Objective To establish an evaluation index system for access to ophthalmic surgery so as to standardize the access. Method Collect 14 ophthalmologists' recommendations on access criteria for ophthalmic surgery in two rounds of questionnaire survey by Delphi method. Results The return rate of rounds of consultation questionnaire was 93.33%, and the average expert authority coefficient was 0.78.Nine ophthalmic surgery access indicators were established. The coordination of expert coefficient was 0.521 after two consultation. It had significant difference ( P＜0.01 ). Conclusion The ophthalmic surgery access indicator system is highly credible and allows quantitative assessment of ophthalmic surgery from various aspects. It is more demanding for ophthalmologist, and gets more involvement of patients in the evaluation of ophthalmic surgery access. It could contribute to scientific and rational decision-making on access for ophthalmic surgery.

OBJECTIVE To study the current situation and problems of military blood emergency support and nosocomial infections,and find out countermeasures.METHODS The current situations and problems of military blood emergency support and nosocomial infections management system were analyzed,especially paying attentions to those parts including selecting blood donors,blood collection,storage,transport and distribution.RESULTS There were a lot of shortcomings existed in the blood infection factors control and management on blood emergency support;many measures should be taken to elovate the level of blood emergency,and reduce the risk of blood infection.CONCLUSIONS Improving and reforming the management system of blood emergency support in army,and maximatily reducing the risk of blood infection are important.

Objective To investigate the relationship of androgen receptor (AR) CAG repeat polymorphism and coronary artery disease (CAD) in elderly men and its potential mechanism.Methods Totally 296 elderly men undergoing coronary angiography were enrolled in this study.Serum total testosterone (TT) and free testosterone (FT) levels were measured.Androgen receptors (ARs) in peripheral lymphocytes were determined by flow cytometry.Genome DNA was extracted from peripheral leucocytes using standard techniques.Gene fragments containing AR CAG repeats were amplified by PCR with specific fluorescent labeled primers.PCR products were separated with agarose gels.CAG repeat number of each sample was obtained by genotyping.Results AR CAG repeats varied from 11 to 28 (P25-P75:18-22; median:20) in elderly male patients.They were divided into the long AR group (CAG repeats≥22,n=82) and the short AR group (CAG repeats＜22,n=214).Compared with the long AR group,serum FT level was much lower in the short AR group [(24.1±23.1) ×10-6mmol/L vs.(31.2±27.8)×10-6mmol/L,P＜0.05].The prevalence of coronary artery disease was higher in the short AR group than in the long AR group [84.1％ (180 cases) vs.69.5％(57 cases),P＜0.05].The FT level was lower in the short AR group combined with CAD than in the control group [(22.4±20.5) ×10-6mmol/L vs.(33.6±32.4)×10 6mmol/L,P＜0.01].There were no significant differences in serum TT and AR levels between the long and short AR groups.No significant correlations were found in the AR CAG repeats polymorphism with FT,TT or AR levels.Age was the main risk factor for FT and AR levels.Logistic regression analysis showed that FT level was negatively correlated with CAD (OR=0.98,95 ％ CI:0.973-0.998,P=0.01),and short AR increased the risk of CAD in elderly male patients (OR=3.44,95％CI:1.887-6.264,P＜0.01).Conclusions Serum FT level is correlated with age and is significantly decreased in elderly male patients with short AR repeats,which may increase the risk of CAD in elderly men.

Objective To evaluate the efficacy and safety of actovegin against acute oral mucositis through a randomized controlled multicenter trial for nasopharyngeal carcinoma(NPC) patients treated by chemo-radiotherapy. Methods From February 2006 to May 2007,a total of 161 patients with newly diagnosed stage Ⅱ-ⅣA(1992 Fuzhou Stage) NPC were randomly assigned to the prevention group,the treatment group and the control group. All patients received current chemo-radiotherapy ± neoadjuvant chemotherapy. Radiation technique and dose were similar among the three groups. Intravenous infusion of aeovegin was started when radiation started in the prevention group and when grade 2 mueositis occurred in the treatment group,which was given 30 ml daily ,5 times per week until the end of radiotherapy. Criteria of NCI CTC 2.0 and VRS were used to evaluate acute oral mueositis and pain degree,respectively. Results 154 patients were eligible for the efficacy analysis,including 49 in the prevention group,53 in the treatment group and 52 in the control group. In the prevention group and the control group, the incidence was 31% and 56% (P=0.011) for grade 3-4 mucositis,59% and 83% (P=0.009) for grade 2-3 pain. In the treatment group and the control group,the corresponding number was 38% and 60% (P=0.023) ,70% and 90%, (P=0.014). The prevention group had a lower incidence(P=0.021) and longer average interval(P=0.009) of grade 2 mucositis when comparing with the control group. No drug-related adverse event was observed. Conclusions Prophylactic or therapeutic use of actovegin by intravenous infusion can significantly reduce the severity of ehemo-radiotherapy induced oral mucositis and pain. The prophylactic use may also postpone and decrease the incidence of grade 2 mucositis,which deserves clinic application.

The aim of this study is to explore the tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats. Healthy male SD rats were randomly divided into two groups (30 each). Both were given PEGylated puerarin at a dose of 488 mg x kg(-1). After 5 min of medication, one group was normal rats, another group with acute myocardial ischemia was established by peritoneal injection of 50 mg x kg(-1) isoprenaline. After administration, the animals were executed at 30, 60, 90, 120, 150 and 180 min, then heart, liver, spleen, lung, kidney were extracted. The content of puerarin in organ tissue was determined by HPLC. The results showed that the AUC of tissue distribution of PEGylated puerarin in normal rats was liver > kidney > heart ≈ spleen > lung > brain. While the AUC of tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats was liver ≈ heart > kidney > lung ≈ spleen > brain. AUC(heart) of PEGylated puerarin in acute myocardial ischemia model rats was 1.7 times than that of the normal rats, and there was significant difference (P < 0.05). Thus, PEGylated puerarin had a good heart-targeting property in early myocardial infarction area, drugs could accumulate in the ischemic myocardium. It provided important information for further study and clinic use of PEGylated puerarin.

Objective To study the acute toxicity of ginkgolic acids from Ginkgo biloba sarcotestas against fish.Methods The ginkgolic acid mixture was obtained from Ginkgo biloba sarcotestas.The acute toxicities of the ginkgolic acid mixture against the fry of Cyprinus carpio var.and fry of Carassius auratus were detected.Results LC50 and LC90 of the ginkgolic acid mixture against the fry of Cyprinus carpio var.were 1.805 mg/L and 2.191 mg/L,respectively.LC50 and LC90 of the ginkgolic acid mixture against the fry of Carassius auratus were 1.930 mg/L and 2.217 mg/L,respectively.Conclusions The toxicity of ginkgolic acids against the fry of Cyprinus carpio var.and fry of Carassius auratus is medium.

Objective:To compare the efficacy of bilateral and unilateral metallic stenting in the treatment of unresectable malignant hilar biliary obstruction.Methods:From January 2012 to December 2018, a total of 300 patients with malignant hilar biliary obstruction (Bismuth type Ⅱ-Ⅳ) were treated with endoscopic metallic stenting in Oriental Hepatobiliary Surgery Hospital. Ninety-four patients with bilateral metallic stenting (bilateral metallic stent group) and 94 patients with unilateral metallic stenting (unilateral metallic stent group) were matched and analyzed by propensity score matching. The clinical success rate, the total number of interventions, the stent patency and overall survival time were compared between the two groups.Results:The clinical success rate in the bilateral metallic stent group was significantly higher than that of the unilateral metallic stent group [98.9% (93/94) VS 78.7% (74/94), χ2=19.352, P<0.001], and the mean number of intervention in the bilateral metallic stent group was significantly less than that of the unilateral metallic stent group (1.2±0.5 times VS 1.7±0.9 times, t=-4.345, P<0.001). The stent patency time in the bilateral metallic stent group was significantly longer than that of the other group [10.0 (8.0, 12.1) months VS 5.7 (5.2, 6.3) months, χ2=19.789, P<0.001]. The median survival time of patients in the bilateral group was numerically longer than that in the unilateral group, but did not reach statistical significance [7.6 (6.3, 8.9) months VS 4.6 (3.7, 5.7) months, χ2=3.628, P=0.057]. Conclusion:Endoscopic bilateral metallic stenting is superior to unilateral metallic stenting in the clinical management of malignant hilar biliary obstruction unsuitable for surgery.

Objective:To investigate the feasibility and efficacy of endoscopic placement of transpapillary parallel-style bilateral metal stents for malignant hilar biliary stricture.Methods:A total of 55 patients with malignant hilar biliary stricture (Bismuth Ⅱ-Ⅳ) were treated with an improved endoscopic drainage technique (endoscopic transpapillary parallel-style bilateral metal stenting) from January 2012 to December 2018 in Shanghai Oriental Hepatobiliary Surgery Hospital. The technical success rate, clinical success rate, incidence of complications, success rate of endoscopic re-intervention, stent patency and overall survival were analyzed.Results:The technical success rate of endoscopic placement of bilateral metal stents was 96.4% (53/55), the clinical success rate was 96.2% (51/53), and the early complication incidence was 13.2% (7/53). The median stent patency was 9.2 months (95% CI: 8.0-10.3 months), the success rate of endoscopic re-intervention of bilateral biliary systems was 92.3% (12/13), and the median overall survival was 6.7 months (95% CI: 4.7-8.8 months). Conclusion:This modified technique of bilateral metal stent placement is safe and effective for malignant hilar biliary stricture that is unsuitable for surgery.

Objective:To compare the efficacy of three approaches of parallel-style bilateral metal stenting in the management of unresectable malignant hilar biliary obstruction.Methods:Data of 118 patients with unresectable malignant hilar biliary obstruction (Bismuth type Ⅱ-Ⅳ) treated by endoscopic bilateral metal stenting in Oriental Hepatobiliary Surgery Hospital from January 2012 to February 2019 were retrospectively studied. According to the method of stent placement, patients were divided into three groups, both stents crossing the main duodenal papilla (long long-stent by stent, LL-SBS) group (53 cases), one stent crossing the papilla (long short-SBS, LS-SBS) group (53 cases) and no stent crossing the papilla (short short-SBS, SS-SBS) group (12 cases). The main outcomes, clinical success rate, stent patency, success rate of re-intervention of both intrahepatic systems and overall survival, were compared among the three groups.Results:There were no significant differences in clinical success rate [96.2% (51/53), 98.1% (52/53), and 91.7% (11/12)], median stent patency [9.2 (8.0-10.3) months, 11.6 (6.8-16.4) months, and 8.1 (3.7-12.5) months] or overall survival time [6.7 (4.6-8.8) months, 7.6 (5.7-9.4) months, and 7.1 (0.7-13.6) months] among the three groups (all P>0.05). The success rate of endoscopic re-intervention of both intrahepatic systems was 12/13, 0/10, and 1/5 in LL-SBS, LS-SBS and SS-SBS groups, respectively ( P<0.001). Conclusion:Parallel-style bilateral metal stenting is an effective endoscopic modality in the treatment of malignant hilar biliary obstruction, and LL-SBS may improve the success rate of endoscopic re-intervention to both intrahepatic systems.

Objective To evaluate the technical feasibility and safety of endoscopic retrograde catheterization of gallbladder (ERCG) and endoscopic transpapillary gallbladder stenting (ETGS) for gallbladder diseases.Methods Patients who underwent ERCG and ETGS in Eastern Hepatobiliary Hospital from January 2010 to June 2016 were enrolled to this retrospective study.The superselection time of cystic duct,the catheterization time of gallbladder,postoperative symptoms and complications were analyzed.Results A total of 10 patients were enrolled to this study,including 2 cases of acute calculous cholecystitis,4 cases of percutaneous transhepatic gallbladder drainage (PTGBD) and 4 cases of cholecystocholedocholithiasis.The success rates of ERCG and ETGS were 100％.Symptoms were relieved in all patients and PTGBD catheter was removed after ETGS.The mean times of ERCG and ETGS were 10.2 ± 6.9 min and 17.0 ± 8.0 min respectively.The mean times of ERCG were 18.5±4.9 min,13.0±3.6 min and 3.3± 1.3 min,respectively (F=18.86,P =0.002).The mean times of ETGS were 25.5±4.9 min,21.0± 4.7 min and 8.8 ± 1.0 min,respectively (F =18.04,P =0.002).Complications included 1 case of cholangitis and 1 case of hyperamylasemia.Cholangitis was relieved after anti-inflammatory treatment.No acute pancreatitis,bleeding,perforation or procedure-related death occurred.Conclusion ERCG and ETGS are safe and feasible,which can play important roles in the treatment of specific gallbladder diseases or gallbladder with bile duct diseases.