AIM:To study the efficacy and safety of intravitreal injection ranibizumab (IVR) assisted 25G+ minimally invasive vitreoretinal surgery (VRS) in the treatment of severe proliferative diabetic retinopathy (PDR).METHODS: Totally 61 patients and 74 eyes were selected with severe PDR from March 2015 to June 2016 in our hospital.According to the principle of voluntary,37 eyes of 31 cases in the VRS before the IVR treatment was set to the joint group,37 eyes of 30 cases line pure VRS was set to the VRS group.We compared the vitreous volume,logMAR,mean IOP,macular central retinal thickness and complications between the 2 groups.RESULTS: The blood rate of glass in the combination group was 8% after 1wk of postoperative which was significantly lower than that of the VRS group 27% (x2=4.573,P=0.032).The glass volume blood rate of the combined group was 0 after 1mo of postoperative while the VRS was 16%(P=0.033).The blood rate of glass in the combination group was 0 at 3mo of postoperative,and 8% in the VRS group(P=0.238).The LogMAR in the combined group was significantly lower than that in the VRS group(t=2.320,P=0.023).There was no significant difference in the mean IOP between the two groups (t=0.516,P=0.608).The mean macular retinal thickness of the combined group was 298.8±78.3μm which significantly lower than the VRS group 357.1±86.2μm(t=3.045,P=0.003).The combined high ntraocular pressure rate of the combined group was 14% which was significantly lower than 32% of the control group(x2=10.385,P=0.001).The rate of anterior membrane of the retina of the combined group,the rate of recurrent traction and the rate of retinal detachment of the newborn were lower than that of the VRS group,but the difference was not statistically significant (P>0.05).CONCLUSION: IVR assisted VRS,although there is a certain controversy,but in the appropriate dose,frequency and time to achieve significant efficacy,safety is also high.

Objective To explore the methods and effects of the general resident nurse on duty system,and thereby to play an effective role of skilled nurses to ensure the quality and safety of nursing.Methods Using the management experience of general resident doctors for reference,a general resident nurse on duty system was established.The general resident nurses were strictly selected,trained and examined.At the same time,the management regulations were formulated.Results This practice cultivated a general resident nurse team with well-prepared nursing knowledge,skilled techniques,good capacity to cope with emergency,which could play important roles in the guidance and quality control of clinical nursing.Conclusion The implementation of general resident nurse on duty system can help train the backbone of specialized care,reserve the force of handling emergency and improve the quality of nursing.

Objective To evaluate the efficacy of 3+x mode for the reduction of unplanned extubation in the patients with stomach cancer. Methods 107 patients with the indwelling gastric tube of gastric cancer perioperative from June 2014 to September 2014 were collected as the observation group, and 101 patients with the indwelling gastric tube of gastric cancer perioperative from June 2013 to September 2013 were collected as the control group. Once preoperative education on stomach tube was performed in the control group, and 3+x education mode was used in the observation group, so as to compare unplanned extubation rate of two groups. Results The tube unscheduled decannulation rate in postoperative patients with gastric cancer in the control group was significantly higher than that in the observation group [4.95 %(5/101) vs 0 (0/107)], and there was significant difference (χ2= 5.168, P= 0.029). Conclusion 3+x mode education can significantly reduce unplanned extubation rate in operation patients with gastric cancer.

OBJECTIVE: To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps, by testing the olfactory function of seventy-four patients before and after endoscopic sinus surgery,and evaluate the outcomes of olfactory dysfunction after endoscopic sinus surgery in patients with choinc rhinosinusitis and the related factors. METHOD: The olfactory function of the seventy-four patients with chronic sinusitis and nasal polyps were tested by the T&T olfactory testing method at pre-operation and four weeks,twelve weeks, twenty-four weeks of post-operation. Patients were divided into two groups, according to whether combined with allergic rhinitis. Data were achieved by the scores of endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey. Parallel processing standard endoscopic operation and processing specification during peri operation period. Analysing the degree of olfactory rehabilitation in chronic sinusitis and nasal polyps with allergic rhinitis. RESULT: (1) Compared with the level of olfactory function, significant improvement was found at first month;however, the olfactory function level 4 weeks after operations was significantly statistically different with that 12 weeks and 24 weeks after operations; (2) Lund-Mackey sinus CT higher score is related to the worse degree of postoperative nasal olfactory rehabilitation (P < 0.05). (3) The higher scores of endoscopic appearances of Kennedy is related to the worse degree of postoperative nasal olfactory rehabilitation (P < 0.05). (4) Allergic rhinitis is one of the factors of olfactory rehabilitation in chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation, the olfactory rehabilitation of patients with allergic rhinitis is worse than that in the patients with no allergic rhinitis. (5) Course of disease is one of the factors of chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation. Longer the course of disease, worse the olfactory rehabilitation. (6) E osinophil count was related to olfactory rehabilitation in chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation. Higher Eosinophil count, worse the olfactory rehabilitation. CONCLUSION FESS plays a positive role in the improvement of olfactory impairment in patients with CRS. It is important to protect the olfactory mucous during surgical removal of sinonasal lesions. The standard intraoperative procedure, treatment on allergic rhinitis and regular follow-up after operation are also very important.
Chronic Disease ; Endoscopy ; Humans ; Nasal Polyps ; complications ; surgery ; Nasal Surgical Procedures ; Olfaction Disorders ; rehabilitation ; Paranasal Sinuses ; surgery ; Postoperative Period ; Rhinitis, Allergic ; complications ; Sinusitis ; complications ; surgery ; Smell

Objective: To develop the ultra performance liquid chromatography tandem mass spectrometry ( UPLC-MS/MS ) for the determination of perfluorocarboxylic acids ( PFCAs ) in fish. Methods: The fish samples were extracted with tert-butyl methyl ether and purified by WAX columns. The WAX cartridges were rinsed with methanol and 25 mmol/L ammonium acetate, and the target compound residues were eluted with 0.5% ammonia methanol and then redissolved with 50% methanol aqueous solution after nitrogen blowing to nearly dry. Nine kinds of PFCAs were simultaneously quantified by UPLC-MS/MS with 1 mmol/L ammonium acetate-methanol solution as the mobile phase. Results: The extraction was separated well in UPLC BEH C18 column. There were good linear correlations of nine kinds of PFCAs in the range of 1.0-200.0 ng/mL, with the coefficients all more than 0.99. The limits of detection and quantification were 0.06-0.19 μg/kg and 0.19-0.62 μg/kg, respectively. The recovery rates were 70.08%-117.24% at different spiked levels ( 5.0, 25.0, 50.0 μg/kg ), and the relative standard deviations were 2.31%-19.68%. Conclusion Through optimizing the pretreatment conditions, the mobile phase of liquid chromatography and the detection conditions of mass spectrometry, the UPLC-MS/MS could meet the monitoring requirements of PFCAs in fish.

OBJECTIVE： To observe the effect of drug loading， medium composition， transdermal enhancer， lauryl alcohol and azone on percutaneous permeation of oxaprozin gel in vitro.METHODS： Drug permeation test was carried out by using modified Franz-type double compartment diffusion cell and isolated mice skin in vitro as transdermal barrier.RESULTS： Under the condition of an effective area of 5.77cm2， it was found that the result was stable and the reproducibility was well with drug loading more than 1.2g， the receiver solution ethanol to normal saline=7∶ 3(v∶ v);The transdermal enhancing effect of lauryl alcohol was superior to that of azone， the effect of mixed transdermal enhancer 3％ AZ＋ 10％ LA was the best.CONCLUSION： The selection of both the optimum release condition and the best penetration enhancers provided reference for oxaprozin transdermal delivery.The standardization of gel percutaneous test in vitro was discussed preliminarily.

Objective To summarize the tending physique of hysteromyoma patients and thus to provide the clinical prevention and treatment methods for the disease.Methods Clinical epidemiology investigation and study methods were adopted to design the unified investigation and study table.Questionnaire survey were performed stochastically to 150 hysteromyoma patients and 150 normal females.Various physique characteristics were recorded.Results Ecchymosis physique were commonly seen in hysteromyoma patients,accounting for 36.7％ in all patients.Conclusion The occurrence of hysteromyoma was closely related to ecchymosis physique.

Objective: To compare therapeutic effects of clopidogrel and loading dose ticagrelor on aged patients with ST elevation myocardial infarction (STEMI).Methods: A total of 160 aged STEMI patients undergoing emergency percutaneous coronary intervention (PCI) were selected.According to random number table, they were randomly and equally divided into clopidogrel group (received loading dose aspirin and clopidogrel therapy) and ticagrelor group (received loading dose aspirin and ticagrelor therapy).Coronary TIMI flow grade, incidence rate of no-reflow after PCI, and incidence of cardiac adverse events and bleeding events in one month after PCI were compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of coronary TIMI flow grade 3 (71.25% vs.90.00%), and significant reduction in incidence rate of no-reflow (28.75% vs.10.00%) in ticagrelor group,P<0.05 all.Compared with clopidogrel group on one month after PCI, there were significant reductions in incidence rates of cardiogenic death (13.75% vs.3.75%), in-stent thrombosis (6.25% vs.0) and recurrent myocardial infarction (10.00% vs.1.25%), but significant rise in incidence rate of dyspnea (3.75% vs.12.50%) in ticagrelor group, P<0.05 all.There was no significant difference in incidence of bleeding events between two groups, P>0.05 all.Conclusion: Loading dose ticagrelor can effectively improve coronary blood flow, reduce no-reflow and its safety is good in aged patients with ST elevation myocardial infarction, which is worth extending.

This study was aimed to explore the mechanism of baicalin on high altitude cerebral hypoxia-ischemia on mice and its influence on related target protein expressions. Morris water maze was used to screen 50 Kunming mice, which were randomly divided into the model group, control group, the low dose (0.05 mg·kg-1), middle dose (0.20 mg·kg-1) and high dose (0.60 mg·kg-1) baicalin group, with 10 rats in each group. The space memory and learning ability of mice were tested. The animal cabin with low oxygen (simulating at 4 000 m altitude) was used to establish the stable high altitude cerebral hypoxia-ischemia mouse model. Changes on SOD content, GSH-PX activities and MDA content in hippocampal tissues of mice were detected. The expressions of different target proteins, including cleaved-caspase 3, P-AKT, GFAP, Bax and Bcl-2 in brain stem of mice were detected by western blot. The results showed that the latent period of the model group was obviously longer than that of the control group (P < 0.05). The latent period of high dose baicalin group was shorter than the model group with significant difference (P< 0.05). Therefore, the best effective dose of baicalin was 0.60 mg·kg-1. Compared with the control group, the content of MDA in the hippocampal tissues of mice in the model group was significantly increased; the SOD and GSH-PX activity were obviously reduced (P < 0.05). Compared with the model group, the SOD and GSH-PX activity were obviously increased in the brain tissues of mice in the high dose baicalin group; and the content of MDA was obviously reduced (P < 0.05). From the level of protein changes, the stripes of cleaved-caspase 3, P-AKT, GFAP protein expressions in the model group were strengthened compared to the control group; the ratio of Bax/Bcl-2 was also obviously increased (P < 0.05). The expression of the baicalin group was lower than that of the model group (P < 0.05). Among them, the expression of the high dose baicalin group was the lowest. It had certain dose-response relationship. It was concluded that baicalin had protective effect on high altitude cerebral hypoxia-ischemia. Its mechanism may be related to its powerful oxidation resistance and its inhibition on expression of different target proteins, including cleaved-caspase 3, P-AKT, GFAP, Bax, Bcl-2 for the change of apoptotic pathway.

Objective:To evaluate the role of miR-124 in breast cancer and its underlying mechanism. Methods:Quantitative re-verse transcription-polymerase chain reaction (qRT-PCR) was employed to quantify the expression level of miR-124 in the breast can-cer cell lines and matched tissues of 52 patients. Cell proliferation, invasion, and migration of MDA-MB-231 and T-47D were deter-mined by miR-124 overexpression in vitro. Luciferase vectors (pMIR-SP1 3'UTR) were also constructed. The predicted target gene of miR-124 was identified via luciferase activation assay. The mRNA and protein expression of SP1 was detected via qRT-PCR and West-ern blot, respectively. Results:MiR-124 was decreased in breast cancer tissues and cell lines. This result is correlated with metastatic capacity, TMN stages, and prognosis in breast cancer tissues. In breast cancer cell lines, ectopic overexpression of miR-124 inhibited cell proliferation, invasion, and migration in vitro. MiR-124 mimics significantly inhibited luciferase activation (P<0.05) in HEK293 cells and could significantly decrease the mRNA (P<0.05) and protein expression levels of SP1 in MDA-MB-231 and T-47D cells. Con-clusion:MiR-124 could be inhibited in breast cancer. The low miR-124 expression is associated with poor prognosis. In addition, miR-124 could inhibit cell proliferation, invasion, and migration by targeting SP1. These findings confirm that miR-124 downregulation may be a key mechanism for breast cancer carcinogenesis.