AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication.
METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.
RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P< 0. 01 ). The visual acurity of all cases increased in different degrees from handle move to 0. 3 to 0-1-1. 0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes (52. 4%), mild iritis in 21 eyes (100%). No cornea burn was encountered.
CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.

Objective To study the effect of folic acid on decreasing level of plasma total homocysteine(tHcy)in patients with sudden sensorineural hearing loss(SSHL) and the optimal dosage of folic acid. Methods Ten randomized controlled trials involving treatment data on 210 patients with SSHL were retrospectively studied.They were divided into seven groups according to the daily dosage of folic acid: group A to group G,0.2 mg,0.4 mg,0.8 mg,2.0 mg,5.0 mg,10.0 mg and 15.0 mg,respectively.Besides oral administration of folic acid,Vitamine B6 and B12were supplemented,and other routine treatment were performed.Fluorescence polarization immunoassay was employed to detect the plasma tHcy before and 3 months after the treatment.And the data of plasma tHcy of 210 patients without SSHL were collected and served as controls.The levels of plasma tHcy were statistically analysed between the SSHL group and control group and among group A to group G. Results The level of plasma tHcy in the SSHL group was significantly higher than that in the control group,(18.07?1.58)?mol/L vs(13.63?1.33) ?mol/L(P0.05). Conclusion The levels of plasma tHcy are significantly increased in SSHL.Folic acid may play an important role in decreasing the levels of tHcy in patients with SSHL,and a dosage of 10 mg/d for oral adminstration is well suggested.

AIM: To evaluate the physiologic change of retinal thickness during pregnancy.
METHODS:Forty cases ( 80 eyes ) were included two groups:40 eyes ( 20 cases ) in healthy pregnant women group (including in the second and last trimester), and 40 eyes (20 cases) in healthy nonpregnant women group ( control group ) . The macular volume, average thickness, central subfield thickness and retinal thickness of other parafoveal areas were measured by optical coherence tomography scan.
RESULTS: The macular volume was 10. 06±0. 41mm3 and 9. 87±0. 30mm3 in healthy pregnant women group and control group respectively. The average thickness was 279. 43±10. 86μm and 274. 25±8. 07μm in healthy pregnant women group and control group respectively. The central subfield thickness was 235. 15±15. 05μm and 233. 00±15. 81μm in healthy pregnant women group and control group espectively. Statistically significant difference was found in macular volume and average thickness (P<0. 05). The retinal thickness of 8 parafoveal areas in healthy pregnant women group increased comparing with control group, but statistical significance was only found in superior-outer area and inferior-outer area(P<0. 05). OCT images of all cases were normal.
CONCLUSION:The macular retinal thickness increases during pregnancy in the second and last trimester. The physiologic change of retinal thickness should be considered when evaluating pathologic retinal disease of pregnant women.

Objective To investigate the changes of thyroid hormones in patients with peripartum car-diomyopathy. Methods Seventy-two patients with peripartum cardiomyopathy were consecutively enrolled and 72 healthy women who had normal delivery were regarded as control. Among all the subjects , free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in the serum and high sensitive C-reactive protein (hs-CRP), interferon-gamma (IFN-γ) and interleukin-4 (IL-4) in the plasma were measured. Results The levels of serum FT3 and FT4 in peripartum cardiomyopathy group were significantly higher than those in control group (P < 0.05). And the level of serum TSH in peripartum cardiomyopathy group was significantly low-er than that in control group (P < 0.05). There were 24 cases with hyperthyroidism in peripartum cardiomyopa-thy group while no patient in the control group had hyperthyroidism (P < 0.05). The levels of plasma hs-CRP and IFN-γ in peripartum cardiomyopathy group were significantly higher than those in the control group (P <0.05). And the level of IL-4 in peripartum cardiomyopathy group was significantly lower than that in the control group (P < 0.05). Conclusions Serum thyroid hormones elevated in patients with peripartum cardiomyopathy and its mechanism might be related to abnormal immune reaction.

Background and purpose:The Smac/DIABLO(the second mitochondrial derived activator of caspase/direct IAP binding protein with low pI)is a new kind of mitochondria protein,it inhibits IAPs(inhibitors of apoptosis protein),including Survivin,and activates caspase-9 and caspase-3,accordingly promotes apoptosis.In this study,we investigated the effect of over-expressing mitochondrial protein-Smac/DIABLO while silencing inhibitor of apoptosis protein-Survivin on the cell growth,cell cycle and apoptosis of human colon cancer cells through cotransfecting both genes.Methods:Constructed survivin-shRNA-EGFP plasmid was transected with Smac-pcDNA3.1 plasmid into Lovo cells at either half each dose or total dose,respectively.Western blot was used to survey the protein level of Smac and Survivin;Hoechst 33258 staining was used to detect the karyomorphological diversity of apoptotic cells and evaluate apoptotic ratio roughly;PI staining and flow cytometry analysis were used to examine cell cycle;caspase-3 Detection Kits was used to detect the activity of caspase-3.Results:The expression of Smac protein increased but Survivin protein decreased 48 hr after transfection.Karyomorphological diversify of apoptotic cells were obviously observed by hoechst 33258 staining.The apoptosis rate in Smav+Survivin shRNA group was(18.5?1.7)%,which was higher than that in Smac group(9.6?1.8)% and Survivin shRNA group(15.0?0.3)%,and all of three groups were significantly higher than the control groups;The cells of G0/G1 phase increased to(51.0?6.2)% in Smac group,and the cells of S stage increased to(53.3?1.3)% in Survivin shRNA group(P

OBJECTIVE: To explore the effect of delta-opioid receptor (DOR) in electroacupuncture (EA) protecting the brain against acute ischemic injury. METHODS: Fifty-one rats were randomly divided into sham ischemia group, ischemia group, sham EA group, EA group, and EA+DOR antagonist (naltrindole) group. Transient focal cerebral ischemia (1 hour) was induced in rat brain by middle cerebral artery occlusion (MCAO) method. EA was applied on Shuigou (GV 26) and Neiguan (PC 6) for 30 min, starting immediately after the onset of reperfusion. Neurological deficit scores and volume of cerebral infarction were detected after 24-hour reperfusion. Other 12 rats were randomly divided into sham ischemia group, ischemia group, EA group and EA + naltrindole group. DOR protein expressions were assessed by Western blotting after 24-hour reperfusion. RESULTS: In comparison with the ischemia group and sham EA group, EA significantly reduced ischemic infarction and neurological deficits (P<0.05); EA significantly increased the expression of 60 kD DOR protein (P<0.05) and tended to increase that of 36 kD DOR protein (P>0.05). When naltrindole was combined with EA, the naltrindole completely abolished the EA-induced protection in ischemic infarction and neurological deficits, and also arrested the expression of DOR. CONCLUSION: EA can up-regulate DOR expression and protect the brain from ischemia-reperfusion injury.

Objective To explore the changes of hydrogen sulfide(H2S) levels in plasma of newborn infants with pulmonary hypertension(PH) and its relationship with pulmonary hypertension,and provide scientific evidence for the decision of treating neonatal PH.Methods Sixteen children with PH and 16 children without PH in ICU from Mar.2005 to Mar.2006 were selected.Ultrasonic cardiogram(UCG) examination was performed for eachpatients.Pulmonary artery pressure(PAP) was measured.The plasma concentrations of H2S,cysteine and PAP of each patient were measured.Results PAP was 4.27-9.73 kPa[(6.49?1.79) kPa] in neonatal PH group,and PAP in control group was normal.The plasma levels of cysteine and H2S in neonatal PH group significantly increased compared with those of control group [(11.94?6.65) ?mol/L vs(6.43?2.08) ?mol/L,t=2.630 P=0.016;(26.99?1.33) ?mol/L vs(24.92?1.36) ?mol/L,t=4.373 P=0].Conclusions Endogenous H2S and cysteine were up-regulated during the development of neonatal PH;it might play an improtant role in the development of PH.H2S possibly depress the PAP by dilating the pulmonary artery to protect the patients with pulmonary hy pertension.

Objective To investigate the relations between serum adiponectin and coronary artery calcification score (CACS) and to find the risk factors for coronary artery calcification in maintenance hemodialysis(MHD) patients.Methods Twenty-seven MHD patients(MHD group) and 13 healthy persons (control group) were enrolled in this study.The serum adiponectin was measured by enzyme-linked immunosorbent assay method.CACS was calculated by multi-row spiral CT.The circulating parameters such as hemoglobin (Hb),calcium,phosphate,calcium-phosphate product,intact parathyroid hormone (iPTH),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),albumin (Alb),high sensitive C-reactive protein (hs-CRP),and so on were detected.Results The level of serum adiponectin in MHD group [(15.00 ± 7.47) mg/L] was significantly higher than that in control group [(2.07 ± 0.83) mg/L],and there was significant difference (P＜ 0.01).Coronary artery calcification(CACS ＞ 0 score) was observed in 88.9％ (24/27) in MHD group and 10/13 in control group.The mean CACS in MHD group was significantly higher than that in control group [655 (0-3 570) scores vs.126 (0-731)scores],and there was significant difference (P ＜ 0.05).Eleven MHD patients and 1 healthy person had severe coronary artery calcifications,(CACS ≥ 400 scores).There was significan t difference in dialysis duration,diastolic pressure,phosphate calcium-phosphate product and adiponectin (P ＜ 0.05 or ＜ 0.01).Spearman analysis showed that CACS of MHD patients was positively correlated with dialysis duration,phosphate,calcium-phosphate product,serum creatinine and adiponectin (P ＜ 0.01 or ＜ 0.05).Only calcium-phosphate product remained as independent predictor of CACS in multivariate analysis (P ＜0.01).Conclusion Coronary artery calcification is common in MHD patients and which is correlated with dialysis duration,serum phosphate,calcium-phosphate product,serum creatinine and adiponectin.

Objective To evaluate the value of computer aided rapid prototyping technology in diagnosis and treatment of complicated pelvic fractures. Methods Twenty-two patients of complicated pelvic fractures were examined by thin-slice CT to gain two-dimensional data of the pelvis. Three-dimensional reconstructions of anatomical models were accomplished by computer aided technology. By rapid prototyping technology , the pelvic models were rendered , by which diagnosis and typing of pelvic fractures were finalized for operation project , mimic operation and guiding the operation. Results Three-dimensional reconstruction images and rapid prototyping pelvic models were extremely similar to what doctors saw in the operations. Preoperative mimic operation shortened the time of operation and reduced the volume of bleeding in the operation. All 22 cases were available for review in follow-up period of 6 ~ 24 months. Patients could sit up in 2 ~ 4 weeks after surgery , and walk with a crutch 6 weeks later. Pelvic fractures reductions were good in 22 cases. According to the Majeed's functional criteria , 16 patients were judged excellent and 3 patients were good. The excellent and good rate was 86.4%. Conclusions Computer aided rapid prototyping technology can overall, direct-viewing, and exactly display the three-dimensional shape of pelvis and spatial relation of anatomic structures. It is important for definite clinic diagnosis , typing and treatment.

Objective:To synthesize autoinducer-2 by the clone and prokaryotic expression of Streptococcus mutans(S.mutans)UAl59 luxS gene and to observe the influence factors.Methods:The expression vector pET21 a(+)-luxS of S.mutans UAl59 was transformed into Escheriehia coli BL2l(DE3).The S-ribosylhomocysteinase(Luxs)expression was induced by IPTG.The His tag fusion protein was isolated by Ni-chelating column and identified by Western blotting.Finally the protein was renatured by dialysis method.S-ribosylhomo-cysteine (SAH)was catalyzed by s-adenosylhomocysteine nucleosidas (Pfs)and LuxS,and then AI-2 was syntheszed.The AI-2 activi-ty was examined by luminescence of Vibrio harveyi BB1 70 when the concentration of LuxS protein or pH(4 -1 2)or the concentration of sodium fluoride was changed in reaction mixes of AI-2 synthesis.Results:Compared with the control group,with the increase of LuxS protein concentration,the relative activity of in vitro synthesized AI-2 increased gradually(P <0.001 ).When pH was between 6 -1 0, the relative activity of AI-2 were the highest,beyond the range of pH,the relative activity of AI-2 decreased(P <0.001 ).When a final concentration of sodium fluoride was more than 0.3%,the luminescence values decreased(P <0.05).Conclusion:LuxS fusion protein can promote the production of AI-2.Optimum pH for AI-2 biosynthesis in vitro must be between 6-1 0.Biosynthesis of AI-2 is inhibited by sodium fluoride with final concentration of more than 0.3%.