AIM: To compare the efficiency and safety of torsional phacoemulsification with or without intelligent phacoemulsification ( IP ) software in hard nucleus cataract extraction.
METHODS: Ninety two eyes with Ⅳ - Ⅴ grades cataracts were enrolled in this randomized prospective study. Operated eyes were divided into two groups -those operated without IP software ( non- IP group, n =43) and those operated using IP software (IP group, n =49 ). The two groups were compared in terms of ultrasound time (UST) and cumulative dissipated energy (CDE). Post- operative outcome measures included the corneal edema and best-corrected visual acuity (BCVA) at 1,7d and 3mo postoperatively, corneal endothelial cell density and percentage of hexagonal cell at 7d and 3mo postoperatively.
RESULTS: UST was measured as 52. 51±9. 64s in non-IP Group and 48. 79±7. 13s in IP Group (P = 0. 030). CDE was 15. 78±3. 73% in non-IP Group and 14. 29±2. 77% in IP Group ( P = 0. 026). At the first postoperative day, the rate of BCVA>0. 1 in non-IP Group was 56%, and the rate in IP Group was 79% (P= 0. 066). Corneal edema in non-IP Group was 2. 98±0. 77 scores, and in IP Group it was 2. 61±0. 64 scores (P = 0. 021). At the postoperative 7 and 30d, the BCVA and corneal edema were no differences between two groups. At the postoperative 7d, corneal endothelial cell density in non- IP Group were 2497. 95 ±211. 48 / mm2 , less than 2586. 26±154. 71 / mm 2 in IP Group (P= 0. 029);percentage of hexagonal cell in IP group was 48. 33±8. 69%,higher than 44. 19±9. 48% of non-IP group(P= 0. 030).CONCLUSION: In hard nucleus cataract extraction, the IP software can combine the advantages of the two kinds of ultrasonic modes, which is more effective with lower ultrasound energy and less injury for the corneal endothclium, and is helpful for the recovery of vision at early stage after surgeries.

OBJECTIVETo analyze the current research status of rehabilitation nursing for adult burn patients in China, and to disuss the related strategies.

METHODSChinese scientific articles on adult burn patients' rehabilitation nursing published from January 2003 to December 2013 were retrieved from 3 databases namely China Biology Medicine disc, Chinese Journals Full-text Database , and Chinese Science and Technology Journals Database . From the results retrieved, data with regard to publication year, journal distribution, research type, region of affiliation of the first author, and the main research content were collected. Data were processed with Microsoft Excel software.

RESULTSA total of 417 articles conforming with the criteria were retrieved. During the 11 years, the number of the relevant articles per year was on the rise, and the increasing rates in 2005, 2008, 2009, and 2013 were all above 30% . Regarding the distribution among journals, these 417 articles were published in 151 journals, with 188 articles in Source Journal for Chinese Scientific and Technical Papers , accounting for 45.08%. Regarding the research type, 173 out of the 417 articles were dealing with clinical experiences, accounting for 41.49% ; 172 out of the 417 articles were dealing with experimental studies, accounting for 41.25% . The regions of affiliation of the first author were mainly situated in Guangdong province, Shandong province, Hunan province, and Jiangsu province, with Guangdong province contributing 58 articles, accounting for 13.91%. The research content of these articles was mainly focused on psychological nursing, nursing model, and health education, respectively 188,101, and 85 articles, accounting for 45.08%, 24.22%, and 20.38%.

CONCLUSIONSThe research on rehabilitation nursing for adult burn patients in China has been carried out nationwide. Although the number of relevant papers is on the rise, the quality of these papers needs to be further improved. There is an urgent need for the guideline on rehabilitation nursing for adult burn patients in China so as to standardize the content and procedure of rehabilitation nursing.

A 56-year-old female patient of Han nationality presented with generalized erythema and vesicles for 6 days,as well as high fever for 2 days.Twenty days prior to hospitalization,the patient received surgical treatment combined with oral methazolamide and glucocorticoids for glaucoma.The patient had a history of allergy to sulfanilamides.On admission,the patient presented with generalized erythema,vesicles and occasional erosions with bilateral eyelid and oral involvement.Nikolsky's sign was positive.Wheezing sound was heard over the right lung.Genetic testing showed that HLA-B5901 allele was positive.The patient was diagnosed with methazolamide-induced toxic epidermal necrolysis (TEN) complicated by pneumonia,and managed with immunoglobulin (25 g/day,5 days),glucocorticoids (the largest dose equivalent to methylprednisolone 160 mg/day),fresh plasma,antibiotics,as well as other supporting and symptomatic treatments.The condition was controlled after 2 weeks,and the patient was cured and discharged from hospital after 25 days.The fact that the patient carried HLA-B5901 allele suggests that HLA-B5901 is strongly correlated with methazolamide-induced TEN or Stevens-Johnson syndrome in Chinese descendants or Han population,besides in Japanese and Korean descendants.

Objective: To detect the relationship between variant of rsl255372 in transcription factor 7-Like 2(TCF7L2) gene and the type 2 diabetes mellitus (T2DM) in Tianjin Han populations. Methods: Three hundred and fifty-two T2DM patients and 176 healthy controls were randomly selected to extract the genome DNA. Denaturing high performance liquid chromatography was used to detect the PCR amplified fragment. The different peaks were chosen for sequencing. The differences of different genotype frequency between the groups were analysed. The Logistic regression was used to evaluate the risk factors of T2DM. Results: The G/T genotype frequencies of rsl2255372 were 18.5% and 2.8% in T2DM group and healthy control group respectively (P < 0.05). The G/T genotype, glycosylated hemoglobin, urea nitrogen and the systolic blood pressure were the independent risk factors of T2DM, and the high density lipoprotein was the protective factor. There was no significant difference of the G/T genotype frequency in T2DM patients with different complications. Conclusion: This study indicates that G/T genotype in the TCF7L2 gene significantly contributes to T2DM susceptibility in Tianjin Han populations. The G/T genotype is one of the risk factors of the T2DM.

Objective To assess the value of endoluminal convex array probe combined with high frequency linear array probe in diagnosis of internal carotid artery occlusion, and to improve the diagnostic accuracy rate of ultrasonography. Methods Patients suspected with ischemic cerebrovascular disease (n=490) were examined by carotid ultrasound. First, suspicious patients with carotid artery occlusion were selected using high-frequency linear array probe, then screen results were confirmed by endoluminal convex array probe and compared with previous results in those patients. Results Sixty eight patients,who were suspected of internal carotid artery occlusion,were screened out by high-frequency linear array probe. Results were re-examined by endoluminal convex array probe, 42 patients were diagnosed as internal carotid artery occlusion, 19 patients were diagnosed as severe stenosis as the internal carotid artery and 7 patients were diagnosed as ca?rotid artery tortuosity with no significant stenosis. Conclusion Endoluminal convex array probe is an effective complement for internal carotid arterial inspection when it combines with high-frequency linear probe. It can improve the diagnostic accu?racy rate of degree and the range in internal carotid artery occlusion and stenosis, therefore reduce chances of misdiagnosis.

Objective To calibrate the dose of 12MeV high-energy electron for Siemens MD7745 medical linear accelerator.Methods The international protocols,contents and technical standards were expatiated.Some existing problems in dose calibration of high-energy electron were analyzed.Results The working precision met the requirement of quality assurance in radiotherapy by WHO.Conclusion In order to improve the therapeutic effect,the dose must be calibrated,and the error in dose calibration of high-energy electron should be reduced to the lowest.

Objective To investigate the expression of recombinant human adiponectin(ADPN) using baculovirus expression system in Sf 9 insect cell line.Methods PCR method was used to amplify human ADPN gene,and then the gene was inserted into plasmid pFastBacl.Recombinant plasmid was transformed into E.coli DH10Bac containing a shuttle vector,Bacmid.Recombinant shuttle vector Bacmid-ADPN was obtained by site-specific transposition and transfect Sf 9 cells.To identify the expressed product by SDS-PAGE、Western blot.Results Sf 9 cells infected by the recombinant baculovirus was observed for morphological changes.The Mw of recombinant protein was about 30 ku and Western blot proved that expressed protein could combine with ADPN polyclonal antibody.ConclusionHuman ADPN gene was successfully expressed in Sf 9 cells,and thus provided the material for studying its bioactivity and mechanism of action.

Vibrio parahaemolyticus has been considered as one of the most important foodborne bacterial pathogens.The loop-mediated isothermal amplification(LAMP) that amplifies DNA with high specificity and rapidity under an isothermal condition was applied for rapid detection of this pathogen for the first time.A set of four primers,two outer and two inner primers,was designed specifically to recognize the thermolabile hemolysin gene(tlh) of V.parahaemolyticus.The LAMP reaction mix was optimized.The most optimal reaction temperature and time of the LAMP assay for the tlh gene were 60℃ and 60min,respectively.Genomic DNAs from 28 bacterial strains including 14 V.parahaemolyticus strains were amplified using LAMP,and no amplicon was observed in other bacterial strains.The detection limit of this LAMP assay was around 90 fg of V.parahaemolyticus genomic DNA and 24 colonies forming units for pure cultures.In addition,this method was applied to detect artificially contaminated food samples,and the detection limit was 89 cfu/g for non-cultured artificially contaminated food samples.These results suggested that detection of V.parahaemolyticus by LAMP is an effective and low-cost procedure with high specificity and sensitivity that requires no specialized equipment.This assay is expected to become a valuable tool for rapid detection and identification of V.parahaemolyticus.

Objective To assess the effects of surgical treatment for patients with blepharochalasis and its associated abnormali- ties. Design Retrospective case series, Participants 35 cases (52 eyes) with blepharochalasis in stable phase. Methods The correction of the abnormalities in upper eyelids: after designing the lid crease incision, the redundant eyelid skin and prolapsed fat were excised, and prolapsed lacrimal glands were sutured back into position in 18 cases (36 eyes) and ptosis was treated in 10 cases (16 eyes). The correction of abnormalities in lower eyelids: lower eyelid retraction was corrected in 4 cases (6 eyes). The correction of lateral canthus malformation: lateral canthus rounding was treated in 7 cases (14 eyes), accompanied with or followed by correction of baggy eyelid or ptosis. Main Outcome Measures The shape, location and movement of bilateral eyelids, the location of lacrimal glands and the cir- cumstance of tear secretion. Results During the follow-up of 6～60 months, the appearance and location of bilateral eyelids and can- thuses were satisfying, the function of eyelids were normal, and no dry eye symptoms were found. Two cases (3 eyes) appeared recurrent lacrimal gland prolapse 29 and 36 months postoperation and received surgeries for correction again. There was no recurrence after the second prolapse correction surgery in the follow-up of 18 and 24 months respectively. Conclusions Surgical treatment for patients with blepharochalasis and its associated abnormalities is safe and effective. Its recurrence rate is low.

Objective To investigate the effect of preoperative oral midazolam on emergence agitation after sevoflurane anesthesia in children.Methods Sixty children,34 males,26 females, aged 2-7 years,ASA grade Ⅰ or Ⅱ,receiving sevoflurane for tonsillectomy/adenoidectomy were ran-domly divided into low dose midazolam group (group M1),high dose midazolam group (group M2) and control group (group C)(n=20 each).The 5 ml mixture of midazolam 0.5 mg/kg,0.75 mg/kg and 10% glucose was taken orally 30 min before anesthesia in group M1 and group M2,respectively. While 5 ml of 10% glucose was given in group C.Anesthesia was induced with inhalation of 8%sevoflurane and maintained with intravenous infusion of remifentanil and inhalation of sevoflurane. Scores of parental separation anxiety scale(PSAS),pediatric anesthesia emergence delirium scale (PAED scale),FLACC scale were compared.Times to extubation and discharge from PACU were al-so recorded.Results Group C showed significantly higher incidence of separation anxiety(P <0.05). The incidence of emergence agitation,peak PAED scores,FLACC scores,time to extubation were similar among three groups.Discharge time from PACU was longer in group M2 (P < 0.05). Conclusion Preoperative oral midazolam 0.5 mg/kg or 0.75 mg/kg can effectively reduce parental separation anxiety.This,however,dose not result in a reduced incidence of emergence agitation after sevoflurane anesthesia.Midazolam 0.75 mg/kg can extend the discharge time from PACU.