Objective To evaluate the therapeutic efficacy of retrobulbar injection with triamcinolone acetonide (TA) for macular edema caused by retinal vein occlusion (RVO). Design Retrospective case series. Participants 21 eyes of 21 patients with macular edema caused by RVO. Methods Retrobulbar injection with TA 40 mg was performed on 21 eyes. The visual acuity, intraocular pres-sure, fundus fluorescein angiography (FFA) and macular central thickness under the optical coherence tomography (OCT) were recorded and analyzed before and after treatment. The follow-up duration was 6-11 months. Main Outcome Measures The visual acuity and the macular central thickness of OCT. Result Visual acuity was improved at the end of follow-up in 16 eyes (76.2%) and unchanged in 5 eyes (23.8%). Macular central thickness was (287.55±121.70) μm at the end of follow-up and (617.23±185.58) μm before treatment. The difference was statistically significant(P=0.000). After treatment, the comparison of visual acuity and macular central thickness be-tween CRVO patients and BRVO patients, as well as between ischemic RVO patients and non-ischemic RVO patients had no significant difference (P>0.05). In patients of course less than 6 months, the visual prognosis after treatment is better than that of before treatment (P=0.011, 0.01), while in patients of course more than 6 months, no difference of vision could be detected before and after treatment (P= 0.583). The result of FFA showed decrease of fluorescein leakage. During follow-up, intraocular pressure of all patients was in the nor-real range. Recurrence of macular edema was found in 8 eyes 2 to 6 months after treatment. Conclusions Retrobulbar injection with TA is a safe, effective, and easy method to treat macular edema caused by RVO. Early treatment can get better efficacy. (Ophthalmal CHN, 2009, 18: 254-256)

Adolescent ; Arteriovenous Malformations ; Female ; Humans ; Portal Vein ; abnormalities

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Objective To analyze the epidemiographic features of malignant tumors of urinary system in renal allograft recipients in our center.Methods A retrospective analysis was performed on 3150 patients who received renal transplantation between June 1978 and Autumn 2006.Twelve cases of urinary tumors were selected for study.Results Among 3150 recipients,33(1.05%)were diag- nosed as malignancies including 12(0.38%)cases in urinary system.The mean age of these patients when diagnosed as urinary tumors was 58.3?4.6(range 48-66).The mean duration of immunosup- pressive treatment was 62?18(range 26-120)months.Six cases received cyclosporine A+azalthio- prine+prednisone(CsA+Aza+Pred),5 cases cyclosporine A+mycophenolate mofetil+prednisone (CsA+MMF+Pred),and one case tacrolimus+mycophenolate mofetil+prednisone(FK506+MMF +Pred).Surgical treatment was carried out in 11 patients.Ten of them were still alive.One case died of cerebral hemorrhage.Conclusions Malignant tumors of urinary system,especially TCC is an im- portant complication in renal transplantation in our center.The occurrence of malignant tumors is inti- mately related to immunosuppressive treatment.The immunological status of patients after renal transplantation should be evaluated in follow-up studies.The treatment consists of complete resection of the mass,decreases of immunosuppressants,chemotherapy or radiotherapy.

Objective To dynamically observe changes of IgG, its subclasses and IgE in sera of mice by immunization with mixed recombinant of BCG-Em Ⅱ/3 and BCG-Em14-3-3 vaccine of Echinococcus multilocularis (Era). Methods Forty Balb/c mice of 12-14 week old and 20-25 g weight were intranasally vaccinated by the vaccine, 4 mice were killed randomly by the weight on 0,2,4,6,8,10,12,14,16 and 18 weeks of immunization respectively, sera were gathered from the eyeball to measure IgG, its subclasses and IgE by routine ELISA. Results Levels of IgG, IgG2a and IgG2b in the sera of mice increased obviously on 2-18 weeks, reached the highest level on 10, 4 and 4 weeks respectively, the value was 0.095±0.033,0.022±0.001,0.023±0.003 respectively, as compared with the value on 0 week(0.030±0.013,0.012±0.004,0.013±0.004), the difference being statistically significant(q=2.95,4.87,2.81 respectively, P < 0.01 or P < 0.05); levels of IgG1, IgG3 and IgE in the sera of mice decreased remarkably on 2-18 weeks,came to the lowest level on 4,2,6 weeks respectively, the value was 0.031±0.004,0.136±0.002,0.114±0.002 respectively, as compared with the value on 0 week(0.192±0.007, 0.175±0.013,0.024±0.003), the difference being statistically significant (q =5.16,4.93,5.32 respectively, P < 0.01 or P < 0.05). Conclusion Helper T cell(TH) Ⅰ response is induced in mice by mixed recombinant of BCG-Em Ⅱ/3 and BCG-Em14-3-3 vaccine on early immunization.

Objective To dynamically observe the changes of subsets of splenocytes in mice by immunization with recombinant BCG-Eg95 vaccine of Echinococcus granulosus(Eg).Methods Balb/c mice were divided randomly into 3 groups according to their weishts:intranasal group.per os group and PBS control.The mice were vaccinated intranasally or orally by the vaccine respectively in experimental groups.and the control mice were given phosphate buffer saline intranasally.These mice were killed to get spleen on 0,2,4,6,8,10,12, 14,16 and 18 week of immunization,respectively.Splenocytes were separated to measure subsets of CD4+ and CD8+T ceUs by FACsort.Results There were marked differences in ratio of CD4+ and CD8+ subsets among the different groups(F value were 21.56 and 22.08 respectively,P＜0.05).There were very marked differences in ratio of CD4+ and CD8+ subsets in different weeks(F value were 5.75 and 6.29 respectively.P＜0.01).In the intranasal group,CD4+ and CD8+ T subsets increased obviously in 6～18 weeks and 12 weeks,and reached the highest level on 10 and 12 week,espectively.Their values were 0.348±0.013 and 0.090±0.003.respectively.There were marked or very marked differences(q value were 7.32 and 5.32 respectively,P＜0.01 or＜0.05)in comparison with 0 week(0.230±0.022 and 0.069±0.015).In the oral group,CD4+and CD8+ subsets rose reinarkablv on 6-16 weeks and 8-18 weeks,achieved the hishest level on 10 and 16 weeks,respectively.Their vahes were 0.405± 0.006 and 0.096±0.004,respectively.There were marked or very marked difference(q value were 7.53 and 5.35 respectively,P＜0.01 or＜0.05)in comparison with week 0(0.230±0.022 and 0.069±0.015).Conclusion CD4+and CD8+T subsets may play an important role in immune response induced in mice by rBCG-Eg95 vaccine.

This article elaborated the connotation and characteristics of research-oriented hospital as well as its inner connection with the development of key disciplines , based on the system dynamics model data analysis of the National TCM Clinical Research Base . It gave suggestions in increasing discipline input , strengthening personnel training , and improving achievement output to research-oriented hospital construction in order to promote the construction of research-oriented hospitals .

This article took the research work of 16 national clinical research base construction units as its background in order to dig the connotation of health service efficiency . Through data envelopment analysis , a comprehensive exposition was given on the inputs and outputs relation of medical and health service efficiency in order to propose appropriate policy recommendations. The study was guided by the scientific development concept in order to gradually improve the efficiency of health services and achieve a comprehensive , coordinat-ed and sustainable development of the hospital .

OBJECTIVEThe best approach for blood pressure (BP) measurement in children remains controversial, especially on the choice of Korotkoff phase 4 (K4) vs. Korotkoff phase 5 (K5) for diastolic BP (DBP) and to compare the differences between K4 and K5 in school-aged children and their predictions to hypertension in adult.

METHODSThe "Beijing children and adolescents BP study" cohort population consisted 2505 school-aged children aged 6 to 17 at baseline survey in 1987, when datum of systolic BP (SBP), DBP measured using K4 and K5, were collected respectively. Among them, 412 individuals with 220 males and 192 females at age of 23-37 years old, were successfully followed up and invited to take part in a clinical examination including anthropometric measurements, SBP and DBP recordings, and a questionnaires in 2005. Method for the BP measurements at both baseline and followed-up was by auscultation with a standard sphygmomanometer. Child hypertension at baseline was diagnosed according to the age-specific cutoffs recommended by the World Health Organization in 1996 (WHO 1996). Adult hypertension was diagnosed according to the China Guideline for Hypertension Prevention and Control issued in 2005. Partial correlation coefficients were calculated to describe the association of K4 and K5 in childhood with SBP and DBP level in adulthood. Multivariate logistic regression analysis was conducted to examine the impact of choice of K5 and K4 as DBP in childhood on prediction to the hypertension in adulthood. Potential confounders such as gender and adult-height were controlled for.

RESULTSAt baseline, the prevalence rates of hypertension were 5.0% with DBP measured using K4, and 2.4% with DBP measured using K5, respectively. The geometric mean difference value of K4 minus K5 (K4 - K5) was (10.1 +/- 1.7 mm Hg) (1 mm Hg = 0.133 kPa) for the 2505 school-aged children, and decreased as age increased. There was no significant difference regarding the values of K4 - K5 between males and females in all age groups except for children who at pubertal stage. The distribution of K4 - K5 value across age groups was statistically significant (P < 0.001), 59.6%, 60.5%, 56.3% and 45.1% of children who aged 6-9 years, 10-12 years, 13-15 years, and 16-17 years with their K4 - K5 value over 10 mm Hg. K4 in childhood was better correlated to both SBP and DBP in adulthood than K5. In general, K4 seemed to be superior to K5 in predicting hypertension in adulthood. The odds ratios of hypertension in adulthood were 1.69 (95% CI: 1.11-2.00), 1.45 (1.05-2.02), 2.18 (1.37-3.47), and 1.66 (1.07-2.59) with each 5 mmHg increasing of K4 measured in children aged 6-9 years, 10-12 years, 13-15 years, and 16-17 years, respectively. The agreement diagnosis between child hypertension and adult hypertension was higher for childhood DBP measured using K4 (20.2%) than that using K5 (12.8%).

CONCLUSIONThere was significant difference between K4 and K5 in Chinese children and adolescents. Choice of diastolic Korotkoff blood pressure could affect DBP tracking from childhood into adulthood. K4 seemed superior to K5 when using auscultator technique to measure DBP.

Adolescent ; Adult ; Blood Pressure ; physiology ; Child ; Female ; Humans ; Hypertension ; epidemiology ; Male

Endoscopy ; methods ; Humans ; Intestinal Diseases ; diagnosis ; diagnostic imaging ; Intestine, Small ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods