AlM:To observe clinical effects between the laser in situ keratomileusis ( LASlK ) surgery and the laser subepithelial keratomileusis ( LASEK ) surgery as the second operation after an unsuccessful LASlK surgery.METHODS:Forty-nine patients (98 eyes) with refractive regression after LASlK operation received the second surgery. All patients were divided into two groups:group A and B. Group A (48 eyes of 24 patients) received LASlK surgery and group B ( 50 eyes of 25 patients ) received LASEK surgery. lnspect the main parameters included visual acuity, refraction, corneal curvature, and the total value of high-aberration after 1wk, 1mo and 1a, t-test of groups was used as statistical analysis method.RESULTS: There was statistically significant (P<0. 05) between the two groups in visual acuity after 1wk. There was no statistically significant between the two groups in visual acuity after 1mo, and there was also no statistically significant between the two groups in visual acuity, average spherical equivalent refractive degree, average corneal curvature, and the total value of high-aberration after one year (P>0. 05). There developed one case of epithelium in growth after LASlK surgery, and one case of haze Ⅱ after LASEK surgery.CONCLUSlON: Both LASlK and LASEK surgery can obtain satisfactory therapeutic results after an unsuccessful LASlK surgery.

AlM:To evaluate the expression of transcriptional factor lslet-1 in retina in experimental retinal neovascularization induced by oxygen.
METHODS: The murine retinal neovascularization were induced by hyperoxia exposure. The morphological observation of retinal neovascularization was performed using angiography by fluorescein dextran injection under the fluorescence microscope, and the new blood vessels were quantified after 5d in room air (17-day-old) by counting the vascular epithelial cell nuclei protruding into viteous cavity using HE stain. Realtime PCR and Western blot were used to examine retinal lslet-1 level in postnatal 7,12, 14,17 and 26d respectively.
RESULTS: A lots of new blood vessels were demonstrated in the mouse retina in hyperoxic group by fluorescein angiography and histological method. Moreover, no significant difference was found in retinal lslet-1 level in postnatal 7d between hyperoxic group and control group, but was significantly higher in postnatal 12, 14 and 17d mice compared with control mice. However, mice at postnatal 26d, expression of lslet-1 in retina decreased to normal level.
CONCLUSlON: ln processing mouse model of retinal neovascularization, sustained hypoxia retinal tissue induce retinal neovascularization by increas the expression of transcription factor lslet-1.

Adult ; Anastomosis, Surgical ; Esophagus ; surgery ; Humans ; Male ; Stents ; Stomach ; surgery ; Tracheoesophageal Fistula ; surgery

Background:Q fever endocarditis,a chronic illness caused by Coxiella burnetii,can be fatal if misdiagnosed or left untreated.Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China,very few cases of Q fever endocarditis have been reported.This study summarized cases of Q fever endocarditis among blood culture negative endocarditis (BCNE) patients and discussed factors attributing to the low diagnostic rate.Methods:We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis (IE) in the Peking Union Medical College Hospital between 2006 and 2016.The clinical findings for each confirmed case were recorded.BCNE patients were also examined and each BCNE patient's Q fever risk factors were identified.The risk factors and presence of Q fever serologic testing between BCNE patients suspected and unsuspected of Q fever were compared using the Chi-squared or Chi-squared with Yates' correction for continuity.Results:Among the IE patients examined,there were 147 BCNE patients,of whom only 11 patients (7.5％) were suspected of Q fever and undergone serological testing for C.burnetii.Six out of 11 suspected cases were diagnosed as Q fever endocarditis.For the remaining136 BCNE patients,none of them was suspected of Q fever nor underwent relevant testing.Risk factors for Q fever endocarditis were comparable between suspected and unsuspected patients,with the most common risk factors being valvulopathy in both groups.However,significantly more patients had consulted the Infectious Diseases Division and undergone comprehensive diagnostic tests in the suspected group than the unsuspected group (100％ vs.63％,P =0.03).Conclusions:Q fever endocarditis is a serious yet treatable condition.Lacking awareness of the disease may prevent BCNE patients from being identified,despite having Q fever risk factors.Increasing awareness and guideline adherence are crucial in avoiding misdiagnosing and missed diagnosing of the disease.

OBJECTIVEThe expressions of caspase-1 and cytokines activated by caspase-1 are associated with the pathophysiology of many diseases for its proinflammatory and proapototic peculiarity. However its relationship to brain injury of developing rats following recurrent seizures has not yet been identified. This study aimed to investigate the role of caspase-1 and cytokines activated by caspase-1 in brain injury of developing rats following recurrent seizures.

METHODSA total of 96 postnatal 20 day Sprague-Dawley rats were randomly assigned into Control and Seizure groups. Seizures were induced in the Seizure group by flurothyl inhalation daily for six days. Brain tissues were sampled at 6 hrs, and at 1, 3, and 7 days after last seizure. The expressions of caspase-1, interleukin (IL)-18 and IL-1beta mRNA in the cerebral cortex were detected by RT-PCR. The water content of the brain and the pathological changes of cortex nerve cells were observed. Brain injury was evaluated using a semiquantitative neuropathological scoring system.

RESULTSThe levels of caspase-1 and IL-18 mRNA in the cerebral cortex of the Seizure group were obviously higher than those in the Control group at 6 hrs, and at 1, 3, and 7 days after seizure (P < 0.05 or P < 0.01). The expression of IL-1beta mRNA in the Seizure group exhibited a biphasic pattern: increased significantly at 6 hrs, and at 1 and 7 days post-seizure (P < 0.01), but was not significantly different from the Control group at 3 days post-seizure. Edema, degeneration and necrosis of nerve cells in cerebral cortex, accompanying by inflammatory cell infiltration and apoptosis of nerve cells, were observed under a light microscope in the Seizure group after recurrent seizures. The water content of the brain in the Seizure group increased significantly compared with that in the Control group at 6 hrs, and at 1 and 3 days after recurrent seizures (P < 0.01). The Seizure group had significantly higher neuropathological scores than the Control group at each time point (P < 0.01).

CONCLUSIONSCaspase-1 and cytokines activated by caspase-1 play an important role in the developing brain injury after recurrent seizures.

Animals ; Brain ; pathology ; Caspase 1 ; genetics ; physiology ; Female ; Interleukin-1 ; genetics ; physiology ; Interleukin-18 ; genetics ; physiology ; Male ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Recurrence ; Seizures ; pathology

OBJECTIVETo explore the possibility of the infrared objective displaying of heat-sensitive state of acupoint.

METHODSFifty-four qualified subjects were enrolled. In the natural state, thermal tomography (TTM) was adopted to shoot the thermograms on the face. After the thermograms collection, the thermo-sensitive detection with moxibustion was applied. The suspending moxibustion with moxa stick was used at Xiaguan (ST 7, affected side) for 10 mm. The cases with heat extension and transmission at the acupoint were recorded at the end of moxibustion. In following, the second infrared radiation detection was done so as to record the changes in the infrared images on the face before and after moxibustion and compare the difference in the heat-sensitive state at Xiaguan (ST 7, affected side) in the subjects between two detection methods.

RESULTSBefore moxibustion, the infrared radiation intensity at Xiaguan (ST 7, affected side) in the patients displayed mostly low temperature feature and its sensibility (true positive rate) was 65.6%, the specificity (true negative rate) was 68.2% and the accuracy was 66.7%. After moxibustion at Xiaguan (ST 7, affected side), there was an obvious block-diffused increment area of infrared radation along the cheek and its sensitivity (true positive rate) was 81.8%, the specificity (true negative rate) was 81.0% and the accuracy was 81.5% as compared with the moxibustion detection.

CONCLUSION(1) The heat-sensitive state at Xiaguan (ST 7, affected side) in the patients of primary trigeminal neuralgia can be objectively displayed by infrared imaging to a certain extent. (2) The acupoint heat-sensitization produced by moxibustion is not only the subjective sensation of the subjects, but also can be objectively displayed by infrared imaging to a certain extent.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Face ; radiation effects ; Female ; Humans ; Infrared Rays ; Male ; Middle Aged ; Moxibustion ; Thermography ; Trigeminal Neuralgia ; therapy ; Young Adult

OBJECTIVETo observe the distribution characteristics of heat-sensitized acupoints in the high incidence region of heat sensitization on the body surface of the patients with trigeminal neuralgia.

METHODSSixty cases of trigeminal neuralgia were collected and 60 healthy subjects were in the control. With moxibustion sensitization method to detect the heat-sensitized acupoints, the probability of the heat-sensitized acupoints in the high incidence region of heat sensitization on the body surface was analyzed and the correlation between the heat-sensitized acupoints and trigeminal neuralgia was discussed.

RESULTS(1) The occurrence rate of the heat-sensitized acupoints in the high incidence region of heat sensitization in patients with trigeminal neuralgia was 83.3% (50/60). (2) The occurrence rate of the heat-sensitized acupoints was high in the site of Xiaguan (ST 7) and Sibai (ST 2), and was secondarily high in the site of Jiachengjiang (Extra), Fengchi (GB 20) and Yuyao (EX-HN 4) in the high incidence region of heat sensitization in patients with trigeminal neuralgia.

CONCLUSIONThe heat-sensitized acupoints are highly correlative with trigeminal neuralgia, which provides the evidence for the further study on prevention and treatment of trigeminal neuralgia with heat-sensitive moxibustion.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Trigeminal Neuralgia ; therapy

Objective To explore the approach and early effects of endovascular stent-graft deployment in the treatment of portal stenosis of cancerous thrombus.Methods Six cases with portal vein stenosis of cancerous thrombus,which caused by primary hepatic carcinoma(5 cases)and eholangiocarcinoma(1 case)and the severity of stenosis showed on contrast enhanced CT were more than 75% or occluded,were performed percutaneous transhepatie or transsplenic portography.FLUENCY~(TM) endovascular stent-graft(10 mm diameter)was placed at the position of stenosis after gastroesophageal varices embolization.Portal pressure was measured pre-and post-deployment.Results Stents were successfully placed in all patients.The average portal pressure decreased from 50.7 cm H_2O(1 cm H_2O = 0.098 kPa)to 41.3 cm H_2O after endovascular stent-graft deployment.The restenosis were found in 2 cases after one month.Haematemesis and refractory aseites appeared in one case respectively,the other 4 cases showed no significant symptoms above caused by portal hypertension.Conclusion It is safe and feasible for endovaseular stent-graft deployment in the treatment of portal stenosis of cancerous thrombus.Selecting the suitable indications,the symptoms of portal hypertension can be controlled effectively.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo compare the difference in clinical efficacy on lumber disc herniation (LDH) treated with Yaoyangguan (GV 3) between mild moxibustion under thermosensitive condition and that under non-thermo-sensitive condition.

METHODSFifty-seven LDH patients were selected as the study objects. Mild moxibustion at Yaoyangguan (GV 3) was applied for 45 min each time. Additionally, the conventional acupuncture was given, once a day, for 20 days. At the end of treatment, two groups were classified. A thermosensitive acupoint group (thermosensitive group) was composed of the cases with thermo-sensitization at Yaoyangguan (GV 3) and presenting for > or =4 times in the entire treatment. A non-thermosensitive acupoint group (tranquilization group) was composed of the cases without thermo-sensitization or the frequency of thermo-sensitization <4 times in the entire treatment. The modified Japanese orthopedics association scoring system (M-JOA) was adopted to observe the cases before and after treatment and 6 months after treatment in the two groups. The efficacy was compared between the two groups.

RESULTSAfter treatment and in 6 months after treatment, the score of M-JOA was apparently reduced as compared with that before treatment in the two groups (all P<0.05). The score reducing in the thermosensitization group was more obvious than that in the tranquilization group (both P<0.01). After treatment and in 6 months after treatment, the curative rate and remarkably effective rate were 89.7% (26/29) and 79.3% (23/29), which was better than 71.4% (20/28) and 60.7% (17/28, both P<0.05) in the tranquilization group separately.

CONCLUSIONMild moxibustion at acupoint under thermosensitive condition achieves the better short-term and long-term effects as compared with that under non-thermosensitive condition.

Acupuncture Points ; Adult ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome