Objective To discuss nursing care of patients underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy. Methods 22 patients who underwent corneal Descemet stripping endothelial keratoplasty to treat bullous keratopathy accepted strengthened psychological care, perfect preoperatively preparation, to sleep in face-up supine position, meanwhile complications were observed and treated carefully. Results 22 patients could persist in sleeping in face-up position for 4days postoperatively. Graft shift occurred in two cases. And after gas reinjection the grafts adhered very well. Intraocular pressure rose in 7 cases .After timely treated these 7 patients were cured and discharged. Conclusions Careful preoperative evaluation and preparation could reduce postoperative complication. Strict measures to keep patients sleeping in face-up supine position, timely observation and treatment of complications should be important to ensure the success of the operation.

Objective To optimize the extraction technology of perilla seeds oil from the oil cake of perilla seeds (OCPS) by using the contents of active fatty acids as evaluation standard. Methods The fatty acids were extracted from OCPS,the residue of perilla seeds after cold-press, by smashing tissue extraction (STE), the new technology selected through comparing with classical leaching extraction (LE), Soxhlet extraction (SE), ultrasonic extraction (UE), and supercritical-CO2 fluid extraction (SFE). For optimized condition of STE, orthogonal test was designed and completed. The contents of five fatty acids in extracted oil and OCPS were determined by GC. Results The optimized extraction parameters were smashing for 1.5 min under extraction power of 150 W and 1:6 of the material/solvent ratio. The contents of five fatty acids in the oils extracted by five techniques from OCPS and determined by GC were as follows:a-linolenic acid (41.12%-51.81%), linoleic acid (15.38%-16.43%), oleic acid (18.93%-27.28010), stearic acid (2.56%-4.01%), and palmitic acid (7.38%-10.77%). Conclusion The results show that STE is the most efficient technology with the highest yield (LE:0.57%; SE:1.03%; UE:0.61%; SFE:0.8(r; STE:1.17%) and shortest time (LE:720 min; SE:360 min; UE:30 min; SFE:120 min; STE:1.5 min) among five tested extraction technologies. It is fast reported using STE to extract herbal oil enriched with active fatty acids.

Objective To produce a kind of biliary stent with Mitomycin C-eliting and evaluate the availability and safety in biliary benign stricture model of rabbit.Methods 36 New Zealand rabbits were fulgurize choledochus to establish model of biliary benign stricture.Rabbits were randomly divided into Mitomycin C-eluting stent group 1 (n =12),polyurethane stent group 2 (n =12) and control group 3 (n =12) one month later.General conditions,survival of the animals and changes in liver function were observed after surgery.The histological changes of bile duct were observed after 30 days.The immunohistochemistry SP method was used to measure transforming growth factor-β1 (TGF-β1) and α-Smooth muscle actin (α-SMA) expression.Results Stricture was improved in the two stent groups.In Mitomycin C-Eluting stent group total bilirubin dropped from 5.56 μmol/l to 0.82 μmol/l,and in polyurethane stent group total bilirubin dropped from 6.72 μmol/1 to 0.87 μmol/l.The total bilirubin decreased in both two stent groups but no statistically significant between the two stent groups,and there were no improvement in control group.Diameter of the stricture bile duct in group 1 was expanded bigger than in group 2 according to histology observation.Inflammatory cell infiltration and collagen fibroplasia in the submucosal were obviously observed in control group.The immunohistochemistry results showed that the TGF-β1 and α-SMA strongly expressed in the stenosis bile duct of group 3.The expressions in group 2 were lower than group 3,but higher than in group 1.And there was significant difference between the two stent groups (P ＜ 0.05).Conclusion The new Mitomycin C-Eluting stent is safe and provides enhanced local drug delivery.It also can inhibit the form of Biliary scar to a certain degree.

Objective To investigate the effect of aloe polysaccharides (AP) pre-emptive treatment on the expression of nuclear factor kappa B (NF-κB),ntercellulor adhesion molecule-1 (ICAM-1) and cell apoptosis in hippocampal brain tissue in rats with severely hemorrhagic shock for the first time of entering high altitude.Methods Forty healthy male SD rats weighing 250-300 g were randomly (random number) divided into 5 groups (n =8 each):sham group,shock group and AP group which was further divided into 3 subgroups as per different dosages of AP administered (AP1:0.75 mg/kg; AP2:1.50 mg/kg; AP3:3.00 mg/kg).Rats in sham group were treated with surgical procedure without exsanguination.Rats in shock group were exsanguinated until hemorrhagic shock emerged without resuscitation.Rats in AP subgroups were intravenously infused with given doses of AP in different AP subgroups at 30 min before hemorrhagic shock.MAP was dropped to (35 ±5) mmHg (1 mmHg =0.133 kPa) in 15 min by bleeding from femoral artery,the mean arterial pressure (MAP) was maintained at (35 ±5) mmHg for 60 min with bleeding or re-transfusing.At 3 h after resuscitation,rats were sacrificed immediately by bleeding,and the hippocampus of brain was harvested on the ice.The expressions of NF-κB and ICAM-1 in the hippocampus of rats were determined by immuno-histochemical method,and number of cell apoptosis in the hippocampus of rats was determined by TUNEL.The means were compared with analysis of variance and Student-NewmanKeuls test,and statistical significance was established at a P value of less than 0.05.Results Compared with sham group,the expressions of NF-κB (5.03 ±0.42),ICAM-1 (4.14 ±0.29) and number of cell apoptosis (44.3 ± 7.2) in hippocampal tissue were significantly increased in shock group (P ＜ 0.05).There were no significant differences in these three variables between shock group and AP1 group.Compared with shock group,the expressions of NF-κB (3.12 ±0.34),ICAM-1 (2.93 ±0.21) and number of cell apoptosis (24.8 ± 3.6) in hippocampal tissue were significantly decreased in AP2 group (P ＜ 0.05).There were no significant differences in these three variables between AP2 and AP3 groups.Conclusion AP pre-emptive treatment can significantly attenuate the expressions of NF-κB,ICAM-1 and number of cell apoptosis in hippocampal tissue in hemorrhagic shock rats.

Objective:To investigate the variations in ocular biometry and its influencing factors in adult Tibetans of Lhasa.Methods:A cross-sectional study was adopted.A total of 100 consecutive adult Tibetans (100 eyes) with cataract, who were treated in Tibet Autonomous Region People's Hospital from March 2017 to July 2017 were enrolled, including 51 males and 49 females, with an average age of (63.38±12.80) years.The subjects were divided into two groups, with 57 subjects (57 eyes) older than 60 years in the elder group and 43 subjects (43 eyes) younger than 60 years in the youth group.Corneal curvature, corneal astigmatism, anterior chamber depth and axial length of subjects were measured and compared with those of Beijing population which were used as standardized data of Han Chinese.The differences in ocular parameters associated with age and gender were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tibet Autonomous Region People's Hospital (No.ME-TBHP-21-KJ-005).Written informed consent was obtained from each subject prior to any examination.Results:The mean corneal curvature, corneal astigmatism, anterior chamber depth and axial length of the 100 Tibetans were (43.68±1.62)D, 0.750 (0.375, 1.000)D, (3.05±0.41)mm, (23.07±0.86)mm, respectively.The axial length of Tibetan was shorter than that of Beijing Han people and the difference was significant ( t=2.65, P<0.01).Corneal astigmatism of the elder group was higher than that of youth group and the difference was significant ( t=2.11, P<0.05).There were no significant differences in corneal curvature, anterior chamber depth and axial length between the elder group and youth group (all at P>0.05).The anterior chamber depth and axial length of males were much longer than those of females, and the differences were significant ( t=2.71, 2.25; both at P<0.05). Conclusions:In adult Tibetan population, the axial length is short, and the anterior chamber is deep.The corneal astigmatism increases with age and there is a gender difference in axial length and anterior chamber depth.

Objective To investigate the outcome of trans-scaphoid perilunar dislocation treated with bone anchor and AO/ASIF hollow screw.Methods Eight patients with trans-scaphoid perilunar dislocation were treated by Depuy Mitek bone anchor and AO/ASIF hollow screw.The postoperative follow-up period was 6～24 months(average 11.1±5.3 months).All patients were assessed by the Cooney's grading system.Results The outcomes of 8 patients were execellent in 5 cases,good in 2 cases,general in 1 case.6 cases got pain relief with an increase of range of motor and grip strength at certain drgree.Postoperative roentgenogram displayed congruity among wrist bones,with no fracture disunion,no loose internal fixation and no traumatic arthritis.Conclusion The bone anchor and hollow screw have advantages as simple-manipulated and reliable for treating trans-scaphoid perilunar dislocation.

Objective:To investigate the efficacy of an anterolateral femoral chimeric perforator flap combined with vancomycin-loaded calcium sulfate in the treatment of chronic infection after internal fixation of calf fracture with soft tissue defects.Methods:Retrospectively analyzed were the data of 16 patients with chronic infection combined with extensive soft tissue defects after internal fixation of calf fracture who had been admitted to Department of Orthopedics, Shenzhen Hospital Affiliated to Peking University from September 2008 to November 2020. There were 11 males and 5 females, aged from 16 to 62 years (average, 37 years). Infection sites: the upper tibia in 4 cases, the middle and lower tibia in 10 cases, and the middle fibula in 2 cases. According to the Cierny-Mader classification, all patients were anatomical type III and by the host classification, there were 14 cases of type B and 2 cases of type C type. The areas of soft tissue defects ranged from 6 cm × 4 cm to 23 cm × 14 cm. All patients were treated by transplantation of an anterolateral thigh chimeric perforator flap combined with vancomycin-loaded calcium sulfate therapy. At the last follow-up, the curative efficacy was evaluated according to the Paley fracture union scoring.Results:All patients were followed up for 8 to 24 months (mean, 16 months). Complete flap survival was achieved in 15 flaps and partial survival in one. According to the Paley fracture union scoring at the last follow-up, the curative efficacy was evaluated as excellent in 15 cases and as good in one. Both the grafted artificial bone and the tibia and fibula achieved bone union after 6 to 12 months (mean, 8.9 months). Infection with chronic sinus tract pus recurred in one case at post-operative one year. After re-debridement, the infection was controlled and the wound healed. The plate internal fixation was replaced by the unilateral or annular external fixator in 14 patients and retained in 2 patients. The lengths of the bone defects averaged 2.4 cm and the time for the external fixation 10.5 months (from 8 to 14 months).Conclusion:In the treatment of chronic infection after internal fixation of calf fracture with extensive soft tissue defects, the efficacy of an anterolateral femoral chimeric perforator flap combined with vancomycin-loaded calcium sulfate is satisfactory, because the flap can fully cover the bone and soft tissue defects while the vancomycin-loaded calcium sulfate can effectively control the infection.

Objective To investigate the application effect of interscalene brachial catheter plus functional exercise af-ter tendon adhesion lysis. Methods A total of 40 patients with 68 fingers who hospitalized due to postoperative tendon adhesions of flexor tendon injury repair and the need of tendon adhesion lysis from January 2012 to December 2013 were chosen, and were randomly divided into group A and group B. Group A received scalene brachial plexus catheter analgesia, and group B received the conventional therapy. Knuckle total active activity and pain degree of the two groups were compared. Results There were significant differences in comparing knuckles TAM of group A before ad-ministration, group A after administration and group B after operation for 1 d to 1 week, and TAM good rate of group A after administration increased significantly. There were significant differences in comparing NRS scores of group A be-fore administration, group A after administration and group B, and pain of patients in group A after administration sig-nificantly improved(P<0.05). Conclusion Application of brachial plexus catheter analgesia can significantly reduce the pain of functional exercise, promote recovery of hand function in patients and reduce the incidence of tendon re-adhe-sions.

OBJECTIVETo confirm a new allele HLA-B*13:01:06 and analyze its nucleotide sequence.

METHODSGenomic DNA was extracted using a Qiagen DNA extraction kit. Nucleotide sequences of HLA-A, HLA-B, HLA-C and HLA-DRB1 were analyzed by polymerase chain reaction-sequence based typing (PCR-SBT). HLA high-resolution results were assigned, and the nucleotide sequences of HLA-B locus was compared with that of HLA-B*13:01:01.

RESULTSThe nucleotide sequence of the new allele shows a strong similarity to that of HLA-B*13:01:01. One nucleotide in exon 2 has changed from G to A at position 219 (codon 49 GCG>GCA), which however did not result in amino acid change.

CONCLUSIONThe novel allele verified by sequencing has been submitted to GenBank and officially named as HLA-B*13:01:06 by the World Health Organization HLA Nomenclature Committee.

Alleles ; Amino Acid Sequence ; Base Sequence ; Exons ; HLA-B Antigens ; genetics ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Sequence Analysis, DNA

Objective To retrieve,evaluate and summarize the best evidence on the management of ocular complications in intensive care patients ventilated in prone position,and to provide references for clinical practice.Methods Evidence on management of ocular complications in intensive care patients ventilated in prone position was systemically retrieved in the guideline websites,professional association websites and databases,such as the BMJ Best Practice,UpToDate,Cochrane Library,Joanna Briggs Institute,PubMed,Web of Science,Science Direct,Embase,CNKI,Wanfang and other databases,including guidelines,clinical decisions,evidence summaries,expert consensuses,group standards,systematic reviews and scoping reviews,published from January 2013 to June 2023.The guidelines were individually evaluated by 4 researchers,and the remaining literature was individually evaluated by 2 researchers.The literature that met the criteria was extracted and graded.Results A total of 15 articles were involved,including 6 guidelines,2 clinical decisions,2 evidence summaries,3 systematic reviews,1 scoping review and 1 group standard.Finally,6 evidence topics and 16 pieces of best evidence were formed,including organization and training,risk identification,eye assessment,eye protection,position management and regular observation.Conclusion This study summarized the best evidence on the management of ocular complications in intensive care patients ventilated in prone position.In the application,the best evidence should be selected according to the clinical situation,so as to reduce the incidence of ocular complications and improve the quality of life of patients.