AIM: To investigate the potential causes and management of the clusters of diffuse lamellar keratitis (DLK) after laser corneal refractive surgery.METHODS: The study enrolled 98 eyes (53 patients) complicated with DLK after receiving laser in situ keratomileusis (LASIK), FS-LASIK or small-incision lenticule extraction (SMILE) in our center from February 10th,2016 to February 22th,2016.They were given clinical classification treatments according to corneal layer inflammatory extent and then followed up after 1, 3, 5, 7, 10d and 1mo.RESULTS: The clusters of DLK occurred 5 times in the study period.The incidence and degree of DLK significantly decreased after changed the sterilization, surgical equipments, temperature and humidity of the operating room.There were 80 eyes (82%) had stage 1 DLK, 11 eyes (11%) had stage 2, 4 eyes (4%) had stage 3 and 3 eyes (3%) had stage 4.The incidence of DLK after FS-LASIK was 40% (79 eyes in 42 patients), that after LASIK assistant by Hastome keratome was 45% (10 eyes in 5 patients), that after SMILE was 20% (9 eyes in 6 patients).After intensive treatment, as glucocorticoid treatment and flap lifting flushing, all cases recovered within 1mo.CONCLUSION: The outbreak of DLK may be associated with the disposable item, flushing liquor, temperature and humidity of the operating room.Early diagnosis, prevention and treatment are the key of decreasing the incidence of DLK.

Objective To investigte the possibility of interventional mechanical thrombectomy dealing with chronic vascular thrombus, and assessing its curative effects. Methods Twenty three cases included 17 males 6 females, and aged from 46 to 80 year with a mean of 64.8. All patients were coinsided with MRA, vascular ultrasound and angiography, in which 12 patients with chronic heart and vascular disease, and 11 patients with serious diabetes. Thrombi were located in iliac artery ( n=9,L=4,R=3 , bilaterals=2), femoral artery( n =2), populiteus artery ( n =2), popliteus artery( n =3), iliac vein ( n =7, L=5,R=2), portal vein ( n =1). The length of thrombi varied from 3 to 8 cm, and the diameter from 5 to 10mm.Filter should be placed in inferior cava vein before venous thrombus treatment ( n =7). Mechanical thrombectomy was undertaken as following: ATD ( n=9, Vein=7), PTD( n =2), and Oasis( n =1). After guide wire passing through thrombus segment, Oasis was inserted for remove thrombus. Urokinase (500 000U) was usually administered for catheter directed thombolysis before/during mechanical thrombectomy. Stent should be placed in the segment if stenosis was confirmed after thrombectomy angiography. Drugs were used after thrombectomy including thromboyltic drug, heparinzed anticoagulation and changing microcirculation. Vascular ultrasound, reconstruction CTA and clinical follow up had all been carried out. Results 12 cases (85.7) were undergone successfully thrombectomy. One case failured with portal vein thrombus formation, the other with multiple segments involvement in femoral artery was treated by combined ATD and Oasis. Sy mptoms of 15 cases were either released or disappared, including ischemia, swelling and motion limitations. The patency shown by vascular ultrasound follow up were 100% in three months, 85.4% in six months, 73.2% in twelve months, with simultaneously blood flow improvement to normal and obviously corrected 76.5%,65.4% 60.1% in 3,6,12 month respectively.Conclusions Interventional mechanical thrombectomy is a new choice of treating chronic vascular thrombus with its direct curative effects, but still needs long term follow up.

Objective To explore the determination of elements selenium content in Se Semen Cassiae. Method Selenium content in Se Semen Cassiae was measured by graphite atomic absorption spectrophotometer. Result and Conclusion An appropriate extraction method and digesting condition were screened out. The determined results were accurate when the digested sample was dissolved and metered volume with 1% HNO3 which containing 0.1% Tween 80.

Objective:To study the function of tumor necrosis factor r eceptor-associated factor 6(TRAF6) in the development of rat dental germ. Methods:After specimen preparation of every stage of rat developing d ental germs, immunohistochemical staining of TRAF6 was carried out. Resu lts:Positive expression of TRAF 6 was observed in thickening stage of de ntal lamina, peripheral dental lamina of bud stage, outer and inner enamal epith elium, stellate reticulum,dental papilla cells and dentinoblasts in early bell s tage, ameloblasts, dentinoblast,intermediate layer, stellate reticulum and denta l papilla cells in late bell stage, and dentinoblasts and ameloblasts in the ger m 7 days after birth. Conclusions:TRAF6 may be a signal transduc tion factor which modulates the proliferation and differentiation of developing epithelial and mesenchymal cells in the development of the dental germ.

ObjectiveTo determine a measurement standard of irregular scar area by comparing the ad-vantages and disadvantages of different measurement methods in measuring same irregular scar area. MethodsIrregular scar area was scanned by digital scanning and measured by coordinate reading method, AutoCAD pixel method, Photoshop lasso pixel method, Photoshop magic bar filled pixel method and Foxit PDF reading software, and some aspects of these methods such as measurement time, repeata-bility, whether could be recorded and whether could be traced were compared and analyzed.Results There was no significant difference in the scar areas by the measurement methods above. However, there was statistical difference in the measurement time and repeatability by one or multi performers and only Foxit PDF reading software could be traced back.ConclusionThe methods above can be used for measuring scar area, but each one has its advantages and disadvantages. It is necessary to develop new measurement software for forensic identification.

Botulism ; therapy ; Child ; Female ; Humans ; Respiration, Artificial

Objective To evaluate the preoperative nutritional status of the patients which were preparing for cardiac valves replacement using nutrition risk screening 2002 (NRS2002),and analyze the evaluation effect and bring forward the corresponding nursing interventions.Methods 226 patients who would carry out cardiac valves replacement in the context of extracorporeal circulation were evaluated by NRS2002 preoperatively.88 patients had nutrition risk.Those elective 88 patients were randomly assigned into the experimental group and the control group,each had 44 cases.Then different nursing measures were implemented in each group and the clinical outcome was contrasted in the two groups.Results In the patients who were preparing for cardiac valves replacement,88 cases had preoperative nutrition risk score ≥3 points and 138 cases ＜ 3 points.Preoperative nutrition risk score had positive correlation with heart function grade.Difference of the experimental group and the control group in length of stay,length of mechanical ventilation after surgery and incidence rate of general complications had statistical significance.Conclusions It is effective to analyze the preoperative nutritional status of the patients with cardiac valves replacement by NRS2002.It may improve prognosis effectively by providing preoperative nursing interventions for patients with nutrition risk.Besides,it provides theoretical basis for further studying the relation between nutrition support and clinical outcome of patients with nutrition risk.

Objective To compare the efficacy of total pelvic floor reconstruction with mesh patch and vaginal hysterectomy with anterior and posterior vaginal wall repair for presby-pelvic floor dysfunction patients.Methods We randomly chose 92 pelvic floor dysfunction inpatients of our hospital from September 2007 to February 2009 and divided them into 2 groups:total pelvic floor reconstruction group(n=70) underwent total pelvic floor reconstruction with mesh patch[12 patients of this group complicated with stress incontinence,4 patients received tension free vaginal tape-obturator(TVT-O) simultaneously];control group(n=22) received vaginal hysterectomy with anterior and posterior vaginal wall repair(3 patients of this group complicated with stress incontinence).A follow-up for 3 to 18 months after the surgery were taken in all the patients.Results In total pelvic floor reconstruction group,no recidivate case was found and the FOP scores and cure rate were 0 and 100% respectively.In control group,there were 7 recidivate cases,all of who were primary vagina anterior wall bulge patients.The cure rate of control group was 68%;For the patients complicated with stress incontinence,they were all cured by TVT-0 or by ascending the front patch in total pelvic floor reconstruction group,but 1 case was as before operation and 2 cases were even worse in control group.Conclusion Total pelvic floor reconstruction with vicarious materials had a definite efficacy for presby-pelvic floor dysfunction.

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Objective To evaluate the safety and feasibility of ketamine-propofol mixture anesthesia for 85 children with congenital heart disease undergoing cardiac catheterization.Methods Eighty-five children with congenital heart disease undergoing cardiac cathete-rization were randomly divided into ketamine group(K group,n=44)and ketamin-propofol group(KP group,n=41).K group:1 mg?kg-1 ketamine was injected intravenously and then infused at 50 ?g?kg-1?min-1 for anesthesia maintenance.KP group:anesthesia was induced with ketamine 1 mg?kg-1 and propofol 1 mg?kg-1 intravenously,and maintained by continuous infusion of ketamine(16.7 ?g?kg-1?min-1)and propofol(33.3 ?g?kg-1?min-1).Electrocardiogram,blood pressure,pluse,respiratory frequency,saturation of blood oxygen were continously monitored.Results Hemodynamic and respiratory function were stable in both 2 groups.Ketamine consumption in K group was significantly more than that in KP group[(52.1?2.8)?g?kg-1?min-1 vs(25.3?7.3)?g?kg-1?min-1],eye opening time and recovery time were also longer in K group than those in KP group [(50.2?16.5)min vs(40.4?18.3)min].Conclusion The ketamine-propofol mixture was a safe,efficacy anesthesia with excellent recovery in children with congenital heart disease undergoing cardiac catheterization.