AIM:To report a case of a chronic glaucoma patient whose reduced eyesight is related to ocular ischemia.METHODS:A case report.RESULTS:A 71 year-old man presented with a decreased left eye vision for over 3 years.During the last two months,he had deteriorated blurred vision when he woke up in the morning.The loss of his lower-half peripheral vision was especially serious.The patient suffered from an episode of transient amaurosis fugax three months ago.According to transcranial Doppler ultrasound scan and cerebral computerized tomographic angiography,the patient was found that he had severe stenosis of the bilateral intracranial internal carotid artery and decreased blood flow velocity within the left ophthalmic artery.His symptoms alleviated after an internal carotid artery endarterectomy.CONCLUSION:When vision loss glaucoma cases are presented,more attention should be paid to the presence of ischemia within the ophthalmic artery except glaucoma.

Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

OBJECTIVE:To evaluate the adverse drug reaction(ADR) induced by Antongding and its safety in use.METHODS:According to the organ/system type recommended by WHO,34 cases with ADRs induced by Antongding were classified.The ADRs in this series were analysed concerning clinical manifestations,severity of symptoms and inducing mechanism and the safety of use of Antongding was discussed.RESULTS:8 organs/systems were involved in 34 cases with ADRs,of them,18 cases had moderate and severe ADRs(52.94%).In vitro experiments showed that Antongding could inhibit CFU-GM in man.CONCLUSION:Antongding is apt to induce ADRs,so it has potential risk in use.

Objective To analyze prophylactic chemotherapy outcome and clinical characteristics in patients of high-risk hydatidiform mole. Methods Twenty-three patients who were diagnosed as high-risk hydatidiform mole and undergone prophylactic chemotherapy in our hospital were retrospectively analyzed.After prophylactic chemotherapy, 11 patients didn't develop to gestational trophoblastic neoplasia (GTN),while the other 12 patients developed to GTN and needed a regimen change to combination chemotherapy.The clinical characteristics of these patients and outcome of prophylactic chemotherapy were compared between two groups. Results There was no significant difference between the two groups on patients' age,weeks of delayed menses, enlarged uterine size excessive for gestational age, and incidence of theca-lutein cysts of ovaries. However,the median levels of pre-evacuation serum β-hCG in two groups were 469 144 U/L and 768 044 U/L respectively, and median days needed for β-hCG declining to normal(≤2U/L) at the first time were 71 and 120 days respectively, which were both significantly different between two groups.Analyzed with receiver operating charactristic(ROC), the level of serum β-hCG could be a predictor for prognosis. Choosing 750 000 U/L as the cut-off value, we could expect the serum β-hCG to have a specificity of 91% and a sensitivity of 58% to predict whether prophylactic chemotherapy will be successful.Conclusions For those patients who have to receive prophylactic chemotherapy because of risk factors and unavailable hCG assessments for follow-up, it's better to use double-agent or combination chemotherapy if the level of serum β-hCG reached 750 000 U/L so as to reduce therapy duration and prevent relevant chemoresistance.

Objective To analyze and compare the clinical characteristics and the treatment outcome of the patients with chemo-resistant and relapsed gestational trophoblastic neoplasia (GTN).Methods The clinical records of the patients with refractory GTN treated at the Peking Union Medical College Hospital (PUMCH) from Jan 2005 to Dec 2007 were retrospectively reviewed.According to the reasons for referral, all cases were classified as chemo-resistant GTN group who had never a normal serum human chorionic gonadotropin-beta subunit (β-hCG) level during their previous treatment, relapsed GTN group who had elevated serum β-hCG levels in the absence of the pregnancy after finished treatment 3 months or more, and undetermined GTN group who had elevated serum β-hCG levels in the absence of the pregnancy less than 3 months after completed treatment.The clinical features and treatment outcomes were compared between undetermined GTN group and chemo-resistant GTN group and also between undetermined GTN group and relapsed GTN group, respectively.Results Of 81 patients with refractory GTN, 32 cases were defined as undetermined GTN, 38 cases as chemo-resistant GTN and 11 cases as relapsed GTN.The median number of previous chemotherapy regimens, the rate of serologic complete remission ( SCR), the patients who needed to change regimens due to resistance, and the patients who needed to change regimens in the undetermined GTN group and the chemo-resistant GTN group were 2.3 versus 3.1 ( P = 0.010),100% (32/32) versus 66% (25/38, P ＜ 0.01 ), 22% (7/32) versus 58% (22/38, P = 0.002) and 28% (9/32) versus 63% (24/38, P = 0.003 ), respectively.No significant difference were observed between undetermined GTN group and relapsed GTN group in clinical features, previous and current treatment or treatment outcome ( all P ＞0.05 ).Conclusions In order to evaluate accurately the treatment outcome of refractory GTN, it seems more appropriate for the patients who had reached the normal value of serum β-hCG when completed treatment to be defined as patients with relapsed GTN, while whose serum β-hCG levels elevated in the absence of the pregnancy after the completion of treatment, irrespectively of duration of stopping treatment.Comparing with the patients with chemo-resistant GTN, the outcome of patients with relapsed GTN is better.

Cone-Beam Computed Tomography ; methods ; Four-Dimensional Computed Tomography ; methods ; Humans ; Image Processing, Computer-Assisted ; methods ; Magnetic Resonance Imaging ; methods ; Multimodal Imaging ; methods ; Neoplasms ; diagnosis ; diagnostic imaging ; radiotherapy ; Positron-Emission Tomography ; Radiotherapy, Computer-Assisted ; methods ; Tomography, X-Ray Computed

Objective To perform the epidemiological analysis of the developmental dysplasia hip(DDH) in Shigatse of Tibet in order to explore the correlation between the onset of DDH with some risk factors such as altitude and take targeted intervention measures to reduce the disability rate of DDH.Methods A total of 5900 children aged 0 to 14 year-old from different altitudes in Shigatse of Tibet were surveyed randomly from June 2013 to June 2014.SPSS 18.0 statistical software was used to analyze the correlation of the onset of DDH with residence altitude,production and living ways,binding method of the lower limbs,delivery situation and genetic factor.Results One hundred and ninety-one DDH cases were screened out,and the average incidence of DDH in Shigatse of Tibet was about 32.4‰,and unilateral was higher than bilateral,fight side(33 cases)∶left side(68 cases) =1.00∶ 2.06.The result of Pearson correlation analysis of the onset of DDH with residence altitude showed that there was significant correlation (r=0.820,P=0.046).The result of Spearman correlation analysis of the onset of DDH with production and living ways showed that there was significant correlation(r=0.530,P =0.048).The result of x2 test analysis of the onset of DDH with binding method of the double lower limbs and breech delivery showed that there was statistical significance (P=0.0017,0.0082).Conclusions The DDH incidence of children living in high altitude areas in Tibet has certain regional characteristics indicating that it has clear correlation with some environmental risk factors such as altitude,methods of the lower limbs binding,production and living ways and breech delivery,especially the bundled package of lower limbs is the main environmental risk factor of DDH.

ObjectiveTo investigate the effect of intrathecal injection of TRPV3-siRNA lentivirus on bone cancer pain(BCP) behaviors in rats.Methods40 female SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 4 groups (n=10 in each group):Sham group (S),BCP group (B),negative control lentivirus group (C) and TRPV3-siRNA lentivirus group (T).Group B,C and T were induced bone cancer pain by intra-right-femur inoculation of Wallker 256 cells,while rats in group S were injected of inactivated cell.Rats in group T were intrathecally treated with 5 μl TRPV3-siRNA lentivirus while rats in group C received 5 μl negative lentivirus on 1~6 d after surgery.All the rats received pain behaviors including paw withdrawal thermal latency(PWTL) and paw withdrawal mechanical threshold (PWMT) at 1 d before BCP and 1,3,6,9,12,15,18 and 21 d after BCP.L4~L6 spinal cords were reserved for RT-PCR and Western Blot.ResultsCompared with group S,PWTL and PWMT of group B were decreased (P<0.05).On the 9th day,PWTL of group T was higher than that of group C((17.52±2.15)s vs (14.36±1.67)s,P<0.05).However,there was no significant difference in PWMT between group T and group C((16.89±1.54)g vs (15.53±1.36)g,P>0.05).The results of RT-PCR and Western blot demonstrated that the expression of TPPV3 in group T was decreased compared with that in group C(P<0.05).ConclusionIntrathecal injection of TRPV3-siRNA lentivirus can inhibit the expression of TRPV3 and thus alleviate symptom of PWTL,but not PWMT.

With this retrospective study, we analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation in typical regions at home and abroad.In foreign countries, drug negotiation mechanism has been implemented for many years, and many countries have established a relatively perfect negotiation system.We selected 8 typical countries and regions for which we statistically analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation and these include the United States, Australia, Canada, France, Germany, Italy, South Korea and Taiwan.However, in recent years some Chinese medical insurance department carried out pilot works on drug negotiations, and they got some successful results of the implementation of practical experience.Eight typical Chinese regions were also selected for statistical analysis, and these include Zhejiang, Hunan, Jiangsu, Jiangxi, Chengdu and Qingdao.From the analysis of the comparison of drug negotiation mechanism in domestic and foreign typical regional, we found that foreign regional drug negotiation mechanism is more mature and perfect, while in the domestic areas the mechanism is still poor at a certain extent as compared to foreign countries.We should learn from the successful experience of foreign countries and also establish and improve the negotiation mechanism that is suitable for China''s national conditions.

0.05).Compared with control group,significant decrease in positive group was found in the interval from first evacuation of HM to resolution of serum ?-hCG level,(83?18) days versus(126?31)days(P0.05).Conclusions Once HM is diagnosed,evacuation should be performed as soon as possible,the later the evacuation begins,the higher the risks of lung metastasis and chemotherapy are.It is not necessary to worry about lung metastasis before evacuation of HM,the outcome of post- chemotherapy is very good.