Filtration surgeries,especially trabeculectomy,are the most common surgeries for glaucoma.Although trabeculectomy has excellent efficacy for reducing intraocular pressure(IOP),glaucoma filtering blebs have been frequently associated with various postoperative complications including filtering bleb failure and ocular surface dysfunctions.Surgical treatments of the natural aqueous outflow system,in and around Schlemm's canal,to restore normal function without penetration of the intraocular space has been considerable interest in recent years as glaucoma surgeons continue their quest for a procedure that reduces IOP without the risk related with filtering bleb.As a result,more blebless glaucoma surgeries have developed gradually in the past years.

Objective: To observe the clinical efficacy of warm needling plus tuina in treating senile functional constipation. ＜br> Methods: Ninety elderly patients with functional constipation were randomized into two groups. Forty-six patients in the treatment group were intervened by warm needling plus tuina; the other forty-four patients in the control group were intervened bySan Huang tablet. ＜br> Results: In the treatment group, 19 patients were cured, 24 cases showed improvement, 3 cases failed, and the total effective rate was 93.5%; in the control group, 16 patients were cured, 18 cases showed improvement, 10 cases failed, and the total effective rate was 77.3%. There was a significant difference in comparing the therapeutic efficacy (P＜0.05), and the therapeutic efficacy of the treatment group was higher than that of the control group. ＜br> Conclusion: Warm needling plus tuina can produce a higher therapeutic efficacy than takingSan Huang tablet in treating senile functional constipation.

The cultivation of clinical skills is essential for graduate education in modern ophthalmology. In order to improve the quality of graduate education and cultivate qualified ophthalmologist, postgraduates should be trained of specific purpose, coordinate the relationship between project research and clinical work, a complete clinical training system and quality control system should be established and the construction of the tutor team should also be strengthened.

Objective To evaluate the clinical safety and efficacy of HIFU treatment of hepatic metastases from colorectal cancer.Methods 20 tumor lesions in 14 patients with hepatic metastases from colonectal cancer were treated with HIFU therapy.The vital signs,main organs'functions,examination of MRI and complications were observed.Results Vital signs of all the 14 patients were stable.The function of liver and kidney were normal and life quality were improved with elevation of Karnofsky in 5 patients.On MRI examination,the MRI signals of treating area of 20 tumor lesion in 14 patients decreased remarkably with disappearance of blood supply and a thin layer of edematous intensified zone was detected on the margin of lesion.6 patients were found to have cord-like burning scar on skin.Conclusion HIFU treatment is safe and effective in treatment of hepatic metastases from colorectal cancer.

As the basis of the health management of the elderly, weight management should receive attention from medical practitioners.However, there is an ongoing debate on the ideal range of body mass index for elderly in China.This article aimed to find the suitable body mass index for Chinese old people by reviewing the literature regarding the body mass and obesity of the elderly.Lots of evidence show that overweight and mild obesity appear to be the optimal weight status for the elderly.

Objective To evaluate the value and the significance of 16-slice spiral computed tomography angiography(MSCTA) in identifying the vertebral artery course variation.Methods MSCTA data in 22 patients with anomalous path of vertebral artery were retrospectively analyzed,13 of them had undergone DSA examinations,and 5 of them had also undergone MRI examinations.Multi-planar reconstruction(MPR),curved MPR,thin-slab maximum intensity projection(MIP),volume rendering(VR) or slab VR(cut-plane VR) were used to assess the anomalous path of the vertebral artery and its relationship with the adjacent large vessels.Virtual endoscopy(VE) was used to evaluate the orifice of the vertebral arteries and its relationship with the aortic arch and the ostia of the adjacent large vessels.Different views of vertebral artery were analyzed on DSA.MSCTA and DSA images were analyzed in blinded fashion for the accuracy of anomalous vertebral artery path and origin detection.Results were compared in a secondary consensus evaluation.Results The anomalous path of the vertebral artery in all 22 patients were correctly displayed on MSCTA,7 of them had anomalous origin of vertebral artery,the anomalous of ostia showed clearly.The vertebral arteriae with course variation were all going up at the front of the foramen transversarium of C6,then bended into the C5,C4 or C3 foramen transversarium.DSA could only be detected the anomalous origin in 13 patients undergone DAS.5 patients indirectly showed having course variation of vertebral artery by MRI.Conclusion MSCTA is superior to DSA in showing the anomalous path and orifice of vertebral artery,it should be considered as a non-invasive imaging tool for these diseases.

The metabolism study of radiolabeled drugs plays an important role in the development of new drugs. It provides information on drug absorption, metabolism, tissue distribution and excretion, and plays an irreplaceable role in the metabolite safety evaluation and mass balance of new drugs. The new guidance draft on clinical trials of radiolabeled drugs recently released by the US FDA puts forward higher standards and has been widely concerned by the industry. In recent years, in the research and development of new drugs in China, ¹⁴C labeled drugs have been used to carry out clinical metabolism studies, which has overcome key technical bottlenecks and accumulated experience. This paper summarizes the above research progress, analyzes the existing problems, and preliminarily looks forward to the future technological development and application.

ObjectiveTo investigate the efficacy of combined therapy of mild hypothermia and hibernation to treat severe brain injury. Methods24 patients with severe brain injury were randomly divided into combined therapy group and normothermia group. Glasgow Coma Scale scores of all the patients were in the range of 3 to 8. No later than 10 hours after their injury, hypothermia patients were given half dosage of No.1 hibernation cocktail and had been cooled by cooling blankets to 32℃-34℃ (rectal temperature) for 5 days, then to 35℃ for 24 hours, and slowly increased to their normal level. 3 days and 7 days after their admission, intracranial pressure,creatine phosphate kinase,partial pressure of arterial O2 and CO2, platelet and Na+,K+ were measured.7 days after their admission, Glasgow Outcome Scale scores of each patient and mortality of each group were measured. ResultsThe mortality of combined therapy group(25.0%) was significantly lower than that of normothermia group (66.6%,P<0.05). The decreased values of intracranial pressure, creatine phosphate kinase and platelet number of combined therapy group were all significantly higher than that of normothermia group respectively (P<0.05). There were no significant difference in mean artery pressure, blood electrolyte, and partial pressure of arterial O2 and CO2 between these two groups(P>0.05). ConclusionThe combined therapy of mild hypothermia and hibernation can effectively reduce the mortality of patients with severe brain injury as it is much easier, less invasive and with less complications.

Objective To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province,and to provide scientific basis for making strategies in prevention and control of the disease. Methods According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties(cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09%(1401/5816). Level of water fluoride was determined in 6940samples from fluorosis villages(villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47%(1522/4415), the highest value of water fluoride was 9.71 mg/L. Conclusions Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.

The recombinant fusion protein staphylokinase-hirudin(rSFH) was purified from the high density-fermented engineered E.coli by means of ion-exchange chromatography (IEC) and gel filtration (GF). The purity of rSFH reached to more than 98% determined by RP-HPLC and SDS-PAGE, and the yield was up to 0.7g per liter of fermentation broth. The analysis of homologous dimmer of rSFH appeared during the purification and calculation of the surface hydrophobic area had been carried out by means of hydrophobic chromatography and MALD-TOF. The influence of sodium chloride and temperature on the behavior of rSFH reversible dimerization was analyzed by high performance sized- exclusive chromatography(HPSEC). It is concluded that the hydrophobic interaction played an important role in the reversible dimerization of rSFH.