Background In clinic practice,three or four rectus muscles often are needed to perform operation for the correction of large angle (＞50Δ) exotropia to avoid eye limited abduction due to lateral rectus superrecession.However,recent study reported that lateral rectus super-recession surgery can effectively correct large angle exotropia without remarkable abduction limitation.This outcome still need to be verified in clinical practice.Objective This study was to observe the outcome of bilateral rectus super-recession or medial rectus resection of the combined non-dominant eye for large angle exotropia.Methods A series case study was carried out.Fifty-one patients with intermittent or constant exotropia were enrolled in Tianjin Eye Hospital from May 2013 to October 2014.There were 29 intermittent exotropia and 22 constant exotropia among the 51 patients.Combined with adjustable sutures,bilateral lateral rectus super-recession or medial rectus resection of combined non-dominant eye was performed in all the eyes,and the examination of the anterior segment,fundus,ocular movement and binocular vision were performed before and after surgery.The deviation angle was measured by prism and alternate cover test.The individualized surgery procedure was designed according to medical history,ocular movement,sensory status and deviation angle.The patients were followed-up for at least 6 months.The eye position,ocular movement and binocular sensory function were compared between peoperation and postoperation.This study was approved by the Ethics Committee of Tianjin Eye Hospital.Written informed consents before the operation were obtained from all patient or their parents.Results Thirty-three patients underwent bilateral lateral super-recession and 18 patients underwent bilateral lateral super-recession of the medial rectus resection of the combined non-dominant eye.The mean angle of exotropia for seeing distance of 5 meters was (-70.57 ± 16.46) Δ (from-52 Δ to-120 Δ) and was (-75.65 ±16.14) Δ for seeing near (33 cm) (from-55Δ to-130Δ).The mean amount of left eye recession was 8-15 mm ([11.17±1.67] mm) and the right eye recession was 9-15 mm ([11.28±1.62] mm).The medial rectus of the dominant eye was resected by 3-6 mm.At the end of following-up,the mean angle of exotropia for seeing distance was (-3.45±4.20) Δ (from +4Δ to-14Δ) and was (-5.49±3.96) Δ for seeing near (from +4Δ to-14Δ).Surgical outcome was effective in 41 patients (80.4％),and 10 patients were undercorrected.The stereopsis of 32 patients improved after surgery,and 18 of 27 patients without preoperative stereopsis function obtained stereopsis after surgery.No ocular motility disorder was found in this group of patients after surgery.Conclusions Bilateral lateral rectus super-recesssion or medial rectus resection of combined non-dominant eye can effectively correct large angle exotropia and reduce the number and amount of surgical muscles without ocular motility disorder.

Objective To establish a rabbit posttraumatic acute diffuse brain swelling (PADBS) model and investigate the mechanism of action.Methods Fifty New Zealand rabbits were assigned to control group (n =10) and model group (n =40) according to random number table.The animal model of sinus balloon compression was established under intracranial pressure monitoring by using intracranial pressure probe.The model group was subdivided equally at 1.5 hours after compression,1.5 hours after decompression,3 hours after decompression and 4.5 hours after decompression,for which intracranial pressure,brain water content,pathological mechanism and ultrastructure were measured dynamically.Results The success rate of modeling was 83％ (33/40).Intracranial pressure was (4.9 ± 0.8)mmHg in control group,(50.1 ± 4.3) mmHg in 1.5 hours after compression group,(45.2 ± 1.7) mmHg in 1.5 hours after decompression group,(48.6 ± 2.2) mmHg in 3 hours after decompression group,and (59.1 ±2.5)mmHg in 4.5 hours after decompression group (P ＜0.05).Brain water content was (75.0 ± 0.6) ％ in control gorup,(76.7 ± 0.8) ％ in 1.5 hours after compression group,(77.3 ± 0.5) ％ in 1.5 hours after decompression group,(78.5 ± 0.6) ％ in 3 hours after decompression group,and (79.4 ± 0.7) ％ in 4.5 hours after decompression group (P ＜ 0.05).Vasogenic brain oedema was seen 1.5 hours after decompression.Cytotoxicity brain swelling generated with brain tissue destroyed 3 hours after decompression.The vicious cycle of high intracranial pressure and brain tissue destruction occurred 4.5 hours after decompression.Conclusion Under intracranial pressure probe monitoring,the rabbit model of PADBS by sinus balloon compression has stable pressure of the sinus balloon and has good reliability and repeatability,which provides a reliable evidence for further study on the possible mechanism and treatment methods of PADBS.

Objective: To observe the efifcacy and safety of bivalirudin on primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI).
Methods: A total of 159 patients with acute STEMI treated by emergent PCI in our hospital from 2011-09 to 2014-01 were retrospectively studied. The patients were divided into 2 groups according to procedural bivalirudin application as Bivalirudin group and Heparin group, and the application of GPI (glycoprotein IIb/IIIa inhibitor) was decided by the operator. The baseline condition, coronary artery imaging condition, peri-operative and 30-day post-operative bleeding, the occurrence rate of MACE were compared between 2 groups.
Results: There were 153 patients completed the follow-up study including 72 in Bivalirudin group and 81 in Heparin group. The peri-operative bleeding rates in Bivalirudin group and Heparin group were 6.5% vs 11.0%, the in-stent thrombosis rates were 0% vs 1.2%, 30-day post-operative bleeding rates were 9.7% vs 13.5% and the occurrence of MACE were 1.4% vs 7.4% allP>0.05.
Conclusion: THE application of bivalirudin in emergent PCI is safe and effective in patients with acute STEMI, it has certain trend to reduce bleeding in relevant patients.

Objective To explore the effects of Shengmai Injection on tumor growth and the expression of P-gp in transplanted tumor of human gastric carcinoma of SGC7901/VCR cell in nude mice.Methods Transplanted tumor model of human gastric carcinoma of SGC7901/VCR cell in nude mice was built, which was divided randomly into five groups: normal saline control-group, 5-FU group, 5-FU + verapamil group, 5-FU +Shengmai group, Shengmai group. Nude mice growth state was observed, average weigh and inhibition rate of transplanted tumor were calculated, and the expression of P-gp was detected.Results There was significanf difference in terms of transplanted tumor weight,volume among 5-FU+Shengmai group and 5-FU group and normal saline group(P0.05); P-gp express had difference between normal saline group and shengmai group, P

Objective To explore the expression of human sodium coupled neutral amino acid transporter 1 (SNAT1) in human glioma tissues and its relationship with clinical pathological parameters and prognosis. Methods Immu?nohistochemical and western blotting were used to detect SNAT1 expression in glioma tissue and tumor peripheral tissue from 89 cases of glioma patients including 55 cases of low grade gliomas (WHO I-II), and 34 cases of high grade gliomas (WHO grade III-IV).χ2 test and was used to analyze the relationship between expression and clinical pathological param?eters of SNAT1. Kaplan-Meier method was used to analyze the effect of different expression of SNAT1 on the prognosis of patients and to establish the Cox regression model. Results The expression of SNAT1 was significantly higher in gliomas than in tumor peripheral tissue (t=-9.803, P=0.001). The expression of SNAT1 was significantly higher in high pathologi?cal grade tissues than in low grade of glioma tissues (t=-6.682, P=0.003). SNAT1 expression was associated with tumor di?ameter and pathological grade (χ2=4.963, 8.527, P<0.05);Cox regression model showed that the tumor pathological grade and different SNAT1 protein expression were independent risk factors for the prognosis of patients with glioma. Conclu?sions The expression of SNAT1 protein is closely associated with the pathological grade of gliomas and the prognosis of the patients, which may be a new target to judge the biological characteristics and to evaluate the prognosis of gliomas.

Objective To investigate the relationship between serum resistin,leptin and adiponectin with microangiopathy in the patients with type-2 diabetes mellitus(T2DM).Methods One hundred and twenty patients with T2DM in our hospital were selected and divided into the non-microangiopathy group (NON-MAP,60 cases) and microangiopathy group (MAP,60 cases) according to whether complicating microangiopathy.Other 60 individuals undergoing healthy physical examination were selected as the normal control group(NC).Fasting serum resistin,adiponectin and leptin levels were detected in each group.Fasting blood glucose,insulin and blood lipid levels were also detected.The insulin resistance was evaluated by using insulin resistance index(HOMA-IR).Results The levels of serum resistin,leptin,free fat acid(FFA) and hs-CRP in the NON-MVP group and MVP group were signifi cantly higher than those in the NC group,while the adiponectin level was sigrnificantly lower than that in the NC group,the difference was statistically significant(P＜0.05).The correlation analysis showed that serum resistin and leptin levels had positive correlation with hs-CRP,FFA,HOMA-IR and TG(P＜0.05),and had negative correlation with HDL-C(P＜0.05);the adiponectin level was negatively correlated with hs-CRP,FFA,HOMA-IR and TG,while positively correlated with HDL-C(P＜0.05);serum resistin and leptin levels had positive correlation,both had significantly negative correlation with adiponectin;with serum resistin,leptin and adiponectin as the dependent variables,the multiple stepwise linear regression analysis showed that HOMA-IR and waist to hip ratio had maximal influence on them.Conclusion Serum resistin and leptin levels increase and adiponectin level decrease in T2DM patients suggests that serum resistin,leptin and adiponectin are correlated with T2DM occurrence as well as microangiopathy occurrence.

Objective To study the effects of Panax Notoginseng Saponins (PNS) on the damaged expression of ZO-1 of brain microvascular endothelial cells caused by Aβ42.MethodsBrain microvascular endothelial cells were divided into normal control group, model group, PNS low-, medium- and high concentration groups. They were incubated for 24h in 5% CO2 incubator at 37℃ . Then cell vitality was detected by MTT colorimetric method and ZO-1 protein expression was tested by Western blot.Results Stimulation of Aβ42 reduced the activity of microvascular endothelial cells (P<0.01) and suppressed the expression of ZO-1 protein (P<0.01). Compared with the model group, the activity of microvascular endothelial cells of PNS groups, especially the high and medium dose groups (P<0.05), and increased the ZO-1 protein expression. Conclusion PNS can partly recover the barrier function of blood brain barrier through inhibiting the decrease of the activity of microvascular endothelial cells caused by Aβ42.

Objective To analyze perioperative management and risk factors for the prognosis of hip fracture surgery in elderly patients.Methods The present study included 112 elderly patients (aged ≥65 years) who received hip fracture surgery from January 2009 to January 2013 in our department,and their clinical data were retrospectively analyzed.Results The percentage of cases with concomitant diseases before operation was 91.0 ％,and the postoperative complications rates were 35.7％.One-year mortality after operation was 21.4％.The percentage of survival cases with daily living activities fully restored to pre injury status was 47.6％.Logistic regression analysis revealed that independent risk factors for the one-year mortality included general health before injury (OR=13.36,P =0.047),pulmonary disease (OR =18.33,P =0.007),number of postoperative complications (OR=15.14,P=0.025),and renal failure (OR=11.26,P=0.034).Conclusions Elderly hip fracture patients have many different concomitant diseases.By applying the qualified levels of perioperative management,anesthetic and operative methods,and postoperative rehabilitation measures according to the conditions of the patient,the incidence of perioperative complications and one year mortality can be decreased,and qualified surgical outcomes can be obtained.The independent risk factors for the one-year mortality include general health before injury,pulmonary disease,number of postoperative complications and renal failure.

Objective: To observe the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine, on insulin resistance in guinea pigs with induced cholesterol gallstones. Methods: Eighty guinea pigs were randomly divided into normal control group, untreated group, YGLDG group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group. Except the normal control group, gallstones were induced by high-cholesterol diet in the guinea pigs. The guinea pigs in the normal control group and the untreated group were administered with normal saline. UDCA and YGLDG were given to the guinea pigs in the corresponding groups for seven weeks. Eight guinea pigs of each group were used to measure the glucose infusion rate (GIR) by using hyperinsulinemic-euglycemic clamp technique. At the end the guinea pigs were killed and their gallstone formation was observed. Results: The gallstones in guinea pigs were identified as cholesterol stones by qualitative analysis through infrared spectrum. The incidence rate of cholelithiasis of the untreated group was 82.35% . The GIR of guinea pigs in the untreated group was obviously lowered down as compared with the normal control group. Compared with the untreated group, the GIRs of the YGLDG group and the UDCA group were obviously increased, especially in the YGLDG group. Conclusion: YGLDG may improve insulin resistance in guinea pigs with cholesterol gallstones by elevating GIR obviously.

Objective To discuss clinical curative effects of using Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects.Methods From August 2010 to August 2010,36 patients with nose alar full-thickness defects in the second affiliated hospital of kunmin medical university,The defect range exceed 1.5 cm× 1.2 cm.50-80 ml expander was implanted in forehead and injected saline water to expand in order to acquire extra skin.We Turn around the skin of defect as the lining of nose,harvest ipsilateral auricular cartilage for nose ala framework,Expanded forehead pedicle flap was transferred to cover framework.The donor area was sutured directly.The pedicle of flap was cut and trimmed after 2 months.Results Follow-up time of 3-18 months after the operation,All flaps are survive,nose alar defects are repaired successfully.Some cases were performed second surgery,postoperative,nose alar color,thickness,nostril size and shape the same with the contralateral side.Donor site healed with linear scar.Conclusions This method could be easy to obtain excess skin,for repairing large sides nose alar full-thickness defect.Frontal scar is not obvious,It is a practical.