Triggering receptor expressed on myeloid cells-1 ( TREM-1 ) is one of immunoglobulin superfamilies found recently.TREM-1 is a crucial molecule for the triggering and amplification of inflammatory response and promote the reduction of in anti-inflammatory factor by crosslinking reaction with its ligand after being activated,or increasing the level of transcription factor.This study shows that TREM-1 may be claimed as a marker of infection,and the blockade of TREM-1 may be a new approach to inflammatory diseases.This study summarizes its structure,signal transduction,expression,accommodation and clinical application.

Objective To evaluate the clinical effects of intra-lamellar orbicularis dissecting micro-traumatic double eyelid surgery for the treatment of adolescent upper eyelid trichiasis. Methods Three cutaneous micro-incisions following intra- and sub-lamellar orbicularis dissections were performed and the deep orbieularis and suborbicularis fat pad between the intended eyelid crease and 1 mm above the eyelid margin were resected. The subcutaneous orbicularis was fixed to the exposed levator aponeurosis at the medial, center and lateral regions. For the quantitative analysis, the entire eyelid margins' eyelashes were equally divided into three sections and the eyelashes lift-up angle (LA), the body curl-up angle (BC) and the end curl-up angle (EC) were compared before and after surgery in each section, respectively. Results One hundred and fourteen eyes of 57 cases were followed up during 24-30 months. Compared to the LA before surgery and 2 years after surgery, it was changed from (26.37±9.67)° to (55.42± 10.03)° in section Ⅰ , and from (22.03±11.64)° to (50.03±10.02)° in section Ⅱ , and from (25.31±8.01)° to (64.05±8.33)° in section Ⅲ. There were no significant changes of BC and EC during following-up. Con-clusions For the adolescent upper eyelid trichiasis, the intra-lamellar orbicularis dissecting micro-trau-matic double eyelid surgery could acquire satisfactory aesthetic appearance and stable eyelashes'position at the same time.

Clinical ophthalmic surgery is a special branch of general surgery,the microsurgery of ophthalmology has properties of high-precision,high-risk and longer learning curve.The ophthalmology department of Tongji University Hospital has explored a set of step-by-step and efficacious postgraduate student education method,including theoretical basis,in vitro stimulation and in vivo practice.The intervention of quality control and incentive mechanism were also included.

BACKGROUND:Comeal graft endothelial cell density may decline spontaneously at a super-physiological speed after penetrating keratoplasty (PKP),even if no corneal rejection happens,and this is chronic corneal allograff dysfunction (CCAD).OBJECTIVE:To investigate the effects of topical corticosteroid treatment on chronic corneal allograft dysfunction after PKP.DESIGN,TIME AND SETTING:A controlled clinical analysis was performed at the Department of Ophthalmology,Tongji Hospital,Tongji University from May 2004 to May 2009.PARTICIPANTS:A total of 54 patients (eyes) who underwent PKP were included in this study.METHODS:Tobramycin-dexamethasone eyedrops was applied 6 times per day as an initial dosage and tapered during 4 months.Thereafter,drug withdrawal group and long term group were randomly divided.Treatments were ceased in the drug withdrawal group but were continued in the long-term group with a dosage of twice per day till 12 months after surgery.MAIN OUTCOME MEASURES:Corneal graft endothelial cell density was followed up.The mean follow up pedod was 3.12±0.28years.RESULTS:The corneal graft endothelial cell density of drug withdrawal and long term groups was dramatically declined within 36 months after PKP.At every time point,the endothelial cell density was significantly decreased compared to the last follow up (all P＜0.01 ).The endothelial cell density was decreased from (2 428±2.11) cells/mm~2 and (2 791±2.29) cells/mm~2 to (1 424±124) cells/mm~2 and (1 614±114) cells/mm~2 in the drug withdrawal and long-term groups,respectively.There was significant difference in endothelial cell density between the two groups no matter prior to surgery or at each time points after surgery,but the declination trends of two groups were basically the same,indicating that graft loss of endothelial cell density was not impacted by topical corticosteroid treatment after PKP (P＞0.05).CONCLUSION:Chronic corneal allograft dysfunction after PKP is independent of topical corticosteroid treatment.

In order to train the clinical ophthalmic seven-year students to further comprehend their professional knowledge and further stimulate their imagination and creation ability, we developed several steps to promote these students' patent designing ability. These steps include: trained targets selection, theoretical knowledge training, clinical practice training, comprehensive quality control, et al. In the implementation of the concrete steps, we put emphasis on the elements such as step by step training, the high quality computer assisted mapping and the internationally compatible contents, et al., and encouraged the students to propose the assumption of solving the problems in the clinical and sci-entific research. And the stimulation mechanism and medical humanity were infiltrated all the while.

Objective To study the asymmetry of the soft tissue thickness of upper eyelids in Shanghai female undergraduates undergoing double eyelid surgery.Methods Data were collected in 565 female students from Shanghai universities.Before surgery,oblique sagittal view images of the upper eyelids by 3.0T MRI were obtained and the following parameters were measured: soft tissue thickness at upper tarsal plate margin and upper central tarsal plate,sub-eyebrow and intra-orbital septum fat pad areas,and whole upper eyelid soft tissue areas.The resected orbicularis and intra-orbital septum fat were weighed by a highly accurated electronic balance.The eyelid asymmetry index (EAI) was calculated.Results The MRI (U/U2) central tarsal plate soft tissue thickness were:4.46±0.90 in the right side and 3.78±1.01 in the left; the intra orbital septum fat areas were:172.33±49.29 in the right and 136.34±37.42 in the left; the whole tissue areas were: 697.13±146.99 in the right and 500.66±158.87 in the left (P＜0.01 for all).The weight of the resected orbicularis oculi muscle and intra orbital septum fat pad were (0.18±0.05) g and (0.17±0.06) g for the right side,and (0.15±0.04) g and (0.06±0.05) g for the left side (P＜0.01 for all),respec tively.The orbicularis EAI was 0.17±0.06,and the intra orbital septum fat EAI was 0.41 ±0.08.Conclusions The asymmetric phenomenon of the upper eyelids' soft tissue thickness is commonly found in the Shanghai female undergraduates,and the main manifestation is that orbicularis and intra orbital septum fat in right side are thicker than that in the left.

Objective To evaluate the clinical effects of small-incision orbicularis-levator fixation technique for monocular double-eyelid blepharoplasty.Methods Data were collected in 56 patients (5 males and 51 females) with monocular double eyelid from January 2013 to January 2014.All patients underwent small-incision orbicularis-levator fixation blepharoplasty.To ensure the symmetry between the two eyelids,extensive study and design might be done before the surgery,including the positon of incisions,the amount of tissue removed,the tightness of sutures fixation during surgery,and so on.Results All patients were successfully operated and were performed postoperative follow-up for 19.3±3.4 months.MRI was taken on their upper eyelids preoperatively and 6 months postoperatively.Before the surgery,the MRI orbicularis oculi muscle thickness were 4.08±0.74 U in the left side and 4.81±1.05 U in the right (t=2.66,P＜0.05);the areas of orbit fat were 84.26±9.75 U2 in the left and 93.85±12.15 U2 in the right (t =3.21,P＜0.05).As for 6 months postoperatively,the MRI orbicularis oculi muscle thickness were 4.07±0.69 U in the left side and 4.37±0.99 U in the right (t=1.46,P=0.15);the areas of orbit fat were 82.88±8.81 U2 in the left and 85.30±11.94 U2 in the right (t =1.21,P=0.23).Fifty-four patients were satisfied with surgery,the eyelid's crease turned narrow in 1 case and disappeared in 1 case.Those 2 cases were adjusted by secondary surgery using the same method.Conclusions Small-incision orbicularis-levator fixation blepharoplasty has a high success rate,with acceptable bilateral symmetry and slight scar.

Objective To explore the value of radiomics in differential diagnosis of small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Methods Literature on the differential diagnosis of SCLC and NSCLC using radiomics was searched in Chinese and English databases.After literature screening and data extraction,Meta-DiSc1.4 and State16.0 SE software were used for analysis.Results A total of 910 patients were included in 8 studies.Meta-analysis results showed that the radiomics differential diag-nosis of SCLC and NSCLC had high co-sensitivity(Sen)and specificity(Spe),0.87[95%confidence interval(CI)0.83-0.91]and 0.88(95%CI 0.85-0.90),respectively.Meta-regression analysis showed that heterogeneity was not caused by feature extraction software type,joint machine learning,image pattern,brain metastasis,and sample size.Publication bias results didn't show any sig-nificant publication bias.Conclusion The radiomics method can differentiate and diagnose SCLC from NSCLC more accurately.When Matlab software is used to extract MRI image features combined with machine learning,and the sample size is large enough,the radiomics can differentiate and diagnose SCLC from NSCLC more accurately.

Transient receptor potential vanilloid receptor 4(TRPV4)is a non-selective cation channel responsible for sensing changes in cell swelling, temperature, mechanical stretch, shear stress and osmotic pressure by regulating transmembrane calcium signaling and thereby influencing gene expression, cell morphology, and cytoskeletal construction. TRPV4 is widely expressed throughout the body. Intraocularly, TRPV4 is functionally expressed in the cornea, lens, ciliary body, trabecular meshwork and retina. In this article, the expression and physiopathological functions of TRPV4 in various tissues of the eye were described. With the in-depth study of TRPV4 in ocular pathophysiological functions, TRPV4 may become a potential drug target in corneal injury repair, glaucoma and retinal angiogenesis, but further in-depth study is still needed.