Barium ; urine ; Spectrophotometry, Atomic ; methods

AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy.
METHODS: Thirty - six patients (36 eyes) with prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure ( IOP), best corrected visual acuity (BCVA) and complications were ovserved and all the patients were followed up at least for 12mo.
RESULTS: Mean preoperative IOP was 35. 20±7. 28mmHg and reduced to 10. 15±3. 34, 11. 23±3. 56, 15. 63±5. 72, 17. 17±5. 47, 17. 73±6. 23,19. 76±5. 43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level (t = 12. 643, 11. 837, 10. 324, 8. 839, 8. 462, 8. 046, all P < 0. 05 ). Visual acuity was not significantly different between pre - operation and 12mo post- operation ( Z = - 0. 420, P > 0. 05). At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient.
CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.

Adult ; Female ; Hamartoma ; complications ; pathology ; Humans ; Peutz-Jeghers Syndrome ; complications ; pathology ; Polyps ; complications ; pathology

Objective Analyze the amino acids and acylcarnitines in the blood of patients first diagnosed with uremia using tandem mass spectrometry in order to provide a basis for clinical diagnosis and treatment. Methods 30 patients with uremia were selected as the research objects,while 15 cases of healthy person were served as the control. The values of 11 kinds of amino acids and 2 kinds of acylcarnitines in the two groups were detected using tandem mass spectrometry,and the data were analyzed and compared. Results The levels of alanine(Ala)and tyrosine(Tyr)in uremia group were significantly lower than those in control group(P < 0.05),while the levels of citrulline(Cit),glycine(Gly)and proline(Pro)were significantly higher in uremia group than in control group (P < 0.05). The differences were mainly in non-essential amino acids between the two groups. The levels of free carnitines and total carnitines in uremia group were significantly higher than those in normal group(P < 0.05). Conclusion For the patients first diagnosed with uremia(not treated with replacement therapy),the disturbance of amino acid metabolism mainly in non-essential amino acids were found in their blood,and the carnitine levels were higher than normal levels. The results could provide the basis for clinical nutrition therapy for patients with uremia.

Seven compounds were isolated from fermentation extract of cave-derived Metarhizium anisopliae NHC-M3-2 by silica gel, semi-preparative HPLC and other chromatographic methods. Their structures were elucidated by UV, IR, MS and NMR methods as 2,3-dehydroindigotide G (1), (-)-regiolone (2), naphtho-γ-pyrone (3), indigotide G (4), indigotide B (5) destruxin A (6) and destruxin B (7). Compound 1 is a new glycoside naphthopyranone compound. The anti-hepatitis B virus (HBV) activity of these compounds was evaluated. The EC₅₀ and CC₅₀ of compound 3 against HBV were 4.5 μmol·L^-1 and 92.3 μmol·L^-1, respectively. This is the first report of the antiviral activity of compound 3.

AIM: To observe the efficacy of surgical excision combined with autologous limbus conjunctival flap transplantation in the treatment of pterygium accompanied with conjunctival cyst.METHODS: Totally 126 patients 188 eyes with pterygium were hospitalized in Department of Ophthalmology of Tongji Hospital of Huazhong University of Science and Technology during August 2013 and August 2015.The patients were divided into two groups: observation group (11 eyes of 11 patients) with pterygium accompanied with conjunctival cyst and control group (177 eyes of 115 patients) with primary pterygium.All patients underwent slit lamp microscope examination, anterior segment photography, and anterior segment optical coherence tomography(OCT).The size of pterygium was calculated by multiplying neck width and length of the covered corneal.All patients underwent excision combined with autologous conjunctival flap transplantation, and the resections were performed pathological section with hematoxylin and eosin staining.All patients were followed up postoperatively for 4-28mo.RESULTS: All cases in the observation group were confirmed by postoperative pathological examination.All cyst walls were complete, and containing single layer of epithelial cells.The mean size of pterygium of the observation group was 6.9±1.7mm2, and 6.3±1.8mm2 for the control group.There was no significant difference between the two groups (P>0.05).The mean postoperative healing time of observation group was 2.1±0.9d, and 1.9±0.8d for the control group.There was no significant difference between the two groups (P>0.05).Recurrence was seen in two eyes within the follow-up period in the control group, and no recurrence in the observation group.CONCLUSION: Surgical excision combined with autologous limbus conjunctival flap transplantation is a safe and effective treatment for pterygium accompanied with conjunctival cyst.

Objective To observe the expression of survivin and Aurora B in human pancreatic cancer BXPC3 cells after the treatment of sulindac and to explore the potential mechanism. Methods MTr assay was used to determine the effect of sulindac on the proliferation of the BXPC3 cells. RT-PCR was used to detect the expression of mRNA level of survivin and Aurora B, western blot was used to detect protein expression of survivin and Aurora B Thr-232. Cell cycle and apoptosis were detected by flow eytometry (FCM). Results The BXPC3 cells were inhibited by sulindac in a dose and time-dependent manner; the expression of mRNA of survivin and Aurora B were both significantly decreased from 1.5644 and 0.6554 to 0. 4372 and 0.1132 (P< 0.01), the expression of survivin protein and the phosphorylation of Aurora B Thr-232 were also decreased from 1.2735 and 0.4680 to 0.2126 and 0.2546 (P<0.01); the proportion of cells in the G0/G1 phase was increased from (56.65±1.93)% to (70.58±3.21)% (P<0.01). Conclusions Sulindac had inhibitory effects on the growth of BXPC3 cells, the possible mechanism was via decreasing the expression of survivin which depressed the activity of Aurora B, then the CPC was influenced. The most of the cells were blocked in the G0/G1 phase, and the cells' mitosis was inhibited.

ObjectiveTo study the effect of pre-arrest and post-arrest mild hypothermia after restoration of spontaneous circulation (ROSC) on myocardial function, ultrastructure, apoptosis of myocardial cells in rabbits with ventricular fibrillation.Methods Sixty-two male New Zealand rabbits were randomly allocated into five groups: namely normothermic control group (NTC group,n = 10), hypothermia control group (HTC group,n = 10), normothermic resuscitation group (NTR group,n = 14), hypothermia pre-arrest group (HPRA group,n = 14), and hypothermia post-arrest group (HPOA group,n = 14). The normal temperature was controlled at (39.0±0.5)℃, and the hypothermia (33.5±0.5)℃. Ventricular fibrillation cardiac arrest (CA) was reproduced in rabbits by transcutaneous epicardium electrical stimulation. The parameters of hemodynamics were monitored dynamically for 4 hours in all the groups, including heart rate (HR), left ventricular end diastolic and systolic pressure (LVEDP/LVESP), maximal rate of increase/decrease in left ventricular pressure (±dp/dt max), and mean arterial pressure (MAP). The body temperature of rabbits in hypothermia groups was maintained by surface cooling for 4 hours followed by rewarming. The survived rabbits were sacrificed at 48 hours after resuscitation, and myocardial apical tissue was harvested for observation of ultrastructure with electronic microscope, and to observe apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining.Results① Resuscitation investigation: there was no significant difference in rate of ROSC, time of CPR and energy of defibrillation among HPRA, HPOA, and NTR groups [rate of ROSC: 85.71%, 71.43%, 71.43%; time of CPR (seconds): 45.3±30.2, 61.2±41.3, 82.3±63.8;energy of defibrillation (J): 14.3±8.9, 22.0±15.5, 25.0±15.8, allP> 0.05].② Hemodynamics: compared with normal temperature groups, animals in hypothermia groups exhibited lower levels of HR (allP< 0.05). Compared with NTR group, HPRA group exhibited higher levels of LVESP (mmHg, 1 mmHg = 0.133 kPa) at 0.5, 1, 2 and 3 hours post ROSC (0.5 hour: 103.8±14.3 vs. 91.6±13.3, 1 hour: 107.2±14.1 vs. 82.7±8.5, 2 hours: 109.0±16.9 vs. 88.8±12.9, 3 hours: 109.1±14.6 vs. 89.3±14.3, allP< 0.05). Compared with NTR group and HPOA group, HPRA group exhibited lower levels of LVEDP (mmHg) at 0.5 hour post ROSC (3.70±0.85 vs. 7.61±2.73, 7.02±3.12, both P< 0.05). Compared with NTR group, HPRA group exhibited lower levels of LVEDP at 1 hour post ROSC (4.34±1.44 vs. 6.99±1.96,P< 0.05). In HPRA group, the level of+dp/dt max (mmHg/s) was higher than that of NTR group and HPOA group at 1 hour and 2 hours post ROSC (1 hour: 2 759.5±321.6 vs. 2 123.0±304.5, 2 283.7±234.2, 2 hours:2 730.6±425.1 vs. 2 221.5±392.9, 2 252.6±476.0, allP< 0.05). There were no significant differences in -dp/dt max and MAP levels among three CPR groups.③ The survival rate at 48 hours post ROSC of NTR, HPRA and HPOA groups was 60%, 75%, and 100%, respectively. Compared with NTR group, higher survival rate was found in HPOA group at 48 hour post ROSC (P< 0.05).④ Compared with NTR group, less damage to myocardial ultrastructure was found in HPRA and HPOA groups. Apoptosis index (AI) was lower in HPRA and HPOA groups than that in NTR group [(28.05±9.82) %, (26.39±8.98) % vs. (42.02±13.36) %, bothP< 0.05].Conclusions Our study shows that mild hypothermia has no effect on ROSC rate. Pre-arrest hypothermia can ameliorate myocardial systolic function of rabbit in early stage after ROSC, and it has no negative influence on diastolic function. Post-arrest mild hypothermia produces no negative influence on myocardial function of rabbit, but it improves 48 hours survival rate in ROSC rabbits. Both pre-arrest and post-arrest mild hypothermia therapy can attenuate myocardial injury in CA model of rabbits by ameliorating mitochondrial injuries and suppressing apoptosis of myocardial cells.

To study the changes of pupil diameter and its effects during phacoemulsification. METHODS: Block design, prospective study. 60 cataract patients (60 eyes) were selected, which divided into two groups according to the age, young age group (group A, 20 eyes of 20 patients) and older age group (group B, 40 eyes of 40 patients). Two groups were all given compound tropicamide eye drops for fully mydriasis before operation, computer software to process images during operation, and according to the cornea amplification ratio measure pupil diameter during the operation phase: before the corneal tunnel incision ( t1 ) , after injection of sodium hyalurantae ( t2 ) , before artificial lens implantation (t3), at the end of the surgery ( t4 ). Statistical analysis of data using SPSS18. 0 software.RESULTS: The pupil diameter measurements of t1-t4 were followed respectively:group A were 8. 36 ± 0. 65, 8. 97±0. 50, 8. 67±0. 63, 8. 72±0. 96mm; group B were 7. 73± 0. 58, 8. 23 ± 0. 59, 7. 89 ± 0. 16, 7. 70 ± 0. 63mm. Overall comparisons between the two groups, the pupil diameter measurements had differences during the operation phase ( F = 26. 696, P< 0. 05 ). Comparisons between the two groups at different time points: the pupil diameter of t1-t4 in group A was larger than that in group B, with statistically differences (P<0. 05). The pupil diameter of each groups had a tendency to change in different operation phrases, with no statistically differences (F=2. 617,P>0. 05). Comparisons in a group at different time points: the pupil diameter of t2 was larger than that in t1, with statistically differences ( P>0. 05), the pupil diameter of t3 and t4 were decreased in group B, with statistically differences (P<0. 05).CONCLUSlON: Compound tropicamide eye drops are given for mydriasis before operation, young patients with cataract and senile patients with cataract can achieve the effect of surgery for mydriasis, the pupil stability of phacoemulsification in senile patients with cataract are lower than that in young patients with cataract.

AIM: To evaluate the relationship between damages of visual field and retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma (POAG)with highly myopia. POAG with highly myopia group (21 eyes of 17 cases), POAG with non-highly myopia group (17 eyes of 16 cases), highly myopia without POAG group (25 eyes of 20 cases) and normal control group (19 eyes of 17 cases).automated perimeter and thickness of RNFL was measured by optical coherent tomography(OCT). Main outcome mean deviation (MD), pattern standard deviation (PSD) and mean sensitivity at superior, inferior, nasal and temporal sectors in total deviation probability plots. Thickness of RNFL at superior, inferior, nasal and temporal sector.total deviation probability plots of the early POAG with highly myopia than that of POAG without highly myopia,and the early visual field defects of glaucoma in pattern deviation probability plots of this group. MD of POAG with highly myopia was more than those of others (P＜0.05).The differences of MD, PSD and mean sensitivity between POAG with highly myopia and others were significant(P＜0.05).Mean sensitivities in each sector of POAG without highly myopia were similar to those of highly myopia(P＞0.05). The thickness of RNFL of POAG with highly myopia was thinner than that of others and the thickness of RNFL of normality was thicker than that of others. The relationship between mean sensitivity and the thickness of RNFL in each quadrant was significant(P＜0.05).judgment of the visual field changes in POAG with highly myopia. The relationship between RNFL thickness by OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with highly myopia. Field; optical coherent tomography