Objective To investigate the long-term results of amniotic membrane transplantation for conjunctival surface reconstruction and analyze the involved microsurgical techniques and associated factors. Methods Fifty-one consecutive cases (55 eyes) with symblepharon at degree due to eye burns or Stevens-Johnson syndrome were accepted amniotic membrane transplantation after lysis of symblepharon. Results Observation time varied from 36 to 44 months (mean value, 38?4 months). Fifty-six point four percent(31/55) eyes got enough conjunctival fornix and resolution of eye movement restrict. About sixteen percent of them (9/55) recurred less symblepharon. Fifteen-five eyes of them(27.3%) recurred moderate symblepharon. The results of AMT for those patients with symblepharon at different degree and between those patients who were performed in different time after eye burns had significant difference statistically ( ? 2 test, P

OBJECTIVE:To gain an idea of current situation of pharmacoeconomic research work in China,so as to promote the level of research work.METHODS:Exisisting problems in pharmacoeconomic research work in 49 articles,published in domestic journals in recent 2 years,were analysed.RESULTS & CONCLUSION:In 49 articles,there exist 8 problems including method of analysis,source of data and cost accounting ect.,which indicates that the pharmacoeconomic research is still in immature stage in China and clinicians and pharmacists should explore these problems without cease to make the research become better day by day and apply to clinical practice early.

Objective To evaluate the use of amniotic membrane patches for mild or moderate eye burns at the stage of acute burns and the involved microsurgical techniques.Methods Thirty-four eyes with corneal burns of Ⅱ to Ⅲ degree in which may have partial limbal necrosis were accepted amniotic membrane patching (21 eyes) or pharmaceutical treatment (13 eyes).Four amniotic patches were procured and examined by transmitting electronic microscope when the exposed corneal surface became re-epithelialization after amniotic membrane inching.Results Amniotic patches became partially melting or prolapsed 5-10 (11± 2) days after surgery.The uncovered corneal surface showed quickly re-epithehalized.There were a few thin fibrovascular membrane invaded onto corneal surface in the patients with more than a half limbal necrosis.Postoperative visual acuity increased 1 to 6 (3.3 ± 1.2) lines.The electronic findings showed that most of the infiltrated polymorphonuclear neutrophils in the anmiotic patches became apoptosis.Corneal melting presented in four of 13 eyes who received only drug treatment and lamellar keratoplasty was then performed.The other eyes manifested pseudo-pterygium or symblepharon at different extent.Conclusion Amniotic,patches may reduce the inflammation of burned cornea and corneal neovascularization,accelerate re-epithelialization of corneal surface,even improve the rehabilitation of burned limbal stem cells.

Objective To investigate the effects of resuscitation with limited fluid on rabbits with uncon-trolled hemordaagic shock. Method Uncontrolled hemorrhagic shock was produced in 40 rabbits. When the mean arterial pressure dropped to 40 manI-Ig and maintained for 30 minutes, resuscitation was initiated with Ringer solu-tion infusion into rabbits in large volume for group N3 (125 mL/kg) ,moderate volume for group N2 (92 mL/kg) and small amount for group N1 (57 mL/kg), and a drop of fluid was not given to rabbits of group N4. Besides, rob-bits of group N5 were controls without shock. MAP, fatality, volume of blood loss, SOD and Her were observed for 120 minutes or until death. Data were analyzed using SNK-q test and rank test. Results MAP, SOD and Het were higher, and fatality and blood loss were lower in group N5 than those in groups N1, N2,and N3 (P<0.01 ). MAP,fatality,blood loss and Het of group N4 were worse than those of groups N1,N2 and N3 (P<0.01). The blood loss and fatality in group N3 were significantly higher than those in groups N1 and N2 (P<0.01 ). SOD of kidney in group N3 was significantly lower than that in group N1 and N2(P<0.01). As the volume of fluid in-creased during resuscitation, Het of all animals was gradually becoming lower. As MAPS in groups N2, N3 and N4 were gradually becoming lower and lower, death increased. Conclusions Limited fluid resuscitation (57～92mL/kg) should be recommended to the therapeutic strategy for uncontrolled hemorrhagic shock.

Objective To survey small dense low-density lipoprotein cholesterol(sdLDL-C)distribution among different popula-tions,and analyze its relationship with lipid component.Methods 986 cases of people who underwent medical examination in the hospital were recruited in the study.There were 654 people with normal concentrations of serum blood lipids(normal blood lipids group),according to sex and age they were divided into groups.The people whose serum lipids concentrations increased above the normal range were divided into TG increasing group,LDL-C increasing group and joint increasing group according to the type of lip-ids componet increased.Serum sdLDL-C,LDL-C,TG,TC,HDL-C,ApoAⅠ and ApoB were determind in the people mentioned a-bove,and the correlation between sdLDL-C and TG,TC,HDL-C,ApoAⅠ,ApoB concentrations were analyzed.Results SdLDL-C began to decline after the age of 70,the difference was statistically significant(P <0.05 );the ensemble average of the males was higher than that of females,the difference was statistically significant(P <0.05).The serum sdLDL-C cocentrations of all the serum lipis increasing groups were significantly higher than those of normal blood lipids group,the difference was statistically significant (P <0.05 ).SdLDL-C concentrations were positively correlated with TC,TG,ApoB(r =0.254,0.589,0.302),and was negative correlated with HDL-C and ApoA Ⅰ (r = - 0.421,- 0.275,- 0.311 ).Conclusion There was a positive correlation between sdLDL-C and TC,TG,ApoB,and sdLDL-C was negatively correlated with HDL-C,ApoAⅠ,which can accurately reflect the overall status of lipid metabolism.

Background Mooren 's ulcer is an immune-related corneal inflammatory disease,and its pathogenesis remains below understood.Previous studies showed that the imbalance of T helper cell type 1 (Th1) and Th2 cell play important roles in the development of some autoimmune diseases.Thereby the influence of Th1/Th2 cells on the pathogenesis of Mooren's ulcer is being concerned.Objective This study was to investigate the change of Th1 and Th2 subsets in periphery blood of patients with active Mooren's ulcer.Methods Eleven consecutive patients with active Mooren's ulcer and 8 age-and gener-matched healthy controls were included in Zhongshan Ophthalmic Center,Sun Yat-sen University from January 2012 to July 2013 under the approval of Ethic Committee of this hospital and informed consent of each subject.The peripheral blood samples of all the subjects were obtained separately and periphery blood mononuclear cells (PBMCs)were isolated.The percentages of Th1 and Th2 in the PBMCs were assayed by flow cytometer.The relative expressions of T-bet mRNA,GATA-3 mRNA and signal transducer and activator of transcription 5 (Stat5) mRNA in the PBMCs were examined and compared by real-time fluorescence quantitative PCR (RT-qPCR) Results The percentage of Th1 cells in CD4+ T cells and Th1/Th2 value was 0.21％ (0.11％,0.31％) and 8.01 (4.49,12.01) respectively in the Mooren's ulcer group,which were significantly lower than 0.35％ (0.22％,0.71％)and 23.90 (22.49,33.49)in the normal control group,respectively (Z =-2.01,P =0.04 ; Z =-3.06,P =0.00).However,no significant difference was found in the percentage of Th2 between the two groups (Z=-1.98,P＞0.05).The relative expressions of T-bet mRNA and GATA-3 mRNA in PBMCs were significantly lower in the Mooren's ulcer group than those in the normal control group (Z =-3.47,-3.06,both at P=0.00) ;While the relative expression of Stat5 mRNA in PBMCs was insignificant changed between the two groups (Z =-1.05,P =0.33).Conclusions Th1 and Th2 cells are unbalanced in the active Mooren's ulcer patients.In addition,the down-expression of relevant transcription factors in peripheral blood also is seen in these patients.It is inferred that Th1 and Th2 cells may participate in the progress of Mooren's ulcer.

Objective To determine the optimal pressure for facemask ventilation during induction of general anesthesia by real-time ultrasonographic measurement of antral cross-sectional area (CSA) in adult patients.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 18-60 yr,with body mass index of 20-25 kg/m2,scheduled for elective operation under general anesthesia,were divided into 5 groups (n=12 each) using a random number table:P10 group,P13 group,P16 group,P19 group and P22 group.After induction of anesthesia,an oropharyngeal airway was inserted,and the patients were ventilated for a 2-min period in a pressure-controlled mode using the two-handed mask ventilation technique.The pressure for facemask ventilation was 10,13,16,19 and 22 cmH2O in P10,P13,P16,P19 and P22 groups,respectively.The antral CSA was measured using real-time ultrasonography before and after facemask ventilation.Respiratory parameters were recorded.Results Compared with group P1O,the number of patients in whom CSA＜340 mm2 after facemask ventilation was significantly decreased in P16,P19 and P22 groups,and the number of patients in whom the tidal volume ≥ 6 ml/kg was increased in P13,P16,P19 and P22 groups (P＜ 0.01).The number of patients in whom optimnal pressure for facemask ventilation was achieved was 2,10,6,4 and 1 in P10,P13,P16,P19 and P22 groups,respectively,with the most cases in group P13 (P ＜ 0.01).Conclusion The optimal pressure is 13 emH2O for facemask ventilation during induction of general anesthesia when determined by realtime ultrasonographic measurement of antral CSA,and it can ensure adequate oxygen supply and reduce gastric insufflation in adult patients.

OBJECTIVETo investigate the effects of fresh and preserved amniotic membrane on polymorphonuclear neutrophils (PMNs) so as to understand the anti-inflammatory mechanism of amniotic membrane transplantation.

METHODSConditioned medium was collected 48 hours after fresh or preserved amnions were cultured in DMEM and 5% CO(2) at 37 degrees C. Then, polymorphonuclear cells were cultured in conditioned culture or DMEM. Fluorescent microscopy with 4',6-diamidino-2-phenylindole (DAPI) staining and cytometry were performed 6, 9, 12, and 15 hours later.

RESULTSApoptotic neutrophils were found in each group at different time points. The percentage of apoptotic cells at 6, 9, 12, and 15 hours after culture in the fresh and preserved amnion groups and the control group was 17.3%, 24.4%, 29.8%, 37.1%, and 16.2%, 20.1%, 23.7%, 27.7%, and 10.2%, 13.7%, 21.1%, 26.4%, respectively (t test, P(1) < 0.01, P(2) < 0.01 and P(3) < 0.01).

CONCLUSIONAmniotic membrane can accelerate apoptosis of polymorphonuclear neutrophils, reduce inflammation, and prevent ocular surface collagen from resolution, indicating that fresh amnion might have a stronger effect than preserved amnion.

Objective To discuss the relationship and clinical significance between anterior rectocele and resultant constipation by the obstruction of functional outlet. Methods The clinical and dynamic defecography materials of 417 cases with resultant constipation by the obstruction of functional outlet were retrospectively reviewed. Dynamically replaying the cases of anterior rectocele and analyzed the representation. Results ①310 cases with anterior rectocele,392 cases with internal rectal prolapse,353 cases with perineum descending,69 cases with pelvic spasm or puborectalis thickening. 95.20% (397/417) cases with more than 2 abnormalities simultaneously,no cases with only anterior rectocele. The difference between men and women was statistically significant(P< 0.01) of anterior rectocele,perineum descending、pelvic spasm or puborectalis thickening. There was no difference with internal rectal prolapse(P> 0.05). ②Dynamically replaying the cases of anterior rectocele:226 cases could drain almost all of the barium of rectum and the distal rectum mucosal fold hypertrophy,account for 72.90% (226/310);71 cases could not drain any or drained driply and prolapse of rectal mucosa or pelvic spasm or puborectalis thickening,account for 22.90% (71/310); 13 cases with protruded sac reduced not obsolete and rearward the sac internal rectal prolapse, account for 4.20% (13/310). Conclusion Anterior rectocele is not the main cause of constipation,to make sure the relationship between anterior rectocele and resultant constipation by the obstruction of functional outer can provide instructional significance for the cure scheme.

Lung cancer is the most common incident cancer and the leading cause of cancer death. In recent years, the development of tumor immunotherapy especially chimeric antigen receptor T (CAR-T) cell has shown a promising future. Epidermal growth factor receptor variant III (EGFRvIII) is a tumor-specific mutation expressed in various types of tumors and has been detected in non-small cell lung cancer with a mutation rate of 10%. Thus, EGFRvIII is a potential antigen for targeted lung cancer therapy. In this study, CAR vectors were constructed and transfected into virus-packaging cells. Then, activated T cells were infected with retrovirus harvested from stable virus-producing single clone cell lines. CAR expression on the surfaces of the T cells was detected by flow cytometry and Western blot. The function of CAR-T targeting EGFRvIII was then evaluated. The EGFRvIII-CAR vector was successfully constructed and confirmed by DNA sequencing. A stable virus-producing cell line was produced from a single clone by limited dilution. The culture conditions for the cell line, including cell density, temperature, and culture medium were optimized. After infection with retrovirus, CAR was expressed on more than 90% of the T cells. The proliferation of CAR-T cells were induced by cytokine and specific antigen in vitro. More importantly, EGFRvIII-CART specifically and efficiently recognized and killed A549-EGFRvIII cells with an effector/target ratio of 10:1 by expressing and releasing cytokines, including perforin, granzyme B, IFN-γ, and TNF-α. The in vivo study indicated that the metastasis of A549-EGFRvIII cells in mice were inhibited by EGFRvIII-CART cells, and the survival of the mice was significantly prolonged with no serious side effects. EGFRvIII-CART showed significantly efficient antitumor activity against lung cancer cells expressing EGFRvIII in vivo and in vitro. Therefore, CAR-T targeting EGFRvIII is a potential therapeutic strategy in preventing recurrence and metastasis of lung cancer after surgery.
Animals ; Carcinoma, Non-Small-Cell Lung ; immunology ; therapy ; Cell Line, Tumor ; ErbB Receptors ; immunology ; metabolism ; Female ; Humans ; Immunotherapy, Adoptive ; methods ; Lung Neoplasms ; immunology ; therapy ; Mice ; Mice, Inbred NOD ; Receptors, Chimeric Antigen ; immunology ; T-Lymphocytes ; immunology ; Xenograft Model Antitumor Assays