Background Many methods are widely studied to improve the therapeutic effect of trabeculectomy for glaucoma,and the clinical effectiveness of the amniotic membrane application during trabeculectomy is one of the research hotspots.Objective This study was to evaluate the efficacy and safety between trabeculectomy with (TE-AMT) and without amniotic membrane transplantation (TE-noAMT) for treating glaucoma.Methods Articles published from 1965 to December 2010 were searched from The Cochrane Library,PubMed,EMBASE,CNKI,Chinese Biomedicine Database,internet by computer,and manual search then was performed according to the predetermined strategy.Randomized controlled trials (RCT) on TE-AMT and TE-noAMT were included.The quality of included articles were scored based on Jadad table,and the relative parameters and information were extracted,including author,design of the trials,country,number of eyes and patients,gender,follow-up duration,age,classification of glaucoma,baseline IOP and loss rate.The main analysis indicators were the percentage of IOP reduction,completely operative successful rate,qualified success rate and adverse events.The pooled estimates were carried out with RevMan version 5.0 software.Results Nineteen RCTs documents were reviewed by meta-analysis with the Jaded scores ≥3 in 2 papers and ＜3 in 17 papers.Total 977 eyes of 818 patients were included.The weighted mean differences (WMD) of the percentage of IOP from baseline were (WMD =8.47％,95％ CI:5.20-11.75) at 6 months and (WMD=9.37％,95％ CI:4.97-13.77) at 12 months postoperatively.Relative risk (RR) of complete success rate and qualified success rate at postoperative 6 months were (1.40,95％ CI:1.19-1.65) and (0.47,95％ CI:0.22-1.00),respectively.RR values of adverse event such as shallow anterior chamber,hyphema,hypotony and choroidal detachment,failed filtering blebs at 6,12 months were 0.51 (95 ％ CI:0.30-0.85),0.43 (95％ CI:0.20-0.92),0.51(95％CI:0.26-1.00) and 0.57(95％CI:0.14-2.31),0.31(95％CI:0.20-0.47),0.31 (95％ CI:0.17-0.55),respectively.Conclusions TE-AMT appears to have better efficacy in lowering IOP,increasing complete success rate and reducing adverse event I in comparison with TE-noAMT.

This paper specifically elaborated the ethics committee of China and the United States review meet-ing in the project report , project FAQ, ethical discussion , voting and so on each link , analyzes the ethical review mode difference between the two countries , and according to the mode of ethical review meeting in China and the United States are compared , and the model helps to find their own ethical review meeting , improve their efficiency of ethical review committee meeting .

Air Pollution, Indoor ; analysis ; Anesthetics ; analysis ; Environmental Monitoring ; methods ; Isoflurane ; analysis ; Methyl Ethers ; analysis ; Operating Rooms

Objective To investigate the effect of aluminum on hair loss induc ed by fluoride in fluorosis mice.Methods Sixty male C57BL mice were divided into four groups according to body mass:control group,fluoride (F) group (F-100 mg/L),aluminum(Al) group(Al3+ 270 mg/L) and F + Al group(F-100 mg/L + Al3+270 mg/L).Mice were killed 1 month and 3 months after the experiment,respectively.Bone F content was detected by ion-selective electrode method.The level of bone Al was measured through inductively coupled plasma emission spectrum.Dental fluorosis and hair loss of mice were evaluated by visual method.Results One month after the experiment,no dental fluorosis and hair loss was found in all four groups.The content of bone F was the highest in F group [(2401.649 + 86.835) mg/kg],and the lowest in A1 group [(427.006 + 11.878) mg/kg].The levels of bone F in F + Al group and control group were (1210.332 + 19.531)mg/kg and (538.001 + 33.337)mg/kg,respectively.The difference was statistically significant between any two groups (all P ＜ 0.05).Three month after the experiment,all mice of F treatment group had dental fluorosis and hair loss(10/10).Alopecia areas were found in the neck and back regions only.There was no hair loss in control group,Al group and F + Al group.No dental fluorosis was found in both control and Al groups.Only 2 mice were found with dental fluorosis in F + Al group.The levels of bone F in F group,F + Al group,control group and Al group were (4098.645 + 58.842),(1888.165 ± 12.187),(876.258 + 14.462) and (662.385 ± 8.966) mg/kg,respectively.The difference was statistically significant between any two groups (all P ＜ 0.05).Conclusions The hair loss is found in fluorosis mice.Hair loss of mice is closely associated with the level of F exposure.Al can prevent the occurrence of hair loss induced by F in mice through reducing the accumulation of F.

Objective To measure and analyze Varian Clinac 21EX accelerator induced radioactivity,and to provide specific recommendations and ways of radiation protection for radiotherapy technicians.Methods To simulate the working environment of radiotherapy technician,and to detect induced radioactivity variation of Varian Clinac 21EX accelerator that induced by 15 MV X-rays under different conditions of beam field area,dose,time,distance and by high energy electron beam (12,16,20 MeV)at the different time.Results The induced radioactivity level was not influenced by different beam field area,and was increased with increasing dose (r =0.930,P ＜ 0.05),decreased with time increase (r =-0.84,P ＜ 0.05),decreased with distance increase(r =-0.975,P ＜ 0.05).The induced radioactivity attenuation levels of the different doses at the same time are different,and have the common characteristic that the induced radioactivity attenuation rate is faster in the initial times.The induced radioactivity levels of high energy electron beams were significantly lower than those of high-energy X-rays.Conclusions During radiotherapy positioning,it is necessary to take measures to protect against the induced radioactivity when high-energy rays with energy greater than 10 MeV will be used.The radiotherapy technician should take the different time and energy interval steps for the different ray type and energy and dose in order to meet the radiation protection principle of optimization.

Objective To explore the relationship of X-ray exposure parameters and false-node rate during image-guidance treatment with CyberKnife spine tracking.Methods Using spine tracking planning on a chest phantom,several combinations of X-ray exposure parameters were used to locate.The false-node ratio and the surface absorbed dose were investigated and the radiation dose was optimized.Results The false-node ratio and surface absorbed radiation dose decreased when the X-ray exposure parameters increased until they saturated.In the range of ≤5.0％ false-node rate,the surface absorbed radiation dose was 0.11,0.26 mGy,and 0.31-0.46 mGy,when the false-node rate was 2.77％,1.07％and 1.0％,respectively.Conclusions In image-guided treatment of CyberKnife,the radiation dose would be optimized,and the patient's radiation dose would be reduced greatly,which is important to protect the patients.

Objective To observe the effect of scalp acupuncture and rehabilitation training on the regulation of neuro-plasticity-associated protein MAP-2 in gerbils modelling cerebral ischemia and reperfusion.Methods Cerebral ischemia and reperfusion were modelled into thirty-six male gerbils.They were then randomly divided into a model group (A),a scalp acupuncture and rehabilitation training group (B) and a rehabilitation training group (C),each of 12 cases.The scalp acupuncture and rehabilitation training were administered daily to the gerbils in group B beginning 24 h after modeling,for 14 d.Any changes in Bederson scores were observed after one,7 and 14 days.On the 14th day the expression of MAP-2 around the infarct focus was detected using western blotting in all 3 groups.Results On the 7th day the average Bederson score in group B (1.81 ± 0.52) was not significantly different from that in group A (2.13 ± 0.49) or group C (2.00 ± 0.31) (P ＞ 0.05).At the end of the treatment,however,there were significant differences between the groups,with group B (0.47 ± 0.31) scoring significantly better than groups C (1.04 ± 0.63) and A (1.46 ± 0.72) (P ＜ 0.05).Group C was also significantly better than group A (P ＜0.05).The expression of MAP-2 as measured as integrated optical intensity (IOD) in group B (0.91 ±0.18) was significantly higher than that in group A (0.43 ± 0.21) and group C (0.67 ± 0.24) (P ＜ 0.05) ; so was group C compared to group A (P ＜0.05).Conclusion The scalp acupuncture combined with rehabilitation training can improve the recovery of motor function and enhance the expression of neuro-plasticity-associated protein MAP-2 in gerbils with after cerebral ischemia and reperfusion.

Objective To summarize the cases of surgical treatment of patients with patent ductus arteriosus (PDA),atrial septal defect(ASD),or ventricular septal defect(VSD) after failure of congenital cardiac catheterization(CCC).Methods From January 2000 to December 2013 in our hospital 26 patients were retrospectively studied,follow-up results recorded for each patient by telephone and outpatient follow-up review.Results There were no deaths.The average age of the patients was (18.8 ± 17.9) (3.0-67.0) years old.The median time of the intervals between interventions and surgeries were 14 days(2 hours to 5 years),the median length of hospital stay were 10 days(7-21 days),median cardiopulmonary bypass time was 67minutes (0-206 minutes),the median blocking time 40 minutes (0-90 minutes),the median time of mechanical ventilation 8.5 hours (2.0-88.0 hours),median ICU stay one day (1-6 days).The average follow-up were (93.0 ± 49.3) months (7.0-182.4 months).Surgical results were satisfactory.Conclusion Interventional treatment of congenital heart disease (CHD) is safe after all,but should strictly the indications controlled,the operations completed by skilled doctors.If there are complex complications,surgical intervention should be concerned,and the results are satisfactory.Patients after CCC should be followed up regularly.

ObjectiveTo evaluate the feasibility and safety of endoscopic intraductal radiofrequency ablation (RFA) for unresectable malignant biliary strictures.MethodsA total of 12 patients with malignant biliary obstructions,who were unsuitable for surgical resection,were prospectively selected for this study.During ERCP,when successful biliary cannulation achieved,a bipolar radiofrequency probe was introduced into bile duct over a guidewire.RFA was given to the tumor lesion under fluoroscopy,followed by stent placement.The patients were closely observed and followed up after the procedure.ResultsSuccessful RFA was achieved in all patients before stents insertion ( plastic and metal stents in 6 respectively,additional pancreatic stents were given to 3).Mild complications of cholangitis and pancreatitis occurred in 1 patient respectively,which were cured with short-term management.Jaundice was promptly controlled in 7 patients (58.3％ ).During the mean follow-up duration of 3.4 (range 0.5-5.5) months,one patient died of cardiocerebral accident and others survived without obvious disconffort.The 1- month and 3- month stent patency was 100％ (12/12) and 80％ (8/10),respectively.ConclusionIt is technically feasible and safe to perform endoscopic intraductal RFA for the palliation of biliary malignancies.The short-term outcome is satisfying,however,long-term result and the better therapeutic schedule need further evaluation.

Objective To study the prevalence of fatty liver and its risk factors in adult population of Pudong New District,Shanghai detected by combination of B-type uhrasonographic features and elevated serum activity of alanine aminotransferase (ALT).Methods A cross-sectional survey was performed in 2017 residents aged 16 years over recruited from four neighborhoods of Prdong New District of Shanghai with multi-phase cluster sampling,including interview with questionnaire,physical check-up,anthropometry, measurement of plasma glucose and lipid profile,ALT activity and real-time B-type ultrasnnography.Serum hepatitis B surface antigen (HBsAg) was further detected for those with elevated ALT activity.Results Prevalence of fatty liver was 21.32 percent (430/2017) in the residents of the District participated in this survey.Prevalence of abdominal obesity,hypertriglyceridemia,hyperlipoproteinemia (low-density lipoprotein-cholecterol),essential hypertension,impaired glucose tolerance,diabetes and metabolic syndrome were 71.16,71.16,11.86,66.74,35.58,24.40 and 47.21 percent in those with fatty liver, respectively,as compared to 26.34,12.73,4.79,39.57,24.01,6.81 and 11.28 percent in those without fatty liver (controls),respectively.Multivariate logistic regression analysis showed that body mass index, 2-h postprandial glucose level,diastolic blood pressure,serum level of triglyceride,abdominal obesity and diabetes all were independent risk factor for tatty liver,with odds ratio (OR) of 1.080,1.149,1.035, 1.526,1.960 and 1.391,respectively.Conclusions Prevalence of fatty liver was relatively high in Shanghai Pudong New District.Fatty liver closely associates with disturbance of carbohydrate and lipid metabolism.