Actins ; metabolism ; Adenoma ; metabolism ; pathology ; Aged, 80 and over ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Leiomyoma ; metabolism ; pathology ; Smooth Muscle Tumor ; metabolism ; pathology ; surgery ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; surgery ; Thyroidectomy ; Vimentin ; metabolism

Objective To analyze the cost-effectiveness of integrated pharmaceutical care (IPC) in community-based patients with chronic obstructive pulmonary disease (COPD).Methods The COPD patients were divided randomly into intervention group (group A,n =79) and control group (group B,n =71).Group A received the IPC intervention measures,including serial lectures of pharmaceutical knowledge,home supervision and web-based communications for while group B group had none.Results As compared with group B,group A obviously improved on the knowledge of pharmaceutical treatment effect and side effect (95.1％,67.4％ vs.63.1％,21.9％,x2 =12.445,P=0.000 vs.x2 =55.557,P=0.000).There were notable differences between two groups [ ( 1.77 ± 1.23 ) vs.( 2.42 ± 1.66 ) s,t =2.583,P=0.011],pulmonary rales [ (0.01 vs.0.01)s,Z =2.370,P=0.018],6-min walk distance (6 MWD) [ (457 ± 67 ) vs.(425 ± 72) m,t =2.760,P =0.007 ],vital capacity ( VC ) [ ( 1.60 ± 0.25 ) vs.( 1.49 ± 0.23 ) L,t =2.718,P =0.007 ) ] andquality-of-life items ( 48 ± 10 vs.52 ± 11,t =2.624,P =0.010) after intervention.Analyze of cost-effectiveness show that groupA was superior to group B [ total effect total cost(TE/TC =764.6/4936,15.49％ )vs.(TE/TC =1509.4/4708),32.06％,x2 =6.183,P ＜ 0.01 ].Conclusion IPC can improve the disease condition and achieve excellent cost-effectiveness for community-based COPD patients.

AIM:To discuss the related factors that affected the stability of posterior corneal surface after laser in situ keratomileusis ( LASIK) .
METHODS:About 64 patients (64 eyes) were enrolled. The correlation among the changes in posterior corneal surface 6 month after LASIK, surgery method, corneal flap thickness ( FT ) , ablation thickness ( AT ) , postoperative residual corneal stroma thickness ( RCST ) , preoperative thinnest corneal thickness ( CT ) , flap thickness/preoperative thinnest corneal thickness ( FT/CT ) , ablation thickness/preoperative thinnest corneal thickness ( AT/CT) , postoperative residual corneal stroma thickness/preoperative thinnest corneal thickness ( RCST/CT) , anterior and posterior preoperative corneal height, the difference of the forward shift in posterior corneal surface ( diff value ) of preoperative and preoperative intraocular pressure were analyzed.
RESULTS: The changes of diff value between preoperative and postoperative were related with diopter (r=0.419, P=0.014), AT (r=0.394, P=0.023), AT/CT (r=0.501, P=0.004), Diff value of preoperative (r=0.501, P=0. 004), RCST (r=-0. 385, P=0. 033) and RCST/CT (r=-0. 401, P=0. 025). The changes of height value from posterior corneal surface between preoperative and postoperative were related with diopter (r=0. 520, P=0. 002), AT (r=0.504, P=0. 003), AT/CT (r=0. 442, P=0. 013), Diff value of preoperative (r=0. 624, P=0. 000) and RCST/CT (r=-0. 394, P=0. 028).
CONCLUSION: AT, RCST, AT/CT, RCST/CT and diff value of preoperative should be the key index that predicted the stability of posterior corneal surface after LASIK,the further research will give the range of safety value.

Animals ; Cardiomyopathy, Dilated ; metabolism ; Connexin 43 ; metabolism ; Disease Models, Animal ; Hypericum ; Male ; Plant Extracts ; pharmacology ; Rats ; Rats, Wistar

Biomarkers ; metabolism ; Cholesterol ; metabolism ; Coronary Disease ; Humans

Objective To evaluate the curative effect,safety and feasibility of interventional therapy for biliary restenosis occurring after surgical T-tube drainage.Methods The clinical data of 25 patients with biliary restenosis that occurred after surgical T-tube drainage,who were admitted to authors' hospital during the period from June 2014 to March 2016,were retrospectively analyzed.The primary diseases included bile duct carcinoma (n=6),gallbladder carcinoma (n=3),biliary stone (n=13),hepatocellular carcinoma (n=2)and gastric cancer after surgery (n=1).Abnormal junction of pancreatic duct and biliary duct was observed in 4 patients.Interventional procedure via T-tube route was carried out in 22 patients,and T-tube radiography with subsequent percutaneous transhepatic cholangial drainage (PTCD) was conducted in 3 patients.Biliary balloon expansion combined with biliary drainage was performed in 21 patients,and biliary metal stent implantation was adopted in 4 patients.For patients with benign biliary stricture,the drainage tube was retained for 2-3 months before it was removed.All the patients were followed up for 3-24 months at outpatient clinic or by the telephone.The curative effect was evaluated with drainage-tube radiography.Results The interventional operation was successfully accomplished in all patients,no procedure-related complications occurred,the technical success rate was 100％.In 15 patients with benign biliary stricture,biliary plasty with balloon expansion via the T-tube fistula was conducted,then a 10.2-12 F drainage catheter was placed in the biliary tract and the T-tube was pulled out.During the follow-up period,one patient with anastomotic stricture of bile duct carcinoma died of pulmonary infection at 8 months after treatment.Of the 10 patients with malignant stricture,the biliary obstruction was located above the T-tube level in 3,and all the 3 patients received PTCD.Among the 3 patients,2 patients had hepatocellular carcinoma complicated by biliary invasion,as the extent of the cancerous thrombus was very large,both internal drainage tube and external drainage tube had to be implanted.After jaundice regression,the two patients died of hepatic failure at one month and 2.2 months after the operation respectively.One patient with gallbladder carcinoma complicated by invasion of bile duct received implantation of biliary stent,and the patient died of tumor deterioration at 2.5 months after the procedure.In 7 patients,the biliary obstruction was located below the T-tube level.hnplantation of internal drainage tube and external drainage tube via the Ttube fistula was performed in 4 patients,and implantation of metal stent was adopted in 3 patients.Among them,2 patients with gallbladder carcinoma died of tumor deterioration at 3.8 months and 5 months after the operation respectively.In 5 patients with cholangiocarcinoma,biliary stent restenosis occurred in 2 at 3 months after the treatment,and PTCD was adopted.Three patients died of tumor deterioration complicated by organ function failure at 3.6 months,5.2 months and 9.0 months after the operation respectively.Conclusion For the treatment of biliary restenosis occurring after surgical T-tube drainage,interventional therapy is safe and feasible with reliable curative effect,it can significantly improve the life quality of patients.

Forty type 2 diabetic patients with diabetic peripheral neuropathy (DPN) were assigned to two groups and treated respectively with?-lipoic acid or mecobalamin for 2 weeks.The results suggested that?-lipoic acid could accelerate the nerve conduction velocity and decrease the plasma level of endothelin and C reactive protein as well as microalbuminceria with a effect similar to mecobalamin therapy on DPN.

Background The surgery for congenital idiopathic nystagmus has make great progression recent year,but the influence of surgery on visual function is closely concerned.Objective This work was to study the surgeries for congenital idiopathic nystagmus with or without strabismus and explore the effect of horizontal rectus muscle surgery on the visual function and ocular movement in congenital idiopathic nystagmus.Methods This was a case-observational study.Sixty cases with idiopathic congenital nystagmus were enrolled assigned to four groups as follows:The patients of group Ⅰ appeared the head postures of less than 15 ° and heterotropia less than 15△underwent extraocular proprioceptiou resection,and those of group Ⅱ presented with the head postures of less than 20° and heterotropia more than 15△ underwent extraocular proprioception resection and stabismus surgery.In the group Ⅲ,the patients had the head postures of more than 15° and heterotropia less than 15△ underwent Park's surgery and part of them underwent extraocular proprioception resection) and the cases in group Ⅳ were selected with the head postures of more than15° and heterotropia more than 15△ underwent Park' s surgery and strabismus surgery ( part of them underwent extraocular proprioception resection).Baseline and follow-up evaluations included the best distance and near corrected visual acuity,head posture,ocular movement and Titmus stereotest.The examination results were compared between before and after operation.Results One year after operation,monocular and binocular distance visual acuity improved significantly in all four groups ( monocular:t =6.00,8.94,11.76,16.41,P =0.00 ; binocular:t=4.81,P=0.01 ; t =6.27,4.25,4.18,P =0.00 ),but monocular and binocular near visual acuity improved significantly only in groups Ⅲ and Ⅳ after operation compared with before operation ( monocular:t=2.91,P=0.01 ; t =5.32,P =0.00 ; binocular:t =3.36,t =4.30,P =0.00 ).The compensatory head posture from 39 subjects was disappeared after operation,showing an evident difference between before and after surgery ( group Ⅲ:t =29.90,P=0.00;group Ⅳ:t=16.91,P=0.00).Strabismus were corrected rightly for 24 patients and undercorrection for 2 patients.( group Ⅱ:t =29.15,P =0.00 ; group Ⅳ:t =36.79,P =0.00 ).The binocular visual function of 23 cases with the age below 12 years were improved throughout the follow up duration ( t =12.06,P =0.00).Conclusions Park' s surgery,extraocular proprioception resection and strabismus corrective operation can improve the visual function and head posture in congenital idiopathic nystagmus patients.

Objective To summarize the features of esophageal hiatus hernia (EHH) on contrast-enhanced ultrasound (CEUS) and investigate the diagnostic value of CEUS in EHH.Methods A retrospective analysis of 88 EHH patients and 50 healthy controls was conducted with focus on their findings on CEUS.Results The structures of the cardiac and abdominal esophagus were clear in 50 healthy controls,and the esophageal hiatus diameters were (1.96±0.39) cm.In contrast,the cardiac and abdominal esophagus in EHH patients were unable to be identified in subdiaphragm region.The esophageal hiatus was wider with a diameter of (3.24±0.76) cm.The difference was statistically significant(t=2.36,P＜0.05).The hernia sacs were found in 78 EHH patients at rest.And the hernia sacs were present on the diaphragm in 10 EHH patients after pressure.The maximum diameter of hernia sac was 7.6 cm.The size of hernia sac may change with abdominal pressure.In sliding EHH patients,the sac wall was found to slide up and down the diaphragm.A mass was found on the wall in 2 patients.The B ring was present in 76 patients.For healthy controls in supine position,contrast-enhanced ultrasound showed that the gastric bottom and diaphragm were at dependent or horizontal position.The gastric bottom and diaphragm was upward in 73 patients.Conclusions The EHH has characteristic appearance on CEUS.It is easy to detect and diagnose EHH with CEUS,which has a diagnostic value in detection of space-occupying lesions in hernia sac.CEUS can be used for EHH screening.

Background Congenital nystagmus is a common disease threatening visual function.The clinical description of congenital nystagmus is still not enough now. Objective The aim of this study was to report the motor and sensory characteristics of congenital nystagmus. Methods A retrospective clinical case analysis was designed.The clinical data of 376 patients with congenital nystagmus were collected.These patients were diagnosed in Henan Eye Institute from January,2005 to August,2011.The clinical characteristics of patients,including age,pedigree analysis,nystagmus classification,ocular alignment,visual acuity,refractive error,stereoacuity and oscillopia,was summarized.Informed consent from all patients and custodian were obtained. Results The age distribution of most patients was ＞5-10 years and ＞ 15-20 years,with the percentage 24.73％ and 24.20％,respectively.Of 376 patients,sensory defect nystagmus was 172 cases,and that of motor sensory defect was 204 cases.The most common inheritance pattern was autosomal dominant.Conjugate uniplanar horizontal oscillations were found in 73.94％patients,and strabismus was found in 66.36％ in this study.Sensory defected subjects did not show a statistically significantly higher strabismus incidence when compared with the idiopaths (x2 =3.048,P =0.081 ).The binocular distance vision in all the subjects was declined in comparison with normal eyes,the best corrected vision was 0.27 ±0.11 and 0.50± 0.13 in sensory defected nystagmus and idiopaths nystagmus respectively,showing a significant difference( t =16.495,P =0.000 ).The incidence of refractive error in this study was 77.62％.Incidence of astigmatism(75.17％ ) was higher than that of myopia and hyperopia ( 39.03％ and 36.12％ ).No significant difference was seen in refractive error incidence between the sensory defected and the idiopaths (x2 =1.337,P =0.248).Patients of 65.18％ displayed non-stereoacuity or very gross acuity levels (3000) in this study,and the patients with idiopathic nystagmus showed better stereoacuity level in comparison with sensory defected ones (x2 =7.058,P =0.008 ).Five of 313 patients existed experienced oscilopla under binocular viewing conditions.Conclusions Autosomal dominant inheritance is the most common pattern of congenital nystagmus.Conjugate uniplanar horizontal oscillation is thought to be a common type of nystagmus.Incidence of strabismus is higher,and visual acuity and stereoaeuity are worse in congenital nystagmus than in common population.Oscillopia is seldom found in congenital nystagmus.