Objective To assess the feasibility of evaluation of coronary flow reserve (CFR) for left anterior descending (LAD),left circumflex (LCx),and right coronary posterior descending artery(PDA) as well as diagnostic accuracy for patency of each branches by transthoracic Doppler echocardiography (TTDE). Methods CFR of main coronary artery branches at the distal sites were studied by TTDE with adenosine infusion (140 μg · kg-1 · min-1) in 439 consecutive patients with suspected coronary heart disease. The relations between CFR and stenosis rates of coronary bifurcations were analyzed. Results Twenty-eight of LAD,12 of LCx and 21 of PDA were occluded in 439 patients. The success rate of CFR assessment of LAD, LCx and PDA were 96.8% (395/411), 74.9% (320/427), 83.0% (347/418)respectively. Then CFR≤2.0 and CFR≤1.7 were chosen as the criteria of coronary stenosis (≥50 %) and severe stenosis(≥75%). The sensitivity and specificity of detection of LAD,LCx and PDA stenosis were 81% and 87% ,64% and 82%, 79% and 85%, respectively. The sensitivity and specificity of diagnosis of LAD, LCx and PDA severe stenosis were 86% and 81%, 70% and 85%, 81% and 82%, respectively.Conclusions CFR evaluation of main coronary artery branches has high feasibility and can provide valuable information for relevant vessel patency.

Rhinovirus

Objective To understand the clinical features of children with acute pancreatitis.Method Clinical data of 106 in patients in Children′s Hospital with acute pancreatitis from Jul.1991 to Jan.2005 were analyzed retrospectively.Results The most frequent(etiologic) factors of childhood acute pancreatitis were idiopathic(35.8%),mumps virus infection(33.9%)and biliary tract diseases(15%).Abdominal pain(96.2%),vomiting(72.6%)and fever(45.3%) were the most common clinical symptoms.And the most common signs were abdominal tenderness(73.6%),abdominal wall rigidity(17.9%)and abdominal distention(10.6%).Multisystem damage usually occurred in childhood acute pancreatitis.Serum amylase,urinary amylase and serum lipase elevated 84.8%,58.5% and 55%in patients,respectively.Fifty-one percont patients had abnormal ultrasound imaging and 81% had abnormal computed tomographic imaging.In 5 patients who were subjected to endoscopic retrograde cholangiopancreatography(ERCP) and magnetic resonance cholangiopancreatography(MRCP),the pancreaticobiliary system was visualized clearly.Nonsurgical therapy was done in most patients,only 6 cases received surgical therapy.Sixty-five cases were cured and 40 cases straightened up,only 1 case died.The efficiency rate was 99%.Pseudocysts occurred in 2 patients.Conclusions Idiopathic pancreatitis and mumps virus infection are the most frequent etiologic factors for childhood acute pancreatitis.Symptoms and signs such as abdominal pain and abdominal tenderness are the important diagnostic bases of childhood acute pancreatitis.Childhood acute pancreatitis was always accompanied by multisystem damage.Pancreatic enzyme test and radiography test were helpful in the diagnosis of childhood acute pancreatitis.Nonsurgical therapy is the leading therapeutic means of childhood acute pancreatitis.Timely diagnosis and allopathy help to improve the prognosis of childhood acute pancreatitis.Pseudocyst is the primary complication of childhood acute pancreatitis.

AIM: To compare the effect of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells and explore the differences between these two most commonly used surgeries for grade Ⅱ-Ⅲ lens nucleus. · METHODS: Retrospective study. We retrospectively evaluated the data of age-related cataract patients who had completed surgery in our hospital between June 2013 and December 2015. There were 84 eyes of 84 patients. The corneal endothelial cell density of all the patients were greater than 2000/mm2 and lens nucleus were gradeⅡ- Ⅲ. The patients were divided into manual small incision cataract surgery ( MSICS ) group and phacoemulsification ( Phaco ) group. MSICS group included 42 cases (42 eyes) and Phaco group included 42 cases ( 42 eyes ) . Postoperative evaluations were performed at 1d, 1wk, 1mo and 6mo and included uncorrected visual acuity ( UCVA ) , corneal endothelial cell density and the proportion of hexagonal cells. · RESULTS: There were no statistically significant differences of the two groups in preoperative basic data, UCVA, corneal endothelial cell density and the proportion of hexagonal cells, nuclear classification. The postoperative UCVA were significantly improved in both groups (x2=148. 01, P<0. 001; x2=165. 97, P<0. 001). The postoperative UCVA were on the rise as time goes on. The postoperative corneal endothelial cell density was obviously reduced in both groups compared with the preoperative (F=37. 74, P<0. 001; F=24. 56, P<0. 001). The proportion of hexagonal cells in Phaco group was declined at 1d (P=0. 002) after the operation and returned to baseline by 1wk (P=0. 894) after surgery. There was no significant difference between the two groups in UCVA, corneal endothelial cell density and the proportion of hexagonal cells at each observation point (P>0. 05). ·CONCLUSION: Manual small incision cataract surgery and phacoemulsification can indiscriminately improve UCVA and decrease the density of corneal endothelial cells. However, the change of hexagonal cells proportion was not obvious. These two surgeries for cataract patients with corneal endothelial cell density greater than 2000/mm2 , grade Ⅱ-Ⅲ lens nucleus have similar efficacy and safety.

Aged ; Antitubercular Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Middle Lobe Syndrome ; etiology ; therapy ; Silicosis ; complications ; Treatment Outcome ; Tuberculosis, Pulmonary ; complications ; therapy

Protein Kinase C ; Radiation, Nonionizing

34 patients who suffered from NVG, excluding patients with shallow anterior chamber.All patients were assigned to groups A and B according the different therapy.Group A ( 15 eyes ) was treated with Ex -PRESS glaucoma filtration device implantation. Group B ( 19 eyes ) underwent a trabeculectomy combined with mitomycin C. All the patients were followed up to 1a.The results of best-corrected visual acuity ( BCVA ) , intraocular pressure ( lOP ) , the combination of lOP lowering medications, complications were recorded statistically analyzed preoperative and 1d, 1, 4wk, 6 and 12mo after operation. · RESULTS: Mean lOP decreased significantly frompreoperative values in both groups ( P=0.01 ) .The both group had similar lOP values changes after 1, 4wk, 6, 12mo, and there were no significant difference in statistics (P=0.451).There was no significant difference in BCVA changes after operation in both groups ( P =0.832).Success rate was 66.7%and 63.1%at 1a after Ex-PRESS glaucoma filtration device and trabeculectomy, respectively. Anterior chamber bleeding occurred to 8 cases after trabeculectomy in group B and to 3 cases with Ex-PRESS glaucoma filtration device implantation in group A.Choroidal detachment occurred to 3 cases in
group A and 6 cases in group B. No other ocular or systemic adverse events were found during the follow-up duration.
·CONCLUSlON:ln the short-term, Ex-PRESS glaucoma filtration device implantation has the advantages of simpleness, safety, minimally invasive, short learning curve for neovascular glaucoma, which provides us an available strategy to conquer NVG by simply operation and less suffering.

AIM: To investigate therapeutic effects of combination therapy for neovascular glaucoma ( NVG) .
METHODS: This retrospective study comprised 34 eyes of 34 patients who suffered from NVG. All patients were assigned to group A, B, C and D according to the different combination therapies. Group A ( 11 eyes of 11 patients ) was treated with intravitreal injection of ranibizumab and panretinal photocoagulation ( PRP ) . Group B ( 10 eyes of 10 patients ) was treated with transcleral cyclophotocoagulation and PRP. Group C ( 6 eyes of 6 patients) was treated with 3 therapies together. Group D (7 eyes of 7 patients) was treated with 810nm transcleral cyclophotocoagulation and soft gas-permeable contact lenses. All the patients were followed-up for 1a. The best- corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) were recorded and analyzed prior to operation and 1, 4wk, 6 and 12mo after operation.
RESULTS: All the post treatment IOP decreased significantly ( P<0. 05 ) from the values before therapy, and the IOP values after 4wk, 6, 12mo were not significantly different ( P > 0. 05 ) in statistics. Most patients' IOP can be controlled below 23mmHg after combination therapy. The visual acuity in group A after 1, 4wk, 6mo compared with those before treatment was significantly increased ( P<0. 05 ) in statistics and other groups did not significantly change before and after treatment (P>0. 05). Anterior chamber bleeding occurred to 2 cases after 1wk of transcleral cyclophotocoagulation. No other ocular or systemic adverse events were found during the follow-up duration.
CONCLUSION: After the combination of intraocular injection of the anti - VEGF drugs, 810nm laser cyclophotocoagulation and PRP, most patients with NVG disease can be effectively treated, can effectively control IOP, and retain part of the visual function, significantly improve the quality of life. In the short - term, combination therapy is safe and effective for NVG, which provides us an available strategy to conquer NVG by simply programmable operation and less suffering.

The incidence of birth defect in China is still high,which is not only affected by genetic factors,but also affected by heavy metals in surrounding that prejudices foetus' normal development.Heavy metal is a kind of inorganic pollutants with high toxicity.Excessive intake of lead,cadmium,arsenic or mercury,and the insufficient intake of zinc,calcium and copper may both lead to at least 1 kind of birth defect.The interactions between heavy metals also affect the outcomes of pregnancy.This paper reviewed different relationships between heavy metals and birth defect recording to relevant achievements such as animal experimentations and epidemiologic study made by researches from at home and abroad in recent years.It is advised to intake adequate zinc and copper and avoid being exposed to harmful metals to make sure the effective reduction of the incidences of birth defects.This paper will also point out the direction of future research about the relationship among the birth defects and heavy metal.

Objective To study the clinical and electrophysiological characteristics of peripheral neuropathy in patients with multiple sclerosis(MS).Methods As a total of 84 MS patients,the clinical and electrophysiological data were analyzed in 16 MS patients with the symptoms of peripheral neuropathy(PNMS group)and in 68 MS patients without peripheral neuropathy(NPNMS group).Results The incidence of peripheral neuropathy was 19.0%(16/84)in this group.The clinical symptoms included extremity numbness in 14 cases(87.5%),limb inertia in 12 cases(75.0%),and radicular pain in 4 cases(25.0%).Signs included decrease of tendon reflex in 15 cases(93.7%),periphery sensory disability in 13 cases(81.2%),and myatrophy in 5 cases(31.2%).The mean age in the PNMS group was(44.6?12.5)years vs.(32.2?11.5)years in the NPNMS group.The course of disease was(39.3?18.3)months vs.(31.6?17.2)months in the NPNMS group,there were significant differences in two groups(P