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

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 evaluate the efficacy of ketamine in preventing postpartum depression in patients undergoing cesarean section.Methods One hundred and twenty ASA physical status Ⅰ patieuts,aged 18-38 yr,with body mass index ＜35 kg/m2,scheduled for elective cesarean section,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ketamine group (group K).Postoperative analgesia was performed with sufentanil 100 μg in 100 ml of normal saline,and sufentanil was infused at 2 ml/h (bolus dose 5 μg,lockout interval 15 min) in both groups.In group K,ketamine 4 mg/kg was added to analgesic pump.VAS score was maintained＜3.Before surgery and at 1,3,5 and 42 days after surgery,depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS),and postpartum depression was defined as EPDS score ≥ 13.Postpartum depression and ketamine-related complications occurred within 3 days after surgery in group K were recorded.Results Compared with group C,EPDS scores were significantly decreased at 1,3 and 5 days after surgery,and the incidence of postpartum depression was decreased in group K.Ketamine-related complications were not found in group K.Conclusion Ketamine (infused starting from the end of operation,lasting for 48 h,total amount 4 mg/kg) for postoperative analgesia can prevent postpartum depression to some extent in patients undergoing cesarean section.

Objective To analyze the CT findings of acute cervical trauma (ACT) and evaluate the value and limitation of CT in the diagnosis of ACT. Methods 78 cases of cervical trauma were examined with X-ray film and thin slice CT. 3D reconstruction was performed routinely. Analysis and comparison of X-ray diagnosis with CT diagnosis were done. Results 60 cases of ACT were diagnosed by X-ray film while 59 cases were confirmed by CT simultaneously. 1 case was diagnosed by X-ray, while its CT findings were normal. Fracture detection rates of CT and X-ray film were 98.3% and 53.3%,respectively. The difference was statistically significant. Conclusion If the patient has the acute cervical trauma, CT can diagnose the fracture, luxation and spinal stenosis more safely and precisely. But CT scan has some limitations. Combining X-ray examination with CT scan is able to raise the diagnostic level.

Objective To analyse the CT findings of acute knee joint injury (AKJI) so as to evaluate the value and limitation of CT in the diagnosis of AKJI. Methods Sixty cases of AKJI were examined with X-ray plain film and thin-section of CT scanning, while three-dimensional reconstruction of CT was performed routinely as well. The results of X-ray films and CT scanning were analysed and compared with clinical data and operative findings retrospectively. Results In 60 cases of AKJI, 141 fractures were found on CT examination, however, only 104 fractures were found on X-ray films. The difference of the results between the two diagnostic imagings was statistically significant(?2=38.12, P

[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 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.

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.

5 cm).The survival rates and the diminished rates of tumors in size were analysed comparatively.Results For small hepatocellular carcinoma,the diminished rates of tumor's size were higher in group PEI than that in group TACE and group CST,and higher in group RF than that in group TACE(P0.05).For large hepatocellular carcinoma,the diminished rates of tumor's size were higher in group TACE and group CST than that in group RF(P