Objective:To observe the changes in the anterior chamber before and after cataract surgery by ultrasound biomicroscopy (UBM) in eyes with primary angle closure glaucoma. Methods: Ultrasound biomicroscopy was used for anterior chamber imaging in 78 eyes of 50 patients with primary angle closure glaucoma before and 1 month after cataract phacoemulsification and intraocular lens implantation. And the intraocular pressures were recorded at the same time. Results: UBM allowed the imaging of the entire anterior eye segment. In the images, the differences between iris thickness (IT), iris zonule distance (IZD) and iris lens angle (?2) before and after the operation were statistically insignificant. After the operation, marked increases were observed in the anterior chamber depth (ACD), angle opening distance at 500 ?m from the scleral spur (AOD500), trabecular iris angle (?1) and trabecular ciliary process distance (TCPD), with statistically very significant differences from preoperation (P

Objective: Fungal keratitis is one of the most common diseases leading to blindness.It has a high incidence in China,and its early diagnosis and treatment are of vital importance.We aimed to investigate the value of laser confocal corneal microscopy in the clinical diagnosis of fungal keratitis.Methods: We conducted laser confocal corneal microscopy on 37 patients suspected of fungal keratitis,and compared the results with those obtained from the corneal tissue smears and fungal cultivation.Results: The fungus-infected corneas histologically exhibited defected epithelial cells,damaged subepithelial nerves and disordered stroma with reduced transparence.The hyphae showed bright,disordered,interlaced thread-or short rod-like structures.The positive rates of smear examination,fungus cultivation and laser confocal corneal microscopy were 48.65,62.16 and 78.39% for the 37 eyes,75.00,87.50 and100% for the 16 untreated eyes,and 28.57,42.85 and 61.90% for the other 21 pretreated eyes.Conclusion: Confocal laser corneal microscopy,rapid,effective and noninvasive,can be used as an important new alternative in the diagnosis of fungal keratitis

Objective Xerophthalmia is a common disease of the ocular surface .Lupus nephritis ( LN) may induce changes in the ocular surface , which has aroused increasing attention in ophthalmology .This study was to observe the morphological changes of the tear meniscus in LN patients with xerophthalmia after treated with artificial tears . Methods This clinical trial included 60 LN patients with xerophthalmia (120 eyes) and another 60 without.The xerophthalmia group received artificial tear eye-drops for 1 month. The tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were measured by anterior segment optical coherence tomography ( AS-OCT) before and after intervention . Results There were significant differences between the xe-rophthalmia and control groups in the baseline TMH ([0.159 ±0.051] vs [0.269 ±0.053] mm, P<0.01), TMD ([0.154 ± 0.012] vs [0.198 ±0.007] mm, P<0.01), and TMA ([0.021 ±0.069] vs [0.052 ±0.021] mm2, P<0.01).After 1 month of intervention with artificial tears, the xerophthalmia patients showed dramatically increased TMH ([0.179 ±0.014] vs [0.159 ± 0.051] mm, P<0.01), TMD ([0.163 ±0.015] vs [0.154 ±0.012] mm, P<0.01), and TMA ([0.040 ±0.017] vs [0.021 ± 0.069] mm2, P<0.01). Conclusion AS-OCT, with its advantages of clearly and objectively imaging and measuring the cross section of the tear meniscus , can be applied to the diagnosis and assessment of xerophthalmia in LN patients , and artificial tear eye-drops can effectively relieve their xerophthalmia symptoms .

Objective To explore the status and influencing factors of surgical site infection (SSI)following lapa-roscopic surgery in patients in department of general surgery,so as to take effective measures to reduce SSI. Methods Active monitoring method was used to survey SSI among 401 patients undergoing laparoscopic surgery from January 1 ,2013 to December 31 ,2013,univariate analysis and multivariate analysis on risk factors for SSI were conducted.Results Of 401 investigated patients,12 (2.99%)developed SSI.Univariate analysis showed that risk factors for SSI in patients with laparoscopic surgery were elderly patients,emergency operation,infected wound,gastrointestinal tract operation,and grade Ⅳof ASA score (all P <0.05 ).Multivariate logistic regression analysis revealed that elderly patients (OR,5.02[95%CI ,1 .38 -30.25]),emergency operation (OR,4.37 [95%CI ,1 .96-28.55]),infected wound (OR,7.27[95%CI ,2.54-25.05]),and gastrointestinal tract operation (OR, 8.13 [95%CI ,1 .38 - 18.33 ])were high risk factors for SSI following laparoscopic surgery (all P < 0.05 ). Conclusion Thereare multiple factors influencing SSI after laparoscopic surgery,diversified prevention and control measures can effectively reduce the incidence of postoperative SSI.

Tolvaptan is a novel oral selective arginine vasopressin V2 receptor antagonist.Tolvaptan improves heart failure signs and symptoms without serious adverse events.Tolvaptan has no effect on all-cause mortality and cardiovascular death or admission rate for heart failure.But in heart failure patients with hyponatremia,tolvaptan can decrease cardiovascular death and admission rate for heart failure.

Two hundred and five patients with hypertensive intracerehral hemorrhage (HICH) received mini-puncture hematoma scavenging technique (MPST; n=80), traditional craniotomy operation (TCO; n=78), or medicine expectant treatment (MET; n=47), respectively. Clinical data demostrated that consciousness level and Glasgow Coma Scale (GCS) was more obviously improved in the MPST group,while postoperative complication rate was relatively lower. The MPST group and TCO group saw no significant difference in over-all matality, although both were significantly lower than the MET group. Severe disability rate in the MPST group was significantly decreased. In comparison with the TCO or MET group, 1 to 3 class activity of daily life score, language function recovery and response rate in the MPST group significantly improved (all P<0.05). We suggest that because of lower severe disability rate, less postoperative complications, and improved quality of life, MPST should be a better treatment of choice for HICH patients.

Objective To present clinical results of endovascular treatment of total iliac vein occlusions and to discuss the technique details of this treatment. Methods From Feb 2006 to Aug 2010,15 patients with chronic total occlusive lesions of the iliac vein and adjacent vein segments underwent endovascular treatment. Average age was (62 ±7) years (range 35 to 81 years), the male/female ratio was 12: 3. Clinical score of CEAP was grade 3 in 33. 3%, grade 4 in 40%, grade 5 in 13. 3%, and grade 6 in 13.3%. Venography showed left iliac vein was occluded in all 15 patients, common femoral vein was occluded in 14 patients, and superior femoral vein was occluded in 9 patients, however profounder femoral vein was patent in these patients with superior femoral vein being occluded. Results No postoperative major morbidity or mortality was seen. The technique success rate was 93. 3%. Treatment failure was caused in one case for a wrong selection of the femoral vein approach site. The average length of stent was 18. 4 cm.In 12(80. 0% ) stents crossed the inguinal ligament. The average follow-up time was 11.6 ± 2. 4 months.The primary patency rates of the stents at 6 months were 92. 9%. 10 (66. 7% ) patients were asympotomatic, 3(20% )were improved, 1 (6. 7% ) was unchanged, and 1 (6.7%) was worse, compared to before intervention. Conclusions Endovscular recanalization and stent placement is a safe and effective treatment for chronic total occluded iliac veins, with good patency, significant symptom resolution, and minimal morbidity in the short term follow-up.

Objective To develop and validate a simple and reliable HPLC method for the analysis of L-carnitine in human seminal plasma and to investigate its clinical significance as a potentially useful index of infertile.Methods After proteins in seminal plasma are precipitated with acetonitrile,L-carnitine in seminal plasma was derivatized to form its ester.HPLC separation of the sample solution was performed on a Lichrospher SiO_2 column and detected by ultraviolet absorbance at 260 nm.A mobile phase composed of acetonitrile-citrie acid buffer(containing 12 mmol/L triethanolamine,pH 5.0)was found to be the most suitable for this separation at a flow rate of 1.2 ml/min and enabled the baseline separation of the L-carnitine from interferences with isocratic elution.The L-carnitine levels in seminal plasma were studied in both 87 patients with infertility and 30 control subjects.Results Under the chromatographic conditions described, the L-carnitine derivative had a retention time of approximately 13 min.Good separation and detectability of L-carnitine in human seminal plasma sample were obtained.The method proved to be linear in the range of L-carnitine from 0 ?mol/L to 1000 ?mol/L.The relative standard deviations of within-and between-assay for L-carnitine analysis were 1.23% and 1.36%,respectively.The recoveries were 91.6% -96.5% for the human seminal plasma samples.L-carnitine concentrations in the populations were(392.7?107.2)?mol/L in the fertile group(n=30),(270.0?83.9)?mol/L in asthenozoospermia group(n=29),(187.9? 43.9)?mol/L in oligozoospermia group(n=19)and(175.7?67.1)?mol/L in oligoasthenozoospermia group(n=39).The large difference(P0.05).Conclusion The determination of L-carnitine level in seminal plasma may prove useful as a potentially biochemical marker of fertility and this is a useful guidance for the clinic therapy and the mechanismic study on the male reproduction.

Objective To evaluate the the effect of microalbuminuria of combined treatment with fosinopril and losartan,or fosinopril,losartan monotherapy in patients with hypertension.Methods In this double-blind, intention to treat study,136 patients with hypertension were randomly assigned to receive fosinopril 10 mg/d(n= 50),losartan 50 mg/d(n=41),or a combination of fosinopril 5 mg and losartan 25 mg (n=45) qd for 4 weeks, followed by titrating to the maximum recommended doses for another 4 weeks.The primary endpoint was the difference of mean sitting blood pressure and microalbuminuria excretion at baseline and week 8.Results At week 8,the combination of fosinopril and losartan therapy lowered mean mieroalbuminuria from baseline by 26.1?10~(-8) mol/L,significantly more than either monotherapy approaches (fosinopril 20 mg,18.3?10~(-8)mol/L,P

Objective To investigate the correlation between serum insulin-like growth factor-1(IGF-1)level and the 131Ⅰahsorbante of thyroid nodule in patients with struma nadosa,to search for simpler and safer methods for differentiating thyroid nodule.Methods Detecting the 131Ⅰ absorbance of thyroid nodule by radioisotope scanning.then the patients were divided into warm and cold nodule groups,and the normal control group was also set up;the levels of IGF-1,FT3,FT4,sTSH were detected in serum of patients with struma nadosa by radio immunoassay,then the correlation between these data and the 131Ⅰabsorbance of thyroid nodule was analyzed.Results In the patients with warnl nodule,the level of serum IGF-1,FT3,FT4 and the 131Ⅰ absorbance of thyroid nodule[(315.86±22.74)μg/L,(9.95±5.62),(67.27±27.31)ng/L,0.64±0.17]were increased obviously when compared with the control group [(256.13±39.85)μg/L,(2.80±1.30),(13.51±5.50)ng/L,0.35±0.15],but the sTSH[(0.35±0.03)mU/L]went down significantly than the control group[(2.71±1.17)mU/L],the difference being statistically significant(P＜0.01).In the patients with cold nodule,the level of serum IGF-1,FT3,FT4,sTSH[(263.17±30.23)μg/L,(2.89±0.98),(14.23±2.84)ng/L,(2.81±0.42)mU/L] had no significant difference compared with the control group(P＞0.05).The level of serum IGF-1 was positively correlated with the 131Ⅰ absorbance of thyroid nodule(r＝0.835,P＜0.01),but negtively correlated with sTSH(r＝-0.326,P＜0.05)in the patients with warm nodule.Conclusion The level of sernm IGF-1 is closely correlated with the 131Ⅰ absorbance of thyroid nodule in patients with struma nadosa.