AIM: To compare the visual effects of optimized aspheric transition zone Laser in situ keratomileusis (OAT z-LASIK )versus conventional Laser in situ keratomileusis (con. LASIK).METHODS: In a prospective study 44 patients (88 eyes)underwent OAT z -LASIK and 50 patients (92 eyes) received conventional LASIK surgery. Visual acuity,refractions、contrast sensitivity (CS),glare sensitivity (GS), and increment of Q-value after surgery were studied.RESULTS: All of operations on 94 cases were successful without severe complication after 3 months' follow-up. There was no significant difference in term of postoperative refractions between the two groups (t-test,P＞0.05). The uncorrected visual acuity (UCVA), CS, GS, and increment of Q-value of OAT z group were significantly better compared to the tradition group 3 months after the surgery (P＜0.05).CONCLUSION: OAT z - LASIK is a more effective procedure to improve visual quality compared to conventional LASIK.

AIM: Firstly to evaluate the changes of corneal sensation and its effect to dry eye syndrome after laser in situ keratomileusis (LASIK); secondly to evaluate the relation between the changes of corneal sensation and the laser ablation depth. ·METHODS: 30 patients (60 eyes) had bilateral LASIK with a superior-hinged flap. Every patient underwent preoperative and postoperative (after one week, one month and three months) evaluations, including corneal sensation, Schirmer's basic tear secretion test, tear breakup time (TBUT), corneal fluorescein stainting, and a questionnaire evaluating dry eye obtained from each patient.·RESULTS: Compared with preoperative level, after one week and one month, the difference of corneal sensation was very significant (P＜ 0.01); after three months, there was no statistical difference (P ＞ 0.05). After one week, there was no statistical difference (P ＞ 0.05) in the subjective dry eye symptoms, after one month, the difference was significant(P=0.025 ＜0.05) and after three months, the difference was very significant (P=0.001 ＜ 0.01). Compared with preoperative level, the basic tear secretion decreased significantly after one week and one month(P＜ 0.01), it did not return to the baseline level after three months (P ＜ 0.01). Tear breakup time decreased significantly after the surgery, and after three months, there was still statistical difference compared with preoperative level (P ＜ 0.01); with cornea fluorescence staining, we found corneal epithelial defect was most serious after one month after LASIK, and did not return to the baseline level after three months (P ＜ 0.01). Linear regression analysis and relevant were used to evaluate the relation between the changes of corneal sensation and the laser ablation depth (r=0.798, P ＜ 0.01). ·CONCLUSION: The central corneal sesation decreased noticeable after LASIK, and it recovered three months postoperatively, but the indicators of dry eye syndrome did not return to their preoperative levels following it. We have found that the decreasation of corneal sensation had positive correlation with the laser ablation depth.

Humans ; Polyomavirus ; classification ; Polyomavirus Infections ; virology

Objective To observe the outcome of patients with ocular cicatricial pemphigoid (OCP) after amniotic membrane grafting or penetrating keratoplasty.Design Retrospective,noncomparative case series.Participants 3 consecutive OCP patients (4 eyes),were included.Methods For 3 patients (4 eyes) in this study,preoperative visual acuity was from HM/5 cm to HM/10 cm.The symblepharon (gradeⅢ) of 2 patients (3 eyes) were detached and amniotic membrane was transplanted,and bandage contact lens were used till 2 months after operations.The other patient (1 eye) was undergone penetrating keratoplasty with glycerol-cryopreserved cornea because of corneal ulcer and perforation.Main Outcome Measures Visual acuity,recovering of conjunctiva and cornea.Results Am- niotic membrane dissolved about 1 month after operation in 2 patients (3 eyes).Symblepharon changed from gradeⅢto gradeⅡ,visual acuity increased to 0.04-0.05,central corneal epithelium was regenerated significantly,and a little new vessel appeared at corneal lim- bus in 2 patients (2 eyes).The graft deliquesced in the patient with penetrating keratoplasty at 20 days after operation and undergone penetrating keratoplasty again after 1 month.In this patient,the graft molten induced the ocular contents run-off and became eyeball at- rophy eventually.Conclusion Our small sample study shows that the symblepharon detachment and amniotic membrane transplantation is effective for improving visual acuity in OCP with ocular surface dysfunction.However,because of various factors,penetrating kerato- plasty is ineffective for OCP with perforating corneal ulcer.

Background Aspheric intraocular lens (IOL) is designed to reduce the spherical aberration of the eye after cataract surgery and to obtain better visual quality.However,the selection of a personalized aspheric IOL is a problem to be solved.Objective This study was to compare the wavefront aberration and quality of vision of patients between the implantation of negative spherical aberration IOL and non-aberration IOL,and to investigate the relationship between corneal Q values and postoperative spherical aberration.Methods One hundred and four eyes of 90 patients with age-related cataract were randomized into two groups.Fifty-two eyes of 46 patients who received a Tecnis Z9001 IOL implantation were assigned as the negative spherical aberration IOL group and 52 eyes of 44 patients who received Akreos AO IOL without aberration were assigned as the non-aberration IOL group.The preoperative corneal Q values were measured and the mean Q value(Q)was computed.Then the patients in the two groups were further divided into 2 subgroups,respectively,based on their Q values were over or below (Q）.The corneal Q values,root mean square(RMS) of ocular spherical aberration,coma and total higher-order aberrations(HOAs) for 5 mm diameter pupil,scotopic contrast sensitivity with or without glare at 6 mm pupil diameter were measured 3 months after surgery.Results The pre-and post-operative corneal Q values were insignificantly changed (t =1.447,P =0.151).The spherical aberration in the negative spherical aberration IOL group was(0.059-±0.047)μm,and that in the non-aberration IOL group was(0.110±0.066)μm,with a statistically significant difference between them (t =-4.567,P=0.000).Scotopic contrast sensitivities at intermediate and high frequencies were significantly better in the negative spherical aberration IOL group than in the non-aberration IOL group (t =2.495,t =2.359,P ＜ 0.05).There was no significant difference in coma and HOAs between the two groups after operation (P ＞ 0.05).Weak positive correlations were seen between the pre-and post-operative corneal Q values and spherical aberration in the two groups(r=0.277,0.292,0.285,0.325,all at P＜0.05).However,no significant differences were found in spherical aberration,contrast sensitivity and scotopic contrast sensitivity between the different subgroups (P ＞ 0.05).Conclusions Negative spherical aberration IOL has lower spherical aberration and better scotopic contrast sensitivity than non-aberration IOL.The results suggest that it may be not enough to choose the corneal Q value only as the single reference criterion for selection of aspheric IOL.

Objective To compare whether there is a difference in medical cost of intensive care unit(ICU)pa-tients with catheter-associated infection (CAI)between before and after targeted intervention.Methods CAI in ICU patients in 2010(pre-intervention group)and 2013 (post-intervention group)were investigated by retrospective survey,hospitalization cost of two groups of patients before and after intervention was compared.Results The morbidity and mortality in patients with CAI both decreased significantly after intervention,morbidity of healthcare-associated infection(HAI)decreased from 13.47% in 2010 to 4.41 % in 2013,mortality decreased from 10.36% in 2010 to 2.2% in 2103.Total hospitalization cost,blood transfusion cost,and cost of special material before and af-ter the implementation of targeted intervention all significantly different (all P <0.05),the difference of procalcito-nin and antimicrobial agents cost were also significant(all P <0.05).Conclusion Medical cost in ICU patients with CAI decreased after intervention.

Objective To evaluate the value of iterative modal reconstruction (IMR) for reducing radiation dose and controlling image quality in cardiac CT. Methods Ten pigs were included. All pigs were scanned on a 256?slice prospectively ECG?gated cardiac CT utilizing routine dose (group A) and tube current reduced by 30%(group B), 50%(group C) and 70%(group D), respectively. Filtered back projection (FBP), hybrid iterative reconstruction (iDose4) and IMR were used for all data, respectively. Image noise and contrast?to?noise ratio (CNR) of ascending aortic root were measured, while overall image quality and coronary artery image quality was rated (five point scale). All results reconstructed by FBP, iDose 4 and IMR were compared. Objective measurements were compared with one?way analysis of variance, and subjective assessments were compared with Kruskal?Wallis H test andχ2 test. Results Compared with that of FBP and iDose4, image noise of IMR was(15.1 ± 6.1),(18.8 ± 5.5),(22.1 ± 4.8)and(33.0 ± 4.0)HU, respectively in group A, B, C and D with significant reduction (F=82.77, 90.71, 96.59, 95.51 respectively, all P<0.01). Using IMR, groups A, B, C, D had higher CNR (42.0±11.1, 37.2±10.4, 31.4±8.7, 23.7±7.0;F=50.65, 53.55, 76.60, 57.36, all P<0.01) and overall image quality (5.0 ± 0.0, 4.8 ± 0.4, 4.6 ± 0.5, 4.5 ± 0.5;H=20.96, 15.63, 18.66, 23.56, all P<0.01) than FBP and iDose4. Using IMR, group A (100%, 40/40) and group B (100%, 40/40) had no significant difference (P>0.05) in the diagnosis rates of proximal coronary arteries compared with that using FBP and iDose4, while group C (100%, 40/40) and group D(92%, 37/40) had significantly increased diagnosis rates (χ2=20.05, 45.72, both P<0.01). The diagnosis rates of distal coronary arteries of IMR reconstruction which were 100%(50/50), 98%(49/50), 90%(45/50), 78%(39/50), respectively in groups A, B, C, D had significant increase compared with that of FBP and iDose4 reconstruction (χ2=7.39, 16.75, 34.62, 81.33, all P<0.05). Conclusions IMR can significantly reduce image noise, improve CNR and image quality compared with iDose4. Application of IMR can reduce radiation dose but without compromising image quality.

Objective To study the quality of life (QOL) of patients with ductal carcinoma in situ (DCIS) and to analyze the relevant factors affecting their QOL.Methods A total of 84 patients with DCIS and 125 patients with invasive breast cancer were surveyed.Researchers used SF-36 to assess the QOL of participants at one year after operation.The relationships between some information of patients and SF-36 score were analyzed,such as age,the type of surgery,endocrine therapy,education,marital status,working status and health insurance.Results Compared to normal women,patients with DCIS had lower QOL in physical function (t =2.468,P =0.029),bodily pain (t =2.076,P =0.039),general health (t =2.153,P =0.033) and mental health (t =3.396,P =0.003).Patients with invasive breast cancer also had poorer QOL in physical function (t =5.638,P =0.002),bodily pain (t =5.417,P =0.002),vitality (t =4.438,P =0.002),general health (t =3.960,P =0.002) and mental health (t =6.020,P =0.001).QOL of DCIS patients was similar to that of invasive breast cancer patients,except that scores of physical function (t =2.714,P =0.032) and vitality (t =2.134,P =0.040) were better in DCIS patients.Endocrine therapy significantly affected the score of QOL of DCIS patients.DCIS patients with endocrine therapy had poorer score in physical function (t =2.082,P ＜ 0.05),bodily pain (t =2.003,P ＜ 0.05),general health (t =2.751,P ＜0.05),vitality (t =2.048,P ＜ 0.05) and mental health (t =4.162,P ＜ 0.05).Conclusion Patients with DCIS have poor QOL at one year after operation.Endocrine therapy significantly reduces their QOL.

Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.