Background Measurement of corneal thickness is of great significance for the design of refractive surgery and the diagnosis of eye diseases,measuring equipments and technology develop rapidly in recent years.Optovue iVue OCT is a new frequency-domain optical coherence tomography (OCT),to compare its results with those of Pentacam and Visante OCT is helpful to objectively assess the clinical value of Optovue iVue OCT.Objective This study was to investigate the repeatability of corneal thickness measurement with Optovue iVue OCT and the comparatbility with Pentacam three-dimensional anterior segment analysis diagnostic system and Visante OCT.In addition,this study attempted to analyze the distribution of average corneal thickness in each quadrant by Optovue iVue OCT.Methods The corneal thicknesses of the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones 1 mm away from the center of the cornea were measured in 45 right eyes of 45 subjects with myopia using Optovue iVue OCT,Pentacam and Visante OCT in Tianjin Eye Hospital.Interclass correlation coefficient (ICC) was used to analyze the repeatability of measurement by Optovue iVue OCT.The agreements between Optovue iVue OCT and Pentacam or Visante OCT were evaluated by Bland-Altman test.The corneal area of 1.0-2.5 mm away from the center was divided into eight quadrants and the average corneal thickness of each quadrant was measured and analysis with Optovue iVue OCT.Results No significant difference was found in corneal thickness values for 3 times by Optovue iVue OCT (P=0.546).The ICC by Optovue iVue OCT was 99.92％,99.99％,99.96％,99.99％,99.99％ and 99.97％ at the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones respectively.There were significant differences among the 3 kinds of methods (P =0.000,0.001,0.000,0.003,0.002,0.000).The measured values of Optovue iVue OCT were significantly lower mean 24.20 μm than those of Pentacam (P=0.000,0.001,0.000,0.003,0.004,0.000),but only the value at 12:00 zone of Optovue iVue OCT was evidently declined in comparison with that of Visante OCT (P =0.016),there were no significant differences between all the other zones (P =1.000,0.447,0.239,1.000,1.000).While the mean corneal thickness value from Pentacam lowed by 14.01 μm in comparison with Visante OCT,all zones had significant differences (P =0.009,0.005,0.034,0.017,0.008) except the central point (P =0.056).Based on the Optovue iVue OCT,the thinnest zone was at temporal quadrant in 23 eyes (accounting for 51.11％) and at superior quadrant or super nasal quadrant in 21 eyes (both at 46.66％).Conclusions Optovue iVue OCT measurement of corneal thickness is of high repeatability and is consistent with Visante OCT in myopic eye.Optovue iVue OCT shows evident difference from Pentacam in the measurement of corneal thickness.The thinnest point of the cornea is mainly in the inferior temporal quadrant and the thickest point is commonly in superior quadrant and nasal superior quadrant based on Optovue iVue OCT.

This paper summarized nursing points for caring 23 cases undergoing pediatric heart transplantation,including:characteristics of accessing and protection of hearts,collaboration in pediatric heart transplantation,nursing of capacity management,temperature controlling,extracorporeal membrane oxygenation and delayed sternal closure during surgeries.The average length of hospitalization for 23 cases was 24.5±8.3 days,1 case died from primary graft failure after 19 months,the rest of 22 cases survived,and cardiac function recovered to NYHA class Ⅰ-Ⅱ.

0.05);the frequencies of IFN-? gene +874 site T and A allele showed significant difference between case group and control group(P0.05).Conclusion T allele of IFN? gene+874 site might have a relationship with generation of ovarian cancer,TT genotype might be susceptibility genotype for ovarian cancer.

Objective To investigate the clinical value of the Classification of acute pancreatitis2012.Methods Medical records and clinical data of patients with acute pancreatitis (AP) who were admitted to First Affiliated Hospital of Guangxi Medical University between October 2009 and September 2012 were retrospectively reviewed and analyzed.Patients were divided into mild acute pancreatitis (MAP),moderately severe acute pancreatitis (MSAP),and severe acute pancreatitis (SAP) groups according to the Classification of acute pancreatitis-2012.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,computed tomographic severity index (CTSI) scores among the 3 groups were compared.Results One hundred and sixty-six patients with AP (119 males and 47 females) were included,and 76 were MAP,65 MSAP and 25 SAP.The average interval between AP onset and hospital admission was (2.27 ± 1.46) d.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,CTSI scores increased with the severity of AP.The corresponding values in SAP group were 21 cases (84.0％),(23.8 ± 13.6) d,(53900 ± 30260) Yuan,48.0％ (12/25) and (5.76 ± 13.8) d,96.0％ (24/25) and (5.00 ± 2.40) d,(3.76 ± 1.30) score,(8.52 ± 4.24) score,(5.44 ± 3.48) score.Seventy-nine patients developed local complications,among them 34 was acute peripancreatic fluid collection,45 was acute necrosis collection.The incidence of acute necrosis collection in SAP group was significantly higher than that in MSAP group (68.0％ vs 44.6％,P =0.047),but the incidence of acute peripancreatic fluid collection in SAP group was significantly lower than that in MSAP group (16.0％ vs 46.2％,P =0.016).Organ failure occurred in 42 patients,among them 35 cases were respiratory failure,2 cases were renal failure,and 5 cases were respiratary and renal failure.The incidence of organ failure in SAP and MSAP group was 100％ and 26.2％,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Classification of acute pancreatitis-2012 is a simple and convenient system,which can predict the severity of AP and appropriate for clinical application.

Objective To investigate the relationship between serum albumin, bilirubin and cognitive impairment in patients with mild cognitive impairment (MCI). Methods Serum albumin, total bilirubin, direct bilirubin, indirect bilirubin were analyzed in 89 cases of MCI and 82 cases of cognitively normal control. All of the cases underwent neuropsychological testing by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The risk factors of MCI were subject to Logistic regression analysis. Results The serum level of total bilirubin in MCI group were significantly lower than that in controls (P < 0.05). There was no significant difference in albumin between MCI and control group (P > 0.05). The bilirubin level was positively correlated with MMSE scores and MoCA scores (including attention, delayed recall and abstract) (P < 0.05), while no significant correlation between serum albumin level and scores of MMSE and MoCA (P > 0.05) by using Spearman correlation analysis. Logistic regression analysis showed that age, education level, diabetes and serum bilirubin levels were independent risk factors for MCI. Conclusion Our data show that decreased serum level of bilirubin is positively related to cognitive impairment.

Objective To investigate the clinical value of multidisciplinary team (MDT) assessment for chronic constipation.Methods The clinical characteristics of 346 patients with chronic constipation who were admitted to the Third Peolep's Hospital of Hangzhou from January 2010 to December 2013 were multidisciplinarily assessed.The muhidisciplinary team was involved surgeons from the department of colorectal surgery,urology,gynecology,psychiatry and psychology,and tools including questionnaires,defecography,anorectal manometry,colon transit study,urodynamic tests,gynecological examination were applied in the study.The measurement data with normal distribution were presented as (x) ± s,the comparison between groups was analyzed using the ANOVA,and the count data were analyzed using the chi-square test.Results Three hundred and forty-six patients who met criteria of this research were selected,including 86 males and 260 females with the ratio of 1 ∶ 3;the mean age was (55 ± 11)years.Of the 346 patients,slow transit constipation accounted for 7.52％ (26/346),defecatory disorder for 60.98％ (211/346),and mixed constipation for 31.50％ (109/346).A total of 93.85％ female patients (244/260) had anterior rectocele,75.43％ (261/346) patients had internal rectal mucosal prolapse,66.76％ (231/346) patients had perineum descending,23.99％ (83/346) had achalasia or inappropriate contraction of internal anal sphincter,18.79％ (65/346) had puborectalis rectocele muscle thickening,5.49％ (19/346) had rectal prolapse.A total of 82.37％ (285/346) patients were involved in other subjects than colorectal surgery.A total of 28.61％ (99/346) patients presented with urinary symptoms,including 65 cases with stress urinary incontinence,23 cases with unstable bladder and 19 cases with bladder neck obstruction (some patients had multiple urological systoms).The incidence of reproductive organ prolapse in female patients was 31.92％ (83/260),the incidence of uterine prolapse and anterior vaginal prolapse were 26.15％ (68/260) and 29.23％ (76/260),respectively.Patients with anxiety and/or depression accounted for 36.13％ (125/346).The male and female patients of slow transit constipation,defecatory constipation and mixed constipation were 10 vs 16,30 vs 79,46 vs 165,respectively,the age was 60 ± 12,56 ± 11,52 ± 10,showing no significant differences (x2=4.046,F =2.877,P ＞ 0.05).In the three kinds of constipation,patients with urinary diseases accounted for 26.92％ (7/26),26.61％ (29/109) and 29.86％ (63/211),patients with gynecological diseases accounted for 11.54％ (3/26),20.18％ (22/109),27.49％ (58/211),patients with psychological diseases accounted for 38.46％ (10/26),39.45％ (43/109),34.12％ (72/211),respectively,showing no significant difference (x2=4.090,P ＞ 0.05).Conclusion MDT assessment for patients with chronic constipation can reflect comprehensively clinical characteristics of chronic constipation,therefore multidisciplinary team should be emphasized in clinical diagnosis and treatment of chronic constipation.

Objective To explore the diagnostic value of three-dimensional ultrasound parameters-vascularity index (VI) and the volume of kidney in chronic kidney disease (CKD). Methods A total of 80 CKD patients at different stages and 30 healthy adults were enrolled in the study. VI and the renal volume were calculated with three-dimensional ultrasound, while resistance index (RI), cortical thickness (CT) and the volume of kidney were calculated with two-dimensional ultrasound, and the correlation of those parameters were analyzed statistically. Results VI of CKD2 patients reduced significantly compared with the control group, and RI of CKD3 patients increased significantly, CT of CKD3 patients reduced significantly. The diagnostic sensitivity, specificity and diagnostic value of VI in patients with early and late CKD were all higher than thpse of RI. Compared with the control group, three-dimensional ultrasound of renal volume and two-dimensional ultrasound volume of CKD 1 patients increased significantly, three-dimensional ultrasound volume of CKD2 patients reduced significantly, and two-dimensional ultrasound volume of CKD4 patients reduced significantly. There was significant negative correlation among VI, three-dimensional ultrasound volume, CT, two-dimensional ultrasound volume and pathological change scoring (r=-0.67, -0.52, -0.43, -0.52). Conclusion VI and three-dimensional ultrasound volume can detect renal function damage more earlier and sensitively than RI and two-dimensional ultrasound volume.

Objective To investigate the distribution and expression of trefoil factor 3(TFF3) in the eosinophilic cells and basophilic cells in the pars distalis of the rat pituitary .Methods The immunohistochemiscal staining technique was used to show the coexpression of TFF3/growth hormone (GH),TFF3/prolactin (PRL),TFF3/thyrotroph (TSH), TFF3/adrenocorticotropin (ACTH),TFF3/follicle stimulating hormone (FSH),TFF3/luteinizing hormone (LH) in two contiguous slices .Results The immunoreactive products of TFF 3 and chromophil cells were brown granules , mainly expressed in cytoplasm .ACTH positive signals were expressed in the cell membrane and mainly located in the pars distalis hypophyseos.TFF3 existed in parts of GH,PRL,TSH,ACTH,FSH and LH cells in contiguous slices, accounting for 19.4%, 22.4%, 9.2%, 6.5%, 35.7%, 8.3%, respectively , in which FSH was the most , PRL and GH were less . Conclusion TFF3 expresses in GH, PRL, TSH, ACTH, FSH, and LH cells in the pars distalis , which enriches the morphological data for the location of TFF 3 in gland cells of pars distalis hypophyseos .

OBJECTIVE: To study the relationship among the dosage, serum concentration and clinical effect of phenytoin(PHT) in treating epileptic patients .METHODS: 130 steady -- state serum concentrations of PHT were determined by fluores-cence polarization immunoassay(FPIA) in 70 patients with or without other drugs used in combination .RESULTS: The indi-vidual difference among the patients who received routine dosage of PHT was very significant. Intoxication occurred ex-tremely often in patients whose PHT serum concentrations were over 30?g/ml .CONCLUSION: It is necessary to perform TDM(Therapeutic Drug Monitoring) and individualize the use of PHT,so that the safe and effective use of drug can be ensured.

Background Small incision lenticule extraction (SMILE) was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LAISK) after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were (1.03 ±0.19)D and (0.95±0.16)D at 1 week and 1 month after surgery,which were higher than (0.88 ±0.18)D at preoperation in the FS-LASIK group (P =0.000,0.012).The stray light values were (0.98±0.16),(0.95±0.14) and (0.94±0.16)D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with (0.91 ±0.15)D in preoperation in the SMILE group (all at P＞0.05).No significant intergroup difference was seen in the stray light values (Fgroup =0.077,P=0.781).The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group (Fgroup =14.798,P＜0.001),with the significant difference in postoperative 1 week between the two groups (P＜0.01).The negative correlations were found between stray light values at 1 week,1 month and 6 months after SMILE with the lenticule thickness/central corneal thickness (CCT) (R2=0.123,0.145,0.098,all at P＜0.05) or between stray light change.Conclusions Intraocular stray light appears less change in operative eyes after SMILE.However,intraocular stray light increases in the eyes received FS-LASIK,especially at early stage after operation.The stray light shifts return to normal with the lapse of postoperative time.