AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients,to observe the patients` visual quality,to evaluate the patients` distance visual acuity,near visual acuity,Pseudo-accommodative power,residual astigmatism,the rotational stability of AcrySof IQ Toric Restor intraocular lens (IOLs),contrast the rate of off-distance glass,the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.METHODS:Carried out in 46 patients (48 eyes) with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016.All the cases were randomly divided into 2 groups: experimental group: 23 cases (24 eyes),AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification;control group: 23 cases (24 eyes),AcrySof IQ was implanted.Uncorrected distance visual acuity (UCDVA) and best corrected distance visual acuity (BCDVA),uncorrected near visual acuity (UCNVA) and best-corrected near visual acuity(BCNVA),Pseudo-accommodative power,residual astigmatism,preoperative and postoperative corneal astigmatism,the rate of off-distance glass,the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05).At 1wk,1,3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group (P<0.05).UCNVA were also statistically better than the control group (P<0.05).The mean residual astigmatisms 1wk,1,3 and 6mo postoperatively were statistically differences between the control group and experimental group (P<0.05).At 6mo postoperatively,patients satisfaction of experimental group were significantly better than control group (P<0.05).Spectacles independence for near vision achieved 83% and 17% in experimental group and control group,experimental group were statistically better than control group(P<0.05).Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group,experimental group were statistically better than control group(P<0.05).CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity,which can significantly reduce preexisting corneal astigmatism in cataract surgery,improve spectacles independence for distance vision and spectacles independence for near vision,have a high patient satisfaction.

OBJECTIVETo study the ischemic times of the main artery injury in the limbs and the influence on the limbs survival rate, and to analyze the reasons for the formation of the ischemia time.

METHODSFrom June 1996 to November 2012, 83 patients with completely severed limb main artery treated in our hospital were retrospectively studied. There were 77 males and 6 females, including 81 adults (ranging in age from 16 to 52 years old, with a median age of 35 years old) and 2 children (4 and 5 years old respectively). Seventy-five patients were treated with end to end anastomosis, 7 patients were treated with great saphenous vein transplantation, and 1 patient was treated with artificial blood vessel transplantation. The prior to admission ischemia time, after admission ischemia time and total ischemia time for successful and unsuccessful patients, as well as the causes of the formation of the ischemia time were studied. Limb survival rate of different ischemic time was counted. Sharpness injury or blunt injury ischemia time and amputation rate were researched statistically. All data were analyzed using SPSS statistical software.

RESULTSThere were 72 limbs survived, 11 amputated. The average ischemia time was (7.45±5.94) h for limb-salvage group and (13.73±14.00) h for amputation group. Prior to admission ischemia time between amputation and limb-salvage group had no significant difference. After admission the ischemia time in amputation group was longer than limb-salvage group. The amputation rate for ischemia time 21 to 44 h group was higher than other three groups (≤ 5 h, 6 to 10 h, 11 to 20 h) (P=0.023, 0.038, 0.044). Amputation reasons can be divided into anastomosis failure in the operation, vascular thrombosis 2 to 4 days after operation and late infection.

CONCLUSIONVascular injury limbs can tolerate longer ischemia time and the limb salvage succeed. Only too long ischemia time (> 20 h), limb amputation rate increases significantly. The main cause of long time ischemia is delayed diagnosis in the hospital. Whether limb-salvage success mainly depends on the degree of trauma and the quality of the anastomosis than ischemia time.

Adolescent ; Adult ; Amputation ; Extremities ; blood supply ; Female ; Humans ; Ischemia ; surgery ; Limb Salvage ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Vascular System Injuries ; surgery

OBJECTIVETo study the influence of actual defect length and gap width of the limbs main artery on the method selection of repairing and reconstruction.

METHODSRetrospective study was carried out for 32 patients with extremity main artery injury from 1996 to 2009, including 30 males and 2 females; 30 adults with an average age of 36 years old ranging from 18 to 51 years, 2 children of 4 and 5 years old respectively. Injured body parts involved axillary artery in 4 cases,brachial artery in 7 cases,radial artery in 2 cases, femoral artery in 4 cases, popliteal artery in 13 cases, posterior tibial artery in 2 cases. Main arterial injury defect gap width of all cases were observed and the reasons were analyzed. All cases were repaired by the method of end to end anastomosis after vessels stretch.

RESULTSThe artery defect width was 3 cm to 7 cm with an average of (4.375 +/- 1.200) cm. Defect width of the upper extremity brachial artery and axillary artery group was (5.73 +/- 0.63) cm,the lower extremity femoral and popliteal artery group (3.80 +/- 0.73) cm, the posterior tibial artery group (3.25 +/- 0.35) cm, the radial artery group (3.00 +/- 0.00) cm. Defect width of upper extremity brachial artery and axillary artery group was larger than that of the other three groups (P < 0.01). End to end anastomosis was performed successfully in all cases. Blood supply recovered well. Because of the severe limb infection 2 patients had amputation in the late. All patients received follow-up. The patients without fracture were followed up to 2 weeks postoperatively, all patients with fractures were followed up to 1 year at least. Limb blood supply was good in all patients during the follow-up.

CONCLUSIONBlood vessel defect gap width is different from the actual vessel defect, but is larger than the actual vessel defect. Misjudgment of the vascular defect length will lead to more vascular transplantation. The vast majority of vascular defect can be directly repaired by the method of end to end anastomosis after the vessel free and stretch.

Adolescent ; Adult ; Arm ; blood supply ; surgery ; Axillary Artery ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Vascular Surgical Procedures ; Young Adult

ObjectiveTo study the pharmacokinetics of iguratimod in rats. MethodsThe concentration ofiguratirnod in the samples was determined by HPLC method. The pharmacokineties parameters were calculated withDAS softwrare. ResultsThe mainpharmacokineties parameters of normal group(6mg/kg) were as follows:t1/2Ke:3.56h, tpeak: 4.00h, Cmax : 8.87μg/ml, AUC0.24 : 74.76μg· ml-1·h-1. The main pharmacokineties parameters of threemodel groups(3,6,12mg/kg) were as follows: t1/2Ke: 4.54,3.20,3.17h, tpcak:3.83,3.83,4.67h,Cmax:3.84, 8.31,12.69μg/ml, AUC0.24 :40.21,76. 72,117.06μg·ml-1·h-1. Except Cmax and AUC, no significant differenceswere found between the three model groups. And the differences between normal group and model group were notsignificant. ConclusionThe pharmacokinetics of rats ks fit to one-compartment model.

Objective To investigate the expression of Oct-4 as a stem cell marker in gastric carcinoma tissues and its clinical significance. Methods From June 1996 to March 2006, 63 paraffin samples of gastric carcinoma tissues were obtained, and the expression of Oct-4 was examined by immunohistochemical staining. Another 58 normal tissues adjacent to gastric carcinoma and 10 normal gastric mucosa tissues were served as controls. The clinieopathologieal data of 63 patients with gastric carcinoma were retrospectively analysed, and their relationship with the expression of Oct-4 was analysed. Fifty of these 63 patients were followed up for 8 years, Kaplan-Meier method and Log-rank teat were employed to explore the correlation between Oct-4 expression and survival, and Cox Regression analysis was performed to evaluate the possibility of Oct-4 expression as an independent prognostic factor for gastric carcinoma. Results The positive expression rate of Oct-4 in gastric carcinoma tissues was 80.95% (51/63), significantly higher than that of normal tissues adjacent to gastric carcinoma (5.2%, 3/58) and normal gastric mucosa tissues (0) (P < 0.01). The expression of Oct-4 was positively correlated to the clinical stage of gastric carcinoma(P<0.01). There was no significant difference in the expression of Oct-4 among patients with different differentiation, age, and gender (P>0.05). Patients with higher expression of Oct-4 had significantly shorter survival time (P<0.05). The expression of Oct-4 was not significantly correlated with the prognosis of gastric carcinoma(RR, 0.554; 95% CI, 0.209-1.466). Conclusion The expression of Oct-4 is correlated with the clinical stage and survival time of patients with gastric carcinoma, however, it is not an independent prognostic factor for gastric carcinoma.

Biomacromolecule drugs have been increasingly used in clinical practice due to their distinct advantages, including precise targeting, small dose, high safety and activity. However, owing to their high molecular weight, strong hydrophilicity, and poor stability in the gastrointestinal tract, the oral bioavailability of the biomacromolecule drugs remains extremely poor. As a novel and innovative technology for active drug delivery, gastrointestinal microneedles hold immense potential in the oral delivery of biomacromolecule drugs because of their low-invasive nature and high permeation enhancement effects. This review primarily summarizes the actuating force, design strategies, fabrication techniques, and applications of gastrointestinal microneedles for the oral delivery of biomacromolecule drugs. Additionally, the challenges and further perspectives in the development this technology are presented, aiming to promote the subsequent research and clinical translation of gastrointestinal microneedles, and to provide a new efficient and safe strategy for oral delivery of biomacromolecule drugs.

Background and purpose:Esophageal cancer(EC) is one of the most common cancers that account for cancer-related deaths and over 400,000 new cases has been diagnosed per year.The morbility of small cell carcinoma of the esophagus(SCEC) is very low.This paper was to study was the clinical characteristics,treatment and prognosis of undifferentiated small cell carcinoma of the esophagus(SCEC).Methods:From 1961 to 2003,743 patients with SCEC were treated in different hospitals.The number of small cell carcinoma of the esophagus seen accounted for 1.38% of esophageal cancer treated in those hospitals in the same period.the average age was 56.8(range,51 to 66).511 of patients were male and 232 female.2 of them had primary tumor in the cervical proportion of the esophagus,68 in the upper thoracic proportion,420 in the mid thoracic proportion,252 in the lower proportion and 1 in the whole esophagus.88 patients were treated by surgery alone,23 by radiotherapy alone,24 patients by chemotherapy alone and all other of patients were treated by combined modality.Results:The median survival was 12.4 months for all patients,with 10.8 months for surgery,6.2 months for radiotherapy,6.6 months for chemotherapy,14.7 months for surgery combined with radiotherapy,16.1 months for surgery combined with chemotherapy,12.3 months for chemoradiotherapy and 16.2 months for surgery combined with chemoradiotherapy,respectively.The survival rates at 1,2,3,4,and 5 years were 56.4%、27%、19.3%、11.1%、(9.7%) for the whole group,respectively.Conclusions:We recommend that combined modality should be used for SCEC.The combination of surgery and multi-drug chemotherapy may improve the treatment outcomes for the patients with early stage SCEC.

Objective To explore the effect of clinical pharmacist on clinical rational use of antineoplastic drugs after participating in treatment group.Methods Retrospective research was used.According to whether there was a clinical pharmacist directly or indirectly involved in,all medical teams of the oncology department were divided into intervention group,advisory group and control group in our hospital.Intervention group was the medical team that had a specialist clinical pharmacist who could intervene irrational use of antineoplastic drug in the treatment on the spot.Advisory group was in the same area with the intervention group,and didn't have a specialist clinical pharmacist, but used to communicate with clinical pharmacist and take his medication advice,where clinical pharmacist indirectly involved in treatment.The control group was the medical group in the other area without clinical pharmacists of oncology department.The control group one and two were with the most beds among the control group.Randomly selected lung cancer,breast cancer,esophageal cancer,gastric cancer,colorectal cancer,gynecological cancer,liver/gallbladder/pancreatic cancer and other tumors patients from intervention group,advisory group,control group one and control group two,from January 2015 to December 2015,10 copies of each case,80 copies of each group.And antineoplastic drugs were commented specially.The information such as sex,age,clinical diagnosis,irrational antineoplastic drug use,adverse reaction and unexpected events and hospitalization time were recorded.Results The rate of irrational antineoplastic drug use of the intervention group (41.25%)was lower than the advisory group(80%),and was significantly lower than two control groups(147.50%,161.25%),advisory group was also lower than two control groups,but no significant differences between the two control groups(χ2 =0.193,P>0.05).Irrational chemotherapy, inappropriate usage and dosage and inappropriate indications were prominent problems in intervention group and advisory group.In addition,there were more improper solvent and contraindicated or adverse interaction problems in two control groups.Adverse events and incidence of unexpected events in intervention group (46.25%,12.50%) were significantly lower than those in two control groups[(73.75%,22.50%),(23.75%,18.75%)].Furthermore, the length of stay of intervention group patients was shortest in four groups (F=8.766,P<0.05).Conclusion By participating in the treatment group,clinical pharmacists can discover the irrational drug use and security risks in treatment,can provide medication guidance,consultation,publicity and other pharmaceutical service for specialist medical staff and patients.They will be more and more prominent in the treatment of cancer.

To study the regulation of androgen receptor (AR) expression in human prostate cancer LNCaP cells by triptolide (TP) and the possible mechanism, by using qRT-PCR and Western blot, the AR mRNA and protein levels in TP treated LNCaP cells were detected, and the AR protein level in TP and NF-κB inhibitor treated LNCaP cells was also detected; a series of pGL3-AR promoter reporter gene vectors were built using restriction-free cloning method, and the vectors were employed to investigate the effects of TP on the transcriptional activity of AR promoter in LNCaP cells; the upstream proteins which may play regulatory roles were detected using western blot assay. After treated LNCaP cells with TP for 48 h, AR mRNA and protein expressions decreased with increasing TP concentration. The expression of AR target gene PART1 and prostate specific antigen (PSA) was also downregulated by TP treatment; a series of pGL3-AR promoter reporter vectors were constructed and validated by sequencing and luciferase activity; the results of dual luciferase reporter assay showed that TP downregulated AR at the transcriptional level; PI3K/AKT/NF-κB pathway which is associated with AR promoter activity was drowregulated by TP. In conclusion, our results demonstrated that the transcriptional activity of AR in LNCAP cells was downregulated by TP, and PI3K/AKT/NF-κB pathway may be involved in the regulation mechanism.

Objective To evaluate the effect of dexmedetomidine on acute kidney injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods One hundred patients of both sexes with rheumatic heart disease,aged 32-64 yr,weighing 46-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were divided into 2 groups (n =50 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was intravenously infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation in group D,while the equal volume of normal saline was given in group C.The urine output per hour during the postoperative 48 h period was recorded.At 6,12,24,36 and 48 h after operation,blood samples were collected from the median cubital vein for determination of serum creatinine levels.The development and severity of acute kidney injury were determined according to the urine output and serum creatinine level.Results Compared with group C,the incidence and severity of acute kidney injury were significantly decreased in the postoperative 48 h period in group D (P＜0.05).Conclusion Dexmedetomidine infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation can reduce the development and severity of acute kidney injury after cardiac valve replacement with CPB in patients.