Background Cataract with preexisted dry eye is a common eye disease.It is speculated that preservative-free artificial tears can inhibit inflammatory procedure,prevent postoperative eye infections and reduce dry eye symptoms.However,relevant literature is rare up to now.Objective This study was to evaluate and compare the therapeutic effects between preservative-free or preservative sodium hyaluronate combined with fluorometholone eyedrops for cataract with dry-eye.Methods A randomized controlled single-blind clinical study was performed.Sixty patients with dry-eye syndrome who was going to receive surgery for cataract removal were enrolled in Yuhuangding Hospital from January to December 2015 under the informed consent.The patients were randomly divided into the test group and control group.Preservative-free or preservative 0.1％ sodium hyaluronate combined with 0.1％ fluorometholone eye drops were topically administered in the eyes of the test group and control group,respectively.Ocular Surface Disease Index (OSDI) score,breakup time of tearfilm (BUT),Schirmer Ⅰ test (S I t),corneal fluorescein staining,impression cytology,goblet cell density and the concentrations of interleukin (IL)-1β,tumor necrosis factor (TNF)-α,catalase (CAT),superoxide dismutase 2 (SOD2) in tears were evaluated and compared.Results There were significant differences in gender,ages,OSDI scores,BUT,S I t value,corneal fluorescein staining scores,impression cytology findings,and goblet cell density between the two groups (all at P＞0.05).OSDI,corneal fluorescein staining scores and imprint cellular level were evidently reduced,and BUT,S I t values and goblet cell density were significantly increased 1 month and 2 months after operation in comparison with the baseline values in the test group (F =13.058,8.027,3.755,21.652,70.962,92.354,all at P ＜ 0.05).The concentrations of IL-1β and TNF-α in tears of the test group were significantly lower,and CAT and SOD2 in the tears of the test group were significantly higher than those in the control group 1 month and 2 months after operation (F=18.731,9.070,15.357,351.359,all at P＞0.05).Conclusions 0.1％ preservative-free sodium hyaluronate combined with 0.1％ fluorometholone eyedrops can relieve the symptoms and signs of dry-eyes following cataract surgery by playing antiinflammatory and antioxidant effects.

Neuronal α4β2 nicotinic acetylcholine receptors (nAChRs) are the most widespread subtypes in central nervous system, α4β2 nAChRs mainly exist in procerebrum, parietal lobe cortex, temporal lobe cortex, hippocampus, basal ganglion and cerebellum. Researches on gene knock-out mice have demonstrated that α4β2 receptors participate in the development, aging, neuron survival, pain, and learning and memory, and are also involved in gamma-aminobutyric acid release and dopaminergic function. Studies have disclosed that α4β2 nAChRs relate to the development of variety of neurological diseases, including pain, Alzheimer's disease and Parkinson's disease.

Neuronal?_4?_2 nicotinic acetylcholine receptors(nAChRs) are the most widespread subtypes in central nervous system.?_4?_2 nAChRs mainly exist in procerebrum,parietal lobe cortex,temporal lobe cortex,hippocampus,basal ganglion and cerebellum.Researches on gene knock-out mice have demonstrated that?_4?_2 receptors participate in the development,aging,neuron survival,pain,and learning and memory,and are also involved in gamma-aminobutyric acid release and dopaminergic function.Studies have disclosed that?_4?_2 nAChRs relate to the development of variety of neurological diseases,including pain,Alzheimer's disease and Parkinson's disease.

Humans ; Imaging, Three-Dimensional ; Neoplasms ; radiotherapy ; surgery ; Radiosurgery ; instrumentation ; methods ; Tomography, X-Ray Computed

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cerebral Cortex ; drug effects ; metabolism ; pathology ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide Synthase ; metabolism ; Nitroso Compounds ; therapeutic use ; Rats ; Rats, Wistar

Objective To investigate the risk factors,severity and infarct site features and clinical characteristics of the elderly patients over 80 years with cute cerebral infarction.Methods One hundred and sixty-two patients with acute cerebral infarction in Red Cross Hospital of Guangzhou,The Forth Affiliated Hospital of Medical College of Jinan University from January 2012 to May 2015 were enrolled and randomly divided into the elderly patients (≥ 80 years old) and the middle aged patients (＜ 60 years old).The risk factors,national institutes of health stroke scale (NIHSS) scores and Oxfordshire community stroke project (OCSP) criteria were compared between the two groups.Results Coronary artery disease,atrial fibrillation and NIHSS in the elderly patients (25％ (22/88),13.6％ (12/88),7.74 ± 4.986) were significantly higher than those of the middle aged group (12.2％ (9/47),4.1％ (3/74),5.04± 4.305),and the differences were significant (x2 =4.281,4.393,t =-3.649;P＜ 0.05 or P＜ 0.001).The logistic regression analysis finally showed that smoking,hyperlipemia,NIHSS scores and gender(male) were the independent risk factors(OR=3.851,3.609,1.100 and 2.670;P＜0.05).There were more LACI patients in the elderly group than he middle aged group ((40.9％,36/88) vs.(60.8％,45/74),x2 =6.369,P ＜ 0.05).Conclusion Compare to the middle aged patients,occurrence of the elderly patients with acute cerebral infarction is more severe,and the clinical features and risk factors have its particularity.Secondary prevention strategy should be emphasized on the control of different risk factors based on the patients' age.

Through an introduction to the importance of medical ethics education and the status quo, this paper discusses how to better combine the medical ethics education with medical students′medical practices. It puts for-ward some suggestions from the institutional arrangements, personnel allocation, and publicitymethods. The ulti-mate goal is that the medical students could get more effective, continue and integration medical ethics education in the process of medical practice.

Holmium ; Humans ; Kidney ; Lithotripsy, Laser ; Shock, Hemorrhagic ; Ureteroscopy

Objective To evaluate the efficacy of lateral femoral approach to continuous sciatic nerve block for patient-controlled analgesia after foot and ankle surgery.Methods One hundred American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes,aged 18-60 yr,weighing 50-100 kg,with body height of 145-190 cm,scheduled for elective foot and ankle surgery,were divided into 2 groups (u =50 each) using a random number table:patient-controlled nerve block analgesia (PCNA) group and patient-controlled intravenous analgesia (PCIA) group.In group PCNA,the lateral femoral approach to sciatic nerve block was performed under the guidance of ultrasound and a neurostimulator,0.2％ ropivacaine 20 ml was injected after successful location,the catheter was inserted,and 0.2％ ropivacaine 10 ml was injected again.In group PCIA,0.2％ ropivacaine 30 ml was injected after successful location of the sciatic nerve.General anesthesia was performed using laryngeal mask airway in both groups.In group PCNA,PCNA was performed with 0.2％ ropivacaine (diluted to 200 ml in normal saline) at the end of surgery,and the PCNA pump was set up with a 0.5 ml bolus dose,a 15-min lockout interval and background infusion at a rate of 5 ml/h.In group PCIA,PCIA was performed with sufentanil 100 μg,tramadol 500 mg and tropisetron 10 mg (diluted to 200 ml in normal saline) at the end of surgery,and the PCIA pump was set up with a 0.5 ml bolus dose,a 15-min lockout interval and background infusion at a rate of 2 ml/h.The visual analog scale score was maintained≤ 3,and postoperative analgesia lasted until postopera-tive 72 h.When visual analog scale scores ≥ 4,tramadol 100 mg was intramuscularly injected as rescue analgesic.The requirement for rescue analgesia and development of adverse effects such as nausea and vomiting,insomnia,puncture site infection and bleeding were recorded within 72 h after surgery.Results The requirement for rescue analgesia and incidence of nausea and vomiting were significantly lower in group PCNA than in group PCIA (P＜ 0.05).Conclusion The lateral femoral approach to continuous sciatic nerve block can be safely and effectively used for patient-controlled analgesia after foot and ankle surgery.

Objective To evaluate the effects ofbeta-endorphin (β-EP) and substance P (SP)with sedative and analgesic drugs on mechanical ventilated patients. Methods Twenty-eight mechanical ventilated patients were randomly divided into two groups: midazolam group (M group, 14 cases) and midazolam combined with fentanyl group (M + F group, 14 cases). Eight healthy persons were as control group (C group). The sedative target was VAS≤3 scores and Ramsay 2-4 scores. The levels of serum β -EP and SP were tested before sedation and 12, 24 h after sedation in mechanical ventilated patients and at 8 Am in C group. The sedation levels were evaluated and the hemodynamie and respiratory parameters were recorded before sedation and 1, 12, 24 h after sedation in mechanical ventilated patients. The oxygenation index was measured before sedation and 1,12, 24 h after sedation. Results The levels of serum β -EP and SP in M and M+F group were significantly higher than those in C group(P< 0.05). After sedation, the level of SP in M+F group [(101.42 ± 12.46) ng/L]was significantly lower than that in M group [(132.72 ± 23.82) ng/L] (P < 0.05). Compared with before sedation, there were significant differences in heart rate, VAS and Ramsay scores between M group and M+F group (P< 0.05). Compared with M group, pressure airway and respiratory rate at 12, 24 h and total after sedation were lower in M+F group (P <0.05). The amount of serum SP in mechanical ventilated patients. Fentanyl improves the ventilator synehron and reduces the dose of midazolam.