1.5mm)and received CTR scleral fixation.Visual acuity before and after surgery were examined.IOL tilt and decentration were measured with PentaCam system.Complications were also recorded.Main Outcome Measures Postoperative visual improvement,IOL position and complications.Results At the last postoperative examination,best corrected visual acuities of all eyes were increased(P=0.000).The mean IOL tilt was 4.33?2.96?before and 4.11?2.05?after CTR fixation,the mean decentration was 2.56?0.90mm before and 1.19?0.71mm after.No significant differences were found in IOL tilt before and after CTR fixation(P=0.844),but there were significant differences in IOL decentration(P=0.009).Posterior capsular opacification was found in 8 eyes(20.5%)during the follow-up period,and 2 eyes(5.1%)received Nd:YAG posterior capsulotomy.1 eye received IOL scleral fixation because of capsule rupture during CTR implantation.2 eyes suffered from temporary IOP elevation after surgery.No other severe complications occurred.Conclusions Phacoemulsification with CTR and IOL implantation is effective and safe for congenital subluxated lenses.CTR scleral fixation is a necessary supplement for severely subluxated lenses and progressive cases.

Objective To evaluate the effect on the corneal endothelial cell after phacoemulsification using the microburst mode with high vacuum. Design Prospective,observational case series. Participants 98 age-related cataract patients (120 eyes). Metheds All patients having phacoemulsification with the Alcon Legacy 20000 Everest software were assigned to 1 of 3 groups (the burst mode group,the pulse mode group and the continuous mode group). Main Outcome Measures Actual power,effect phaco time,visual acuity,corneal edema,and corneal endothelial cell loss. Results The mean actual power of the burst group was statistically lower than those of the other two groups,the effect phaco time of the burst group was statistically shorter than those of the other two groups. The corneal edema and the endothelial cell loss of the burst group were less than those of the other two groups. Conclusion The microburst mode with high vacuum increased efficiency of ultrasound power and decreased the loss of endothelial cell. (Ophthalmol CHN,2006,15: 201-205)

Objective To evaluate the effects of alpha-lipoic acid (α-LA)on autophagy in human skin fibroblasts (HSFs). Methods HSFs at passage 3 - 5 were divided into several groups to be cultured with α-LA at final concentrations of 0, 0.01, 0.05, 0.10, 0.15, 0.20 and 0.50 mmol/L for 4, 12 and 24 hours, respectively. Methyl thiazolyl tetrazolium(MTT)assay was performed to evaluate cellular proliferative activity, monodansylcadaverin(MDC)staining to determine autophagy levels, and Western blot to measure the expression of the microtubule-associated protein 1 light chain-3B(LC3-B). Results After incubation for 24 hours, there was a significant difference in the proliferative activity of HSFs among all the groups (F = 10.41, P < 0.05), while no significant differences were observed after incubation for either 4 or 12 hours (F = 2.85, 1.34, respectively, both P > 0.05). MDC staining also showed a significant difference in the percentage of autophagosome-positive cells among all the groups after 24-hour incubation (F = 8.03, P < 0.05), but no significant difference after either 4- or 12-hour incubation (F = 0.11, 0.10, respectively, both P > 0.05). Western blot revealed that the degree of conversion from LC3-Ⅰ to LC3-Ⅱ(LC3-Ⅱ/LC3-Ⅰratio)was significantly different among all the groups after 24-hour incubation (F = 37.49, P < 0.05), but similar after 4- and 12-hour incubation (F = 3.38, 2.13, respectively, both P > 0.05). Conclusion α-LA may inhibit basal autophagy in HSFs.

Objective To evaluate the effects of ultraviolet A (UVA) on autophagy in human skin fibroblasts (HSFs).Methods Cultured HSFs were randomly divided into chronic and acute UVA radiation groups.HSFs in the chronic UVA radiation groups were irradiated with UVA at 5,10 and 20 J/cm2 separately once a day for 4 consecutive days,with HSFs receiving no radiation serving as the chronic radiation control group;HSFs in the acute UVA radiation groups received a single session of radiation with 5,10,30 and 60 J/cm2 UVA separately,with HSFs receiving no radiation serving as the acute radiation control group.After additional culture for different durations,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of HSFs,monodansylcadaverin (MDC) staining to determine autophagy levels,and Western blot analysis to track the conversion of the microtubule-associated protein 1 light chain-3 (LC3)-Ⅰ to LC3-Ⅱ.Statistical analysis was carried out by using one-way analysis of variance followed by Students-Newman-Keuls (SNK) test for multiple-group comparisons and by the independent sample t test for two-group comparisons.Results The cellular proliferative activity significantly decreased in the 3 chronic radiation groups at 1 hour after the final UVA radiation compared with the chronic radiation control group (F =155.5,P ＜ 0.05),and in the 4 acute radiation groups at 1,6 and 12 hours after UVA radiation compared with the acute radiation control group (F =1 335,1 649,2 774,all P ＜ 0.05).MDC staining showed that the autophagy levels in HSFs significantly increased in the 3 chronic radiation groups after UVA radiation compared with the chronic radiation control group (F =748.62,P ＞ 0.05),but showed no significant changes in any of the acute radiation groups at 1,6 or 12 hours after UVA radiation compared with the acute radiation control group (F =0.014,0.004,0.002,all P ＞ 0.05).The ratio of LC3-Ⅱ to LC3-Ⅰ was significantly elevated in all the 3 chronic radiation groups at 1 hour after UVA radiation compared with the chronic radiation control group (t =9.002,21.772,18.33,all P ＜ 0.05),but experienced no obvious changes in any of the acute radiation groups at 1,6 or 12 hours after UVA radiation compared with the acute radiation control group (F =0.13,0.27,0.06,all P ＞ 0.05).Conclusion Chronic UVA radiation can upregulate autophagy levels in HSFs,but acute UVA radiation has no evident effects on it.

AIMTo observe protective effects of ginsenoside Rb3 on glutamate excitotoxic injury in cultured hippocampal neurons and involved mechanisms.

METHODSOn cultured rat hippocampal neurons treated with glutamate at toxic concentration, we made the following investigations: by using MTT assay, LDH leakage detection, tests of total NOS, iNOS and cNOS activity, and the protective effects of ginsenoside Rb3.

RESULTSGinsenoside Rb3 can enhance the hippocampal neuronal viability, decrease the LDH leakage, elevate the viability of cNOS, and in the same time weaken iNOS's viability.

CONCLUSIONGinsenoside Rb3 has the significant protective effects on glutamate excitotoxic injury. The involved mechanism may include antagonizing the injury of neuron membrane, inhibiting the viability of iNOS, and increasing the activity of cNOS.

Animals ; Animals, Newborn ; Cells, Cultured ; Ginsenosides ; pharmacology ; Glutamic Acid ; adverse effects ; Hippocampus ; cytology ; drug effects ; L-Lactate Dehydrogenase ; metabolism ; Neurons ; drug effects ; metabolism ; Neuroprotective Agents ; pharmacology ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective: To compare and analyze the effects of forearm flap and superior trapezius myocutaneous flap in repairing oral cancer defects. Methods: 56 cases of defect repair after oral cancer radical surgery were treated with the forearm flap (29 cases) and superior trapezius myocutaneous flap (27 cases). The success rate, postoperative quality of life and postoperative recovery time of the two groups were compared. The t-test was used for statistical analysis. Results: The success rate of forearm flap group was 96.6%(28/29) compared to 96.3%(26/27) in the trapezius myocutaneous flap group (P=0.920). The postoperative recovery time was (9.4±2.7) d (forearm flap group) and (9.3±2.6) d (trapezius myocutaneous flap group), respectively (P=0.489). The score of postoperative quality of life was 576.3±76.2 (forearm flap group) and 568.4±79.3 (trapezius myocutaneous flap group), respectively (P=0.471). There was no significant difference in all comparisons (P>0.05). Conclusions The free forearm flap and the superior trapezius myocutaneous flap pedicled with the transverse cervical artery can be used to repair the oral cancer, and satisfactory function and ideal clinical effect can be achieved. Both two kinds of flaps have high success rate and good clinical practical value. The latter has little influence on the donor site, and can be used as the first choice.

OBJECTIVETo investigate the effect of air pollution on stroke mortality in Tianjin, China, and to provide basis for stroke control and prevention.

METHODSTotal data of mortality surveillance were collected by Tianjin Centers for Disease Control and Prevention. Meteorological data and atmospheric pollution data were from Tianjin Meteorological Bureau and Tianjin Environmental Monitoring Center, respectively. Generalized additive Poisson regression model was used in time-series analysis on the relationship between air pollution and stroke mortality in Tianjin. Single-pollutant analysis and multi-pollutant analysis were performed after adjustment for confounding factors such as meteorological factors, long-term trend of death, "days of the week" effect and population.

RESULTSThe crude death rates of stroke in Tianjin were from 136.67 in 2001 to 160.01/100000 in 2009, with an escalating trend (P = 0.000), while the standardized mortality ratios of stroke in Tianjin were from 138.36 to 99.14/100000, with a declining trend (P = 0.000). An increase of 10 µg/m³ in daily average concentrations of atmospheric SO₂, NO₂ and PM₁₀ led to 1.0105 (95%CI: 1.0060 ∼ 1.0153), 1.0197 (95%CI: 1.0149 ∼ 1.0246) and 1.0064 (95%CI: 1.0052 ∼ 1.0077), respectively, in relative risks of stroke mortality. SO₂ effect peaked after 1-day exposure, while NO₂ and PM₁₀ effects did within 1 day.

CONCLUSIONAir pollution in Tianjin may increase the risk of stroke mortality in the population and induce acute onset of stroke. It is necessary to carry out air pollution control and allocate health resources rationally to reduce the hazard of stroke mortality.

Air Pollutants ; analysis ; Air Pollution ; analysis ; China ; epidemiology ; Environmental Monitoring ; Humans ; Models, Theoretical ; Particulate Matter ; analysis ; Poisson Distribution ; Stroke ; epidemiology ; mortality ; Survival Rate ; Time Factors

BACKGROUNDCathepsin S and its endogenous inhibitor cystatin C are implicated in the pathogenesis of atherosclerosis, especially in the plaque destabilization and rupture leading to acute coronary syndrome. However, whether circulating cathepsin S and cystatin C also change in association with coronary plaque morphology is unknown yet.

METHODSWe recruited 98 patients with unstable angina (UA, n = 6) or stable angina (SA, n = 2) who had a segmental stenosis resulting in > 20% and < 70% diameter reduction in one major coronary artery on coronary angiography. Thirty-one healthy subjects served as controls. Intravascular ultrasound (IVUS) was used to evaluate plaque morphology. Plasma cathepsin S and cystatin C were measured as well.

RESULTSAt the culprit lesion site, plaque area ((7.85 +/- 2.83) mm(2) vs (6.53 +/- 2.92) mm(2), P = 0.027), plaque burden ((60.92 +/- 11.04)% vs (53.87 +/- 17.52)%, P = 0.025), remodeling index (0.93 +/- 0.16 vs 0.86 +/- 0.10, P = 0.004) and eccentricity index (0.74 +/- 0.17 vs 0.66 +/- 0.21, P = 0.038) were bigger in UA group than in SA group. Plasma cathepsin S and cystatin C were significantly higher in patients than in controls (P < 0.01). Plasma cathepsin S was higher in UA group ((0.411 +/- 0.121) nmol/L) than in SA group ((0.355 +/- 0.099) nmol/L, P = 0.007), so did the plasma cystatin C ((0.95 +/- 0.23) mg/L in UA group, (0.84 +/- 0.22) mg/L in SA group; P = 0.009). Plasma cathepsin S positively correlated with remodeling index (r = 0.402, P = 0.002) and eccentricity index (r = 0.441, P = 0.001), and plasma cystatin C positively correlated with plaque area (r = 0.467, P < 0.001) and plaque burden (r = 0.395, P = 0.003) in UA group but not in SA group.

CONCLUSIONSPlasma cathepsin S and cystatin C increased significantly in UA patients. In angina patients, higher plasma cathepsin S may suggest the presence of vulnerable plaque, and higher plasma cystatin C may be a clue for larger atherosclerotic coronary plaque.

Adult ; Aged ; Aged, 80 and over ; Cathepsins ; blood ; Coronary Artery Disease ; blood ; diagnostic imaging ; pathology ; Cystatin C ; blood ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; methods

Objective To explore the influence factors for the functional improvement after the fetal olfactory ensheathing cell (OEC) transplantation for chronic spinal cord injury(SCI). Methods The olfactory bulbs were harvested and trypsinized down to single fetal OEC. They were cultured for 12-17 days prepared for use. From November 2001 to December 2003, a total of 300 patients volunteered for the fetal OEC transplantation, among whom 222 suffered from complete chronic SCI and 78 suffered from incomplete chronic SCI. The procedures were performed on the patients with a disease course ranging from 6 months to 31 years (average 3.1 years) after their injuries. The fetal OEC was transplanted by the form of injections into the spinal cord at the upper and lower ends of the injury site. All the patients were assessed by the ASIA standard before the transplantation and 2-8 weeks after the transplantation. The influence factors including age, sex, duration after the injury, and injury degrees and levels were compared with those in the functional improvement after fetal OEC transplantation. Results The partially-improved neurological functions assessed by the ASIA standard were indicated by the motor scores increasing from 39.1±20.6 to 45.9±20.3 (P<0.001), the light touch scores from 51.7±24.9 to 63.4±23.0 (P<0.001), and the pin prick scores from 53.0±24.2 to 65.3±22.7(P<0.001). There was no significant difference in the functional improvement of the motor, light touch, and pin brick when compared with the age, sex, duration after the injury, and the injury degrees and levels. The motor scores and light touch scores at the cervical level were higher than the scores at the thoracic level. Conclusion The fetal OEC transplantation can partially improve the neurological functions quickly in treatment of the chronic spinal cord injury. All the influence factors except the motor scores and light touch scores, which were higher at the cervical level than at thoracic level, have no impact on the functional improvement after the fetal OEC transplantation.

BACKGROUND: It was thought that there was no regeneration capacityin central nerves. Recent research shows that regeneration capacity of injured neural axons and recovery of some neurological functions can be achieved by changing local surroundings after spinal cord injury (SCI).OBJECTIVE: To probe into whether the transplantation of fetal olfactory ensheathing cells (OECs) in recovering the neurological functions of patients with chronic SCI is safe, feasible, and effective.DESIGN: Auto-control observation before and after surgery.SETTING: Neurological Research and Treatment Center of Beijing Xishan Hospital; Second Department of Neurosurgery in Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences; Second Department of Neurosurgery in Naval General Hospital.PARTICIPANTS: A total of 171 patients with chronic spinal cord injury were selected from the Second Department of Neurosurgery in Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences and the Second Department of Neurosurgery in Naval General Hospital betweenNovember 2001 and February 2003, of which there are 147 patients with complete injury and 24 ones with incomplete injury. Post-injury period ranged from 0.5 to 18 years. Process of treatment is discussed and permitted by relevant Medical Ethics Committees. Cells were obtained from voluntary donors and patients agreed to receive the treatment.METHODS: ① Fetal olfactory bulbs were cultured for 12-17 days after being digested into single cells. ② Fetal OECs were transplanted into sites rostral and caudal to the epienter. ③ Neurological functions of all patients 2-8 weeks before and after operation were evaluated according to the scoring standard of ASIA.MAIN OUTCOME MEASURES: ① Status of functional recovery in spinal cord of patients after transplantation of OECs. ② Harmful events and side effects.RESULTS: A total of 171 patients were involved in the analysis of results.①Status of functional recovery in spinal cord of patients with OECs transplantation: Partial neurological functions of 171 patients rapidly recovered,whose motor function score increased from (34.5±20.3) points before operation to (42.0±20.0) points (P ＜ 0.001) after operation, score of light touch increased from (47.2±24.0) points to (61.8±23.0) points (P ＜ 0.001) after operation,score of pain sense increased from (48.6±23.5) points to (64.0±22.8) points (P ＜ 0.001). ②Harmful events and side-effects: Early manifestations of spinal cord injury induced by infection in surgical area of one patient aggravated; two patients suffered from serious pulmonary infection,one patient from thalamic hemorrhage. Three patients mentioned above died of serious respiration and circulatory failures.CONCLUSION: OEC transplantation can rapidly promote partial neurological function of patients with chronic SCI, while the mechanism needs further observing.