To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.
●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.
●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.
●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

AlM: To compare the clinical efficacy of treatment on recurrent pterygium using different concentration mitomycin C ( MMC) in the pterygium excision operation combined with the corneal limbal stem cell autografting ( CLSCA) .METHODS: Sixty patients ( 65 eyes ) with recurrent pterygium were randomly divided into three groups. All cases were accepted CLSCA, 21 patients (22 eyes) were given 0. 15g/L MMC during operation, 20 patients ( 22 eyes) were given 0. 25g/L MMC during operation, 19 patients ( 21 eyes ) were given 0. 4g/L MMC during operation. The patients were followed up for 6mo to 2a.RESULTS:The recurrent rates of the three groups were 9%, 5%, 5% respectively. There was no statistically significant differences (P>0. 05). The complication rates of the three groups were 5%, 36%, 33% respectively. There were statistically significant differences (P<0. 05). CONCLUSlON: The treatment to the recurrent pterygium using low concentration MMC has the similar recurrence rates, but the complication rate was lower, it is an ideal operation method, and it is worth popularization and application.

BACKGROUND:Hydrophilic acrylic materials with good biocompatibility have been widely used in clinic. However, there are some problems about the biocompatibility and safety of hydrophilic acrylic intraocular lens after long-term clinical application. OBJECTIVE:To discuss the biocompatibility and stability issues and corresponding processing methods after hydrophilic acrylic intraocular lens implantation. METHODS:A computer-based search of Wanfang and PubMed database was performed for articles related to clinical application of hydrophilic acrylic intraocular lens published from 2005 to 2014. The keywords were “hydrophilic acrylic,intraocular lens” in Chinese and English, respectively. A total of 618 articles were initialy retrieved, and finaly 35 articles were included in result analysis. RESULTS AND CONCLUSION:As the hydrophilic acrylic intraocular lens is foldable, a smal incision is required for implantation and the operation is simple that cause less damage to the patients. In addition, the hydrophilic acrylic intraocular lens has poor bacterial and inflammatory cel adhesion, which leads to a low probability of infective endophthalmitis after implantation. But there is a high incidence of posterior capsule opacification as wel as some refractive errors and visual quality problems after implantation. Taken together, to solve these problems depends on the continuous improvements and updates of intraocular lens materials and designs.

Cytomegalovirus Infections ; complications ; Female ; Humans ; Infant ; Male ; Nephrotic Syndrome ; etiology

OBJECTIVE: To evaluate the relative bioavailibility and bioequivalence of paroxetine hydrochloride film-coated tablets. METHODS: In a randomized crossover study, 24 healthy Chinese male subjects received a single oral dose (20 mg) of either test or reference paroxetine hydrochloride tablets after an overnight fast. The plasma concentrations of paroxetine were determined by a validated LC-MS/MS method. The pharmacokinetic parameters, the relative bioavailability and bioequivalence of two formulations were evaluated by DAS 2.0 software. RESULTS: After a single oral dose of 20 mg test or reference paroxetine tablets, the pharmacokinetic parameters of paroxetine were as follows: ρmax(5.102 ± 2.955) and (5.396 ± 2.852) μg · L-1; tmax (5.22 ± 1.83) and (5.35 ± 0.78) h; t1/2(11.76 ± 2.91) and (11.98 ± 3.57) h; AUC0~96h(118.1 ± 90.2) and (118.9 ± 86.0) μg · h · L-1; AUC0-∞ (120.2 ± 91.0) and (121.5 ± 87.6) μg · h · L-1, respectively. CONCLUSION: The relative bioavailability of the test paroxetine hydrochloride film-coated tablets is (100.6 ± 22.0)%. The two preparations are bioequivalent. Copyright 2012 by the Chinese Pharmaceutical Association.

Objective To explore the changes of Nogo-A mRNA and Nogo receptor(Ng-R) mRNA expressions in hippocampus of immature rats after febrile seizures(FS).Methods One hundred and twenty-seven male SD rats(15 days) were randomly divided into control group(immersed in 37 ℃ water,n=40)and hyperthermia treated group(immersed in 44.5 ℃ water,n=87).The latter was further divided into febrile control group(n=42) and FS group(n=45) according to whether seizures occurred or not.Each group was further divi-ded into 5 groups according to different therapies(1,3,5,7,10 times treatment).Then 5 cases of the 8 rats were randomly used to observe the expressions of Nogo-A mRNA,Ng-R mRNA in hippocampus by using reverse transcriptase polymerase chain reaction(RT-PCR).Three of the 8 rats were randomly used to observe the changes of neurons and mossy fiber sprouting(MFS) in hippocampus by Nissl and Timm staining.Results 1.No seizures occurred in normal control group.Seizures occurred in 2 rats of febrile control group.In FS group,various seizures occurred such as nodding spasms,tonic seizures,clonic seizures and tonic-clonic seizures,2 rats died of drowning and 3 rats died of status epilepticus.2.The expressions of Nogo-A mRNA,Ng-R mRNA in the immature rats′ hippocampus became up-regulated after the 7th and 10th seizure,significantly higher than those of the other 2 control groups(Pa

Objective To observe the effect of intravitreal lucentis injection combined with macular grid photocoagulation for diabetic macular edema (DME).Methods 42 DME patients(42 eyes) according to different treatment methods,were divided into the combined group 21cases(21 eyes) and photocoagulation group 21 cases (21 eyes).The combined group was treated with connaught suitable for intravitreal injection combined macular grid photocoagulation , and the photocoagulation group was treated with simple macular grid photocoagulation .After 1 weeks,2 weeks,4 weeks,8 weeks,12 weeks and best corrected visual acuity before treatment (BCVA) and macular foveal thickness ( CMT) changes were comparative analyzed between the two groups .Results The BCVA values of the photocoagulation group before surgery ,1 week,2 weeks,4 weeks,8 weeks,12 weeks,were (0.74 ±0.24), (0.56 ±0.22),(0.52 ±0.23),(0.51 ±0.21),(0.51 ±0.20),(0.53 ±0.21),and CMT values were (440.36 ±50.56)μm,(376.06 ±28.60)μm,(365.45 ±30.02)μm,(361.38 ±29.56)μm,(358.68 ±30.46)μm,(360.43 ±29.36)μm;The BCVA values of the combined with preoperative group before surgery ,1 week, 2 weeks,4 weeks,8 weeks,12 weeks,were (0.70 ±0.23),(0.55 ±0.19),(0.52 ±0.18),(0.50 ±0.20), (0.48 ±0.19),(0.47 ±0.20),and CMT values were (442.32 ±54.35)μm,(385.14 ±27.34)μm,(345.32 ± 28.12)μm,(336.24 ±28.17)μm,(326.45 ±27.65)μm,(315.36 ±28.23)μm.The differences of BCVA and CMT values of the two groups in each time period values before and after treatment were statistically significant ( all P<0.05),and after 8 weeks,12 weeks,the differences of BCVA and CMT values between the two groups were statisti-cally significant(all P<0.05).Conclusion The macular grid photocoagulation only or lucentis injection combined with macular grid photocoagulation for diabetic macular could increase BCVA and reduce macular edema instinctively , but the difference was not significant .Combined therapy could preserve the visual acuity and delay time to relapse .

Objective To investigate the protective effect and mechanism of betaxolol on optic nerves after experimental retinal ischemia-reperfused injury. Methods Retinal ischemia was induced in SD rats by increasing intraocular pressure through intracameral infusion. Sixty-eight rats were randomly divided into 3 groups: normal control (eight rats), 0.25% betaxolol treatment (thirty rats) and saline control group (thirty rats). The latter two groups were subdivided into group 1 day, 3 and 7 days after reperfusion, respectively, with 10 rats in each group. Betaxolol and normal saline was applied to the right eyes of the rats in the treatment group and to the ones in normal saline control group, respectively. The amplitude of b-wave of electron retinograph (ERG) was observed and the histological and ultrastructural changes were detected by light and electron microscopy. The expression of neural nitrogen oxide synthase (nNOS) was detected by immunohistochemistry. The content of malonyldialdehyde (MDA) and the superoxide dismutase (SOD) activity were measured by spectrophotometer. Results [WTBZ]Began from the first day after reperfusion, in saline control group, the amplitudes of ERG b-wave reduced continuously, the histopathological damages of retina were aggravating, the expression of nNOS increased, MDA level increased and SOD level decreased persistently, which significantly differed from the normal control group (P0.01). Conclusion Betaxolol, by reducing intracellular overfreight of Ca~(2+),inhibiting production of NO and elevating the ability of anti-oxidation in rat retina, can protect retinal neurons from ischemia-reperfused injury.

Background Studies show that retinal neurodegeneration may precede retinal microvascular changes in diabetes mellitus.The apoptosis of retinal ganglion cells (RGCs) is an early finding in retinal neurodegeneration.Toll-like receptor 4 (TLR4) is proved to be up-regulated in diabetic rats retina.However,the impact of TLR4 on RGCs damage in retinal neurodegeneration is poorly understood.Objective The aim of this study was to investigate the expressing change of TLR4 induced by high glucose in RGCs in order to offer a basis for the prevention diabetic retinal neurodegeneration and the study on targeting drugs.Methods RGCs were isolated and purified from the retinas of SPF SD rats aged postnatal 1-3 days by using papain digestion method and then were identified by immunofluorescence technology to detect the expression of Brn3a,a specific marker of RGCs.The cells were divided into normal control group and 10,20,30 mmol/L glucose groups.The expressions of TLR4 mRNA and protein in the ceils were detected by real-time fluorescence quantitative PCR and Western blot analysis in 24 and 48 hours after addtion of glucose.All procedures performed in studies were in accordance with the Association for National Institutes of Health (NIH) Statement for the Care and Use of Laboratory Animals recommendations.The protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University.Every effort was made to minimize animal discomfort and stress.Results The normal cells grew well with the shape of near roundness after inoculaton.The cells were gradually enlarged and clustered with obvious axons and dendrites 24 hours after purifying.Brn3a showed the positive expression in cultured cells.At 24 hours and 48 hours after glucose culture,the cell structures were gradually invisible in most cells.The expressions of TLR4 mRNA in the cells were 0.945 ±0.237,1.180±0.193 and 0.827±0.213 at 24 hours and 1.509±0.422,2.433±0.617 and 1.435±0.410 at 48 hours after culture in the 10,20 and 30 mmol/L glucose groups,respectively,which were significantly higher than 0.600±0.099 and 0.724±0.302 in the normal control group (all at P＜0.01).The expressions of TLR4 protein in the cells were 0.442±0.147,0.626±0.128 and 0.330±0.153 at 24 hours and 0.464±0.121,0.930±0.441 and 0.394±0.158 at 48 hours after culture in the 10,20 and 30 mmol/L glucose groups,respectively,which were significantly higher than 0.090±0.050 and 0.094±0.070 in the normal control group (all at P＜0.01).Conclusions A large number of RGCs die in a high-glucose environment in vitro,meanwhile,the expression of TLR4 up-regulates in the cells,indicating that TLR4 maybe participate in the damage of RGCs induced by high glucose.

Objective To investigate the effect of electroacupuncture on the rehabilitation of rheumatoid arthritis (RA) and level of nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α) and interleukin 1β (IL-1β). Methods 140 cases of RA meeting the inclusion criteria were divided into control group and observation group equally according to therapeutic schemes. All the patients accepted medicine and rehabilitation training, while the observation group accepted electroacupuncture in addition. The effective rate and the symptoms were observed, the serum level of rheumatoid factor (RF), antistreptolysin O antibody (ASO), C-reactive protein (CRP), NF-κB, TNF-α and IL-1β were tested before and after treatment. Results The effective rate was 92.8% in the observation group, which was significantly more than that of 80.0% in the control group (P<0.05). The joint pain index, joint tenderness index and joint swollenness index reduced in the observation group compared with those in the control group (P<0.05), as well as the serum level of RF, ASO, CRP, NF-κB, TNF-α and IL-1β (P< 0.05). Conclusion Electroacupuncture may improve the effects of rehabilitation training for RA and inhibit the inflammation, which may associate with the inhibition of activation of NF-κB.