AlM: To learn the changes of the tear film before and after the trabeculectomy of glaucoma and explore the incidence of dry eye and the prevention and control measures.METHODS:The 36 patients (60 eyes) of glaucoma were examined in detail before 3d of trabeculectomy and after the surgery at 3, 7, 14 and 30d. The examinations include lower eyelid central river of tears, break-up time ( BUT) , Schirmer I test ( S I t ) and staining scores of corneal fluorescein under slit lamp microscope.RESULTS:The tear meniscus height of central lower eyelid was increased and the tear film BUT was shortened at the same time, the scores of S I t was reduced and corneal fluorescein staining score was increased at postoperative 3 and 7d compared with that of preoperation. The tear meniscus height of central lower eyelid, tear film BUT and Slt and score of corneal fluorescein staining began to recover in most of the affected eyes after surgery 14d. At 30d after surgery, 22%of patients tear film failed to recover to the preoperative level; dry eye occured in 18% preoperative eyes with normal tear film.CONCLUSlON:Trabeculectomy of glaucoma may affect the stability of the tear film and some patients showeing obvious dry eye and should be intervened and treatmented timely.

OBJECTIVE To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore the possible pathogenetic mechanism, diagnosis and treatment. METHODS 218 cases of the SD in our department were retrospectively analyzed, and 37 patients with primary BPPV during the same period were used as control group. All patients were confirmed by the examination of Dix-Hallpike and the roll check,the primary disease (sudden deafness) of secondary BPPV patients were in line with the Chinese Medical Association diagnostic criteria. RESULTS In all these patients with SD,there were 91 cases with BPPV secondary to the SD. There were 67 cases of BPPV of posterior semicircular canal and 21 cases of BPPV of lateral BPPV semicircular canal. Besides, 3 cases were of multi-semicircular canal affected. All patients with BPPV were diagnosed as the same ears as the SD. The symptoms were alleviated and initial success rate was 68.1%. During 6-22 month follow-ups, total success rate was 100%, and recurrence rate was7.7% (7/91). The hearing recovery of high frequency is worse than that of the low frequency. There were 2 cases of recurrence in lateral BPPV group, 5 cases in posterior BPPV group. All were cured by reposositioning maneuver. All patients with primary and secondary BPPV were cured with Epley maneuver or Barbecue roll maneuver, and the curative effect of them is similar. CONCLUSION The occurrence of BPPV may follow SD,and the majority of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy for secondary BPPV.

Objective:To investigate the effect of HLA genetic susceptibility and NK cell receptors and immune response on the occurrence and development of the Cervical cancer.Methods: Select the 200 patients confirmed by the pathological biopsy in our hospital from January 2013 to January 2014 as the observation group.At the same time,randomly select the 200 healthy women as the control group.Both of them blood 2 ml peripheral blood,sample the cervical cell from the observation group.Having the cytological ob-servation and the DNA′s probe of the HPV,observe two group′s HPV infection rates and HLA′s parting.Results: The HPV infection rates of the observation group is 91%,and the rates of the control group is 16%.The differences between them were all significant(P<0.05).The HLA-KIR*1003,HLA-KIR*14,HLA-KIR*17,HLA-KIR*02,HLA-KIR*12 distribution frequency of the observation group are 41%,39%,35%,15%,53%.The HLA-KIR*1003,HLA-KIR*14,HLA-KIR*17,HLA-KIR*02,HLA-KIR*12 distribution frequency of the control group are 18%,15%,14%,52%,89%.The differences between them were all significant ( P<0.05).Among them The HLA-KIR*1003, HLA-KIR*14, HLA-KIR*17 distribution frequency of the observation group are significantly higher than the control group, HLA-KIR*02 , HLA-KIR*12 distribution frequency of the observation group are significantly lower than the control group.Conclusion:During the occurrence and development of the Cervical cancer,the HLA-KIR*1003,HLA-KIR*14,HLA-KIR*17 may be the risk factors for the Cervical cancer;the HLA-KIR*02,HLA-KIR*12 may be the protective factors for the Cervical cancer.

Objective To study the recent clinical efficacy of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy in the treatment of locally advanced pancreatic cancer.Methods 48 cases of untreated locally advanced pancreatic cancer were randomly divided into treatment group (compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy) and control group (three-dimensional conformal intensity modulated radiationtherapy),there were 24 cases in each group.Three-dimensional conformal intensity modulated radiation therapy used 95 ％ isodose coverage PTV.Using 6 MV X-ray irradiation,2 Gy/day,5 times/week,the total radiation dose was 50 Gy/25 times/5 weeks to complete.Treatment group:one week before treatment infusion of compound matrine injections 20 ml/time,l/d,21-day was one cycle.Control group:simple intensity modulated radiotherapy.Results After treatment,the clinical benefit response rate of the treatment group was 87.5 ％ (21/24),the control group was 70.83 ％ (17/24),the difference was statistically significant (P =0.045).Term efficacy rate of the treatment group was 79.17 ％ (19/24),the control group was 50.00 ％ (12/24),the difference was statistically significant (P =0.035).Adverse reactions were hematologic toxicity,leukopenia occurred in the treatment group was 16.67 ％ (4/24),but the control group was 45.83 ％ (11/24),the difference was statistically significant (P =0.029).Conclusion The effects of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy for locally advanced pancreatic cancer are good,they can relieve pain,improve short-term efficacy,reduc side effects,and improve the quality of life.

Objective To compare the effects of small dose remifentanil and fentanyl on hemodynamic responses to orotracheal intubation in children.Methods Ninety ASAⅠorⅡchildren (57 males, 33 females) aged 3-9 yrs weighing 17-34 kg scheduled for elective plastic surgery under general anesthesia were randomly allocated to one of 3 groups (n = 30 each): groupⅠcontrol (C); groupⅡfentanyl (F) and groupⅢremifentanil (R) . The children were premedicated with intramuscular scopolamine 0.01 mg?kg-1(the maximum dose 0.3 mg) and midazolam 0.1 mg?kg-1.Anesthesia was induced with propofol 2.5 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group F fentanyl 2?g?kg-1 was injectedⅣ5 min before intubation while in group R remifentanil 1?g?kg-1 was injectedⅣover 30 seconds immediately after vecuronium. Tracheal intubation was performed at 2 min after vecuronium injection. Noninvasive BP and HR were recorded and RPP (SBP?HR) was calculated before (baseline) and immediately after induction (T1),during intubation (T2) and at 1,2,3,4, 5 min after intubation.Results BP was significantly decreased after induction of anesthesia (T1) as compared to the baseline values in all 3 groups (P

Field practice teaching is an important part in pharmaceutical botany. According to the problems in the traditional field practice, an innovative system of field practice teaching was built. A series of reform and innovation was integrating and rationally allocating the existing resources. Combining the tra-ditional cognitive practice teaching and self-study, image-text card of medicinal plant was edited to enrich the teaching content, and the diversification of evaluation methods was proposed. This method could mobi-lize the enthusiasm of the students, improve the comprehensive quality of students and obtain good teaching effect.

Objective To study the clinical significance of combined routine ultrasound and ultrasound elastography in diagnosing thyroid microcarcinoma so as to facilitate the diagnoses of the thyroid diseases of the pilot.Methods Totally 284 thyroid nodules with the sizes less than 1 cm underwent routine ultrasound and ultrasound elastography examinations from June 2013 to June 2016.Results There were 221 benign nodules (77.8％) and 63 malignant ones (22.2％) confirmed by FNAC cytological,surgical and pathological examinations.Of the 63 malignant nodules,there were 60 cases of thyroid papillary carcinoma,one case of follicular carcinoma and two cases of medullary carcinoma.There was significant difference between the strain ratios of the benign and malignant nodules (P＜0.05),the ultrasound elastography scores of the benign nodules were statistically different from those of the malignant nodules (P＜0.05).The sensitivity,specificity and accuracy of ultrasound elastography were 90.3％,83.2％ and 86.9％ respectively when used to diagnose the thyroid nodule with the size less than 1 cm.Conclusion Routine ultrasound combined with ultrasound elastography can improve the diagnosis accuracy of small thyroid cancer,and is of great significance in early diagnosis and treatment of thyroid cancer of the pilot.

To explore the significance of the application of standardized special staining technique in pathologic diagnosis of pulmonary fungal infectious diseases.Methods Final pathologic diagnosis of 104 cases pulmonary fungus infection disease in Beijing Chaoyang hospital from September 2011 to March 2016 were selected;HE staining only,HE staining combined with the traditional manual special staining method PAS and hexamine silver,and HE staining combined with automatic special staining PAS and hexamine-silver were used and compared.The two kinds of special staining technology were compared;the microscopic observation,analysis results (all the first staining results,not including the results of complex staining),the results on the basis of final pathologic diagnosis were also compared with the clinical preliminary diagnosis.Results Lung fungal infectious disease diagnosis rate and fungal classification rate,from low to high order consistence,showed that for the primary clinical diagnosis (29.8％ and 19.2％),HE staining (32.7％ and 32.7％),HE staining combined with traditional manual special staining method PAS and hexamine silver (90.4％ and 87.5％),and HE staining combined with automatic special staining PAS and hexamine-silver (98.1％ and 94.2％).The four methods were statistically significant on two aspects (P ＜ 0.01,P ＜ 0.01);the fourth method was significantly different from the first two (P ＜ 0.01,P ＜ 0.01).The fourth method was significantly different from the third kind of diagnosis rate (P ＜ 0.05),typing rate was no significant difference (P ＞ 0.05).But automatic special dyeing method of PAS and hexamine silver steps were more simple,with standardized chemical reagents,no artificial and environmental factors,short time-consuming,and less number of dropping-off and restaining of the section.Conclusion HE staining and its combination with automatic special staining of PAS and hexamine silver are much more standardized,and help to improve the diagnosis of pulmonary fungal infectious diseases and fungal classification rate.

Objective To study the mechanism of acupuncture combined with herb decoction for brain occlusion. Methods one-side middle cerebral artery occlusion (McAo) rat by ehermoregulation was used as focal cerebral ischemia experimental animal. All animals were divided into four groups as model group, acupuncture group, herb decoction group, acupuncture combined with herb decoction group. And the dynamic changes of c-fos protein in ischemia region of brain tissue after treatment were observed. Results All of acupuncture group, herb decoction group and combining group could enhance the expression of c-fos protein in all stages of ischemia, and combining group was enhanced significantly. Conclusion Compared with herb decoction or acupuncture, the method of acupuncture combined with herb decoction could improved the stress ability of nerve cells of acute brain ischemia by enhance the content of c-fos protein significantly.

Objective To explore the clinical manifestation,laboratory tests,imaging and treatment of general paralysis of insane(GPI).Methods The clinical data of 2 patients with GPI analyzed retrospectively.Results 2 sufferers were both male,and mainly presented with memory decline and mental disorder.One case presented with visceral crisis.Both rapid plasma reagin test and treponema gelatin agglutination test in serum and CSF were positive.Brain MRI scanning showed ventriculomegaly.After antisyphilitic treatments,2 patients obviously improved.Conclusion GPI are often seen in middle-aged males and its misdiagnosis rate is high.The diagnosis of GPI should be considered in young patients with dementia without clear reason.Early diagnosis and active treatments are important for the prognosis of this disease.