AIM:To study the effect of different surgeries for vision and postoperative complications in leprosy patients with lagophthalmos.METHODS:A retrospective analysis.Totally 68 leprosy patients (97 eyes) with lagophthalmos were selected who treated with different surgeries during May 2007 to September 2015 in our sanatorium.The surgeries included nylon thread correction surgery, tarsorrhaphy, temporalis transposition surgery.We observed and compared the best corrected visual acuity(BCVA) and the rate of postoperative complications, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus.RESULTS:The effect on BCVA of patients treated with nylon thread correction surgery and tarsorrhaphy:the preoperative and postoperative BCVA was significantly different of the two groups (Z=-4.193,-4.213;P<0.05);the preoperative and postoperative BCVA was not significantly different of the patients underwent temporalis transposition surgery (Z=-1.532, P >0.05).The postoperative complications:(1) epiphora:there was 91% in patients underwent nylon thread correction surgery, 89% in patients underwent tarsorrhaphy, 59% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=12.198, P<0.05);(2) lacrimal duct injury:there was 66% in patients underwent nylon thread correction surgery, 95% in patients underwent tarsorrhaphy, 41% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=22.415, P<0.05);(3) hard to open eyes:there was 56% in patients underwent nylon thread correction surgery, 55% in patients underwent tarsorrhaphy, 22% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=8.795, P<0.05);(4) infections:there was 84% in patients underwent nylon thread correction surgery, 3% in patients underwent tarsorrhaphy, 11% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=60.858, P<0.05).CONCLUSION:There are certain clinical efficacy for lagophthalmos caused by leprosy after surgery, especially patients after temporalis transposition surgery can close eyes by oneself.And their vision does not change significantly, which suggests that this surgery may prevent exposure injury for cornea.But the iatrogenic injury, the vision decrease in patients underwent other surgeries and the ocular tissue damage, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus should be pay more attention to.

Objective: To optimize the formula of memantine hydrochloride sustained release pellets and investigate the drug release in vitro.Methods: Memantine hydrochloride sustained release pellets were prepared by a fluidized bed.The factors such as inlet air temperature, spray pressure and feeding rate were optimized by orthogonal tests.The Box-Behnken response surface methodology was used to screen the major influencing factors (ethyl cellulose aqueous dispersion, PEG 6000 and the coating weight) in the release of memantine hydrochloride.The coating formula and coating weight were optimized with the cumulative release rate of memantine hydrochloride in 2, 6,and 12 h as the response values.The drug release in vitro was also studied.Results: The optimum preparation parameters of the pellets were as follows: the inlet air temperature of 45℃, the spray pressure of 1.0 bar, and the feeding rate of 1.5 r·min-1.The best sustained release coating formula was as follows: the content of ethyl cellulose aqueous dispersion of 8.4%, the content of PEG 6000 of 2.3%, and the weight gain of sustained release layer of 16.7%.The memantine hydrochloride sustained release pellets had notable sustained release effect.Conclusion: Orthogonal tests and Box-Behnken response surface method can be used for the formula optimization of memantine hydrochloride sustained-release pellets.The established fitting model is simple with good predictability.

Objective To analyze the amount and allocation of pediatric healthcare resources in Chengdu,and to recommend on local pediatric healthcare resources shortages.Methods Pediatric healthcare resources data of Chengdu came from pediatric relevant data reported regularly at yearend by the counties and districts to healthcare administration of the city.Data from such reports were subject to statistics with various indexes and descriptive analysis.Analyzed in focus was the distribution in 2015 of pediatric healthcare resources of the city among medical institutions of various types,levels and properties,as well as causes for such shortage.Results Tertiary hospitals hold 62.3% of the pediatric beds and 64.2% of pediatricians,and provide around 70% of the medical workload for pediatric outpatients and inpatients,upon the majority of pediatricians with master degree and above,and senior ones of/above associate chief physician titles;Tertiary hospitals have 58.7% of the pediatric beds and 49.7% of pediatricians,yet the outpatients served by specialized hospitals were 5% above tertiary hospitals.Conclusions The imbalance and shortage in total of pediatric resources in Chengdu result from stable source of manpower supply,high professional risk exposure,low income,and long training duration among others.Such measures as a better pediatrician development system,greater incentives for pediatric development,and enhanced development pediatric service consortiums,as well as greater support for private specialized pediatric hospitals.Those measures combined can effectively alleviate the shortage of pediatric resources.

Objective To investigate the 5-and 10-year survival and complications of patients with stage Ⅱb cervical carcinoma treated by pre-operative photon radiotherapy (POPRT) plus brachytherapy (192Ir) and selective lymphadenectomy hysterectomy (SLH) plus intra-operative electron radiotherapy (IOERT). Methods From February 1997 to May 2007, 160 patients with stage Ⅱb cervical carcinoma were treated by POPRT of 20 Gy in 10 fractions to the whole pelvis, 192Ir brachytherapy of 14 Gy in 2fractions, followed by IOERT of 18 -20 Gy to the whole pelvis during SLH one week after. Results The follow-up rate was 98.1%. The number of patients followed-up for 5 and 10 years was 143 and 135,respectively. The 5-year overall survival rate, disease-free survival rate and local control rate of all patients were 89.4%, 86. 3% and 96. 3%, with the corresponding 10-year rates of 84.4%, 81.0% and 95.0%,respectively. The radiation-induced rectitis and cystitis were 5.0% and 0. 6%, respectivly. The rate of hydronephrosis and lower extremity edema was 6. 3% and 1.3%, respectively. Conclusions Combination of EBRT plus 192Ir brachytherapy and SLH plus IOERT could improve the survival and local control of patiens with cervical carcinoma, with only a few side effects.

Baekground:Obstetric hemorrhage is a major cause of maternal death during cesarean delivery.The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section.Methods:We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018.In this study,196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group).Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group.Patients in the IOCS group were matched 1:1 to patients in the ABT group.Results:After propensity score matching,137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group.Patients in the IOCS group were associated with significantly shorter length of hospital stay,compared with ABT group (8.9 ±4.1 days vs.10.3 ± 5.2 days,t=-2.506,P =0.013).The postoperative length of hospital stay was 5.3 ± 1.4 days for patients in the IOCS group and 6.6 ± 3.6 days for those in the ABT group (t =-4.056,P ＜ 0.001).The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ± 15.4 and 96.3 ± 16.6g/L,respectively,which were significantly different (t=2.615,P=0.009).Allogeneic red blood cell transfusion was significantly lower at 0 unit (range:0-11.5 units) in the IOCS group when compared with 2 units (range:1-20 units) in the ABT group (P ＜ 0.001).Condusions:This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.

OBJECTIVETo study DNA damage, Bcl-2 and Bax expression, and ultrastructure change in spermatogenic cell of mice by cadmium exposure.

METHODSTwenty-four male mice were divided into 4 groups: 3 groups treated with cadmium chloride of 1, 5, 10 micromol x kg(-1) x d(-1) i.p. respectively for 5 days, and one normal saline control group. The DNA damage of spermatogenic cell by single-cell gel electrophoresis technology was detected. The expression positive rate of Bcl-2, Bax protein in spermatogenic cell by the immunohistochemical method was assayed, and the ultrastructural change of spermatogenic cell by the transmission electron microscope was observed.

RESULTSDNA damage rates of of spermatogenic cell in 1, 5, 10 micromol/kg cadmium chloride groups were higher than that of normal group (P < 0.001). Bcl-2 protein expression positive rates were lower than that of normal group (P < 0.001). Bax protein positive expression rate in 5 micromol/kg group was higher than those in normal group, and 1, 10 micromol/kg groups. The ultrastructure of karyotis, karyotheca, mitochondria, endoplasmic reticulum in three treated groups had different degree of damage and the degree of ultrastructural change was increasing with rising concentration of cadmium.

CONCLUSIONCadmium exposure will cause the DNA break, Bcl-2 and Bax protein abnormal expression and ultrastructural change in spermatogenic cell.

Animals ; Apoptosis ; Cadmium Chloride ; toxicity ; DNA Damage ; Male ; Mice ; Mice, Inbred ICR ; Proto-Oncogene Proteins ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; Spermatozoa ; drug effects ; metabolism ; ultrastructure ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo identify whether Radix Bupleuri (Bupleurum chinense) was fumed with sulfur.

METHODA static headspace GC-MS method was used to detect sulfur in the fumatory Radix Bupleuri, the authentic samples free of sulfur was detected as reference.

RESULTSulfur was detected in six samples from nine samples collected in different locations.

CONCLUSIONThe method can be used to detect sulfur rapidly in the fumatory Radix Bupleuri with sulfur.

Bupleurum ; chemistry ; Drug Contamination ; Gas Chromatography-Mass Spectrometry ; methods ; Hot Temperature ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Sulfur ; analysis ; Technology, Pharmaceutical

Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%～69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%～47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.

Described in the paper is the practice of Chengdu in its pilot of medical alliances in 2015 ,which effectively elevated the medical capacity and quality of care of medical institutions within Pujiang county. Such measures as enhanced management and mechanism ,clarified government responsibility ,standardized medical service quality ,and enhanced coordination within the healthcare system are proposed to enhance the medical alliances and the hierarchical medical system .

Objective To evaluate the accuracy of 64-slice CT in the diagnosis of coronary in-stent restenosis (ISR).Methods Fourteen patients with 37 implanted coronary stents were examined by both 64-slice CT angiography (CTA) and conventional coronary angiography(CCA).The diagnosis of ISR was evaluated by two methods(visual inspection and the measurement of the in-stent contrast attenuation)on CTA.The accuracy of the two methods in the diagnosis of ISR was compared with reference to CCA.Results ISR(＞50%)was found on CCA in 11 stents.CTA with visual inspection and with measurement of in-stent CT attenuation correctly detected ISR in 2 and 3 stents respectively with reference to CCA.The sensitivity, specificity,positive predictive value and negative predicitive value of the two methods were 18%,69%, 20%,67% and 27%,81%,38%,72%,respectively.There was no significant difference (P＞0.05) between the accuracy of two methods.Conclusion The ISR was very difficult to diagnose by 64 slice CT, but the high specificity of 64-slice CT study implied an important role in excluding ISR.