Corticosteroids are widely used to treat ocular fundus diseases such as inflammatory disease,macular edema and choroidal neovascularization.To increase local drug concentration and reduce systemic side effects,corticosteroids are often delivered by periocular or intravitreal iniection.However there are still more and more clinical complications with the expanded scope of application of these drugs.In order to achieve the best risk-benefit ratio,fully understanding the pharmacological characteristics,indications,contraindications and complications of corticosteroid is critical for clinicians to prescribe this drug to their patients.

Objective To study safety and values of laparoscopic surgery in the management of gynecological diseases in senile women.Methods Clinical data between 27 cases of laparoscope surgery(Laparoscopic Group) and 25 cases of open surgery(Open Group) from January 2001 to December 2006 were retrospectively compared.Results The operation time in the Laparoscopic Group(20.0?7.9) min was significantly shorter than that in the Open Group(44.0?7.2) min(t=-11.419,P=0.000);the blood loss in the Laparoscopic Group(21.9?20.0)ml was distinctively less than that in the Open Group(62.6?29.4)ml(t=-5.875,P=0.000);the postoperative pyrexia in the Laparoscopic Group(3 cases) was significantly less than that in the Open Group(12 cases)(?2=8.606,P=0.001);the time to first flatus in the Laparoscope Group(13.9?2.9)h was significantly shorter than that in the Open Group(23.4?4.3)h(t=-9.404,P=0.000);hospital stay in the Laparoscope Group(7.6?0.9) d was significantly shorter than that in the Open Group(10.2?1.2) d(t=-8.882,P=0.000).Conclusions On the basis of intensive treatment of preoperative complications and perioperative monitoring,laparoscopic surgery is an ideal procedure for benign gynecological diseases in senile women.

Objective To determine the efficacy and safety of hysteroscopic resection with dipolar electrodes for submucous myoma of the uterus. Methods By hysteroscopy combined with B-ultrasonography,totally 456 cases of submucous myoma of the uterus were confirmed in our hospital from January 1998 to December 2007. Among the patients,241 cases showed type 0,138 patients were type Ⅰ,and 77 cases were type Ⅱ. In 341 of the cases,the myoma sized 1.0 to 2.0 in diameter,86 cases from 2.1 to 4.0 in diameter,and the other 29 cases had the myoma ranged from 4.1 to 6.0 cm in diameter. Hysteroscopic resection with dipolar electrodes were performed on all the cases,among which microelectrode was used in 341 patients,and ring electrode was employed in 115 cases. Results The operation time ranged from 9 to 55 min with a mean of (32.9?16.7) min. The removed tissues weighed (30.2?8.2) g in average (ranged from 5 to 55 g). During the operation,the patients had 5 to 100 ml blood loss [mean,(48.1?12.7) ml]. No complications occurred during and after the operation. The patients were followed up for three months,during which 431 (94.5%) showed reduced menstruation and decreased menstrual blood loss,only 5 patients (1.1%,all were type Ⅱ) had residual myoma. In this series,totally 42 patients wished pregnancy,15 of them became pregnant in 24 months postoperation. After the treatment,anemia was corrected in 206 patients with the level of Hb increased to a normal range;before the operation,81 patients had menstrual pain,42 of them were relieved and 19 were improved by the operation,while the other 20 showed no changes in the symptoms. Conclusion Hysteroscopic resection with dipolar electrodes is safe and effective for uterine submucous myoma.

Objective To analyze the effect of intensive pupillary dilation on intraocular pressure(IOP) in early stage after vitreoretinal surgery(VRS).Design Retrospective case series.Participants 32 patients(34 eyes) with 30 mmHg or more of IOP at the first day after VRS were enrolled in this study.Methods Tropicamide-phenylephrine eyedrop(Mydrin-P~(?)) was applied to the operated eye 3 times with interval of 5 minutes and IOP was measured again 2 hours later.IOPs were compared with t test.Main Outcome Measures IOP.Results The mean IOP was 37.26?6.07 mmHg before using tropicamide-phenylephrine eyedrop and 34.82?8.46 mmHg after using it two hours later(P=0.02),and mean decline of IOP was 2.44 mmHg in general.IOP was decreased in 20/34 eyes(58.82%) with mean decline 6.2 mmHg.IOP was unchanged in 4/34 eyes(11.76%).IOP was increased in 10/34 eyes(29.41%) with mean IOP up 4.1 mmHg.Conclusions The IOP increasing after vitreoretinal surgery is not the reason for stopping pupillary dilator.On the contrary,the IOP of about 60%patients can decrease with rational using pupillary dilator.

BACKGROUND:Different operation approaches can be selected during the repair of thoracolumbar fractures. Traditional posterior median approach wil cause great wound on patients, and easily induces some adverse consequences. OBJECTIVE: To compare the effects and biocompatibility of conventional posterior median approach and paraspinal approach fixation for treatment of thoracolumbar fractures. METHODS: A retrospective analysis was performed on clinical data of 53 cases of thoracolumbar fracture in the Shaanxi Province Nuclear Industry 215 Hospital from December 2012 to December 2013. They were divided into two groups according to approach method. The control group (n=27) received pedicle screw placement fixation through conventional posterior median approach. The observation group (n=26) underwent pedicle screw placement fixation through paraspinal muscle approach. After repair, they were folowed up for 12 months. Imaging results, pain score and perioperative relevant indexes were observed and compared in both groups. RESULTS AND CONCLUSION: Imaging examination was conducted before repair, immediately after repair and during final folow-up in both groups. The height of vertebral anterior border and kyphosis correction effect were good after different therapies in both group, but no significant difference was detectable between the two groups (al P > 0.05). These findings suggest that height of vertebral anterior border and kyphosis correction effect were identical between the two groups. Pain visual analog scale score was significantly lower in the observation group than in the control group at 24 hours and 3 days after repair and during final folow-up (al P < 0.05). Perioperative relevant indexes were analyzed in both groups. Intraoperative bleeding amount, drainage and bed time after repair were observed in the observation group, which showed significant advantages as compared with the control group (al P < 0.05). These results confirmed that compared with the traditional posterior median approach surgery, minimaly invasive pedicle screw placement through paraspinal muscle approach for thoracolumbar fractures can obtain better repair effects and biocompatibility.

Objective To observe the clinical manifestations,therapeutic efficacy and results of bacterial culture of seven patients of scleral buckle (SB) infection after scleral bulking surgery.Methods Seven patients (seven eyes) underwent SB removal for SB infections were enrolled in this study.The patients included four males (four eyes) and three females (three eyes).The patients aged from 12 to 69 years,with a mean age of 42.7 years.There were four right eyes and three left eyes.The duration (interval between primary surgery and SB removal) ranged from two weeks to ten years,with a mean of 47.5months.Six patients were concurrent with systemic disease.All the patients were examined for visual acuity,slit lamp microscope and indirect ophthalmoscope examination.Some patients also received external eye examination and fundus photography.Whether SB exposure or not and the clinical manifestations were observed.SB removal was performed in all the patients and the SB were sent to the laboratory for bacterial culture.The follow-up time ranged from two weeks to eight months,with a mean of 3.2 months.Whether infections recurrence and retinal detachment or not were observed.Results SB exposure was in three eyes.Obvious ocular pain and swelling,conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes; irritation and discharge were in one eye.No SB exposure was in four eyes.Ocular pain and swelling,conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes.Repeated subconjunctival hemorrhage and diplopia were presented in one eye.Visual acuity decline,conjunctival sac discharge and total retinal detachment were in one eye.All patients had no intraocular inflammation.The infection was controlled after SB removal and the retina was attached during the follow up.The bacterial culture were all positive,which included Staphylococcus aureus,Staphylcoccus epidermidis and Erysipelothrix rhusiopathiae,Gram positive corynebacterium,Aspergillus flavus,Kocuria roseus,Streptococcus oralis,Maxwell Corynebacterium.Conclusions The clinical manifestations of SB infection and the pathogenic microorganisms are variable.SB removal can control the infection.

Objective To study the electrophysiological properties of rat skeletal muscle within the frequency from 100Hz to 100MHz.Methods The AC impedance of rat sural muscle tissues was measured using the Agilent 4294A impedance analyzer, then the electrophysiological properties of the normal rat sural muscle cells were established in the respect of cell dielectric spectroscopy, Cole-Cole plots, spectrum of loss factor and loss tangent.Results (1) The dielectric response of rat sural muscle cells was frequency-dependent, such as increase in frequency caused decrease in permittivity. At the same time the conductivity trended to arise; (2) The dielectric parameters(?_L,?_h,?_L,?_h,△?″_ max,△tg?_ max,f_ C1,f_ C2) cell fiber parallel to the applied electric field differed from that cell fiber perpendicular to the applied electric field; (3) The effect of alternating current electric field on rat sural muscle cells showed a dielectric dispersion phenomenon, representing two characteristic frequency: the 1 st frequency(f_ C1(∥)=f_ C1(⊥)=1.02 kHz) and 2 nd frequency(f_ C2(∥)=59.31 kHz,f_ C2(⊥)=380.04kHz). Conclusion The method for studying the electrophysiological properties of rat skeletal muscle cells was established in the respect of the frequency domain,providing a possibility for investigating muscle fatigue in the future.

Objective To investigate the effect of IL 6 on prostatic carcinoma cell lines,and differential effects on androgen dependent and androgen independent prostatic carcinoma cells. Methods The IL 6 producing capacities of LNCaP and PC 3 cells were determined,and effects of exogenous IL 6 and anti IL 6 antibodies on LNCaP and PC 3 cells were examined. Results LNCaP produced a very small amount of IL 6,but PC 3 produced more,the concentration of IL 6 being 190 pg/48h per ml(1?10 6).The exogenous IL 6 inhibited LNCaP growth significantly,but had no obvious effect on PC 3 cells.Anti IL 6 antibidies lowered PC 3 cells growth rate but had neutral effect on LNCaP. Conclusions PC 3 cells produces IL 6 massively in autocrine manner.IL 6 could be antagonized by anti IL 6 antibodies,resulting in slowing PC 3 cells growth,and LNCaP cells growth could be inhibited by exogenous IL 6.

The J-curve phenomenon in the antihypertensive treatment of cardiovascular disease has had more theoretical and experimental evidence and has been recognized by most researchers.However,there are a few related studies and reports about whether antihypertensive treatment has the J-curve phenomenon in ischemic stroke.It has not yet reached a consensus.This article reviews this phenomenon and expecting it to contribute to the blood pressure mangement of ischemic stroke.

Objective To analyze the characteristics ot lymph node metastasis and prognostic factors for carcinoma of papilla of Vater (CPV) after pancreaticoduodenectomy (PD).Methods From January 2005 to December 2010,94 patients with CPV underwent PD and dissection of regional lymph nodes at the Eastern Hepatobiliary Surgery Hospital.We carefully evaluated nodal involvement in the patients to determine the lymphatic spread of CPV and analyzed the clinicopathological variables in relation to prognosis.Results The overall rate of nodal involvement was 46.8％.Using the UICC staging (7th edition),lymphatic invasion in pT1,pT2,pT3 and pT4 were 15.4％ (2/13),62.7％ (32/51),80.0％ (8/10) and 100％ (2/2),respectively.The metastatic rates in the posterior pancreaticoduodenal lymph nodes,the mesopancreatic lymph nodes,the hepatoduodenal ligamental lymph nodes and the proper hepatic periarterial lymph nodes were 30.9％ (29/94),21.3％ (20/94),11.7％(11/94) and 6.4％ (6/94),respectively.Significant prognostic factors were tumor pT stage (P＜0.01),duodenal wall infiltration (P =0.001),liver metastasis (P =0.001),pancreatic paren chymal invasion (P=0.004),nodal involvement (P＜0.01) and different regional lymph nodes invasion (the posterior pancreaticoduodenal,P＜0.01; the mesopancreatic,P＜0.01; the hepatoduodenal ligamental,P＜0.01; the proper hepatic periarterial,P=0.010).Cox regression analysis for overall survival revealed that the posterior pancreaticoduodenal nodal involvement (P＜0.01),the mesopancreatic nodal involvement (P＜0.01) and duodenal wall infiltration (P=0.019) were significant independent prognostic risk factors.Conclusions The mesopancreatic lymph nodes and the posterior pancreaticoduodenal lymph nodes should equally be regarded as the first stop in lymphatic spread of CPV.Therefore,we should pay much attention to these regional lymph node dissections,especially to ensure complete resection of the uncinate process and the mesopancreas.