BackgroundLaser peripheral iridotomy(LPI) can break the pupillary block,and is an effective method of treating acute primary angle closure (APAC).However,a part of APAC eyes may gradually develop a formation and extension of peripheral anterior synechia(PAS) and increased intraocular pressure(IOP) after LPI.ObjectiveTo investigate the relationship between appositional angle closure and darkroom provocative test(DRPT) in the fellow eyes with APAC after LPI.Methods Fellow eyes of APAC without PAS after LPI were studied.Ultrasounic biomicroscopy(UBM) were performed in darkness to observe whether appositional angle closure occurred and compare the relationship between the quadrants with appositional angle closure and the results of DRPT.Results Fifty-four patients were included in the study.Appositional angle closure was observed in at least one quadrant in 20(37.0％ ) of the 54 fellow eyes with APAC after LPI.Fifty-one patients were given DRPT and positive result in 9 patients( 17.6％ ).According to the quadrants with appositional angle closure,there were 5 patients with DRPT positive results in 46 patients with appositional angle closure 0 to 2 quadrants,and 4 patients with DRPT positive results in 5 patients with appositional angle closure 3 to 4 quadrants ( P =0.003 ).Bivariate correlation analysis indicated a positive correlation between the value of the increased IOP in DRPT and the number of quadrants with appositional angle closure in darkness( r =0.397,P =0.004).ConclusionsA certain proportional fellow eyes of APAC appeared appositional angle closure in darkness and DRPT positive result after LPI.The more the quadrants of appositional angle closure after LPI,the greater the likelihood of a positive DRPT.It suggests that the APAC fellow eyes and attack eyes with the same anatomical configuration still have the possibility of angle closure after LPI,and need follow-up and treatment for a long time.

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.

Animals ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; physiopathology ; Carcinoma, Small Cell ; metabolism ; pathology ; physiopathology ; Cell Differentiation ; Chromogranin A ; metabolism ; Humans ; Male ; Neuroendocrine Cells ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; physiopathology

Background The diagnosis of central serous chorioretinopathy (CSC) is mainly dependent onfluorescine fundus angiography (FFA). However, the combination of optical coherence topography (OCT) with FFA offers a new approach to the research of the pathogenesis of CSC. Objective This clinical study was designed to study the combined application of the FFA and OCT for the research of the pathogenesis of central serous chorioretinopathy (CSC). Methods Forty-four eyes of 44 patients with CSC were included in this study with 36 cases of males and 8 cases of female. The patients were aged 39.3 ± 5.3 years and the visual acuity was 0. 64 ±0. 27. FFA and OCT examinations were performed in all patients and the FFA images were imported into the Topcon 3D OCT 1000 device to locate the conformity of OCT lesions with the leakages of FFA. The neuroepithelial layer thickness at the fovea and the height of the neuroepithelial layer detachment were measured using 3-D OCT. Results OCT showed serous REP detachment in 34 eyes (77.3%) and rough surfaces of RPE in 10 eyes (22. 7% ). In thirtyfour eyes with RPE detachment, the OCT lesions and FFA leakage spots conformed to the same locations in 31 eyes, but the other three eyes did not. The mean foveal neuroepithelial thickness was (138.5±19.4) μm in CSC eyes and that of normal eyes was ( 131.35±5. 01 ) μm ,showing a significant difference between them( t=0. 39 ,P＞0. 05 ). The mean height of neuroepithelial detachment was (263.3 ± 126.7 ) μm in CSC eyes. Conclusion RPE detachment occurs in CSC eyes and further induces macular neuroepithelial detachment. Leakage lesion of fluorescine corresponds to RPE detachment. CSC without RPE detachment may be related to the increase in RPE permeability. OCT can accurately measure the thickness of the macular neuroepithelial layer and the height of the neuroepithelial detachment.

OBJECTIVETo explore the mechanism of acupuncture for treatment of lumbar nerve root compression injury.

METHODSFifty healthy SD rats were randomly divided into 5 groups, a normal group, a model group treated by saline, a medication group treated with Caerulein, an acupuncture group treated with acupuncture at L5, L6 Jiaji (EX-B 2) and a warm needle group treated with acupuncture and moxibustion at L5, L6 Jiaji (EX-B 2). The lumbar nerve root compress injury model was made by placing microsilica gel tablet. After they were treated for 14 days, the compressed nerve root was taken and the ultra-microstructure changes of the injured nerve root were observed by electron microscope and changes of nitric oxide synthase (NOS) and calcitonin gene-related peptide (CGRP) expressions were investigated by ELISA assay.

RESULTSThe changes of ultra-microstructure of the nerve root were the most obvious in the model group and the changes in the medication group, the acupuncture group and the warming needle group reduced in order; the NOS activity and CGRP content in the nerve root tissue of the compressed area in the warm needle group were significantly reduced as compared with the model group (P < 0.05), but with no significant difference as compared with those in the normal group (P > 0.05).

CONCLUSIONWarm needle treatment can effectively maintain cellular form, and ultra-microstructures of nerve root dorsal root ganglia, and effectively inhibit the release of inflammatory factors NOS and CGRP.

Animals ; Calcitonin Gene-Related Peptide ; immunology ; Disease Models, Animal ; Female ; Humans ; Inflammation Mediators ; immunology ; Male ; Moxibustion ; methods ; Nitric Oxide Synthase ; immunology ; Radiculopathy ; immunology ; therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Nerve Roots ; immunology ; ultrastructure

Objective To discuss the method, safety and clinical value of biliary stenting combined with 125I seed implantation intracavitary irradiation in treating malignant obstructive jaundice. Methods A total of 36 patients with malignant obstructive jaundice were enrolled in this study. PTCD was carried out in all patients, which was followed by biliary stenting combined with 125I seed implantation intracavitary irradiation treatment. The results were analyzed. Results During the interventional management, displacement of the stent and 125I seeds were observed in two cases, and the displaced stent and 125I seeds were replaced to the right position with the help of biliary biopsy forceps. The technical success rate was 100%, and the remission rate of the jaundice was 100%. All the patients were followed up for 1-23 months. No radioactive particles leaking or complications such as radiation enteritis occurred. No in-stent obstruction due to tumor recurrence was observed although slight dilatation of intrahepatic bile duct was detected in 25%of patients, which was resulted from intimal hyperplasia at the stent mesh and/or biliary stone formation. The median survival time was 10.9 months. Conclusion For the treatment of malignant obstructive jaundice, biliary stenting combined with 125I seed implantation intracavitary irradiation is safe, reliable and effective. This technique can prolong stent patency time as well as the patient’s survival time.

OBJECTIVETo compare therapeutic effects of acupuncture at pain points and massage combined with medicine on myofascial pain syndrome (MPS).

METHODSOne hundred and fifty cases were randomly divided into an observation group (n=90) and a control group (n=60). The observation group was treated with needle-sticking method combined with single-finger meditation pushing therapy at pain points, and the control group with local application of Votalin Emulgel combined with Tuina. All the patients were treated for 1 course and followed up after 3 months and their therapeutic effects were compared.

RESULTSThere were significant differences in cumulative scores of symptoms before and after treatment in the two groups (both P < 0.01), and there were no significant differences in the pain and pressure pain between the two groups (P > 0.05), and there were significant differences in the muscle spasm and joint range of motion between the two groups (P < 0.05); after treatment, the markedly effective rate and the total effective rate in the observation group were 57.8% and 94.4% respectively, and were 31.7% and 73.3% respectively in the control group, with a significant difference between the two groups (both P < 0.05).

CONCLUSIONNeedle-sticking method combined with single-finger meditation pushing therapy at pain points can effectively alleviate pain and pressure pain in the patients with MPS and it has better therapeutic effect in the markedly effective rate and the total effective rate as well as improvement of muscle spasm and joint range of motion than local application of Votalin Emulgel combined with Tuina.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myofascial Pain Syndromes ; therapy ; Treatment Outcome ; Young Adult

Objective To explore the clinical value of maternal and umbilical blood inflammatory markers,interleukin-6 (IL-6),neutrophil-to-lymphocyte ratio (NLR),C-reactive protein (CRP) and procalcitonin (PCT),in the diagnosis of histologic chorioamnionitis (HCA).Methods A total of 102 suspected chorioamnionitic cases were enrolled from January 2014 to July 2017.They were assigned into two groups based upon postpartum histopathological examination of placenta:HCA group (48 cases) and control group (54 cases).Maternal and umbilical blood samples were collected for routine blood test and tested for IL-6,NLR,CRP and PCT levels.T,Mann-Whitney U or Chi-square (or Fisher's exact) test was used for data comparison.Meaningful indicators in maternal and umbilical cord blood were analyzed by logistic regression analysis and correlation analysis.At the same time,receiver operating characteristic (ROC) curve was drawn to evaluate their diagnostic values.Results (1) IL-6 level and NLR in maternal blood in HCA group were higher than those in control group [6.95 (2.40-13.50) vs 3.90 (2.30-9.20) pg/ml,Z=-5.147;5.03 (1.92-9.20) vs 3.94 (1.85-11.17),Z=-3.097;both P＜0.05],and the levels of white blood cells,neutrophile granulocytes,CRP and IL-6 as well as NLR in umbilical cord blood were also higher [(9.4± 2.0)× 109/L vs (8.6 ± 1.4)× 109/L,t=-2.522;(6.87t1.62)× 109/L vs (5.99± 1.26)× 109/L,t=-3.071;12.30 (0.50-89.04) vs 3.18 (0.50-88.93) mg/L,Z=-4.519;(8.78±2.56) vs (4.78±1.45) pg/ml,t=-7.025;(4.45±1.36) vs (3.78±1.22),t=-3.020;all P＜0.05].(2) Logistic regression analysis showed that elevated levels of IL-6 and NLR in maternal blood and CRP and IL-6 in umbilical cord blood were independent risk factors for HCA [OR (95％CI):1.65 (1.32-2.06),1.34 (1.02-1.77),1.05 (1.00-1.11) and 2.39 (1.72-3.32),all P＜0.05].Positive correlations were found between the levels of IL-6 in maternal and umbilical cord blood,and between NLR in maternal blood and CRP level in umbilical cord blood (correlation coefficient:0.680 and 0.230,both P＜0.05).(3) IL-6 level in umbilical blood was of the greatest value in the diagnosis of HCA among all single markers,followed by IL 6 in maternal blood,CRP in umbilical blood and NLR in maternal blood [area under the ROC curve (AUC):0.904,0.796,0.760 and 0.678].When two indexes were combined,NLR in maternal blood+IL 6 in umbilical cord blood showed the highest diagnostic value,followed by,IL 6 in maternal blood+CRP in umbilical cord blood,IL-6+NLR in maternal blood and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.917,0.870,0.823 and 0.791).When three indexes was used in combination,the diagnostic value of IL-6 in maternal and umbilical cord blood+NLR in maternal blood was higher than that of IL-6 and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.919 and 0.836).(4) There were 13 cases (27.1％) with neonatal complications in HCA group and two (3.7％) in control group (P＜0.05).Conclusions Changes in NLR and IL-6 levels in maternal blood and NLR,IL-6 and CRP levels,and white blood cells and neutrophile granulocytes counts in umbilical cord blood are associated with HCA.The diagnostic efficacy of two indexes combined is superior to that of single index,while the combination of three indexes can significantly improve the diagnostic accuracy and authenticity.

AIM:To investigate the relationship between Sonic Hedgehog(Shh)signaling pathway and cell cycle and radioresistance of esophageal cancer by up-regulating Gli1,a key factor in Shh signaling pathway.METHODS:The human esophageal cancer cell line Eca 109 was transfected with plasmid to induce Gli 1 over-expression,which served as Eca109-ox-Gli1 group.In addition, Eca109 cells transfected with empty plasmid served as negative control group and the untreated Eca109 cells were used as normal control group.The expression of Gli1 was confirmed by real-time PCR and Western blot.The radiosensitivity of the cells in the 3 groups was determined by colony formation assay.The effect of irra-diation on the cell cycle was analyzed by flow cytometry.RESULTS:The expression of Gli1 in Eca109-ox-Gli1 group was higher than that in the other 2 groups(P<0.05).The survival fraction at dose of 2 Gy in Eca109-ox-Gli1 group was high-er than that in normal control group, indicating that the radioresistance of the Eca 109 cells transfected with Gli1 plasmid was increased.The cells in Eca109-ox-Gli1 group showed higher S phase proportion than that in normal control group and negative control group(P<0.01).After irradiation at dose of 6 Gy,all cells in the 3 groups found that the cell cycle was arrested at G2/M phase,while the cells in normal control group showed higher G 2/M phase proportion than that in Eca109-ox-Gli1 group(P<0.01).CONCLUSION: The up-regulation of Gli1 may enhance the radioresistance of esophageal cancer by regulating the cell cycle.

Objective: To explore the diagnostic value of serum NSE, S100B protein and myocardial zymogram in premature infants with intrauterine infection. Methods: From January 2016 to December 2017, 60 preterm infants with intrauterine infection in the Integrated Chinese and Western Medicine Hospital of Wenzhou were selected in the study.According to whether brain injury occurred, they were divided into brain injury group (28 cases) and non-brain injury group (32 cases). Serum NSE content was detected by chemiluminescence method, serum S100B protein level was detected by enzyme linked immunosorbent assay (ELISA), and serum CK and HBDH levels were detected by automatic biochemical analyzer.The serum levels of NSE, S100B, CK and HBDH were compared between the two groups, the combined diagnostic efficacy of NSE+ S100B protein+ CK+ HBDH was analyzed, the correlation of serum NSE, S100B protein, CK, HBDH with brain injury wasanalyzed. Results: The levels of serum NSE [(2.43±0.54)μg/L] and S 100B [(14.36±3.21)ng/L] in the brain injury group were higher than those in the non-brain injury group [(0.97±0.27)μg/L and (8.10±1.87)ng/L] (t=13.498, 9.370, all P<0.05). The levels of serum CK [(437.64±54.12)U/L] and HBDH [(387.91±56.45)U/L] in the brain injury group were significantly higher than those in the non-brain injury group [(183.54±32.58)U/L and (174.3±26.63)U/L] (t=22.347, 19.126, all P<0.05). The sensitivity and specificity of the combined diagnosis of NSE+ S100B protein and myocardial zymogram were higher than those of each single index.Serum NSE, S100B protein, CK and HBDH were positively correlated with brain injury. Conclusion The elevation of serum NSE, S100B protein and myocardial zymogram in preterm infants with intrauterine infection after birth has certain clinical significance in judging whether brain injury occurs or not.