Objective To discuss nursing care of patients underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy. Methods 22 patients who underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy accepted strengthened psychological care, perfect preoperatively preparation, to sleep in face-up supine position, meanwhile complications were observed and treated carefully. Results 22 patients could persist in sleeping in face-up position for 4days postoperatively. Graft shift occurred in two cases. And after gas reinjection the grafts adhered very well. Intraocular pressure rose in 7 cases .After timely treated these 7 patients were cured and discharged. Conclusions Careful preoperative evaluation and preparation could reduce postoperative complication. Strict measures to keep patients sleeping in face-up supine position, timely observation and treatment of complications should be important to ensure the success of the operation.

Objective:To investigate the expressions and significance of tyrosine kinase receptor EphA2 and its ligand ephrinA1 in human malignant gliomas and their correlation with tumor angiogenesis. Methods:The expressions of EphA2, ephrinA1, and CD105-stained microvessel density (MVD) were detected via immunohistochemical assay in 62 glioma tissues and 8 normal brain tissues. The correlation between EphA2 and ephrinA1 expression and microvessel counts in the glioma tissues were assessed. Results:Immunohistochemical staining results revealed that variable levels of EphA2 and MVD expression were significantly higher than that of the normal brain samples. Statistical difference was observed in EphA2 and MVD expressions between human gliomas and normal brain samples (P<0.01). The positive rate of EphA2 and MVD expressions was significantly higher in high-grade gliomas (WHO III-IV) than that in low-grade gliomas (WHO I-II) (P<0.01). EphrinA1 was expressed at low levels in most malignant gliomas, and the increased ephrinA1 expression was associated with lower-grade histology. MVD was significantly positively correlated with EphA2 expression (r=0.713, P<0.01) and significantly negatively correlated with ephrinA1 expression (r=-0. 772, P<0.01). EphA2 was significantly negatively correlated with ephrinA1 expression (r=-0.912, P<0.01). Conclusion:Specifically over-expressed EphA2 and its low-expressed ligand ephrinA1 in malignant gliomas may be closely correlated with the invasion and malignant degree of gliomas. Cooperation is involved in the angiogenesis and has an important function in the initiation and progression of gliomas.

Objective To study the application of transcatheter superselective arterial embolization for the spinal tumorectomy preopera-tive.Methods From January 2009 to September 2015,the data of 65 patients with spinal tumor were collected.Before operation,all the pa-tients had been performed the transcatheter superselective arterial embolization by Seldinger technology,the embolization effect and the blood loss volume were recorded.Results The pathological vertebral body of 62 patients were significantly dyed and the tumor-feeding artery were obvious.But no obvious tumor-feeding artery and the tumor dyeing was found in 3 cases.The tumor-feeding artery positive incidence of angi-ography was 95.3%(62/65).All cases intubation was successful but one.After embolization, the pathological vertebral body was removed completely.The blood loss volume was 500-3 000 mL,with an average (1 400.65 ±230.62) mL.Conclusion The transcatheter superse-lective arterial embolization could reduce the blood loss in spinal tumorectomy and the operation risks,and increase the possibilities of radical resection,which is an effective preoperative intervention.

Objective To develop SYBR Green I real-time PCR assay for detection and identification of Hepatitis B virus. Methods Based on the sequences of Hepatitis B virus gp1 gene,primers were designed.The reaction assay and thermal cyc-ling profile were optimized.The positive standard was from recombinant clone.Both the developed assay and Zhejiang kuake biotechnology company’s assay were applied in 100 patients serum.Results The detection limit was between 5×102 copies/ml to 5×108 copies/ml with a good liner correlation and no cross reaction.The whole process just needed 2.5 h.Comparing with the company products,the sensitivity and specificity of the developed assay were 100% and 92.5% respectively.Con-clusion The established assay is rapid,simple,high sensitivity and specificity.It is not only valuable for the identification of Hepatitis B virus patients,but also provide accurate quantitative analysis for HBV patients.

Objective:To investigate the effect of Tongrnai Yangxin Pill on the serum hepcidin level of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.Methods:Seventy patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease whose age were above 40 years old were enrolled as the research group and divided into the medication group (group Ⅱ) (n=35) and the nonmedication group (group Ⅲ)(n=35),while 40 CAD patients were enrolled as the normal control group (group Ⅰ).Before and after medication,the Hepc,Hb,etc levels were compared between two groups.Results:Before medication,the levels of Hepc in the two research subgroup were significantly higher than that of the control group (P＜0.05).At 8 weeks after treatment,the Hepc level of group Ⅱ was significantly declined,and the level of Hb was increased than those before treatment (P ＜0.05);the Hepc levels of group Ⅰ and group Ⅲ showed no significant difference (P＞0.05),the Hepc levels of group Ⅱ and group Ⅲ were obviously higher than that of the control group (P ＜0.05),the Hepc levels of group Ⅲ was obviously higher than that of the group Ⅱ(P＜0.05),the Hb level of group Ⅲ was obviously lower than those of group Ⅰ and group Ⅱ (P＜0.05).Conclusion:Tongmai Yangxin Pill could reduce the level of Hepc and enhance the Hb levels of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.It was useful to the patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease,especially patients with mild anemia.

Objective To investigate the micminnammatory state and its relationship with atherosclerosis and cardiac function in patients on continuous ambulatory peritoneal dialysis(CAPD). Methods Sixty-seven CAPD patients,27 non-dialytic stage 5 chronic kidney disease(CKD 5)patients and 27 gender and age matched healthy controls wore enrolled in this cross-sectional study.Clinical data and biochemical parameters were collected.Serum interleukin-6(IL-6)and IL-10 levels were measured by enzyme-linked immunosorbent assay(ELISA).High-sensitivity C-reactive protein(hs-CRP)was measured by immunoturbidimetry.Prevalence of atherosclerosis was detected by carotid uhrasonography while cardiac function was detected by echocardiography. Results Serum levels of inflammatory biomarkers were elevated significantly in CAPI)and CKD 5 patients as compared with healthy controls[IL-6(ng/L):2.400,1.515 vs 0.698;IL-10(ng/L):1.988,1.958 vs 0.277;hs-CRP(mg/L):1.090,1.345 vs 0].Left ventricular mass index(LVMI),myocardial performance index(Tei index 0.75±0.31,0.66±O.27 vs 0.52±0.23)in CAPD and CKD 5 patients increased significantly.The prevalence of carotid artery atherosclerosis and left ventricular hypertrophy(LVH)in CAPD and CKD 5 patients was significantly higher than that in healthy controls.No significant difference of the ultrasonic parameters was found between CAPD and CKD 5 patients.In CAPD patients,IL-6 was positively correlated with Tei index,whereas IL-10 was negatively correlated with INMI and was positively correlaled with ejection fraction(EF).In a multiple regression model,IL-6,self-rating depressive scale(SDS)score and pulse pressure were independent predictors of carotid artery atherosclerosis.Similarly,IL-6 and primary hypertension were independent correlates of Tei index in CAPD patients. Conclusions Microinflammatory state exists in either non-dialytic CKD 5 patients or CAPD patients and it is associated with atherosclerosis and cardiac distunetion.IL-6 is an independent risk factor of atherosclerosis and increased Tei index in CAPD patients.

Objective To explore the prognostic factors for the recurrence of vaginal stump of earlystage cervical cancer after radical hysterectomy and evaluate the effect on clinical prognosis.Methods Clinical data of stage Ⅰ-ⅡA cervical cancer patients undergoing radical hysterectomy in Guizhou Cancer Hospital from January,2007 to December,2016 were retrospectively analyzed.Results A total of 493 patients were enrolled and followed up until May 30,2018.Among them,96.6％(474/493) completed the follow-up.The median age was 45 years.Patients aged 40-50 years had a high incidence rate.In total,451 cases (91.48％) had no recurrence of vaginal stump.The average time without stump recurrence was 51.2 months and the median time without stump recurrence was 44.8 months.Multivariate Cox regression analysis demonstrated that pelvic external irradiation and brachytherapy were the independent prognostic factors for the recurrence of vaginal stump (P=0.000,0.000).Tumor size,lymph node metastasis and pelvic external irradiation were the independent prognostic factors for overall survival (P=0.045,0.022,0.000).Conclusions Pelvic external irradiation and brachytherapy play an extremely pivotal role in reducing the risk of vaginal stump recurrence after radical hysterectomy for patients with stage Ⅰ-Ⅱ A cervical cancer.Tumor size,lymph node metastasis and pelvic external irradiation are the independent prognostic factors for overall survival of patients with stage Ⅰ-Ⅱ A cervical cancer following radical hysterectomy.

Objective To compare the effect of different therapeutic methods upon the survival of stage Ⅰ-Ⅱ A cervical cancer patients with intermediate risk factors and explore the optimal treatment for patients with early-stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy.Methods Clinical data of 323 patients with the following intermediate risk factors of lymphovascular space invasion,depth of stromal invasion or tumor size ＞ 4 cm were retrospectively analyzed.The impact of observing (NT),chemotherapy (CT),radiotherapy (RT) and concurrent chemoradiotherapy (CCRT) on survival was statistically compared.The Kaplan-Meier method was used to survival analysis,and log-rank test difference,Cox model was used to prognostic factor analysis.Results The 5-year progression-free survival (PFS) and overall survival (OS) of all patients were 79.0％ and 84.8％.Univariate and multivariate analyses demonstrated that TS＞ 4 cm and therapeutic method were the independent prognostic factors of PFS.The number of risk factors and therapeutic method were the independent prognostic factors of OS.In the whole group,both RT and CCRT could improve the prognosis of patients with no statistical significance (P＞0.05).In the subgroup analysis,for patients with a single intermediate risk factor (low risk group),CT could significantly prolong the PFS (P=0.026) rather the 5-year OS (P=0.692).Compared with NT and CT,RT and CCRT could improve the PFS and OS,whereas no statistical significance was noted between the RT and CCRT (both P＞0.05).For those with ≥2 risk factors (high risk group),CCRT could significantly prolong the PFS compared with CT (84.9％ vs.70％;P=0.006),but did not improve the OS (P=0.107).Compared with RT,CCRT could significantly improve the PFS and OS (both P＜0.05).Conclusion For patients with only one risk factor,RT can enhance the clinical prognosis.CCRT can improve the clinical prognosis of stage Ⅰ-Ⅱ A cervical cancer patients with ≥ 2 risk factors.

Objective: To observe the effects of miR-204 on the proliferation and invasion of retinoblastoma (RB) cells and to explore the potential regulatory mechanism. Methods: The expression level of miR-204 in RB cell lines (Y79, SO-RB50, and HXO-Rb44) as well as in normal human retinal pigment epithelial cell line hTERT RPE-1 was detected using qRT-PCR. The Y79 cells were divided into two groups (negative control group and miR-204 group) by respectively transfecting Y79 cells with NC-mimics and miR-204 mimics using liposome transfection method. The effects of miR-204 on Y79 cell proliferation was detected with CCK-8 assay; while the effect of miR-204 on migration and invasion of Y79cellsweredeterminedbycellscratchassayandTranswellassay,respectively.Besides, thepotentialtargetgeneofmiR-204waspredictedbybioinformatics;and the influence of miR-204 on the expression of high mobility group AT-hook 2 gene (HMGA2) at both mRNA and protein levels was detected using qRT-PCR and Western blotting, respectively. Results: miR-204 expression in RB cell lines Y79, SO-RB50 and HXO-Rb44 was remarkably lower than that in normal human retinal pigment epithelial cell line hTERT RPE-1 (P<0.01). miR-204 expression in Y79 cells was markedly up-regulated after transfection with miR-204 mimics (P<0.01) along with significantly reduced cell proliferation, migration and invasion capacities (all P<0.01), and mRNA and protein expressions of HMGA2 were also outstandingly reduced (P<0.01). Conclusion: miR-204 is lowly expressed in RB cell lines; in addition, miR-204 over-expression can suppress RB cell proliferation, migration and invasion, the mechanism of which might be related to down-regulation of the expression of HMGA2.

Objective:To investigate the optimal bladder filling volume in the 3D brachytherapy of postoperative cervical cancer.Methods:Totally 111 early cervical cancer patients with positive incisal margins or insufficient safety boundaries were included. The normal saline 50, 60, 70, 80, 90, and 100 ml were filled into their bladders, and accordingly six groups were determined, and 66, 69, 66, 69, 72, 56 person-times in each group, respectively. The CT-based simulation positioning was performed. According to the ICRU 89 report, high-risk clinical target volume and organs at risk such as bladder and rectum were delineated. The Oncentra planning system was used to prepare the treatment program. The high-risk clinical target volume (HR-CTV), D90, and the D2 cm 3 and D1 cm 3 of organs at risk under different volumes were recorded. Results:Compared to the 60 ml group, the volume and dosage of HR-CTV in the groups of 50, 70, 80, 90, and 100 ml had no significant difference ( P>0.05). The D2 cm 3 and D1 cm 3 of the bladder and rectum of patients in these groups significantly decreased, and the difference was statistically significant ( tbladder = 3.21, 5.83, 2.89, 12.95, 7.96, Pbladder = 0.031, 0.010, 0.041, 0.000, 0.001; trectum = 2.94, 4.66, 2.53, 5.89, 4.13, Prectum = 0.037, 0.024, 0.049, 0.005, 0.028). The pairwise comparison among these groups except for the 60 ml group showed that the volume and dosage of HR-CTV and the D2 cm 3 and D1 cm 3 of bladder and rectum had no significant difference ( P > 0.05). Moreover, the D2 cm 3 and D1 cm 3 of sigmoid colon and small intestine of these groups had no significant difference ( P > 0.05). Conclusions:In the 3D brachytherapy of postoperative early cervical cancer, a bladder filling volume of 60 ml can ensure the volume and dose of HR-CTV and can protect the bladder and rectum compared with other filling volumes.