AlM: To evaluate the therapeutic effects and safety of femtosecond laser assisted penetrating keratoplasty ( FS-PKP) .
METHODS: ln the retrospective case series study, 46 cases ( 48 eyes ) with FS- PKP holds were analyzed. Preoperative best corrected visual acuity ( BCVA) was 2. 35 ± 1.01 (with a standard logarithmic eye chart). Opacities were all from epithelium to endothelium, including keratoconus, keratolukoma and corneal scarring etc. The full-thickness corneal donor-recipient grafts in different diameter and incision kerfangle were made by femtosecond laser in keratoplasty. The patients were treated according to the conventional penetrating keratoplasty after surgery. Evaluation indexes included preoperative and postoperative 1, 6, 10mo uncorrected visual acuity (UCVA), BCVA, corneal astigmatism (CA) and surgical complications. Forty-three cases (44 eyes) with traditional PKP were as control group. The data of two groups were analyzed by mean comparison of two groups and Chi-square test in SPSS 18. 0.
RESULTS: All the operations were completed successfully, postoperative visual acuity of all patients had different degrees of increase. Comparison with the postoperative UCVA of traditional PKP surgery, UCVA was 3. 48 ± 0. 43 and 2. 97 ± 1. 14 at 1mo after operation, respectively, with statistically significant difference ( P=0. 009). The UCVA was 3. 86±0. 25 and 3. 74±0. 73 at 3mo after operation, respectively; the UCVA was 4. 04 ± 0. 23 and 3. 98 ± 0. 29 at 6mo after operation, respectively, with no statistically significant difference (P=0. 146, P=0. 56). ln FS-PKP group, BCVA was better than traditional PKP surgery group, with statistically significant difference ( P=0. 002 ). While there had no statistically significant difference between two groups of BCVA at 6, 10mo after operation (P6mo =0. 132, P10mo =0. 47). The incidence of complication of FS-PKP surgery, such as postoperative astigmatism, postoperative intraocular pressure and postoperative incision dehiscence were significantly lower than the one of traditional PKP surgery(P<0. 05).
CONCLUSlON:Compared with traditional penetrating keratoplasty, FS-PKP provides significantly faster visual recovery in the early postoperative period, and induces significantly less corneal astigmatism and lower incidence of complication. lt reflected the clinical superiority of this new technology .

A 19-year-old Chinese woman presented with progressive ulcers and recurrent fever for 1 year.The lesions originally began with purplish red maculopapules,then rapidly developed into ulcer with severe pain and spread to the trunk and extremities accompanied by intermittent fever.Histopathology revealed lymphoid infiltration of middle and large atypical T cells throughout the dermis and subcutaneous fat laver along with focal epidermotropism.The lymphoid infiltrates were positive for CD3,CD8,T-cell intercellular antigen(TLA)and T-cell receptor β(TCR-β).Gene analysis showed the rearrangement of T-cell receptor gene.According to the above findings,the patient was diagnosed as primary cutaneous aggressive epidermotropic CD8-positive cytotoxic T-cell lymphoma. Combined thempy with cyclophosphamide,vincristine,prednisone and bleomycin resulted in partial remission of skin lesions,but she eventually died 22 months after the onset of disease.

Bronchi ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Pneumonectomy ; Pulmonary Sclerosing Hemangioma ; pathology ; surgery

Objective To explore the repair method for refractory diabetic wound. Methods A total of 206 patients with refractory diabetic foot ulcers were treated with proper surgical treatments.Results Of all, 106 patients were treated by skin flap (51.5 % ), with one stage wound healing rate of 85.8%; 122 patients were repaired with split-thickness skin graft ( 59.2% ), with survival rate of the graft for 79.5%. Simple toe amputation was made in 34 patients (46 toes). The high level amputation was performed in 56 patients (27.2%). Of all, 132 patients were followed up for 6-18 months, which showed that ulcer recurred in 12 patients (9.1%). Conclusion Timely and effective treatment as well as flap and skin graft repair could reduce high level amputation rate of diabetic foot ulcer and promote the quality of life.

Objective To study the clinical effect and application value of micro-plasma beam joint radiofrequency treatment for the striae of pregnancy.Methods 21 female patients with the striae of pregnancy were included in this study,treated from the July 2012 to March 2014,aged 25-37 years;and time of the striae was from 3 months to 7 years.Micro-plasma radiofrequency technology was used to treat the striae,with interval of 30 days each time for total seven months.The total effective rate,satisfaction,and the adverse reaction were evaluated after the treatment.Results 21 patients included grade 4 in 6 cases,grade 6 in 10 cases,grade 2 in 4 cases and grade 1 in 1 case;the total effective rate was 95.2％ (20/21).Satisfactory degree was for the level C in 6 cases,B in 14 cases,and A in 1 case,with total satisfactory rate of 95.2％ (20/21).Adverse reactions included mild pigmentation in 2 patients after scab skin falling off,and disappeared at the end of the treatment course.Conclusions Micro-plasma beam combined with radio frequency in treating the striae of pregnancy has clear curative effect and good clinical application value.

OBJECTIVETo evaluate the current cornea donation awareness of tissue donors in the city of Nanjing, China.

METHODSAltogether 2000 registered tissue donors in the Red Cross Eye Bank of Nanjing by the end of 2010 and 2000 control residents of Nanjing in February to June 2011 were randomly selected to participate in our field questionnaire survey. The questionnaire consisted of questions regarding the understanding of cornea donation, the attitude toward cornea donation, and attitude toward legislation and free donation. The awareness of cornea donation between the registered tissue donors and residents was compared. Related factors of the willing-ness to donate corneas and to become a tissue donor were evaluated with univariate and multiple logistic regression analysis.

RESULTSA total of 1867 (response rate: 93.4%) tissue donors and 1796 (response rate: 89.8%; effective questionnaires: 1697) residents participated in this survey. For the questions about the knowledge of cornea donation, 90.3% tissue donors (residents: 78.9%) knew that donated corneas could be used for transplantations; 71.2% tissue donors (residents: 47.6%) knew that the appearance would not be destroyed after cornea donation; 70.7% tissue donors (residents: 20.0%) knew the formalities to become a cornea donor. For attitude toward cornea donation, 82.2% tissue donors (residents: 45.1%) were willing to donate corneas or eyeballs after death; 84.0% tissue donors (residents: 30.2%) had discussed with their families about donation; 85.1% tissue donors (residents: 24.8%) supported their families' or friends' cornea donation. For attitude toward legislation and free donation, 88.3% tissue donors (residents: 61.3%) approved of legislation to regular cornea donation; 72.2% tissue donors (residents: 38.8%) thought that cornea or organ donation should be gratis. The difference between two groups was significant (P<0.001). However, some tissue donors did not know cornea donation well, some even opposed the legislation of cornea donation and free donation protocol. For the factors influencing the willingness to donate corneas, population was the most relevant factor (P<0.001), since tissue donors were more willing to donate corneas than residents. Other significantly related factor were age, gender, occupation, and education level (P<0.001), while political status or religion were not significant. For the factors related to becoming a tissue donor, older age, male, white-collars (including white-collar, civil servant, teacher, soldier, lawyer, salesman, healthcare provider), higher education level, party members (including the Chinese Communist Party members, democratic party members, and the Communist Youth League members) (P<0.05).

CONCLUSIONSThe registered tissue donors have better understanding and more positive attitude towards cornea donation than control residents do. They approve of the legislation of cornea donation and free donation protocol. It may be more effective to target the population of over 58 years old, male, white-collars, well-educated people, and party members in the promotion of cornea donation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Corneal Transplantation ; Female ; Humans ; Male ; Middle Aged ; Registries ; Tissue Donors ; legislation & jurisprudence

OBJECTIVETo study the expression of microRNAs (miRNAs) in extranodal NK/T cell lymphoma, nasal type (EN-NK/T-NT).

METHODSTaqMan low density arrays were used to assess the expression level of 665 miRNAs in one case of EN-NK/T-NT and one normal nasopharyngeal tissue. Ninety-five miRNAs were found to be aberrantly expressed (86 being up-regulated and 9 being down-regulated) in EN-NK/T-NT, compared with normal nasopharyngeal tissue. The aberrant expression was found to be most significant in 8 miRNAs. According to the literature and miRNA database, the expression patterns of these 8 miRNAs were further analyzed in 15 cases of EN-NK/T-NT and 3 normal nasopharyngeal specimens, using the single tube TaqMan microRNA assays.

RESULTSThree of the 8 miRNAs showed statistically significant difference in the expression in EN-NK/T-NT and normal nasopharyngeal specimens. These 3 miRNAs (miR-223, 886-3p and 34c-5p) were considered to play crucial roles in hemopoiesis, cellular proliferation and apoptosis. MiR-223 and miR-886-3p were significantly over-expressed in EN-NK/T-NT (P = 0.002, P = 0.010) while miR-34c-5p was significantly under-expressed (P = 0.017).

CONCLUSIONSCertain types of miRNAs, especially those related to hemopoiesis, cellular proliferation and apoptosis, are aberrantly expressed in EN-NK/T-NT. The potential role of miRNAs in the molecular genetics of EN-NK/T-NT requires further investigation.

Adult ; Aged ; CD56 Antigen ; metabolism ; Female ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Lymphoma, Extranodal NK-T-Cell ; genetics ; metabolism ; pathology ; virology ; Male ; MicroRNAs ; genetics ; metabolism ; Middle Aged ; Nasal Mucosa ; metabolism ; Young Adult

Objective To investigate the flora distribution and drug resistance status in the Affiliated Hospital of Academy of Military Medical Sciences so as to provide experimental data for clinical doctors to use antibiotics more efficiently.Methods The clinical data of pathogenic bacterial infections over nearly one year in our hospital were retro -spectively analyzed .Results There were 3815 strains of pathogenic bacteria isolated from the sample .The percentage of Gram-positive strains was 36.4%while that of Gram-negative bacteria was 63.6%.The most common bacteria were Esche-richia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus epidermidis.In terms of drug tolerance , Enterobacteriaceae remained highily sensitive to carbapenems .The total resistance rate was 2%-5%.The resistance rate of A.baumannii to meropenem and imipenem was 60%.There were still a few pan-drug resistant strains among K.pneumoniae,A.baumannii and P.aeruginosa,but there were no drug resistant strains to vancomycin , tige-cycline and linezolid in Staphylococcus.The resistance rate of Enterococcus faecium to vancomycin was 9%.The bacteria were distributed predominantly in ICU ,Department of Hematology and Department of Oncology .The samples were mainly composed of phlegm specimens .Conclusion The high distribution in the three departments mentioned above is largely re-lated to the diseases being treated .The specimens from the lower respiratory tract show more types of bacteria that are mostly drug-resistant, and the isolating rate of vancomycin resistant Enterococcus and carbapenems resistant K.pneumoniat is com-paratively high .

OBJECTIVETo evaluate the expression and prognostic significance of T-bet and its cofactors EOMES, ETS-1 and MEF [which are transcription factors and responsible for development of natural killer (NK) cells] in the extranodal NK/T-cell lymphoma, nasal type (EN-NK/T-NT).

METHODSThe expression status of T-bet, EOMES, ETS-1 and MEF in 40 cases of EN-NK/T-NT occurring in Chinese population was studied by immunohistochemistry and in-situ hybridization (ISH). The clinical relevance was also evaluated. The control cases included 18 cases of peripheral T-cell lymphoma, 10 cases of B-cell lymphoma, 5 cases of normal spleen, 5 cases of normal thymus and 10 cases of nasal mucosal tissues affected by chronic inflammation.

RESULTSThe expression levels of T-bet mRNA and protein were high in EN-NK/T-NT (82.5% and 100%, respectively) and in peripheral T cell lymphoma (17/18 and 72.2%, respectively). There was no expression in B-cell lymphoma. The expression of EOMES (80.0% by ISH), ETS-1 (82.5% by ISH) and MEF (62.5% by ISH) was high in EN-NK/T-NT, but not in the control group. The frequency of co-expression of T-bet and EOMES (75%, 30/40) was significantly higher than that of the other genes. Follow-up study showed that the mean and median survival of the 19 cases of EN-NK/ T-NT was 33 months and 10 months, respectively. The five-year survival rate was 10.5%. Statistical analysis showed that only treatment modalities significantly affected the patients' overall survival; and none of the four transcription factors had significant impact on survival. The expression rates of T-bet, EOMES, ETS-1 or MEF had no significant difference between the 9 alive and the 10 dead cases.

CONCLUSIONSThe expression of T-bet correlates with the lymphoma types. It is mainly expressed in peripheral NK and T-cell lymphomas. The important functional gene engaged in NK cells development is highly expressed in EN-NK/T-NT. They may play a crucial role in pathogenesis and aggressive biologic behavior.

Adolescent ; Adult ; Aged ; China ; epidemiology ; DNA-Binding Proteins ; metabolism ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Extranodal NK-T-Cell ; Lymphoma, T-Cell, Peripheral ; metabolism ; Male ; Middle Aged ; Nose Neoplasms ; drug therapy ; metabolism ; pathology ; radiotherapy ; Proto-Oncogene Protein c-ets-1 ; metabolism ; RNA, Messenger ; metabolism ; Survival Rate ; T-Box Domain Proteins ; genetics ; metabolism ; Transcription Factors ; metabolism ; Young Adult

Objective To retrospectively analyze treatment status quo of giant cell tumor of bone around the knee in several institutes,and to investigate risk factors affecting selection of surgical manners,tumor recurrence,and functional outcomes.Methods A total of 222 patients with giant cell tumor of bone around the knee confirmed by pathology,who had undergone surgical treatment in 5 institutes from March 2000 to May 2012,were enrolled in this study.There were 120 males and 102 females,with an average age of 35.5 years.The epidemiology,clinical and radiographic features and risk factors affecting selection of surgical manners,tumor recurrence,and functional outcomes were analyzed.Results Intralesional curettage was performed in 128 patients(57.6％),intralesional curettage combined with partial resection in 13 patients (5.8％),and marginal excision in 79 patients (35.5％).A total of 159 patients were followed up.The local recurrence rate was 19.0％ for patients treated with intralesional curettage,8.9％ for marginal excision and 0％ for intralesional curettage combined with partial resection,and the total local recurrence rate was 14.5％(23/159).The mean duration from primary operation to recurrence was 23.9 months.Univariate analysis indicated that surgical manner was the only factor affecting local recurrence.Pathological fracture,Campanacci grades,Enneking system as well as soft tissue mass had a significant influence on the selection of surgical manners.The mean MSTS score after intralesional curettage was obviously higher than that after marginal excision.Conclusion The surgical manner is the only factor affecting local recurrence and limb function.