Objective To investigate the effect of extracapsular cataract extration by small incision after glaucomatous filtering surgery.Methods Non-phacoemulsificatinon extracapsular cataract extraction with posterior chamber intraocular lens implantation through temperal small tunnel incision was performed on 56 eyes of 48 glaucoma patients with preexisting filtering bleb.Results Visual acuity was improved in 56 eyes of 48 cases postoperatively.No severe complication was found intraoperatively and postoperatively.The postoperative IOP was (14.18?3.72)mm Hg.The functiond filtering bled had no apparently cicatrisation.Conclusion The operation is an effective method to treat cataract after glauconcatous filtering surgery.

The technique of transcervical chorionic villus sampling (TCVS) was studied in 155 cases for selected abortion in the first trimester of pregnancy, and 3 kinds of suction tube were compared. The ultrasonic mothod for the aspiration of chorionie villus sampling is more effective than the blind aspiration, giving a success rate of 99%. The modified suction tube with a stainless steel wire along-side as a supporter is simpler than the Portex's tube, giving a oneshot success rate of 85%. This shows that the TCVS is more satisfactory if the embryo is implanted into the posterior wall of the uterus. With the B-mode scanner, it gives the highest one-shot success rate and the amount of the obtained tissue is the greatest in the 7th and 8th weeks of gestation. Twenty cases were followed up for 3 to 7 days after the procedure before selective abortion. No complications occurred during and after the TCVS, indicating that this technique ia simple, safe and reliable.

Mother-Fetus ABO blood group incompatibility is one of the most common causes of hemolytic disease of newborns in China. To identify the blood group of the fetus in case of suspected mother-fetus blood group incompatibility in the first trimester of pregnancy, the author determined blood group substance (BGS) in 40 chorionic villi samples taken by the absorption-elution procedure during 6 to 12 weeks of gestation, with a simultaneous parental blood group determination as control. The BGS detected in those specimens were all in accordance with those of the blood groups of their coriesponding parents. Among the 40 samples of chorionic villi, 20 were redetermined, and the results were the same. This demonstrates the feasibility of the procedure to identify the fetal blood groups by the determination of BGS in the chorionic villi by transcervical aspiration. The study presents, apparently, a new and simple diagnostic method for detecting mother-fetus blood incompatibility in early pregnancy, thas giviing a prospectively preventive study on those types of blood group incompatibility.

Objective:To detect the methylation status of insulin-like growth factor Ⅱ(IGF-Ⅱ)gene promoter P3 in salivary pleo-morphic adenoma(SPA).Methods:The methylation of IGF-Ⅱ gene promtor P3 was examined in 26 cases of salivary pleomorphic adenoma with adjacent normal salivary gland tissues,1 0 cases of salivary gland malignant tumor (except malignant pleomorphic ade-noma)and 1 0 cases of normal salivary gland tissue by nested methylation specific polymerase chainreaction(nMSP),1 0 samples(3 SPA and controls,2 malignance and controls)were examined by pyrosequencing.Results:9 out off the 26 SPA showed lower level methylation oevel of IGF-II gene promoter P3.Normal salivary gland and salivary gland malignant tumor tissue did not.Conclusion:IGF-II gene promoter P3 with low level of methylation may play a role in the development of SPA.

Epstein-Barr virus (EBV) remains one of the most important pathogens in children,which usually causes acute EBV infection,chronic active EBV infection,hemophagocytic lymphohistiocytosis,lymphoma and other cancers.Therefore,effective laboratory diagnosis is of importance in diagnosis,surveillance,and control of EBV-associated disease.Currently,a variety of detection methods have been applied in clinical laboratories and typical diagnostic assays are always focusing on EBV-DNA and serological tests.Different assays vary in different purposes and applications,which seems to be difficult to choose an appropriate technique.This article aims at systematically analyzing clinical significance of these assays and evaluating the immune functions of EBV infection and the detection of susceptibility genes of EBV-related disease.

Objective:To investigate the relationship among college student’s depression symptoms, problem solving appraisal and perceived stress.Methods:275 college students completed questionnaires, including CES-D, Chinese Perceived Stress Scale (CPSS) and Chinese Problem Solving Inventory (CPSI). Results: Among these students, 52% reported on the level of health risk stress (HRS), 55.3% had depression symptoms. There were significant correlation among depression symptoms, perceived stress and problem solving appraisal. The causal relationship between them were identified with the path analysis method, problem solving in special, seems to have both direct and indirect effect on the prediction of depression and on perceived stress. Conclusion:There is a high level of college student perceived stress and depression symptoms. Problem solving appraisal is an important factor for both of them.

Based on the organizational strategy,the balanced scorecard(BSC) is a kind of customized performance measurement system.Put forward by Robert Kaplan and David Norton in 1990,it has been using at several healthcare organizations and led to a great deal of innovation in organizing and management.This paper aims to introduce the composition,characteristics and successful cases of BSC,and analyze the feasibility of adopting this method in domestic healthcare organizations.

Objective To investigate the correlation and risk factors between vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN).Methods A total of 121 cases of VAIN patients was retrospectively analyzed with examination results such as clinical manifestations,liquid based cytology (TCT),human papilloma virus infection,virus infection type,and clinical data of treatment and follow up.Results VAIN Ⅰ,VAIN],and VAIN Ⅲ] were accounted for 33.9％ (41/121),38.0％ (46/121),and 24.4％ (34/121) ; for 40 or less years old patients,VAIN Ⅲ was accounted for 10.7％ (3/28) ; for more than 40 years old patients,VAIN Ⅲ was accounted for 33.3％ (31 /93).Among 121 VAIN patients,77.7％ (94/121) patients had CIN history,15.7％ of which (19/121) had a history of cervical cancer; 27.3％ (33/121) with hysterectomy history,of which 75.8％ (25/33) was due to cervical intraepithelial neoplasia and cervical cancer resection of the uterus.Papilloma viral load in patients with VAIN Ⅰ was detected with a (HPV-HC2) positive rate of 87.8％ (36/41),while in VAIN Ⅱ and VAIN [patients,the positive rate was 100％,the infection of high risk type of HPV ratio was 95.9％ (116/ 121).of which the mixed infection was accounted for 56.9％ (66/116).There was 94.6％ in oatients with VAIN (114/121),and liquid-based cytology test results suggest abnormality; 88.4％ (107/121) in patients with VAIN lesions occurred in upper 1/3 of vaginal.After diagnosed cervical disease,the onset time of VAIN was (3.45 ± 2.02) years,non-total-hysterectomy was (3.24 ± 1.97) years,after hysterectomy to pathological diagnosis time for VAIN was (5.01 ± 3.95) years:for the diagnosis of VAIN disease after resection of cervical original time was (3.96 ± 2.99) years,and rather than non cervical disease resection was an average of (9.94 ±5.37) years.In the course of treatment of the 12l cases of CIN patients,6 cases of patients were progressed to invasive carcinoma.Conclusions The clinical manifestation of VAIN is similar to CIN,the principle of diagnosis and treatment of CIN can also apply to VAIN,high risk HPV infection virus,cervical intraepithelial neoplasia are the risk factors for VAIN.

Objective To evaluate the accuracy of stroke volume variation(SVV)in blood volume monitoring during induction in patients undergo?ing coronary artery bypass grafting(CABG). Methods Thirty ASAⅡorⅢpatients,aged 53?74 year,BMI 21?27,NYHA classⅡorⅢ,scheduled for CABG were enrolled in this study. MAP,HR,CVP,SVV,cardiac output(CO),cardiac index(CI),stroke volume index(SVI)and systemic vascular resistance index(SVRI)were continuously measured by Vigileo/FloTrac system and recorded simultaneously at the following time points:T1(baseline level)and T2(after induction and before intubation). Calculate the changes of SVV,CVP and CI(△SVV、△CVP and△CI). Pa?tients whose△CI≥15%were defined as the responders to the insufficiency of blood volume. The receiver operating characteristic(ROC)curve for SVV and CVP were plotted,and the area under the curve were calculated. Results Compared with T1,significant decrease in CO,CI and SVI was observed at T2 . Meanwhile,SVV increased from 8%±5%to 17%±12%(P=0.012). Twenty?four patients were responders to intravascular volume insufficiency due to induction. SVV were significantly higher in responders than in non?responders(20%±13%vs 9%±4%,P=0.036). A threshold SVV value of 10.5%allowed discrimination between responders and non?responders to blood volume insufficiency,with a sensitivity of 75%and a specificity of 80%. The area under the curve for SVV was 0.875,and the 95%confidence interval was 0.689 to 1.000. Conclusion SVV exhibited reliable sensitivity and specificity in monitoring blood volume changes during induction in patients undergoing CABG.

Objective To investigate the effect of remote ischemic preconditioning (RIPC) combined with dexmedetomidine on the lung injury during one-lung ventilation (OLV) in the patients undergoing thoracic surgery. Methods Eighty ASA physical status I or Ⅱ patients, scheduled for elective radical operation for esophageal cancer, were randomly divided into 2 groups(40 patients each group) using a random number table: control group and RIPC combined with dexmedetomidine group (ORD group). In ORD group,10 min after endotraeheal intubation, RIPC was induced by 3 cycles of 5 min lower extremity ischemia followed by 5 min reperfusion, and at the same time a loading dose of dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min and then dexmedetomidine was infused at a rate of 0.5 μg/(kg·h) until the end of operation. At 0, 30 min, 1 h and 2 h of OLV(T1-4), blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α (TNF-α), interleukin (IL)-1βand IL-10.Oxygenation index and respiratory index were calculated. Exhaled breath condensate was collected at T1, T3 and T4, and the pH value was measured. Results The respiratory index at T2-4 in 2 groups were significantly higher than those at T1, control group: 1.16 ±0.12, 1.02 ±0.10 and 0.97±0.12 vs. 0.49±0.06, ORD group: 0.84±0.15, 0.72±0.12 and 0.65±0.10 vs. 0.48±0.08, there were statistical differences (P<0.05). The oxygenation index at T2-4 in 2 groups were significantly lower than those at T1, control group: (287.1±21.8), (306.8±35.2) and (312.9±25.5) mmHg (1 mmHg=0.133 kPa) vs. (426.5±39.0) mmHg, ORD group: (335.0±34.7), (341.1±41.3) and (359.1±38.8) mmHg vs. (433.6±23.8) mmHg, there were statistical differences (P<0.05). Compared with control group, the respiratory index at T2-4 in ORD group were elevated, the oxygenation index at T2-4 in ORD group were depressed, there were statistical differences (P<0.05). The TNF-α and IL-1β at T3-4 in 2 groups were significantly higher than those at T1, control group: (31.4±6.7) and (38.3±7.2) μg/L vs. (16.2±5.1) μg/L, (7.2±1.6) and (12.3±4.2) μg/L vs. (3.0±0.7) μg/L, ORD group: (21.7±5.4) and (23.4±5.1) μg/L vs. (16.3±4.7) μg/L, (4.8±0.9) and (6.3±1.6) μg/L vs. (2.9±0.8) μg/L, there were statistical differences (P<0.05). The pH value of exhaled breath condensate at T3-4 in 2 groups were significantly lower than those at T1, control group: 6.41±0.23 and 6.33±0.21 vs. 6.93±0.35, ORD group: 6.79±0.30 and 6.74±0.33 vs. 7.07±0.22, there were statistical differences (P<0.05). The IL-10 at T4 in 2 groups were significantly higher than those at T1, control group:(30.6±6.3) μg/L vs. (19.2±5.3) μg/L, ORD group: (41.3±5.2) μg/L vs. (19.5±4.9) μg/L, there were statistical differences (P<0.05). Compared with control group, the TNF-α and IL-1β at T3-4 in ORD group were depressed, the pH value of exhaled breath condensate at T3-4 in ORD group were elevated, the IL-10 at T4 in ORD group was elevated, there were statistical differences (P<0.05). Conclusions RIPC combined with dexmedetomidine can inhibit inflammatory responses and reduce airway acidification, thus attenuate the lung injury during OLV in the patients undergoing thoracic surgery.