AlM:To analyze and compare the effect of femtosecond laser micro - incision corneal stromal lens excision ( SMlLE) and excimer laser in situ keratomileusis ( LASlK) in the treatment of myopia after operation, to explore the safety, operability and prediction of SMlLE.METHODS:ln this prospective clinical controlled study, 100 cases ( 200 eyes ) received SMlLE and 100 cases ( 200 eyes) undergone LASl in our hospital in the same period were selected. Uncorrected visual acuity, diopter, corrected visual acuity, slit lamp examination, intraocular pressure and corneal anterior segment OCT, corneal topography (Obscan ll) of two groups in 1d, 1wk, 1, 3, 6mo, 1a were compared. lndependent samples t test was used for data analysis.RESULTS:1) Postoperative slit lamp examination:after 1d in SMlLE group, there were less eyes had corneal layer between mild cloudy or edema; postoperative 1wk corneal layer disappeared, cornea became clear and transparent. 2 ) Postoperative vision recovery: 1d after operation, vision recovery in LASlK group was better than that in SMlLE group, the difference was statistically significant (P<0. 01), there were no significant differences at 1wk, 1, 3, 6mo, 1a after operation ( P>0. 05 ). 3 ) Obscan ll examination: graphics in the SMlLE group was more regular and placed in the center, no eccentric and irregular graphics, better than that in the LASlK group. 4) Anterior segment OCT examination:postoperative corneal flap in the SMlLE group was more uniform and accurate, but it was thin in the center and slightly thick the peripheral part in the LASlK groups. 5 ) Postoperative visual quality assessment used subjective questionnaire survey. The two groups had statistically significant difference on 4 points and 1 points (P<0. 05). Complains in the LASlK groups were more that that in the SMlLE group. While, no complain of the SMlLE group was higher than that of the LASlK group. Glare of postoperative patients with night vision and dark environment in the SMlLE group was better than that of the LASlK group.CONCLUSlON: SMlLE is safe, effective, stable and predictable for the correction of myopia.

BACKGROUND :Although the conventional 20 G pars plana vitrectomy can improve the prognosis of vitreous-retina diseases,but it would also cause serious operation related injury and much complications.OBJECTIVE:To evaluate the practicability and safety of 25-gauge transconjunctival sutureless vitrectomy system (TSV25G) in the macular surgery, so as to elicit the preliminary clinical experience of mimimally invasive vitrectomy system.DESIGN:Case analysisSETTING: Department of Ophthalmology, General Hospital of Chinese People's Armed Police Force; Department of Ophthalmology, Beijing Sino Japen Friendship Hospital; Department of Ophthalmology and Visual Science, Chinese University of Hong Kong; Department of Ophthalmology,Prince of Wales Hospital, Hong Kong PARTICIPANTS: From July 2003 to July 2004, 16 patients with macular diseases were admitted to the Department of Ophthalmology in the General Hospital of Chinese People's Armed Police Force and taken as subjects (n=16), they were confirmed as epiretinal membrane in 9 eyes, idiopathic macular hole in 3 eyes, traumatic macular hole in 2 eyes and vitreo-macu lar tractional syndrome in 2 eyes. The course of disease ranged from 3 to 36 months with eyesight varied between 0.06 and 0.4.METHODS: 16 eyes underwent preoperative ophthalmic evaluation in cluding visual acuity measurement, Amsler chart test, slit lamp microscopy,.indirect ophthalmoscopy tonometry and optical coherence tomography (OCT). For the macular hole patients OCT was performed. 25-gauge Transconjunctival Sutureless Vitrectomy System (TSV25G) was used to carry on minimally invasive surgery under anesthesia state, the surgical parameter was set as: high speed cutter with rate of 1500 cuts per minute,BSS bottle was hang at height of 40-50 cm, the maximum aspiration of TSV25G was 550 mm Hg with the intraocular pressure remained at around 29-35 mmHg during the operation. Three-beveled trocar were used to make three-transeonjunctival incision on sclera of about 0.5 mm long respectively in the infratemporal, superotemporal, and supraotemporal quan drants, meanwhile a transconjunctival cannula was placed. One end of the infusion tube was inserted into the infratemporal cannula to establish infusion with the other two cannulas used for the intraocular operation with 25-gauge vitreous cutter and other instruments, such as vitreoectomy and membrane dislocation. The surgery was terminated by removing the cannula except for ceaseless leak, the conjunctival and scleral incision were not sutured. Patients received follow-up examination for 1-12 months postoperatively.MAIN OUTCOME MEASURES:①The operative time and the time for the establishment of three access. ② Changes of intraocular pressure after operation. ③ The effusion from the puncture after the intraocular perfor mance. ④ The postoperative vision, operative complication and the sealing of the holes.RESULTS:All of the 16 patients completed the vitrectomy; and entered the data analysis.①16 patients complete the vitrectomy with the operative time of 28-56 minutes (the mean of 37 minutes). The average time for the establishment of three access and closing was 84 s and 32 s respectively.②The average preoperative intraocular pressure was 16.4 mm Hg,comparing with 13.5,15.5,17.9 mm Hg at postoperative 1 day, 1 w and 1 m. ③Water leakage were found in 4 wounds of three patients after operation, 3 wounds were sealed after injecting 1-2 mL disinfected air into the eyes, the other one sutured with 6-0 absorbable suture. ④The mean time of inpatients were 5 days postoperatively. The visual acuity improved in 14 patients by the average of three lines, amongst which visual acuity was found improved to above 0.8 in 5 patients and the visual distortion disappeared in 8 eyes and attenuated in 3 eyes. But still there were 2 cases without improvement.No surgical complications were noted and macular hole gained clinical sealing in totally 5 eyes.CONCLUSION: TSV25G system can simplify the surgical procedure with many other advantages such as decreasing the operation related injury and complications, as well as shortening operative time, which benefits the rapid rehabilitation.

Objective To explore the associations of serum Mir-217 with silent information regulator 1 (Sirt1)and hypoxia-inducible factor-1α(HIF-1α)in type 2 diabetic patients with different urinary albumin excretion rates. Methods A total of 479 patients with type 2 diabetes were divided into normoalbuminuric(D1, n=181), microalbuminuric(D2, n=165), and macroalbuminuric(D3, n=133)subgroups. 192 normal subjects served as control group. Serum level of Mir-217 was detected by realtime PCR. Serum Sirt1, HIF-1α, and vascular endothelial growth factor ( VEGF ) levels were determined by enzyme-linked immunosorbent assay. Results Compared with control subjects, serum Mir-217 level was significantly increased in type 2 diabetic patients and gradually increased in D1, D2, and D3 groups(P<0. 01). The parameters of age, diabetes duration, body mass index, fasting plasma glucose, fasting insulin, homeostasis model assessment of insulin resistant index(HOMA-IR), HbA1C, low density lipoprotein-cholesterol( LDL-C) , total cholesterol ( TC ) , triglyceride ( TG ) , serum uric acid ( SUA ) , blood urea nitrogen(BUN), HIF-1α, VEGF, and Mir-217 all were positively correlated with ACR(all P<0. 05). High density lipoprotein-cholesterol(HDL-C)and Sirt1 were negatively correlated with ACR(both P<0. 05). VEGF, HIF-1α, Mir-217, BUN, diabetes duration, LDL-C, Sirt1, and SUA were independent factors that influenced ACR(all P<0. 01). Additionally, diabetes duration, HOMA-IR, HbA1C, ACR, LDL-C, TC, TG, SUA, BUN, HIF-1α, and VEGF were positively correlated with Mir-217(all P<0. 05), while Sirt1 was negatively correlated with Mir-217(P<0. 01). Conclusion Serum Mir-217, as a possible biomarker for early diagnosis of diabetic nephropathy, may be involved in the development of diabetic nephropathy by promoting chronic inflammatory reaction, renal fibrosis, and angiogenesis.

Objective To improve the understanding of the characteristics of obstructive sleep apnea-hypopnea syndrome (OSAHS) in the elderly patients, and to improve the diagnosis and treatment level. Methods Monitoring results of polysomnography (PSG) from 110 elderly OSAHS patients were analyzed retrospectively. The general conditions, sleep architecture, apnea and hypopnea events, oxygen reduction as well as possible correlations between various indicators were analyzed using SPSS18.0 statistical software. Results The median rapid eye movement (REM) and non-REM (NREM) sleep time of elderly patients with OSAHS accounted for 2. 17% and 76.73%,respectively. The median arousal index was 45.6 times/h. The longest time of sleep apnea was (51.94±22.06) s, the median of average sleep apnea time was 22.50 s, the longest time of hypopnea was (47.06±12.52) s and the average hypopnca time was (21.50±4.63) s. The median respiratory disturbance index (RDI) of all patients was 21.50, the patients with RDI between 5 and 20 accounted for 46.40%, with RDI between 20 and 40 accounted for 31.80% and with RDI over 40 accounted for 21.8%. The average oxygen saturation accounted for (93.45% ± 2.81%), the lowest oxygen saturation accounted for (76.3%± 10. 5%) and the median oxygen desaturation index was 31.6;times/h. BMI was negatively correlated with lowest oxygen saturation (r=-0. 378, P＜0.01) and average oxygen saturation ( r = - 0. 355, P ＜ 0. 01 ), while was positively correlated with oxygen desaturation index (r=0. 338, P＜0. 01 ). The lowest oxygen saturation was negatively correlated with the longest time of obstructive apnea (r= -0. 47, P＜0. 01 ), the average time of obstructive apnea (r=-0.316, P＜0.01), the longest time of hypopnea (r=-0.293, P＜0.01) and the average time of hypopnea (r=-0. 277, P＜0.01). The median time intervals of oxygen desaturation during supine, left side and right side position were 2.36 min, 11.54 min and 12.45 min,respectively. The median time intervals of oxygen desaturation during left side and right side position were both longer than that of supine position (Z= -6.12 and -7. 10 respectively, both P＜0.01).Conclusions Elderly patients with OSAHS manifest obvious disorder of sleep structural and sleep fragmentation. According to RDI, the majority of the patients are classified as mild to moderate in severity. However, elderly patients with OSAHS are severe regarding to hypoxia relatively. The severity of hypoxia is related with BMI and the lasting time of sleep-disordered breathing events, and hypoxia are less severe when sleeping on left side or on right side.

To optimize the water extraction process for glycyrrhiza. Methods: HPLC was used to determine the con-tents of glycyrrhizic acid and liquiritin. The comprehensive index included the contents of glycyrrhizic acid and liquiritin and the yield of dry extract. The water amount and the extraction time were selected as the independent variables, and the comprehensive index was set as the dependent variable. Design-expert 8. 06 software was used to fit multivariate linear or quadratic multinomial models for the experimental values. Response surface methodology was used to optimize the water extraction process. The prediction was carried out through comparing the observed and predicted values. Results:The regression coefficient of binomial fitting complex model was as high as 0. 979 7. The optimum conditions of extraction process were as follows:12-fold amount of water, extracting 3 times with 90 min for each time. The deviation between the observed and predicted values was -1. 72%. Conclusion: Central composite design-response surface methodology is convenient and highly predictive in optimizing the water extraction process for glycyrrhiza, which can be applied in the further membrane separation and purification.

Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.

Abstract: Objective - - To establish a pre column derivatization high performance liquid chromatography method for detecting Methods dimethyl sulfate (DMS) in workplace air. DMS in workplace air was collected with mercaptopyridine impregnated （ silicone tube. The derivative of DMS and mercaptopyridine was eluted by mobile phase phase A: water, phase B: acetonitrile, ∶ the volume ratio was 40 60) , and separated with a C18 column, then detected with diode array detector and quantitated by a Results - standard curve. The linear range of DMS was 0.17 40.00 mg/L, with the correlation coefficient of 0.999 95. The detection limit and the lower limit of quantitation were 0.05 and 0.17 mg/L respectively. The minimum detection concentration and minimum quantitation concentration were 0.02 and 0.04 mg/m³, respectively (air sample volume of 4.5 L, 1.0 mL sample - - - solution). The average desorption efficiency was 98.40% 102.00%. The within run and between run relative standard deviations - - were 0.61% 3.92% and 1.71% 6.00%, respectively. The samples could be stored at room temperature for at least 14 days. Conclusion This method can be used to detect DMS in workplace air.

Objective To evaluate the relationship between Multi-slices spiral(MSCT) perfusion and microvessel density (MVD) in maxillofacial tumors. Methods Thirty-one cases of maxillofacial tumors were studied with MSCT perfusion imaging before operation. The time-density curve, perfusion, time to peak(TTP), and Peak enhancement imaging (PEI) of tumors were calculated. MVD of the tumors was measured with immuno-histochemical method by means of detecting factor Ⅷ in all the histologic specimens. Relativity analysis was carried between MSCT perfusion imaging parameters, perfusion curve types and MVD. Results MVD of maxillofacial tumors were higher than normal tissue. MVD remarkably correlated with malignancy of the tumors. Perfusion and time to peak (TTP) correlated well with MVD(t=7.09,4.10, P0.05). Significant difference of MVD in three types of perfusion curve was found(F=8.09,P

Objective Negative pressure aspirator clogging ( OSAC) frequently occurs in orthopedic surgery .This study was to investigate the frequency , location , and mechanisms of OSAC in China by analysis of the current status and clinical observation of OSAC so as to provide evidence for the solution of the problem . Methods Using the two-stage random sampling method , we conduc-ted a questionnaire survey on OSAC among 738 clinical orthopedists during the 16th and 17th Chinese Orthopedic Association Confer-ences.Totally, 160 out 1200 orthopedic surgeries were randomly selected in the time order of operation , including 38 cases of total hip arthroplasty ( THA) , 39 cases of total knee arthroplasty ( TKA) , 43 cases of extremity and spinal fractures surgery , and 40 cases of other orthopedic surgeries .We also obtained the satisfaction scores with the existing aspirators from related medical professionals . Results Among the 738 respondents included into the analysis , 706 (95.7%) thought that OSAC often occurred during surgery , 631 (85.5%) considered THA to be the leading cause of OSAC , and 714 (96.7%) regarded the tip and hose joint of the aspirator as the common causes . The mean satisfaction score with the existing aspirators was 7.62 ±0.74.Clinical observation showed the mean frequency of OSAC to be 2.55 ±1.62 in THA, 1.95 ±1.33 in TKA, 1.52 ±1.18 in extremity and spinal fracture surgeries , and 0.95 ± 0.68 in other orthopedic surgeries , and the satisfaction score to be 7.36 ±0.84. Conclusion OSAC has a high incidence rate during orthopedic surgeries in China , thus affecting orthopedic surgery and reducing orthopedists'satisfaction with the aspirators . The current negative pressure aspirator system demands prompt improvement .