Objective To evaluate the efficacy of endoscopic variceal ligation(EVL)in esophageal variceal bleeding (EVB)in elderly patients with hepatic cirrhosis,and the safety of endoscopic operation under anesthesia.Methods From July 2007 to July 2013,170 patients diagnosed as liver cirrhosis complicated with EVB were retrospectively analyzed.Among them,139 patients who received EVL were divided into elderly anesthesia group (n=52,age≥60 years),elderly non-anesthesia group (n=45 ,age≥60 years)and non-elderly anesthesia group (n=42,age<60 years);the other 31 cases (age≥60 years) received propranolol therapy.The degree of satisfaction of visual fields and esophageal peristalsis under the gastroscope,the effect,adverse effects and complications of EVL,the recurrence of EVB and mortality of each group were analyzed.Two-way analysis of variance and crosstabs chi square test were performed for statistical analysis.Results The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope were 82.5 % (104/126)and 89.7% (113/126)in elderly anesthesia group;82.6% (71/86) and 89.5 % (77/86)in non-elderly anesthesia group;40.3% (29/72)and 44.4% (32/72)in elderly non-anesthesia group.The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope in anesthesia group were better than those in non-anesthesia group (χ2 =47.46,64.28;both P <0.01 ). The efficacy rates of EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group were 84.6%(44/52 ),68.9%(31/45 )and 81 .0%(34/42 ),respectively.The variceal recurrence rates were 19.2% (10/52 ),20.0% (9/45 )and 19.0% (8/42 ),respectively.There was no significant difference among them (all P > 0.05). Rebleeding rate of medication treatment group was 58.1%(18/31),which was obviously higher than that of elderly anesthesia group (19.2%,10/52 ), elderly non-anesthesia group (31 .1 %,14/45 )and non-elderly anesthesia group (23.8%,10/42 ),and the difference was statistically significant (χ2 =15 .10,P <0.01 ).No case of hepatic encephalopathy was found in elderly anesthesia group or non-elderly anesthesia group after EVL.The incidence of pneumonia in elderly non-anesthesia group was 4.2%(3/72),which was higher than that of elderly anesthesia group and non-elderly anesthesia group,and the difference was statistically significant (χ2 =8.93,P =0.01). The mortality within a month after EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group was 0,8.9% (4/45 )and 0,and the difference was statistically significant (χ2 =9.27,P =0.01).Conclusion The efficacy of EVL under anesthesia in EVB in elderly patients with liver cirrhosis was good,with no induction or aggravation of hepatic encephalopathy or irreversible complications were found.

Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

Twenty-nine cases of fasciitis of back muscles were treated by acupuncturing the main acupoints, including Ashi acuponit, Jianjing (GB 21), Tianzhu (BL 10) and Tianzong (SI 11), plus cupping on the painful part of back. After 2 courses of treatment, 26 cases were cured and 3 cases improved.

AIM:To evaluate flight attendants' ocular surface after different refractive corrections. ·METHODS:Forty-two flight attendants (84 eyes) were enrolled in the study. Those flight attendants, who were followed up from September 2014 to September 2016, all followed the doctor's orders. According to different refractive corrections, those flight attendants were divided into 4 groups: corneal refractive surgery group, soft contact lens group, rigid gas permeable contact lens ( RGP) group and control group without any refractive corrections. OSDI scores, tear meniscus heights, BUTs, fluorescein staining scores and Schirmer's tests were taken and analyzed. ·RESULTS: Compared with the control group, OSDI scores were worse, tear meniscus heights ( TMH ) were reduced, BUTs were shortened, fluorescein staining(FS) scores were worse, Schirmer's Tests ( SⅠt) were shorter in soft contact lens group and corneal refractive surgery group (P<0. 05). However, the above parameters did not change significantly in RGP group ( P>0. 05 ) . There was no significant difference in lid margin abnormalities among the four groups (F=3. 82, P=0. 45). ·CONCLUSION: RGP can improve flight attendants'ocular surface micro-environment.

Objective: To evaluate the effect of roughness on adhesive properties of polymethyl methacrylate and SY-1 silicone elastomer.Methods:5 specimens of polymethyl methacrylate were polished by sand paper of different standards and the roughness of polymethyl methacrylate surfaces were measured by roughmeter. The tension strength between polymethyl methacrylate with different degrees of roughness and SY-1 silicone elastomer were tested according to national standards. Results: After the surfaces of polymethyl methacrylate were respectively polished by sand paper of the standard 160,320 and 800, the sufrace roughness decreased, but the tension strength between polymethy1 and SY-1 silicone elastomer was increased(P

AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

Objective To evaluate the role of TVS in assessing endometrial pathology in women with postmenopausal bleeding and in evaluating the depth of myometrial invasion in endometrial carcinoma.Methods A group of 111 women with postmenopausal bleeding were examined by TVS,endometrial thickness,echotexture,blood flow characteristics were evaluated.Results An endometrial thickness less than 5 mm was associated with normal or benign condition.This suggested that endometrial biopsy or curettage might not be necessary in this situation,visualization of abnormal blood flow within the endometrium in the endometrial carcinoma with mean resistance index constituted a statistical difference compared with that of benign endometrium(P<0.05).TVS accurately detected depth of myometrial invasion in endometrial carcinoma,and had significant relation with pathologic assessment(r=0.98,P<0.001).Conclusion TVS could be implemented as a routine first-step procedure in patients with postmenopausal bleeding.

It was reported that Os-thole(Ost) was isolated from the fruits of Cnidium monnieri(L. ) Cusson, possessesanti - arrhythmic action and depressed the aortic pressure action in animal studies. Its calcium -antagonistic effects were studied on the isolated rabbit aortic strips.Ost shifted the dose response curves for NE, CaCl2 and KC1 nonparallelly to the right, and depressed their maximal response; pD2' value is 3. 16, 4. 28 and 4. 39 respectively. It produced neither ?- a-drenoceptic stimulating nor ? - adreno-ceptic blocking effects. At the concentration of 100 ?mol ? L-1, Ost significantly inhibited the intra cellular Ca2+ dependent component of NE - induced contraction of the aortic strips, however, it didn't in-hibit the extra cellular Ca2+ dependent component of NE - induced contraction of the aortic strips, These results indicated that Ost produced relaxation on vascular smooth muscle might result from its antagonistic effect to Ca2+ and mainly blocked calcium influx through PDC, and the mode of its anta -gonism is similar to that of verapamil.

Objective To explore the effect of pyrrolidine dithiocarbamate(PDTC) on the expression of E-selectin and the activities of enzymes in oxidative stress in the pancreas of rats with severe acute pancreatitis(SAP).Methods Rat model of ASP was build by intraperitoneal injection of L-arginine(totally 5 g/kg,twice in an interval of 1 h).Thirty-six SD rats were assigned to 6 groups randomly and equally,that is,normal control,SAP,PDTC pretreatment group 1(1 mg/kg) and 2(100 mg/kg),and PDTC treatment group 1(1 mg/kg) and 2(100 mg/kg).PDTC pretreatment was preformed by subcutaneous injection of PDTC 1 h before first injection of L-arginine.For the animals in treatment groups,PDTC was given 3 h after first injection.Normal control was given intraperitoneal injection of normal saline.In 24 h after the first injection of L-arginine,the activity of myeloperoxidase(MPO),lipid peroxide(LPO) and nitric oxide synthase(NOS) were detected.Expressions of E-selectin was detected through inmmunohistochemical method,and activity of NF-?B-DNA binding were detected by electrophoretic mobility shift assay(EMSA).Results In SAP groups and PDTC pretreatment and treatment groups,the expression of E-selectin,activities of NF-?B,MPO,LPO,and inducible NOS(iNOS) were higher,but the activity of constitutive NOS(cNOS) was lower than those in the normal control(P0.05).Conclusion PDTC of 1 mg/kg can alleviate the inflammation in SAP by blocking the translocation of NF-?B,however,the 100 mg/kg PDTC shows little protection in this process.

Objective To compare the therapeutic efficacy of two different administration routes of insulin administra?tion on juvenile type 1 diabetes mellitus (T1DM) complicated with diabetic ketoacidosis(DKA). Methods A total of 223 cases of juvenile T1DM was included in this study, among which 98 were complicated with DKA. Insulin was delivered through either continuous subcutaneous insulin infusion(CSII) by insulin pump or via multiple subcutaneous insulin injec?tion (MSII). Recovery period of blood glucose, insulin doses that were adminstrated, the urinary ketone bodies clearance time, the recovering time from DKA and the frequency of hypoglycemia incidence were all compared between these two routes. Results Both CSII and MSII routes reversed blood glucose and DKA effectively. However the recovering time of blood glucose and DKA, insulin dosage,the urinary ketone bodies clearance time and the frequency of hypoglycemia inci?dence all improved better or quicker in CSII than in MSII. Conclusion CSII by insulin pump is safer and more effective than MSII in the treatment of junvenile T1DM with metabolic disturbance and diabetic ketoacidosis.