目的探讨麻风性并发性白内障摘除术的并发症及其处理方法。方法回顾性分析8例(13眼)麻风性并发性白内障摘除术的病例资料。结果 11眼视力改善;术中出现虹膜裂伤、晶状体前囊膜破裂、玻璃体溢出等;术后出现角膜混浊、球结膜缝线拆除后裂开、慢性虹膜睫状体炎急性发作、慢性进行性虹膜炎、瞳孔上移和瞳孔区出现膜状物等并发症。结论麻风性并发性白内障摘除术易出现多种并发症,可做相应处理加以避免。

OBJECTIVE To explore the risk factors in aged patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies. METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed. RESULTS Totally 155 VAP of elderly patients had serious underlying diseases,and treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were mutiple-resistant. CONCLUSIONS The prevention of VAP was in priority for control of VAP patients.In order to control the occurrence and spread of VAP,clinicians should cut the time of ventilator,pay more attention to sterilization and isolation,and strengthen the tend of the patients.

Objective To investigate the value of ultrasound-guided Mammotome minimal invasive system in the treatment of breast fibroadenoma.MethodsFrom January 2007 to October 2008,266 benign breast lesions of 183 cases were treated by ultrasound-guided Mammotome minimal invasive system.The diameter of the masses ranged from 4 to 25 mm(≤ 10 mm in 73 cases,10-20 mm in 148,and ≥ 20 mm in 45).ResultsThe 266 lesions in the 183 patients were excised completely by using the Mammotome system.The excision was performed for a mean of 15 times in each case(ranged from 5 to 44 times) with an average operation time of 26 minutes(10 to 60 minutes).No complication was found after the surgery except slight subcutaneous ecchymosis in 2 cases.The length of the incisional scar,which was not apparent,ranged from 2.5 to 4 mm.The 183 cases were followed up by ultrasonography for 2 to 22 months(mean,12 months),during which their BI-RADS scales ranged from Ⅰ to Ⅱ,no local recurrence was found.ConclusionsUltrasound-guided Mammotome minimally invasive system is feasible for total resection of breast fibroadenoma with appropriate sizes.The technique leads to fewer complications and good cosmetic results.Further studies on the system are necessary for the treatment of multiple breast fibroadenomas.

Objective To evaluated the effect of special nursing after coronary intervention in elderly.Methods 142 cases of consecutive patients with coronary artery disease were treated with percutaneous coronary intervention.According to the nursing models,the patients were divided into special nursing group(86 case) and routine nursing group(56 case).Results The incidence of aypnia,dysphoria,hospital onset of infection or other complication after intervention in special nursing group was less than that of routine nursing group.Conclusion The special nursing may accelerate the recovery of the old patients with coronary artery disease after coronary intervention.

OBJECTIVE To intensify the management of the nursing in operating room and to prevent and control nosocomial infection. METHODS During the course of the management of nosocomial infection in operating room,the causation of nosocomial infection was found through analyzing the possible tache of nosocomial infection and a series of relevant measures were taken to improve the control of nosocomial infection in operating room. RESULTS The management system of nosocomial infection in operating room was intensified and nosocomial infection in operating room was controlled effectively. CONCLUSIONS The establishment of the effective system and measures of nosocomial infection in operating room have an important effect on the improvement of the management of the nursing operating room and the control of nosocomial infection.

Objective To study the change of postprandial triglyceride (TG) concentrations after a high-fat meal in patients with coronary heart diseases (CHD), patients with essential hypertension (EHP) and healthy controls, and to explore the optimal time point to measure postprandial TG metabolism. Methods Fifty-four CHD patients, thirty-six EHP patients and twenty-five healthy controls were recruited. The concentrations of serum TG in fasting state and at 2, 4, 5, 7 h after a single high-fat meal (800 kcal, including 50 g fat) were measured. Results The postprandial serum TG concentrations increased significantly at 2, 4, 5 h point in all subjects (all P

Objective:To evaluate the efficacy of Epstein-Barr nuclear antigen 1/immunoglobulin A (EBNA1/IgA), BamH1 Z transactivator/IgA (Zta/IgA), capsid antigen/IgA (VCA/IgA), and Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) in detecting different stages of na-sopharyngeal carcinoma (NPC). The relationship between the EBV markers and stages of NPC was also analyzed. Methods:Blood sam-ples of 152 untreated patients with NPC and 675 healthy subjects were collected.ELISA was used to detect the serum levels of EBNA1/IgA, Zta/IgA, and VCA/IgA. Fluorescence quantitative PCR (FQ-PCR) was used to detect the plasma levels of EBV-DNA. ROC and correla-tion analyses were employed to assess the detection assays for NPC diagnosis. The positive rates of EBV markers in NPC patients in dif-ferent stages were analyzed statistically. Results: The positive rates of EBNA1/IgA, Zta/IgA, VCA/IgA, and EBV-DNA in NPC patients were higher than those in the healthy individuals. The expression of EBNA1/IgA was relatively high in early NPC. The sensitivity of EB-NA1/IgA was 77.8%. In advanced NPC, the level of EBV-DNA was high, and the sensitivity of EBV-DNA was 88.8%. The specificity of EBV-DNA and EBNA1/IgA could reach more than 96%. The combination of EBV-DNA and EBNA1/IgA showed the best diagnostic value, with a sensitivity of 92.1%(early stage 82.5%, advanced stage 98.9%) and a specificity of 96.9%. The positive rates of EBV-DNA were positively associated with the NPC clinic stage and N stage. The positives rates of Zta/IgA were positively associated with the NPC N stage. Conclusion:The best single index for NPC screening in an asymptomatic population is EBNA1/IgA. EBV–DNA is an ideal index for auxiliary diagnostics of advanced NPC. The combination of EBV-DNA and EBNA1/IgA shows the best diagnostic value. EBV-DNA is an important index in the stage and illness monitoring of NPC. Zta/IgA can indirectly reflect the character of lymph node metastasis, and it may be useful in assessment of NPC surveillance.

The clinical features of Lophomonas blattarum infection in 26 patients with bacterial pneumonia were analyzed.Common manifestation included fever,cough and breathlessness.Computed tomography(CT)showed interstitial change and alveolar exudation.The parasites were found in sputum smear and from the bronchoalveolar lavage fluid(BALF).Metronidazole was effectively used to cure the pulmonary infection of L.blattarum.

Objective To observe the possible anti-inflammatory and anti-angiogenesis effects of iguratimodon human synovial fibroblast cell line MH7A derived from patients with rheumatoid arthritis (RA).Methods MH7A cells were stimulated with interleukin (IL)-1β and treated simult aneously or sequenti-ally with different concentrations of iguratimod and methotrexate (MTX).Release of vascular endothelial growth factor (VEGF), endostatin (ES) and tumour necrosis factor-α (TNF-α) was quantified by enzyme linked immunosorbent assay (ELISA).The statistics software SPSS 13.0 was used for statistical analyses.The experimental data were analyzed in terms of variance analysis and LSD test.In all cases, a P value lower than 0.05 was considered significant.Results The concentrations of VEGF, ES and TNF-α of the control group were (57±98) pg/ml, (924±39) pg/ml, (16.40±6.08) pg/ml respectively, while those of the experimental group were (1 155±177) pg/ml, (295±35) pg/ml and (36.90±3.54) pg/ml respectively.The differences of VEGF (t=9.092, P＜0.01) and ES (t=19.685, P＜0.01) between the control group and the experimental group was statistically significant.There was significant difference in the levels of TNF-α between the two groups (t=2.495, P＜0.05).VEGF of the iguratimod groups was (640±127) pg/ml in the iguratimod group (100 μmol/L), (787±172) pg/ml in the iguratimod group (25 μmol/L), and (776±99) pg/ml in the iguratimod group (6.25 μmol/L).VEGF of the MTX groups was (1 322±264) pg/ml in the MTX group (100 μmol/L), (1 071±63) pg/ml in the MTX group (25 μmol/L), and (863±70) pg/ml in the MTX group (6.25 μmol/L).All concentration of the iguratimod groups could effectively reduce the expression of VEGF in MH7A cells.Compared with the experimental group, the difference was statistically significant (100 μmol/L group: t=4.264, P＜0.01;25 μmol/L group: t=3.045, P＜0.01;6.25 μmol/L group: t =3.132, P ＜0.01).MTX (6.25 μ mol/L) could reduce the expression of VEGF in MH7A cells.Compared with the experimental group, the difference was statistically significant (t=2.415,P＜0.05).ES of the iguratimod groups was (979±30) pg/ml in the iguratimod group (100 μmol/L), (842±14)pg/ml in the iguratimod group (25 μmol/L), and (485 ±72) pg/ml in the iguratimod group (6.25 μmol/L).ES of the MTX group was (934±23) pg/ml in the MTX (100 μmol/L) group, (825±28) pg/ml in the MTX group (25 μmol/L), and (772 ±44) pg/ml in the MTX group (6.25 μmol/L).Both iguratimod and MTX groups effectively increased the expression of ES in MH7A cells.Compared with the experimental group, the difference was statistically significant (100 μmol/L group: t=21.387, P＜0.01;25 μmol/L group: t=17.122,P＜0.01;6.25 μmol/L group: t=5.929, P＜0.01).The expression of ES of the iguratimod group (100 μmol/L)and iguratimod group(25 μmol/L) was higher than that of the iguratimod group (6.25 μmol/L).The difference was statistical significant(100 μmol/L group: 6.25 μmol/L group was t=15.458,P＜0.01;100 μmol/L group: 6.25 μ mol/L group was t=11.193, P＜0.01).The expression of ES of the iguratimod group(6.25 μmol/L) was lower than that of the MTX group (6.25 μmol/L).The difference was statistically significant (t=9.001, P＜0.01).TNF-α was (4.73 ±1.15) pg/ml in the iguratimod group (100 μmol/L), (4.40±2.65) pg/ml in the iguratimod group (25 μmol/L), and (4.40±0.10) pg/ml in the iguratimod group (6.25 μmol/L).TNF-α of the MTX groups were (4.40±3.61) pg/ml in the MTX group (100 μ mol/L), (13.40±16.46) pg/ml in the MTX group (25 μmol/L),and (21.73±16.50) pg/ml of the MTX group (6.25 μmol/L).Both the iguratimod groups and the MTX group (100 μmol/L) effectively reduced the expression of TNF-α in MH7A cells.Compared with the experimental group, the difference was statistically significant(100 μmol/L group: t=3.914, P＜0.01;25 μ mol/Lgroup: t=3.955,P＜0.01;6.25 μ mol/L group: t=3.955, P＜0.01).Theexpression of TNF-α of the MTX groups (100 μ mol/L and 25 μmol/L) reduced significantly.Compared with the experimental group, the difference was statistically significant (100 μmol/L group: t=3.955, P＜0.01;25 μmol/L group: t=2.859, P＜0.05).The expression of TNF-αof the iguratimod group (6.25 μmol/L) was lower than that of the MTX group (6.25 μmol/L).The difference was statistical significant (t=2.359, P＜0.05).Conclusion Iguratimod presents strong anti-inflammatory and antiangiogenesis properties.This study provides insight into the possible molecular mechanisms of iguratimod and suggests that it can be a medication for the treatment of chronic inflammatory diseases like RA.

Objective To get the facts on lifestyle and bone mineral density among the community residents who are above 40 years old in Nanchang,therefore to offer reference for prevention and treatment to the community residents with abnormal bone mineral density.Methods Use Ultrasound bone mineral density detection instrument to detect the calcaneus mineral density among 10 002 community residents who were over 40 years old.The results can be classified as normal,osteopenia and osteoporosis.A questionnaire survey was conducted among all interviewees.The questionnaire consisted of basic information,general situation,lifestyle,height,weight,waistline,hipline.The body mass index was calculated.The relationship between bone mineral density and smoking,drinking,milk,sodas,sports,etc was analyzed.Results As to osteoporosis,the morbidity of male patients was 6.8％,and that of female patients was 10.4％,as to osteopenia,the morbidity of male patients was 43.8％,and that of female patients was 39.7％.Male smokers' morbidity of abnormal bone mineral density was high,there were no significant differences among the groups,female smokers' morbidity of abnormal bone mineral density was low,there were significant differences among the groups.Drinkers' morbidity of abnormal bone mineral density was low,there were no significant differences among the groups;People taking milk and sodas,taking more exercises suffered from lower morbidity of abnormal bone mineral density,there were significant differences among the groups.Conclusions Female,the elderly,povertyin movement,low intake of milk result in high morbidity of abnormal bone mineral density,while the influence of drinking and smoking on abnormal bone mineral density requires further research.