Background Integrated transepithelial photorefractive keratectomy (TransPRK) is a new kind of surface ablation and has a fast reepithelialization and uncorrective visual acuity (UCVA) recovery as well as slighter postoperative pain,and epipolis laser in situ keratomileusis (Epi-LASIK) has been recognized to be an effective method for myopia.But there have been few studies to evaluate the dynamic change of the corneal biomechanical properties and posterior corneal elevation after TransPRK.Objective This study was to assess and compare the effectiveness and safety between TransPRK and Epi-LASIK for myopia with thin cornea.MethodsThis study was approved by Ethic Committee of Jinan Mingshui Eye Hospital,and written informed consent was obtained from each patient.In this prospective non-randomized controlled study,93 right eyes of 93 myopic patients with the central corneal thickness 460 to 500 μm were included in Jinan Mingshui Eye Hospital from June to December 2013 under the informed consent.The eyes were divided into TransPRK group for 46 eyes and Epi-LASIK group for 47 eyes.UCVA,manifest refraction,haze,corneal biomechanical properties,posterior corneal elevation,Qvalue and corneal high order wavefront aberration were analyzed before and 1 week,1 month,3 months and 6 months after operation,respectively,and the examination results were compared between the two groups.Results There was no statistically significant difference in the eyes of postoperative UCVA and manifest refraction between the TransPRK group and the Epi-LASIK group at various time points (all at P＞0.05).Six months after surgery,the percentage of eyes with UCVA of 1.0 or better was 93.9％,and 90.9％ eyes exhibited the targeted refraction in ± 1.00 D in the TransPRK group.Corneal haze was most obvious 1 month after surgery in both groups,with the incidence of 32.6％ (15/46) in the TransPRK group and 17.4％ (8/47) in the Epi-LASIK group,but no significant difference was found in the eye numbers with haze between the two groups (x2 =2.841,P =0.092).No significant differences were seen in the corneal hysteresis(CH) values and corneal resistance factor(CRF) values between the two groups (CH:Fgroup =0.000,P =0.999;CRF:Fgroup =0.110,P =0.741),however,the postoperative CH values and CRF values were significantly declined in comparison with preoperative ones,with significant differences among various time points (CH:Ftime =103.658,P =0.000;CRF:Ftime =132.008,P =0.000),while there were no remarkable differences between any two time points in postoperation (all at P＞0.05).Posterior corneal surface height shifted rearward 1 week,1 month,3 months and 6 months after surgery,showing remarkable differences in comparison with before surgery in both groups (Ftime =12.868,P =0.001),but no significant differences between the two groups (Fgroup =1.923,P=0.169).No significant differences were found in Q-value between the two groups (Fgroup =0.191,P=0.663).Root mean square (RMS) and spherical aberration values elevated in postoperation compared with preoperation,with significant differences between them(all at P＜0.01),but the comparison between intergroup was insignificant (RMS:Fgroup =0.299,P =0.586;Spherical aberration:Fgroup =1.290,P =0.259).Conclusions TransPRK for myopia with thin cornea is safe and stably effective like Epi-LASIK.TransPRK affects corneal biomecbanical properties early after surgery but the effect gradually lessens over time.The posterior corneal elevation shows a tiny backward displacement,while posterior corneal asphericity has no change.

Objective To investigate the characters of morphology change and protein expres-sion in progressed renal cell carcinoma after the treatment of sorafinib. Methods Clinical data of 2 cases with progressed renal cell carcinoma treated with sorafenib were collected. The HE slices were reviewed. Immunochemistry was used to detect the expression of Vimentin, AE1/AE3, CK7, CK8, CK18, CD10, VEGF, VEGFR2, p53 and Ki-67 levels. Results There was no difference in patho-logic type between before and after the therapy of sorafenib. Both of the 2 cases were showed degener-ation in tumor cell in different degree with fibrosis and necrosis. The expression of renal cell carcinoma related antigens (Vimentin, AE1/AE3, CK7, CK8, CK18 and CD10) had no difference before and af-ter the treatment of sorafinib. The expressions of VEGF, VEGFR2, p53 and Ki-67 were increased, and the expression of Bcl-2 was decreased after the therapy of sorafinib. Conclusions There may be some morphologie differences between the metastatic tumor or the recurrent tumor and primary tumor because of the treatment of sorafenib. However the pathologic type is the same before and after the treatment of sorafenib. The main differences are the degeneration of the tumor cell and fibrosis after the treatment of sorafenib. The expression changes of VEGF and VEGFR2 may be related to the sor-afenib application.

OBJECTIVE:To establish a method for the content determination of paeoniflorin in Bazhen pill(concentrated pill). METHODS:HPLC was performed on the column of wondasil C18 with mobile phase of acetonitrile-1% phosphoric acid(15∶85, V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm,and column temperature was 30 ℃. RESULTS:The lin-ear range of paeoniflorin was 0219-1.32 μg(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 95.82%-101.82%(RSD=2.13%,n=6). CONCLUSIONS:The method is simple,stable and reproducible, and can be used for the content determination of Bazhen pill(concentrated pill).

OBJECTIVE:To evaluate the effect of psychological intervention based on pharmaceutical care on the communi-ty patients with essential hypertension. METHODS:172 patients with essential hypertension in a community health service certer in Nanjing Gulou area in 2013 were divided into control group(n=87)and intervention group(n=85)by simple random meth-od. Control group received conventional antihypertensive drugs and management,intervention group additionally received pharma-ceutical care and psychological intervention,it lasted 6 months. Blood pressure controlling,drug compliance,mastery of drug knowledge and health status in 2 groups before and after treatment were compared. RESULTS:Before treatment,there were no significant differences in the systolic blood pressure(SBP)and diastolic blood pressure(DBP)between 2 groups(P>0.05);af-ter treatment, SBP and DBP in 2 groups were lower than before,SBP and DBP in intervention group were lower than control group,the decrease degree of SBP and DBP was bigger than control group,the differences were statistically significant (P<0.01). 1 month after the beginning of intervention,there was no significant difference in the proportion of drug compliance be-tween 2 groups (P>0.05);1 month after the end of the intervention,the proportion of drug compliance in intervention group was higher than 1 month after the beginning of intervention and control group,the differences were statistically significant(P<0.05). Before treatment,there was no significant difference in mastery of drug knowledge between 2 groups (P>0.05);after treatment,the proportion of patients showed good and excellent mastery of drug knowledge was higher than before and control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in scores of physical,mental,social health subscale and SRHMS between 2 groups(P>0.05);after treatment,scores of physical health subscale and SRHMS in control group,each subscale and to-tal scale scores in intervention group were higher than be-fore, and scores of mental, social health subscale and SRHMS in intervention group were higher than control group, the differences were statistically significant (P<0.05). CONCLUSIONS: The psychological intervention based on pharmaceutical care can effectively promote the con-trol of blood pressure,improve drug compliance,mastery of drug knowledge,health status and mental situation,which is worth of popularizing and applying in community health services.

Objective To evaluate the value of CT and MRIin diagnosis of littoral cell angioma(LCA) of spleen.Methods CT and MRI findings the data of 6 patients with LCA were rospectively analyzed,and all patients were proved LCA of spleen by pathology.Then enhanced CT (n =4 cases) and MRI (n =2 cases) were performed.The imaging performance of LCA was observed,and its imaging features was summarized.Results None of patients showed obvious signs and symptoms of hypersplenism,4 cases were with splenomegaly.5 patients had a single lesion,only one had few lesions.There were not any calcification or envelopement of all the lesions.On CT,all lesions demonstrated distinct borders.The enhanced scan for low-density nodules demonstrated slow progressive enhancement.On MRI,all the LAC had well circumscribed borders,and demonstrated T1 · hypointense and T2-equal,hyperintense signals,and progressive enhancement on the post contrast images.Conclusion CT and MRI imaging of littoral cell angioma of spleen have special imaging characteristics,those particular findings is helpful in the diagnosis.

Objective To evaluate the predictability of ablated depth in photorefractive procedures by Zeiss MEL80 and VISX Star S4 excimer laser.Design Prospective,comparative case series.Participants 168 eyes of 84 people with myopia and cylinder.Main Outcome Measures Corneal thickness and ablated depth.Methods The thickness of cornea by Zeiss MEL80 and VISX Star S4 were measured by anterior segment OCT.The actuality ablated depth and calculated depth were compared.Results There were no significant differences between actuality ablated depth and calculated depth in Zeiss MEL80.And in VISX Star S4,the actuality ablated depth was more than calculated depth.Linear regression of changes in ablated depth on myopia and cylinder yielded the following formulaus:△ablated depth(VISX Star S4)= 2.324 *|myopia|+ 5.270 *|cylinder|-6.772.Conclusions Different excimer laser has different changes between actuality ablated depth and calculated depth.To guarantee the safety of LASIK,Ophthalmologists should know the characteristics of the excimer laser.

ObjectiveTo discuss the effect of argon laser on retinal vein obstruction (RVO) . Methods428 eyes of 422 patients with RVO were treated by argon laser.Among them, there were 386 eyes with ischemic RVO,42 eyes with no-ischemic RVO, and 129 eyes with macular vesicular edema(MVE).ResultsThe vision acuity of 207 eyes is improved, and not changed in 138 eyes. The disappearing rate of MVE is 84.45%(82/97). ConclusionUsing argon laser to treat RVO can curb new vascular of retina building, lighten MVE and protect vision function.

Objective To explore the feasibility of endothelial function of dorsal artery of foot in patients with type 2 diabetes(T2DM) by high frequency ultrasound combined with warm bath test.MethodsThirty-five patients with T2DM and thirty normal people were collected,all subjects were examined by high frequency ultrasound.Diameter of brachial artery in baseline and after reactive hyperaemia were detected;Diameter of dorsal artery of foot in baseline and after the foot immersed in 40℃ warm water for 5 minutes were acquired.Flow mediated dilatation of dorsalis pedis artery(FMDDPA) and flow mediated dilatation of brachial artery(FMDBA) were calculated and compared.Multiple stepwise regression analysis was used to examine the correlation between FMDDPA and hemoglobin A1c(HbAlc). Results The FMDDPA and FMDBA were decreased in patients with T2DM (P<0.01).The FMDDPA and FMDBA were correlated significantly(r=0.864,P<0.01).In stepwise regression analysis,HbA1c is the most affecting factor for FMDDPA (R2=0.321,P<0.01).Conclusions Ultrasound combined with warm bath test can be used to detect the change of endothelial function of dorsal artery of foot in patients with T2DM,which have a certain clinical application value in endothelial function of terminal limb artery.

To explore the role of β-endorphin (β-EP) in the pathogenesis of the acute encephaledema, the levels of β-EP in both of plasma and CSF were determined by radioimmunoassay in 69 children with infection of central nervous system consisting of 39 cases with encephaledema and 30 cases without encephaledema, respectively. Another 19 cases without intracranial infection were as the control group. The results showed that the levels of plasma and CSF β-EP in the encephaledema group (50.74 ng/L±26.60ng/L，62.72ng/L±39.23ng/L) were significantly higher than those in without encephaledema group (32.78 ng/L±21.2ng/L，34.13ng/L±30.26ng/L)and the normal group (14.83ng/L±6.55ng/L，9.77ng/L±6.33ng/L)，respectively (P＜0.01).It is concluded that β-EP plays an important role in the occurrence and development of encephaledema in children with the infection of central nervous system.

Objective To clarify the MUM1/IRF4 expression in follicular lymphoma (FL) and its clinical and pathological significance. Methods Ninety-six cases FL were immunostained with MUM1,CD10,bcl-2,bcl-6 and Ki-67 antibodies. The results were compared with their clinical and pathological features. Results The overall MUM1 expression rate in FL was 59.2 % (58/96),including 36.2 % (19/51) grade 1 or 2 and 86.4 %(39/45) grade 3 cases (x2 =24.406,P <0.001). 68.9 % cases with diffuse area were MUM1 positive (x2 =8.161,P =0.004). MUM 1 and CD10 expression had inverse correlation,83.3 % CD10 negative cases were MUM1 positive (x2= 12.649,P<0.001). The mitosis rate and Ki-67 label index were statistically higher in MUM1 positive cases than in negative cases (t = -3.852 & -4.610,respectively,P <0.001). Conclusion MUM1 can be used as a biomarker to divide FL into different malignancies. The MUM1 positive FL may be the feature of high grade non germinal center B cell malignant lymphoma.