Objective　To investigate the effect of turning scleral flap of self-body over drainage in trabeculectomy.Methods　The surgery was performed on one eye of a rabbit while　the other eye of the same rabbit was conducted with the routine trabeculectomy as the control group. The filtering bleb, intraocular pressure and pathology were observed. Results　The intraocular pressure in the experimental eye was much lower than that in the control group 3～12 weeks after the operations (P＜0.05).As it was within 2 weeks after the surgeries, but there was no significant filtering difference (P＞0.05).The rate of eyes with functional bleb in the experimental group was significantly higher than that in the control group at the postoperative 2～7 weeks .Conclusion　This study suggests the turning of self-body over drainage surgery can help to maintain filtering function for a long time and to prevent complication after filtering surgery.

Objective To assess left ventricular (LV) global systolic function in patients with essential hypertension with normal geometric LV by 3-dimensional ultrasound speckle tracking imaging(3D-STI). Methods Fifty patients with essential hypertension were enrolled in this study, 29 normal subjects matched with age and sex were selected as control groups. LV global longitudinal peak systolic strain (GLS), radial peak systolic strain (GRS), circumferential peak systolic strain (GCS), LV global 3-dimentional radial peak systolic strain (3DGRS) were measured in all subjects by 3D-STI from the apical full-volume image and compared between groups. LV ejection fraction (LVEF) was acquired from 3D-STI.Results Compared with controls, LV GLS, GRS, GCS and 3DGRS were significantly reduced in patients with hypertension ( P ＜ 0.05 for all). A Pearson correlate revealed that LV GCS, GLS and GRS corresponded with LVEF( r1 =0.930, P1 ＜0.001; r2 = 0.705, P2 ＜0.001; r3 =0.474, P3 =0.001,respectively) in patients with hypertension, and LV GCS, GLS correlated with LVEF( r1 = 0. 838, P1 ＜0. 001; r2 = 0. 697, P2 ＜ 0. 001, respectively) in normal subjects. Conclusions LV global 3D strain decreases in patients with hypertension in the early period,3D-STI could evaluate the early change of heart function in patients with hypertension. LV circumferential movement plays a major role in the LV 3D movement and impacts on LVEF.

Objective To determine the extracellular enzymatic activity of common pathogens for onychomycosis, in the hope of finding virulence factors associated with the pathogenesis of onychomycosis. Methods Strains tested in this study included standard strains of common dermatophyte and non-dermatophyte fungi as well as clinical isolates of Trichophyton rubrum from patients with onychomycosis. All the tested strains were cultured in medium containing nail fragments at 25 ℃ for 10 to 21 days followed by the determination of the nail fragment-containing medium, a significant increase was observed in the activities of esterase, esterase lipase, N-acetyl-β-glucosaminidase and α-mannosidase in dermatophytes compared with non-dermatophytes (all P ＜ 0.05 ), as well as in the activity of N-acetyl-β-glucosaminidase in Trichophyton rubrum compared with the other tested species of fungi (all P ＜ 0.05). No significant difference was noted in the activity of extracellular enzymes, except for that of naphthol-AS-BI-phosphohydrolase, between the isolates of Trichophyton rubrum from patients with different ranges of scoring clinical index for onychomycosis (SCIO). Conclusions In specific conditions, the extracellular enzymatic activity of fungi isolated from patients with onychomycosis is associated with fungal species, and may have a certain influence on the manifestations of anychomycosis.

To compare the luminescent characters in different bacteria of two different recombinant mycobaceriaphages by using biolimenescent methods in order to understand the differences between sensitivity and specificity of these phages, and to set up methods to use recombinant mycobacteriaphages in detecting drug suscepbility of mycobacteria. Result showed that both two phages have high light production in action with mycobacterium selectively and have almost no light production with E. coli , the difference is very obvious. Among different mycobacterium, BCG has the highest light production and mycobacterium tuberculosis has the lowest light production. The sensitivity of Phage 88 is higher than Phage 40, the difference is obviously. It can be considered that both recombinant mycobacteriaphages can detect mycobacterium specifically, but Phage 88 is more suitable for clinical usage.

Objective To evaluate the effect of Jostent coronary stent-graft in endovascular treatment of traumatic carotid cavernous fistula. Methods Eight patients with traumatic carotid-cavernous fistula were treated by Jostent coronary steat graft from June 2001 to May 2007. Results The stent graft was successfully implanted in the target artery in all patients. The fistula in all patients was removed and the parent arteries kept unblocked. The clinical outcome was favorable, with no operation-related complications occurred. The ang4ogram showed normal patency of the parent arteries, without recanalization of the fistula six months after the stent graft implantation in six patients. Conclusions Stent graft is a useful tool for endovascular treatment of carotid cavernous fistula in selected patients. Further research is needed to optimize the stent graft for further use in cerebrovascular system.

OBJECTIVETo observe the changes in subgingival microflora before and after Er:YAG laser treatment on diabetic patients with periodontitis, and to compare with the subgingival microflora of chronic periodontitis.

METHODSSubgingival plaque of 13 pairs of teeth (26 sites) was selected from type 2 diabetic patients at pretreatment, one month post-treatment, and three months post-treatment. Subgingival plaque was also obtained from 11 cases of moderate to severe chronic periodontitis with similar severity of periodontitis. The DNA of the subgingival plaque samples was extracted. Whole bacterial 16S rDNA gene fragments separated by denaturing gradient gel electrophoresis. Specific DNA bands were then chosen for retrieval and sequencing.

RESULTSThe gene sequencing results of the special DNA bands of subgingival plaque samples show that the pathogenic bacteria of both diabetic periodontitis and simple chronic periodontitis were Prevotella intermedia and Tannerella forsythia, respectively. The composition of the subgingival microflora before and after laser treatment changed. Some DNA bands, including that of Tannerella forsythia, disappeared or weakened one month after treatment. A new strip appeared, which belonged to Actinomyces sp.

CONCLUSIONThe profiles of the subgingival microflora changed after treatment, and one month was indicated as an important stage. Er:YAG laser may have an important function in delaying microflora recolonization.

Objective To discuss the clinical effects of hemiarthroplasty for the treatment of intertrochanteric comminuted fracture in aged patients.Methods From June 2006 to June 2010,91 cases with intertrochanteric comminuted fractures were treated by hemiarthroplasty using Zweymtüller long-stem cementless implant.There were 35 males and 56 females,with an average age of 81.2 years (range,75-94 years).There were fresh fractures in 75 cases and old fractures in 16 cases.According to classification of Evans-Jensen,there were 36 cases with type Ⅲ fracture and 55 with type Ⅳ.Osteoporosis was graded by Singh index,and there were 51 cases with level Ⅲ and 40 with level Ⅱ.The interval between injury and operation was 2-10 d (average,3.5 d).Results The surgery lasted 30-50 min (average,39 min).The blood loss was 320-610 ml (average,405 ml).The hospital stay was 14-21 d (average,16.5 d).Two cases who experienced with the infection of the respiratory system after operation,recovered through routine treatment.Thirty-seven cases were followed up for 15 to 38 months (average,24.5 months).According to the Harris score,the overall rate of excellent or good result was 83.8％ (31/37).Conclusion Hemiarthroplasty using Zweymüller long-stem cementless prosthesis is reliable option for intertrochanteric comminuted fracture in the aged patients.

BACKGROUND: That the nerve growth factor(NGF) is capable of treating peripheral nerve injury has been broadly acknowledged. But it is not sure whether it is able to pass through blood brain barrier(BBB) to act on central nerve system. In this study, the NGF encapsulated in liposome was compared with NGF alone in their abilities of passing through BBB.OBJECTIVE: To compare the dedicated distribution of NGF in different forms using single photon emission computerized tomography(SPECT).DESIGN: It is a randomized controlled study with New Zealand rabbits as subject.SETTING: An affiliated hospital of Nanjing Medical College.MATERIALS:The trial was conducted in Nanjing Senke Medical Company and the Nuclear Medicine Department of the First Hospital of Nanjing Medical College from June 2003 to May 2004. The subjects were 19 New Zealand rabbits of either sex, weighting (2.0 ±0. 2) kg, from Anlimo Technology Company. [99Tcm] -NGF(labeling rate 98.9%, purity 99.7% )was made by Senke Medical Company. Liposome was provided by Shengyang Pharmaceutical College. Urethine solution(200 g/L) was from Pharmacy Department of NanJing Medical Collage.METHODS: [99Tcm]-NGF was encapsulated in liposome and was treated as the following: The liposomesA containing 1.48 × 108Bq[99Tcm] -NGF were injected into rabbits and its distribution percentage was analyzed with SPECT. The same amounts of[99Tcm] -NGF and[99Tcm] -NGF-ordinary liposomesB were treated in the same way.MAIN OUTCOME MEASURES: The ratio of concentration and radiation percentage of NGF in brain to those in the whole body.RESULTS: The[99Tcm]-NGF encapsulated in self-made liposomeA presented high radiation in the brain. But[99Tcm] -NGF alone was almost completely excreted through urinary system and[99Tcm] -NGF encapsuled in ordinary liposomeB was mostly phagocytized by liver reticuloendothelial system.CONCLUSION: The self-made NGF-liposomeA is brain-dedicated, which set a basis for drugs to pass through BBB.

ObjectiveTo evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell (UC-MSC) transplantations in decompensated liver cirrhosis patients with ascites.MethodsFifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group (n=38) and control group (n=16) in a prospective controlled single-blinded trial.UC-MSC (0.5-1.0) × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group,respectively.The liver function,hepatitis B virus (HBV) DNA level,ascites and the model for end-stage liver disease(MELD)scores at different time points were compared between two groups.The comparison between groups was done by Mann-Whitney U test,and the data before and after transplantations were compared by Wilcoxon signed rank sum test.ResultsThere were no significant differences of alanine transaminase (ALT),total bilirubin (TBil),cholinesterase (CHE),HBV DNA positive rate and MELD scores at different time points between two groups (P＞0.05).However, the albumin ( A1b)level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were (28.47±4.45)g/L at week 0 and ( 34.82±4.50)g/L at week 48 (P=0.046). Meanwhile, the ascites reduced markedly in treatment group with (46.6 ±30.6) mm at week 0 and (6.6±13.6) mm at week 48,which were significantly different from control group at the end of follow-up (P =0.037). Conclusion UC-MSC transplantations may help to increase A1b level and reduce ascites in patients with decompensated liver cirrhosis.

Objective To evaluate a score system(Association of Coloproctology of Great Britain and Ireland ACPGBI)in prediction of postoperative mortality from colorectal cancer patients in a Chinese hospital. Methods We analyzed retrospectively 904 patients with histologically confirmed colorectal cancer who had colorectal surgery from 1992 to 2005.There were 525 colonic cancer patients and 379 rectal cancer patients.We divided patients into several groups according to operative urgency(elective or emergency);surgeons(colorectal specialists or other surgeons);cancer location(colon or rectal).According to ACPGBI score we got the prediction.This prediction was compared with the actual mortality;Chi-square test,receiver operator characteristic curve(ROC),Hosmer-Lemeshow goodness-of-fit test were used.Results Observed overall mortality within 30 days after surgery was 1.0%(9/904),and the predicted mortality was 8.3%(75/904).In all the subgroups the predicted momdity wag higher than observed mortality.We found that the actual mortality was higher in an individual subgroup in which the predicted mortality was higher. Conclusions For colorectal cancer patients undergoing a surgery the predicted mortality of ACPGBI score system was higher than the actual mortality in a Chinese hospital.