With the development of corneal refractive surgery, especially the application of femtosecond laser, and the lack of corneal donor, corneal stromal lenticules produced in refractive surgery have gradually attracted the attention of ophthalmologists.Most fresh corneal stromal lenticules are difficult to put into use immediately, so how to better preserve and treat the lenticules is a problem that ophthalmologists need to solve.Corneal stromal lenticules can be used in the treatment of many kinds of ophthalmic diseases.In this article, the preservation and treatment of corneal stromal lenticules, as well as its application and prospects in treating hyperopia and presbyopia, keratoconus, corneal ulcer, corneal dystrophy, dermoid tumors and recurrent pterygium, corneal thinning after laser in situ keratomileusis, and covering glaucoma drainage valve to prevent exposure were reviewed to provide reference for further clinical research and application.

OBJECTIVETo explore the effect of electroacupuncture (EA) on the expression of Ghrelin and mRNA expression of its receptor in functional dyspepsia (FD) rats.

METHODSTotally 80 rats were divided into the normal group, the model group, the drug therapy group, and the EA group according to random digit table, 20 in each group. FD model was duplicated by clipping tail modeling. Drug containing cisapride [2 mL/100 g, 0.09 g/(kg x d)] was administered to rats in the drug therapy group from the 3rd day after successful modeling, once per day. EA at Zusanli (ST36) (0.3-0.5 cun) and Taichong (LR3) (0.1-0.2 cun) was performed in the EA group. The twirling of needle was performed to the subsidence of needle, and then the needle was connected to HANS-200A Acupoint Nerve Stimulating Device using disperse-dense wave at 2 Hz, 2 mA, 30 min each time, once per day. Six days consisted of one therapeutic course, two courses in total with an interval of one day. The intestinal propulsive rate of ink was observed. Ghrelin protein expression in gastric tissue was detected by Western blot. mRNA expression of growth hormone secretagogue receptor (GHS-R) in stomach, hypothalamus, and hippocampus was detected using Real-time PCR respectively.

RESULTSCompared with the normal group, the intestinal propulsive rate of ink, Ghrelin protein expression in gastric tissue, mRNA expression of GHS-R in stomach, hypothalamus, and hippocampus decreased in the model group (P < 0.05, P < 0.01). Compared with the model group, the intestinal propulsive rate of ink, Ghrelin protein expression in gastric tissue, mRNA expression of GHS-R in stomach, hypothalamus, and hippocampus increased in the EA group (P < 0.01); mRNA expression of GHS-R in stomach, hypothalamus, and hippocampus increased in the drug therapy group (P < 0.01). Compared with the drug therapy group, Ghrelin protein expression in gastric tissue, mRNA expression of GHS-R in hypothalamus increased in the EA group (P < 0.05, P < 0.01).

CONCLUSIONEA could regulate Ghrelin content and GHS-R mRNA expression of FD rat hypothalamus, hippocampus, and gastric tissue, and promote the intestinal propulsive rate of ink.

Acupuncture Points ; Animals ; Dyspepsia ; metabolism ; therapy ; Electroacupuncture ; Ghrelin ; metabolism ; Hippocampus ; metabolism ; Hypothalamus ; metabolism ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Receptors, Ghrelin ; metabolism ; Stomach ; metabolism

Objective To develop a non-invasive method for diagnosis of esophageal varices in patients with cirrhosis induced by viral hepatitis.Methods The clinical data,including results of blood routine,liver function,blood coagulation and color ultrasonography,of patients with cirrhosis induced by viral hepatitis from the First Affiliated Hospital of Zhengzhou University during December 2011 and December 2012 were retrospectively analyzed.Patients with hematopoietic diseases and portal vein thrombosis were excluded,and no patients received beta-blocker,endoscope band ligation,and splenectomy treatment.According to gastroscopic results,all patients were divided into no/mild group and mid/serious group.Correlations between clinical data and esophageal varices were analyzed by Logistic regression method,and receiver operating characteristic (ROC) curve was used to evaluate their values for diagnosis of esophageal varices.Results Totally 96 patients were enrolled in the study,30 without or with mild esophageal varices,and 66 with mid/serious esophageal varices.There were significant differences on platelet (PLT),plateletcrit (PCT),platelet distribution width (PDW),alanine aminotransferase (ALT),aspartate aminotransferase (AST),spleen thickness (ST) and PLT/ST between no/mild group and mid/ serious group (Z/t =-2.842,-3.151,-2.549,-3.463,-3.601,-4.360and 11.877,P＜0.05 or P ＜ 0.01).Multivariate logistic regression analysis showed that only ST was statistically different between two groups (OR =1.127,OR 95％ confidence interval (CI):1.012-1.256,P =0.030).The area under the curve (AUC) was 0.728,and 95％ CI:0.628-0.827.With the cut off value of 52.5 mm,the sensitivity,specificity,and Youden index of ST in diagnosis of esophageal varices were 53.0％,90.0％ and 0.43,respectively.Conclusion ST measured by color ultrosonography can be used for early diagnosis of mid/serious esophageal varices.

Objective To explore and analyze perioperative psychological care and its effect in craniotomy patients under sober state.Methods 10 patients with cerebral tumor of functional zone undergoing craniotomy under conscious state were given pertinent psychological nursing and psychological counsehng,besides,perioperative comprehensive nursing wag given in order to reach the aim of effective psychological nursing.Results The perioperative behavioral control of patients wag better,they could cooperate with the operation as requested and reached the anticipated aim.All patients rehabilitated at discharge.Conclusions Effective psychological care plays a very important role to ensure the success of sober craniotomy and rehabilitation of patients.

Objective To investigate the role of nucleotide-binding oligomerization domain-containing protein 1 (NOD1) in inducing insulin resistance in differentiated human adipocytes.Methods Human preadipocytes obtained via liposuction were induced to differentiate into mature adipocytes.iE-DAP,a specific ligand for NOD1,was administered to human adipocytes in culture.NF-κB transcriptional activity and proinflammatory cytokines production were determined by luciferase assay and enzyme-linked immunosorbent assay.Glucose uptake in adipocytes was measured by 2-deoxy-D-[3 H] glucose uptake (P＜0.05).The expression of phosphatidylinositol-3-kinase p85 (PI-3K p85),insulin receptor substrate-1 (IRS-1) and Akt phosphorylations were detected by Western blotting.Results NF-κB transcriptional activity and cytokines such as interleukin (IL)-6,IL-8,and monocyte chemotactic protein 1 secretion were markedly increased after stimulation with iE-DAP (P＜0.05 or P＜0.01).Insulin-induced glucose uptake was decreased with the activation of NOD1 in a dose-and time-dependent fashion.NOD1 activation weakened insulin signal transduction as being revealed by increasing IRS-1 Ser307phosphorylation,reducing protein expression of PI-3K p85,and attenuating insulin-induced phosphorylation of Akt on Ser473 and Thr308in human adipocytes.Conclusion These results indicate that NOD1 activation induces inflammatory response and insulin resistance via IRS-1/PI3-K/Akt signaling pathway in human adipocytes.

Objective To investigate early nasogastric nutrition on patients with acute decompensated chronic heart failure,and observe its influence on patient's disease outcome.Methods From January 2012 to December 2013,100 cases with acute decompensated chronic heart failure were used as the research subjects,were randomly divided into experimental and control groups with 50 cases each group.Patients of two groups adopt expansion of blood vessels,strong heart,diuresis,and routine anti-infection treatment;Based on this scheme,experimental group adopt early nasogastric nutrition.The cardiac function index,the change of nutritional status and clinical curative effect and the result of follow-up within 1 year after discharge of two groups were compared.Results Left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) in two groups after treatment were decreased,and the descender of experimental group was superior to that of the control group with statistically significant difference (P ＜ 0.05).After treatment,left ventricular ejection fractions (LVEF) of two groups were improved,and the rise of experimental group was superior to that of control group with statistically significant difference (P ＜0.05).In the two groups after treatment,the serum brain natriuretic peptide (BNP) levels were significantly decreased,and the descender of the experimental group was more than that of control group with statistically significant difference (P ＜ 0.05).After treatment,body mass index (BMI),the level of serum prealbumin (PA),transferrin (TRF),and the total number of lymphocytes of two groups were increased significantly (P ＜ 0.05);and BMI,the level of serum PA and TRF,and the total number of lymphocytes of the experimental group were significantly better than those of the control group (P ＜ 0.05).The total effective rate of the experimental group was significantly higher than that of the control group (P ＜ 0.05).The exacerbation rates,readmission and mortality rate of experimental group follow-up within 1 year after discharge were significantly lower than that of the control group (P ＜ 0.05).Conclusions The early nasogastric nutrition on the patients with acute decompensated chronic heart failure was better able to improve patients' nutrition state,more conducive to patients with cardiac function recovery,improve the clinical curative effect,and reduce the exacerbation rates,and readmission and mortality rate.

Objective To determine the median effective dosage of 0.5% ropivacaine for ultrasoundguided lateral popliteal sciatic nerve block. Methods Twenty-three ASA Ⅰ or Ⅱ patients of both sexes, aged 19-20 yr weighing 52-90 kg received lateral popliteal nerve block guided with ultrasound for foot and ankle surgery.The volume of 0.5% ropivacaine injected was determined by the response of the previous patient using an up-anddown technique. The initial volume was 18 ml. Each time the volume increased/decreased by 2 ml.Successful nerve block was defined as complete loss of pinprick sensation in both tibial and common peroneal nerve distribution with concomitant inability to perform plantar or dorsal flexion of the foot 30 min after injection. Results The median effective dosage of 0.5% ropivacaine resulting in complete block of the sciatic nerve in 50% patients was 13 ml (95% confidence interval 11.3-14.9 ml).Conclusion The median effective dosage of 0.5% ropivacaine for ultrasound-guided lateral popliteal sciatic nerve is 13.0 ml.

Objective To search for one method which is security firm and effective for trachea intubation in order to avoid unplanned extubation and realize nursing security. Methods 120 cases with severe brain injury and trachea intubation were divided into the observation group and the control group with 60 cases in each group randomly.The trachea intubations was fixed with Y-type plaster in the observation group,the control group used traditional fixation method with two pieces of 3M transparence film.The cases with trachea cannula displacement and unplanned extubation were compared between two groups. Results The cases needed re-fixation of the trachea cannula and with unplanned extubation in the observation group was less than the control group. Conclusions To use Y-type plaster to fix the trachea intubation can effectively prevent unplanned extubation,increase efficiency of clinical nursing work and ensure the security of patients.

Objective To study the value of detection of C- reactive protein(CRP), serum glucose concen-tration and APACHE Ⅱ grade for estimating inflammation, pathogenetic condition and prognosis of systemic inflam-matory response syndrome (SIRS) patients.Methods 50 SIRS patients in ICU were selected and were divided into S1 and S2 subgroup according to SIRS diagnosis standard, and 18 patients developed MOBS.30 patients without SIRS, were selected as control group.Detection of CRP, serum glucose concentration and APACHE Ⅱ grade were per-formed.Results CRP(76.19±11.98 mg/L vs.14.04±5.70 mg/L) ,serum glucose concentration(7.10±1.30 mmol/L vs.5.32±1.09 mmol/L) and APACHE Ⅱ grade (20.06±6.39 vs.7.90±3.54) of SIRS group were higher than that of non-SIRs group (P<0.01).CRP, serum glucose concentration and APACHE Ⅱ grade all are higher in group S2 than that of group S1 (91.25±9.89 mg/L vs.62.29±10.38 mg/L,8.32±2.40 mmol/L vs.7.10±1.69 mmol/L,26.72±5.14 vs.18.37±5.70).MOBS incidence and case fatality in S2 subgroup (12/15 and 6/35) were higher than that of S1 subgroup(10/15 and 3/35 ) (P<0.01 ).Conclusion CRP, serum glucose concentration and APACHE Ⅱ grade are increased in SIRS patients and with their increasing, MOBS incidence and case fatality were also increasing.CRP, serum glucose concentration and APACHE Ⅱ grade are significant factors in estimating SIRS patients pathogenetic condition and their prognosis.

Objective To assess the feasibility and advantage of systematic transperineal ultrasound guided template prostate biopsy. Methods In a prospective study, a total of 1270 patients(26 -90 year old,mean age 70. 4) who met the inclusion criteria underwent 11 regions systematic transperineal ultrasound guided template prostate biopsy. The median PSA level was 12. 96 ng/ml(range 0. 25000. 0 ng/ml) and the mean prostate volume was 53. 6 ml(range 7-200 ml). Results Prostate cancer was detected in 486 of 1270(38. 3%). The prostate cancer detection rate in group with PSA 0-4.0, 4. 1-10. 0, 10. 1-20. 0, 20. 1-40.0, 40. 1-60.0, 60. 1-100.0、and> 100. 0 ng/ml groups was 21.9%(16/73 )、16.6%(67/ 403)、30.7% (122/397)、46. 7%(77/165)、68. 3%(41/60)、86.2% (46/54) 、99.2% (117/118), respectively . While cancer detection rate in group with prostate volumes less than 20, 21-40, 41-60, 61-80 and great than 80 ml was 72. 1%(49/68 )、55. 6%(234/421) 、32.5%(136/418)、23.3%(48/206)、12. 1%、(19/157). The mean positives for the cancer of regions 1- 10 and region 11 (the apical region) were 35.3% vs. 44.8% in patients whose PSA＜20ng/ml(P＜0. 05). The positives for cancer within the right lobe and left lobe were 70. 8% vs. 74.2%(P>0.05)and the positives for cancer within the anterior and posterior parts were 79. 4% vs. 86. 8%(P>0. 05). No serious complication occurred during the procedure. Conclusions Systematic transperineal ultrasound guided template prostate biopsy could be accurate and safe. Prostate carcinoma foci are more frequently localized in the apical region in patients with PSA ＜20 ng/ml. Special attention should be paid to the apical region during the process of biopsy.