AlM:To compare the efficacy and complication of extra-trabeculotomy in combination with trabeculectomy and trabeculectomy and compound trabeculectomy in the treatment of primary infantile glaucoma.
METHODS: Patients with primary infantile glaucoma undergone one of the three procedures from Jan 2006 to Jan 2014 were selected. Among them, group A ( 20 patients, 31 eyes ) underwent extra- trabeculotomy in combination with trabeculectomy, group B ( 20 patients, 32 eyes ) underwent trabeculectomy, while group C ( 20 patients, 30 eyes) underwent compound trabeculectomyRESULTS:The success rates in group A were 96. 8% at the time of discharge and 90. 3% during follow-up (mean 24mo) ; the rates in group B were 96. 9% and 81. 2%( mean 24mo) the rates in group C were 83. 3% and 76. 7%( mean 24mo ) respectively, the differences being significant (P <0. 05). ln group A and group B, there was no severe complications, while in group C, one case had vitreous prolapse.
CONCLUSlON: Extra - trabeculotomy in combination with trabeculectomy is more efficacious and safer than trabeculectomy and compound trabeculectomy in the treatment of primary infantile glaucoma. lt should be the first choice for primary infantile glaucoma.

Objective To compare the prognoses in pregnancy women receiving routine perineal shaving and non perineal shaving before vaginal delivery through meta analysis.Methods The randomized controlled trials or non-randomized controlled trials for comparing the prognoses in pregnancy women receiving routine perineal shaving and non perineal shaving before vaginal delivery were retrieved from databases,including Cochrane Library,PubMed,EMbase,SCI,Ovid,CBM,Wanfang,VIP and CNKI,till December 2015.The studies were selected according to the inclusion and exclusion criteria,and the data were extracted and evaluated by two reviewers independently.The Meta-analysis was conducted via RevMan 5.2.6 software.Results A total of 6 studies (including three articles in English and three ones in Chinese) including 1 924 delivery women were included,1 083 cases in the perineal shaving group and 841 cases in the non perineal shaving group.No statistically significant difference was found in the incidence rate of fever after delivery between the perineal shaving group and the non perineal shaving group[Z=0.57,P=0.57,RR=1.14,95 ％ CI(0.73,1.76)],and there was no statistically significant difference in post-operative wound infection between the two groups [Z=0.43,P=0.66,RR=1.11,95％CI(0.69,1.78)].Conclusion Perineal shaving may be not an essential nursing intervention before vaginal delivery.

Immobilization conditions of Candida tropicalis to be absorbed in polyurethane foam carrier materials were studied on the xylitol production from corn hemicellulosic hydrolysate. Optimum batch-fermentation conditions were as follows: inoculum amount, 7% (volume ratio); polyurethane foam quantity, 1.0 g/100 mL; 30?C; initial pH, 6.0. Shaking speed was divided into two-phase to accommodate the dissolved oxygen, with 200 r/min at 0~24 h and 150 r/min at 24 h~46 h. The immobilized cells on polyurethane foam carrier have high density and good resistance to inhibitors in the hydrolysates. Average xylitol yield and volumetric productivity of polyurethane foam immobilized fermentation were much higher than the fermentation without immobilization. Corn cob hydrolysates can be directly biotransformed to xylitol without decoloration or ion-exchange treatment. This process can effectively reduce production costs, and it shows broad prospects of applications. Average xylitol yield was 67.6% and xylitol volumetric productivity was 1.92 g/(L?h).

To assess the effect of prostaglandin E_1(PGE_1)on renal blood flow and serum endothelin of liver recipients.Methods PGE_1 was administered in 38 liver recipients at the dose of 0.6?g?kg~(-1)?h~(-1)during liver transplantation and every day after operation.The effects of PGE_1 on serum endothelin concentration and creatinine(Cr)were observed and these indexes were compared with those in the control group(n=18).The renal blood flow resistance indexes(RI)were measured by Doppler ultrasound.Results Cr and RI were significantly lower in PGE1=treated group than those in the control group.PGE_1-treated group also showed a significantly lower serum endothelin concen- tration.Conclusion Administration of PGE_1 in liver recipients can significantly improve the early re- nal function by reducing serum endothelin concentration and dilating renal blood vessels.

Objective To investigate celecoxib self-microemulsifying drug delivery system (CXB-SMEDDS) that was developed to increase the dissolution rate and oral bioavailability of celecoxib.Methods The formulation of CXB-SMEDDS was optimized by pseudo-ternary phase diagrams analysis.The appearance, morphology, particle size distribution and in vitro drug release behavior of CXB-SMEDDS were investigated after diluted by water.The bioavailability of CXB-SMEDDS was determined by oral administration to rats compared with CXB suspension.Results An optimized formulation was selected: Medium chain triglycerides as oil phase, Tween 20 as surfactant, Transcutol HP as cosurfactant.The ratio of oil phase, surfactant and cosurfactant was 2∶9∶9.Upon mixing with water, CXB-SMEDDS formed a clear and transparent microemulsion solution with homogeneous small spherical under transmission electron microscopy.For particle size of CXB-SMEDDS was found to be (57.6±14.2) nm.The in vitro dissolution test indicated a significant improvement in release characteristics of CXB.The AUC of CXB-SMEDDS and CXB suspension were (5.54±0.94) and (3.32±0.59) mg·L-1·h, respectively.The relative bioavailability was 166.9%.Conclusion The SMEDDS can significantly increase celecoxib dissolution in vitro and bioavailability in vivo.

ObjectiveTo explore the diagnostic methods and surgery pattern at the first time of spontaneous perforation of congenital choledochal cyst.MethodsEleven cases(4 male,7 female) with spontaneous perforation of congenital choledochal cyst were 6 months to 5 years old,and their average course of disease were 4 days.Gustily abdominal distension,abdominal pain,crying and fever were present in all cases.Jaundice(7 cases) and emesis(5 cases) appeared.All cases were detected with physical sign of peritonitis by physical examination.Choledochal cysts were confirmed by CT or B ultrasound in 8 cases.All cases accepted abdominal paracentesis and biliary ascites was drawn.Three different operative procedures were performed:choledochocyst excision & Roux-Y choledocho-jejunostomy(2 cases),choledochotomy with T-tube drainage(3 cases),and cholecystostomy(6 cases).Nine children receiving external drainage operation accepted a second operation to rebuild biliary tract(choledochocyst excision & Roux-Y choledochoje-junostomy) after 3 to 6 months.ResultsAll cases had got satisfactory therapeutic efficacy without any grave complication such as fistula of anastomotic stoma,infection of biliary tract or obstruction of biliary tract.During operation,perforations were located in the juncture of choledochus and cystic duct in 5 children and were not found in the other 6 children.In the second operation,the cases receiving cholecystostomy had less peritoneal adhesion,anatomic structure changes,haemorrhage[(30-50) mL vs(100-200) mL] and operation time[(2.5-3.0) h vs(3.5-5.0) h] than those receiving choledochotomy with T-tube drainage,and did not appear inadequate drainage for cystic duct obstruction.ConclusionsFor children with more organ inflammatory edema and adherence and in a bad overall condition,the first-time operation of cholecystostomy is more reasonable.

BACKGROUND: Endothelial cell structural and functional integrity is importnat decisive fatcor for ischemic time-window and hemorragic transformation follwing brain ischemic injury.OBJECTIVE: To investiagte the endotheliocyt endurance to various course of ischemic injury basing on dynamical observation of morphological and ultrastructural changes of endotheliocyte during IR injury.DESIGN: Randomized controlled experiment.SETTING:Neurological Internal Department of the Second Affiliated Hospital of Jinan University.MATERIALS: This experiment was carried out in the Animal Experimental Laboratory of the Second Affiliated Hospital of Jinan University from March 1998 to March 1999. Totally 53 SD rats were randomly dihours of 6 rats.METHODS: Thread-bolt occlusion method was used to establish focal brain ischemia model on rats. Brain tissue was evenly cut into five coronary segments: namely A, B, C, D and E, segments C underwent TTC staining for marginal region location. segments D was taken for routine dehydration, transparency, envelop, slice and HE staining,optical microscopic observation. Ischemic surrounding area and central brain tissues was obtained from slice B, fixed and enveloped before cutting into ultrathin slices that was observed under transmission electron microscope.the occurring time of hemorrhagic infarction at different ischemic time cell vacuolization degree in foot process layer at different ischemic time points.RESULTS: Totally 53 rats were enrolled in this experiment and all data was entered into results analysis. Under optical microscope: Neuropil loose and small vascular surrounding edema was observed at ischemia 3 hours.Small arterial broken and hemorrhage occurred at ischemia 12 hours reperfusion 3 hours. Under electron microscope: Capillary endothelial nuclear swelling was observed at ischemia 3 hours, with cytoplasmic pinocytosi increasing and vacuolization in foot process layer appearing+; At ischemia 3 hours reperfusion 3 hours, the foot process layer vacuolization in center area was (++) and (+++) in marginal area; while at ischemia 6 hours reperfusion 3 hours, endothelia tight junction opened and vacuolization in foot process layer was (+++); pinocytosis was found obviously reduced after ischemia 12 hours reperfusion 3 hours, mitochondrial swelling was seldom observed, but tight junction increasingly opened and vacuolization in foot process layer appeared (+++) - (++++).CONCLUSION: Obvious structural changes of endotheliocyte appeared in post-ischemia 3 hours, endotheliocyte tight junction openning was observed at ischemia 6 hours, and hemorrage transformation occurred after ischemia 12 hours, mainly at the post-reperfusional ischemia center.

AIM: To investigate the probably mechanism of amniotic extraction inhibiting haze formation after epipolis laser in situ keratomileusis (Epi-LASIK) in rabbit cornea.METHODS: Thirty rabbit corneas were performed with Epi-LASIK.All eyes were randomly divided into three groups: eyes treated with amniotic extraction (AE group),eyes treated with 1g/L dexamethasone (hormone group) and eyes treated with solvent (solvent control group).Haze grade evaluation was performed under the slit lamp after Epi-LASIK for 1,4 and 8wk.The repair of corneal epithelium was observed by using HE staining,and the expression of NF-kB protein P65 was detected by immunohistochemistry.The expression levels of inflammatory cytokines (TNF-α,TGF-β1 and IL-1) and anti-inflammatory cytokines (IL-4,IL-10 and IL-13) were determined by ELISA.RESULTS: HE staining showed that the basal cells of corneal epithelium were more uniform and arranged regularly in AE groups after Epi-LASIK for 1wk as compared with the hormone group and the solvent control group.After 4wk,there were a few of new collagen fibers in the superficial stroma of AE group,forming a small amount of scar.After 8wk,the corneal stroma of AE group showed a small amount of new collagen fibers,arranged regularly,and rarely formed scar.At the early stage (1 and 4wk),AE treatment has an obviously effect on inhibiting the secretion of inflammatory factors (TNF-α,TGF-β1 and IL-1) and anti-inflammatory factors (IL-4,IL-10 and IL-13),and the difference was statistically significant (P<0.01).Moreover,the activation of the NF-kB signaling pathway was significantly inhibited by treatment with AE in the early postoperative period (1 and 4wk).CONCLUSION: Amniotic extraction may reduce the inflammatory response in corneal epithelial cells by inhibiting the NF-kB signaling pathway,thereby inhibiting the formation of collagen and scar and the occurrence of haze.

AIM: To evaluate the effects of total flavonoid of chrysanthemum on the expressions of Fas and FasL in male rabbits with dry eye, and to investigate the therapeutic effects of the total flavonoid of chrysanthemum on dry eye.
METHODS: Totally 150 male Japanses white rabbits were divided into blank group ( group A ) , sham -operated group ( group B ) , model group ( group C ) , androgen control treatment group (group D), and total flavonoid of chrysanthemum treatment group ( group E ) . The dry eye model was established with orchiectomy on group C, D and E. Rabbits in group E were treated with total flavonoid of chrysanthemum. Rabbits in group D were treated with androgen intramuscular injection. Rabbits in the group A, group B, group C was treated with normal saline. All rabbits were detected with Schirmer's Ⅰ test and tear break-up time (BUT). Fas, FasL were checked on immunohistochemistry.
RESULTS:The Schirmer's I test values of group E was significantly higher than that of group C ( P<0. 01 ) and the BUT value of group E was significantly longer than that of group C ( P<0. 01 ). The quantity of positive expression of Fas in glandular tube cell and acinar epithelial celland apoptosis cells of group E after treatment at 1, 3, 5mo were significantly lower than that of group C, cell population of the positive expression of FasL was obviously higher than that of group C (P<0. 01).
CONCLUSION:The main component of chrysanthemum is flavonoid, which could significantly inhibit happening of dry eye in rabbit after androgen level lowered and lacrimal gland apoptosis and keep basic tears secretory volume and tear film stability.

AIM: To compare the effectiveness of botulinus toxin of type A and complete resection of the periorbital muscle on idiopathic blepharospasm.
● METHODS: Patients with idiopathic blepharospasm and having undergone either of two procedures from Dec. 2010 to Jun. 2015 were selected ( 60 patients ) . Among them, group A (30 patients, 60 eyes) underwent botulinus toxin of type A, group B (30 patients, 60 eyes) underwent complete resection of the periorbital muscle.
●RESULTS: ln group A, the patients with complete response, obvious response, partial response, and no response were 36(60. 0%), 20(33. 3%), 2(3. 3%) and 2 (3. 3%) cases respectively. ln group B, the patients with complete response, obvious response, partial response, and no response were 16(26. 7%), 24(40. 0), 12(20. 0%) and 8 ( 13. 3%) cases respectively. The difference was statistically significant ( Z = - 2. 968, P = 0. 003 ). The relapse rate of group A and group B were 93. 3% and 20. 0% after 6mo, the difference was statistically significant (χ2=32. 851, P<0. 001).
●CONCLUSION: The botulinus toxin injection of type A is effective for idiopathic blepharospasm. But recurrence rate is high after 6mo. Complete resection of the periorbital muscle have long-term efficacy for idiopathic blepharospasm. It′s a supplementary therapy after idiopathic blepharospasm recurrence.