Objective To explore the clinical therapeutic methods for secondary glaucoma induced by the migration of silicone oil into the anterior chamber.Methods Totally 26 cases of such secondary glaucoma,including 22 aphakic eyes and 4 phakic eyes were subjected.Silicone oil was directly taken out for the patients whose retina was reposited well after silicone oil injection for over 3 months.The aphakic patients underwent 6 o'clock position peripheral iridectomy with laser or operation on prone position,then silicon oil was reinjected,and trabeculectomy was carried out through inferior cornea.The phakic patients received silicone oil aspiration with Healon from the anterior chamber.When silicone oil remigrated into the anterior chamber,the crystal was resected,silicone oil was reinjected,and 6 o'clock position peripheral iridectomy were performed.The patients were followed up for 3 months after the intraocular pressure(IOP) reaching normal range.Results Except one patient gave up treatment,all the patients had stable and normal IOP after 3 months of follow-up.IOP was controlled through different methods in 21 aphakic eyes:5 with prone position,5 with 6'clock position peripheral iridectomy through laser or operation,4 with silicon oil reinjecting,2 with direct aspiration of silicone oil,and 3 with trabeculectomy under cornea.IOP was controled in all of phakic eyes:3 with Healon aspiration of silicone oil,1 with crystal resection and reinjection of silicone oil.Conclusion Secondary glaucoma induced by migration of silicone oil into the anterior chamber can be satisfactorily treated by many ways.

Objective:To construct an operating room equipment cloud model and improve the evidence theory management model,and to improve the efficiency of operating room equipment management.Methods:The evaluation index system of operating room equipment using efficiency was constructed,and the evaluation and management of operating room equipment was carried out based on the cloud model and the optimization method of improved evidence theory.A total of 40 operating room instruments and equipment in clinical use in Huangshan Shoukang Hospital from October 2022 to October 2023 were selected and managed using the conventional management model and the cloud model and improved evidence theory management model(referred to as the improved evidence model)according to different management modes,with 20 units in each mode.The differences in the timeliness of equipment management,the defect rate of equipment management,and the increase in cost-effectiveness of equipment between the two management modes were compared.Results:The operating room equipment failure warning time,engineer maintenance time and equipment information push time using the improved evidence mode were(2.36±0.11)s,(4.25±1.25)d and(0.89±0.11)min,respectively,which were less than those of the conventional management mode,the difference was statistically significant(t=12.439,9.209,8.686,P<0.05).The proportions of equipment repacking error,equipment damage and equipment maintenance in operating room using improved evidence mode were 5%(1/20),5%(1/20)and 10%(2/20),respectively,which were lower than those of the conventional management mode,the difference was statistically significant(x2=7.025,8.533,7.619,P<0.05).The operating benefit,support cost,diagnosis and treatment fee and scientific research cost of operating room equipment using the improved evidence mode increased by(3.36±0.35)%,(4.25±0.87)%,(4.25±0.56)%and(4.11±0.56)%,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=10.759,8.906,10.301,12.361,P<0.05).Conclusion:The application of cloud model and improved evidence theory management mode in hospital operating room equipment management can realize centralized maintenance and management of operating room equipment,improve the efficiency of operating room equipment management,enhance the cost effectiveness of equipment application,and reduce the risk of equipment use.

Objective To evaluate the clinical effect of warm acupuncture,manipulation combined with western medicine in the treatment of primary frozen shoulder. Methods A total of 90 patients with primary frozen shoulder, from October 2015 to February 2017, were randomly divided into three groups (n=30):the western medicine group, the traditional Chinese medicine(TCM) group and the integrated TCM and western medicine group. The western medicine group was treated with local block and intra-articular injection. The TCM group was treated with acupuncture combined with manipulation. The integrated TCM and western medicine group were treated with western medicine and TCM. The three groups were treated for four weeks. The shoulder function (Constant-Murley shoulder scores) and shoulder pain (VAS scores) were evaluated in the three groups after treatment. Results The effective rate in TCM and western medicine group was 100％ versus TCM group 83.3％,and Western medicine group 76.7％, which showed significantly higher differnce among three groups (P<0.05). The Constant-Murley shoulder scores in TCM and western medicine group were (72.4 ± 3.8 vs. 67.5 ± 4.5, 58.9 ± 5.4), which were significantly higher than those in TCM group and western medicine group (P<0.05). The VAS scores in TCM and western medicine group were (1.6 ± 0.7 vs. 2.5 ± 0.8, 2.7 ± 0.7) which were lower than those in TCM group and western medicine group (P<0.05). Conclusions The combination of warm acupuncture, manipulation and western medicine could improve shoulder function and reduce shoulder pain in patients with primary frozen shoulder..

Objective:To compare the effects of staged percutaneous coronary intervention(PCI)after emergency PCI and emergency culprit-only PCI on clinical outcomes of elderly patients with ST-segment elevation myocardial infarction(STEMI)and multivessel disease.Methods:A retrospective analysis was performed on 389 elderly patients with STEMI and multivessel lesions, aged ≥70 years and within 12 h of onset, admitted to the Clinical College of Thoracic Medicine, Tianjin Medical University, between January 2014 and September 2019.According to different revascularization strategies, enrolled patients were divided into the culprit-only PCI group(79.18%, 308)and the staged PCI group(20.82%, 81). Kaplan-Meier analysis and the Cox proportional hazards regression model were used to compare the incidences of major adverse cardiac and cerebrovascular events(MACCE), all-cause death, cardiac death, recurrent myocardial infarction, stroke and ischemia-driven revascularization between the two groups and to evaluate the effects of different revascularization strategies on MACCE and all-cause death.Then subgroup analysis was performed.Results:During a 56-month follow-up, 131 patients developed MACCE and 96 patients died.Compared with the culprit-only PCI group, the staged PCI group had a lower risk of MACCE( HR: 0.404, 95% CI: 0.227-0.716, P=0.002), all-cause death( HR: 0.354, 95% CI: 0.171-0.730, P=0.005), cardiac death( HR: 0.363, 95% CI: 0.157-0.838, P=0.018), and recurrent myocardial infarction( HR: 0.229, 95% CI: 0.055-0.953, P=0.043). There was no significant difference in the incidence of stroke or ischemia-driven revascularization between the two groups( P>0.05). The reduced risk with staged PCI for MACCE and for all-cause mortality persisted in all subgroups.Multivariate Cox proportional hazards regression revealed that, after adjusting for confounding factors, staged PCI was an independent protective factor for MACCE( HR: 0.44, 95% CI: 0.239-0.815, P=0.009)and for all-cause death( HR: 0.390, 95% CI: 0.90, P=0.020). Conclusion:Compared with culprit-only PCI, staged PCI can significantly improve the long-term prognosis of elderly patients ≥70 years with STEMI and multivessel disease within 12 h of onset.

Objective: To investigate retinochoroidal changes and establisheye damage model after brain impact injury.Methods: An eye damage model after brain impact injury was established by striking the frontoparietal zone in rabbits with BIM-Ⅱ bioimpact machine. Seventeen rabbits were killed at 4 different intervals after injury. The pathological characteristics of the retinal and choroid damages were observed.Results: All the rabbits had severe brain injury with subarachnoid hemorrhage and brain contusion. The eye damage occurred in all of the 17 rabbits. Hemorrhage in optic nerve sheaths was observed and retinal edema and bleeding was discovered with ophthalmoscope. Histopathologic study displayed subarachnoid hemorrhage in the retrobulbar portion of the retinal nerve, general choroid blood vessel dilatation, retinal nerve fibre swelling within 6 hours after injury, and flat retinal detachment with subretinal proteinoid exudation, and degeneration and disappearance of the outer segment of the optic cell over 6 hours after injury.Conclusions: The pathological characteristic of the eye damage at early stage following brain impact injury is local circulation disturbance. At late stage, it features in retinal detachment, and optic cellular degeneration and necrosis.

Objective To investigate the changes in G protein-coupled receptor 124 (Gpr124) expression in human retinal microvascular endothelial cells (HRMEC)under high-glucose condition and the regulatory effect of Gpr124 interference on HRMEC.Methods Immunofluorescence assay was used to observe the expression of Gpr124 in HRMEC.The cells were divided into a blank group and a high glucose group.CCK-8 assay and EdU cell proliferation assay were used to detect cell viability and proliferation,respectively.The Gpr124 expression was knocked down by transducting lentiviral virus carrying shRNA targeting Gpr124.Thus,the cells were divided into a blank control group,a high glucose control group,a high glucose+shRNA group,and a high glucose+Gpr124 shRNA group.Cell scratch test was performed to evaluate cell migration,and Matrigel plug assay was employed to assess the cell tubule formation.Western blotting was applied to detect the protein levels of Gpr124,VEGFA,MMP9,and β-catenin.Results The HRMEC from the high glucose group showed enhanced cell viability and increased number of proliferating cells compared to the cells of the blank group (P<0.01).High glucose treatment also induced increased expression levels of Gpr124,VEGFA and MMP9 (P<0.01),and larger migratory area and in vitro angiogenic area as well as longer tube diameter at all time points when compared with the conditions in the blank control group (P<0.01).However,knockdown of Gpr124 resulted in a significant decrease in HRMEC migration and in vitro angiogenic capacity,accompanied by decreases in protein expression of VEGFA,MMP9 and β-catenin (P<0.01).Conclusion Gpr124 can regulate the proliferation,migration,and tube formation ability of HRMEC under high-glucose condition,and also inhibit the overexpression of VEGFA and MMP9,which may be through regulating the classical Wnt/β-catenin pathway.

Objective:To investigate the association between cytokines and ocular chronic graft-versus-host disease (cGVHD) and identify specific biomarkers for ocular cGVHD to enhance clinical diagnosis, treatment, and evaluation.Methods:A mouse model of cGVHD was established to explore the correlation between cGVHD and serum cytokines. Based on the findings from the animal experiments and literature review, a panel of 16 cytokine combinations was identified. Enzyme-linked immunosorbent assay (ELISA) was used to compare the cytokine concentrations in the serum and tear samples from patients who underwent allogeneic hematopoietic stem cell transplantation from June 2017 to March 2022 at the Medical Center of Hematology, Xinqiao Hospital, Army Medical University.Results:① Compared with the control group, mice with cGVHD exhibited elevated serum IL-1β, IL-6, IL-8, IL-17, IFN-γ, CX3CL1, CXCL11, CXCL13, CCL11, and CCL19 concentrations (all P<0.05). ② Analysis of the cytokine profiles of the serum and tear samples revealed that compared with patients without ocular cGVHD, those with ocular cGVHD exhibited increased serum IL-8 [ P=0.032, area under the curve (AUC) =0.678]; decreased serum IL-10 ( P=0.030, AUC=0.701) ; elevated IL-8, IFN-γ, CXCL9, and CCL17 in tear samples; and lower IL-10 and CCL19 in tear samples (all P<0.05, all AUC>0.7). Moreover, cytokines in tear samples showed correlations with ocular surface parameters related to ocular cGVHD. Conclusions:Tear fluid demonstrates greater specificity and sensitivity as a biomarker for diagnosing ocular cGVHD than serum biomarkers. Among the identified cytokines in tear samples, IL-8, IL-10, IFN-γ, CXCL9, CCL17, and CCL19 serve as diagnostic biomarkers for ocular cGVHD post-transplantation, offering practical reference value for diagnosis.