AIM: To study the clinical effect of implantation of multifocal intraocular lens ( lOL ) combined with cataract extraction and lOL in cataract patients.
●METHODS:A total of 86 cases ( 86 eyes ) of cataract patients admitted to our hospital from Feb. 2014 to Mar. 2015 were divided into two groups according to the order of admission, each of 43 cases. The 43 patients with cataract extraction combined with non spherical astigmatism correction type monofocal lOL implantation for the treatment as the control group, the other 43 patients with cataract extraction combined with aspheric toric multifocal lOL implantation were treated as the observation group. After 1y of follow- up, the visual acuity, astigmatism and the contrast sensitivity of the two groups were observed.
●RESULTS: There was no difference in visual acuity between two groups (P>0. 05). Postoperative observation group of uncorrected near visual acuity ( UCNVA ) was significantly better than the control group (P<0. 05), and the other indexes were not different (P>0. 05). There was no difference in astigmatism between the two groups before and after operation ( P> 0. 05 ). There was no difference in contrast sensitivity between two groups ( P>0. 05). The contrast sensitivity of the control group was better than that of the observation group (P<0. 05), and the rest had no difference (P>0. 05).
● CONCLUSION: Astigmatism correction multifocal intraocular lens on corneal astigmatism after surgery has a good effect, the naked eye near visual effect is better, the rest of the visual acuity is stable, good visual quality, worthy of clinical application and promotion.

Objective To investigate the stimulation of exosome derived from osteosarcoma cells suppressing cytotoxic T cells and the inhibitory effect of active T cells for surpressing osteosarcoma cells. Methods Exosome derived from tumor cells was isolated and purified by ultracentrifugation. Its morphology was observed with transmission electron microscope, and the major histocompatibility complex-I ( MHC-I) molecules were analyzed by western blot. Mice bone marrow-derived dendritic cells were pulsed with exosome. Surface membrane MHC-I molecules were analyzed with flow cytometry. The effect of active T cells on the growth of osteosarcoma cells were detected by MTT assay after the T cells being stimulated by exosome-pulsed dendritic cells. Results The exosome was round or near round corpuscle, and the diameter was about 50-100 nm by transmission electron microscope. The size was relatively homogeneous. Western blot showed that the exosome expressed MHC-Ⅰmolecules. Surface membrane CD80,MHC-I and II molecules were expressed on 77. 16%, 83. 21%, and 91. 26% of LPS-treated dendritic cells, respectively, which were up-regulated compared to untreated cells. Dendritic cells pulsed with exosome derived from osteosarcoma cells caused significantly higher T cells stimulation and osteosarcoma cells inhibition as compared to un-pulsed dendritic cells. (P<0.05). Conclusion T cells can inhibit the growth of osteosarcoma cells after being stimulated by exosome-pulsed dendritic cells in vitro.

Objective To discuss how to use the core elements of international classification of functioning,disability and health(ICF) as a guide in stroke operation treatment to develop targeted,effective therapy plan and rehabilitation goals,establish individualized treatment of rehabilitation,and to observe the effect of limb movement function in stroke patients. Methods Sixty cases patients with stroke and aged from 40 to 65 years old were selected. The body function and structure of all stroke patients were marked by comprehensive evaluation scores of The National Institutes of Health Stroke Scale ( NIHSS ) and Fugl?Meyer assessment. And then they were randomly divided into two groups,30 cases in each group. The observation group used the Chinese version of brief ICF Core Sets for evaluation, and set individualized treatment according to the results of the assessment;The control group, according to the conventional rehabilitation process, involved in training routine physical therapy. Again 8 weeks after treatment for patients with evaluation,the assessment results was compared with the results of the first assessment. Results Before treatment, the NIHSS, Fugl?Meyer assessment and Chinese version of brief ICF core elements scale scores for the observation group were 7. 95±2. 37,34. 5±4. 0 and 82. 15±17. 96,for the control group were 7. 58±2. 25,34. 8±4. 0 and 81. 55±18. 78. After treatment,the above three rating scale scores, for the observation group were improved to 4. 78 ± 1. 63, 56. 3 ± 4. 2, 60. 45 ±11. 04,for the control group were improved to 5. 13±1. 75,48. 1±3. 8,73. 56±16. 89. The two groups were significantly improved ( observation group:t=4. 94, 15. 51, 18. 59, P<0. 05;control group:t=3. 17, 14. 66, 12. 33,P<0. 05). After treatment,compared with the control group of three rating scale scores(5. 13±1. 75,48. 1
±3. 8 and 73. 56±16. 89),the observation group(4. 78±1. 63,56. 3±4. 2 and 60. 45±11. 04) improved more apparently(t=3. 15,14. 54,15. 45,P<0. 05) . Conclusion Guided by the idea of ICF and scale,with the demand of the patients as the center,to develop personalized physical therapy,can achieve more productive and more targeted rehabilitation goals.

Objective To investigate the surgical techniques and clinical effects of anterior retropharyngeal approach in treatment of C2/3 fracture and dislocation.Methods Twelve patients with C2/3 fracture and dislocation treated via anterior retropharyngeal approach between November 2011 and April 2013 were included in the study.There were 7 males and 5 females aged from 19 to 65 years (mean,35 years).Primary pathologies included 7 patients with traumatic C3 fracture,2 with Hangman fracture and 3 with fracture and dislocation of the anteroinferior margin of C2 vertebrae.C2-C4 vertebrae were exposed using anterior retropharyngeal approach,followed by C2/3 discectomy or C3 corpectomy,decompression,interbody cage fusion or titanium mesh cage fusion,and anterior internal fixation.Results Exposure of lesion was sufficient for all patients and all operations were completed under direct vision,with mean operation time of 140 minutes and mean blood loss of 120 ml.One patient with reduced tone after operation gradually recovered in a week; one with dysphagia after operation recovered in 3 months; one with skin necrosis 7 days after operation was recovered by changing dressing; for the rest,there were no complications of incision hematoma,infection,or asphyxia.Ten patients were followed up for mean 15 months,which showed bony fusion in mean 6 months.At final follow-up,no implant loosening or displacement occurred.Conclusion Anterior retropharyngeal approach to C2/3 fracture and dislocation provides sufficient exposure of lesions,minor trauma,and less bleedings and complications,but as the local anatomy is complicated,there indeed exists a learning curve of the approach.

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

OBJECTIVETo observe the clinical efficacy differences among warming-promotion acupuncture, regular acupuncture and psychological care for post-earthquake depression.

METHODSNinety cases of post-earthquake depression in Gansu province were randomly divided into a warming-promotion acupuncture group, a regular acupuncture group and a care group, 30 cases in each one. The psychological treatment was applied in the care group; the regular acupuncture at Baihui (GV 20), Sishencong (EX-HN 1)), Fengchi (GB 20), Shenmen (HT 7), Yang-lingquan (GB 34), Taichong (LR 3) and Sanyinjiao (SP 6) was used in the regular acupuncture group; based on the treatment of regular acupuncture group, the warming-promotion acupuncture was applied in the warming-promotion acupuncture group, once a day. Ten days were taken as one course with an interval of two days between two courses. Totally 3 treatment courses were completed. The Hamilton depression (HAMD) scale before and after treatment in each group was observed while the efficacy was analyzed.

RESULTSAll three treatments were effective for depression. The total cured rate was 86.67% (26/30) in the warming-promotion acupuncture group, which was obviously superior to 50.00% (15/30) in the regular acupuncture group (P < 0.01) and 33.33% (10/30) in the care group (P < 0.001). After the treatment, the score of HAMD was all reduced in three groups, in which the effect in warming-promotion acupuncture group was superior to that in the regular acupuncture group and care group (9.02 +/- 2.37 vs 10.73 +/- 2.28 and 11.05 +/- 2.01, P < 0.05, P < 0.01).

CONCLUSIONThe warming-promotion acupuncture has positive effect on post-earthquake depression, which has special effect and is worthy of clinical generalization and application.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Aged ; Child ; Depression ; therapy ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Needles ; Young Adult

AIM: To investigate the effect of peribulbar anesthesia on intraocular pressure(IOP)and ocular amplitude pulse(OPA).METHODS: Thirty-two consecutive adult patients with monocular cataract enrolled in this study. IOP and OPA were measured with dynamic contour tonometer(DCT)before and 3, 10 minutes after administration of lidocaine anesthesia. Data were analyzed with software SPSS 11.5.RESULTS: The IOP remained stable in the injected eyes and the non-injected eyes after administration of lidocaine anesthesia. The OPA was significantly decreased after injection of anesthesia agent in the injected eyes. The OPA in the non-injected eyes increased significantly 3 minutes after injection of the anesthesia agent, returning to preinjection level 10 minutes after the injection.CONCLUSION: Peribulbar anesthesia leads to decrease of OPA and shows no effect on IOP in the injected eyes.

Objective To assess the potential clinical signiifcance of myocardial composite index (MCI) in the evaluation of left ventricular myocardial function in breast cancer patients with postoperative chemotherapy by speckle tracking echocardiography (STE). Methods A total of 33 consecutive breast cancer patients with postoperative chemotherapy were prospectively enrolled in Shanghai East Hospital, Tongji University, from February 2012 to February 2013. Thirty-six female healthy volunteers were enrolled as the controls. Routine echocardiographic parameters [left ventricular end diastolic volume (EDV), end systolic volume (ESV), interventricular septum thickness at diastole (IVSTd), left ventricular posterior wall thickness (PWTd) and left ventricular ejection fraction (LVEF)] were obtained. EDV and ESV were corrected for body surface area, and then end diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated. STE-derived parameters [left ventricular global longitudinal strain (GLS), global radial strain (GRS), left ventricular twist (LVtw) and myocardial composite index (MCI)] were evaluated. All above data were obtained after 5 anthracycline-based chemotherapeutic cycles and compared with baseline measurements in controls respectively. Receiver operating characteristic (ROC) curves were constructed to determine optimal sensitivity and specificity of continuous variables for the prediction of future cardiotoxicity. Results (1)Changes in EDV, ESV, IVSTd, PWTd and LVEF showed no significant decreases compared with baseline and controls (F=1.35, 2.04, 1.28, 2.34, 2.16, P > 0.05 for all), while the changes in ESVI and EDVI showed statistically decreases (F=4.73, 6.86, P < 0.05 for all);(2)The changes in EDVI and ESVI showed signiifcant decreases compared with baseline (t=6.10, 5.13, P<0.05 for all) and controls (t=5.26, 4.24, P<0.05 respectively);(3)The change in GRS showed no statistical signiifcance compared with baseline and controls (F=1.23, P>0.05), while change in GLS, LVtw and MCI showed statistical significances compared with baseline and controls (F=4.29, 5.02, 12.35, P<0.05 for all);(4)The changes in GLS, LVtw and MCI showed signiifcant decreases compared with baseline (t=5.33, 13.94, P<0.05 respectively) and controls (t=4.97, 4.46, 7.18, P<0.05 all);(5)The area under receiver operating characteristics curve (AUC) of MCI was 0.894, and its optimal cut-off value was-265.7 (%×degree) with sensitivity of 82.6%and specificity of 78.7%. Conclusion MCI based on STE, combining myocardial strain and cardiac twist, may be an accurate predictor in identifying potential cardiotoxicity in postoperative chemotherapeutic survivors with breast cancer.

Purpose To assess the feasibility of dual-energy dual-source virtual noncontrast (VNC) CT in the diagnosis of laryngeal carcinoma,in order to reduce radiation hazard.Materials and Methods Forty-nine patients with clinically identified laryngeal carcinoma underwent conventional non-contrast (CNC) scan as well as arterial and venous dual-phase and dual-energy VNC scan.The VCN images of arterial and venous phase were obtained by using the dual-energy software.The mean CT value,signal-to-noise ratio (SNR),contrast noise ratio (CNR),lesion morphology,image quality and radiation dose were compared between the VNC and CNC images.Results The mean CT value,SNR,CNR and image quality scores of CNC were higher than those of VNC images of arterial and venous phase (P＜0.05).There was no significant difference in the image quality scores of VNC between the arterial and venous phase (P＞0.05).The image quality scores of VNC were all above 3,which could meet the diagnostic requirements.There was no significant difference in the shape,size,boundary and cystic necrosis of the lesions,invasion of the surrounding space,osteolytic destruction and size of the surrounding lymph node between the CNC and VNC image.The radiation dose of dual-phase dual-energy scan was 0.42 mSv,which was 18.3％ lower than that of the conventional three-phase scan.Conclusion For laryngeal carcinoma,the VNC images from the dual-energy CT scan can be used to reduce the radiation dose without affecting image quality and diagnosis accuracy,which has good clinical value.

Objective To investigate the left ventricular (LV) performance in patients with essential hypertension(EH) by global performance index (GPI) based on three-dimensional speckle tracking imaging (3D-STI).Methods A total of 164 EH patients were enrolled and divided into four subgroups according to LV configuration:LV normal group (LVN,n =67),concentric cardiac remodeling group (CCR,n =49),concentric cardiac hypertrophy group (CCH,n =28) and eccentric cardiac hypertrophy group (ECH,n =20).Thirty age and sex matched healthy volunteers were enrolled as controls.3D-STI was performed to assess LV 3D global strain and LV torsion,then LV systolic dyssynchrony index (SDI) and global performance index (GPI) were calculated.Global strain parameters were investigated among the groups,and correlations with GPI were studied.Results GPI,global longitudinal strain(GLS),global area strain(GAS),global radial strain(GRS) and global 3D strain(G3DS) in EH groups were respectively lower than those in the normal controls,and there were statistical differences among the respective parameters (P ＜0.05,respectively).SDI in group CCH and ECH were significantly higher than that in normal controls (P ＜ 0.05,respectively).In multivariate stepwise regression analysis,GAS was the most influential to GPI.Conclusions GPI based on 3D-STI may accurately reflect LV performance in patients with EH,and has potential applications in clinical practice.