Objective　To evaluate the therapeutic effects of trabeculectomy through two right angle incisions.Methods　Trabeculectomy was performed on 23 cases (25 eyes)through two right angle incisions.Results　All operated eyes formed functional fistulizing blebs and their intraocular pressure were nomal in the follow up periods of 3～10 months.Conclusion　The trabeculectomy through two right angle incisions is better than traditional trabeculectomy and similar to clear-cornea trabeculectomy with the merits of simplicity and fewer complications.

Objective To investigate the feasibility of genetically modified X-linked inhibitor of apoptosis protein (XIAP) of rat adipose-derived mesenchymal stem cells (ADSCs) by isolating and cultivating rat ADSCs in vitro. Methods ADSCs were isolated from rat groin fat pads by collagenaseⅠdigestion under sterile condition. ADSCs were passaged and amplified with 10%FBS DMEM. The multi-differentiation potential of ADSCs was verified by cultivated with differentiation medium. XIAP expression plasmid was transfected into ADSCs. The anti-apoptotic ability of XIAP transduction was detect-ed by Western blotting assay. Results ADSCs were mainly spindle-shaped and whirlpool-shaped arranged. Results of flow cytometry showed that there were higher expressions of CD29, CD44, CD90 and CD105 in ADSCs, which differentiated into lipocytes, chondrocytes and osteoblasts under specific conditions. There is XIAP gene modified adipose-derived mesenchy-mal stem cells Band in the corresponding molecular mass of PVDF membrane area. Conclusion ADSCs were isolated from rat subcutaneous fat pads and were easily cultivated, passaged and amplified. ADSCs can differentiate into osteoblasts, chon-drocytes and adipocytes under specific conditions, which are better resource for being used in cell therapy and tissue engi-neering.

Objective To observe the change of neuropeptide of the infant patients with post infection cough (PIC) and explore the possible pathogenesis and diagnostic value.Methods Fifty-two cases with PIC in our hospital were selected as PIC group,while thirty infant patients with bronchopneumonia as pneumonia group.Phlegm cells classification and substance P(S P),neurokinin(NKA),neurokinin (NKB),calcitonin gene-related peptide (CGRP) concentration of the patients in both groups were compared.Results Phlegm cells classification of the two groups showed that,compared with the PIC group,the neutrophils,macrophages,and lymphocytes of the infant patients in the pneumonia group were obviously higher (P ＜ 0.05).After anti-infection treatment,the neutrophils,macrophages and lymphocytes of the infant patients in the pneumonia group were obviously lower(P ＜ 0.01).The phlegm cells classification of the PIC group had not changed significantly before and after treatment (P ＞ 0.05).After treatment,the phlegm cells classification of both groups had no significant difference (P ＞ 0.05).During the progress of treatment,there was no evident change for the eosinophils (P ＞ 0.05).Neuropeptide of the two groups showed that,before treatment,the SP and CGRP of the patients in the PIC group were (538.4 ±432.2) ng/L,(123.6 ±70.2) ng/L,and that in the pneumonia group were (613.2 ± 345) ng/L,(156.2 ± 82.6) ng/L.There was no significant difference (P ＞ 0.05).After treatment,the SP and CGRP of the PIC group were (552.8 ± 421.7) ng/L,(133.5 ± 81.3) ng/L,and there was no significant difference (P ＞0.05).While the SP and CGRP of the patients in the pneumonia group were (156.2 ± 131.2) ng/L,(741.2 ± 35.4) ng/L,they were obviously lower (P ＜ 0.01).There was statistical difference compared with the PIC group after treatment (P ＜ 0.01).The NKA and NKB had not changed significantly before and after treatment.Conclusion Airway neurogenic inflammation mediated SP and CGRP plays a key role in the acute and chronic infections.The increase of SP and CGRP is closely related to the morbidity of PIC.So SP and CGRP is a reference index for early detection of PIC.

Objective To investigate the clinical application value of the critical value electric reporting system .Methods The critical value data from Aug .1 ,2015 to Jan .31 ,2016 were inquired through the electronic hospital information system (eHIS) .The incidence rate of critical values ,items distribution and department distribution were analyzed .Results A total of 3 405 items of crit‐ical value were reported .The occurrence rate of critical values was 0 .45% .The top 5 of critical values numbers were chlorine (25 .76% ) ,myocardial‐specific isoenzyme of creatine kinase (19 .97% ) ,serum sodium (9 .43% ) ,platelet count (9 .05% ) and partial pressure of carbon dioxide (6 .40% ) .The top 5 departments of critical values reported number were the cardiology department (18 .94% ) ,followed by neurological intensive care unit (12 .04% ) ,intensive care unit (9 .52% ) ,second wards of neurosurgery (5 .11% ) and neurovascular wards (5 .02% ) .The median time of critical value report was reduced by 33 .33% and the quartile range time weas reduced by 40 .00% .Conclusion The application of critical value electric reporting system reduces the elapsed time of critical value report ,increases the promptness and accuracy of critical value report ,and has an important significance to guarantee the medical quality .

Objective To explore the possibility of heterodimerization between orexin type 2α receptor (OX2αR) and orexin type 2β receptor (OX2βR).Methods Using confocal laser scanning microscope,enzyme linked immunosorbent assay (ELISA),fluorescence resonance energy transfer (FRET) and Bioluminescence resonance energy transfer (BRET) to study the interaction between OX2αR and OX2βR.Result Confocal laser scanning microscope and ELISA showed that OX2αR and OX2βR were both expressed in the cytoplasm.The FRET demonstrated that the signal of the experimental group (OX2αR-YFP+ OX2βR-CFP) was significantly stronger than that of control group (YFP+OX2βR-CFP).The BRET value of the experimental group (OX2αR-YFP+OX2βR-Rluc,mBRET ratio was 65± 15) was higher than that of control group (YFP+ OX2βR-Rluc/OX2αR-YFP+Rluc,mBRET ratio was 10±5) (P＜0.05).Conclusion There are heterodimerization between mOX2αR and mOX2βR.

ObjectiveTo investigate the safety and efficacy of carbon dioxide ( CO2 ) insufflation during ERCP.MethodsBetween January and August 2011,a total of 102 consecutive patients who underwent ERCP were randomized to accept CO2 insufflation ( n =52 ) of air insufflation ( n =50 ) during the procedure.ERCP was carried out with the same instrument by an expert endoscopist who was blinded to the insufflation gas used and the procedure was controlled at 30 minutes to 1 hour.The heart rate,oxygen saturation of the patient was continuously monitored during the procedure.Before the procedure and 1 hour after the end of operation,abdominal X-ray was taken to evaluate the width of intestine,and the degree of intestinal expansion was defined as normal,mild,moderate and severe according to the width increased.A questionnaire with 100 mm visual analogue scale (VAS) was used to quantify the abdominal pain and distention experienced at 1 hour,2 hours,and 6 hours after the procedure.The patients' vital signs,bowel dilatation,the average operating time,abdominal pain score and distention score on VAS,and complications in 2 groups were analyzed.ResultsThe baseline characteristics of 2 groups were comparable.ERCP was successfully performed in all the patients and no complication was observed.In CO2 group,the average operating time,mean heart rate and oxygen saturation were (45.2 ± 10.6) min,( 102.2 ± 10.3 ) bpm and ( 99.5 ± 0.5)％,which were (48.5 ± 11.2) min,( 100.3 ± 11.4) bpm and (98.9 ±0.6)％,respectively,in air group.There were no significant differences on these items between the 2 groups ( P ＞ 0.05 ).Moderate to severe intestinal expansion 1 hour after ERCP was found in 14 patients (26.9％ ) in CO2 group and in 28 patients (56.0％ ) in air group,and the latter was significantly higher than the former (x2 =11.61,P =0.009).Both of the mean abdominal pain and abdominal distention scores at 1 hour post-ERCP in CO2 group were lower than those in air group,but without significant difference (P ＞0.05).However,the mean abdominal pain scores at 2 hours and 6 hours post-ERCP in CO2 group were significantly lower than those of patients in air group (7.4 ±2.2 vs.18.7 ±4.6 at 2 hours post-ERCP,9.6 ±3.7 vs.20.1 ±4.5 at 6 hours post-ERCP,all P ＜ 0.05 ).Similarly,the mean abdominal distention scores at 2 hours and 6 hours post-ERCP in CO2 group were significant lower than those of patients in air group (7.6 ±3.6 vs.18.3 ±4.1 at 2 hours post-ERCP,8.9 ±3.7 vs.19.4 ±4.2 at 6 hours post-ERCP,all P ＜0.05).ConclusionThe use of CO2 insufflation instead of air during ERCP appears to be safe.Insufflation of CO2 during ERCP palliates the intestinal expansion,post-ERCP abdominal pain and distention comparison to insufflation of air.However,because of the single-center clinical observation with limited number of cases,the safety and efficacy of CO2insufflation during ERCP requires to be further evaluated.

ObjectiveTo investigate the diagnostic value of transgastic peritoneoscopy for ascites of unknown aetiology.MethodsTransgastric peritoneoscopy was performed on 7 patients with ascites of unknown aetiology.Diagnosis and complications were both recorded.ResultsDiagnosis of all the 7 patients were confirmed after transgastric peritoneoscopy,among whom 6 ( 85.7％ ) were found to have tuberculosis peritonitis,and 1 ( 14.3％ ) with liver disease.All patients recovered after the operation.No intraoperative or postoperative complications occurred.ConclusionTransgastric peritoneoscopy is a valuable diagnostic method for ascites of unknown aetiology.

ObjectiveTo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of laterally spreading tumors (LST).MethodsESD was applied to remove 32 colorectal LSTs larger than 2 cm.The characteristics of the tumors and clinical results including en bloc resection rate,procedure time,complication and recttrrence rates were retrospectively evaluated.Results The lesions ranged from 2.5 cm to 8.0 cm,with a mean diameter of 4.1 ± 2.1 cm.En bloc resection wasachieved in 29 patients (90.6％ ) with a mean operation time of 75.7 ±66.0 min.Immediate arerial bleeding occurred in 5 ( 15.6％ ) cases but was stopped successfully by clips or coagulations.Late bleeding occurred in 2 ( 6.2％ ) and perforations in 3 (9.4％ ),which were closed successfully by clips without surgery.Pathological diagnosis revealed low-grade intraepithelial dysplasia in 19 (59.4％ ),high-grade intraepithelial dysplasia in 6 ( 18.8％ ),and carcinomas in 7 (21.9％).The lesions were restricted in mucosal layer in 25 (78.1％ ),infiltrating into sm1 layer in 5 ( 15.6％ ) and sm2 layer in 2 (6.2％ ),and the later 2 were referred to surgery.Twenty patients were followed up for 3-12 months,and no local recurrence was found..ConclusionESD was an effective and safe therapy for colorectal LST larger than 2 cm.

Objective To investigate the amino acid patterns in penicillin-binding protein 2(PBP2)in Neisseria gonorrhoeae isolates with reduced susceptibility to ceftriaxonc.and the relationship between the amino acid patterns and reduced ceftriaxone susceptibility.Methods DNA was extracted from 13 clinical isolates of N.gonorrhoeae.including 11 strains with decreased susceptibility to ceftriaxone and 2 sensitive isolates.The full-length penA gene encoding the penicillin-binding protein 2 was amplified and sequenced.BLASTn and BLASTx programs were used to assess the insertion and substitution patterns of nucleotides in penA gene and of amino acids in PBP2,respectively.Results BLASTn analysis revealed insertion or substitution of 18-38 nucleotides in the penA gene of gonococcal isolates with reduced ceftriaxone susceptibility.As shown by BLASTX analysis.there were five patterns of amino acid substitution or insertion in PBP2 of the 11 isolates with reduced ceftriaxone susceptibility.However.mosaic structure of PBP2 was not found in any of these isolates.Conclusion Mosaic PBP2 seems not to be the major factor contributing to the decrease in susceptibility of N.gonorrhoeae to ceftriaxone.

Objective To investigate the diagnosis and treatment of anorectal malignant melanoma,in order to regulate surgical methods and explore multi-modality treatment.Methods Clinical pathological features,diagnosis and treatment procedures of 38 patients with anorectal melanoma were reviewed,and their correlation with prognosis were analyzed.Results In 38 patients,10 of them were male and 28 were female,with the mean age of 58.7 years old (ranged 28-75 years old).28 patients underwent abdominoperineal resection,10 patients underwent wide local excision.The 1-,3-,and 5-year disease-free survival rates were 64.9 ％,18.5 ％ and 5.7 ％,respectively.The 1-,3-,and 5-year overall survival rates were 85.8 ％,24.1％ and 6.4 ％,respectively.Tumor thickness (≥ 1.51 rm) and tumor diameter (≥3 cm) were associated with lymph metastases (x2 =13.093,4.449,P =0.011,0.020),tumor thickness was also associated with distant metastases (x2 =11.965,P =0.018).According to the Kaplan-Meier method,comprehensive treatment after surgery had significant effects on disease-free survival (x2 =7.441,P =0.006).Tumor thickness,lymph metastases,and clinical staging had significant effects on overall survival (x2 =16.741,16.474,16.775,P =0.002,0.000,0.000).Cox proportional hazards model indicated that comprehensive treatment after surgery was the independent prognostic risk factors of disease-free survival (95 ％ CI 1.420-17.621,P =0.012).Tumor thickness and lymph metastases were the independent prognostic risk factors of overall survival (95 ％ CI 0.250-0.949,1.033-2.573,P =0.035,0.036).Conclusion Early detection,reasonable surgical procedure,generalized systemic focus on immunotherapy treatment are the key to improve quality of life and prolong the survival time of anorectal malignant melanoma patients.