AlM: To study the trabeculectomy clinical effect of use tunnel knife to make double - deck scleral flap and to cut off the layer scleral flap of glaucoma.METHODS: Using the random grouping method to divide 46 cases (60 eyes) of glaucoma into the treatment group of 24 cases (32 eyes) and control group of 22 cases (28 eyes). The treatment group, tunnel knife was used to make double- deck sclera flap and superficial scleral flap about the size of 5mm×5. 5mm, 1/3 scleral thickness, under the sclera flap made another one about the size of 3. 5mm× 4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. ln control group, routine glaucoma trabeculectomy was undergone.RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference (P< 0. 05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0. 05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference (P<0. 05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90. 63% and 96. 88% in the treatment group, and those were 75% and 89. 29% in control group. There was significant difference between two groups(P<0. 05).CONCLUSlON:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.

AIM: To analyze the effect of myopic adolescents wearing orthokeratology lens on the corneal surface curvature radius and anterior chamber depth.METHODS: Totally 120 cases of adolescent myopia were selected, among them 58 cases with 116 eyes were divided into 11-14 years old group and 62 cases with 124 eyes were 15-18 years old group according to the age.They were treated with long-term orthokeratology lens treatment, and two groups of patients were observed before wearing lens(T0), wearing for 6mo (T1), 12mo (T2) for uncorrected visual acuity, the average refractive degree improvement, the central corneal thickness, corneal curvature changes and the incidence of complications.RESULTS: The uncorrected visual acuity of the two groups at 12mo after wearing were better than that at 6mo which was better than that before wearing;the diopter had the same trend.The uncorrected visual acuity and the diopter of the 11-14 years old group at 6 and 12mo was better than those of 15-18 years old group with significant difference (P<0.05).The central corneal thickness of the two groups at 12mo after wearing were less than that at 6mo which was less than that before wearing.There was no significant difference of the central corneal thickness between the two groups at 6 and 12mo after wearing (P>0.05).The corneal anterior surface curvature of the two groups at 12mo after wearing were more than that at 6mo which was more than that before wearing.The axial length of the 11-14 years old group was longer than that of the 15-18 years old group with significant difference (P<0.05).There was no significant difference on the corneal posterior surface curvature of the two groups before and after wearing (P>0.05).There was no significant difference on the anterior chamber depth between the two groups at different time or between before and after wearing (P>0.05).CONCLUSION: Long-term wearing orthokeratology lenses have a significant effect for control ling juvenile myopia, and can improve the corneal anterior surface curvature, especially in the lower age group, and has no significant effect on the anterior chamber depth.

Through defining the connotation of division and cooperation among medical institutions, this paper introduces the current status for division and cooperation among medical institutions of Britain, Germany, Singapore and USA. The advantages include excellent general practices, optimal health resource allocation, effective first treat-ment in community health facilities, and effective two-way referral. We analyzed the influence of some new policies on the division and cooperation among medical institutions such as medical association, managed care and the General Practices’ service contract. This provided a lot of experience and revelations, including the dynamics to promote the division and cooperation, the separation of outpatient services and inpatient services, privatization of primary medical institutions, division and cooperation between medical institutions and nursing, rehabilitation institutions, distinguis-hing the division and cooperation from hospitals alliance, and division and cooperation among medical institutions can not resolve the all issues in the medical care supply system.

Objective To evaluate the clinical efficacy of 5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) in the treatment of condyloma acuminatum. Methods Thirty-six cases of condyloma acuminatum were treated with ALA-PDT. Results After the treatment, 33 (91.67%) patients were cured, 35 (97.22%) improved. Relapse occurred in 3 (8.33%) patients. Side effects were noted in 2 (5.56%) patients. Conclusions ALA-PDT is a relatively simple, effective and safe treatment with a lower recurrence rate for condyloma acuminatum, especially for small skin lesions or lesions at specific area. However, the high expense required for multiple treatments with ALA-PDT may restrict its application.

Aim The kinetics of nicotinic acetylcholine receptor (N-AChR) was stadied. MethodsThe saturation experiments of Torpedo electric organ N-AChR were taken with125I-?-BuTX. The results were calculated by Scatfit program. Experiments were thenperformed to study the kinetics of dissociation of ?-BuTX and nicotine from N-AChR,respectively. When their binding reached saturation, an excess of 1000 times ?-BuTX ornicotine was added. The saturation binding properties of the N-AChR extracted fromleg muscles of the 13th day chick embroys and optic lobes of the 20th day chick em-broys were studied. The results were calculated by Scatfit program. The othe experi-ments were taken to observe the competition between mcotine and 125I-?-BuTX forbinding with Torpedo, optic lobe and skeletal muscle of the chick N-AChRs. ResultsThe saturation experiments of Torpedo electric organ N-AChR resulted in a Scatchardplot of hyperbola which responded to the model of two kinds of receptor with on eli-gand.The difference of and B max between high affinity binding site and low affnitybineing site was significant. The dissaciation experiment showed that the fast dissocia-tion rate of tow ligands was 500 times more than that of the slow dissociation rate. Thisresult suggested that there may be two subtype N-AChRs.The saturation bindingproperties of N-AChR of leg muscles and optic lobe of the chick embroys revealed aScatchard plot of two kinds of N-AChR indicating a single type of site. The bindingaffinity of receptor of optic lobe was 100 times more than that of muscles. In competi-tion for Torpedo receptor by nicotine and 125I-?-BuTX, the values of IC50 were different:which suggested that two kinds of receptor sites were existent. In competition ofNicotine and 125I-?-BuTX for optic lobe and skeletal muscles of the chick N-AChR, thevalue IC50 of skeletal muscles N-AChR was 7. 7 times higher than that of optic lobe. Itindicated that two kinds of N-AChR subtype existed in the optic lobe and in theskeletal muscles of chick respectively. Conclusion N-AChR of Torpedo electric organcontains two kinds of subtype receptors. N-AChR of optic lobe of chick embroys is onesubtype receptor, and N-AChR of skeletal muscles of chick embroy is another subtypereceptor.

Background & Objective: Early life stresses, such as social isolation, have lasting effects on the development of emotion and behavior, in which vasopressin plays important roles. This study aimed to assess the possible association of central release of vasopressin with social isolation. Methods: The social isolation model was performed in male mice who endured 6-week social isolation after weaning. Vasopressin expression in the paraventricular nucleus of hypothalamus (PVN) was measured with immunohistochemistry. Released vasopressin from PVN was measured with radioimmunoassay. Results: Vasopressin immunoreactive cells number decreased in the PVN, medial parvocellular division in social isolation-reared mice, compared to the group-reared counterparts. Social isolation decreased short social exposure-induced vasopressin release from PVN. Isolation-reared mice exhibited anxiogenic profile and difficulty in social recognition. Conclusions: This study provides new evidence for the important role of vasopressin in the development of emotional and social behaviors.

T were also detected in the controls.Conclusion Nephrotic syndrome may be associated with NPHS2 identified in children.

Objective To investigate clinical features and therapeutic protocols of vulvovaginal-gingival syndrome(VVGS). Methods Clinical data were collected from 11 female patients with VVGS and analyzed. Results Among the 11 patients, the mean and median ages at a definite diagnosis of VVGS were both 46 years, and the average disease duration was 4 years. Painful erosive erythema was found on the vaginal vestibule in 7 patients, on the gingiva in 10, as well as on the bilateral buccal mucosa in 5. Additionally, 8 and 4 patients reported dyspareunia and vaginal hemorrhage, respectively. Seven patients were treated with low-dose oral methylprednisolone combined with hydroxychloroquine or colchicine, and the other 4 were treated with oral hydroxychloroquine alone. Furthermore, all of the 11 patients applied topical tacrolimus 0.1%ointment. Finally, 8 patients were cured or markedly improved. No obvious adverse reactions were observed in any of the patients. Conclusions VVGS mostly occurs in middle-aged women, with the vaginal vestibule and gingiva as predilection sites of painful erythema and dyspareunia as common symptoms. Patients have good responses to methylprednisolone combined with hydroxychloroquine, and hydroxychloroquine alone also shows good efficacy in patients with mild VVGS. Tacrolimus 0.1%ointment can be one of drugs for topical maintenance treatment of VVGS.

Objective To investigate the production path of major histocompatibility complex class Ⅰ chain-related gene A(MICA) antibodies and the impact on the therapeutic efficacy after acute rejection in renal transplantation recipients.Methods Luminex flow cytometry was used to detect antiMICA antibodies and the antibody specificity in 157 pre-transplant kidney transplant recipients randomly selected.The clinical data were collected,anti-MICA antibody production pathway and immunoglobulin types were analyzed,and the impact of IgM anti-MICA antibody and IgM&IgG complex anti-MICA antibodies on acute rejection (AR) incidence and therapeutic efficacy after renal transplantation.Results Of the total 157 recipients,19 recipients were positive for anti-MICA antibodies before renal transplantation in 68 recipients who had history of blood transfusion,pregnancy and transplant sensitized experience (27.9％ ); In 89 recipients having no sensitized experience,MICA antibodies were positive in 26 recipients (29.2％ ) (P＞0.05).In 45 anti-MICA antibody-positive recipients,the anti-MICA antibodies type was IgM in 26 cases having no sensitized experience; and that was IgG and IgM complex in 19 cases having sensitized experience.In 38 antiMICA antibody-positive recipients undergoing kidney transplantation,7 out of 22 IgM anti-MICA antibodies recipients had AR (31.8％) that was reversed by methylprednisolone pulse therapy,and 7out of 16 IgM&IgG complex anti-MICA antibodies recipients had AR (43.8％) and treated with methylprednisolone pulse therapy:reversion in 3 recipients (42.9％),and the graft function loss in 4 recipients.The AR incidence was not associated with the two immunoglobulin types of MICA antibodies(P＞0.05),but there was significant difference in the reversal rate of AR (P＜0.05).Conclusion For non-allergenic history recipients,there exists the classic “natural antibodies” pathway in the production of the anti-MICA antibodies whose immunoglobulin type was IgM.In addition,the reversal effect of AR in recipients with IgM anti-MICA antibodies was much better.We need to attach importance to IgM&IgG complex anti-MICA antibodies for the pre-transplant anti-MICA antibodies in renal transplant recipients,because their AR treatment outcome is poor.

Objective To establish a stable animal model for sequentially dynamic and direct monitoring of the skin wound infection. Methods The mice with full-thickness skin incisions were replicated. After immediate subcutaneous suture,the mice were randomly divided into four groups,ie,Group A was inoculated with 50 μl sterile PBS solution),Groups B,C and D were inoculated with 50 μl suspension containing 1 × 106,1 × 108 and 1 × 1010 colony forming unit (CFU)/ml bioluminescent methicillin-resistant staphylococcus aureus (MRSA) respectively.Then,the diet behavior of each group was observed and the mean weight and mortality of each group were also recorded at different time points.The bioluminescent intensity of fluoresce in the wounds was recorded at different time points by using the charge-coupled device (CCD) based imaging system.Local wound tissues were incised at 24 hours after inoculation for HE staining so as to observe wound inflammatory reaction in each group.Wound healing time of each group was also recorded. Results ( 1 ) Average weight:Groups A and B showed unobvious changes in weight; Group C lightened until day 3 after inoculation and then recovered gradually to the preinoculation level at day 14; Group D lightened gradually until death.(2)Mortality:Groups A and B had no death; Group C had 10％ deaths at day 14; Group D had 100％ deaths.(3) Bioluminescent intensity of wounds:Groups A and B showed a gradual weakened luminescence since the day of inoculation and had almost complete disappearance at days 5 and 7 respectively; there was no sign of obvious increase or decrease in Group C from the day of inoculation till day 14 ; Group D had a gradual increase since the day of inoculation and the luminous area expanded until the death.(4) HE staining at 24 hours after inoculation:all the four groups showed inflammatory cell infiltration,especially in Groups C and D.(5) Wound healing time:wound healed at days 5 and 7 after inoculation in Groups A and B; the wounds showed no healing even at day 14 in the Group C,but the wounds length and area did not show obvious enlargement or diminishment ; the wounds extended gradually until the death in the Group D,since the day of inoculation. Conclusions The inoculation of 50 μl suspension with 1 × 108 CFU/ml bioluminescent MRSA to full-thickness skin incision rats allows direct,real-time dynamic and continuous detection of the occurrence and development of the wound infections.The infection model is easy to make and has stability and high repeatability.