To observe the clinic effects and complication of Ahmed glaucoma valve(AGV) implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases ( 44 eyes ) of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure ( lOP ) , visual acuity, and complication of post - operation were contrasted with those of pre-operation.RESULTS:The success rate was 84. 1%, the mean preoperative lOP in research group was 52. 1±10. 1mmHg, and the last follow up mean lOP was 15. 6 ± 6. 9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber ( 4 eyes ) , choroidal detachment ( 3 eyes), drainage tube shift (1 eye), hyphema (6 eyes), drainage tube blockage ( 1 eye ) , expulsive choroidal hemorrhage (1 eye), and fiber wrap of drainage tray (5 eyes) .CONCLUSlON:AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. lt avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. lt is an effective procedure for refractory glaucoma.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Osteoporosis ; drug therapy ; Phytotherapy

OBJECTIVE: To analyze the causes of the esophagogastric junction outlet obstruction (EGJOO) patients, to discuss the differences of the clinical manifestation and esophageal motility characteristics between the anatomic EGJOO (A-EGJOO) and functional EGJOO (F-EGJOO) subgroups, and to search the diagnostic values of the specific metrics for differentiating the subgroups of EGJOO patients. METHODS: For the current retrospective study, all the patients who underwent the esophageal high resonance manometry test were retrospectively analyzed from Jan 2012 to Oct 2018 in Peking University Third Hospital. The EGJOO patients were enrolled in the following research. The clinical characteristics, such as symptoms and causes of the patients were studied. Then the patients were divided into two subgroups as A-EGJOO subgroup and F-EGJOO subgroup. The clinical symptoms and the main manometry metrics were compared between these two subgroups. The significant different metrics between the two groups were selected to draw receiver operating characteristic (ROC) curves and the diagnostic values were analyzed in differentiating the A-EGJOO and F-EGJOO subgroups. RESULTS: The most common symptom of EGJOO was chest pain or chest discomfort (30.63%), then the dysphagia (29.73%), and acid regurgitation/heartburn (27.03%). Non-erosive reflux disease (36.04%) was the most popular cause for EGJOO, then the reflux esophagitis (17.12%). Besides the intra-EGJOO and extra-EGJOO lesions, the connective tissue disease (6.31%) and central nervous diseases (2.70%) were found to be the etiology of EGJOO. The causes of the rest 19 EGJOO were unknown. A-EGJOO patients presented significantly higher intra bolus pressure (IBP) than that of F-EGJOO [6.80 (5.20, 9.20) mmHg vs. 5.10 (3.10, 7.60) mmHg, P=0.016]. The area under curve of IBP was 0.637. When IBP≥5.15 mmHg, the sensitivity was 78.60% and specificity 50.70% to differentiate A- or F-EGJOO. CONCLUSION Chest pain or chest discomfort was the most common symptom in EGJOO patients. Besides the intraluminal structural disorders, the extra-luminal causes were found in EGJOO patients. A-EGJOO presented higher IBP than that of F-EGJOO patients. The cutoff value of IBP to differentiate A-EGJOO from EGJOO was 5.15 mmHg with sensitivity 78.06% and specificity 50.70%. However for the low area under curve, the diagnostic value of IBP was limited.
Deglutition Disorders ; Esophageal Motility Disorders/diagnosis* ; Esophagogastric Junction ; Humans ; Manometry ; Retrospective Studies

Objective To research the infections of respiratory syneytial virus(RSV)in children with respiratory tract inflammation and define its molecular epidemic features in Urumchi.Methods SamDles were collected from November 2006 to April 2007 in the People's General Hospital of Xinjiang Uygur Autonomous Region,including 112 respiratory secretions and 280 nasopharyngeal swabs. RSV and its subgroups were detected by nested PCR.The five positive amplicons selected randomly from all positive samples were sequenced and compared with other RSV in GenBank by BLAST and DNAStar.Results of all 392specimens.68 RSV G gene segments were tested.Among them,RSV lineage A occupied 93.3%,while B occuDied 6.7%.The identities between them were 63.1%-99.4%.Phylogenetic analysis defined that they belonged to two different clusters.Conclusion RSV was one of the important viruses leading to children's respiratory tract infections in the People's General Hospital of Xinjiang Uygur Autonomous Region during winter and spring from 2006 to 2007.RSV subtype A was the prevalent genotype in the hospital dunng this epidemics.

Abstract: Objective　To investigate the distribution and drug resistance characteristics of pathogenic bacteria in patients with neutropenic acute leukemia (AL) and bloodstream infections (BSI). Methods　The clinical data of 258 neutropenic acute leukemia patients with bloodstream infections, who admitted to Shengjing Hospital of China Medical University from January 2016 to December 2021, were collected and analyzed for pathogenic bacteria and drug resistance. Results A total of 268 strains of pathogenic bacteria were isolated from 258 patients, including 180 strains of gram-negative bacteria (67.16%), 61 strains of gram-positive bacteria (22.76%), and 27 strains of fungi (10.07%). Gram-negative bacteria were mainly Klebsiella pneumoniae (53/268, 19.78%), Escherichia coli (49/268, 18.28%) and Pseudomonas aeruginosa (41/268, 15.30%). Gram-positive bacteria were mainly coagulase negative Staphylococcus (31/268, 11.57%) and Staphylococcus aureus(17/268, 6.34%). The main fungi were Candida tropicalis (25/268, 9.33%). Escherichia coli (33/268, 12.31%) was the most common pathogen isolated from acute myeloid leukemia (AML), followed by Pseudomonas aeruginosa (25/268, 9.33%), coagulase-negative Staphylococcus (18/268, 6.72%) and Candida tropicalis (18/268, 6.72%). Klebsiella pneumoniae (35/268, 13.06%) was the most common pathogen isolated from acute lymphoblastic leukemia (ALL),followed by Pseudomonas aeruginosa (15/268, 5.60%) and Escherichia coli (14/268, 5.22%). The resistance of Gram-negative bacteria to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, ertapenem, amikacin, cefoxitin, amoxicillin/clavulanic acid was low. Gram-positive bacteria were sensitive to linezolid and vancomycin. Candida was sensitive to flucytosine, amphotericin B and itraconazole. Conclusions　In patients with granulosa after AL chemotherapy combined with BSI, the pathogenic bacteria isolated from AML are diverse, and the pathogenic bacteria isolated from ALL are mainly gram-negative bacteria. Pathogenic bacteria have different degrees of drug resistance to commonly used antibacterial drugs, so it is important to strengthen the monitoring of the distribution of pathogenic bacteria and the change of drug resistance and rational use of antibacterial drugs to minimize the death of patients.

Background Porcine fibrin sealant kit has been widely used in surgery for clotting and woundssealing.It is thought to be a substitution for inert gas and silicone oil in vitrectomy.But whether it produce toxic effect on retina or not after intravitreal injection is still studying.Objective This study aimed to investigate the retinal toxicity of porcine fibrin sealant kit following intraocular application.Methods Vitrectomy was performed on bilateral eyes of 15 pigmented rabbits.Porcine fibrin sealant kit of 0.5 ml was intravitreally injected in the lateral eyes of the rabbits as the experimental group,and equal volume of BSS was used at the same way in contralateral eye as control group.The inflammatory response of eye was observed under the slit lamp and ophthalmoscopy in 1 day,3,7,15,30 days after injection.Schi(o)tz tonometer was used to measure intraocular pressure(IOP) in 1 day,3,7 days,and retinal function was evaluated by electroretinogram (ERG) before operation and 30 days after operation.B-ultrasonic examination was carried out 30 days after surgery.Animals were sacrificed and eyeballs were obtained for retinal histopathological and ultrastructural examination in 30 days after operation.Results Complications appeared in 7 eyes of the experimental group,including cataract in 3 eyes,proliferation vitreoretinopathy and retinal detachment in 5 eyes,endophthalmitis in 1 eye,however,the cataract in 2 eyes and retina injury in 2 eyes were found in 15 control eyes.On the 30 days after injection,no inflammation was found in the 8 eyes without complication in the experimental group and 11 eyes in the control group.The IOP change was insignificant in different groups and various time points (Fgroup =0.008,P =0.929 ;Ftime =3.600 P =0.075).No significant difference was found in a-wave amplitude between groups and various time points(Fgroup =0.728,P =0.405 ; Ftime =0.516,P =0.482),and so was the b-wave amplitude (Fgroup =0.222,P =0.644 ; Ftime =0.057,P =0.814).On the 30th day after operation,arrangement of the retina was regular and no tissue edema and inflammatory cell infiltration were seen in both groups under the light microscope.Transmission electron microscope revealed that the ultrastructures of retinal cells,photoreceptor and retinal pigment cell were normal with the clear subcellular organelle,intact cellular membrane structure and mitochondria in both groups.Conclusions Domestic porcine fibrin sealant kit does not produce toxic effect on retina after intravitreal injection in rabbit.

0.05).(4) Significant differences between CC and CIN Ⅰ for p16,CDH1,RASSF1A and TIMP3 genes(P

ObjectiveTo evaluate the influence of continuous venovenous hemofiltration (CVVH) on measurement of transpulmonary thermodilution parameters.MethodsA prospective observational study was conducted. Fifty-six patients who received CVVH and hemodynamic monitoring at the same time admitted to the Department of Critical Care Medicine of Tianjin Third Central Hospital from July 2012 to July 2014 were enrolled. In all the patients, the dialysis catheter was inserted through the femoral vein, and transpulmonary thermodilution measurements were performed by pulse indicator continuous cardiac output (PiCCO) monitoring technology at the same time. Mean arterial pressure (MAP), central blood temperature, cardiac index (CI), global end-diastolic volume index (GEDVI), intrathoracic blood volume index (ITBVI) and extravascular lung water index (EVLWI) were measured before CVVH, immediately after CVVH, and 30 minutes after CVVH, respectively.Results In the 56 patients, there were 36 males and 20 females, (66±16) years of old, height of (172±6) cm, body weight of (68±10) kg. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) scores was 26±6. After CVVH,the central blood temperature was gradually decreased, and blood temperature at 30 minutes after CVVH was significantly lower than that before CVVH (℃: 37.17±1.06 vs. 37.57±1.26,P< 0.01). There were no significant changes in MAP and EVLWI before and after CVVH, the MAP was (89±20), (86±16), (90±17) mmHg (1 mmHg = 0.133 kPa) at three time points respectively, and EVLWI was (9.4±3.2), (9.3±3.0), (9.4±2.9) mL/kg, respectively. After CVVH, CI, GEDVI and ITBVI showed a gradual downward tendency. Compared with those before CVVH, the decline of CI, GEDVI, and ITBVI immediately after CVVH was not statistically significant [CI (mL·s-1·m-2): 62.18±24.34 vs. 63.85±21.84, GEDVI (mL/m2): 705±103 vs. 727±100, ITBVI (mL/m2): 881±129 vs. 908±125, allP> 0.05]. CI, GEDVI, ITBVI at 30 minutes after CVVH were significantly decreased [CI (mL·s-1·m-2): 57.84±20.50 vs. 63.85±21.84, GEDVI (mL/m2):681±106 vs. 727±100, ITBVI (mL/m2): 851±133 vs. 908±125, allP< 0.05]. CVVH was associated with a decline of 6.01 mL·s-1·m-2 at 30 minutes after CVVH [95% confidence interval (95%CI) = -10.67 to -1.50,P = 0.011]. The declines of GEDVI and ITBVI were observed with 46 mL/m2 (95%CI = -81 to - 11,P = 0.014), 57 mL/m2 (95%CI =-101 to - 13,P = 0.014 ) respectively 30 minutes after CVVH.Conclusions CVVH had no significant effect on the transpulmonary thermodilution measurements of CI, GEDVI, ITBVI and EVLWI. Thirty minutes after the start of CVVH, CI, GEDVI and ITBVI was decreased significantly, but had no effect on EVLWI.

Purpose To analyze differential diagnosis between Hashimoto thyroiditis of atypical cell clusters ( ACC) and papillary thy-roid carcinoma (PTC). Methods 153 cases of Hashimoto thyroiditis (HT) were collected and divided into 3 groups:PTC group (49 cases), ACC group (32 cases), and HT as control group (72 cases). Morphology observations were done. CD56, CK19, galectin-3 and Ki-67 were detected by immunohistochemistry. Results Morphologic differences were observed among the groups. PTC showed milder positive expression of CK19 and galectin-3, and weaker positive expression of CD56 than that of ACC. Ki-67 index in ACC and PTC was lower than that of HT. Conclusions Morphological characteristics combined with CD56, CK19, Galectin-3 and Ki-67 evalu-ations could be valuable in the differential diagnosis between PTC and ACC.

OBJECTIVETo compare the effect of reinforcing Shen method (RSM) and activating blood method (ABM) in treating osteoarthritis (OA) at the molecular level.

METHODSThe physical and chemical characteristics of components from respective recipes of RSM and ABM, and network features of component-target interaction network were analyzed by computer simulation methods including chemical space, molecular docking, and biological network, etc.

RESULTSThe chemical components of RSM and ABM were scarcely scattered with larger overlapping. Among established networks, the distribution of network features was partially similar in RSM and ABM. The average target number correlated with each component was 1.86 in RSM and 2.11 in ABM respectively. Each average target number was respectively correlated with 4.46 compounds and 3.93 compounds, reflecting multi-component and multi-target actions.

CONCLUSIONComputer simulation could intuitively trace out similarities and differences of two different methods and their interaction with targets, which revealed that the compatibility of RSM and ABM could have broader protein targets and potential synergism at the molecular level.