Twenty-one eyes of 13 patients with juvenile glaucoma confirmed by ocular tension, vision, eye ground and gonioscope underwent trabeculectomy combined with amniotic membrane transplantation. The posttransplant intraocular pressure significantly decreased compared to pretreatment (P

Objective: To determine the expression of Fas ligand (FasL) in the patients with esophageal carcinoma and its clinic significance. Methods: The expression of FasL was measured by immunohistochemical technique in 30 patients with esophageal cancer. The numbers of tumor infiltrationg (TIL) were accounted by immunohistochemically stained CD45. Results: 76.6% of specimen expressed FasL. The difference of FasL expression was significant between each TNM stage. There was a negative correlation between the number of TIL and the expression of FasL. Conclusion: The expression of FasL in esophageal carcinoma may correlate with its invasion and metastasis.

Objective Valve replacement is a conventional therapy for the mitral insufficiency caused by IE. Mitral valve repair as an optional procedure for the disease has become feasible in recent years. However, concerns from surgeons about the recurrence of endocarditis after mitral valve repair remained. in this study we evaluated the long-term clinical outcomes of patients treated with surgery for the mitral insufficiency caused by infective endocarditis (IE). Methods Between July 1990 and July 2007, 83 consecutive patients (male 62, female 21) with mitral valve IE were enrolled in this study. Forty-one (49.4% )patients received mitral valve repair ( MVP,group A) and 42(50. 6% ) patients received mitral valve replacement ( MVR, group B). Thirty-seven cases had concomitant aortic valve replacement; 1 patient had aortic valve repair; 4 cases had ventricular septal defect repair; 1 case had atrial septal defect repair, 12 cases had bicuspid valve repair; 2 cases had coronary artery bypass graft and 1 case had femoral artery thrombus. Intraoperative transesophageal echocardiography were performed in 18 cases for the evaluation of mitral valve regurgitation. Mean cardiopulmonary bypass time, aortic clamping time and postoperative ventilation time were recorded and analyzed. Mid- and long-term clinical and echocardiographic outcomes were assessed.Results Preoperative left ventricular end systolic diameter, left ventricular ejection fraction and the classification of New York Heart Association in group A were significantly lower than those in group B (P ＜ 0. 05), but no difference was observed between the 2 groups in the cardiopulmonary bypass time and the crossclamping time. However, the intubation time and ICU time were shorter in group A than those in group B ( P ＜ 0.05 ). More vegetations were seen in the MVR group than in the MVP group. Three (3.6% ) patients died after the operation in group B. All patients were assessed as in NYHA Ⅰ-Ⅱ at discharge.A follow-up was done between 1 to 165 months (mean 39 months) with a mean follow-up rate of 95%. In the MVR group, peri-valvular leakage happened in 1 case, cerebral hemorrhage happened in 2 cases and repetitive pleura! effusion in 1 case. One death happened in the MVR group and none in the MVP group. The 10-year survival rate (100% ) in group A was nonsignificantly higher in group A than that (75% ) in group B(P =0.081). Conclusion Mitral valve repair is feasible for treating mitral valve lesions caused by endocarditis, and may provide an optimistic long-term outcome to the patients. The indication for mitral valve repair is mild to moderate mitral valve lesion. Experienced cardiac surgeons, use of antibiotics before and after the operations based on drug-sensitivity test and blood test, as well as follow-up the patients yearly, are important factors for the favorite outcomes.

ObjectiveTo investigate the effects of alpha-lipoic acid on serum soluble intercellular adhesion molecule-1 (sICAM-1) and high sensitive-C reactive protein (hs-CRP) levels in patients with early diabetic nephropathy (DN).MethodsA total of 61 patients with early DN were randomized into treatment group (n =31 ) and control group ( n =30 ).The two groups were both treated with dietary control and oral hypoglycemic drugs or insulin.Meanwhile,the treatment group was additionally given alpha-lipoic acid 300 mg/d by intravenous infusion for 20 days.The levels of sICAM-1 and hs-CRP in each group were detected.Results The levels of sICAM-1 and hs-CRP were decreased significantly in alpha-lipoic acid treatment group after 20 days of therapy ( [ 198.03 ±23.67] μg/L vs [271.17 ±34.66] μg/L,[5.16 ±0.43] mg/Lvs [7.95 ±0.88]mg/L,P ＜0.01 ).Conclusion alpha-lipoic acid may decrease the expression of slCAM-1 and hs-CRP,and that may be one of the mechanisms to postpone the progress of early DN.

[Objective] To review the treatment of metabolic syndrome from phlegm and stasis, so as to provide effective ideas for the treatment of metabol-ic syndrome.[Method] Through searching for literatures related to Chinese medicine treatment of metabolic syndrome in the last decade, we can summarize the role of phlegm and blood stasis in the metabolic syndrome and its relationship with various components of metabolic syndrome. We can also research the application of the resolving the phlegm and removing blood stasis in the metabolic syndrome. [Results] Phlegm, blood stasis consistently run through the metabolic syndrome, and have a close relationship with each component of metabolic syndrome. The prescription of resolving the phlegm and remov-ing blood stasis can not only improve the clinical symptoms, but also can improve obesity-related indicators, reduce blood glucose, increase insulin sensitiv-ity, improve endothelial function and so on. [Conclusion] Treating metabolic syndrome from phlegm and stasis is safe and effective, which can reverse dia-betes, insulin resistance and prevent cardiovascular events through multi-channel, multi-level, multi-target. It has a broad application prospect and is worth further in-depth study.

Objective To evaluate the operative results of 542 patients underwent mitral valve repair and the results of 20-years follow-up.Methods A total of 542 patients [306 males,236 females;mean age (38.75?19.38) years) underwent mitral valve re- pair between 1985 and 2006.Mean follow-up was (41.03?40.40) months (1～240 months),and follow-up was 90.8% complete. Results The post-operative mortality was 3.7 %,and 96.3 % of patients were in NYHA class Ⅰ and Ⅱ after surgery.During fol- low-up,there were 20 deaths and 23 reoperations.Survival at 7-year,10-year and 15-year was 91%,88% and 70%,respectively. Freedom from reoperation at 7-year and 10-year was 94% and 86%,respectively.Conclusion Valve repair in mitral leaflet disease is a standard technique,with a good operative results.

Objective To investigate the application of CUSUM (cumulative sum control chart) curve in cardiac clinical teaching of resident surgeon education.Methods We chose a surgeon of 10years work experience of attending the preparation operation of internal mammary artery as control reference (standard group,28 patients) and a resident engaged in professional clinical cardiac work no more than 5 years as group 1,a professional training physician engaged in cardiac surgery clinical work more than 5 years as group 2 and took 40 patients' data respectively from the two groups' preparation of internal mammary artery operation.And then we recorded the postoperative mammary artery flow,internal mammary artery preparation time and adverse events data and made statistics analysis with SPSS 19.0,and CUSUM curve with Matlab R2012b polynomial curve.Results When the density of operate interval and the operate numbers came to about 25 cases,the polynomial eurve's slope rate went up to 0,regardless the surgeons' experience,CUSUM value was accumulated from 66 to 76,and overcame the learning curve successfully.However,when the density of operate interval did no reach the standard,the surgeon's CUSUM ploynomial cmwe slope rate never reached to 0,and can't overcome the learning curve.Conclusion CUSUM curve gives a clear quantitative indicator to the cultivation of clinical physician,and makes teaching teachers can understand the young physicians' learning process,so as to change the teaching plan,help young physicians cross the learning curve as soon as possible.

Objective To observe the effect and safety of modified Yishen Zhuyang Huoxue Huazhuo Formula for polycystic ovarian syndrome (PCOS) in the TCM pattern of deficiency of spleen and kidney with phlegm-dampness. Methods Totally 123 cases were recruited into this study and randomized to two groups by central random approach, 64 cases in the observation group and 59 cases in the control group. Patients in the observation group were given the modified Yishen Zhuyang Huoxue Huazhuo Formula, while those in the control group were given compound cyproterone acetate tablet, for two treatment courses, three months for one course. The changes of ovarian volume and the number of follicles before and after treatment were observed. Adverse reactions were also evaluated. Results Bilateral ovarian volumes in both groups decreased after treatment (P<0.05, P<0.01), while the control group showed a significant better improvement (P<0.05). The number of follicles in the two groups decreased, but no significant difference were observed between the two groups (P>0.05). The rate of adverse reaction in the observation group was lower than the control group. Conclusion Modified Yishen Zhuyang Huoxue Huazhuo Formula is effective for PCOS patient by reducing the ovarian volume with a low incidence of side effect.

Objective To study the effect of abnormal blood pressure (BP) circadian rhythm on subtypes of acute ischemic stroke (AIS) in hypertensive patients .Methods Ninety-seven AIS pa-tients with hypertension were divided into arterothrombosis (AT)group (n=66)and small artery disease (SAD)group (n=31)according to the modified TOAST classification .Their 24 h ambula-tory BP was monitored .The 24 h BP ,daytime and nighttime BP ,morning BP surge and BP circa-dian rhythm were compared between the two groups .Results The nighttime SBP was significant-ly higher in AT group than in SAD group (133 .86 ± 18 .17 mm Hg vs 124 .42 ± 16 .06 mm Hg , P<0 .05) .The absent rate of BP circadian rhythm was higher in AT group than in SAD group (84 .8% vs 64 .5% ,P<0 .05) .However ,no significant difference was found in morning BP surge between the two groups (37 .9% vs 19 .4% ,P>0 .05) .Conclusion Absent BP circadian rhythm and elevated nighttime BP are related with AT type ischemic stroke .