Objective In this study,patients with idiopathic intracranial hypertension(IIH)were selected as a model for spaceflight-associated neuro-ocular syndrome(SANS)to conduct an eye movement manipulation intervention experiment.The aim was to explore whether eye movements have an effect on reducing the subarachnoid space around the optic nerve.Methods Twenty-three patients with IIH who met the inclusion criteria were subjected to history taking,collection of basic systemic data including age,height,weight,and blood pressure,and baseline data collection including intraocular pressure(prone)and transorbital ultrasound optic nerve sheath complex image acquisition.The subjects were then subjected to the eye movements intervention and IOP(prone)and transorbital ultrasound optic nerve sheath complex image acquisition were measured at 10 minutes,30 minutes and again 3 days after the intervention.Results The study enrolled 23 subjects with an average age of(29.58±11.25)years and a mean BMI of(28.56±6.3)kg/m2.The average cerebrospinal fluid pressure through lumbar puncture was(310.25±20.78)mmH2O.There were no significant changes in intraocular pressure at various time points before and after the eye movement exercises(P=1.000).Similarly,there were no significant changes in the diameter of the optic nerve at 3 mm and 5 mm posterior to the globe(P=1.000).However,the diameter of the optic nerve sheath at 5 mm posterior to the globe,as well as the width of the subarachnoid space of the optic nerve at 3 mm and 5 mm posterior to the globe,and the area of the subarachnoid space of the optic nerve from 3 mm to 5 mm posterior to the globe,all decreased significantly after performing eye movement exercises for 10 minutes and 30 minutes.These measures returned to baseline levels after three days of eye movement exercises,with significant differences observed across time points(P<0.05).Specifically,compared to baseline values,the diameter of the optic nerve sheath at 5 mm posterior to the globe decreased by 0.33 mm(95%CI:0.034-0.624,P=0.02)after performing 30 minutes of eye movement exercises.Additionally,the width of the subarachnoid space of the optic nerve at 3 mm and 5 mm posterior to the globe decreased by 0.2 mm(95%CI:?0.037-0.452,P=0.034)and 0.29 mm(95%CI:?0.265-0.344,P=0.01),respectively.Finally,the area of the subarachnoid space of the optic nerve from 3 mm to 5 mm posterior to the globe decreased by 0.21 mm2(95%CI:0.155-0.762,P=0.02).Conclusion This study initially proposes an eye movement manipulation method(eye movement exercise)that can reduce the subarachnoid space gap of the optic nerve posterior to the globe,including the direction,duration,rhythm,and frequency of eye movements.It was found that regular eye movements for a certain period of time can deform the optic nerve sheath,compress the subarachnoid space of the optic nerve posterior to the globe,and narrow its gap.As the duration and frequency of eye movement exercises increase,the width or area of the subarachnoid space of the optic nerve decreases more significantly.However,eye movement exercises cannot maintain the deformation of the optic nerve sheath for a long time,and after a certain period of time,the gap of the optic nerve sheath returns to baseline levels.

Objective To investigate the predisposing locations of active hemorrhage in patients with esophageal variceal bleeding. Methods Data of 823 patients with acute esophageal and gastric variceal hemorrhage receiving emergency gastroscopy diagnosed from January 2003 to December 2013 were retrospectively studied. The location and site of active hemorrhage or stigmata were analyzed and its relationship with active hemorrhage was discussed. Results A total of 372(45. 2%,372/823) patients with active bleeding and stigmata were found under emergency endoscopy. Among 372 patients, 190 got accurate hemorrhage and stigmata location and site description. Bleeding or stigmata in 58(30. 5%) patients was 28-32 cm from incisor in group A, and that in 132 (69. 5%) patients was more than 35 cm in group B ( χ2＝57. 642, P＜0. 000 1). In 190 cases, the proportion of bleeding or stigmata at 3:00 point was the highest (37%,70/132), followed by those at 12:00 point(30%,58/132),6:00 point(24%,45/132),and 9:00 point (9%,17/132). The change trend of the percentage of each point in group A and group B was the same as that in all cases. The percentage of almost all points in group B was significantly higher than that in group A except that at 9:00 point ( P＜0. 000 1).Conclusion Esophageal variceal bleeding in cirrhosis is more common at 3:00 point, 6:00 point and 12:00 point of esophagus, and the high risk area is 35 cm below the incisors.

Objective To evaluate the clinical effect of balloon closure combined with endoscopic therapy on spontaneous gastrorenal shunt ( SGRS ) and spontaneous splenorenal shunt ( SSRS ) . Methods The data of 33 patients of gastric varices with SGRS or SSRS diagnosed in the Chinese PLA General Hospital between January 2009 and February 2016 were collected. All patients were treated with the balloon retrograde distributary channel blocking technique and endoscopic histoacryl injection. Patients' clinical data, complications and effect of endoscopic therapy were retrospectively analyzed. Results In the 33 patients of gastric varices, gastrorenal shunt was found in 28 ( 84. 8%) cases and splenorenal shunt was found in 5 ( 15. 2%) cases. After the balloon blocking technique, 24 cases ( 72. 7%) were occluded successfully. Four cases failed in occlusion of SSRS due to tortuosity. There were no postoperative ectopic embolism, infection, hepatic encephalopathy, liver function deterioration, and other complication. Early latex varices were found in 21 cases after three months follow-up. Conclusion The balloon blocking technique combined with tissue adhesive injection could safely and effectively avoid the risk of ectopic embolism and plays an important role in the treatment of gastric varices in merger portasystemic shunt.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.