AIM: To evaluate the clinical outcomes of management in younger patients with primary chronic angle-closure glaucoma (PCACG).METHODS: Thirty-eight patients (50 eyes) aged 40 or younger with confirmed diagnosis of PCACG in advanced or late stage who received surgical treatment in Zhongshan Ophthalmic Center from January 2000 to December 2005were retrospectively investigated. All patients underwent trabeculectomy. The mean follow-up was 23.6±7.5 months.Full ophthalmic examinations were performed. The clinical outcomes including clinical presentations, surgical results and complications were evaluated.RESULTS: The mean age of patients was 33.5±6.1 years old. There was a female preponderance (60.5%). The mean axial length was 22.4±3.5mm with 18.0% short axis of eyeball and 14% nanophthalmos. There was 60.0% fiat anterior chamber depth (＜1.9mm). Ultrasonic Biomicroscopy identified that plateau iris was the most common underlying etiology (80.6%). There was a statistically significant difference in intraocular pressure (IOP) reduction postoperativelyvs preoperatively (P＜0.001). Four eyes failed to control IOP and received second filtration surgery. The main postoperative complications included shallow anterior chamber (20.0%) and malignant glaucoma (12.0%).CONCLUSION: The younger PCACG patients in advanced or late stage can be effectively managed by trabeculectomy.They have more frequency of postoperative sustained shallow anterior chamber and malignant glaucoma. Careful ophthalmic examinations, delicate surgical procedures and well-managed technique of complications were suggested on younger PCACG patients.

AIM: To study the causes of pyogenic granuloma after hydroxyapatite(HA) orbital implants.METHODS: HA orbital implants (250 cases) in our hospital (68 pegged implants) were reviewed.All patients were followed up from 18 months to 10 years. Implants were removed after medical therapy which was proved to be ineffective.RESULTS: Ten of 250 cases of HA orbital implants developed pyogenic granuloma. Pyogenic granuloma occurred in 1 unpegged implants patient and 9 patients after pegging and drilling of HA implantation over 4～7 years. The pyogenic granulomas were not controlled by medical therapy effectively. Implants were removed in 9 cases except 1 case denied removing and continued medical therapy.CONCLUSION: Pyogenic granuloma was serious complication that occurred after HA orbital implants. Partial vascularization, implant exposure, xenogenic sclera implant, pegging and drilling of HA implantation are risk factors that affect the development of pyogenic granuloma.Pyogenic granuloma hasn't relation with implanted peg material. Pyogenic granuloma denotes the potential implant infection, and all implants should be removed finally.

Objective To study the relationship between coronary arteriographic and fluorescence fundus angiographic characteristics in type 2 diabetic patients with coronary heart disease.Methods The study was carried out by the analysis of the data from coronary arteriography and fluorescence fundus angiography in 203 type 2 diabetic patients with coronary heart disease in different groups divided according to age or total cholesterol level. Logisitic regression analysis was applied to explore various risk factors to angiographic characteristics.Results With advancing age,there were more involvement of 3 coronary vessels or the left main branch along with stageⅢretinopathy,but less single vessel diseases in the coronary arteries and less stageⅠretinopathy.The difference in coronary angiographic and fluorescence fundus angiographic characteristics between groups with different total cholesterol levels was not significant.Logistic regression analysis suggested that coronary artery diaease was related to age,sex and blood glucose and triglyceride levels while diabetic retinopathy was related to blood glucose level and age.Conclusion There is great difference in coronary arteriography and fluorescence fundus angiography among different age groups.Aging may aggravate the lesions both in the coronary arteries and fundal vessels in type 2 diabetic patients with coronary heart diseease.

OBJECTIVETo explore the changes in spatial learning performance and long-term potentiation (LTP) which is recognized as a component of the cellular basis of learning and memory in normal and lead-exposed rats after administration of melatonin (MT) for two months.

METHODSExperiment was performed in adult male Wistar rats (12 controls, 12 exposed to melatonin treatment, 10 exposed to lead and 10 exposed to lead and melatonin treatment). The lead-exposed rats received 0.2% lead acetate solution from their birth day while the control rats drank tap water. Melatonin (3 mg/kg) or vehicle was administered to the control and lead-exposed rats from the time of their weaning by gastric gavage each day for 60 days, depending on their groups. At the age of 81-90 days, all the animals were subjected to Morris water maze test and then used for extracellular recording of LTP in the dentate gyrus (DG) area of the hippocampus in vivo.

RESULTSLow dose of melatonin given from weaning for two months impaired LTP in the DG area of hippocampus and induced learning and memory deficit in the control rats. When melatonin was administered over a prolonged period to the lead-exposed rats, it exacerbated LTP impairment, learning and memory deficit induced by lead.

CONCLUSIONMelatonin is not suitable for normal and lead-exposed children.

Animals ; Female ; Lead ; toxicity ; Learning ; drug effects ; Long-Term Potentiation ; drug effects ; Male ; Maze Learning ; drug effects ; Melatonin ; administration & dosage ; toxicity ; Rats ; Spatial Behavior ; drug effects

OBJECTIVETo study the content of phytoestrogen in dissimilarity herbs.

METHODThe activity of phytoestrogen in heat-clearing drugs, drugs for relieving exterior syndrome, diuretic, anastaltics, tonics and astringents were detected based on the recombinant yeast cell (W303-1A/hER-ERE-Lac Z). The estrogenic activity in traditional Chinese materia medica were assayed quantitatively by determining the expression of beta-galactosidase.

RESULTThe phytoestrogen concentration (6.35 x 10(-3) nmol x g(-1) E2 equivalent) in heat-clearing drugs was the highest while that in anastaltic and tonic drugs was the lowest, which was less than the detected limit.

CONCLUSIONCompared with the other traditional Chinese materia medica, the content of phytoestrogen, which can bind to estrogen receptor, in giant knotweed rhizome, forsythia suspense, ash bark, baical skullcap root and ophiopogonis tuber were higher.

Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Phytoestrogens ; analysis ; metabolism ; Plants, Medicinal ; chemistry ; Receptors, Estrogen ; metabolism ; Recombination, Genetic ; Saccharomyces cerevisiae ; chemistry ; cytology ; drug effects ; genetics ; beta-Galactosidase ; analysis

Objective To investigate the impact on the retention time of retention enema at chen shi in patients with sequelae of pelvic inflammatory disease.Methods 60 residential patients (from May 2009 to June 2010 ) with pelvic inflammatory disease were randomly divided into observation group and control group based on table of random number,each group had 30 cases.The observation group practiced enema at 7:00 ～ 9:00comparing with the control group at routine time(19:00 - 21:00).Investigate the percentage of bowel movement before enema,the feeling of bowel movement and the retention time.Results The times of appearance and the degree of feeling of defecation is significantly lower in observation group than that in control group after enema (Z =- 5.968,P ＜ 0.01 ),there were no differences before enema (Z =-0.561,P ＞ 0.05) ; The media retention time is (13.425 ± 5.362)h in observation group comparing with (9.303±2.695)h in control group,the difference is significant ( t =-20.200,P ＜ 0.01 ).Conclusions Retention enema at Chen Shi can increase the retention time and alleviate awareness of defecation.

Objective To investigate the learning organization culture in the nurses of different working seniority,so as to provide a reference for the construction of learning organization.Methods A total of 680 registered nurses in three tertiary hospitals were investigated with general information questionnaire and the Learning Organization Questionnaire in nursing.Results Six hundred and eighty questionnaires were distributed.There were 636 valid questionnaires and the valid returned rate was 93.5％.Significant difference was found in the nurses with different working seniority (F =28.655,307.027,164.362,4.887,150.052,respectively;P ＜0.01).The nurses with work seniority more than 21 years had the highest scores of learning organization [(23.76 ± 3.33),(21.60 ± 1.44),(21.08 ± 1.70),(12.61 ± 1.37),(79.06 ± 5.11)],while the nurses with work seniority between 1 and 10 years had the lowest scores [(21.35 ± 2.51),(17.21 ± 1.44),(17.68 ± 1.62),(11.85 ± 1.84),(68.08 ±4.91)].And the scores of nurses with work seniority between 11 and 20 years were in the middle level [(22.88 ± 3.42),(19.66 ± 1.52),(19.79 ± 1.54),(12.17 ± 2.02),(74.50 ± 6.57)].Conclusions The nurses with shorter working seniority have stronger wish to improve the learning organization culture,so the learning organization should be strengthened.Further research should be done so as to increase core competency and improve the organization construction.

Objective To investigate the phenotype, frequency and function of CD4 + T cell subsets and the relevant cytokines, as well as the relationship between these cells and appearance of pneumonia of novel (H1N1 ) influenza A patients. Methods 68 healthy people,53 confirmed novel A( H1N1 ) influenza patients without pneumonia and 16 confirmed severe novel A( H1N1 ) influenza patients with pneumonia were enrolled in this study. Viral load in nasopharyngeal swabs specimens was measured by real time PCR assay.The phenotype and percentage of CD4+ T cell subsets including Th1, Th2, Th17, and Treg cells were measured by Flow cytometry analysis. The relevant cytokines in plasma including TGF-β, IL-6 and IFN-γ were measured by ELISA. Data was analyzed by one way ANOVA. Results It was found that peak viral load and viral shedding period of severe patients with pneumonia was significantly increased compared with mild patients without pneumonia ( P ＜ 0. 05 ). The percentage of Th17 cells of severe patients with pneumonia was significantly diminished compared to that of healthy subjects and mild patients without pneumonia( P ＜ 0. 05 ). However, Th1 ,Th2, Treg cells frequencies had no significant differences ( P ＞ 0. 05 )among these three groups. The level of TGF-β in plasma for the severe patients with pneumonia was also significantly decreased compared to that of healthy subject and mild patients without pneumonia( P ＜0. 05 ).The viral shedding period inversely correlated with the frequency of Th17 cells ( r = - 0. 38, P ＜ 0.05 ).Conclusion H1N1 influenza A virus can inhibit Th17 cells to differentiate, particularly more extent in patients with pneumonia. Impaired Th17 cells may correlate with viral clearance and pneumonia of novel H1N1 influenza A patients.

OBJECTIVETo evaluate the reliability of the birth defects surveillance system in four counties with high prevalence of birth defects (Pingding, Xiyang, Taigu and Zezhou counties) in Shanxi province, China.

METHODSOne township was selected from each county as study site. The health workers chosen from township or village level were trained to visit families on the outcomes of each pregnancy who gave birth during year 2003 in the study site. The number of births and cases collected in the study were compared with that from the surveillance system. The number of births reported by surveillance system in four counties was also compared with the data from the local government. The criteria of evaluation were: 1) number of the missing report of births should < or = 5%, 2) the number of missing report on major external birth defects cases should < or = 10%. Researchers from the Peking University were responsible for examining the quality of surveillance in some terminal units of surveillance system.

RESULTSThe numbers of births reported in the study and from the surveillance system for four-township were 1043 and 997, respectively. 46 births were missing and the rate of misreporting for births was 4.4%. The numbers of birth defects cases reported in the study and from the surveillance system were 30 and 29, respectively. 1 case of birth defect as missed, and rate of misreporting for birth defects cases was 3.3%. The total number of births reported from surveillance was similar to that in the study in four counties, with a difference of 1.2%. Birth registry data was rather readable and special health workers responsible for surveillance work were present in all the terminal units of the surveillance system.

CONCLUSIONThe misreporting of births and cases existed in the birth defects surveillance system of the four counties in Shanxi province, but were lower than the allowable criteria. The surveillance units had better registration, reporting and administration of births and birth defect cases. Hence, the quality of the data from the surveillance system in these four counties was reliable.

Birth Certificates ; China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Humans ; Infant, Newborn ; Population Surveillance ; Pregnancy ; Pregnancy Outcome ; Registries ; Reproducibility of Results

OBJECTIVETo analyze the complications and treatment results of intraoperative radiotherapy (IORT) for esophageal carcinoma.

METHODSSixty patients with thoracic esophageal carcinoma underwent esophagectomy through right thoractomy, 30 patients of whom received IORT of 15 - 25 Gy.

RESULTSIn patients who underwent IORT, 2 cases of pneumonitis, 1 case of anastomotic leak and 1 case of incisional wound infection were found. In patients underwent surgery only, 1 case of thoracic empyema and 1 case of anastomotic leak were found. All the complications ultimately healed. There was no operative mortality. During the follow-up of 3 years, in patients who underwent IORT, 2 of 3 died of radiation pneumonitis 24 and 26 months after IORT with one complicated with bronchoesophageal fistula. One of 3 died of multiple lung metastases. The 3-year survival rate was 88.0% (22/25) in IORT group and 76.0% (19/25) in surgery only group.

CONCLUSIONIntraoperative radiotherapy can reduce locoregional recurrence if performed to thoracic esophageal carcinoma patients without surgical contraindication or distant metastasis. Radiation pneumonitis, a common complication difficult to manage, implies a poor prognosis and, consequently, the lung and bronchus should be protected from the radiation.

Adult ; Aged ; Combined Modality Therapy ; Esophageal Neoplasms ; mortality ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy Dosage