Objective To evaluate the therapeutic efficacy of retrobulbar injection with triamcinolone acetonide (TA) for macular edema caused by retinal vein occlusion (RVO). Design Retrospective case series. Participants 21 eyes of 21 patients with macular edema caused by RVO. Methods Retrobulbar injection with TA 40 mg was performed on 21 eyes. The visual acuity, intraocular pres-sure, fundus fluorescein angiography (FFA) and macular central thickness under the optical coherence tomography (OCT) were recorded and analyzed before and after treatment. The follow-up duration was 6-11 months. Main Outcome Measures The visual acuity and the macular central thickness of OCT. Result Visual acuity was improved at the end of follow-up in 16 eyes (76.2%) and unchanged in 5 eyes (23.8%). Macular central thickness was (287.55±121.70) μm at the end of follow-up and (617.23±185.58) μm before treatment. The difference was statistically significant(P=0.000). After treatment, the comparison of visual acuity and macular central thickness be-tween CRVO patients and BRVO patients, as well as between ischemic RVO patients and non-ischemic RVO patients had no significant difference (P>0.05). In patients of course less than 6 months, the visual prognosis after treatment is better than that of before treatment (P=0.011, 0.01), while in patients of course more than 6 months, no difference of vision could be detected before and after treatment (P= 0.583). The result of FFA showed decrease of fluorescein leakage. During follow-up, intraocular pressure of all patients was in the nor-real range. Recurrence of macular edema was found in 8 eyes 2 to 6 months after treatment. Conclusions Retrobulbar injection with TA is a safe, effective, and easy method to treat macular edema caused by RVO. Early treatment can get better efficacy. (Ophthalmal CHN, 2009, 18: 254-256)

Objective To evaluate the application of intra-aortic balloon counterpulsation(IABP) in acute myocardial infarction(AMI) with cardiogenic shock.Methods The study enrolled 65 AMI patients with cardiogenic shock and all the patients underwent primary PCI treatment.Among them,30 patients had IABP suppont during operations.Results In all the 30 cases with IABP support,the hemodynamic parameters improved in 30 minutes and stabilized in 2-8 hours.There was no reocclusion and death during querations.The death rate of the IABP group during hospitalization was 40%.Among the other 35 patients without IABP support,6 patients died during PCI and the in hospital death rate was 74.3%.Conclusion IABP can improve hemodynamic parameters and the perfusion of coronary artery in patients with cardiogenic shock.It can increase the success rate of primaty PCI,reduce the risk of low cardiac output and reocclusion during operation.IABP support during PCI can also improve the prognosis and reduce the motality rate of AMI patients with cardiogenic shock.

Yohimbine (0. 5~4mg ? kg-1, sc) and idazoxan (2~8 mg ? kg-1,sc) showed a dose related antagonistic action on the inhibitory effect of xylazine (4mg ? kg-1,sc) on the gastrointestinal propulsive motility in mice. Xylazine (2mg,4mg ? kg-1,sc),clonidine(120 ?g ? kg-1,sc) exhibited the inhibitory effect of gastrointestinal basic electrical rhythm on the stomach, duodenum, jejunum and ileum in rats.The inhibitory effects of these drugs were the strongest at 30 min after administration of Compounds. Yohimibine (4mg ? kg-1,sc) was found to antagonize the inhibitory effect of xylazine (4mg ? kg-1,sc) on the gastrointestinal basic electrical Rhythm.

Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.

Objective:To research the number and function of monocyte-macrophages in patients with chronic active hepatitis B. Methods:The 51 chronic viral hepatitis B( CHB) patients were selected randomly,which consisted of 20 cases of mild-moderate,31 cases of severe group and 13 cases of healthy controls. PBMCs were separated by percoll. Monocytes were tagged by CD14,the molecules CD80,CD86,HLA-DR and CD163 were detected by flow cytometry which expressed on the surface of PBMCs. Serum cytokine were detected for IL-10, IL-12 and IL-23 by ELISA. The distribution of CD68 was detected in the liver by immunohistochemical staining. Results:The expressions of CD80 for all chronic hepatitis B patients were lower than the controls respectively,no matter mild-moderate or even severe group. Similarly,the HBV patients expressed lower level of CD86 in the peripheral blood mononuclear cells when compared with the control group. Furthermore, there was statistically difference between the levels of CD86 in severe group compared with control group (P<0. 01). As the expression of CD80 and CD86,the levels of HLA-DR in the patents had also declined when compared with controls. While the HLA-DR levels in both the mild-moderate HBV hepatitis groups were statistically significant higher than the severe group (P<0. 01). Different from the above all,the expression of CD163 in all chronic HBV hepatitis was higher than the control group. The CD68 positive cells in chronic HBV patients were observed and infiltrated increasingly in portal area and hepatic lobules (P<0. 05). There were statistically significant differences of IL-10 levels between the mild-moderate group,severe group and the control group,respectively (P<0. 01). Conclusion:Macrophages have participated in the pathological lesions of liver in CHB patients,among peripheral blood mononuclear cells,the phenomena of imbalance between type M1/M2 and polarization to type M2 have been observed,which participated in the development of the chronicity of CHB.

Objective To summarize the experience in the treatment of Marfan syndrome of pregnancy complicated with acute type A aortic dissection.Methods Three women with Marfan syndrome of pregnancy complicated with acute type A aortic dissection were treated.The average age was 28.6 (25-31) years,and the average gestational age was 36.5 (32-38) weeks.At first caesarean operation were performed under general anesthesia.Bentall + Sun' s operation was performed under deep hypothermic circulatory.After operation,the mother and fetus were followed up.Results Three women and their fetus were safe.The average extracorporeal circulation time,aorta clamp time and circulatory arrest time were 265 (210-280) min,135 (120-160) min and 26.5 (20-29) min,respectively.After a mean follow-up of 2.0 (1.0-2.5) years,3 patients were living well.CT angiogram detected normal aortic,with no signs of distal dilation.Three fetus were normal in development and neurocognitive function.Conclusion Methods of surgical repair and fetal delivery should be chosen based on aortic pathological changes and gestational age to maximize the safety of the mother and fetus.

Objective To evaluate the diagnosis value of urodynamics in patients with benign prostate hypertrophy(BPH).Method With urodynamic device,the full set of urodynamic exam was administrated in 427 patients with BPH,and the externalsphincter urethral myogram was monitored simultaneously in pressure-flow studies(PFS).The umdynamic finding such as Q_(max),P_(det)-Q_(max),DS(descending slope)and post-voiding residual(PVR)were recorded,as well as the situation of bladder detrusor constraction and bladder compliance and urethral sphincter coodination.The bladder outflow obstruction was diagnosed by A-G nomogram,P-Q plot and DS.The IPSS score and prostate volume were also acquired.Results The diagnostic rate of BOO is 81.5%,among them concomitantly detrusor muscle impair in 117 cases (27.4%),decreased bladder compliance in 162 case(37.9%),urethral sphincter dyssynergia in 148 cases(34.7%),and unstable bladder in 164 cases(38.4%).The increase degree of BOO show an increasing tendency with urodynamic finding such as Q_(max),P_(det)-Q_(max),P_(open),DS,IPSS score and prostatic volume respectively,but a decreasing tendency with Q_(max) and bladder compliance.Conclusions The urodynamic exam plays an important role in diagnosis of BOO.There is a positive relation among degree of BOO with urodynamic findings such as P_(det)-Q_(max),P_(open),DS and IPSS score and prostatic volume,however,a negative relation with Qmax and bladder compliance respectively.

Objective To estimate the influence of 1,25(OH)2D3 on the proliferative ability of and methylation levels of genomic DNA and proliferation-associated gene promoter in human HaCaT keratinocytes.Methods Some cultured HaCaT cells were treated with 1,25 (OH)2D3 of 10-6,10-7 and 10-8 mol/L for 24 hours,then,methyl thiazolyl tetrazolium (MTT) assay was carried out to evaluate the proliferative activity of cells,and a global DNA methylation quantification kit was used to determine the global DNA methylation level.Real-time PCR was conducted to quantify the mRNA expression of DNA methyl transferases (DNMTs) and methyl-DNA binding domain (MBD) proteins,and methylation-specific PCR (MS-PCR) to evaluate the methylation status of promoter region in the programmed cell death 5 (PDCD5) and tissue inhibitor of metalloproteinase 2 (TIMP2) genes,in HaCaT cells after 24-hour treatment with 1,25 (OH)2D3 of 10-6 mol/L.The HaCaT cells receiving no treatment served as the control.Results Compared with the untreated HaCaT cells,those treated with 1,25(OH)2D3 of 10-6 mol/L showed significantly down-regulated proliferative activity (0.152 ± 0.027 vs.0.290 ± 0.017,P ＜ 0.01),global DNA methylation level (0.187 ± 0.071 vs.0.316 ± 0.049,P ＜ 0.05),DNMT3a and DNMT3b mRNA expression levels (P ＜ 0.01 or 0.05),but markedly upregulated mRNA expression levels of MECP2,MBD2,PDCD5 and TIMP2 (P ＜ 0.01 or 0.05).Moreover,the DNA methylation levels within the promoter region of PDCD5 and TIMP2 genes were significantly lower in HaCaT cells treated with 1,25 (OH)2D3 of 10-6 mol/L than in the control cells (0.38 ± 0.135 vs.0.72 ± 0.121,0.46 ± 0.172 vs.0.68 ± 0.133,both P＜ 0.05).Conclusions 1,25(OH)2D3 may down-regulate the global genomic DNA methylation level of,and modulate the expression of DNA methylationmodifying genes in,HaCaT cells.Furthermore,1,25 (OH)2D3 can decrease the promoter methylation levels but induce the overexpression of PDCD5 and TIMP2 genes,and decelerate the proliferation of HaCaT cells.

Objective To compare the assessment results of Loewenstein occupational therapy cognitive assessment (LOTCA) and mini-mental state examination(MMSE) in stroke patients,and to analyze the correlation between the two assessments and to explore the applicable values of LOTCA in assessing vascular cognitive function impairment (VCI).Methods According to the diagnostic standard of cognitive impairment with MMSE,thirty stroke patients with cognitive impairment were selected as cognitive impairment group,thirty stroke patients without markedly cognitive impairment as stroke control group,and thirty normal subjects served as normal control group.All the subjects' age,gender and level of education were matched in the three groups. All the subjects were assessed with LOTCA and MMSE.ResultsThe total scores of LOTCA had high positive correlation with the total scores of MMSE in cognitive impairment group ( r =0.934,P ＜ 0.01 ),the correlations were also found between every sub-items of LOTCA and those of MMSE (P ＜ 0.01 ).The total scores and the scores of sub-items of LOTCA in cognitive impairment group were significantly lower than those in stroke control group and were those in normal control group(P ＜ 0.01 ),particularly lower scores in LOTCA sub-items of thinking operations,orientation,visuomotor organization.The scores of sub-items of LOTCA,including thinking operations,visuo-motor organization,attention,orientation,spatial perception were all significantly lower in stroke control group than those in normal control group(P ＜0.01 ),especially in thinking operations and visuo-motor organization sub-items.Conclusions Correlations were found between LOTCA and MMSE.Compared to MMSE,LOTCA could detect vascular cognitive function impairment earlier and is much more comprehensive,so it is suitable to assess vascular cognitive impairment patients with no dementia.