Objective To analyse the effect of vitrectomy in diagnosing and treating endogenous endophthalmitis. Methods The effects of treatment, prognosis and the final follow-up visual acuity of 22 patients (30 eyes) with endogenous endophthalmitis diagnosed in our hospital from Jan 2000 to Dec 2003 were retrospectively reviewed. Results In 21 patients who underwent blood or vitreous body smear and culture, 18 (86%) had a positive result, including bacteria in 6, fungi in 11, and mixed infection in 1. In 16 patients who had complete follow-up data, successful vitrectomy were performed on 13 (81.3%) including 6 with functional success. Conclusion Vitrectomy may improve the positive rate of culture and vision prognosis in patients with endogenous endophthalmitis.

Objective To evaluate the clinical result of anterior elbow approach and internal fixation for the treatment of capitulum humeri fractures. Methods From January 1997 to December 2003,11 patients of 9 males and 2 females with capitulum humeri fractures were chosen anterorredial approaches of elbow. The fractures were terated with under direct vision and were fixed with screws. The left arms in 7, right in 4, the age of the group were from 14 to 18 years old, with the average of 15 years. 7 cases of them were treated with close reduction but failed. The operative time was from 3 days to 7 days after injury. They were fresh and close fractures. According to wangyicong's classification system all were TypeⅠ. Results All operations were successful, no nerves and blood vessels injury, the incisions were all healed by first intention. The X-ray films shows that the fractures were anatomic reduction. The healing time was 6 weeks in average and all patients were followed up with an average 3.5 years, no postoperative complications such as:myositis ossificans, post-traumatic arthritis, avascular necrosis of capitulum humeri. According to Cassebanm and the percentage of elbow joints pain was measured with patient visual pain index function score system: 7 caese of excellent, 4 case of good. Conclusion Displace of capitulum-trochlea hemeri does not link with muscle and capsula articularis, blood carries supply. Without avascular necrosis probably occurs at far stage. The close manipulation of capitulum humeri fractures hardly succeeds. The treatment with accurate open reduction associated with strong fixation can decrease the rate of avascular necrosis in the capitulum humeri fractures. The capitulum humeri fractures are suitable for opening reduced direct vision and fixing with screws through anteroeedial approaches of the elbow. The patients were encouraged to proceed for active rehabilitation early such as the elbow flexion-extension. Its short-term clinical outcomes is more excellent.

OBJECTIVE:To establish an HPLC method for the assaying of silybin in Gantai capsule.METHODS:The assay was performed on Diamonsil C18 column.The mobile phase consisted of potassium dihydrogen phosphate solution-methanol(45:55)with a flow rate at 1.0ml/min,detection wavelength at 288nm,column temperature at(25?2)℃.The sample size was 20?l and the internal standard was kaempferol.RESULTS:There was a good linear relationship within the concentration range of 0.126～1.26 mg/ml(r=0.9 998)for silybin.The average recovery was 102.9%(RSD=1.50%).CONCLUSION:The method was simple,accurate and reproducible,and suitable for the assaying of silybin in Gantai capsule.

Objective To observe the clinical manifestations and fe at ures of fundus fluorescein angiograms (FFA) of patients with multifocal choroidi tis (MFC). Methods The data of 8 patients who had been diagnos ed by clinic and FFA as with MFC were collected, and their clinical manifestatio ns and results of FFA were analyzed and valued. Results The ag e of the 7 female and 1 male patients ranged from 16 to 32, and all of the 8 pa tients had high myopia (from -6.00 D to -8.00 D) with binocular multiple small yellowish white lesions in posterior pole of the fundus and a few phlogistic ce lls in vitreous body. In addition, macular choroidal neovascularization membrane (CNV) was found in 6 patients, binocular in 2 and monocular in 4. The results o f FFA in 7 patients showed hypofluorescence of the yellowish-white lesions at t he early phase and pigmentation at the late phase; Corresponding manifestations of FFA could be found in the patients attended by CNV surrounded by leakage. Conclusion MFC are mostly diagnosed in young females with myopia. Most of the patients had binocular affection with multiple small yellowish whit e lesions at the posterior pole, whose FFA shows hypofluoresence of the active l esions at the early phase and pigmentation at the late phase. CNV may occur in p atients with MFC.

BACKGROUND: Essential tremor is a kind of dyskinesia disease with a tendency to heredity. β-adnephrin receptor blocker is mainly used for treatment, but the dosage was great, patients could not persist in treatment. Hydrochloric-acid arotinolol, which characterizes by little side effect, is a β-receptor blocking agent combined with blocking effect of α receptor, and is an ideal drug to treat essential tremor in Japan.OBJECTIVE: To observe the reliability and curative effect of hydrochloric-acid arotinolol on essential tremor among Chinese people.DESIGN: Case analysis.SETTING: Neurological Departments of Beijing Hospital of Ministry of Public Health and General Hospital of Beijing Military Area Command of Chinese PLA.PARTICIPANTS: Totally 30 patients with essential tremor, 19 males and 11 females, aged from 21 to 74 years, with course of 1-40 years, average of (15.8±12.6) years, were selected from Neurological Departments of Beijing Hospital of Ministry of Public Health and General Hospital of Beijing Military Area Command of Chinese PLA from April 1999 to December 2000.METHODS: Tremor degree of upper limb, caput and lower limb, degree of dysfunction of hand, tremor degree of hand during writing and circling, and chief complaint of pain caused by tremor were scored before medication and 2, 4 and 6 weeks after medication. Scores were determined as 1 point, 2 points and 3 points according to mild, moderate and severe degree respectively. Evaluated criteria: ① Obviously effective: Differences were more than 7 points before and after treatment. ② Effective: Differences were 6.5-3 points before and after treatment. ③ A little effective: Differences were 3-1.5 points before and after treatment. ④ No changes: Differences were from 1 to -1 points before and after treatment. ⑤ Worse: Differences were less than -1.5 points before and after treatment. Meanwhile, blood pressure and heart rate of patients and side effect of drug were observed.MAIN OUTCOME MEASURES: ① Results of effective evaluation; ②Blood pressure and heart rate before and after treatment; ③ Adverse events and side effect.RESULTS: Totally 30 patients entered the final analysis. ① Among 30 patients with essential tremor, 6 had obvious effect, 11 had effect, 5 had a little effect, 7 had no effect, and 1 was worse. ② Average of blood pressure before treatment was (138.5±14.6)/(84.2±6.4) mm Hg (1 mm Hg=0.133 kPa), and was (130±10)/(79.7±6.3) mm Hg after 1 course. Average heart rate was (77.5±6.4) times/minute before treatment and (75±6.4) times/minute after treatment. The difference was not significant. ③ Among 30 patients, 4 had side effect at various degrees which was accounted for 13.4%; 1 had distress after medication, 1 had agrypnia, 2 had fullness in head and dizziness, and 1 gave up the treatment because of deteriorated tremor.CONCLUSION: Hydrochloric-acid arotinolol can improve tremor symptom of patients obviously and is an effective drug to treat essential tremor with convenient and safe medication.

BACKGROUND:Recently, a neuroprotective effect of granulocyte colony-stimulating factor was reported in a model of cerebral infarction and a model of acute spinal cord injury. However, the applied animal model was not established by impact method, different from pathophysiological process of human.
OBJECTIVE:To observe effects of granulocyte colony-stimulating factor on motor function in a rat model of spinal cord injury induced by Al en’s method.
METHODS:Wistar rats were used to establish spinal cord injury at T 10 level using modified Al en’s method. They were randomly assigned to two groups, granulocyte colony-stimulating factor group, treated with granulocyte colony-stimulating factor, and vehicle group, treated with equal volume of PBS. The motor function was evaluated with Basso-Beattie-Bresnahan score and modified Rivlin loxotic plate test monitored at 1, 7, 14, 21, 28 and 35 days, and four-limb muscle strength was assessed using Grid walk test at 7, 14, 21, 28 and 35 days post-operatively.
RESULTS AND CONCLUSION:Hind limbs paralysis occurred in al animals postoperatively. Scores of Basso-Beattie-Bresnahan and modified Rivlin loxotic plate test were greater in granulocyte colony-stimulating factor group compared with vehicle group at 7, 14, 21, 28 and 35 days (P<0.05-0.01);mean Grid walk test errors were less in granulocyte colony-stimulating factor group compared with vehicle group at 14, 21, 28 and 35 days (P<0.05-0.01). Results indicate that motor function and four-limb muscle strength were improved fol owing granulocyte colony-stimulating factor therapy compared with vehicle group, indicating that granulocyte colony-stimulating factor has a positive effect on spinal cord injury.

OBJECTIVE:To discuss clinical efficacy and safety of alteplase combined with butylphthalide to the patients with acute ischemic stroke. METHODS:98 patients with acute ischemic stroke in our hospital were selected and divided into ob-servation group and control group according to random number table,with 49 patients in each group. Control group was addition-ally given Butylphthalide and sodium chloride injection 100 ml,ivgtt,bid,on the basis of routine treatment as controlling blood glucose,blood pressure,etc.;observation group additionally received Alteplase for injection 5 mg added into NS 10 ml,iv+Al-teplase for injection 45 mg added into NS 100 ml,ivgtt,qd,on the basis of control group. Both groups were treated for 2 weeks. Clinical efficacies of 2 groups were compared as well as cerebral infarction area,NIHSS score,ability score of daily liv-ing,the levels of IL-6,IL-8,IL-10,CRP,24 h urine protein,Scr and creatinine clearance rate before and after treatment. The occurrence of ADR was also recorded. RESULTS:1 patient of observation group and 2 patients of control group withdrew from the study due to severe hemorrhage. Total effective rate of observation group(95.83%)was significantly higher than that of con-trol group(80.85%),with statistical significance(P<0.05). Before treatment,there was no statistical significance in above in-dexes between 2 groups (P>0.05). The cerebral infarction area and NIHSS score were reduced significantly in observation group after treatment,ability score of daily living were increased significantly in observation group after treatment,and the im-provement of observation group was significantly better than control group,with statistical significance (P<0.05). 24 h urine protein and Scr of observation group was significantly lower than those of control group,with statistical significance(P<0.05). the level of IL-6 in observation group 1 week after treatment and the levels of IL-6,IL-8,IL-10 and CRP 2 weeks after treat-ment were significantly lower than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Alteplase combined with butylphthalide show signifi-cant therapeutic efficacy,can effectively reduce the level of serum inflammatory factors,control brain tissue ischemia and cere-bral infarction area,and improve neurologic function and pro-tect renal function in patients with acute ischemic stroke.

Objective To illustrate and discuss the technique and clinical value of scapula Y-position radiography.Methods Scapula Y-position radiographies were performed on 110 patients with shoulder joint injury or omalgia.The patient standed in front of the panel face to face, with the affected joint closed to the panel, and the arms fell naturally and palms pronated to stick close to the body.The angle between the coronal plane and the panel was about 55 to 65 degree, put the affected caput humeri at the center of the panel,tilted the tube to foot-side by 15 degree,and aimed the axis at caput humeri.Results Among the 110 patients, 82 radiographies were successfully taken by the first time,28 failed because of the inappropriate body-tilt angle.We had exposed 5 acromion fractures cases, 20 flexural and hook-form acromion cases, 35 cases with the acomion-caput humeri distance less than 1 cm, and 2 coracoid fracture cases.Conclusion Scapula Y-position radiography has high clinical value that could expose the osseous anatomic exit of the rotator cuff and guide the clinical treatments.

Objective:To search for a better RT-PCR method for detecting CK19 mRNA. Methods: RT-PCR methods were used to detect the expression of CK19 mRNA in the tumor tissues and in the peripheral blood of patients with gastric cancer and in the peripheral blood of healthy subjects. Results: The influence of pseudogene and genome was observed through nonreversely transcripted RNA controls and comparison of several pairs of primers.The interference could be effectively eliminated by regulating the annealing temperature based on mismatched primers. Conclusion: The presence of pseudogene and genome interferes the experimental protocol in RT-PCR,which can be resolved with the method introduced in our paper.

OBJECTIVE:To establish an approach to determination of ketoconazole and desamethasone acetate in novel ketoconazole spraying film.METHODS:Chromatography was performed using a Waters Symmetry C 18 .The mobile phase consisted of methyl-monopotassium phosphate(4∶1).Detection wave was at239nm.The flowing rate was0.6ml/min.RESUL_ TS:Excellent linear correlations were showed when the concentrations of ketoconazole and desamethasone acetate were in the ranges of0.2～2mg/ml and0.02～0.2mg/ml respectively.The mean recoveries of ketoconazole and desamethasone acetate were98.41%(RSD=2.29%,n=6)and97.84%(RSD=2.60%,n=6)respectively.CONCLUSION:The established approach is precise,reliable and therefore applicable to the quality control of novel ketoconazole spraying film.