AIM:To explore the cataract suspensory ligament rupture and artificial lens implantation suture fixation into capsular bag without capsular tension ring(CTR).METHODS:We reviewed 20 cases of 20 cataract suspensory ligament rupture without CTR intraocular lens (IOL) implantation fixation in our department from Jan.2012 to Dec.2016.The needle crossed into ocular ciliary sulcus, in the equator of the eye ball which suspensory ligament rupture from, then the needle crossed out 1.5mm away from the angle of sclera.Sutures fixed on the IOL, then the artificial lens implantation in the pouch, carried out in accordance with the Z type suture, or to the beforehand prepared triangle scleral flap.The visual acuity, intraocular pressure, the anterior chamber and the IOL position were measured after operations.RESULTS:All of the postoperative visual acuity improved different level.The postoperative best corrected visual acuity(BCVA) was ≥0.8 in 4 eyes(20%), 0.5-0.6 in 7 eyes(35%), 0.3-0.4 in 8 eyes(40%), 0.1 in 1 eye(5%) because of the glaucoma optic atrophy.There were 12 cases with mild corneal endothelium edema, 4 cases exudation membrane in the pupil area, 2 cases hyphema, all of which recovered after treatment.There were 2 eyes with vitreous prolapse in the pupil, 1 case appeared mild IOL center deviation and no special treatment for the vision did not be involved.Followed up for 6mo, displaced stitches or artificial lens shift did not occur.CONCLUSION:Without CTR, the IOL implantation and suture fixation in capsular bag during cataract surgery is a surgical method for basic-level hospitals.

In the health service field,health resources and health service supple capacity were related with the resource and capacity in economics.Health resources,health service supple capacity and their relationships were important factors for the cooperation and benign interaction of hierarchical medical institutions.However,inversion of health resources and health dislocation of service supply capacity exacerbated the agglomeration degree of patients in the tertiary medical institutions under the impact of residents' freely searching for medical service concept.Vicious interaction and mutual competition among hierarchical medical institutions had become an important obstacle for the implementation of hierarchical medical services.Therefore,its mechanism needed to be clarified while the corresponding policy recommendations should be proposed.

Objective To establish a method for the determination of alum residual amount in Rhizoma Pinelliae Preparata from different companies,and to provide a scientific evidence for quality evaluation of Rhizoma Pinelliae Preparata.Methods Na2EDTA titration method was applied for the quantitative analysis.Results There were obvious differences in residual quantity of alum in Rhizoma Pinelliae Preparata from different companies.Conclusion The method is simple,reproducible and accurate,it can be used for the determination of alum residual amount in Rhizoma Pinelliae Preparata.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.

Translational medicine has been on the rise for 20 years as a new model of biomedical research,which plays a positive role in narrowing the gap between basic research and clinical medicine and in development of medical sciences.This paper traced back the milestones of translational medicine,and analyzed the hurdles for China to develop translational medicine,namely the organization system,management model and benefit sharing.On such basis,the authors recommended on the development and strategy,especially in clinical medical institutions in China.

Objective:Dysmenorrhea is the common gynecological problem among adolescent girls and women of reproductive age. This study aim to develop a dysmenorrhea Quality of Life (QoL) scale based on Traditional Chinese Medicine (TCM) theory.Methods:We conducted focus group discussions and in-depth interviews with TCM gynecologists and patients, and adapted items from previously published scales. We generated an initial pool of 41 items with 8 domains. Delphi method was used to item preliminary selection. Then, we administered the items to a sample of adolescent girls ( n=200), and the distribution of survey items, discrete trend, factor analysis, correlation coefficient, Cronbach’s α coefficient were used to select items. Results:After two rounds of Delphi, a total of thirty items were included in the dysmenorrhea QoL scale. The expert positive coefficient were 100% and 83.3% with high motivation. The authoritative coefficient were greater than 0.7, the results showing authoritative and reliable. The Kendall’s coefficient of concordance W was 0.333 ( χ2=128.271, P<0.001). In sample analysis, the items were deleted when they met more than two standards. The final scale retained 20 items, covering 8 dimensions. Conclusions:The methods for selection of dysmenorrhea QoL scale based on TCM theory were preferable. Given the paucity of research in this area, this new dysmenorrhea QoL scale may provide opportunities for the patient-reported outcome (PRO) evaluation in the field of TCM.

Object To optimize the preparation procedure for WEI'AN GRANULES Methods The optimum conditions of WEI'AN GRANULES were selected with the active components: magnolol, polysacchride of Rhizoma Atractylodis Macrocephalae and berberine hydrochloride as mark by orthogonal test Results The optimum preparative procedure was as follow: Cortex Magnoliae officinalis and Fructus Aurantii Immaturus were extracted with water and precipitated with alcohol (adding 20 fold water as much as medicine, extracting three times, 0 5 h per time and precipitated with 95% alcohol to remove impurities); Rhizoma Coptidis was extracted with 95% alcohol by refluxing; Rhizoma Atracylodis Macrocephalae and other herbs were extracted with water (adding 24 fold water as much as medicine, extracting twice, 2 h per time, its granule size of Rhizorna Afracylodis Macrocephalae was 2 mm to 4 mm) Conclusion The optimum preparative procedure is reliable and the extracting ratio of active component is high

Objective To explore the safety and effectiveness of transurethral resection of the prostate (TURP) for large benign prostatic hyperplasia.Methods A total of 56 cases of patients with large benign prostatic hyperplasia were analyzed retrospectively.Results The weight of prostate tissue resected with TURP was 60.2 g (48-122 g).The resection rate was 60％,operation time 113.4 min (70-180 min).The lower urinary tract symptoms (LUTS) after TURP was improved significantly.The international prostate symptom scores (IPSS) of 38 cases were decreased from (25.6±1.5) before operation to (6.0± 2.0) after operation.The maximum urine flow rate were increased from (5.0±1.9) ml/s to (18.0±4.5) ml/s.The mean residual urine volume of 22 cases were reduced from 95 ml (40-250 ml) to 10 ml (0-60 ml).Conclusions Skilled TURP technology for large benign prostatic hyperplasia is a safe treatment with good effect and low complications rates.

Objective To evaluate the blood-saving effect of combination of hemocoagulase artox for injection and tranexamic acid (TXA) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Eighty ASA Ⅱ patients (NYHA Ⅰ or Ⅱ),aged 50-70 yr,weighing 50-100 kg,scheduled for elective OPCABG,were randomly divided into 4 groups (n =20 each):control group (group C),hemocoagulase atrox for injection group (group H,n =20),TXA group (group T) and hemocoagulase atrox for injection + ·TXA group (group HT).Hemocoagulase atrox 0.04 U/kg (the highest dose 4 U) was injected at 20 min before skin incision,and additional hemocoagulase atrox 2 U was given every 2 h starting from 15 min after administration of protamine until the end of operation in group H.TXA 20 mg/kg was injected intravenously at skin incision,followed by a continuous infusion of TXA at 10 mg· kg-1 · h-1 until the end of operation in group T.Hemocoagulase atrox and TXA were given as the method described in groups H and T.Venous blood samples were taken from the central vein before operation,at the end of operation,and 24 h after operation to determine the plasma D-Dimer concentration.The amount of blood loss,allogeneic red blood cells and plasma infused during operation,volume of drainage during 0-6 and 6-24 h after operation,total volume of drainage and volume of allogeneic blood transfused during operation were recorded.The deep vein thrombosis was recorded.Results Compared with group C,the amount of blood loss during operation was significantly decreased in groups T and HT,and the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in groups H,T and HT (P ＜ 0.05).Compared with groups H and T,the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in group HT (P ＜ 0.05).No deep vein thrombosis was observed in the 4 groups.Conclusion The combination of hemocoagulase artox for injection and TXA provides better blood-saving effect than either alone for the patients undergoing OPCABG without increasing the risk for thrombosis.

Object To investigate the features of health related quality of life ( HRQOL) among elderly hypertensive patients with different body mass index (BMI) so s to provide evidence for the health promotion of hypertensive. Methods A cross-sectional survey of health status data from a population of 1281 elderly hypertensive patients from Beijing and 8 provinces of China ( Jiangsu, Anhui, Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan) was made in the study. Analysis of variance was applied to compare the differences in HRQOL of elderly hypertensive patients in different BMI categories. Results For the elderly hypertensive patients with low body mass index, the scores of 8 dimensions and scores in physical component summary (PCS) and mental component summary( MCS) of SF-36 were the lowest;except the role-emotional(RE) dimension,the scores of other 7 dimensions,PCS and MCS were significantly different(PF,RP,BP,GH,VT,MH, P<0.01; SF,PCS,MCS, P<0.01). Comparing the scores between any two groups in PCS, the scores of patients with low body mass index were significantly lower than normal weight group (62.30 ± 22. 12 vs72.40 ±20.86, P<0.05) .overweight group (62.30 ± 22.12 vs 74.97 ± 19.20, P<0.05 ) and obese group (62.30 ± 22.12 vs 74.57 ± 19. 22, P < 0.05 ). Comparing the scores between any two groups in MCS,the scores of patients with low body mass index were significantly lower than normal weight group (68. 81 ± 20. 48 vs 74. 70 ± 20.41, P < 0. 05), overweight group (68. 81 ± 20. 48 vs 78.08 ±18.23, P<0.05) and obese group (68.81 ±20.48 vs 78. 69 ± 17.77, P<0.05); the score of normal weight group was significantly lower than the overweight group (74. 70 ±20. 41vs 78. 08 ±18.23, P<0.05). Gender Stratification showed that females with low body mass index had worse HRQOL than males. Conclusion The HRQOL of elderly hypertensive patients with low body mass index is significantly lower than normal weight patients, overweight patients and obese patients, the health promotion of elderly hypertensive patients with low body mass index should be paid more attentions, especially females with low body mass index.