AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication.
METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.
RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P< 0. 01 ). The visual acurity of all cases increased in different degrees from handle move to 0. 3 to 0-1-1. 0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes (52. 4%), mild iritis in 21 eyes (100%). No cornea burn was encountered.
CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.

Exposure to traffic-related air pollutants(TRAP)has been implicated in airway allergic diseases.Recent findings include epidemiologic and mechanistic studies that shed new light on the impact of TRAP on allergic rhinitis(AR)and the biology underlying this impact.These studies have found that oxidative stress induced by TRAP could affect the axis of epithelial cell-dendritic cell-T cell towards a T-helper 2 immune response,which is the major mechanism between TRAP and AR.Further,epigenetics and microRNA might be involved in this process.Our review will summarize the most recent findings in each of these areas.
Air Pollutants ; toxicity ; Air Pollution ; Humans ; Oxidative Stress ; Rhinitis, Allergic ; etiology ; Vehicle Emissions ; toxicity

Objective To identify the patient satisfaction on follow-up service from the community health service (CHS) or West China hospital (WCH) and to compare the patient satisfaction on follow-up service from CHS and WCH.Methods A cross-sectional survey was used in this study to identify the patient satisfaction on day surgery.The questionnaires were self-made through literature review.Purposive sampling was used in collecting the data.Results Totally 758 qualified questionnaires were collected.The proportions of qualified questionnaires were 96.3％.Respectively,79.3％ of patients were completely satisfied with follow-up service from WCH,19.3％ of patients were partly satisfied,and 1.4％ of patients were completely dissatisfied.66.7％ of patients were completely satisfied with follow-up service from CHS,33.3％ of patients were partly satisfied with follow-up service from CHS,and no objects were completely dissatisfied.Conclusions Patient satisfaction on follow-up services from WCH was higher than CHS.It is essential to enhance follow-up services from CHS.

Objective To observe the therapeutic effect of phloroglucinol combined with diazepam in prolonged or protracted active phase of first stage of labor,and the outcome of perinatal phase.Methods Two hundred vaginal delivery primipara with prolonged or protracted active phase after dilatation of cervix 2-3 cm were selected.The patients were divided into 2 groups by random digits table method with 100 cases each,the patients in observation group were given phloroglucinol 80 mg and diazepam 10 mg,and the patients in control group were given diazepam 10 mg.The cervical dilatation,the degree soft hardness and edema of cervix,time of active phase,time of second stage of labor,mode of delivery,vaginal bleeding in 2 h postpartum and outcome of perinatal phase in the 2 groups were observed.Results In observation group,the cervical dilatation rate was (2.31 ± 0.27) cm/h,the time of active phase was (187.27 ± 33.22) min.In control group,the cervical dilatation rate was (1.82 ±0.48) cm/h,the time of active phase was (251.32 ± 45.33) min,there were statistical differences between 2 groups (P ＜ 0.05).The rate of uterineincision delivery in observation group was significantly lower than that in control group [18.0％(18/100) vs.32.0％ (32/100)],there was statistical difference (P ＜ 0.05).There were no statistical differences in time of second stage of labor,vaginal bleeding in 2 h postpartum,rate of neonatal asphyxia between 2 groups (P ＞0.05).Conclusion The effect of phloroglucinol combined with diazepam in prolonged or protracted active phase is remarkable,it can promote the progress of labor,speed up delivery progress,improve the rate of vaginal delivery and decrease the rate of uterine-incision delivery,and no adverse effects on the outcome of perinatal phase,it is worth popularizing.

AIM: To establish an HPLC for determining notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1 in Xueshuantong Injection (total saponin of Radix et Rhizoma Notoginseng).METHODS: The analysis was performed on UltimateTM XB C18 column(4.6 mm ? 250 mm,5 ?m) with a gradient mobile phase of acetonitrile(A)water(B) (0-30 min,20% A→38% A;30-31 min 38% A→20% A;31-40 min,20% A) at a flow rate of 1.0 mL/min.The column temperature was maintained at 40 ℃,and the detection wavelength was set at 203 nm.RESULTS:The linear range of notoginsenoside R1 fell within 0.40 -4.01 ?g (r =0.999 9 ) and the average recovery was 99.36 % (RSD = 0.72% ,n = 6).The linear range of ginsenoside Rg1 fell within 1.47-14.69 ?g (r = 0.999 9) and the average recovery rate was 99.41% (RSD = 0.52% ,n = 6).The linear range of ginsenoside Rb1 fell within 1.50-15.03 ?g(r = 0.999 9) and the average recovery rate was 99.47% (RSD = 0.50% ,n = 6).CONCLUSION: This method is accurate,simple,rapid and can be used for the quality control of Xueshuantong Injection.

Background:Lipopolysaccharide( LPS)and(1,3)-β-D glucan( BG)are involved in the process of Crohn’s disease(CD)by activating immune cells in gut to produce inflammatory cytokines. Aims:To investigate the relationship between LPS,BG and disease activity of CD. Methods:Sixty-eight patients with CD from April 2013 to July 2014 at Shanghai Tenth People’s Hospital were enrolled,of them 41 cases were active-CD( A-CD group)and 27 cases were remission-CD(R-CD group). Twenty healthy subjects were served as normal controls. Crohn’s disease activity index (CDAI)and simple endoscopic score for Crohn’s disease(SES-CD)were used to assess the disease activity and severity. Serum levels of LPS,BG,ESR and CRP were determined,and their relationships were analyzed. Results:Serum levels of LPS and BG in A-CD group were significantly higher than those in R-CD and control groups(P all < 0. 05). No significant differences in serum levels of LPS and BG were found between R-CD and control groups(P all > 0. 05). Levels of LPS and BG were positively correlated with CDAI,SES-CD and ESR(P all < 0. 05),but was not correlated with CRP(P all >0. 05). Conclusions:Serum levels of LPS and BG can be used to assess the disease activity and severity of endoscopic mucosal lesions in CD.

Objective To investigate the clinical status of massive transfusion in elderly patients in general hospital in order to improve the clinical use of blood and ensure the security of blood transfusion in elderly patients.Methods 100 patients who required massive transfusion were divided into 2 groups:elderly group (patients aged 60 years and over,n=32) and non-elderly group (patients aged under 60 years,n=68).Clinical blood transfusion indications in all patients met the Technical Criterion of Clinical Blood Transfusion issued by Ministry of Health of the People's Republic of China in 2000.Clinical data were analyzed and compared between the two groups.Results Elderly patients with massive transfusion were mainly in department of surgery,including department of orthopedics,general surgery,hepatobiliary surgery,cardiac surgery and urology surgery and gastroenterology,and the mean age of patients in these departments was 71.5 years,69.9 years,72.0 years,66.0 years,65.5 years,70.8 years respectively,accounting for 50.0％,70.0％,20.0％,75.0％,20.0％ and 66.7％ in all patients who required massive blood transfusion respectively.The mean blood transfusion volumes were higher in patients in department of gastroenterology,general surgery,hepatobiliary surgery and orthopedic,in which the mean units of red blood cell components transfusion were 14.0 U,7.0 U,5.2 U and 4.1U respectively,the mean units of plasma components transfusion were 23.3 U,8.4 U,8.0 U,0.5 U respectively,and the mean uint of platelet components transfusion was 1.6 U in hepatobiliary surgery.Conclusions The risk of blood transfusion is higher in the elderly than in the non elderly.We should select the effective blood components reasonablely,reduce the unnecessary blood transfusion and decrease the dependence on plasma transfusion to avoid the transfusion overload and adverse reactions.

To review the outcome of the endovascular treatment of aortoiliac occlusive disease,the recent literature concerning endovascular treatment as well as aortoiliac occlusive disease was extensively reviewed,and the research and development were summarized.The results are:(1) In most cases,endovascular invention is better than surgery ; (2) Stent placement has a higher technical success rates and a better longterm outcome than percutaneous transluminal angioplasty,primary or selective stent placement,which is better,is controversial; (3)Covered stents perform better than bare stents in longer-term patency and clinical outcome ; (4)Endovascular treatment of complex AIOD provides excellent early and long-term results,similar to those obtained in the treatment of simple lesions.So,in general,endovascular treatment of aortoiliac occlusive disease provides excellent clinical results,further research is needed.

Background Many researches have reported the high proliferation ability of pterygium tissue.However,the origin of cells in pterygium tissue and their role in pathogenesis and recurrence of pterygium are below understand up to now.Objective This study is to explore the role of bone marrow derived stem cells and progenitor cells in the pathogenesis of pterygium.Methods Informed consent was obtained from 12 patients with the pterygium stretching the edge of the pupil prior to this trail.Pterygium specimen was obtained from 8 patients with primary pterygium and 4 patients with recurrent pterygium during the operation.The normal conjunctival tissue was obtained from the location of 10 mm from the pterygium in the operation eye.The expression levels of marker of the primitive haematopoietic progenitors(AC133),marker of the haematopoietic progenitor cells and endothelium (CD_(34)),marker of haematopoietic and stromal progenitor cells (C KIT ),and differentiation antigen of bone marrow fibroblast cells and nonhaematopoietic progenitor cells 1 (STRO 1) were detected by using immunohistochemistry.Results Various progenitor cell markers originated from bone marrow,including CD_(34),AC133,C KIT,STRO 1,were positively expressed in pterygium specimen rather than normal conjunctival specimen mainly in the basal epithelium or stroma of pterygia tissue.Majority of the positive cells were seen in the head of pterygium.C KIT positive cells were observed mainly in the basal epithelium and stroma of pterygium.The morphology of positive cells varied upon different distribution.Fibroblast like and spindle shaped positive cells were seen in the stroma layer of pterygium,and round or ovoid shaped cells were in basal epithelial layer.The distribution and shape of positive cells for AC133 and CD_(34) were similar to ones of C KIT but numbers of cells were varied between them.C KIT,AC133 and CD_(34) positive cells were coexpressed in basal epithelium and vascular endothelium.Expression of STRO 1 was found in the stroma layer not in the basal epithelium of pterygium.Similar distribution,numbers and shape of positive cells were seen between recurrent and primary pterygium.Conclusion The cells with stem cells markers and progenitor cells markers originated from bone marrow may play a role in the pathogenesis of pterygium.

Objective To evaluate the hemodynamic effects of rocuronium in patients with rheumatic heart disease during induction of anesthesia.Methods Twenty patients of either sex (ASA classes Ⅲ -Ⅳ ;NYHA classes Ⅱ -Ⅲ) scheduled for valve replacement were included in this double blinded study. Their ages ranged from 34 to 62 yr and weights from 48 to 70 kg. The patients were premedicated with intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.3mg. Radial artery was cannukted for direct BP monitoring and Swan-Ganz catheter was placed via right internal jugular vein for hemodynamic monitoring before induction of anesthesia.TOF,BIS,ECG and SpO2 were also monitored throughout anesthesia. Anesthesia was induced with midazolam 0.05-0.1 mg?g-1 and fentanyl 10-15?g?kg-1. The patients were randomized to receive either rocuronium 0.6 mg?kg-1 (group Ⅰ,n=10) or vecuronium 0.1 mg?kg-1(group Ⅱ,n=10) to facilitate tracheal intubation when BIS value dropped to 60%.The patients were mechanically ventilated (VT 8-10 ml?kg-1 ,RR 10-12 bpm).Systolic arterial pressure (SAP),MAP,HR,cardiac output (CO), PCWP, CVP, mixed venous blood O2 saturation (SvO2), BIS and TOF were recorded and stroke volume (SV), stroke index (SI), LVSWI and rate-pressure product (RPP) were calculated before anesthesia (To), 1 min after administration of muscle relaxant (T1), when TOF reached 0 (T2) and 1,2,3,4,5,7,10,15,20,25,30 min after tracheal intubation (T3-13).Results The demographic data including age, sex and body weight were comparable between the two groups. In rocuronium group HR increased by 17.43% -7.54%,SAP increased by 16.94% - 12.3% and RPP increased by 13.96% - 22.67% respectively during 1-7 min after intubation (T3-8) as compared with the baseline values (To), significantly higher than those in vecuronium group (P