AIM: To study the effect of torsional mode phacoemulsification on cornea in patient with age-related cataract.METHODS: Totally 161 age-related cataract patients (196 eyes) were assigned randomly to phacoemulsification by torsional mode(Group A) or conventional ultrasound mode (Group B) in our hospital from January 2012 to December 2014.The intraoperative data of effective ultrasound time(UST)and effective cumulative dissipated energy(CDE) were recorded.Postoperative outcomes and the change of the best corrected visual acuity(BCVA),corneal edema degree(CED),central corneal thickness(CCT) and endothelial cell count were also recorded and compared.RESULTS: For grade Ⅰ,Ⅱ,Ⅲ and Ⅳ nuclear density,the mean UST and mean CDE were significantly lower in Group A.The average BCVA of Group A was better than Group B at 1 and 7d after surgery.But at 30d postoperative,there was no statistical difference between these two groups(P>0.05).The corneal clarity and the mean change of central thickness showed significantly less corneal edema in Group A than Group B in 1 and 7d postoperatively.This difference was no longer found significantly at 30d after surgery(P>0.05).At 7 and 30d postoperative,the endothelial cells in Group B were lower than in Group A.CONCLUSION: By reducing the effective UST and CDE intraoperatively,the main effect of torsional mode phacoemulsification on cornea shows less damage to endothelium cells,and patients get better prognosis.But the damage to cornea by torsional mode phacoemulsification isn`t fundamentally solved.

Objective To study the relationship among apoptosis,NF-KB activation and uPA expres- sion in human colon carcinoma cell line HCTll6 induced by 5-fluorouracil,and to observe the effect of in- hibiting activity of NF-KB by PDTC on apoptosis as well as expression of uPA.Methods Cell apoptosis was analysed by Annexin V-FITC.Fluctuation of NF-KB and uPA was detected by semi-quantitative immuno- histochemistry.Results 5-fluorouracil could induce apoptosis and activate NF-KB.PDTC could significantly increase the apoptosis and suppress the activation of NF-KB induced by 5-fluorouracil.There was a positive correlation between the changes of uPA and NF-KB.Conclusion 5-fluorouracil could induce apoptosis,ac- tivate NF-KB and up-regulate expression of uPA of HCT116 cells.The mechanism of enhanced apoptosis by PDTC may be related to suppressing activation of NF-?B and down-regulating expression of uPA.

Objective To introduce the transfer of anterolateral thigh flap with iliotibial tract in repair of massive skin and soft tissue defects of the forearm and reconstruction of extension or flexion of the forearm. Methods Eight cases of complicated raw wounds of the forearm were repaired with transfer of anterolateral thigh flap with iliotibial tract. Flexor tendons of 3 cases and extensor tendons of 5 cases were repaired with iliotibial tract. The axial vessel of the flap was used to rebuild blood supply of the hand. Results All the flaps survived completely. A follow-up ranging from 3 months to 2.5 years re- vealed that the reconstructed forearms were good in appearance and soft in texture and restored protective sensation. Affected limbs could perform extension or flexion. Total range of motion (TRM) of the hands was excellent in 6 cases and poor in 2. Conclusion Anterolateral thigh flap with iliotibial tract can not only repair soft tissue defects of the forearm, but also reconstruct the main extension or flexion of the forearm simultaneously.

Objective To investigate the setup errors of head and neck tumor patients with head mask-ing by TomoTherapy with megavoltage CT (MVCT),and to measure the CTV -PTV margins.Methods There were 34 patients with head and neck tumor .All patients had received MVCT scanning before radiation was deliv-ered.The MVCT images were registered with the kilovoltage CT (kVCT)images,the setup errors of the left -right (x),anterior-posterior(y),superior-inferior(z)and transverse profile rotation(Roll)were obtained by matc-hing MVCT with kVCT,followed by calculating the reasonable CTV -PTV margins with the formula M=2.5∑+0.7σ.Results Six hundred and forty MVCT images in total were received for the patients ,the systemic ±random errors in x,y,z and Roll directions were ( -0.15 ±0.55) mm,(0.30 ±0.56) mm,(0.35 ±0.71) mm and (-0.07 ±0.52)°,the CTV-PTV margin in x,y and z directions were 3.31 mm,5.32 mm and 3.35 mm.Con-clusion we demonstrate a theoretic foundation for our CTV -PTV margins in head and neck tumor patients by analyzing the setup errors ,and it also can provide necessary quality assurance for precise radiation .

Objective To investigate the risk factors and patterns of radiation induced gastroduodenal complications in patients with pancreatic cancer following tomotherapy (TOMO) using endoscopy.Methods Patients with pancreatic cancer who were treated TOMO in Air Force General Hospital from February 2010 to May 2015 were collected.All patients underwent endoscopic examination before and after radiotherapy.The radiation injuries were observed,and factors influencing radiation-induced gastroduodenal complications were analyzed.Results The median time of gastroscopy after radiotherapy was 1 month,radiation gastritis and duodenitis were 41 cases (58.6％),radiation gastric and duodenal ulcers were 30 cases (42.9％),and hemorrhage 7 cases (10.0％),scar formation 3 cases (4.3％),6 cases (8.6％) had newly developed gastric retention,and 4 cases (5.7％) had newly developed gastric varix.Univariate analysis showed that relieving jaundice and radiation protection (amifostine) were associated with the development of radiation gastric ulcers (x2 =4.186,P =0.041;x2 =5.679,P =0.017).Conmon terminology criteria for adverse events (CTCAE) ≥2 was associated with the development of radiation duodenal ulcers (x2 =3.960,P =0.047).Mean dose (Dmean) ＞ 13.39 Gy and Dmean ≤13.39 Gy gastric ulcers rates were 25.0％ and 9.1％,respectively (AUC =0.740,P =0.048).Conclusion The TOMO induced gastroduodenal injury in patients with pancreatic cancer is frequent.Relieving jaundice is the protection of radiation gastric ulcer.Dmean ＞ 13.39 Gy is independent predictive factors for radiation gastric ulcers.Patients after TOMO should be examined by endoscopy early.

Objective To study the dose characteristics of Body γ Knife and Tomotherapy treatment plans for hepatocellular carcinoma,and compare their differences between organs at risk (OAR) dose and the range of low dose.Methods CT simulation images of twelve patients with hepatocellular carcinoma were selected,the target volume and OAR were drew by doctor.Body γ Knife and Tomotherapy treatment plans were optimized with their own planning station.The dosimetric characteristics were evaluated by dose volume histograms and were compared.To analyze the difference between the two techniques,the paired t-test was applied.Results The Dmax and Dmean of target with Body γ Knife were higher than Tomotherapy (P =0.002,0.000),but the conformal index of PTV of Tomotherapy was superior to the Body γ Knife (P =0.001).The Dmax of spinal cord and left kidney with Body γ Knife was lower than Tomotherapy (P =0.013,0.012),and it was also in the Dean of stomach and left kidney (P =0.010,0.023).In the volume dose comparison,the V40,V35,V30,V25 and V20 of normal tissue (all Body-PTV) and liver (all liver-GTV) with Body γ Knife were higher than Tomotherapy (P =0.001,0.001,0.001,0.007,0.029),but the V10 and V5 were lower (P =0.019,0.031),the Dmax of stomach,Dmean of right kidney and liver were no statistical difference (P =0.247,0.308,0.401).Conclusions Both treatment plans could meet the clinical dosimetric need,by the same prescription dose,Dmax and Dmean of target of Body γ Knife were higher than Tomotherapy.Tomotherapy had excellent dose-target conformal and could reduce the range of V25-V40 of OAR and normal tissue,but the range of V5-V10 was increased obviously.

Objective To evaluate preventive effect of polysaccharides from Lycium ruthenicum Murray against photodamage in HaCaT cells,and to explore its possible mechanism.Methods Ultrasoundassisted extraction was used to extract polysaccharides from Lycium ruthenicum Murray in Qaidam Basin.In vitro cultured HaCaT cells were randomly divided into 3 groups:control group receiving no treatment,ultraviolet B (UVB) group irradiated with 30 nJ/cm2 UVB alone for 1 hour,experimental group pretreated with 2 g/L Lyeium ruthenicum polysaccharide solution followed 6 hours later by 30 mJ/cm2 UVB radiation for 1 hour.At twelve hours after UVB radiation,an inverted microscope was used to observe cell morphology.Then,MTS assay was performed to estimate cell proliferation,flow cytometry to detect cell apoptosis,an enzyme-labeled antigen method to detect levels of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px),as well as to evaluate the activity of superoxide dismutase (SOD) and catalase (CAT),and enzyme-linked immunosorbent assay (ELISA) to measure levels of intedeukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-α) in HaCaT cells and their culture supernatant.Results Compared with the control group,the UVB group showed obscure cell morphology,cell death and floating phenomenon,while cells became swollen but renained morphologically distinct in the experimental group.MTS assay revealed that the cell proliferative activity significantly differed among the above 3 groups (F =48.88,P ＜ 0.01),and the cell proliferative activity was significantly lower in the UVB group (1.72 ± 0.12) than in the control group (2.34 ± 0.11,P ＜ 0.05) and experimental group (2.11 ± 0.10,P ＜ 0.05).Moreover,the apoptosis rate was significantly higher in the UVB group (82.41％ ± 2.49％) than in the control group (3.98％ ± 0.19％,P ＜ 0.05) and experimental group (22.79％ ± 0.97％,P ＜ 0.05),as well as higher in the experimental group than in the control group (P ＜ 0.05).Compared with the control group,the UVB group showed significantly higher levels of MDA,supernatant levels of IL-1 and TNF-α,and intracellular levels of TNF-α,but significantly lower GSH-Px levels and activity of SOl and CAT (all P ＜ 0.05).However,there was no signifi-cant difference in the intracellular level of TNF-α between the UVB group and control group (P ＞ 0.05).Conclusion Lycium ruthenicum polysaccharide has protective effects against photodamage in HaCaT cells,likely by reducing the synthesis and secretion of inflammatory substances as well as free radicals.

Objective To investigate effects of rectal cancer to undergo total mesorectal excision (TME)or three space dissection(TSD)with pelvic autonomic nerve preservation(PANP).Methods TME or/ and TSD was applied in 247 Patients with advanced rectal cancer in which 185 cases (74.9 %) underwent PANP(Group P)including TME-PANP(Group Pro)139 cases and TSD-PANP(Group Ps)46 cases.The other 62 cases underwent none-PANP(Group P-)due to tumor invasion.Results There were no death cases for operation inall patients.Group Pm was better than Group Ps in the operation time and the difficulty of proce- dure(P0.05).Conclusion The procedure with TME to preserve pelvic autonomic nerves adapts to the majority of rectal cancer patients.TSD procedure is more complex than TME.Statistically,the survival differ- ence between Patients with TSD and with TME is no defective.The survival time is determined to the tumor's earlier diagnosis and therapy.

OBJECTIVETo assess the feasibility of interstitial magnetic resonance lymphangiography (IMRL) with intracutaneous injection of gadobenate dimeglumine--a commercially available, non-ionic, extracellular paramagnetic contrast agent.

METHODSWe studied 10 patients with lower extremity lymphedema. A mixture of 7.5 ml gadobenate dimeglumine and 0.5 ml 2% lidocaine were evenly subdivided into 8 portions and injected intracutaneously into each web space of both feet. For IMRL, a 3D fast spoiled gradient-recalled echo T1-weighted images with a fat saturation technique (T1 high resolution isotropic volume excitation, THRIVE) was performed.

RESULTSThe beaded appearance of lymphatic vessels extending from the injection site were detected in 11 of 12 lower legs and the best delineation of lymphatic vessels was present at 15-30 minutes after injection. In 6 of 12 affected thighs, lymphatic vessels could be also visualized with the strongest enhancement at 45 minutes.

CONCLUSIONIMRL is a safe and technically feasible new method which can effectively visualize the pathological lymphatic vessels in lower extremity lymphedema.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Lower Extremity ; Lymphedema ; diagnostic imaging ; Lymphography ; methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

OBJECTIVETo observe the effect of Chinese herbal therapy on T-lymphocyte subsets in patients with IgA nephropathy (IgAN).

METHODSTotally 36 inpatients and outpatients at Department of Nephropathy, Xiyuan Hospital, China Academy of Chinese Medical Sciences, from June 2011 to June 2013 were recruited in the treatment group, while 20 volunteers were recruited as the healthy control group. Patients in the IgAN group only took Chinese herbal decoctions by syndrome typing for 3 months (except those accompanied with hypertension additionally took antihypertensive agents such as angiotensin-converting enzyme inhibitor and/or dihydropyridines calcium antagonist). No intervention was performed in the healthy control group. The values of Th1, Th2, and CD4+ CD25+ Treg, and red blood cell number in urine were detected using flow cytometry before and after treatment. 24 h urine protein was detected using inmmunoturbidimetry.

RESULTSCompared with the healthy control group, the CD4+ CD25+ Treg level obviously decreased in the IgAN group, showing statistical difference (P < 0.01). In the IgAN group, Th1, 24 h urine protein, and urine red blood cell counts were obviously lower after treatment, showing statistical difference when compared with before treatment (all P < 0.05).

CONCLUSIONChinese herbal therapy could reduce urine erythrocyte number and 24 h urine protein of IgAN patients, and down-regulating Th1 expression might be its mechanism.

Adult ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glomerulonephritis, IGA ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocyte Subsets ; drug effects ; Young Adult