AlM: To observe the postoperative intraocular pressure ( lOP) and operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time.
METHODS: A total of 12 neovascular glaucoma cases ( 14 eyes ) secondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0. 1-0. 2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the lOP and complications.
RESULTS:lOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average lOP at 1wk was 16. 7±14. 4mmHg, 15. 7±8. 8mmHg at 1mo and 12. 9±4. 5mmHg at 6mo, which compared with untreatment ( 39. 6 ± 10. 0mmHg ) was statistically significant different (P<0. 01). ln follow up time 3 cases were relapsed which were supplied with transscleral or endoscope cyclophotocoagulation. During the follow-up period no endophthalmitis and complications such as eyeball atrophy were found.
CONCLUSlON: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

r cirrhosis. NO and ET-1 are involved corporately in the development of liver cirrhosis, but not the main factors facilitating hypoxemia of liver cirrhosis.

Thirty-two patients with comminuted proximal humerus fractures(Neer Ⅲ or Ⅳ) were admitted to Department of Orthopedics,First Hospital of Jilin University from March 2001 to April 2006.The patients consisted of 19 males and 13 females,aged 19-70 years,including 15 of 19-49 years and 17 of 50-70 years.All patients underwent treatment of cloverleaf plate-screw fixation.During the follow-up for 8 months,union time and scores from Constant & Murley functional scale were similar between male and female groups.Compared with patients aged 50 years,and the scores from Constant & Murley functional scale were significantly lower(P 50 years old is relatively longer with unfavorable functional recovery in the shoulder joint.

Objective To investigate the expression of Toll-like receptor 4 (TLR4) and myeloid derived suppressor cells(MDSC) in bone marrow cells in children with acute myeloid leukemia (AML),and to detect its relationship with the clinical features,the effect of chemotherapy and prognosis.Methods Twenty-nine cases of children with AML were collected from June 2013 to March 2014 in People's Hospital of Wuhan University,in which 11 cases of low-risk group,10 cases of middle-risk group,8 cases of high-risk group;and 17 cases of non blood disease was as the control group.The expressions of TLR4 and MDSC were detected by using reverse transcription-polymerase chain reaction (RT-PCR),Western blot methods,immunohistochemical staining,and flow cytometry,respectively,in the bone marrow cells of 29 children with AML.Results The mRNA and protein expression of TLR4 in the initial treatment group was higher than those in the complete remission group(t =3.092,3.393,all P ＜ 0.05).The mRNA and protein expression of TLR4 in the relapse group was higher than those in the complete remission group(t =4.013,4.279,all P ＜ 0.05).The positive expression rates of MDSC in the above 3 groups were (29.77 ± 1.39) ％,(5.19 ± 0.65) ％,(38.62 ± 3.54) ％,respectively,compared with the control group [(1.32 ± 0.27) ％] and there was significant difference(all P ＜0.05).The positive expression rates of TLR4 and MDSC in the initial treatment group,relapse group and complete remission group were significantly higher than those in the control group,with significant differences (initial treatment group TLR4:t =3.559,P ＜ 0.05;MDSC:t =3.727,P ＜ 0.05;relapse group TLR4:t =4.043,P ＜ 0.05;MDSC:t =4.125,P ＜ 0.05;complete remission group TLR4:t =2.798,P ＜ 0.05;MDSC:t =3.469,P ＜ 0.05).Pearson rank correlation analysis showed that there was a positive correlation between the expression of TLR4 and MDSC (r =0.673,P ＜0.01).Conclusions The expressions of both TLR4 and MDSC play an important role in onset,progression,curative effect and prognosis in children with AML,and the two may play an importment role in synergistic effect.

Objective To investigate the molecular mechanism underlying lymphocyte functionassociated antigen-1 (LFA-1) / intercellular adhesion molecule-1 (ICAM-1) mediated anti-neoplastic effects of cytokine induced killer (CIK) cells. Methods Lymphocytes isolated from peripheral blood of children leukemia were induced with interferon-gamma (IFN-y), anti-CD3 monoclonal antibody (CD3McAb) and interleukin-2 (IL-2) and co-cultured with dendrite cells (DC) to generate DC-CIK cells. When treated with LFA-1 monoclonal antibody, cytotoxicity of DC-CIK cells against leukemia cell lines was measured by the MTT assay, while RT-PCR and Western blotting were used to determine mRNA and protein expressions of GATA-3 and T-bet in DC-CIK cells, respectively. IL-12, IFN-γ and tumor necrosis factor-α (TNF-α) levels released by DC-CIK cells were quantified by ELISA. Results Induced DC-CIK cells were regular, round and transparent with variable cell volume and cellular aggregation. When treated with mouse anti-human LFA-1 monoclonal antibody, the cytotoxicity decreased mostly towards B95 cells under administration of 20 μg/ml LFA-1 monoclonal antibody in comparison with the control group(t =10.138, P ＜0.05). It led to a highest elevation of GATA-3 mRNA and protein levels (t =16.386, P ＜ 0.05; t =22.652, P ＜ 0.05) and a most decrease of T-bet mRNA and protein levels (t =17.728, P ＜0.05; t =17.452, P ＜0.05) under 20 μg/ml LFA-1 monoclonal antibody in B95 cells group in comparison with the control group. The expression levels of IL-12,IFN-γ, and TNF-o in supernatant were the lowest under 20 μg/ml LFA-1 monoclonal antibody in B95 cells group in comparison with the control group (t =21.621, P ＜0.05; t =13.739, P ＜0.05; t =15.278, P ＜0.05).Conclusion GATA-3 and T-bet were implicated in the LFA-1/ICAM-1 mediated anti-neoplastic effects of DC-CIK cells via activation of the Th1 pathway, with high secretion of Th1 cytokines, such as IL-12, IFN-γ and TNF-α.

Objective To explore the prognostic determinants and clinical treatment strategy in 142 patients with severe trauma brain injury(STBI).Methods Retrospective analysis of clinical data of 142 patients with STBI in our department from April 2006 to April 2012.All the patients were divided into good prognosis group(Ⅲ~V grade)and poor prognosis group(I~Ⅱgrade)ac-cording to the GOS classification standard.Age,gender,GCS,encephalocele,morphotogy of the basal cisterns on CT scanning,asso-ciated inj ury,shock,hyoxemia,underlying disease and hyperglycemia were chosen as the observation index.Statistical analysis was performed with Pearson Chi-square Test.Results 52.11% of patients with good prognosis,47.89% of patients with poor progno-sis and 3 1 .6 9% of patients were dead.Age,GCS,encephalocele,morphotogy of the basal cisterns on CT scanning,associated inj ury, shock,underlying disease were the prognostic determinants of STBI(all results P<0.05).Conclusion Age,GCS,encephalocele, morphotogy of the basal cisterns on CT scanning,associated inj ury,shock,underlying disease can determine the prognosis of STBI. Multidisciplinary cooperation treatment depending on the patient′s conditions is the key of improving the outcomes of STBI.

Objective To detect the levels of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and investigate its relationship with liver function, ascites and heart structure in patients with liver cirrhosis. Methods The levels of plasma NT-proBNP and various clinical and biochemical parameters were determined in 60 patients with liver cirrhosis and 30 healthy controls. Meanwhile Child-Pugh liver function was classified. All people underwent color Doppler echocardiography. Results The level of plasma NT-proBNP was significantly elevated in patients with liver cirrhosis [(38.63±36.05)pmol/L], compared with that of the controls [(7.50±8.25)pmol/L],P<0.01. There was no significant difference in different Child-Pugh class and aseites amount of liver cirrhosis. E/A < 1 and E wave decelerate time (EDT) was in-creased in liver cirrhosis. Conclusion The levels of plasma NT-proBNP in liver cirrhosis are significantly elevated, and related to early impairment of diastolic function. But it does not correlate with liver function and aseites.

BACKGROUND:The previous researches indicate that, shock waves can enhance the proliferation of T-cells and the expression of interleukin (IL)-2 through a mechanism that involves p38 mitogen activated protein kinase (MAPK)activation.OBJECTIVE: To investigate if adenosine triphosphate (ATP) release is an underlying mechanism through which low-density shock waves (LDSWs) augment T-cell function.DESIGN: Controlled repetitive measurement by groups, taking cells as subject.SETTING: Department of Orthopedics, the First Hospital of Jilin University.MATERIALS: KDE-2001 Extracorporeal Shockwave Lithotripter (Beijing Zhongke Jian An Meditechs Co., Beijing, China).p38 MAPK inhibitor SB203580 1 mg (BioSource Inc., Camarillo, CA); p38 MAPK kit for detecting phosphorylation (Cell Signaling Technology, Inc. U.S.A.); P2 receptor inhibitor suramin 50 mg (BIOMOL Research Laboratories Inc., PA) was prepared into 0.02 mol/L solution by 1.749 2 mL IMDM. ATP enzyme: apyrase 200 U (Sigma, U.S.A.); P2X7 receptor antagonist KN-62 (BioSource Inc., Camarillo, CA); ATP Bioluminescence Assay Kit CLS Ⅱ (Roche Diagnostics GmbH,Mannheim, Germany).METHODS: The experiment was carried out in the Orthopedic Laboratory of the First Clinical Hospital in Jilin University from January 2005 to December 2006. ①An Extracorporeal Shockwave Lithotripter (at 7 kV generator voltage, 0.3 μF capacitance, 23 MPa positive pressure, 0.18 mJ/mm2 energy flux density) was applied for LDSWs treatment ranging from 50 to 400 impulses. ②ATP release into the culture supernatant from Jurkat T-cells or human peripheral blood mononuclear cells (PBMCs) was determined with a specific ATP Bioluminescence Assay Kit. ③Negative control group excluded antagonist or inhibitor. Human PBMCs were used to determine the effect of LDSWs on activated T-lymphocyte proliferation. Human Jurkat cells were used to study the effects of LDSWs on IL-2 expression. Expression and phosphorylation of p38 MAPK in Jurkat T-cell were measured by Western Immunoblotting with anti-p38 MAPK antibodies and anti-p38 MAPK phospho-specific antibodies that recognized the phosphorylation (on Thr180/Tyr182).MAIN OUTCOME MEASURES: extra-cellular ATP release, IL-2 expression in cell suspension, cellular proliferation and the phosphorylation of p38 MAPK.RESULTS: ①ATP release under the condition without LDSWs was obviously lower than that with LDSWs of 100, 150,200, 250, 300, 360 and 400 impulses (P ＜ 0.01), and ATP release increased with the LDSWs impulse.②Compared with negative control group, the additions of apyrase, KN-62 or suramin attenuated the 3H-TdR incorporation of the phytohemagglutinin-stimulated PBMCs or CD3/CD28-stimulated Jurkat T-cells, which were effected with LDSWs of 100,150, 200, 250, 300, 330 impulses at 0.18 mJ/mm2 (P＜ 0.01). IL-2 expression in the cellular supernatant was also significant increased (P ＜ 0.01). ATPase, KN-62 or suramin all decreased the effect of LDSWs on p38 MAPK of Jurkat T-cells.CONCLUSION: ①LDSWs deform cellular membranes but have no effect on organelle, which results in ATP release from Jurkat cells. Exogenous ATP release activates P2X7 receptor and p38 MAPK, and increases IL-2 expression. LDSWs enhance T-cell proliferation and IL-2 expression through a mechanism that involves ATP release, P2X7 receptor and phosphorylized p38 MAPK activation. ②The release of ATP plays a key role in the mechanism through which LDSWs regulate the function of T cells.

Objective To examine the effects of different doses of midazelam on ED50 of emulsified isoflurane and to determine the type of interaction between them for hypnosis by isobelographic analysis in rats. Methods One hundred and twenty-five adult male SD rats weighing 240-300 g were randomized into 5 groups (n=25 each): group Ⅰmidazolam (M); group Ⅱ emulsified isnflurane (Ⅰ); group Ⅲ ,Ⅳ ,Ⅴ, 1/4, 1/2 and 3/4 ED50 of midazelam for hypnosis + emulsified isoflurane (MI1 , MI2, MI3). Up-and-down sequential experiment was used to determine ED50of midazolam and emulsified isoflurane for loss of righting reflex in group Ⅰ -Ⅴ . The intial dose of midazolm was 17.3 mg/kg in group M. The initial doses of emulsified isoflurane (120 mg/ml) were 0.55 (in group Ⅰ, 0.22 (MI1), 0.19 (MI2) and 0.12 ml/kg (MI3) respectively. In group MI1-3 midazolam was injected over 15 seconds and after an interval of 2.5 min emulsified isoflurane was injected over 10 s. ED50 was calculated using Dixon-Mood method. Isebolographic and algebraic analyses were used to determine the type of interaction between midazolam and emulsified isoflurane. Results The five groups were comparable with respect to M/F sex ratio and body weight. The Edso of midazolam was 26.0 mg/kg in group M. Midazolam 6.5, 13.0 and 19.5 mg/kg were given in group MI1 , MI2 and MI3 respectively. The ED50 of emulsified isoflurane was 0.67 (ingroup Ⅰ), 0.30 (MI1), 0.22 (MI2) and 0.18 ml/kg (MI3) respectively. The isobolographic analysis indicated that with increasing doses of midazolam, the Edw of emulsified isoflurane decreased progressively in a non-linear fashion. The isobolographic and algebraic analyses demonstrated that the interaction between midazolam and emulsified isoflurane was synergistic for hypnosis. Conclusion The hypnosis is synergistic when midazolam 6.5,13 mg/kg are combined with emulsified isoflurane and additive when midazolam 19.5 mg/kg is combined with emulsified isoflurane.

Objective To study the CT perfusion features of various lymph nodes in the neck.Methods Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology,including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes,and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were (28. 13 ±5.08), (31.08 ±5.82),and ( 11.24 ±5.31 ) s,respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma (P ＜ 0. 05). Their frequencies of marginal blood flow were 5/9,4/19, and 39/55 (70. 9% ), respectively. The frequency of marginal blood flow in the tuberculosis lymph nodes and metastatic lymph nodes was statistically higher than that of lymphoma ( P ＜ 0. 05 ). Their frequencies of central blood flow were 2/9, 11/19, and 9/55 (16.4%), respectively. The frequency of central blood flow in the lymphoma was statistically higher than that of tuberculosis lymph nodes and metastatic lymph nodes ( P ＜ 0. 05 ). Their values of L/T were 1.82 ± 0. 32, 1. 80 ± 0. 39, and 1.84 ± 0. 36,(40. 98 ±6. 62) s,respectively. There were no significant differences in L/T, BF, BV and TTP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes( P ＞ 0. 05 ). Conclusion CT perfusion,especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes.