Objective To analysis of the causes, operative methods and the clinical results in patients with dislocated intraocular lens(IOL). Methods 11 cases (11 eyes) underwent surgical management of dislocated IOL were analyzed retrospectively. Results In the all cases trauma was the main cause; Surgical techniques included IOL exchange in 3 eyes and IOL removal in 1eye,removal combined with re-implantation in 5 eyes, simple cut the after cataract in 2 eyes, the final best-corrected visual acuity was 0.6~0.8 in 3 patients (27.27%), 0.4～0.5 in 4 patients (45.45%) ,0.2~0.3 in 2 patients (18.18%) and

ObjectiveTo investigate the clinical features of the abnormal chromosome karyotypes in twin pregnancies complicated with fetal malformations. Methods Totally 181 twin pregnancies (362 fetuses) in which one or two fetuses had abnormalities diagnosed by ultrasound were referred to the First Affiliated Hospital of Sun Yat-Sen University from January, 2000 to September, 2010. They were divided into different groups according to ( 1 ) maternal age: the cases with maternal age ≥35 were divided into advanced pregnancy group ( 105 fetuses) , and those with maternal age ＜35 were divided into young pregnancy group (203 fetuses) ; ( 2 ) conceived method : those conceived by assisted reproductive technology were divided into assisted reproductive group (81 fetuses), and the natural conception pregnancies were divided into natural conception group (227 fetuses) ; ( 3 ) chorionicity: the monochorionic twin (MCT) pregnancies were divided into MCT group( 123 fetuses), and the dichorionic twin (DCT) pregnancies were divided into DCT group( 185 fetuses); (4) structural abnormalities: 205 fetuses with structural abnormalities were divided into the abnormal fetal group, and 103 fetuses without structural abnormalities were divided into the normal fetal group. All fetuses were examined by the ultrasound and chromosomes were examined in 308 fetuses. Results( 1 ) The karyotype of fetuses: among 181 twin pregnancies, 23 cases had chromosomal abnormalities in 1 or 2 fetuses ( 12. 7％ ,23/181 ), and chromosomes were exarmined in both fetuses in 20 of 23 cases. Twenty-six of 308 fetuses were found with abnormal chromosomes ( 8.4％, 26/308 ) , and the aneuploid was the most common type of abnormal karyotypes ( 53.8％ , 14/26 ). Twenty-one of 205 fetuses with malformations were found with abnormal karyotypes (10. 2％, 21/205 ). (2) Seven of 123 fetuses in MCT group were with abnormal karyotypes (5.7％, 7/123), and 19 of 185 fetuses in DCT group were with abnormal karyotypes ( 10. 3％, 19/185 ). There was no statistical difference of abnormal chromosome incidence between the two groups. There were 14 fetuses with aneuploid in DCT group ( 7.6％, 14/185 ) ;but there was no fetus with aneuploid in MCT group. There was statistical difference between these two groups. In two cases of DCT group, only one fetus with malformation received chromosome examination because another fetus was dead, and the karyotypes were trisomy 21 and trisomy 18 respectively. Both fetuses of the rest 17 cases received chromosome examination, and the chromosomes of both fetuses in each pregnancy were different. Fifteen of 19 fetuses with abnormal chromosomes in DCT group were complicated with structural abnormalities, and 7 fetuses of 4 twin pregnancies in MCT group were with chromosomal abnormalities. (3) The comparison of the abnormal karyotype incidence between the advanced pregnancy group and young pregnancy group: the abnormal karyotype incidence of the advanced pregnancy group was 7. 6％ (8/105), and that was 8.9％ (18/203) in young pregnancy group. There was no statistical difference between the two groups ( P ＞ 0. 05 ). Six of 105 fetuses in advanced pregnancy group were aneuploids (5. 7％, 6/105), and 8 of 203 fetuses in young pregnancy group were aneuploids (3.9％, 8/203). The aneuploid incidence in advanced pregnancy group was significantly higher than that in young pregnancy group ( P ＜ 0. 05 ). (4) The comparison of the abnormal karyotype incidence between the assisted reproductive group and the natural conception group: 11 of 81 fetuses were with the abnormal karyotypes in assisted reproductive group ( 13. 6％, 11/81 ), and 15 of 227 fetuses were with the abnormal karyotypes in assisted reproductive group (6. 6％, 15/227). There was statistical difference between the two groups ( P ＜0. 05). There were 7 fetuses with the aneuploid in assisted reproductive group ( 8. 6％, 7/81 ) and 7 fetuses with the aneuploid in natural conception group ( 3. 1％, 7/227 ), which showed no statistical difference ( P ＞0. 05 ).(5) The comparison of the abnormal karyotype incidence between the abnormal fetal group and normal fetal group: 21 of 205 fetuses in abnormal fetal group were with abnormal karyotypes (10. 2％, 21/205), and 5 of 103 fetuses in normal fetal group were with abnormal karyotypes ( 4. 9％, 5/103 ) . There was no statistical difference (P ＞ 0. 05 ). 13 fetuses in abnormal fetal group were with the aneuploid (6. 3％, 1 3/205), and only one fetus in normal fetal group was aneuploid (1.0％, 1/103 ). There was statistical difference between the two groups ( P ＜ 0. 05 ). ConclusionsAneuploid is the most common abnormal karyotype in twin pregnancy complicated with fetal abnormalities, especially trisomy 21. Aneuploid mainly occurs in only one fetus of DCT, and chromosomal discordance is usually found in DCT. While in MCT, the twin fetuses with the same abnormal karyotype may have different pbenotypes. The results suggest that it is necessary to analyze both karyotypes of twins even if only one fetus is complicated with structural abnormalities.

Objective To explore the clinical effects of pedicled omentum in preventing anastomotic leakage after resection of colorcctal cancer complicated with intestinal obstruction.Methods The clinicopathologic data and anastomotic leakage rate of 102 patients with colorectal cancer undergoing resection from Dec.2012 to Dec.2015 were analyzed.Results Seven patients in the control group developed anastomotic leakage.Only 1 patient in the experimental group developed anastomotic leakage.The incidence of anastomotic leakage in the control group was 12％,while that in the experimental group was 2％ (x2 =4.250,P =0.039).Of the 7 patients complicating anastomotic leakage in control group,1 died of multiple organ failure,1 was cured with conservative treatment,and 5 were done with diverting stoma.The one leakage in experimental group was cured by conservative treatment.Conclusion Pedicled omentum is useful in the prevention of anastomotic leakage after resection of colorectal cancer in settings of intestinal obstruction.

Objective To investigate the efficacy of wrapping and suturing of pancreatic stump with the avascular zone of the transverse mesocolon for preventing pancreatic leakage after distal pancreatectomy.Methods The clinical data of 69 patients who received distal pancreatectomy at the Affiliated Tumor Hospital of Zhengzhou University from May 2011 to March 2014 were retrospectively analyzed.The pancreatic stump was wrapped with the avascular zone of the transverse mesocolon after suturing the pancreatic stump in 34 patients (the modified group),and the pancreatic stump of 34 patients was sutured without any other treatment (the control group).The time for pancreatic stump management,complications,time for drainage tube placement and duration of postoperative hospital stay of the 2 groups were compared.Patients were followed-up through outpatient examination and telephone interview till June 2014.The measurement data and the count data were analyzed using the t test and the chi-square test,respectively.Results The time for pancreatic stump management of the modified group and the control group were (15.2 ± 2.1) minutes and (13.2 ± 3.2) minutes,with no significant difference between the 2 groups (t =1.565,P ＞ 0.05).No patient was complicated with other diseases in the modified group,while 9 patients in the control group was complicated with pancreatic fistula,with significant differences between the 2 groups (x2=9.399,P ＜0.05).The time for drainage tube placement of the modified group and the control group were (6.1 ± 2.2) days and (16.6 ± 3.5) days,the duration of postoperative hospital stay were (12.5 ± 2.5) days and (21.5 ± 3.5) days,with significant difference between the 2 groups (t =-11.902,-9.853,P ＜ 0.05).Sixty-three patients were followed up from 1 to 35 months with a mean time of 15 months.Fifteen patients died,and the condition of other patients was normal.Conclusion Wrapping and suturing of the pancreatic stump with the avascular zone of the transverse mesocolon is effective for preventing the pancreatic leakage after distal pancreatectomy and shortens the time of postoperative hospital stay.

Objective To investigate the clinical efficacy of three dividing lines in radical right hemicolectomy for right colon cancer.Methods The clinical data of 166 patients with right colon cancer (including ileocecal cancer,ascending colon carcinoma and hepatic flexure of the colon) who were admitted to the Affiliated Tumor Hospital of Zhengzhou University from March 2009 to August 2014 were retrospectively analyzed.Eightythree patients who underwent radical right hemicolectomy via three dividing lines were allocated to the modified group and 83 patients who underwent radical right hemicolectomy via medial approach were allocated to the control group.The operation time,volume of intraoperative blood loss,number of lymph node dissection and processing time and volume of the superior mesenteric vein (surgical trunk) hemorrhage were analyzed between the 2 groups.Patients were followed up by outpatient examination and telephone interview till November 2014.The measurement data with normal distribution were presented as x ± s.The comparison between groups was analyzed using t test.The count data were analyzed by the chi-square test.Results The operation time in the modified group and in the control group were (75 ± 7) minutes and (109 ± 13) minutes,respectively,with a significant difference (t =-36.700,P ＜0.05).The volume of intraoperative blood loss and number of lymph node dissection in the modified group were (118 ± 15)mL and 19 ±4,which were not significantly different from (116 ±22)mL and 18 ± 3 in the control group (t =0.104,12.300,P ＞ 0.05).During D3 lymph node dissection,the incidence of hemorrhage of the superior mesenteric vein,processing time of hemostasis and volume of blood loss were 3.6％ (3/83),(7 ± 3) minutes and (103 ± 25) mL in the modified group and 9.6％ (8/83),(20 ± 5) minutes and (209 ± 37)mL in the control group,respectively.There was no significant difference in the incidence of hemorrhage of the superior mesenteric vein between the 2 groups (x2 =2.434,P ＞ 0.05).There were significant differences in the processing time of hemostasis and volume of blood loss between the 2 groups (t =38.100,29.200,P＜0.05).The patients were followed up for 3 months to 5 years with a median time of 22 months.Of 166 patients,23 died,11 were loss to follow-up and others survived at the end of follow-up.Conclusion Three dividing lines is safe and feasible in radical right hemicolectomy for right colon cancer,with a good clinical efficacy.

Objective To investigate the effects of pancreaticoenterostomy by separating and continuous suture on pancreatoduodenectomy.Methods The clinical data of 76 patients who underwent curative pancreaticoduodenectomy from March 2002 to October 2014 in Tumor Hospital of Zhengzhou University were retrospectively analyzed.Of all the patients,43 received pancreaticoenterostomy by separating and continuous suture (study group),and the other 33 patients received BPJ anastomosis (control group).All the patients used Child reconstruction,the diagnosis of pancreatic fistula was made according to ISGPF criteria.The operation time of pancreaticoenterostomy,the incidence of hemorrhage of anastomosis and the incidence of pancreatic fistula were retrospectively analyzed.Results The age,sex,hemoglobin,albumin,total bilirubin,the incidence of co-morbidity of diabetes,extent of surgical resection between 2 groups were comparable without significant difference.In study group,the time of pancreaticoenterostomy was 11 min(8 ～ 15 min),there were 4 patients with class Ⅰ pancreatic fistula,and 1 patient with class Ⅱ pancreatic fistula.No patient developed class Ⅲ pancreatic fistula or anastomotic bleeding.In control group,the time of pancreaticoenterostomy was 16 min(12 ～25 min) which was only available for 5 patients,and no records for other patients.There were 6 patients with pancreatic fistula including 4 patients with class Ⅱ,2 patients with class Ⅲ,while no records for class Ⅰ.Four patients were found to have anastomotic bleeding.Conclusions With the pancreaticoenterostomy by separating and continuous suture method,the surgical field is fully exposed,the suture time is shortened and the incidence of anastomotic bleeding and pancreatic fistula is reduced.

Porcine alveolar macrophages (PAMs) represent the first line of defense in the porcine lung after infection with porcine circovirus type 2 (PCV2) via the respiratory tract. However, PCV2 infection impairs the microbicidal capability of PAMs and alters cytokine production and/or secretion. At present, the reason for the imbalance of cytokines has not been fully elucidated, and the regulatory mechanisms involved are unclear. In this study, we investigated the expression levels and regulation of interleukin-1beta (IL-1β) and IL-10 in PAMs following incubation with PCV2 in vitro. Levels of IL-1β and IL-10 increased in PAM supernatants, and the distribution of nuclear factor kappa B (NF-κB) p65 staining in nucleus, expression of MyD88 and p-IκB in cytoplasm, and DNA-binding activity of NF-κB increased after incubation with PCV2, while p65 expression in PAM cytoplasm decreased. However, when PAMs were co-incubated with PCV2 and small interfering RNA targeting MyD88, those effects were reversed. Additionally, mRNA expression levels of Toll-like receptors (TLR)-2, -3, -4, -7, -8, and -9 increased when PAMs were incubated with PCV2. These results show that PCV2 induces increased IL-1β and IL-10 production in PAMs, and these changes in expression are related to the TLR–MyD88–NF-κB signaling pathway.
Circovirus* ; Cytokines ; Cytoplasm ; In Vitro Techniques* ; Interleukin-10* ; Interleukin-1beta* ; Lung ; Macrophages, Alveolar* ; NF-kappa B ; Respiratory System ; RNA, Messenger ; RNA, Small Interfering ; Toll-Like Receptors

Objective: To establish a scoring system to predict the risk of anastomotic leakage in patients with rectal cancer older than 60 years. Methods: The study included 995 patients (≥ 60 years) with rectal cancer locating 3-12 cm from the anal verge who underwent anterior resection or intersphincteric resection at the Department of General Surgery, Henan Cancer Hospital from January 2012 to December 2016. Potential risk factors for leakage were subjected to univariate analysis. Multivariate logistic regression analysis was used to identify the independent risk factors for anastomotic leakage. The scoring system was developed based on regression coefficient for each significant risk factor. One point was allocated to the risk factor with a regression coefficient β < 1, and two points were allocated to the risk factor with β > 1. The proposed scoring system was tested by the area under curve (AUC) of the receiver operating characteristic curve (ROC) . Results: Surgery was successfully performed in all 995 patients. The incidence of anastomotic fistula was 4.6% (46/995) . Among these 46 patients, 31 recovered after conventional treatment, and 13 patients underwent transverse colostomy, and 2 died of multiple organ failure. Independent risk factors included age (β = 0.643, OR = 1.902, 95%CI: 1.020 - 3.614, P = 0.048) , body mass index (BMI) (β = 1.218, OR = 3.379, 95%CI: 1.607 - 7.105, P = 0.001) , albumin levels (β = 0.986, OR = 2.681, 95%CI: 1.432-5.021, P = 0.002) , and level of anastomosis from the anal verge (β = 1.395, OR = 4.034, 95%CI: 2.086-7.801, P = 0.000) . The scoring system was created base on coefficient β of the independent risk factors (age≥70 years for 1, BMI≥25 kg/m² for 2, albumin levels < 35 g/L for 1, level of anastomosis from anal verge < 4.0 cm for 2) . All the scores were added up, and all patients were divided into the high-risk group (4-6 points, n=71) and intermediate-low-risk group (0-3 points, n=924) based on the scoring system. The incidence of anastomotic leakage in the two groups was 23.9% (17/71) and 3.1% (29/924) , respectively (χ² = 60.092, P = 0.000) . The AUC of age, BMI, albumin levels, and level of anastomosis from the anal verge were 0.598, 0.591, 0.622, and 0.635 respectively. The AUC of the scoring system was 0.656, which was higher than above parameters with a sensitivety of 0.37 and specificity of 0.94. Conclusions The scoring system is effective and accurate for identifying a subgroup at high risk for postoperative anastomotic leakage in rectal cancer patients over 60 years old.

Objective: To assess the clinical value of neutrophil-to-lymphocyte ratio (NLR) in predicting anastomotic leak of postoperative rectal cancer patients. Methods: The clinical data of 787 rectal cancer patients who underwent anterior resection from January 2014 to December 2017 in Affiliated Tumor Hospital of Zhengzhou University were collected. The postoperative numbers of white blood cell (WBS) on postoperative day (POD)1, 3 and 5 were detected, and the NLR was calculated. The relationship of NLR and the incidence of anastomotic leak was analyzed, and the area under the receiver-operating characteristic (ROC) curves was calculated. The accuracy of postoperative NLR in predicting the incidence of anastomotic leak was evaluated. Results: WBC counts of patients with leak on POD1, POD3 and POD5 were 13.2×10⁹/L, 9.1×10⁹/L and 8.9×10⁹/L, respectively, while those of patients without leak were 12.9×10⁹/L, 9.0×10⁹/L and 8.8×10⁹/L. The WBC count was not significantly different between patients with or without leak (P>0.05). The average NLR values of patients with or without leak were 13.3 and 11.6 on POD1, 10.9 and 7.6 on POD3, 9.3 and 5.3 on POD5, respectively. The NLR values of patients with leak on POD3 and POD5 were significantly higher than those of patients without leak (P<0.05). The cutoff value of NLR on POD3 was 8.6, the sensitivity and specificity of detecting the leakage was 73.2% and 75.6%, respectively, and the area under curve (AUC) was 0.744. The cutoff value of NLR on POD5 was 5.5, the sensitivity and specificity was 69.6% and 75.5%, the AUC was 0.726. The multivariate analysis result showed that NLR >8.6 was an independent factor for anastomotic leak prediction. Conclusion Postoperative NLR on day 3 is useful in predicting anastomotic leak and can decrease the incidence of complication in rectal cancer patients who underwent anterior resection.