Objective To compare subjective refraction based on power vectors and conventional subjective refraction in different degrees of astigmatism.Methods A total of 143 subjects (143 right eyes) were divided into two groups according to astigmatism degree:low astigmatism group (0-1.50 D) and high astigmatism group (1.50 -3.00 D).Subjects were then examined by both methods to fetch refraction data,and then the equivalent spherical M component,J0 component,J45 component and the duration of refraction procedures were compared and analyzed.Results There was no statistically difference in age,gender,M component,J45 component and time consuming of subjective refraction between the high and low astigmatism groups (all P ＞ 0.05),but intergroup comparison of J0 component from subjective refraction based on power vectors and conventional subjective refraction was significantly different (all P =0.00).In the low astigmatism group,the agreement of M,J0 and J45 measured by the two methods was tmified,and the mean absolute value of M,J0 and J45 difference was 0.04 D,0.02 D and 0.02 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0.37 D,0.13 D and 0.17 D,respectively,and there was no statistically difference in time consuming of the two methods (P =0.72).In the high astigmatism group,the agreement of M,J0 and J45 measured by the two methods was poor,and the mean absolute value of M,J0 and J45 difference was 0.43 D,0.21 D and 0.00 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0.75 D,0.50 D and 0.30 D,respectively,and the difference in time consuming of the two methods approached statistical significance (P =0.00),suggesting time consuming of subjective refraction based on power vectors was longer.Conclusion Subjective refraction based on power vectors has good effect on low astigmatism,and it needs to be further improved for clinical practices.

BACKGROUND: Shape memory polyurethane (SMPU) may be employed for bone repair capable of resisting stress shielding and bone non-union due to the shape memory effect responding to changed external temperature. Evaluating the cytocompatibility of SMPU is important for its further in vivo experiments and applications. However, few have been done to investigate the cytocompatibility of SMPU after encounted from deforming and shape recovering.OBJECTIVE: To evaluate the osteoblast compatibility of SMPU before and after stretching-shape recovering process. METHODS: Solvent casting method was used to fabricate SMPU films; the obtained SMPU films were stretched to 200%, and then fixed and finally recovered to its odginal shape at T_g+15 ℃, T_g-15 ℃ and T_g+15 ℃, respectively. Atomic force microscope (AFM) with tapping mode was employed to probe the surface morphology and phase separation of SMPU. Primary osteoblasts at 3-5 passages were seeded on SMPU films in vitro to evaluate the adhesion, proliferation and spreading of osteoblasts. RESULTS AND CONCLUSION: There were obvious and regular phase separation resulted from soft segments and hard segments in SMPU, and some groove-ddge architectures within a scale of micrometers were produced by the stretching-shape recovering process. These special micropatterned structures promoted osteoblast adhesion and proliferation, and also resulted in partially oriented cell growth along the grooves. Shape memory process, i.e. stretching-shape recovering process may obviously change the surface morphology of SMPU films, and suggesting better biocompatibility with osteoblasts.

Objective To compare the efficacy of dexmedetomidine versus remifentanil in combination with sevoflurane for gynecological laparoscopy. Methods Forty ASA Ⅰ or Ⅱ patients aged 18-64 yr with body mass index of 18-30 kg/m2 undergoing gynecological laparoscopy were randomly assigned to one of two groups ( n =20 each): dexmedetomidine group (group D) and remifentanil group (group R). Starting from 5 min before induction of anesthesia, dexmedetomidine was infused at 0.05 μg · kg - 1 · min- 1 in group D and remifentanil at 0.1 μg· kg- 1· min-1 in group R for 10 min, then dexmedetomidine infusion rate was increased to 0. 3 μg· kg-1 · h-1 and remifentanil infusion rate was increased to 0.15 μg· kg-1 · min-1 . Anesthesia was induced with propofol 1.5-2.0 mg/kg and fentanyl 2 μg/kg. Tracheal intubation was facilitated with cis-atracurium 0.15 mg/kg. Anesthesia was maintained with sevoflurane and fentanyl 1 μg/kg and intermittent iv boluses of cis-atracurium. Narcotrend index was maintained at 40-50. Blood sample was taken from external jugular vein for blood gas analysis and determination of serum concentrations of corticosteroid, norepinephrine and epinephrine before administration, at 5 min after intubation, at 10 min of aeroperitoneum and at 5 min after extubation. The pH value and concentrations of lactic acid and glucose were recorded. The time for recovery of spontaneous breathing, eye-opening time, extubation time, orientation time and perioperative side-effects were recorded. Numeric rating scale was used to assess the intensity of pain during 2 h after operation. The analgesics used were also recorded. Results The serum concentrations of norepinephrine and epinephrine were significanfly lower at 10 min of aeroperitoneum, the time for recovery of spontaneous breathing was shorter, eye-opening time longer and the incidence of shivering and nausea and vomiting lower, the percentage of patients requiring rescue opioids lower in group D than in group R ( P ＜ 0.05). Conclusion The efficacy of dexmedetomidine combined with sevoflurane anesthesia is better than remifentanil combined with sevoflurane anesthesia for gynecological laparoscopy.

Objective: To investigate the clinical characteristics and outcomes of ulcerative colitis (UC) with cytomegalovirus (CMV) infection. Methods: The related data of 300 patients with UC who were treated in the department of gastroenterology of the First Affiliated Hospital of Xiamen University from January 2013 to October 2017 were analyzed retrospectively. Eighty cases with CMV infection were included into the observation group while 220 cases without CMV infection were enrolled into the control group. The disease characteristics, clinical features, treatment and outcomes were compared between the two groups. Results: For disease characteristics, course of disease in observation group was significantly shorter than that in the control group (t=18.498, P<0.05). The previous application rates of glucocorticoid and immunosuppressant in the observation group were significantly higher than those in the control group (χ²=31.241, 10.381, P<0.05). The incidence rates of glucocorticoid dependence and glucocorticoid resistance in the observation group were significantly higher than those in the control group (χ²=17.513, 64.927, P<0.05). For clinical characteristics, the incidence rates of fever, abdominal pain and weight loss in the observation group were significantly higher than those in the control group (χ²=25.112, 20.633, 13.000, P<0.05). Colonoscopy showed that the ulcer rate in observation group was significantly higher than that in the control group (χ²=15.496, P<0.05). For outcomes, the improvement rate of the observation group was significantly lower than that of the control group (55.00% vs. 79.55%) (χ²=17.933, P<0.05). Conclusions The clinical symptoms of patients with UC and CMV infection are more obvious, the disease was more serious, the ulcer rate is higher and the clinical outcomes were worse than those of uninfected patients.

To investigate the chemical constituents of Saussurea deltoidea, 10 compounds were isolated from the title plant by various chromatography methods such as silica gel, RP-18 silica gel, Sephadex LH-20 column chromatography, HPLC, et al. Their structures were elucidated by spectral analysis. Five isoprenoids and Five phenylpropanoids were isolated and elucidated as (3R, 6R, 7E) -3-hydroxy-4, 7-megastigmadien-9-one (1), (3S, 5R, 6S, 7E) -5, 6-epoxy-3-hydroxy-7-megastigmen-9-one (2), 3-hydroxy-beta-damascone (3), S-(+) -dehydrovomifoliol (4), megastigman-5-ene-3beta, 9R-diol (5), coniferaldehyde (6), beta-hydroxypropiovanillone (7), 3-hydroxy-1-(4-hydroxy-3, 5-dimethoxyphenyl) -1-propanone (8), dihydrosyringenin (9), 4-[(1S) -3-hydroxy-1-methoxypropyl]-2, 6-dimenthoxyphenol (10). All the compounds were isolated from S. deltoidea for the first time.
Saussurea ; chemistry ; Terpenes ; isolation & purification

Objective To explore the influence of dialect-based communication obstacle on the safety of ophthalmic operation room and to provide the basis for improving the safety of ophthalmic operation room. Methods An in-depth interview was taken on 10 medical staff by qualitative research. The information was arranged and analyzed by phenomenology method. Results The interview with the surgical doctors on the communication barriers were extracted to three themes, including lower surgical efficiency, decreased patient satisfaction, increased risk of surgical complications, the interview with the surgical nurses on the dialects leading to communication barriers were extracted three themes, including surgical verification difficult to carry out, affect the perioperative care, hinder the postoperative mission to carry out, the extracted themes about the impact on patients include increased stress and anxiety affect the surgical outcome, poor intraoperative experience reduced satisfaction, the extracted themes about solution include the organization of medical staff to learn the dialect of the common language, recruit staff diversification, to provide professional translation, standardized body language to instruct the patient. Conclusions In this study, the experience of communication disorder caused by doctors and nurses in the ophthalmic operating room reflects the shortcomings of the safety management of the ophthalmic operating room. These deficiencies can be reduced by the independent study of the medical staff.

In surgery of patients with hypertensive intracerebral hemorrhage, precise positioning and minimally invasive operation provide a strong guarantee for overall curative effect. As an emerging visualization software, 3D-Slicer can optimize surgical approach, achieve precise intraoperative positioning, and accurately measure hematoma volume to guide treatment plan implementation. This article reviews the application of 3D-Slicer in surgery of patients with hypertensive intracerebral hemorrhage.

Objective:To investigate the effects of TNF-α knockout on liver and spleen neutrophil responses to Vibrio vulnificus bloodstream infection in a mouse model. Methods:(1) TNF-α-knockout (TNF-α -/-) and wild-type (WT) C57BL/6J mice aged 6-8 weeks were randomly divided into four groups with six in each group: uninfected WT group, infected WT group, uninfected TNF-α -/- group and infected TNF-α -/- group. The mouse model of bloodstream infection was constructed by intraperitoneal injection of Vibrio vulnificus CGMCC1.1758 (2×10 8 CFU/200 μl), while the mice in the uninfected groups were injected intraperitoneally with equal amount of PBS. (2) Liver immune cells and splenocytes were isolated 4 h after infection and subjected to analyze the percentages and numbers of neutrophils, and the changes in cell viability, cellular reactive oxygen species (ROS) level and phagocytosis by flow cytometry. In addition, effects of Vibrio vulnificus bloodstream infection on mTOR signaling pathway in murine neutrophils were evaluated in vivo. Results:(1)Compared with the uninfected WT group, the percentages and numbers of neutrophils in liver and spleen tissues of the infected WT group increased significantly. The percentage and number of liver neutrophils were significantly higher in the infected TNF-α -/- group than in the infected WT group, but no significant difference in spleen neutrophils was detected between the two groups. (2) Compared with the infected WT group, the phagocytosis of liver neutrophils rather than that of spleen neutrophils was enhanced in the infected TNF-α -/- group. (3) The survival rates of neutrophils in both liver and spleen were decreased, while the cellular ROS level was significantly increased in the infected WT group compared with those of the uninfected WT group. Compared with the infected WT group, the infected TNF-α -/- group had increased survival rates of both liver and spleen neutrophils, but decreased level of ROS. (4) The levels of p-AKT (S473) in liver and spleen neutrophils of the infected WT group were lower than those of the uninfected WT group. Compared with the infected WT group, the infected TNF-α -/- group had lower level of p-AKT (S473) in liver neutrophils, but higher p-AKT (S473) level in spleen neutrophils. There were no significant differences in p-4E-BP1(T37/46) levels between the uninfected WT group and the infected WT group. The p-4E-BP1 (T37/46) level in liver neutrophils was lower in the infected TNF-α -/- group than in the infected WT group, but no significant difference in p-4E-BP1 (T37/46) levels in spleen neutrophils was observed between the two groups. Conclusions:TNF-α had different effects on the neutrophils in spleen and liver tissues of mice with Vibrio vulnificus bloodstream infection. It played a critical role in regulating the recruitment, phagocytic function and mTOR signaling of liver neutrophils after Vibrio vulnificus infection in vivo.