AIM: To compare the effects of different surgeries in the treatment of angle closure glaucoma with cataract and the improvement of quality of life.METHODS: The clinical data of 60 cases (60 eyes) with angle closure glaucoma and cataract who were admitted to the hospital between January 2014 and October 2016 were collected.According to the surgical method, they were divided into the control group (simple trabeculectomy, n=28) and the observation group (trabeculectomy combined with phacoemulsification and intraocular lens implantation, n=32).The changes of visual acuity and intraocular pressure before and after surgery were compared between the two groups.The incidence of postoperative complications was statistically analyzed, and the quality of life was compared between the two groups.RESULTS: Before surgery, there was no significant difference in visual acuity, intraocular pressure and anterior chamber depth between the two groups (P>0.05).At 4wk after surgery, the visual acuity of two groups increased and intraocular pressure decreased.The anterior chamber depth of observation group increased while that of the control group decreased (P<0.05).At 4wk after surgery, the visual acuity and anterior chamber depth of observation group were higher than that of the control group but intraocular pressure was lower than that of control group (P<0.05).The success rate of surgery and the opening rate of chamber angle after surgery in the observation group were higher than those in the control group (P>0.05).The incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05).Before surgery, there was no statistically significant difference in quality of life score between the two groups (P>0.05).At 4wk and 3mo after surgery, the scores of the two groups increased (P<0.05), and the quality of life scores of observation group were higher than those of the control group at different time (P< 0.05).CONCLUSION: The success rate of trabeculectomy combined with phacoemulsification and intraocular lens implantation is high in the treatment of angle closure glaucoma with cataract.The regimen can improve the visual function, reduce the incidence of postoperative complications, and improve the quality of life of patients.

AIM:To investigate the changes of visual development produced by monocular atropinization in rats.
METHODS: Twenty normal SD rats were randomly divided into two groups: control group ( n = 10 ) and atropinization ( experimental) group ( n=10 ) . All the left eyes were selected as the experimental eyes, and the right eyes served as the normal eyes. The left eyes in atropinization group was produced by 1% atropine, 3 times a day and the right eyes in control group was treated with normal saline, 3 times a day. The flash visual evoked potentials ( F-VEP ) and retinoscopy refraction of the rats'both eyes were detected at five time points:0, 7, 14, 21, and 28d after atropinization, respectively. After 28d, six rats were randomly selected from both groups and each group had three rats. The expression of the c- fos mRNA was observed in both visual cortexes. Another six rats were chosen for the same test after 2d dark environment with 2h light later. The expression of c-fos mRNA was detected again.
RESULTS: After 14d anisometropia was observed in experimental group, the difference was 3. 9D ( P<
0.0 5 ) , F-VEP P1 wave of the rats left in experimental group was reached to 88. 9±1. 889ms at 21d, there was statistical difference compared with the right eye ( P<0.05). After 28d, c-fos mRNA expression in the left visual cortex of rats in the experimental group was higher than that of the right side, but there was no significant difference. But when underwent 2h light stimulation after in the darkroom 2d, the c-fos mRNA expression in in the left visual cortex of rats in the experimental group was 5 times higher than that of the right side, there was a statistically significant difference (P<0. 05).
CONCLUSION: In the critical period of visual development, monocular chronic atropine in rats can form anisometropia, may delay the transmission of the optic nerve, hinder the normal development of the visual cortex. Monocular atropinization in rats can be used as the model of anisometropia.

This paper reports 17 cases of hypomagnesemic convulsiens of the newhorn that were admitted from Se-Ptember 1981 to January 1983. Only 2 patients were breast-fed.Symptoms and signs of hypomagnesemia are indistinguishable from these of hypocalcemia unless the serum magne-sium is determ ined. Serum magnes iumlevels had been determined in 50 normal children. The average value-2 standard deviation=2.17-2?0.34=1.49mEq/L.We defined hypomagnesemia as the serum magnesium lcvels below 1.48mEg/L. The serum magnesium levels of 17 patients varied from 0.65 to 1.46m Eq/L. Of 10 cases serum calcium le-vel6mg/dl.2.5%MgSO_4 was given intraveno-usly by continuous infusion in a dose of 2-4ml/kg every 12 hours. After the convulsions had been controlled a dose of 25% MgSO_4 was given intramuscul-arly in a dose of 0.4ml/kg twice daily Convulsions usually ceased after 1--4doses of MgSO_4, but the serum magne-sium levels did not rise to normal le-vels until 2-6 days. The convulsions could not be controlled by repeated ad-ministrations of calcium gluconate in 5 patients who had both hypomagnes-emja and hypocalcemia. Only after theadministiation of MgSO_4 did the serum calicum levels rise to the normal level and the convulsions cease.Electrocardjograms recorded in 7 patients all were abnormal but 1 case,so we should pay attention to the inf-luence of magnesium upon the heart.

Development of liver fibrosis is closely associated with angiogenesis and abnormal vascular remodeling. Recent studies have highlighted the importance of angiogenesis and vascular remodeling in fibrogenesis, the results that inhibition of angiogenesis is effective in suppression of liver fibrosis demonstrate that therapies with several molecular targets against angiogenesis, inflammation and fibrosis might be beneficial for the treatment of cirrhosis. However, there is some evidence that inhibition of angiogenesis can even worsen fibrosis. This article outlines recent advances regarding the interplay between inflammation, angiogenesis and fibrogenesis in terms of cellular and molecular mechanisms, and suggests a requirement of greater understanding to intervene in these key processes, such as liver sinusoidal endothelial cell fenestration and impact distinct chemokine actions driving monocyte migration and differentiation, for therapeutic benefit in the future.
Humans ; Inflammation ; therapy ; Liver Cirrhosis ; therapy ; Neovascularization, Pathologic ; therapy ; Vascular Remodeling

Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

0.05).Our data also showed no significant association between the genotypes and the severity of the disease.One-way ANOVA showed that BDNF genotype had no association to the age of onset for developing AD.Conclusions Our results indicate that Va166Met SNP in BDNF gene is not associated with AD.

AIM:To compare the contrast sensitivity obtained through anterior surface modified prolate intraocular lens with the contrast sensitivity obtained through standard spherical intraocular Iens.METHODS:Patients presenting for cataract surgery in one eye were randomized to receive either the Acrysef IQ intraocular lens(AIcon)or the AR40e intraocular lens(AMO).50 eyes after phacoemulsification with IOL implantation were included,23 eyes received Acrysof IQ,and 27 eyes received AP40e intraocular lens (AMO).Contrast sensitivity testing under photopic conditions (85cd/m2)served as the prindpal outcome measure.The contrast sensitivity function was measured with CSV-1000E Vision Testing Instrument(provided by VECTOR ⅥSION COMPANY) at 30 days after surgery.RESULTS:The Acrysof IQ intraocular lens provided statistically significantly better contrast sensitivity at 6,12 and 18 cydes per degree under photopic conditions.CONCLUSION:The use of anterior surface modified prolate intraocular lens for cataract surgery has the potential to improve functional vision.

Objective To discuss the efficacy of application combination Of minimal immunosuppressive drugs in chronic allograft nephropathy after renal transplantation. Methods Data were drawn from the First Hospital of Tsinghua University.From September 1,2004 to July 1,2006,31 cadaver kidney transplantations were performed using triple immunosuppression with tacrolimus(n=31)and MMF plus steroids before using new strategy.The new strategy is Rapamycin+tacrolimus+MMF+Prednisone.The serum ereatinine,GFR(ml/min/1.73 m2)and 24-hours urine protein before and after 12 months of using lOW dose combination of calcineurin inhibitors,MMF,Rapamune,Predsone and Q80 were recorded.During this time,the concentration of tacrolimus,rapamune were monitored as well. Results After 12 months follow-up,the serum creatinine of 28 patients were decreased from(300±21)μmol/L to(215±38)μmol/L.GFR(ml/min/1.73m2)was elevated from 42.54±2.95 to 49.98±3.05.Three patients whose serum creatinine was 416-464μmol/L had to take hemodialysis.The 24-hours urine protein(g)of 31 patients below 0.8 g did not increase urine protein during follow-up.One patient's 24-hours urine protein(g)increased from 0.95 to 1.29.The patient and graft survival rate was 100%(31/31),90.3%(28/31)respectively.The rapamune main side effect was hyperlipidemia. Conclusions Rapamune and low dose Tacrolimus+Myeophenolate Mofetil+Corticosteroid could be a safe treatment.It may improve renal function in chronic allograft nephropathy.

OBJECTIVETo summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.

METHODSThe clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females, aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor, and the muscle strength under tumor plane had decreased at different levels, with the strength of grade II-IV. Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.

RESULTSSix operations had been performed including 5 en bloc and 1 subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation, 1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up, according to ASIA grade, 5 cases were good and 1 case was invariant. During the follow-up, only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.

CONCLUSIONGanglioneuroma is a benign and rare tumors in spine. Clinically, radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganglioneuroma ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Neoplasms ; diagnosis ; surgery

Objective To investigate the optimum ratio of medicine dosage for dexmedetomidine mixed with oxycodone used for patient-controlled intravenous analgesia (PCIA) after gastrointestinal surgery.Methods Eighty patients of both sexes, aged 35-64 yr, weighing 55-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective gastrointestinal surgery, were randomly divided into 4 groups (n=20 each) using a random number table: oxycodone group (group O), and different ratios of medicine dosage when dexmedetomidine was added to sufentanil groups (OD1-3 groups).At 15 min before the end of surgery, oxycodone 0.1 mg/kg was injected intravenously, and PCIA pump was connected simultaneously.In group O, the PCIA solution contained oxycodone 1.00 mg/kg in 100 ml of normal saline.In group OD1, the PCIA solution contained oxycodone 1.00 mg/kg and dexmedetomidine 2.5 μg/kg in 100 ml of normal saline.In group OD2 , the PCIA solution contained oxycodone 0.75 mg/kg and dexmedetomidine 2.5 μg/kg in 100 ml of normal saline.In group OD3, the PCIA solution contained oxycodone 0.50 mg/kg and dexmedetomidine 2.5 μg/kg in 100 ml of normal saline.The PCIA pump was set up to deliver a 0.5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Oxycodone 0.05 mg/kg was injected intravenously as a rescue analgesic, and visual analogue scale score was maintained ≤ 4.The requirement for rescue analgesics was recorded.The requirement for the rescue analgesic was recorded within 48 h after surgery.The number of successfully delivered doses, and occurrence of adverse reactions such as bradyeardia, hypotension, nausea, vomiting, over-sedation, somnolence, pruritus, and respiratory depression were recorded.Patient's satisfaction with analgesia was recorded at 72 h after surgery.Results No patients required the rescue analgesic or developed over-sedation, vomiting, respiratory depression and hypotension in the four groups.Compared with group O, the incidence of somnolence was significantly increased in group OD1, the incidence of nausea, somnolence, bradycardia and pruritus was decreased in OD2 and OD3 groups, and the degree of patient's satisfaction with analgesia was increased in OD1-3 groups (P＜0.05).Compared with group OD1, the incidence of nausea, somnolence, bradycardia and pruritus was significantly decreased in OD2 and OD3 groups, the degree of patient's satisfaction with analgesia was increased in group OD3 (P＜0.05) , and no significant was found in the degree of patient's satisfaction with analgesia in group OD2 (P＞0.05).Compared with group OD2, no significant was found in the incidence of adverse reactions (P＞0.05) , and the degree of patient's satisfaction with analgesia was significantly decreased in group OD3 (P＜0.05).The number of successfully delivered doses was significantly larger in group OD3 than in O, OD1 and OD2 groups (P＜0.05).Conclusion Dexmedetomidine 2.5 μg/kg added to oxycodone 0.75 mg/kg is the optimum ratio of medicine dosage when used for PCIA after gastrointestinal surgery.