?As a globally recognized irreversible blindness disease, glaucoma can lead to pathological intraocular hypertension, loss of optic ganglion cells and axonal progressive, more and more deep optic cup, and the expanded visual field defect. Various researches show that excitatory amino acid toxicity, oxidative damage, apoptosis, intracellular Ca2+overloading etc. , pathogenic factors are all involved in the occurrence and development of glaucoma. Now, a variety of clinical drugs and operation treatment are applied to control the glaucoma progress. Further more, there are many new drugs and methods in the process of development. This is an article on the current anti-glaucoma drugs.

Humans ; Hypertension, Pulmonary ; diagnosis ; Magnetic Resonance Imaging

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Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.

Objective:China was categorized as one of the 68 countdown countries to achieve the United Nations Millennium Development Goals (MDG) 5. This paper aimed to analyze the situation of maternal survival, and coverage of proven cost effective interventions in China, where specific attention was paid to disparities. Methods: National maternal and child mortality surveillance data were used to estimate maternal mortality ratio (MMR). Coverage for proven interventions was analyzed based on National Health Services Survey, where experts' consultations were made for complementation. Results: There had been a significant reduction of MMR in China, however great disparities existed, with rural Ⅱ to Ⅳ areas experiencing 2 to 5 times higher maternal mortality risks than urban areas and accounting for over 70% maternal mortality burdens. Postpartum hemorrhage, pregnancy associated hypertension, embolism and sepsis were the leading causes, and over 75% of the maternal mortality was caused by preventable or curable causes. Maternal health services utilization decreased in accordance with region' s development level. Socioeconomic factors like financial difficulties were the main obstacles hindering access of care.Even those who made deliveries in hospitals faced different probabilities in receiving qualified care according to their socioeconomic standings. Conclusion: China is on track to achieve MDG 5, however great disparities exist. It is necessary to specifically target rural types Ⅱ to Ⅳ areas. Major causes of maternal mortality which can be prevented or averted through the provision of essential obstetrical care. Yet as compared with maternity health needs, insufficient coverage of maternal and child health (MCH) care services and poor service quality are the leading predisposing factors contributing to maternal mortality in China.

Objective To investigate the application of ultrasound and blood indicators in diagnosis of early liver cirrhosis (S4) for patients with chronic hepatitis B (CHB).Methods Data of blood and ultrasound examinations of 631 patients with CHB who received liver biopsy in the Sixth People' s Hospital of Shenyang during April 2002 and March 2011 were collected.Logistic regression analysis was performed to determine the factors independently correlated with early liver cirrhosis,and the diagnostic model was established using these indicators.The diagnostic value of the established model was assessed by using area under receiver operating characteristic curve (AUROC) and compared with FIB-4 index,aspartate aminotransferase (AST)/platelet (PLT) ratio index (APRI) and S index.Results Logistic regression analysis indicated that age,PLT,albumin globulin ratio (A/G) and splenic square area (SPS) in ultrasound findings were independently correlated to early liver cirrhosis (Wald =10056,46.236,3.751 and 10.669,P ＜0.01).AUROC of the model based on the above factors in diagnosing early liver cirrhosis was 0.908,which was higher than those of FIB-1 index,APRI index and S index (Z =8.322,4.334 and 4.087,P ＜ 0.05).Taking 0.063 as cut-off value,the sensitivity,specificity,positive predict value and negative predict value of the established model in diagnosis of early liver cirrhosis were 90.1％,77.8％,50.0％ and 97.1％,respectively.Taking ＜0.060 and ≥0.110 as the cut-off values to exclude,and diagnose early liver cirrhosis,69.7％ (440/631) patients could avoid liver biopsy.Conclusion The model based on age,PLT,A/G and SPS can effectively predict early liver cirrhosis,and can reduce liver biopsy.

Objective To observe the expression of resistin mRNA and protein in adipose tissues of obese rats,and to explore the correlations between resistin and obesity,insulin resistance.Methods Thirty SD rats were divided into control group(n=15) and high-fat diet group(n=15).The rats in control group recieved common forage.The obese and insulin resistance models were induced with high-fat diet in SD rats.The plasma insulin level was determined by double antibody radioinimunity analysis,and automatic biochemistry analyzer in plement was used to detect the plasma free fatty acid.After 11 weeks,glucose tolerance test was carried out to determine blood glucose levels at intervals(0,30,60,90,120 min).Resistin mRNA from fat pads tissue was extracted by RT-PCR,and then its protein was detected by Western blot.The data were analyzed statistically by SPSS 11.5 software.Results After 11 weeks,the rats′ weight in high-fat diet group increased obviously than that of control group,as well as fasting blood glucose,free fat acid homeostasis model assessment of insulin resistance(HOMAIR) and the glucose tolerance in high-fat diet group reduced greatly.The resistin mRNA and protein in white adipose tissues were significantly higher in the obese mice than those of control group(Pa

Objective To compare the efficacy of alfentanil and remifentanil in minimizing the propofol injection pain. Methods A total of 175 adult female patients undergoing gynecological procedures with general anesthesia were randomly divided into four groups.Patients received alfentanil 1mg(2 mL,AL group,n=43),remifentanil 0.01 mg(2 mL,REM1 group,n=43),remifentanil 0.02 mg(2 mL,REM2 group,n=45) or normal saline(2 mL,control group,n=44) 30 seconds prior to propofol administration.Visual analogue scale(VAS) was employed to evaluate the subjective feelings of pain due to propofol injection,and adverse effects were recorded. Results One patient in REM2 group and one patient in control group were excluded due to difficulty in venous catheterization.The injection pain in AL group,REM1 group and REM2 group was significantly less severe than that in control group(P

Objective To investigate the clinical significance of thyroglobulin antibody (ATG) and thyroid peroxidase antibody (ATPO) in patients with vitiligo. Methods Venous blood samples were obtained from 87 patients with vitiligo and 90 age- and sex-matched normal human controls. Chemiluminescence was applied to measure the serum levels of ATG, ATPO, free triiodothyronine, free tetraiodothyronine and thyroid stimulating hormone (TSH). Results There was a significant increase in the positivity rates of ATG (23.0% vs 6.7%, P < 0.01) and ATPO (24.1% vs 7.8%, P < 0.01) as well as the serum level of TSH (3.4 ± 2.4 vs 2.4 ± 1.2 pmol/L, P < 0.05) in the patients with vitiligo compared with the normal human controls. It is worth mentioning that all patients positive for ATG or ATPO were diagnosed with vitiligo vulgaris. The positivity rates of ATG and ATPO in patients with vitiligo aged from 11 to 20 years and 21 to 40 years were significantly higher than those in age-matched normal controls (all P < 0.05). Also, female patients had a higher positivity rate of ATG and ATPO than female controls did (34.1% vs 8.5%, χ2 = 8.90, P < 0.01; 34.1% vs 10.6%,χ2 = 7.29, P < 0.05). The highest positivity rates of both ATG and ATPO were 53.3%, which were observed in vitiligo patients aged from 11 to 20 years, followed by patients from 21 to 40 years (ATG 34.5%, ATPO 34.5%). In patients with vitiligo positive for both ATG and ATPO, the occurrence of autoimmune thyroid disease was 70% (14/20), significantly higher than that in ATG- and ATPO- positive healthy controls (16.7%, χ2 = 5.4, P < 0.05). Conclusions ATG and ATPO were observed in young female patients with vitiligo vulgaris, and they may be associated with the development of autoimmune thyroid diseases.

Objective To examine the relationship between the A118G polymorphism of mu-opioid receptor(OPRM1) gene and analgesic effects of oxycodone hydrochloride in patients with severe cancer pain. Methods Fifty-nine patients with severe cancer-induced pain were divided into 3 groups by genotype(AA group,AG group and GG group,23,28,8 patients, respectively). They were orally treated with oxycodone hydrochloride sustained-release tablets,and the treatment dosage and adverse reactions(including nausea,vomiting,dizziness,constipation,etc.)were compared between groups. Results The variation of allele frequencies(118G)was 37.3%.The dosage of oxycodone hydrochloride sustained-release tablets used in AA, AG and GG groups was(27.0±14.3),(36.4±22.5)and(55.0±35.1)mg,respectively,and the differences were statistically significant between groups( P = 0. 01). On the part of adverse reactions,the incidence of nausea and vomiting,dizziness, constipation was 28.8%,22.0%,and 52.5%,in AA,AG and GG groups,respectively,and there was no significant difference between groups(P>0.05). Conclusion The analgesic effect of oxycodone hydrochloride is affected by opioid receptor gene polymorphism.Patients with G allelic variation(AG or GG genotype)require larger doses of oxycodone hydrochloride than those with AA genotype.However,adverse reactions are not associated with polymorphism.