[Objective] To observe Yishi Oral Liquid effect on treating middle and old aged asthenopia. [Method] Choose 125 cases of middle and old aged asthenopia, and randomly divide them into observation group 65 cases treated wutg Yishi Oral Liquid, and control group 60 cases with Mingmu Rehmannia Pil;meanwhile both groups reduced the time with the eye and made massage on the acupoints around the eyes. [Result] With 2~4 weeks of treatment, in the observation group, 23 cases were cured, 25 had marked effect, 13 effective, 11 had no effect, the total effective rate was 93.85%;for the control one, they were respectively 14,19,16,11 and 81.67%. The comparison showed the observation group was better than control one. [Conclusion] Yishi Oral Liquid treating middle and old aged asthenopia has good clinical effect, can obviously relieve the symptoms of blurred vision, phengophobia, lacrimation and aningerestling eyes, helpful to recovering eyesight.

Posner-Schlossman syndrome (PSS) or glaucomatocyclitic crisis is a rare,unilateral recurrent inflammatory ocular hypertensive disease.Although it is typically self-limited and has benign prognosis,some cases were reported with advanced optic nerve cupping and associated visual field loss.Current therapeutic strategies are mainly focused on controlling intraocular pressure and reducing inflammation.These treatments may relieve acute episode of PSS,but could not decrease the recurrences.Therefore,the etiology of PSS is extremely important.This review summarized and analyzed the advances in the etiology and pathogenesis of PSS in recent twenty years,including microbial infection,allergy,abnormal vascular reactivity,autoimmune and endocrine.Infectious theories are most studied at present.The probabilities of varicella-zoster virus and herpes simplex virus as the etiology of PSS were considered to be very small.Heliobacter pylori was thought to be related to the pathogenesis of PSS and glaucomatous optic nerve injury.The most likely cause of PSS is cytomegalovirus infection,but there existed evidences that opposed the theory.Due to the small sample size and limit of technology,the evidences of allergy,abnormal vascular reactivity,autoimmune and endocrinic factors as the pathogenesis of PSS were not definite.In conclusion,no single factor could explain the etiology and pathogenesis of PSS,multiple factors such as external factor,internal factor and autogenous factor might be involved.

A geometrical model of L4-L5 lumbar segment was constructed using a three-dimensional graphics software. Four conditions of the degenerated discs, i. e. light degeneration, moderate degeneration, severe degeneration and complete excision degeneration, were simulated with loading situations using finite element method under the condition of appropriate computational accuracy. By applying a vertical load of 378.93 N on L4 vertebral plate, stress nephograms on joint isthmus under four different working conditions were obtained. The results showed that the contacted area of facet joint was influenced by the degree of intervertebral disc degeneration level, which influenced the mises stress on joint isthmus. It was proved that joint isthmus was the important pressure-proof structure of the back of lumbar vertebra, and the stress values and distribution were related to structural stiffness of the back of lumbar vertebra as well as the contact area of facet joint. The conclusion could be the theoretical reference for the analysis of spinal biomechanics and artificial disc replacement as well.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Intervertebral Disc ; pathology ; Intervertebral Disc Degeneration ; Lumbar Vertebrae ; physiopathology ; Models, Anatomic ; Pressure ; Zygapophyseal Joint

Objective To investigate the prevalence and influencing factor of metabolic syndrome(MS)in rural elderly population. Methods With randomized cluster sampling,investigations including questionnaires,physical examination,fasting plasma glucose,blood lipids were performed in rural population aged over 60 years in Changzhou city in 2004-2005. Results A total of 4976 elderly people were enrolled in the study.The prevalence of MS was 24.1%,and 10.3%in men,34.3%in women by international diabetes federation(IDF)2005 definition.86.2%individuals had one or more of the metabolic disorders.Logistic regression analysis showed that sex,smoking,sweetmeat,family history of essential hypertension(EH)and tea drinking were influencing factors of MS. Conclusions The prevalence of MS is high in rural elderly population,especially in females.

Objective To study the CT features of small hepatocellular cancer.Methods 37 patients with small hepatocellular cancer proved histopathologically underwent spiral CT examinations including plain scans and contrast-enhanced scans.The arterial phase scan,the portal phase scan and delayed phase scan started at 25th second,70th second and 5th minute respectively after injecting the contrast medium with the high pressure syringe,the velocity was 2.5 ~3 ml/s,and the dose was 1.5 ml/kg.Results 73% (27/37) of tumors showed hyperdensity in arterial phase,65%(24/37) of tumors was hypodensity and 35% (13/37) had hyperdensity during portal phase,of which eight showed hypodensity in equilibrium phase.Conclusion Spiral CT can display the features of blood supply of small hepatocellular carcinoma that is of benefit in early diagnosis.

Objective To evaluate the impacts of comprehensive diabetes intervention to provide evidence for effective diabetic control in rural communities.Methods Diabetic patients from four communities at Wujin District of Changzhou City were selected.One hundred and seventy-three patients from two communities received comprehensive intervention,including medication therapy,diabetes education,and diet.exercise,and behavior instruction(intervention group);142 patients from the other two communities got medication therapy only (control group).All the participants were interviewed with structured questionnaire and phyrsical examination.The second epidemic investigation was conducted at 4 years to evaluate the effects of the intervention.Results At the end of the intervention,the awareness rates of normal fasting plasma glucose,major diabetes risk factors,healthy diet,and therapeutic strategies in the intervention group were 90.8%.74.6%,89.6%,and 59.5%,respectively,which were significantly higher than those in the control group (all P<0.05).For the intervention group,the rates of diet behavior or physical exercise change were 68.8% and 58.4%.respectively.which were much higher than those of the control group(all P<0.05).The average levels of systolic pressure,diastolic pressure,fasting plasma glucose,and total cholesterol were (130.6±10.4)mm Hg(1 mm Hg=0.133 kPa),(78.4±7.5)mm Hg,(6.2±3.1)mmol/L,and (4.5±0.9)mmol/L,respectively,in the intervention group,which were lower than those in the control group(all P<0.05).Conclusion Comprehensive intervention shows significant effects on rural community patients with diabetes.

Objective:To evaluate the prognosis of non-small cell lung cancer (NSCLC) patients with pleural dissemination after differ-ent surgical interventions. Methods:We retrospectively reviewed clinical and survival data of 153 NSCLC patients with pleural dissemi-nation who were diagnosed and treated in our hospital from May 2002 to May 2011. Results:The overall 3-and 5-year survival rates of all the patients are 38.5%and 24.2%, respectively, with a median survival time (MST) of 29.0 months. A total of 122 patients accept-ed primary tumor resection whereas the remaining 31 received pleural biopsy. The 5-year survival rate of the primary tumor resection group was 26.2%with a MST of 29.0 months and 16.1%for the pleural biopsy group with a MST of 24.0 months. The survival analysis showed no significant differences in the prognosis between the primary tumor resection and pleural biopsy groups (P>0.05). In the pri-mary tumor resection group, different surgical interventions (with or without lymph nodes dissection, with or without metastatic nod-ules resection, lobe, or partial lobe resection) had no effect on prognosis (P>0.05). Conclusion:Patients with pleural dissemination had poor prognosis. Different surgical interventions showed no survival benefits for patients with NSCLC regarding pleural dissemination. The role of surgery was to rule out or confirm pleural dissemination. The definite value of surgery still needs further exploration.

BACKGROUND:Until now, musculoskeletal bioengineering used in the orthopedic surgery and regenerative medicine are developing. OBJECTIVE:To summarize the construction strategies for tissue-engineered knee ligaments. METHODS:A computer-based online search was conducted in PubMed to screen the relevant literatures using the terms“knee ligament”AND“tissue engineering”OR“regenerative medicine”. The literature retrieval, data assessment and extraction were performed by both authors independently. The relevant literatures were included through reviewing preclinical and clinical studies to display the preclinical and clinical medicine progresses in the construction strategies for tissue-engineered ligaments. RESULTS AND CONCLUSION:Included 224 literatures focus on the construction strategies for tissue-engineered ligaments, including stem cel therapy, growth factors, biomaterials and scaffolds, and mechanical stimulation pattern. Construction techniques for tissue-engineered ligaments have some potential advantages, such as rapid function recovery, good tenacity, and reduced relapse. However, rigorous and high-level randomized control ed clinical trials are needed for the translation of preclinical results into successful clinical trials.

Objective The application of intraoperative evoked EMG monitoring during lumbar pedicle screw fixation and to find new stimulus threshold criterion.Methods The validity of the evoked EMG monitoring in detecting the malposition of the pedicle screws was tested again by animal experiment.Nineteen patients was inserted pedicle screws with persistent evoked EMG monitoring via tap stimulator,and the electric current was set at 30% of bone threshold of the same pedicle,all patients were ohecked by CT scan to prove the outcome.Results Thirty-two pedicles of six dogs were inserted Kirchner wires.The stimulate thresholds of mal-position wires had significant difference with those of normal-position wires.During clinical trial,122 screws were inserted in to nineteen patients.Four screws were positive during intraoperative evoked EMG monitoring.Of which one screw was confirmed as mal-position during operation and was then adjusted;another screw was found to be mal-positioned by CT scan post-operation;the other two screws were found normal by CT scan.The sensitivity of this technique was 100% and the specificity was 98%.Conclusion Intraoperative evoked EMG monitoring during lumbar pedicle screw fixation can detect the mal-positioned screws and to protect the nerve roots.The stimulate current may set at 30% of the bone threshold of the relevant pedicle.

Background: Insomnia often responds to the orexin receptor antagonist suvorexant. This study aimed to evaluate the efficacy and adverse events of suvorexant for Chinese patients with primary insomnia over 6 months. Methods: A total of 120 patients with primary insomnia were assigned randomly to two groups that received placebo or suvorexant (40 mg) for 6 months. The primary outcomes were the total sleep time (sTST), time to sleep onset (sTSO), and sleep quality (sQUAL). The secondary outcomes were the Insomnia Severity Index (ISI) score and adverse events. Results: A total of 111 patients completed the study and all of them were included in the final analysis. Suvorexant showed greater efficacy than the placebo in enhancing sTST, sTSO, sQUAL and ISI score at months 1 and 6. Serious adverse events were documented in 2 patients (3.3%) in the suvorexant group and 1 patients (1.7%) in the placebo group. The most common adverse event was somnolence, which occurred in 7 patients (11.7%) in the suvorexant group and 2 patients (3.3%) in the placebo group. No death related to suvorexant treatment was recorded. Conclusions: Suvorexant was efficacious and well-tolerated in a group of Chinese patients with primary insomnia over 6 months.
Sleep Initiation and Maintenance Disorders