AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Objective To discuss the neuropsychological mechanism of executive control for methadone maintenance patients(MMP).Methods Using the event-related potentials (ERPs) technique to reveal the time course of information processes with high temporal resolution,and exam the function of attention monitoring and response inhibition in heroin-dependent MMP.Results (l) The behavioral results: there were significant withinsubjects Stroop interference effects for the MMP and control groups (reaction time:control group' s congruent condition(766.57±75.64) ms,incongruent condition(879.52±62.31) ms,MMP group' s congruent condition (821.89±64.44) ms,incongruent condition (906.29 ± 69.46) ms,P＜ 0.001 ; error rate: control group' s congruent condition (4.15± 2.92) ％,incongruent condition (8.70 ± 6.12) ％,P＜ 0.001,MMP group' s congruent condition (12.07 ±10.80) ％,incongruent condition (16.60±12.43)％,P＜0.01).(2)ERPs data showed that MMP demonstrated significantly smaller incongruent-N2/N450/SP amplitudes than controls,and all disappearing incongruent effects in N2,N450 and SP,comparing statistically significant incongruent effects for controls in N2,N450 and SP.In MMP group,the amplitudes of N2 and N450 incongruent condition (N2 (1.40± 2.91) μV、N450 (1.29 ± 0.55) μV) were bigger than congruent condition amplitudes(N2(0.77±3.61) μV 、N450(0.83± 1.07) μV,P＜0.05),but the amplitude of SP (0.37±3.58)μV was smaller than congruent condition(1.53±3.05) μV,P＜0.001 ;in control group,the amplitudes of N2 and N450 incongruent condition((-0.30±3.45) μV,N450(1.77± 1.55)tμV) were smaller than congruent condition (N2(1.10±3.64) μV,P＜0.001； N450(2.37±2.12) μV,P＜0.05),the amplitude of SP ((1.93±1.65) μV) was bigger than congruent condition((0.98±2.02)μV,P＜0.01).Conclusion There are impaired executive control functions during the conflict monitoring process and the conflict resolution process for MMP.These results provide the neural electrophysiological evidence to explain relapse behaviors in methadone maintenance patients.

Objective To determine the placental transfer of epidural levobupivacaine for cesarean section. Methods Sixty parturients (ASA ⅠorⅡ) aged 24-35 yr weighing 60-80 kg undergoing elective cesarean section under epidural anesthesia were studied. Epidural anesthesia was performed at L1,2 or L1,3 interspace. The catheter was advanced 3 cm cephalad into the epidural space. A test dose of 0.5% levobupivacaine 5 ml with 1:200 000 epinephrine was injected. If there were no signs of subarachnoid injection in 5 min, 9-12 ml of 0.5% levobupivacaine was administered twice at 5 min interval. Arterial blood samples were taken from the double- clamped umbilical cord segment at delivery for determination of blood pH. Apgar scores at 1 and 5 min after birth were recorded. Blood samples were taken from maternal and umbilical vein for determination of plasma levobupivacaine concentration by high performance liquid chromatography ( HPLC). Results The pH of the umbilical arterial blood was ≥ 7.25. The Apgar scores at 1 and 5 min after birth were ≥ 7.0. The levobupivacaine concentration of maternal and umbilical venous blood was 0.35±0.24 and (0.24 ±0.21) μg/ml respectively at the time of delivery. The ratio of umbilical and maternal venous blood levobupivacaine concentration was 0.7 ± 0.3. Conclusion Epidural levobupivacaine can cross the placenta during cesarean section. The ratio of umbilical and maternal venous blood levobupivacaine concentration is 0.7.

OBJECTIVE:To observe therapeutic efficacy of adjuvant treatment of Xuebijing injection for severe acute pancreati-tis. METHODS:80 cases of severe acute pancreatitis were randomly divided into control group and observation group with 40 cas-es in each group. Control group was given symptomatic and supportive treatment,and observation group was additionally given in-travenous injection of Xuebijing injection 100 ml,twice a day,on the basis of control group. The levels of TNF-α,IL-6 and hs-CRP,organ failure were compared between 2 groups before and after treatment. RESULTS:There was no statistical significance in the levels of TNF-α,IL-6 and hs-CRP in 2 groups before treatment(P>0.05);after treatment,the levels of TNF-α,IL-6 and hs-CRP in observation group was significantly lower than control group and before treatment,with statistical significance (P<0.05). The proportion of renal function,respiration function and circulating failure in observation group were significantly lower than in control group,with statistical significance (P<0.05). CONCLUSIONS:Adjuvant treatment of Xuebijing injection for se-vere acute pancreatitis can significantly reduce the level of inflammation in the body and reduce organ damage.

0.05). Serum glutamate pyruvate transaminase activity significantly decreased in the injured liver BMSCs group (P

0.05). Conclusions Our prospective study suggests that mode of anesthesia does not influence significantly the outcome of newborn infants delivered by elective cesarean section. It seems that both general and epidural anesthesia can be used in elective term cesarean sections safely.

Objective: To evaluate the clinical value of positron emission tomography/ computed tomography(PET/CT) with fluorine-18-labeled fluorodeoxyglucose(18F-FDG) in dectecting and diagnosing the recurrence and metastasis of colorectal cancer.Methods: The results of whole-body PET/CT of 68 patients with colorectal cancer were analyzed retrospectively.The average follow-up time was 15.8 months.The diagnosis of recurrence tumor and/or metastasis was based on pathologic examination,colonoscopy,multi-modality imaging and clinical follow-up.Results: Fifty-five of the 68 patients had recurrence and /or metastasis but no recurrence was found in the other 13 cases.The sensitivity,specificity and accuracy of PET/CT in detecting recurrent and metastatic tumor were 96.4%,76.9% and 92.6% respectively.PET/CT successfully detected one or several malignant insidious lesions in 8 cases with negative findings by CT and /or ultrasonography,and it revaeled more malignant lesions than CT and ultrasonography in 30.9%(17/55)of the patients.The clinical therapeutic strategies were changed in 11 case duo to the results of PET/CT,and the influence rate of PET/CT was 16.2%.The metastasis was mainly confined in the liver,lung,peritoneal cavity and retroperitoneal region.In the examination of the 24 patients with increased serum CEA,the positive rate of PET/CT was 91.7%.Conlusion: PET/CT can detect the recurrence and metastasis of colorectal cancer with high sensitivity and accuracy.

Aim To study the effect and investigate the underlying mechanism of astragaloside Ⅳ on contraction and relaxation in isolated rat aortic rings.Methods The relaxation effect of astragaloside Ⅳ(1～100 mg?L~(-1))on phenylephrine-preconstricted aorta ring was recorded.The effect of astragaloside Ⅳ on the contraction induced by cumulative phenylephrine,KCl or CaCl_2,was recorded respectively.Results Astragaloside Ⅳ dilated aortic vessels in a dose-dependent manner,which was partly inhibited by preincubation with non-selective nitric oxide synthase inhibitor,guanylyl cyclase inhibitor and cyclooxygenases inhibitor indomethacin.Astragaloside IV could also antagonize phenylephrine-,KCl-and CaCl_2-induced vessel contraction.Conclusion Astragaloside IV dilated aortic vessels partially though endothelium-dependent NO pathway and inhibited vessel contraction via interfering Ca~(2+) influx.

Objective To get the quantitative result of the impact of air sulfur dioxide on human health in the urban districts of Shanghai. Methods The approach recommended in this paper is based on the internationally accepted quantitative risk assessment framework and the unit increase in mortality or morbidity per unit increase of air pollutant level. Results In 1990,1998,the air sulfur dioxide caused 450～2 400,30～170 attributable deaths,accounting also for 54 600,4000 of chronic bronchitis,515 800,32 200 of outpatient visits of internal medicine,157 000～7 000 of outpatient visits of paediatrics medicine, 101 900～334 600, 6 600～23 200 of emergency room visits,23.3%,1.6% increase of cough,53.3%,3.6% increase of out of breath. Conclusion The impact of air sulfur dioxide in the urban districts of Shanghai on public health is considerable,although there is a decline trend.

Objective To explore the effecr of problem-based leaming(PBL) in emergency clinic skill training.Methods Totally 65 students participating in emergency clinical skill training in The Ninth People's Hospital of Shanghai Jiao Tong University were enrolled.Thirty-three 2008 grade five-year clinic majors as control group were taught by traditional teaching method while Thirty-two 2009 grade five-year clinic majors as experimental group were taught by PBL.After the courses,final examinations (theoretical exam,case analysis and skill appraisal) and questionnaire smvey were used to evaluate the teaching effectiveness between the two groups.Data were managed by SPSS 13.0 software package.Quantitative data between two groups were compared by t-test.Enumeration data between two groups were compared by chi-square test.Results There was no difference in theoretical score between two groups(P=0.212).Scores of case analysis and skill appraisal in experimental group were higher than those in control group (P＜0.05).There were significant differences between experimental group and control group in arousing students' learning interest,promoting understanding of knowledge,cultivating clinical comprehensive ability,increasing communication skills,improving team cooperation ability and clinical operating ability(P＜0.05).Conclusions PBL mode is better than traditional teaching methods in emergency clinical skill training.PBL can improve students' clinical comprehensive ability and emergency operations can be perfectly applied in clinic typical cases.