AIM: To compare and contrast different operation after cataract patients with refractive change rules. To analyze the patients with refractive stability after cataract surgery, and to provide a reference for cataract patients with clinical surgery after visual quality.
●METHODS: Retrospective study. A total of 126 cases (150 eyes) were selected from Jan. 2014 to Dec. 2015 in Changzhou First People′s Hospital of cataract extraction combined with foldable intraocular lens implantation for cataract patients as the research samples. According to the different operation for three groups, the first group of 42 patients ( 50 eyes ) underwent above 3 mm clear corneal incision;52 cases in group 2 (60 eyes) underwent temporal side 3 mm clear corneal incision. The third group, 32 cases (40 eyes) underwent 3 corner above the scleral tunnel incision. All the cases were measured at different time point in patients with naked eyes far visual acuity, best corrected visual acuity, spherical degree, the degree of astigmatism and astigmatic axial, comparative analysis of after cataract surgery in patients with refractive change regularity and stability of refraction.
●RESULTS: The uncorrected distance visual comparison within the group, and each time point after preoperative differences were significant ( P< 0. 01 ), and the early postoperative period after 1, 3mo significantly different (P<0. 05). Three groups of patients after surgery compared with preoperative uncorrected distance visual acuity improved significantly, and were stable after 1mo. Compare the best corrected distance vision within the group, and each time point after preoperative differences were significant (P<0. 01), postoperative 1wk and after 1, 3d significantly different (P<0. 05), after 1wk and after 1, 3mo was not significantly different ( P > 0. 05 ), three groups of patients were compared with the preoperative best corrected distance visual acuity were increased significantly, and were in stable after 1wk; relatively spherical degree within the array, after 1d and 3d was not significantly different (P>0. 05), hyperopia drift, after 1wk and 1, 3d was significantly different (P<0. 05), after 1wk and 1, 3mo was not significantly different ( P>0. 05 ). Three groups of patients′spherical degrees after 1wk were stabilized. Comparative degree of astigmatism within the array, postoperative compared with preoperative corneal astigmatism were increased 1d after surgery. Corneal astigmatism in each group reached the maximum, and then decreases 1wk and 1d after surgery, compared with postoperative 3d was significantly different ( P<0. 05 ). After 1wk and 1, 3mo was not significantly different ( P>0. 05 ) . Three groups of patients were compared with preoperative astigmatism were significantly increased, and in operation after 1wk were stabilized;astigmatic axis were three groups in the preoperative astigmatism against the rule, the first and third group after 1d, three Tianshun rule astigmatism proportional were increased, and then decreased. Group 2 the- rule astigmatism proportion, after 1wk, 1 and 3mo, the first and third group gradually reduced the proportion of cis regulatory astigmatism, and compared with preoperative increased, increasing the-rule astigmatism group 2 ratio, and increased compared with preoperative.
●CONCLUSION: Above 3 mm the transparent corneal incision, temporal clear corneal incision and above the scleral tunnel incision different surgical postoperative visual acuity are good. lt can be used as a routine surgical procedure in treatment of cataract;phacoemulsification in cataract patients with former majority against the rule astigmatism. After cataract surgery, early refractive state is a state of mild hyperopia and stabilized about 1wk, combined with clinical guide glasses.

ObjectiveTo investigate the influence of age on hypnotic target plasma concentration (CT) of dexmedetomidine (Dex) administered by TCI.MethodsSixty ASA Ⅰ - Ⅱ patients aged 18-85 yr undergoing lower abdominal or extremity operation under combined spinal-epidural anesthesia were divided into 2 age groups ( n =30each):18 yr＜groupⅠ＜55 yr (Y) and 65 yr＜group Ⅱ＜85 yr (E).Each group was further divided into 5subgroups (n =6 each) receiving Dex administered by TCI at CT of 0.54,0.64,0.76,0.90,1.07 ng/ml in group Y and 0.36,0.42,0.51,0.60,0.71 ng/ml in group E respectively.Hypnosis was defined as no response to verbal command (OAA/S score ≤2) and loss of eyelash reflex.A quantal response model (probit analysis) was used to calculate the concentration-effect curve and predict plasma EC50 and EC95 (95％CI) of Dex.ResultsEC50 (95％CI) was 0.478(0.424-0.536) ng/ml and EC95(95％CI) 0.641 (0.567-0.816) ng/ml in group E,significantly lower than EC50 (95 ％ CI) 0.738 (0.657-0.827) ng/ml and EC95 (95％CI) 0.990 (0.874-1.267 ) ng/ml in group Y.ConclusionThe EC50 and EC95 of dexmedetomidine for hypnosis were significantly lower in the elderly than in younger patients.

Objective To explore the relationship between the levels of inflammatory factors and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).Methods Fifty patients with T2DM were recruited and divided into T2DM with insulin resistance(IR) group(26 patients) and T2DM without insulin resistance (NIR) group (24 patients) according to insulin resistance index (HOMA-IR).Twenty-four healthy individuals conducting physical examination were recruited as the healthy control group.All participants underwent carotid ultrasound IMT to assess carotid intima-media thickness.The level of fasting plasma glucose (FPG),fasting insulin (FINS),blood lipids,high sensitivity C reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) were measured.Homeostasis model assessment (HOMA)index was used for quantitative analysis of HOMA-IR.Results The levels of HOMA-IR,hs-CRP,TNF-α and IMT in control group,NIR group and IR group increased gradually and were significantly different(HOMA-IR:(1.74 ±0.49) vs.(2.24 ±0.41) vs.(4.89 ±0.84) ;F =190.228,P ＜0.01) ;hs-CRP(mg/L):(1.75 ±0.83) vs.(3.08 ± 1.04) vs.(5.89 ± 1.17) ;F =106.523,P ＜ 0.01) ;TNF-α (ng/L):(15.25 ± 7.64) vs.(23.38 ± 8.82) vs.(47.42 ± 9.97) ;F =89.210,P＜0.01) ;IMT(mm):(0.69 ±0.31) vs.(1.07±0.32) vs.(1.49±0.43);F=30.942,P＜0.01).Correlation analysis showed that the level of hs-CRP was positively correlated with the levels of HOMA-IR and IMT (r =0.453 and 0.395 respectively,P ＜ 0.05) ;The level of TNF-α was positively correlated with the levels of HOMA-IR and IMT (r =0.428 and 0.376 respectively,P ＜ 0.05) ; The level of HOMA-IR was positively correlated with the level of IMT (r =0.403,P ＜ 0.05).Conclusion Inflammatory activity is found in patients with T2DM,which is significantly correlated with insulin resistance.Inflammatory factors and insulin resistance play an important role in the occurrence and development of carotid atherosclerosis in patients with T2DM.

Objective To investigate the effects of ω-3 fish oil lipid emulsion via vein on the inflammatory response,immune and organ function in patients with severe acute pancreatitis.Methods A total of 53 patients with severe acute pancreatitis were randomized into conventional therapy plus fish oil group (FO group) and conventional therapy group (CON group).The patients in FO group were treat with ω-3 fish oil lipid emulsion (0.2 g · kg-1 · d-1,10％) based on conventional therapy for 14 days.The level of C-reactive protein (CRP),TG and TC were detected before treatment and at day 7 and day 14 after treatment.CD4+,CD4+/CD8+ and C3,C4 were also detected at day 1 and day 14 after treatment.At the same time,acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score),intra-abdominal pressure,negative fluid balance time,enteral nutrition start-time and ICU stay time were observed and recorded.Results Forty-five out of 53 patients were finally recruited into results statistics.The level of CD4+,CD4+/CD8+ and C3 at day 14 after treatment in FO groups improved significantly than that in the CON group (P ＜0.05).The levels of CRP,intra-abdominal pressure and APACHE Ⅱ score at day 7 and day 14in FO group descended more obviously than that in the CON group (P ＜ 0.05).The negative liquid balance time in FO group (3.55 ±0.86) days was obvious shorter than that in CON group (4.61 ± 1.12) days,while enteral nutrition start-time (3.86 ± 1.17) days was significantly earlier compared with CON group (5.30 ± 1.61) days (P ＜ 0.05),however ICU stay time and 28 days mortality rate had no significant difference between the two groups.Conclusions ω-3 fish oil lipid emulsion can decrease the inflammatory response and the negative liquid balance time,improve the immune function and restore bowel function in severe acute pancreatitis patients.Therefore,it maybe provide a new and effective means for severe acute pancreatitis.

Background and purpose:Radiomics is an emerging field that generates large amounts of valuable clinical information through extracting quantitative imaging features. The purpose of this study was to use the radiomics approach to assess the value of features captured from PET and CT in predicting the therapeutic effect in stageⅠ non-small cell lung cancer (NSCLC) after stereotactic ablative radiotherapy (SABR).Methods:Patients with stageⅠ NSCLC conifrmed by pathology and treated with SABR were included retrospectively. The gross tumor volume (GTV) was deifned by two radiologists. PET and CT scan images were collected, and radiomic features were further extracted and analyzed. Non-negative matrix factorization was used to distinguish patients with or without local control.Results:Sixteen patients were eligible for analysis. This study identiifed two PET features (LL_GLCM_Maximal_Correlation_Coeffcient and HL_GLRMS_LRE) captured from PET/CT as having signiifcance in classifying patients with or without disease development. This study not ifnd similar results in CT scans.Conclusion:It seems feasible to use radiomics information effects from PET/CT to predict therapeutic effects of SABR in stageⅠ NSCLC. Further investigation is needed.

Objective To investigate the therapeutic efficacy and safety of endoscopic resection of giant gastric stromal tumors without explicit evidence of metastases.Methods A total of 12 giant gastric stromal tumors with no evidence of metastases diagnosed by endoscopic ultrasound (EUS) and computed tomography (CT) scan were managed by endoscopic resection.Operation time,blood loss and the incidence rate of perforation were recorded respectively.The diagnoses of tissue specimens were made by pathological examination and immunohistochemistry.In order to assess local recurrence and distant metastases,endoscopy and endoscopic ultrasound follow-up examinations were performed routinely at 2,6 and 12 months,and the whole abdominal CT scan was also performed at 12 months after operation.Results Endoscopic resections were successfully performed in 10 of 12 cases (83.3％),among which,6 underwent endoscopic submucosal excavation (ESE) without unexpected perforation and 4 endoscopic full-thickness resection (EFR)with intentional perforation.The rate of intentional perforation was 33.3％ (4/12),and all the perforations could be sealed by endoscopic methods.The blood losses were all more than 100 ml,which could be controlled by argon plasma coagulation,electrocoagulation or hemostatic clips.In the 10 encapsulated tumors,8 could be smoothly removed from esophagus,whose long diameter of the minimum cross section was less than 3.5 cm,however,2 tumors whose diameters were larger than 3.5 cm were taken out after segmentation.In the 10 tissue samples,9 were confirmed as low risk GIST,1 larger than 5 cm was pathologically confirmed as high risk GIST.During 1-year follow-up,no local recurrence or peritoneal metastasis was found.2 tumors,larger than 5.0 cm,could not be removed by endoscopic methods due to uncontrolled bleeding.The rate of uncontrolled bleeding was 16.7％ (2/12).The patients were transferred to surgery,and pathologically confirmed as having high risk GIST.Conclusion For low-risk giant gastric stromal tumors whose diameters were less than 5cm without evidence of metastases,endoscopic resection is considered as a safe and effective procedure.Tumors with long diameter of the minimum cross section less than 3.5 cm are more suitable for endoscopic resection,which can be smoothly taken out through cardia.However,for high-risk GIST larger than 5.0 cm,the rate of uncontrolled bleeding is high,so endoscopic resection should be adopted with discretion.

Objective:To investigate the effect of 2-deoxy-D-glucose (2-DG) on hunmanγδT cells on the expression of CCR5 and killing function in vitro.Methods:UsingγδT medium to cultivate peripheral blood mononuclear cell( PBMCs) in vitro.After co-cultured with various concentrations of 2-DG for 48 h,the expression of CCR5 and killing activities of γδT cells for each group were detected by flow cytometry and CCK-8 methods.Results: 2-DG could not promote the growth of γδT cells with the increase in concentration from 0 μmol/L to 1.0 μmol/L and decreased thereafter.The certain concentration ( 0-2.0 μmol/L ) of 2-DG could upregulate the expression of CCR5 in dose dependent manner.Besides,at 0.5μmol/L and 1.0μmol/L of 2-DG could increase the ex-pression of CD107a and perforin and have no effect on the granzyme B.Conclusion: Human γδT cells isolated from peripheral blood treated with 2-DG could promote the expression of CCR5 and increase the killing activities at certain concentration in vitro.

Objective:To investigate the effect of glycogen synthase kinase-3β inhibitor TWS119 on hunman γδT cells growth and phenotypic characteristics. Methods:Using γδT medium to cultivate human peripheral blood γδT cells in vitro. After co-cultured with different concentrations of glycogen synthase kinase-3β( GSK-3β) inhibitor 4, 6-disubstituted pyrrolopyrimidine ( TWS119 ) for indicated time,growth curve and Wnt/β-catenin activation of in each group were determined by CCK-8 and Western blot assays. The CD62L and CD45RA expression theγδT cells were detected using flow cytometry. Results:Wnt/β-catenin pathway ofγδT cells could activate by TWS119. In the first group,TWS119 could upregulate the expression of CD62L and CD45RA in dose dependent manner while inhibit the growth and ratio of γδT cells. In the second group,TWS119 could promote the growth and ratio of γδT cells with the increase in concentration from 0 μmol/L to 4. 0 μmol/L and decreased thereafter. Besides,TWS119 could promote the expression of CD62L in a dose-dependent and had no effect on the CD45RA. Conclusion: Human γδT cells isolated from peripheral blood treated with TWS119 gave rise to two subsets of CD45RA+CD62L+γδT cells and CD62L+γδT cells.

Objective To study the effect of electroacupuncture on the behavior of APP/PS1 transgenic mice of different age, and to explore the optimal intervention time of electroacupuncture in treating Alzheimer's disease (AD). Method APP/PS1 double-transgenic mice of 4 months, 6 months and 9 months old, 20 in each age group, were randomized into a model group and an electroacupuncture group, and ten C57BL/6 wild-type mice were taken as a control group; after 6-week electroacupuncture treatment, the Morris water maze was adopted for spatial memory and behavioral test, and the changes of behavior in each group were observed.Result Of the 5-month-old mice, there were no significant between-group differences (P>0.05), while the time factor (day) produced a statistical significance (P<0.01); of the 7-month-old mice, there were significant differences considering the different groups, time factor and interaction (P<0.01); of the 10-month-old mice, there were significant differences considering the different groups, time factor and interaction (P<0.05). The spatial probe test showed that there were significant between-group differences in comparing the platform crossings and swimming distance in platform quadrant in each age group (P<0.05).Conclusion Electroacupuncture can improve the learning and memory of APP/PS1 double-transgenic mice, the age of 6-7 months old is possibly the optimal intervention time of electroacupuncture for AD, but there still requires further mechanism studies.

This study was purposed to explore the mechanisms of preventive effect of tetrandrine (TTD) on doxorubicin (ADM)-induced multidrug resistance (MDR) in human leukemia cell line K562 from two aspects of the transcription control of MDR1 gene and cell apoptosis. The experiment was divided into 3 groups: group I-blank control; group II-ADM-induced drug-resistance; group III-ADM-induced drug-resistance after pretreatment with TTD. Reverse transcription-PCR (RT-PCR) was used to detect the mRNA expression levels of c-Jun, YB-1 and Survivin genes. Western blot was used to determine the nuclear protein expression levels of c-Jun and YB-1. Flow cytometry was used to assay the apoptosis of cells. The results showed that as compared with group I, the expression levels of c-Jun mRNA and nuclear protein decreased (p < 0.05), as well as the expression levels of YB-1 mRNA and nuclear protein increased in group II (p < 0.05). However, the expression of Survivin mRNA had no change (p > 0.05); the apoptosis rate of cells was 8.31%. As compared with group II, the expression levels of c-Jun mRNA and nuclear protein increased (p < 0.05), expression levels of YB-1 mRNA and nuclear protein as well as Survivin mRNA decreased in group III (p < 0.05). The apoptosis of cells was 97.2%. It is concluded that TTD can inhibit the expression of YB-1 and up-regulate the expression of c-Jun, thus inhibit the expression of MDR1 gene. TTD can also inhibit the expression of Survivin and increase the apoptosis of cells induced by ADM.
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Apoptosis ; drug effects ; genetics ; Benzylisoquinolines ; pharmacology ; Drug Resistance, Multiple ; drug effects ; genetics ; Drug Resistance, Neoplasm ; drug effects ; genetics ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; K562 Cells ; Proto-Oncogene Proteins c-jun ; metabolism ; Y-Box-Binding Protein 1 ; metabolism