Objective To assess the clinical effectiveness and safety of gatifloxacin gel to bacterial conjunctivitis. Methods Double-blind and random selection were designed for the study,with levofloxacin gel as the control medicine.Thirty-six eyes of the experimental group and 36 of the control group were eligible for evaluation.Each eye received the gel one drop a time and three times per day.The gels were applied to the conjunctiva sac for 7 d. Results The clinic effectiveness of experimental group and control group were 88.89% and 91.67%,which indicated no significant difference.Microbial eradication rates were 90.48% and 93.75%,no significant difference either.Safety composite scores were similar between groups. Conclusion Gatifloxacin ophthalmic gel is safe and effective for treatment of bacterial conjunctivitis,and contains certain clinical value.

Objective To construct the fibroblast-specific non-viral vector pcDNA3-CEP-BMP-2 containing collagen 1A2 enhancer and promoter,and to validate the enhancement of BMP-2 expression in the human dermal fibroblasts by this vector,compared with the routine non-viral BMP2 vector. Methods The sequences for collagen 1A2 enhancer and promotor,and BMP-2 gene were ligated into the pcDNA3 plasmids.The plasmids were transfected into human skin fibroblasts and vein endothelial cells by means of cationic liposomes.The expressions of the plasmids in these two kinds of cells were detected by RT-PCR.The osteogenic phonotypes of fibroblasts were determined.(Results)pcDNA3-CEP-BMP-2,which contained collagen 1A2 enhancer and promoter could enhance the BMP-2 expression in the fibroblasts but not in vein endothelial cells.Osteogenetic phenotypes were more obvious in the fibroblasts transfected with pcDNA3-CEP-BMP-2 than in pcDNA3-BMP-2-transfected ones. Conclusion Collagen 1A2 enhancer and promoter can enhance BMP2 expression in fibroblasts.

Objective To evaluate the possibility of keyhole approaches for surgical treatment of petroclival meningiomas. Methods We retrospectively analyzed our experience in 14 cases with petroclival meningiomas surgically treated from May 2003 to January 2004. Eight tumors involved the upper and middle clivus.five tumors were attached to the entire width of clivus and one tumor involved the middle and lower cilvus. The tumors infiltrated into parasella regions or cavernous sinus in six cases simultaneously. Retrosigmoidal keyhole approach was selected to remove the tumors in 6 cases, and subtemporal keyhole approach was selected in 2 cases,while the combined retrosigmoidal and subtemporal keyhole approaches were applied in other six cases. Results Gross total resections of the tumors were achieved in 8 cases, subtotal resections in 4 cases, large resection in two cases who had recurrent tumors. Postoperatively, neurological intact or unchanged were found in 8 cases. The main surgical complications were mild facial palsy (4 cases) , abducent dificits (3 cases) ,temporary oculomotor nerve dificits (2 cases),and lower cranial nerve palsy (1 case). One patient died from disseminated intravascular coagulation (DIC) two weeks after surgey. There were no CSF leakage and infections after surgery in all cases 11 to 19 months follow-up studies demonstrated the great improvement of the Ⅲ and Ⅶ nerve deficits,but minor improvement in the Ⅵ nerve deficits. Conclusion According to the location and extension of the tumors, retrosigmoidal or subtemporal keyhole approaches or their combined can be selected for surgical treatment. These keyhole approaches can expose sufficiently the petroclival region, shorten the surgical time, and minimize the complications. Combined usage of minimally invasive techniques including the keyhole approach and radiosurgey in the treatment of the petroclival meningiomas is suggested.

Objective To evaluate the application of echocardiography in the diagnosis of bicuspid aortic valve and its pathophysiologic development and to demonstrate the degree of aortic valve dysfunction. Methods The echocardiographic characteristics and clinical data were analyzed retrospectively in 135 patients with bicuspid aortic valve to demonstrate the variation of aortic valve dysfunction in the progression of the course of the disease. Results Isolated aortic regurgitation was present in 68 (50%) patients, 19 (14%)patients had isolated aortic stenosis and 29 (22%)patients had combined aortic stenosis and regurgitation, 19 (14%) patients had neither stenosis nor regurgitation. Aortic regurgitation were all more commen within each age group, aortic regurgitation were also more commen within each age group in patients in their advanced course who went to surgical treatment. Conclusions Echocardiography is an effective method in the early diagnosis of aortic valve dysfunction.

two-dimensional strain echocardiography can observe dynamic change of regional systolic function,combined with the two methods can more accurately assess the treatment results of coronary artery bypass surgery.

Objective To evaluate the dyssynchrony of left ventricle in patients with coronary artery disease(CAD) by two-dimensional strain echocardiography (2-DS). Methods The myocardium of left ventricle of 33 patients with CAD and 30 nomal controls were detected by 2-DS. The time from onset QRS complexes to peak systolic longitudinal strain(Ts) and the standard deviation of Ts of 18 left ventricular segments (Ts-SD)were measured. Results There were 168 segments whose flow was provided by coronary artery with stenosis≤75% ,210 segments whose flow was provided by coronary artery with stenosis 75 %. ①Ts was delayed significantly and Ts-SD was obviously higher in patients with stenosis≥75% when compared with the control group. ②Ts was delayed and Ts-SD was higher in patients with stenosis≥75% compared with those whose stenosis was ≤75%. ③There were no statistical differences in Ts and Ts-SD between the patients with stenosis ≤75% and the control group. ④When left ventricular systolic dyssynchrony was defined as Ts-SD≥33.0 ms, there were 22 patients with systolic dyssynchrony of all 26 patients whose coronary artery stenosis≥75%, there were no patient with systolic dyssynchrony of all 7 patients whose stenosis ≤75%. Conclusions Although there are no evident regional wall motion abnormalities by routine echocardiography,in patients with severe coronary artery stenosis,2-DS can detect exactly the dyssynchrony of left ventricle.

Objective To review the experience of treatment for prosthetic valve endocarditis(PVE)after mitral valve replacement(MVR)in 16 cases.Methods From September 1979 to December 2010,16 patients were diagnosed as PVE after MVR by modified Duke University diagnostic criteria.There were 10 males and 6 females.Their ages ranged from 19 to 55 years old(mean 28 years old).The incidence of PVE was 0.97％(16/1657)after MVR.Blood culture positive was in 5 cases.Medical treatment alone was performed in 10 patients who were treated by using Penicillin or Vancomycin with other broad-spectrum antibiotics,using Fluconazole and Amphotericin if necessary.Combined medical and surgical management were performed in 6 cases.One emergency case was operated because of obstinate heart failure.Five cases underwent operation after adequate antibiotics treatment and general condition improvement.The infective tissue and vegetation were aggressively debrided after the infective prosthetic valve removed.Before the new valve was replaced paravalvular tissue must be flushed with diluted iodine solution and large quantities of normal saline.Tricuspid valve repair (TVR)was performed during the same period in 3 cases.Results Hospital death occurred in 8 patients and only 2 patients were recovery in group with medical treatment only.The main reasons of death were infective shock and cardiac failure in 4 patients,cerebral complications(embolism or bleeding)and multiple organs failure in 4 cases.While 6 patients cured after combined medical and surgical management.Follow-up had been carried out in 8 cases for 1.7 to 15 years(mean 5.1 years).Eight years later one patient was re-operated because of severe tricuspid regurgitation and paravalvular leak.There was no PVE recurrence in others.Conclusion Combined medical and surgical management for PVE get a better result than medical treatment alone.Good prognosis lies in timely diagnosis,adequate antibiotics,aggressive debridement of infective tissue and better myocardium protection during operation.

Objective To explore the effect of carvedilol on ACE2 gene and protein expression in chronic heart failure rats after myocardial infarction.Methods The heart failure model was induced by acute myocardial infarc- tion (AMI) through ligating the left anterior descending coronary artery.One month after operation,rats were randomized to receive placebo or carvedilol 2 mg/(kg?d),by gavage.Sham-operated rats were used as the control group.Hemodynamies,body mass and left ventrieular mass index,plasma and myocardial level of angiotensin Ⅱ were determined.ACE2 gene and protein expression was assessed by using RT-PCR and Western Blot.Results The mortality of placebo and Carvedilol groups were 20%,compared with 0% in sham operated rats.Carvedilol significantly improved LVEDP,LVSP,+dp/dt_(max) and-dp/dt_(min) in CHF rats but all the hemodynamics data were still inferior than that of controls.Plasma and myocardial angiotensin Ⅱ level were increased significantly in CHF placebo rats than those of control rats (plasma Ang Ⅱ:CHF:194?19 vs controls:132?15 ng/L,myocardium Ang Ⅱ:CHF:6.7?0.4 vs control:3.8?0.3 ng/g,P

Objective To investigate the value of high-dose dobutamine stress echocardiography combined with two-dimensional strain imaging in early diagnosis of coronary artery disease. Methods Highdose dobutamine stress echocardiography was performed to 28 patients with suspected coronary artery disease. All wall movements were observed during resting condition and at all stress levels,respectively;the peak systolic longitudinal strain in each endomyocardial segment of left ventricular was measured; the sensitivity and specificity between visual method and two-dimensional strain imaging in diagnosing myocardial ischemia with high-dose dobutamine stress echocardiography were compared. The average peak systolic longitudinal strain was calculated against control group, coronary artery disease group during ischemia segments and non-ischemia segments, and a comparison was made inside each group as well as against the other groups. The area under receiver operating characteristic curve of the peak systolic longitudinal strain was used to predict the sensitivity and the specificity of myocardial ischemia. Results With dobutamine dose of 40 μg·kg-1 · min-1 ,wall motion abnormalities were diagnosed in 6 patients (20 segments) through visual method, myocardial ischemia was found in 15 patients (148 segments) through computing the peak systolic longitudinal strain. Inside the coronary artery disease group during ischemic　segments,the majority of peak systolic longitudinal strain was significantly reduced ( P＜0.05) compared to the non-ischemic segments and the control group. In diagnosing myocardial ischemia in high-dose dobutamine stress echocardiography, the sensitivity of visual method and two-dimensional strain imaging were 35.3％ and 88.2％(P＜0.01), specificity 100％ and 100％(P＞0.05), and accuracy 60.7％ and 92.8％ (P＜0.01). The cutoff value of the peak systolic longitudinal strain was less than or equal to 14.9％, its sensitivity and specificity in predicting myocardial ischemia were 83.3％ and 91.7％,respectively. Conclusions High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can increase the sensitivity of detecting myocardial ischemia and detect concealed myocardial ischemia. High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can be used in early diagnosis of coronary artery disease.

Aim To observe the effect of hemodialysis on pharmacokinetics of sparfloxacin in thepatients contracting chronic renal failure. Methods Sparfloxacin concentrations inserum and urine of hemodialysis and non-dialysis patients were measured with a highperformance liquid chromatography method after administration a single oral dose of 200mg sparfloxacin. The pharmacokinetic parameters were computed with the programPKBP-N1.Results The main pharmacokinetic parameters in hemodialysis group wereT1/2(ka) - (1. 25 ?0. 57) h, T1/2(?) = (11. 88?4. 13) h, Tpeak = (4. 18 ? 0. 78) h,Cmax = (0.80 ? 0. 17) mg? L-1 and AUC0-= (6. 90 ? 3. 25) mg?h?L-1, while innon-dialysis group were T1/ 2(ka) = (1. 12 ? 0. 42) h, T1/ 2(?) = (15. 93 ? 5. 20) h, Tpeak =(3. 88 ? 0. 75) h, Cmax = (0. 69 ? 0. 37) mg?L -1, AUC0-= (10.05 ? 4. 13) mg?h?L-l. The original sparfloxacin discharge rats in urine within 24 h were (8. 98 ? 3. 92) % and(10. 58 ? 5. 64) % separately. T1/2(?) and AUC in hemodialysis group were markedly lowerthan in non-dialysis group (P