Objective To investigate the emergency treatment and correlation factors of aqueous misdirection during glaucoma and cataract surgery in glaucoma patients.Design Retrospective case series.Participants 126 cases(132 eyes)of angle-closure glaucoma patients with aqueous misdirection during surgery,100 cases(100 eyes)of angle-closure glaucoma patients without aqueous misdirection during surgery and 100 cases(100 eyes)of senile cataract patients.Methods We performed pars plana vitreous water-bag aspiration or anterior vitrectomy on glaucoma patients with aqueous misdirection during surgery.All the factors in observation group and control groups were compared and analyzed by logistic regression.Main Outcome Measures Preoperative highest intraocular pressure(HIOP),intraocular pressure after maximum dose(IOP),anterior chamber depth(ACD),lens thickness(LENS),axial length (AXL),mean keratometry(K),intraocular lens diopter within-0.5D corrected by SRK-T formula(IOLD).Results Among all the 132 angle-closure glaucoma eyes whose posterior chamber pressures were increased during surgery,we performed pars plana vitreous water-bag aspiration in 123 eyes(93.18%),and anterior vitrectomy in 9 eyes(6.8%).Postoperative complications included shallow anterior chamber in 20 eyes(7 eyes with malignant glaucoma,9 eyes with choroidal detachment,4 eyes with delayed local suprachorodal hemorrhage),and vitreous local hemorrhage in 1 eye.Means of all the observation indexes on three groups showed significant difference(all P

Formation of dermal collagen fiber is a complicated and sequential process with the progressive assembly of collagen. Collagen monomers form stepped and orderly protofibrils through longitudinal displacement. Subsequently, protofibrils or protofibrils and collagen are bonded by covalent bonds to form orderly lamellar structure of collagen fibers. Then collagen fibers are tightly wound into coarse collagen fiber bundles by covalent crosslinking. Decorin is a multifunctional small leucine-rich proteoglycan. It can prevent the aggregation of protofibrils by binding to the specific site of collagen with its core protein, and adjusting the spacing between the protofibrils with its glycosaminoglycan chain. Thus, by effecting the formation of collagen fibers with regulation of collagen assembly, decorin may help prevent scar formation and even promote regeneration.
Collagen ; Decorin ; metabolism ; Extracellular Matrix ; Extracellular Matrix Proteins ; metabolism ; pharmacology ; Fibrillar Collagens ; metabolism ; ultrastructure ; Fibrin ; metabolism ; Humans ; Microfibrils ; metabolism ; Proteoglycans ; metabolism ; pharmacology

Objective To investigate the effect of EGB on SOD, MDA of ventilator-induced lung injury in rats and its possible mechanisms. Methods Thirty male SD rats were randomly divided into 3 groups: control group (C group), high tidal ventilation group (H group) and EGB group (E group). The setting mechanical ventilation was VT=30 mL/kg, RR=40/min, I/E=1/3, PEEP=0 cmH2 O and FiO2=21%. The broncho-alveolar lavage fluid (BLAF) and serum were obtained for determination of the levels of SOD and MDA at the end of 4 h mechanical ventilation. The Lungs were removed, and the wet-to-dry weight ratio (W/D) and pulmonary pathologic changes were measured. Results As compared with C group, W/D and the levels of MDA were significantly increased in H group, but the levels of SOD were reduced in H group. As compared with H group, W/D and the levels of MDA were significantly decreased in E group, but the levels of SOD were increased in E group. Pulmonary pathologic changes were alleviated in E group comparing with H group. Conclusion EGB injection may have a protective role against hyperoxia and induced pulmonary damage in rats.

Objective:To investigate the clinical effects of health and safety management in elderly patients receiving gastroenteroscopy under sedation.Methods:From February 2018 to November 2019, 126 elderly patients admitted to the cadre medicine and gerontology department of our hospital to undergo gastroenteroscopy under sedation were included as research subjects.According to the digital random number method, they were divided into the control group and the test group(n=63, each group). The control group was given routine management, while the test group was given routine management plus health and safety management.Clinical effects and safety were analyzed and compared between the two groups.Results:There was no significant difference in scores of the Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD)between the two groups before intervention.After intervention, the scores of HAMA and HAMD were lower in the test group than in the control group[(39.2±3.1)scores vs.(48.6±2.1)scores, (40.1±4.1)scores vs.(52.6±5.5)scores, t=19.926 and 14.463, both P=0.000]. The incidence of postoperative complications was lower in the test group than in the control group(7.94% or 5/63 vs.19.05% or 12/65, χ2=14.209, P=0.002). The differences between maximum and minimum values of heart rate(HR), diastolic blood pressure(DBP), respiratory rate(RR)and systolic blood pressure(SBP)were lower in the test group than in the control group(all P<0.05). The length of the procedure was shorter and the anesthetic dose was lower in the test group than in the control group(9.11±2.56 min vs.13.56±3.05 min, 15.35±2.66 ml vs.21.67±6.15 ml, t=8.870 and 7.486, both P=0.000). Patient satisfaction was higher in the test group than in the control group( χ2=16.383, P=0.014). Conclusions:Health and safety management can improve emotional health, stabilize vital signs and enhance satisfaction in elderly patients undergoing gastroenteroscopy under sedation.

Objective To explore the effect of state of the ankle on peak torque of knee flexors and extensors. Methods 18 adults in community over 65 years old were included. Their peak torque with knee flexion and extension was measured under 4 kinds of action of ankle. Results There was significant difference in peak torque neither flexion nor extension among 4 kinds of action of ankle (P>0.05). Conclusion It is unimportant of the state of ankle for knee training.

AIM: To explorethe therapeutic efficacy of treating cataract phacoemulsification remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.
METHODS:Twenty-seven cases ( 27 eyes ) of glaucoma combined cataract surgery(3mo) in the early failure were treated with that the phacoemulsification auxiliary hook into anterior chamber under the original sclera flap, open from the inside have adhesion of the sclera flap. Postoperative follow-up 12mo, the intraocular pressure and best corrected visual acuity were observed.
RESULTS: The postoperative follow- up was 12mo. There were functional filtering bleb in 14(52%) eyes; and the IOP was below 21mmHg in 17 eyes(63%) without any anti- glaucoma drug, and in 7 eyes ( 26%) with 1 - 2 categories of lower intraocular pressure( IOP) drugs, and 3 eyes(11%), failure and the success rate was 89% after 12mo. Average intraocular pressure after 1wk, 1mo, 3mo, 6mo and 12mo were(7. 1±4. 3) mmHg,(10. 5±5. 1) mmHg,(15. 1±4. 8 ) mmHg, ( 16. 8±5. 2 ) mmHg, ( 17. 3±5.1 ) mmHg, significantly lower than the IOP preoperatively(30. 2±6. 8) mmHg (P<0. 01). Average visual acuity ( all of the following were best corrected vision) after 1wk, 1mo, 3mo, 6mo and 12mo was(0. 32±0. 52),(0. 52±0. 42),(0. 55±0. 39),(0. 53±0. 47),(0. 54±0. 42 ). Postoperative 1wk visual acuity deeper than preoperative( 0. 46 ± 0. 44 ) ( P < 0. 05 ), more than all improved compared with preoperative ( P < 0. 05 ). Postoperative anterior chamber bleeding in 5(19%) eyes, all absorbed itself in 3 to 5 days; ciliochoroidal detachment in 7 ( 26%) eyes, except one case need operate, others were conservative treatment to heal. Postoperative continuous low intraocular pressure concurrent macular edema was 1 eyes(4%), 4mo healed after treatment.
CONCLUSION: It is a safe and effective method thattreating phacoemulsification cataract remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.

Objective To discuss the influence about three kinds of nasal feeding methods on ICU critical patients with gastrointestinal complications, thus providing guidance for ICU patients to choose reasonable way of nasal feeding pump injection. Methods 120 ICU patients were randomly assigned into three groups, which is the continuous 6-hour and intermittent 2-hour every three time pump group and continuous 24-hours pump group and intermittent 24-hour(continuous 2-hour and intermittent 1-hour every eight time units)pump group ,each group has 40 cases. To observe the the influence about three different way of nasogastric on ICU critical patients with gastrointestinal complications. Results The incidence of diarrhea and constipation among the three groups was not statistically significant (P>0.05) . The gastric retention rate of the continuous 24-hour pump group was significantly higher than that of the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, the differences were statistically significant (P < 0.05). There was no statistically significant difference between the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, (P > 0.05). Conclusions The continuous 24-hour pump group in gastric retention was slightly worse than the other two pump way. Compared with ICU class three a week and feeding times , the continuous 6-hour and intermittent 2-hour pump method is more suitable for ICU patients.

Objective To observe the clinical effect of preoperative intranasal dexmedetomidine on sedation and preventing postoperative agitation in children inguinal hernia operation .Methods Forty children patients ,aged 1-s5 years old ,ASA Ⅰ ,were selected and equally randomized into 2 groups ,receiving intranasally dexmedetomidine 1 μg/kg(group Dex) and the same volume of normal saline (group NS) at preoperative 30 min respectively .The sedation score ,emotion score when separating from their par‐ents ,mask inhalation induction resistance score were evaluated at 30 min after medication ,furthermore the agitation scores were ob‐served and recorded at postoperative 30 min ,1 ,2 h .Results The sedation score ,emotion score when separating from their parents and mask inhalation induction resistance score in the Dex group were superior to the NS group ,moreover the agitation score at each points were lower than those in the NS group(P<0 .05) .Conclusion Preoperative intranasal dexmedetomidine can be safely used in children inguinal hernia operation ,has better sedative effect ,meanw hile reduces the postoperative agitation occurrence .

There are disadvantages in examination in basic medical stage. For example, there is too much quantity of work in written examination and the time is short for preparation for oral examination. Basic medical college reforms the examination in the first stage. The exam is composed of two parts. One is performed in computer instead of being written on paper,the oth-er is oral test whose topic is informed one term ahead of time. These can improve the students’ ability to summarize what they have learned in class.