AIM: To compare the refraction error(RE)3mo after phacoemulsification combined with intraocular lens implantation(PHACO+IOL)between patients with acute primary angle-closure glaucoma(APACG)with cataract(APACG group)and patients with simple cataract(cataract group), and the biological parameters of the eye(axial length,corneal curvature, anterior chamber depth)associated with the postoperative RE in the APACG and cataract groups.

METHODS: This was a prospective, non-randomized, case-control study. Each group had 30 cases(30 eyes). Intraocular pressure, axial length, corneal curvature, and anterior chamber depth were measured. The reserved refractive power was calculated using the SRK-II formula. Three months postoperatively, subjective RE was calculated as the postoperative refractive power which subtracted the preoperative reserved diopter(RE was considered as <-0.50D or >+0.50D; -0.50D to +0.50D not considered as RE). An independent sample t-test was used to compare the difference in RE between the two groups and to compare the differences among relevant parameters such as axial length, corneal curvature, and anterior chamber depth. Paired t-test was used to compare preoperative and postoperative parameters such as axial length, corneal curvature, and difference in anterior chamber depth.

RESULTS: Mean RE in the cataract group was -0.46D±0.46D, with 24 cases of myopic RE(80%)and 6 cases of hyperopic RE(20%). Mean RE in the APACG group was +0.56D±0.79D, with 9 cases of myopic RE(30%)and 21 cases of hyperopic RE(70%). The difference in RE between the two groups was statistically significant(P<0.05). On comparison of pre- and postoperative biological parameters of the two groups, in the cataract group, there was a non-significant difference in pre- and postoperative axial length(23.55±0.47mm versus 23.56±0.48mm, respectively; P>0.05). In the APACG group, pre- and postoperative axial length was 21.71±0.46mm and 21.52±0.54mm, respectively; the difference was statistically significant(P<0.05). In the both the cataract and APACG groups, postoperative anterior chamber depth was significantly higher than preoperative(4.09±0.38mm versus 2.71±0.24mm, in the cataract group, and 3.55±0.35mm versus 1.90±0.23mm, In the APACG group, respectively; both P<0.05). In the cataract group and the APACG groups, pre- and postoperative average corneal curvature were not significantly different(43.93D±0.95D versus 43.92D±0.95D, in the cataract group, and 44.71D±0.84D versus 44.70D±0.9D, In the APACG group, respectively; P>0.05). On comparison of biological parameters between the two groups, postoperative ocular axial length shortening in the APACG group was statistically significant compared with the ocular axial changes in the cataract group(P<0.05). The postoperative anterior chamber deepened markedly in the APACG group; this was statistically significant compared with the cataract group(P<0.05).

CONCLUSION:Postoperative RE in patients with APACG and cataract who underwent PHACO+IOL is relatively large compared with patients with simple cataracts. These patients with APACG and cataract also show hyperopia drift, which is more significantly correlated with postoperative ocular axial length shortening and increased anterior chamber depth.

AIM: To compare the ability of spectral-domain optical coherence tomography(SD-OCT)and slit lamp biomicroscopy to detect anterior segment findings in patients with closed globe injury.

METHODS: This is an observational, cross-sectional study. Sixteen patients with a closed globe injury were consecutively recruited from January 2010 to July 2015 in Huizhou Municipal Central Hospital. All patients underwent complete ophthalmic examination, including assessment of visual acuity, measurement of intraocular pressure using a noncontact tonometry, and slit lamp biomicroscopy. SD-OCT was used to examine the anterior segments of all injured eyes. Two patients had bilateral ocular injuries and received bilateral SD-OCT examinations. The OCT findings of the cornea, iris, anterior chamber and lens were recorded and compared with findings seen using slit lamp biomicroscopy.

RESULTS: All 18 eyes were examined by SD-OCT had hyphema occupying at least one-third of the anterior chamber volume. Sixteen eyes had corneal edema and corneal abrasion detected on both slit lamp biomicroscopy and OCT examination. OCT examination was also able to detect Descemet's membrane detachment(n=7), angle recession(n=6), lens subluxation(n=3)and iridodialysis(n=3).

CONCLUSION: SD-OCT was able to identify features of closed globe injury that were otherwise not visible on slit lamp biomicroscopy. SD-OCT may have advantages over clinical examination in cases of closed globe injury.

Objective To investigate the therapeutic effects of fluorouracil implants in Stage Ⅲgastric carcinoma patients after radical gastreetomy. Methods The general state of health and cumulative survival of 200 stage Ⅲ gastric carcinoma patients undergone radical gastrectomy from January, 1999 to, December 2002 in the People's Hospital of Zhongshan City were analyzed, in which only 120 patients administrated fluorouracil implants during radical gastreetomy. The therapeutic effects of fluorouracil implants in stage Ⅲ gastric carcinoma patients after radical gastrectomy were observed. Results The differences of weight (P = 0.041), HGB(P =0.024), Plt(P =0.017), CEA(P =0.001), CA19-9(P =0.003) were significant between two groups. The incidence rate of nausea/emesis in group T (28 %) was higher than that in group O(17 %, P = 0.006), and incidence rates of myelosuppression(P =0.81), diarrhea(P =0.72), hepatic function lesion(P =0.97) and renal function lesion(P =0.20) were no significant. The cumulative 5-year survival rate of group T(45 %) was higher than that in group O (15 %, P =0.002). Conclusion Fluorouracil implants can improve the therapeutic effects on gastric carcinoma patients undergone radical gastrectomy.

Objective To investigate the expression and significance of β-catenin and peroxisome prolifera-tot-activated receptor-γ,(PPARγ) in bepatocellular carcinoma. Methods Tissue microarrays were established to detect β-catenin and PPARγ expression in 49 cases of hepatocellular carcinoma,49 cases of adjacent nontumoral liv-er tissue and 6 cases of normal liver tissue. The relationships between PPARγ and β-catenin as well as between PPARγ and clinicopathological parameters were observed. Results The aberrant expression rate of β-catenin was 69.39%,48.98 % and 0 respectively (P=0.001). The positive expression rate of PPARγ was 51.02%,30.61% and 0 respectively (P=0.016). Clinicopathological analysis revealed that the increase of PPARγ expression was not associated with age,tumor size,serum alpha fetoprotein (AFP) levels,tumor embolus of portal vein or inferior vena cava,and HBsAg infection(χ2=0.214,3.201,0.046,3.201,P>0.05 for each),but correlated with differentiation grades(χ2=4.693,P<0.05). Aberrant expression of β-catenin was associated with PPARγ expression(χ2= 5.130,P<0.05). Conclusion Aberrant expression of β-catenin may involve in the liver carcinogenesis. The high expression of PPARγ in hepatocellular carcinoma is significantly correlated with the clinicopathological characteris-tics. Detection of PPARγ is valuable for diagnosing hepatocellular carcinoma,and evaluating malignancy extent and prognosis.

AIM: To evaluate and compare the quality of life of patients submitted to phacoemulsification combined with goniosynechialysis(PPI+GSL)and trabeculectomy, and analyze the potentially involved variables.

METHODS: A perspective, randomized case-control study was conducted. Patients with acute primary angle-closure glaucoma(ACG)and early cataracts underwent PPI+GSL implantation(group A, n=29)and trabeculectomy(group B, n=30). The quality of life was assessed using the National Eye Institute 25-Item Visual Function Questionnaire(NEI-VFQ-25)before and 6mo after surgery. Intraocular pressure(IOP), best corrected visual acuity(BCVA), review frequency and the basic characteristics were recorded simultaneously.

RESULTS: Compared with preoperative status, the IOP in both groups was significantly decreased(all P<005), and the BCVA was significantly increased in group A(P<0.05), while did not differ significantly in group B(P>0.05). Besides, group B presented higher review frequency than group A(P<0.05). Moreover, significant increases in postoperative scores were founded in the two groups respectively(all P<0.05). Compared with group B, group A had better postoperative performance in items of general vision, ocular pain, long-distance activities, social functioning and role limitations(all P<0.05). Besides, group A presented significantly higher net increases in postoperative total scores than group B(P<0.05), which was positively associated with the degree of the BCVA recovery and negatively associated with review frequency(R²=0.48, F=5.00, P<0.05).

CONCLUSION: APACG patients with early cataracts, PPI+GSL determines better improvement in quality of life compared to trabeculectomy.

Objective: To describe the current reporting of pneumonia of unknown etiology (PUE) and factors that affect reporting by clinicians in China using the PUE surveillance system in order to provide a reference for improving PUE reporting rates in the future. Methods: Clinicians were recruited via the Sojump platform and requested to complete an anonymous self-administered questionnaire. Multivariate logistic regression analysis was used to assess factors influencing clinicians' reporting activities. Results: This study showed a low PUE case reporting rate and a poor understanding of PUE reporting among the investigated clinicians. Of the 136 clinicians who had diagnosed PUE cases, multivariate logistic regression analysis results showed that clinicians who had attended in-hospital training were more likely to report PUE than those who had not (OR 4.48, 95% CI 1.49-13.46). Clinicians with an expert panel on PUE in their hospital were more likely to report PUE cases than those without (OR 5.46, 95% CI 1.85-16.11). Conclusions: There is a need to promote and reinforce PUE surveillance system training among medical staff. In addition, PUE testing technologies in hospital laboratories should be upgraded, especially in primary and unclassified hospitals, to increase surveillance efficiency and improve PUE reporting rates.

Bungarus Parvus, a precious animal Chinese medicinal material used in clinical practice, is believed to be first recorded in Ying Pian Xin Can published in 1936. This study was carried out to analyze the names, geographical distribution, morphological characteristics, ecological habits, poisonousness, and medicinal parts by consulting ancient Chinese medical books and local chronicles, Chinese Pharmacopeia, different processing standards of trditional Chinese medicine(TCM) decoction pieces, and modern literatures. The results showed that the earliest medicinal record of Bungarus Parvus was traced to 1894. In 1930, this medicinal material was used in the formulation of Annao Pills. The original animal, Bungarus multicinctus, was recorded by the name of "Bojijia" in 1521. The morphological characteristics, ecological habits, and poisonousness of the original animal are the same in ancient and modern records. The geographical distribution is similar between the ancient records and modern documents such as China Medicinal Animal Fauna. The dried body of young B. multicinctus is used as Bungarus Parvus, which lack detailed references. As a matter of fact, it is still inconclusive whether there are differences between young snakes and adult snakes in terms of active ingredients, pharmacological effects, and clinical applications. This study clarified the medicinal history and present situation of Bungarus Parvus. On the basis of the results, it is suggested that systematic comparison on young and adult B. multicinctus should be carried out to provide references for revising the medicinal parts of B. multicinctus.
Animals ; Bungarus ; Snakes ; China ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal

Artemisiae Argyi Folium is commonly used in clinical practice. Artemisiae Verlotori Folium, the dried leaves of Artemisia verlotorum, is often used as a folk substitute for Artemisiae Argyi Folium in Lingnan area. In this study, gas chromatography-triple quadrupole mass spectrometry(GC-MS) was used to detect the volatile oil components of 27 samples of Artemisiae Verlotori Folium and 13 samples of Artemisiae Argyi Folium, and the volatile components were compared between the two species. The internal standard method was combined with multi-reaction monitoring mode(MRM) to determine the content of six major volatile components. Hierarchical clustering analysis(HCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were carried out for the content data. The results showed that the Artemisiae Argyi Folium samples had higher content and more abundant volatile oils than the Artemisiae Verlotori Folium samples. Artemisiae Argyi Folium mainly had the components with lower boiling points, while Artemisiae Verlotori Folium mainly had the components with higher boiling points. Terpenoids were the main volatile components in Artemisiae Verlotori Folium(mainly sesquiterpenoids) and Artemisiae Argyi Folium(monoterpenoids). In addition, Artemisiae Argyi Folium had higher content of oxygen-containing derivatives than Artemisiae Verlotori Folium. Furthermore, the stoichiometric analysis showed that the two species could be distinguished by both HCA and OPLS-DA, indicating that the volatile components of the two were significantly different. This study can provide a scientific basis for the quality evaluation and data support for the local rational application of Artemisiae Verlotori Folium in Lingnan.
Gas Chromatography-Mass Spectrometry ; Chemometrics ; Oils, Volatile ; Drugs, Chinese Herbal ; Plant Leaves ; Artemisia