AIM:To analyze the 34 cases of patients with diagnosis of lacrimal duct disease, to explore the cause and clinical characteristics of lacrimal duct inflammation, and to study the common misdiagnosis to improve the diagnosis rate, to provide clinical experience for medical workers.
METHODS: A total of 34 eyes of 34 patients were selected from 2011-06 to 2015-06 to our hospital for lacrimal duct incision. Clinical data of patients including age and gender distribution, eye and lesion location, duration, canaliculitis clinical symptoms and previous misdiagnosis were collected. The operation of lacrimal duct was carried out, and the secretion of lacrimal secretion was checked.
RESULTS:Patients over the age of 40 accounted for 77%of the population, men accounted for 23. 5%, women accounted for 76. 5%. Left eye in 15 cases, right eye in 19 cases, and were monocular onset, 26 cases ( 76%) of patients with lower lacrimal duct inflammation. Clinical symptoms: increased secretion, canthal conjunctival congestion, swelling, lesion location around the lacrimal puncta swelling and tenderness, slightly raised, epiphora, foreign body sensation. The culture results Showed 34 cases of discharge inspection. A total of 20 cases were fungal growth, 6 cases of bacterial growth rate were 59%, 18%, and 8 cases were not detected, 10 cases of lacrimal duct stone were found by pathological examination. There were 3 cases of Aspergillus, 5 cases of Candida, 2 cases of actinomycetes, 4 cases found in Gram staining microscope. Misdiagnosis of canaliculitis for other eye diseases, including 12 cases of chronic dacryocystitis, 8 cases of chronic conjunctivitis, 6 cases of acute conjunctivitis, stye in 4 cases, the misdiagnosis rate reached 88%.
CONCLUSION:In the middle and old aged people, the lacrimal duct is more than that of the male. The main pathogenic bacteria causing lacrimal duct infection may be fungi, which can be treated with anti-fungal drugs. For the removal of the lacrimal duct stone, we should distinguish the types of pathogenic bacteria for the treatment of the disease. In the case of misdiagnosis, the clinical manifestations of different clinical manifestations from the lacrimal duct infection and other diseases of the eye should be carefully examined and carefully treated.

?AIM: To study correcting effect and visual quality after laser - assisted in situ keratomileusis ( LASIK ) with femtosecond and posterior chamber intraocular lens ( ICL) implantation in high myopia patients.?METHODS: Fifty-five patients ( 106 eyes ) with high myopia from February 2012 to February 2015 in our hospital were analyzed. According to the different operation, patients were divided into the observation group( using ICL implantation, 27 cases with 53 eyes) and the control group (using LASIK, 28 cases with 53 eyes). Postoperative follow-up was 1a, to observe and analyze the visual quality, higher order aberration and complications of two groups.?RESULTS: Uncorrected visual acuity ( UCVA ) , the best corrected visual acuity ( BCVA ) , effectiveness index and security index at 1a postoperatively of observation group, were 1. 04±0. 86(LogMAR), 0. 97±0. 19(LogMAR), 104. 69± 18. 56, 108. 79 ± 17. 68, significantly higher than those of control group 0. 78 ± 0. 11 ( LogMAR ), 1. 04 ± 0. 09 (LogMAR), 93.78±15. 65, 100. 71±11. 68 (P<0. 05). And observation group in the two kinds of light and shade environment at various spatial frequency contrast sensitivity were higher than the control group. Those under the light environment at 1. 5, 3, 6, 12 c/d and under dark environment at 1. 5, 3, 6, 18 c/d compared were different between the two groups (P<0. 05). Spherical aberration and comatic aberration of observation group at 1a after operation were lower than those of control group (P<0. 05 ). The difference of trefoil between the two groups was not significant ( P > 0. 05 ). No severe complications were observed in both groups.?CONCLUSION: LASIK with femtosecond and ICL lens implantation can effectively improve the patient’s visual quality, but for patients with high myopia, ICL lens implantation effect is more significant, the safety index of ICL implantation, as well as the effectiveness index and the visual quality are better than those of LASIK.

OBJECTIVETo observe differences of therapeutic effects among acupuncture bloodletting, penicillin and acupuncture bloodletting combined with penicillin for children acute tonsillitis and providea better treatment method in cli nic.

METHODSSeventy-five mild cases were selected into section of mild symptoms while seventy-five severe cases were selected into section of severe symptoms. Cases in the two sections then were divided into, an acupuncture bloodletting group, a penicillin group and a comprehensive group by random digital table method separately, 25 cases in each one. Qu-chi (LI 11), Hegu (LI 4), Dazhui (GV 14), Shaoshang (LU 11) and Erjian (EX 11) were selected in the acupuncture bloodletting group, intravenous injection of penicillin sodium was applied in the penicillin group and acupuncture bloodletting combined with penicillin was applied in the comprehensive group. Efficacy assessment was conducted after 3 days in the section of mild symptoms and after 5 days in the section of severe symptoms.

RESULTSFor the section of mild symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group and 92.0% (23/25) in the acupuncture bloodletting group, which were both superior to 68. 0% (17/25) in the penicillin group (P<0.05), but no statistical significance was seen between the comprehensive group and acupuncture bloodletting group (P>0.05). For the section of severe symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group, which was obviously superior to 60.0% (15/25) in the acupuncture bloodletting group (P<0.01) and 68.0% (17/25) in the penicillin group (P<0. 05), and no statistical significance was seen between the acupuncture bloodletting group and penicillin group (P>0.05).

CONCLUSIONThe efficacy of acupuncture bloodletting combined with penicillin is little different from that of acupuncture bloodletting for treatment of children acute tonsillitis with mild accompanied symptoms, which were both superior to intravenous injection of penicillin sodium. For severe accompanied symptoms, the efficacy of acupuncture bloodletting combined with penicillin is obviously superior to acupuncture bloodletting and penicillin.

Acupuncture Points ; Acupuncture Therapy ; Bloodletting ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Infant ; Male ; Penicillins ; therapeutic use ; Tonsillitis ; drug therapy ; therapy ; Treatment Outcome

AIM :To investigate the association of primary open-glaucoma (POAG), intraocular pressure (IOP) and systemic blood pressure in a rural population aged 50 years old or above in Shaanxi Province, China.METHODS: In the population-based, cross-sectional study, 1 775 (83.53%) residents, aged 50 years old or above, from 3 counties of Shaanxi Province, China, undertook an interview with a standard questionnaire and a detailed eye examination, including logarithm of the minimum angle of resolution visual acuity, slit-lamp biomicroscopy, applanation tonometry and dilated fundus examination. Two blood pressure reading in the sitting position were taken. Gonioscopy was performed if a narrower peripheral anterior chamber (less than one fourth of the corneal thickness) was indicated. Automated visual field testing was performed by participants assessed to have suspicion of glaucomatous disc damage or if IOP was 22mmHg or higher.RESULTS: IOP significantly correlated with systemic blood pressure, and both IOP and systolic blood pressure increased significantly with increasing age. No association between POAG and hypertension was found. The frequency of POAG increased significantly with lower diastolic perfusion pressure.CONCLUSION: Data in our study are accordance with those reported in other population-based studies, and confirm that lower diastolic perfusion pressure is a significant risk factor for primary open angle glaucoma.

AIM: To assess the prevalence and risk factors for age-related macular degeneration (AMD) in a rural population in Shaanxi Province of China.METHODS: A total of 2 835 (81.00%) people aged 40 years old or more, from Fuping county, Jingbian county and Yang county of Shaanxi Province, China, underwent a comprehensive interview and a relative eye examination. The present of AMD was classified into neovascular AMD (NV) and pure geographic atrophy (GA) by using direct ophthalmoscopy for fundus examination according to International Classification System.RESULTS: The prevalence (95% CI) of AMD was 3.00% (2.42, 3.71) in this population, of which NV accounted for 1.45% (1.05, 1.98) and 1.55% (1.14, 2.10)for GA. The prevalence of AMD increased significantly with increasing age (P ＜0.001). AMD was present in 0.47% of participants aged 40 to 49 years, rising to 11.90% of participants older than 80 years, of which the corresponding data increased from 0.28% to 4.76% for NV and from 0.19% to 7.14% for GA. No significant difference was found in the prevalence of NA and GA between genders in this population. With multiple logistic analyses, apart from advancing age, only smoking was found to have a strong association with any type of AMD.CONCLUSION: The prevalence of AMD in the rural population of Shaanxi Province of China is lower than that reported from other population-based studies in different provinces of China, less than that reported in whites, more than that reported in blacks. Except increasing age, smoking is also a significant well-known risk factor for AMD.

· AIM: To assess the prevalence and related risk factors for primary angle-closure glaucoma in a rural population for 40 years of age or older in Shaanxi Province.· METHODS: By using a stratified, cluster-based, random sampling technique, 8 500 persons of all ages were selected randomly, including 3 500 those aged 40 years or more, from the North, the South and the Middle of Shaanxi Province in Western China from July to December in 2003. All participants had an interview with a standard questionnaire and those questions related to glaucoma of previous diagnosis and treatment, family history and outbreak history. Then a detailed and relative eye examination was performed, including logarithm of the minimum angle of resolution visual acuity, external eye examination with slit-lamp biomicroscopy and fundus examination. The intraocular pressure was measured with Perkins applanation tonometry to those persons aged 50 years old or more and those with suspected increased IOP. A further examination was performed to those persons with suspicious glaucoma, including repeated tonometric examination, gonioscopy, dark room test, automated visual field testing, et al.·RESULTS: 6 815 of the eligible 8 500 persons of all ages were interviewed and examined from July to December in 2003, a response rate of 80.18%, including 2835 of the eligible 3 500 persons of 40 years old or more with a response rate of 81.00%. According to Van Herick method, the percentage of shallow peripheral anterior chamber was 13.6%, of which 10.4% was in grade 2, 3.0% in grade 1, and 0.2% in grade 0. In this rural population for 40 years of age or older 31 participants were found to have primary angle-closure glaucoma, with the prevalence of 1.09%. With multiple logistic analyses, the prevalence increased significantly with age (P=0.008), whereas no significant difference (Pgender=0.180, Peducation=0.199) was found in the rate with gender and education, although women and illiteracy seemed to be at increased risk of the disease (OR: 1.77, 95%CI,0.77-4.10; OR: 1.71, 95%CT, 0.76-3.87). Of 31 participants, 21 persons (67.74%) had not been previously diagnosed and treated. Of 10 participants previously diagnosed, 6 (60%) had been received peripheral iridectomy; nevertheless, no any other treatments were performed. 48.39% participants suffered from visual impairment in various degrees, of which the percentage of blindness in either eye accounted for 29.03%. Of those with primary angle-closure glaucoma, 22 persons (70.97%) were classified as having chronic from of the disease.· CONCLUSION: In this rural population in Shaanxi Province of China, the rate of occludable angles is 13.6%, more common than that reported previously in other Chinese populations. The prevalence of primary angle-closure glaucoma is close to that from other Asian populations, increasing with age. A majority of glaucoma was undiagnosed and untreated previously.

· AIM: To assess the prevalence and related risk factors of primary open angle glaucoma (POAG) in a rural population in Shaanxi Province.· METHODS: By using a stratified, duster-based, random sampling technique, 8 500 persons of all ages were selected randomly, from the North, the South and the Middle of Shaanxi Province from July to December in 2003. All participants had an interview with a standard questionnaire and those questions related to glaucoma of previous diagnosis and treatment, family history and outbreak history. Then a detailed and relative eye examination was performed, including logarithm of the minimum angle of resolution visual acuity, external eye examination with slit-lamp biomicroscopy and fundus examination. The intraocular pressure was measured with Perkins applanation tonometry to those persons aged 50years old or more and those with suspected increased IOP. A further examination was performed to those persons with suspicious glaucoma, including repeated tonometric examination, gonioscopy, dark room test, automated visual field testing, et al.· RESULTS: 6 815 of the eligible 8 500 persons of all ages were interviewed and examined from July to December in 2003, a response rate of 80.18%. 9 participants were found to have POAG, with the prevalence of 0.13%, age ranging from 38 to 80 years (mean year:62.0). In those aged 30 years old or more, the prevalence of the disease was 0.23%, 0.28% and 0.39% for those more than 40 and 50 years old, respectively. The rate of suspicious POAG was 0.18% (12 cases) with age ranging from 35 to 77 years (mean year: 54.7). With multiple logistic analyses, the prevalence increased significantly with age (P=0.023). Other than increasing age, myopia was also a strong risk factor for POAG. Of 9participants with POAG, only 2 cases (22.22%) had been previously diagnosed. No one with POAG was received any treatment previously. 66.67% (6 cases) participants with POAG suffered from visual impairment in various degrees secondary to POAG. The percentage of blindness in either eye was 33.33%.· CONCLUSION: The prevalence of POAG is close to that from other Chinese populations, increasing with age. A majority of glaucoma was undiagnosed and untreated previously.

Objective To establish the reference databases for bone mineral density(BMD)in multiple skeletal regions,which would be useful for diagnosis of osteoporosis(OP)and prediction of fracture risk in adult women in Qingdao.Methods BMD was measured by dual-energy X-ray absorptiometry at skeletal regions of lumbar spine,left hip(femoral neck,Ward's triangle and greater trochanter)in 868 healthy adult women aged 25- 83 years and 191 women with fractures.BMD of skeletal regions with age-related change was found to fit in 8 kinds of regression models.Best model equations of fitting were found and the reference database was established.BMD of women with fractures was compared with the reference databases to predict the risk of fracture.Results BMD in 6 skeletal regions changed with aging and a cubic regression model was better fitted with aged-related change as compared with other regression models.The coefficients of determination(R~2)of fitting curve were 0.21?0.09 (P＜0.01).The BMD reference databases of women in Qingdao were established by cubic regression equation, the peak BMD of lumbar spine and hip appeared at 25-29,and 40-44 years old groups respectively.Finally,the BMD in fracture group was significantly decreased by 1.6-2.5 s as compared with the peak BMD of health women. Conclusion The bone quantity is lost rapidly after 45 years old in women.If the BMD in women after 50 years old is decreased by 1.6-2.5 s compared with the peak BMD in the same area,the risk of fracture is increased.

Objective To study the expression level of peptidylarginine deiminase 4 (PADI4) and protein tyrosine phosphatase nonreceptor type 22 (PTPN22) in the synovium of rat model of collagen-induced arthritis, and to explore their possible therapeutic role in rheumatoid arthritis.
Methods Thirty-two female Wistar rats weighing 100±20 g were randomly assigned into 3-week collagen-induced arthritis (CIA) model group (n=8), 4-week CIA model group (n=8), 6-week CIA model group (n=8), and the control group (n=8). The body weight changes of each group were recorded. The expression levels of PADI4 and PTPN22 were detected and compared by the methods of immunohistochemical staining and Western blot.
Results Arthritis of rat began to form 14 days after sensitization and the joint swelling reached peak at 28 days. The weights of the rats slowly grew both in CIA model groups and the control group. Immunohistochemical staining results showed that the positive expression of PADI4 and PTPN22 was mainly located in cartilage peripheral mononuclear cells, the cytoplasm of infiltrated cells, and bone marrow cavity. There were significant differences in the optical density of PADI4 and PTPN22 among CIA model groups and the control group (PADI4, 0.2898±0.012, 0.2982±0.022, 0.2974±0.031, 0.2530±0.013 in 3-week CIA model, 4-week CIA model, 6-week CIA model and control groups;PTPN22, 0.2723±0.004, 0.2781±0.010, 0.2767±0.008, 0.2422±0.019;all P<0.05). The expression bands of PADI4 were observed in Western blot 3 weeks after initial immunization, the thickest in the 4th week, and decreased in the 6th week. The expression bands of PTPN2 were observed at all the time points, with no obvious time-dependent trend.
Conclusions PADI4 and PTPN22 are obviously correlated with CIA in rat model. PADI4 is expressed at early stage of the disease, while the expression of PTPN22 sustains throughout the course.

Background and Objective: The expression of transcription factor Elf-1 and inhibitor of apoptosis survivin in non-small cell lung cancer(NSCLC)is correlated with the angiogenic factor vascular endothelial growth factor(VEGF),and are both factors affecting the cell cycle.This study investigated the expression of Elf-1,survivin,and intratumoral microvessel density(iMVD)assessed by monoclonal antibody CD105 in NSCLC,and explored their correlations with clinicopathologic features and angiogenesis of NSCLC.Methods: PowerVisionTM-9000 immunohistochemistry was used to evaluate the expression of Elf-1,survivin,and CD105 in tissue microarrays containing60 specimens of NSCLC and 9 specimens of normal tissue.Western blot analysis was used to evaluate the protein levels of Elf-1 and survivin in 17specimens of NSCLC and 5 specimens of normal tissue.Results: Elf-1 and survivin were detected in 1 of the 9 normal tissues.The positive rates of Elf-1and survivin in NSCLC were 70.0% and 65.0%,respectively.The expression levels of both Elf-1 and survivin were significantly related to tumor differentiation,lymphatic metastasis,clinical stage,and postoperative survival time(P<0.05).Overexpression of both were related to poor prognosis: the survival rates were significantly lower in patients with positive expression than in those with negative expression(P<0.01).Elf-1 expression was positively correlated with survivin expression(r=0.769,P<0.01.Elf-1 and survivin expressions were positively correlated with iMVD(r=0.446,P<0.01 ; r=0.435,P<0.01).Conclusions: The expression of Elf-1 and survivin in NSCLC is related to differentiation,lymphatic metastasis,clinical stage,and prognosis,and both are positively correlated with iMVD.Detection their combined expression can help to predict the malignant behavior of NSCLC.Blocking the activity of Elf-1 and survivin may be a new way to inhibit angiogenesis in NSCLC.