Objective To investigate the therapeutic value of endoscopic implantation of metal stents for obstruction caused by left-sided malignant colorectal tumor.Methods Data of 29 patients with left-sided malignant colonic obstruction who underwent stenting from May 2007 to May 2011 were retrospectively analyzed.Results Self-expanding metal stents were successfully implanted in 27 patients.Symptoms of abdominal distention and vomiting subsided in these patients.The procedure failed in 2 patients (2/29,6.9％ ),because the guidewire failed to pass the colonic stricture due to edema and the length of the diseased colon.Technical success was achieved in 27 of total 29 patients (27/29,92.6％ ).Out of the 27 patients,stage Ⅰ primary left-sided colonic resection and anastomosis were successfully performed in 24 patients.Colonic perforation was found intraoperatively in 1 patient ( 1/27,3.7％ ) who subsequently recovered after operation.There was no death during the perioperative period with the average hospital stay of 11.7 days.A mean colonic stent patency for 5 months was observed in 3 patients who underwent palliative stenting only.Conclusion Endoscopic implantation of metal stents is effective for left-sided malignant colorectal obstruction.As a bridge to surgery,it facilitates sufficient bowel preparation for elective radical operation.

Objective To explore the mechanisms and the significance of compatibility of Heixiaoyao Powder by observing the effect of Heixiaoyao Powder on mice model of senile dementia induced by scopolamine. Methods Kunming mice were randomly divided into five groups including control group, model group, Heixiaoyao Powder group, Xiaoyao powder group and streamlined formula group, with 10 mice of each group. Scopolamine hydrobromide intraperitoneal injection was adopted to make memory impairment in mice model, and followed by drugs treatment with corresponding decoction of the crude drug 2.314 g /(kg·d). Control group and model group were given normal saline orally once a day, all groups were treated for 10 days continuously. After 6 and 8 days of the administration, water maze test, stair jumping test and darkness avoidance test were conducted to test behavior proficiency, and the activity of acetylcholinesterase (AchE) activity and choline acetyltransferase (ChAT) in brain tissue were tested also. Results Compared with model group, Heixiaoyao Powder group, Xiaoyao Powder group and streamlined formula group could significantly reduce the error number and shorten latency in the water maze test, decrease the time of electrical shocks and prolong the incubation period of time in both stair jumping test and darkness avoidance test, and could increase ChAT activity and lower AchE activity in brain tissue of mice (P<0.01 or P<0.05), especially the effects of Heixiaoyao Powder group. Conclusions Heixiaoyao Powder and its analogous formula have the function of preventing and treating senile dementia.

Objective To explore the effects of ferulic acid on gastric cancer cell line MGC-803 proliferation;To discuss the mechanism of apoptosis induced by ferulic acid. Methods Ferulic acid with a variety of concentrations was used to treat gastric cancer cell line MGC-803 for 24, 48, 72 h;MTT experiment was used to detect the growth of gastric cancer cells. After gastric cancer cell line MGC-803 were treated with ferulic acid with a variety of concentrations (0, 5, 7.5, 10 mg/mL) for 48 h, all gastric cancer cells were collected and stained by Annexin V-FITC/PI for the detection of apoptosis by flow cytometry. RT-qPCR and Western-blot methods were used to detect mRNA and protein levels of Caspase-3, Caspase-9, Bax, Bcl-2 and Xiap. Results Compared with the control group, the OD value of cell line MGC-803 treated by ferulic acid with a variety of concentrations (5, 7.5, 10, 12.5 mg/mL) decreased significantly;the anti-tumor effect of ferulic acid was obvious;IC50 of 24, 48, and 72 hours after treated by ferulic acid was 12.93, 9.73 and 5.52 mg/mL respectively. Cell lineMGC-803 treated by ferulic acid with a variety of concentrations (5, 7.5, 10 mg/mL) after 48 h could induce the apoptosis of MGC-803 cells, up-regulate mRNA and protein levels of Caspase-3, Caspase-9, and Bax, down-regulate mRNA and protein levels of Bcl-2 and Xiap. Conclusion Ferulic acid can inhibit the proliferation of MGC-803 cells effectively and induce the apoptosis of MGC-803 cells, which mechanism is related to mitochondria apoptosis pathway and the down-regulation of Xiap expression.

Objective:To investigate the impact of recombinant human epidermal growth factor (rh-EGF) on the epithelial recovery and the tear film stability after trans-epithelial corneal collagen crosslinking in patients with progressive keratoconus.Methods:A randomized controlled clinical trail was designed.Consecutive 66 patients (37 males and 29 females) with an average age of (21.27±3.80) years old diagnosed with primary progressive keratoconus and hospitalized in Xiamen Eye Center Affiliated to Xiamen University from October, 2016 to January, 2017 were enrolled and treated with unilateral enhanced transepithelial corneal crosslinking surgery by iontophoresis, and the patients were randomly divided into control group and experimental group according to random number table method, with 33 patients 33 eyes in each group.The eyes in the control group were treated with carboxy-methylcellulose sodium lubricant eye drops and the eyes in the experimental group were treated with rh-EGF eye drops.The ocular surface disease index (OSDI) questionare, slit lamp examination, Schirmer Ⅰ test, corneal fluorescein sodium staining scoring, non-contact tonometry, uncorrected visual acuity, best corrected visual acuity, bulbar conjunctival congestion scoring, lacrimal sevretion test, non-invasive break-up time of tear film (NIBUT), as well as tear meniscus height analysis were performed before surgery, and on day 1, day 3, day 5, day 7, day 14 and day 28 after surgery.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Xiamen Eye Center Affiliated to Xiamen University (No.2016-ME-003).Results:On day 7 after surgery, the OSDI values were increased in both groups than the preoperative value, while the value in the experimental group was significantly lower than that in the control group ( P<0.05). There were statistically significant differences in the overall corneal epithelial staining score values between the two groups at different time points ( Fgroup=16.701, P<0.01; Ftime=454.418, P<0.01). The corneal epithelial staining score in the experimental group on day 3 and day 5 after surgery were significantly lower than those in the control group (1.79±0.65 vs. 2.70±0.68; 0.91±0.46 vs. 1.55±0.51) (both at P<0.01). The conjunctival congestion score in the experimental group was significantly lower than that of the control group on day 3 and day 5 after surgery (both at P<0.05). There were statistically significant differences in the overall NIBUT values between the two groups at different time points ( Fgroup=13.084, P<0.01; Ftime=34.383, P<0.01). The NIBUT values were significantly decreased rapidly on day 7, day 14 and day 28 after surgery in both groups (all at P<0.01), but gradually recovered.The NIBUT of the experimental group on day 7 and day 14 after surgery were significantly higher than those of the control group ([8.18±2.26]seconds vs. [5.93±2.33]seconds; [9.49±1.95]seconds vs. [7.52±2.27]seconds) (both at P<0.01). No statistical differences were found in the tonometry value, visual acuity, value of Schirmer I test as well as tear meniscus height at any time point before or after surgery between the two groups (all at P>0.05). Conclusions:Recombinant human epidermal growth factor has positive effects in the patients received enhanced transepithelial corneal crosslinking surgery, presenting with promotion of epithelial healing, relief of post-operative discomfort, and the recovery of tear film stability.

AIM: To investigate the preoperative ocular symptoms and the characteristics of asymptomatic ocular surface abnormalities in hospitalized patients with primary pterygium.METHODS: Cross-sectional study. Hospitalized patients diagnosed with primary pterygium and scheduled to receive pterygium excision surgery at the Xiamen Eye Center of Xiamen University from August 2022 to October 2022 were enrolled. Ocular surface disease index questionnaire(OSDI), six examinations including non-invasive tear film break-up time, Schirmer I test, tear meniscus height, lid margin abnormality, meibomian gland dropout and tear film lipid layer thickness, and anterior segment optical coherence tomography(AS-OCT)were performed and statistically analyzed.RESULTS: A total of 178 cases(178 eyes), with a mean age of 54.39±10.75 years old, were recruited, including 75 males(42.1%)and 103 females(57.9%). The average values of ocular surface parameters in these patients included OSDI: 11.47±9.69, tear film break-up time: 7.10±3.86 s; tear meniscus height: 0.16±0.07 mm, Schirmer I test values: 14.39±7.29 mm/5 min, and pterygium thickness: 504.74±175.87 μm. Totally 161 eyes(90.4%)presented with abnormal lid margin, 44 eyes(24.7%)presented with meibomian gland dropout score ≥4, 52 eyes(29.2%)presented with low lipid layer thickness. In the 6 objective examinations, abnormalities in at least 4 of these tests were found in 85.4% of eyes. Pterygium morphology was classified into four grades: 10 eyes(5.6%)of grade Ⅰ, 93 eyes(52.2%)of grade Ⅱ, 60 eyes(33.7%)of grade Ⅲ, and 15 eyes(8.4%)of grade Ⅳ. In patients with a higher grade of pterygium, the tear film break-up time was lower, and the proportion of abnormal lid margin was also significantly higher(P<0.05). The patients were further divided into two subgroups, including 121 eyes(68.0%)with normal OSDI <13 in the normal group and 57 eyes(32.0%)with OSDI ≥13 in the abnormal group. No significant difference was found in the proportion of meibomian gland dysfunction between the two groups of patients(71.9% vs. 71.9%, P=0.872). In addition, there were differences in the number of abnormal objective examinations(4.11±0.85 vs. 4.91±0.99, P<0.001).CONCLUSIONS: Asymptomatic ocular surface abnormalities were present preoperatively in patients hospitalized for primary pterygium. A comparable high incidence of structural or functional meibomian gland dysfunction existed in pterygium patients with or without apparent ocular discomfort. More attention should be paid to the ocular surface abnormalities in those asymptomatic patients before primary pterygium surgery.

AIM: To investigate the efficacy and safety of ZKY001 eye drops with different concentrations in the treatment of corneal epithelial defects(CED)after primary pterygium excision.METHODS: This was a multicenter, randomized, double-blinded, placebo-controlled phase II clinical trial. From March 15, 2022 to November 14, 2022, patients with primary pterygium who had undergone surgery were recruited from 12 tertiary hospitals across China. Using block randomization, 178 patients(178 eyes)were randomly assigned to 3 groups in a 1:1:1 ratio: 0.002% ZKY001 group(n=59), 0.004% ZKY001 group(n=59), and placebo group(n=60, receiving ZKY001 sham eye drops). Subjects in each group received 1 drop of the study drug 4 times per day for 4 d. The percentage of CED area recovery from baseline, the first complete healing time of CED area, the number of first complete healing cases of CED, and changes in visual analogue scale(VAS)scores for eye discomfort including eye pain, foreign body sensation, tearing and photophobia were observed.RESULTS: In terms of improvement in CED, there were no statistically significant differences among the three groups including the first healing time of CED, the percentage improvement in CED area compared to baseline, and the percentage of first healing cases at different follow-up visits(all P>0.05). Numerically, the first healing time of CED was shorter in the test groups compared to the placebo group(67.87±21.688 h for the 0.002% ZKY001 group, 61.48±22.091 h for the 0.004% ZKY001 group, and 68.85±20.851 h for the placebo group). On D1 morning, the percentage improvement in CED area compared to baseline was maximally different from the placebo group, and the numerical difference advantage was maintained at subsequent follow-up visits. The number of first healing cases in the CED area at different follow-up visits was higher in the test groups than the placebo group. In terms of improvement in ocular discomfort, the total VAS scores were lower in the test groups compared to the placebo group, mainly due to reductions in foreign body sensation and pain scores. At D3, the 0.004% ZKY001 group showed statistically significant improvement in foreign body sensation(P<0.017). In terms of safety, the overall incidence of adverse events was low(9.0%)and similar among groups.CONCLUSION: The use of ZKY001 eyedrops after primary pterygium surgery can safely improve the CED repair, and alleviate postoperative symptoms caused by CED.