of GRP78, CHOP and caspase-12 was up-regulated, and p-Akt/Akt was increased in group N (P＜0.05), and no significant change was found in the parameters mentioned above in N+K and N+L groups (P＞0.05).Compared with group N, the cell survival rate was significantly decreased, the apoptosis rate was increased, the expression of GRP78, CHOP and caspase-12 was up-regulated, and p-Akt/Akt was decreased in N+K and N+L groups (P＜0.05).Conclusion NGF-β can mitigate the cell apoptosis induced by endoplasmic reticulum stress during H/R, and activation of PI3K signaling pathway is involved in the mechanism.

Objective To evaluate the effects of nerve growth factor-beta (NGF-β) pretreatment on cell apoptosis induced by endoplasmic reticulum stress during ischemia-reperfusion in isolated rat hearts.Methods Male Sprague-Dawley rats,weighing 180-220 g,were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.The hearts were excised and perfused in a Langendorff apparatus with K-H solution aerated with 95％ O2 and 5％ CO2 at 37 ℃.Thirty-two isolated rat hearts were randomly divided into 4 groups (n =8 each) using a random number table:control group (group C),I/R group,NGF-β pretreatment group (group N) and NGF-β combined with K252a (trkA receptor antagonist) pretreatment group (group N + K).In group C,the hearts were continuously perfused with K-H solution for 195 min.The hearts were perfused with K-H solution for 45 min in group I/R.In N and N + K groups,the hearts were perfused with K-H solution for 15 min,and then with K-H solution containing 0.1 μg/ml NGF-β and 0.1 μg/ml NGF-β mixed with 100 nmol/L K252a,respectively,for 30 min.The perfusion was suspended for 30 min followed by 120 min of reperfusion with K-H solution in I/R,N and N + K groups.HR,left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP) and + dp/dtmax were measured at the end of 15 min equilibration (baseline) and at 5,30,60 and 120 min of reperfusion.Myocardial specimens were obtained at 120 min of reperfusion for detection of myocardial apoptosis (by TUNEL) and expression of glucose-related protein 78 (GRP78),CCAAT/enhancer-binding protein homologous protein (CHOP),and caspase-12 (by Western blot analysis).Apoptosis index was calculated.Results Compared with group C,HR,LVDP and + dp/dtmax were significantly decreased,and LVEDP,apoptosis index and expression of GRP78 and CHOP were increased in I/R and N groups,and the expression of caspase-12 was upregulated in I/R group.Compared with group I/R,HR,LVDP,and + dp/dtmax were significantly increased,and LVEDP,apoptosis index and expression of GRP78,CHOP and caspase-12 were decreased in group N,and the expression of GRP78 was down-regulated in group N + K.There was no significant difference in cardiac function indexes between group I/R and N + K.Compared with group N,HR,LVDP and + dp/dtmax were significantly decreased,and LVEDP,apoptosis index,and expression of GRP78,CHOP and caspase-12 were increased in group N + K.Conclusion NGF-β pretreatment can protect the isolated rat hearts against ischemia-reperfusion injury,and inhibition of the endoplasmic reticulum stress-triggered cell apoptosis after activating trkA receptors is involved in the mechanism.

Objective:To investigate the effect of Ku70 silencing on the expression of apoptosis-related genes in human NSLC cell line,A549 and drug-resistant A549DDP.Methods:Expression of Ku70mRNA in human A549 cells was examined by RT-PCR.Expression of apoptosis-related genes was examined by PCR-Array assay.Results: The Ku70mRNA was higher in A549DDP cells than in A549 cells.The expression of BAX,TP53 and TP73 was significantly increased whereas the expression of TNFRSF1A and BFAR decreased in siRNA-Ku70 A549DDP cells when compared to those of A549DDP cells.Conclsion:The amount of Ku70 mRNA is higher in A549DDP cells,suggesting that Ku70 is important for drug-resistance; Silencing Ku70 might reverse the drug-resistance in A549DDP cells through regulation of expression of apoptofic genes.

BACKGROUND: Serum creatinine (SCr) is the most commonly used parameter to estimate renal function impairement, but there are some shortcomings. Many factors including age, gender, drug, diet, muscle mass and metabolic rate can influence SCr, leading to an inaccurate estimation of kidney impairment. Studies have shown that cystatin C (CysC) is not affected by factors such as muscle mass, age, gender, diet, inflammation or tumor. The present study was undertaken to compare the sensitivity of CysC and SCr in evaluating renal function impairment at early stage of shock. METHODS: Seventy-one patients aged 38.3±21.4 years, who had been treated at the Emergency Medicine Department of the First Affiliated Hospital, Sun Yat-sen University between February 2006 and June 2007, were studied. They were divided into groups A, B, C, and D according to the shock time. Serum sample was drawn from each patient at 1, 2, 3, 4 hours after shock to determine SCr and CysC. CysC and SCr were determined again at 72 hours and 7 days after shock. RESULTS: CysC increased earlier than SCr in the 71 patients, and CysC decreased slower than SCr when shock was corrected. CysC increased at 1 hour after shock. There was a negative correlationship between CysC, SCr and glomerular filtration rate (GFR), especially at early stage of shock. CONCLUSIONS: There is renal injury at early stage of shock. CysC is more sensitive than SCr in assessing renal function at the early stage of shock.

Objective To investigate the effect of propofol anesthesia on electroconvulsive therapy (ECT)-induced hyperphosphorylation of Tau protein in hippocampus in depressed rats.Methods Thirty-two female WYK rats in which the total score was 30-120 after Open-field test,aged 24 weeks,weighing 200-250 g,were randomly divided into 4 groups ( n =8 each):control group (group C),propofol group (group P),ECT group (group E)and propofol + ECT group (group PE).In groups C and E,the animals received intraperitoneal normal saline 5 ml,and in addition the animals received ECT 15 min later in group E.In groups P and PE,the animals received intraperitoneal 100 mg/kg propofol 5 ml,and in addition the animals received ECT 15 min later in group PE.The learning and memory function was assessed by Morris water maze test at 24 h after ECT.The animals were sacririced at 6 h after Morris water maze test and the hippocampal tissues were removed for determination of the expression of phosphorylated Tau protein.Results Compared with group C,the escape latency was significantly prolonged,the swimming time was significantly shortened in groups P,E and PE,the expression of phosphorylated Tau protein in hippocampus was down-regulated in group P,and the expression of phosphorylated Tau protein in hippocampus was up-regulated in group E ( P ＜ 0.05).Compared with group E,the escape latency was significantly shortened,the swimming time was significantly prolonged,and the expression of phosphorylated Tau protein in hippocampus was down-regulated in group PE (P ＜0.05).Conclusion The mechanism by which propofol anesthesia improves cognitive impairment induced by ECT may be related to inhibition of hyperphosphorylation of Tau protein in hippocampus in depressed rats.

·AIM: To report the results of phacotrabeculectomy with 2.8mm scleral tunnel incision.·METHODS: Phacotrabeculectomy was performed through an identical 2.8mm scleral tunnel incision in 52 eyes of 49 patients with cataract and glaucoma. The incision was closed with out suture. Foldable intraocular lens was implanted in all eyes.·RESULTS: The control of intraocular pressure on 36 eyes was desirable. The average postoperative intraocular pressure was (8.24±3.61)mmHg, (13.22±4.12) mmHg, (12.11±4.23)mmHg and (12.59±4.26)mmHg at one week, one month, three months and six months. As compared with 56 eyes in which phacotrabeculectomy was performed with 5.5mm scleral tunnel sutureless incision, there was no statistical difference, between the two, regarding the mean postoperative intraocular pressure at six months (t=1.7536,P=0.08239).The retinal nerve fiber layer thickness was not statistically different between the preoperative and postoperative times in one year in 26 eyes. The uncorrected postoperative visual activity was 0 8 or better in 62% of 52 eyes.·CONCLUSION: The advantages of this operative method are minimal size scleral flap, smaller and sutureless incision, immediate chamber restoration, decrease in postoperative astigmatism, enhanced postoperative visual activity, reduced postoperative inflammatory response and complications.

Among several intraoral distalizing devices,the pendulum appliance is one of the most commonly used noncompliance appli-ances.It is widely used to correct Class Ⅱ molar relationship.More healthy teeth can be preserved with the using of pendulum appliance in the tooth extraction of borderline cases.The pendulum appliance was modified and used in clinic.Long-term observasion showed that the modified pendulum appliace is effective in orthodontic treatment.