To evaluate the efficacy and safety of limbal relaxing incision ( LRl) for correcting corneal astigmatism during implantable collamer lens ( lCL) surgery.METHODS:A total of 185 eyes of 105 patients with high myopia and corneal keratometric astigmatism were included in the study. lCL surgery with concomitant relaxing incision was performed in 105 eyes of 60 patients in LRls group ( Group A) . Eighty eyes of 45 patients only underwent lCL surgery were in control group ( Group B) . All patients undergone ophthalmic examination that included uncorrected visual acuity ( UCVA ) , best -corrected visual acuity ( BCVA ) , Pentacam analysis system to observe the changes of corneal astigmatism before and 1wk, 1 and 3mo after surgery.RESULTS: Respectively comparing UCVA between two groups in 1 and 3mo postoperatively, the P values were considered statistically significant ( P < 0. 05 ). But, respectively comparing BCVA between two groups in 1wk, 1 and 3mo postoperatively, the P values were considered no statistically significant ( P > 0. 05 ). Preoperative corneal astigmatism was 1. 52 ± 0. 55D in group A and 1. 48 ± 0. 57D in group B, there was no statistically significant difference (P>0. 05). One week postoperatively, the astigmatism was 0. 55 ± 0. 41D in group A and 1. 20 ± 0. 48D in group B. One month postoperatively, the astigmatism was 0. 60 ± 0. 38D in group A and 0. 93 ± 0. 47D. Three months postoperatively, the astigmatism was 0. 51 ± 0. 32D in group A and 0. 96 ± 0. 40D in group B. The difference between the two groups were statistically significant ( P<0. 05 ). The difference value of corned astigmatism before surgery and 1wk, 1 and 3mo after surgery had statistical significance ( P<0. 05). ln LRls group, at preoperative and postoperative time points, the average corneal astigmatism changes were also considered statistically significant difference (P<0. 05). CONCLUSlON: LRls performed during lCL surgery appeared to be an effective and safer procedure to reduce pre-existing corneal astigmatism and improve UCVA as well as the visual quality.

Objective To investigate the adjunctive therapeutic effect of recombination growth hormone(rhGH) on the elderly patients with pulmonary infection.Methods 53 elderly patients with pulmonary infection were randomly divided into rhGH group(n=25) and control group(n=28).The rhGH group were received hypodermic introl group were received standard therapy.Clinical efficacy were compared between two groups.The level of albumin (ALB),growth hormone (GH),insulin-llke growth factor-1 (IGF-1),leptin (LP) were measured and the body mass index(BMI) was observed in all cases before and after treatment.Results The overall efficacy of rhGH group and control group was 88.0% versus 60.7%.The results showed significant statistical difference between both groups(P＜0.05).After treating with rhGH for 10 days,the level of BMI,ALB,GH,IGF-1 and LP were increased in the rhGH group,which were(26.1±4.1)kg/m2;(38.4 ±6.6)g/L;(7.0 +0.9) μg/L;(27.3 ±6.1)μg/L;(6.9 ± 1.1)μg/Lrespectively.And the level of BMI,ALB,GH,IGF-1 and LP were (21.8 ± 3.4 ) kg/m2 ;( 29.5 ± 5.1 ) g/L;( 4.0 ±0.4) μg/L;( 22.0±3.8 )μg/L;( 3.8±0.8 )μg/L in the control group after treatment.The results showed significant statistical difference between both groups(P＜0.05).Conclusion There was obvious adjunctive therapeutic effect of rhGH to the elderly patients with pulmonary infection by improving the nutritional state of these patients.

As the necessary depletion material in hospitals,sterile packing material shows category diversification when being selected.This paper briefly analyzes the functions and values of domestic common sterile packing material such as pure cotton wrap cloth,hard quality packing container,paper/ plastics packing bag and the crease wrapping paper.Reasonable suggestions are also put forward.

ObjectiveTo evaluate the safety and efficacy of pull through technique in the treatment of middle or low rectal cancer.MethodsRetrospective study was made on 101 patients of rectal cancer undergoing pull through resection in terms of the safety and efficacy. The technique was in brief to make coloanal anastomosis through an everted rectal stump, and pull back the proximal colon into the pelvic cavity. ResultsAll postoperative patients were followed up from 5 to 10 years. Normal or good fecal continence was achieved in 87% (88/101) of the patients, fair in 7 9%(8/101), and poor in 4 9%(5/101). Anastomotic fistula developed in 5 patients (4 9%), and local recurrence rate was 15%. The 5, and 10 year survival rates were 64% and 58%, respectively. ConclusionsColoanal anastomosis provides effective treatment for middle and low rectal cancer with a satisfactory long term survival rate and quality of life.

0.05),the overall response rate was 56.0% .Symptoms(18/25) related to cancer improved and side-reactions were tolerable. Conclusions:Treatment of relapse and metastatic colorectal cancer with combined chemotherapy based on oxaliplatin,irinotecan and 5-Fu by arterial intervention and iv drip is safe and effective,with only slight side-effects. This treatment can improve the symptoms and life quality of patients.

Objective:To study the effect of compressive stress on expression of connective tissue growth factor(CTGF) in rabbit mandibular condylar chondrocytes in vitro. Methods:CTGF mRNA were determined by semiquantitative RT-PCR in rabbit mandibular condylar chondrocytes cultured in vitro. Results:Within a certain compressive stress, CTGF mRNA were up-regulated with the increase of compressive stress. While under certain compressive stress, CTGF mRNA were gradually up-regulated following the increase of culturing time, and reaching the maximum at 2~6 h, then gradually down-regulated until at 24 h. Conclusion:Application of different compressive stresses can up-regulate the expression of CTGF mRNA in rabbit mandibular condylar chondrocytes. It may be involved in the stress -mediated mandibular condylar cartilage remodeling.

Objective To evaluate lactulose breath hydrogen test in diagnosis of small intestinal bacterial overgrowth in children.Me-thods Thirty-five children,aged 3 to 13 years old with mean (7.72?3.06) years old presented with chronic diarrhea,abdominal pain and flatulence.Among them,18 cases were male and 17 cases were female.Breath hydrogen test was carried out after the administration of a 0.5 g?kg-1 or 10 g lactulose,which was 100 g?L-1 solution.After the ingestion of lactulose,the breath hydrogen was collected in every 20 minutes and up to 3 hours.Small intestinal bacterial overgrowth was diagnosed as positive when the hydrogen concentration increased more than 20 mg?m-3 in a sample.Results Eighteen cases in 35 (51.43%) children were positive and 17 cases were negative.Among these positive cases,8 cases in 18 (22.86%) patients were typically double peaks in breath hydrogen concentrations.Among the causes of small intestinal bacterial overgrowth in children,4 cases with chronic superficial gastritis,4 cases with chronic bacterial enteritis,2 cases with malnutrition and anorexia,1 case with volvulus of stomach,1 case with massive resection of small intestine,1 case with steatorrhea and 5 cases with unknown causes.Four cases of chronic bacterial enteritis were gained remission by antimicrobial agents.The other cases were treated by lac-to-and bifidbacteria probiotics.Seven patients of the clinical systems were controlled,3 cases were improved remarkably and 4 cases were failed.Conclusions The lactulose breath hydrogen test is validated as screening test in the diagnosis of small intestinal bacterial overgrowth in children.Antimicrobial agents and bifidbacteria probiotics is effective in treatment of small intestinal bacterial overgrowth.

Objective:To detect the expression of microchromosome maintenance protein 4 (MCM4) in pancreatic ductal adenocarcinoma, and to explore the clinical prognosis of MCM4 and pancreatic ductal adenocarcinoma. To explore the possibility of MCM4 as a potential biomarker for pancreatic ductal adenocarcinoma.Methods:The mRNA level of MCM4 in pancreatic ductal adenocarcinoma and normal tissues adjacent to the cancer was analyzed by bioinformatics methods, and the relationship between its expression and the survival rate of patients with pancreatic ductal adenocarcinoma was analyzed. The clinicopathological data of 76 patients with pancreatic ductal adenocarcinoma who underwent surgical treatment were retrospectively analyzed. Immunohistochemical method was used to detect the expression level of MCM4 protein in pancreatic ductal adenocarcinoma tissue and normal tissues adjacent to the cancer, and to analyze its relationship with clinicopathological characteristics of patients with pancreatic ductal adenocarcinoma.Results:The results of bioinformatics analysis showed that MCM4 mRNA was significantly highly expressed in pancreatic ductal adenocarcinoma tissue, and was significantly correlated with the overall survival rate and disease-free survival rate of patients (all P<0.05). Immunohistochemical results showed that the expression of MCM4 in pancreatic ductal adenocarcinoma tissue was significantly higher than that in normal tissues adjacent to the cancer. The high expression of MCM4 in pancreatic ductal adenocarcinoma tissue was related to tumor size ( P=0.038), but not related to age, gender, and tumor grade (all P>0.05). Conclusions:MCM4 is highly expressed in pancreatic ductal adenocarcinoma tissues and indicates a poor prognosis, and its expression level is related to the tumor stage of pancreatic ductal adenocarcinoma. MCM4 may serve as a new potential biomarker for pancreatic ductal adenocarcinoma.

Objective The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for discriminating nonmetastatic from metastatic mediastinal lymph nodes in lung cancer.Methods IVIM was performed preoperatively on 66 patients with lung cancer during October 2015 to June 2016 in Capital Medical University Affiliated Beijing Chaoyang Hospital.Preoperative examination including the chest MRI scan,chest CT,head MRI,bone scan-ning and the cardiopulmonary function.None of the patients was undergone any kind of treatment about the cancer before the examinations,the neoadjuvant chemotherapy or radiation therapy,immunotherapy and gene targeted therapy were included.Measured the short axis diameter and the IVIM parameters of the mediastinal lymph nodes,apparent diffusion coefficient(ADC),diffusion coefficient(D),pseudo-diffusion coefficient(D *),and perfusion fraction(f).All the patients underwent the lobectomy or wedge resection and lymph node dissection or systematic sampling.By comparing the IVIM parameters of the nonmetastatic and metastatic mediastinal lymph nodes according to the pathological examination,draw the ROC curves to find the best cutoff value for diagnosis.And 42 cases were used to comparing the value of the MRI and CT in differential diagnosis.Results MRI measured 184 groups mediastinal lymph nodes,including 164 groups without metastasis,20 groups with metastasis.The ADC,D,D *,f values and short axis diameter of the nonmetastatic lymph nodes(n =164) were(2.880 ± 0.785) × 10-3 mm2/s,(0.670 ± 0.179) × 10-3 mm2/s,(0.383 ± 0.123) × 10-3 mm2/s,0.422 ± 0.119,(6.546 ± 1.932) mm,respectively,and (1.897 ±0.657) × 10-3 mm2/s,(0.472 ±0.210) × 10-3 mm2/s,(0.354 ±0.130) × 10-3 mm2/s,0.412 ±0.090,(7.510 ± 2.773) mm respectively for the metastatic lymph nodes (n =20).The ADC and D value of the nonmetastatic lymph nodes were significantly higher than the metastatic lymph nodes(P ＜0.01).While the other paraneters(D *,f,and short axis diameter) between the two groups did not show significantly different.Optimal cutoff values(area under the curve,sensitivity,and specificity) for distinguishing metastatic from nonmetastatic lymph nodes were as follows:ADC =1.890 × 10-3 mm2/s (0.871,92.7％,80.0％);and D =0.648 × 10-3mm2/s(0.740,70.0％,84.1％).Conclusion IVIM is useful to distinguish metastatic from nonmetastatic lymph nodes in lung cancer.The ADC and the D values are significant higher in metastatic lymph nodes,which more sensitive than the other parameters(D *,f,and short axis diameter).As a result,IVIM can be used in the N-stage diagnosis of lung cancer.

Objective To explore economic valuation of the minimally invasive esophagectomy.Methods The cases undergone esophagectomy were studied retrospectively.Monofactorial analysis was done to evaluate the impact of various factors on the overall hospitalization costs.The correlated factors then were used as independent variables to carry out the multiple linear regression aimed at the hospitalization costs.Results The results of monofactorial analysis showed that the accompanying diseases,days during hospitalization,modes of esophagectomy,postoperative complications were correlated factors of the overall hospitalization costs.According to the multiple linear regression,it were sorted based on descending order duing to its effect of largenning the hospitalization costs:postoperative complications (β =0.439,P =0.000),days during hospitalization (β =0.397,P =0.000),accompanying diseases(β =0.257,P =0.000),modes of esophagectomy(β =0.132,P =0.000).The expenses caused immediately by the operations were statistically more of the minimally invasive surgery than that of the open procedures whatever the numerous or proportion of the overall costs (P =0.000).Conclusion Combined thoracoscopic and laparoscopic esophagectomy was more expensive than open operation.Nevertheless,impact of the other factors,such as postoperative complications,were more significant than that of the different procedure.h was a strategy to minimally invasive osophagectomy that hospitalization costs could be reduced by means of controlling complications and diminishing hospitalization days.