Objective To investigate the short term efficacy and security of different diameters of ampulla balloon dilation in the treatment of choledocholithiasis. Methods 80 patients with extrahepatic bile duct stones treated by EPBD were included in this study. All the patients were divided into 8 mm group, 10 mm group, 12 mm group, 14 mm group, which were according to the diameter of common bile duct (CBD) and stones. CBD stones were removed with retrieved balloon, Dormia basket, and/or mechanical lithotripsy if necessary. The incidence of 24 h hemorrhage, acute pancreatitis, hyperamylasemia and intestinal perforation were observed, and the incidence of pneumobilia and duodenobiliary reflux two weeks after EPBD. Then analyzed the short-term efficacy of the four groups. Result The overall success of stone removal in all groups were 100.0%, there was no significant differences in bleeding, intestinal perforation, hyperamylasemia, pancreatitis between each group (P > 0.05) . There shows significant differences in pneumobilia and duodenobiliary reflux two weeks after EPBD (P < 0.05). The incidence of pneumobilia and duodenobiliary reflux increased with the size of the balloon. Conclusion The application of EPBD is effective and safe for bile duct stone removal, while with the increasing of balloon diameter, the function of Oddi sphincter has severely influenced.

ObjectiveTo observe the discoloration of chemical indicator cards in different positions in pressure steam sterilization bags and stetilization effect.MethodsFrom January 2009 to January 2011,168 packages needing sterilization were divided into group A and group B randomiy with 84 packages in each.We put chemical indicator cards on different positions in the packages.Then discoloration of chemical indicator cards and the qualified rate of bacteriology detection were observed.ResultsThere were 9cases of uneven discoloration in group A,and the incidence rate was 10.71％,higher than group B.The unqualified rate of bacteriology detection in group A was 2.38％,higher than group B(1.19％),but the difference was not statistically significant.ConclusionsChemical indicator cards could reflect the effect of sterilization,but placing them in different positions can appear different results.The chemical indicator cards that placed between the two packing layer could provide powerful evidence for sterilization effects for clinicians,and avoid unnecessary economic waste in Sterilization and Supply Center,which is worthy of being widely used in Sterilization and Supply Center.

The paper discussed the working platform for medical ethics education,for the purpose of making such education regular,normalized and popular among the staff.Such means as better organization,innovative media,reinforced implementation and repeated examination will encourage hospital staff to develop better medical ethics for better quality of care and elevation of hospital culture and social satisfaction.

Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; virology ; Male

34 patients who suffered from NVG, excluding patients with shallow anterior chamber.All patients were assigned to groups A and B according the different therapy.Group A ( 15 eyes ) was treated with Ex -PRESS glaucoma filtration device implantation. Group B ( 19 eyes ) underwent a trabeculectomy combined with mitomycin C. All the patients were followed up to 1a.The results of best-corrected visual acuity ( BCVA ) , intraocular pressure ( lOP ) , the combination of lOP lowering medications, complications were recorded statistically analyzed preoperative and 1d, 1, 4wk, 6 and 12mo after operation. · RESULTS: Mean lOP decreased significantly frompreoperative values in both groups ( P=0.01 ) .The both group had similar lOP values changes after 1, 4wk, 6, 12mo, and there were no significant difference in statistics (P=0.451).There was no significant difference in BCVA changes after operation in both groups ( P =0.832).Success rate was 66.7%and 63.1%at 1a after Ex-PRESS glaucoma filtration device and trabeculectomy, respectively. Anterior chamber bleeding occurred to 8 cases after trabeculectomy in group B and to 3 cases with Ex-PRESS glaucoma filtration device implantation in group A.Choroidal detachment occurred to 3 cases in
group A and 6 cases in group B. No other ocular or systemic adverse events were found during the follow-up duration.
·CONCLUSlON:ln the short-term, Ex-PRESS glaucoma filtration device implantation has the advantages of simpleness, safety, minimally invasive, short learning curve for neovascular glaucoma, which provides us an available strategy to conquer NVG by simply operation and less suffering.

AIM: To investigate therapeutic effects of combination therapy for neovascular glaucoma ( NVG) .
METHODS: This retrospective study comprised 34 eyes of 34 patients who suffered from NVG. All patients were assigned to group A, B, C and D according to the different combination therapies. Group A ( 11 eyes of 11 patients ) was treated with intravitreal injection of ranibizumab and panretinal photocoagulation ( PRP ) . Group B ( 10 eyes of 10 patients ) was treated with transcleral cyclophotocoagulation and PRP. Group C ( 6 eyes of 6 patients) was treated with 3 therapies together. Group D (7 eyes of 7 patients) was treated with 810nm transcleral cyclophotocoagulation and soft gas-permeable contact lenses. All the patients were followed-up for 1a. The best- corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) were recorded and analyzed prior to operation and 1, 4wk, 6 and 12mo after operation.
RESULTS: All the post treatment IOP decreased significantly ( P<0. 05 ) from the values before therapy, and the IOP values after 4wk, 6, 12mo were not significantly different ( P > 0. 05 ) in statistics. Most patients' IOP can be controlled below 23mmHg after combination therapy. The visual acuity in group A after 1, 4wk, 6mo compared with those before treatment was significantly increased ( P<0. 05 ) in statistics and other groups did not significantly change before and after treatment (P>0. 05). Anterior chamber bleeding occurred to 2 cases after 1wk of transcleral cyclophotocoagulation. No other ocular or systemic adverse events were found during the follow-up duration.
CONCLUSION: After the combination of intraocular injection of the anti - VEGF drugs, 810nm laser cyclophotocoagulation and PRP, most patients with NVG disease can be effectively treated, can effectively control IOP, and retain part of the visual function, significantly improve the quality of life. In the short - term, combination therapy is safe and effective for NVG, which provides us an available strategy to conquer NVG by simply programmable operation and less suffering.

Objective To monitor the activities of orbicularis oculi muscle by analyzing the electroneurogram (ENG) of its innervating nerve. Methods The ENG was recorded in vivo by a cuff electrode implanted around a dog’s zygomatic branch of facial nerve. The differences between the ENG during relaxing period of the orbicularis oculi muscle and during the constricting period were analyzed to explore a way to monitor the muscle activities. Results The ENG signals indicating occurrences of eye blinking events were extracted in the study. Time-frequency analysis showed that there was no ENG difference when the orbicularis oculi muscle was in relaxing periods no mater whether it was in the nature eye-opening period or in the interval of eye blinking. The ENG of orbicularis oculi muscle in constricting period was different from the ENG in relaxing period at amplitude and frequency. Conclusion It is feasible to monitor the orbicularis oculi muscle activities by ENG analysis.

Objective To evaluate the value of ischemia modified albumin (IMA) in the diagnosis of coronary heart disease (CHD) and the correlation between IMA levels and the pathological scope of coronary atherosclerosis .Methods A total of 88 coro-nary heart disease(CHD) patients diagnosed by coronary arteriongraphy (CAG) were selected ,including stable angina pectoris (16 cases)(SA group) and acute coronary syndrome (72 cases)(ACS group) .ACS group was further divided into 3 groups :unstable an-gina pectoris(30 cases)(UA group) ,non-ST-elevation myocardial infarction (19 cases) (NSTEMI group) ,ST-elevation myocardial infarction(23 cases) (STEMI group) .According to the results of CAG ,CHD patients were divided into 3 groups:1 vessel lesion group ,2 vessels lesion group and 3 vessels lesion group ,and 60 healthy physical cases were selected as control group .Results IMA in the CHD group was significantly higher than in control group (P<0 .05) .IMA in the ACS group was higher than SA group (P<0 .05) .IMA in the NSTEMI group and STEMI group were significantly higher than UA group (P<0 .05) .IMA levels and the degree of coronary atherosclerosis were significantly positively correlated (P<0 .05 ,r=0 .570) .When the cut-off value of IMA was 80 .10 U/mL ,the area under the curve was 0 .869 ,the specificity was 98 .4% and the sensitivity was 65 .9% .Logistic regression a-nalysis showed that IMA was an independent predictor of CHD .Conclusion IMA has a high negative predictive value in the diag-nosis of CHD ,there was a significantly positive correlation between IMA level and the pathological scope of coronary atherosclero-sis .

Abstract: Objective　To investigate the fundus arteriosclerosis and its influencing factors in HIV/AIDS patients after long-term highly active antiretroviral therapy (HAART). Methods　The clinical basic data and fundus examination data of 203 HIV/AIDS patients before and after HAART in the Fourth People 's Hospital of Nanning from January 2020 to June 2022 were collected to evaluate the occurrence of fundus arteriosclerosis and analyze its influencing factors. Results　Of the 203 HIV/AIDS patients, 159 patients developed fundus arteriosclerosis, with an incidence of 78.33%, including 33 patients with grade Ⅰ(20.75%), 87 patients with grade Ⅱ (54.72%), 28 patients with grade Ⅲ(17.61%), and 11 patients (6.92%) with Grade Ⅳ. Before HAART, there was no significant difference in CD4+T lymphocyte count, CD8+T lymphocyte count, viral load, white blood cell count, platelet count, hemoglobin, serum creatinine, blood urea nitrogen, triacylglycerol, total cholesterol, fasting blood glucose, alanine aminotransferase, aspartate aminotransferase and serum total bilirubin between the atherosclerosis group and normal group (P>0.05). After 6 months of HAART, CD8+T lymphocyte count, triacylglycerol and fasting blood glucose in atherosclerosis group were significantly higher than those in normal group (P<0.05). In the stratified comparison of CD4+ and CD8+ lymphocyte counts after 6 months of HAART, the proportion of patients with CD4+ lymphocyte count (CD4+)<200 (cells/μL) in the atherosclerosis group was significantly higher than that in the normal group; the proportion of patients with CD4+ lymphocyte count (CD4+)≥500 (cells/μL) was significantly lower than that in the normal group; the proportion of patients with CD8+ lymphocyte count CD8+≥ 800/μL was significantly higher than that in the normal group (all P<0.05). Binary logistic regression analysis showed that opportunistic infection, HIV course, CD4+T, CD8+T lymphocyte count after HAART and triglyceride were independent risk factors for ocular fundus atherosclerosis in HIV/AIDS patients (all P<0.05). Conclusions　The incidence of ocular fundus arteriosclerosis is high in HIV/AIDS patients. More than 4 years of HIV course, combined opportunistic infection, Low CD4+T lymphocyte count after 6 months of HAART, high CD8+T lymphocyte count and high triglyceride level are independent risk factors for ocular fundus arteriosclerosis in HIV/AIDS patients. Fundus screening should be performed before and after HAART in such population, HAART program should be formulated for the risk of cardiovascular disease, and risk management of cardiovascular disease should be strengthened during treatment to improve patient outcomes.

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