AIM: To compare the effectiveness on 10g/L cyclopentolate and 10g/L atropine on cycloplegia in children before optometry.
METHODS:Eighty eyes of 40 children among 4-12 years old with refractive error were recruited in this study. 10g/L cyclopentolate eye drops were topically administered once per 5min for 3 times and optometry was performed after 45min. Three days after that, 10g/L atropine sulfate eye gel then was used 3 times per day for consecutive 3d and again the refractive diopter was obtained at the 4th d. The differences of the results in retinoscopy refraction were compared between 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel.
RESULTS: Therefraction results of those given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel were no statistical different in both 4-8 years group and 9-12 years group with myopia (≤-3. 00D) (P=0. 411, 0. 924). The differences of refraction results of both the drugs were significant in 4 - 8 years group with low hypermetropia, medium hypermetropia and high hypermetropia (P=0. 007, 0. 007, 0. 009). No significant difference was found in 9 - 12 years group with low hypermetropia (P= 0. 592), given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel, but the differences of refraction results of both the ophthalmic preparations above were significant in 9-12 years group with medium and high hypermetropia (P=0. 039, 0. 012).
CONCLUSION:Both 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel have the cycloplegic effects, but their cycloplegic effects are significant different among hypermetropia children. Thus, the reasonable cycloplegic should be chosen according to the specific situation.

Background Researches demonstrated that ciliary neurotrophic factor (CNTF) can enhance survival and promote differentiation of neutron.Meanwhile,CNTF also is thought to play an important role in the development of visual pathway.But,less studies are reported in the relationship of CNTF and form deprivation amblyopia.Objective This study was to investigate the expressions of CNTF in visual cortex area 17 in form deprivation amblyopia model.Methods Twelve 4-week-old cats were randomized into normal group and form deprivation amblyopia group.Monocular form deprivation amblyopic models were established in 6 cats by eyelids suture method.Pattern visual evoked potential(P-VEP) was recorded to evaluate the amblyopic models 16 weeks later following the eyelids suturing.Then,bilateral visual cortex tissue was incised at a vertical in sagittal axis fashion to prepare the section.Nissl staining was used to detect the morphologies of neurons.Expression of CNTF in Ⅰ-Ⅵ layers of visual cortex area 17 was located and quantified by immunochemistry.The positive cell number and gray scale for CNTF were calculated and compared between two groups.The use of the animals complied with Regulations for the Administration of Affairs Coucerning Experimental Animals by State Science and Technology Commission.Results Compared with the normal group,P-VEP amplitude was significantly reduced (6.11 ±1.56 μV vs.11.42±t.92 μV) and latency was significantly prolonged(75.77±9.83 ms vs.58.56±7.17 ms) in the form deprivation amblyopia group (t=5.272,3.464,P＜0.05).Nissl staining showed that the number of neurons in the form deprivation amblyopia group was less than that in the normal group.In the form deprivation amblyopia group,neurons became shrinkage and turned round,cytoplasmic processes get shortened,and the nucleus became small.The number of Nissl bodies was decreased.lmmunochemistry showed the positive neutrons for CNTF in Ⅰ-Ⅵ layers of visual cortex area 17 in hoth normal cats and model cats with the more positive cells in Ⅱ-Ⅳ layers.Compared with the normal group,the positive cell number for CNTF was significantly reduced in Ⅱ-Ⅳ layers of visual cortex area 17 in the form deprivation amblyopia group (Ⅱ layer:95.93±8.24 vs.116.25±6.52;I layer:102.65±7.45 vs.125.23±8.21;Ⅳ layer:l10.65±6.85 vs.139.54±4.26) (t=4.737,4.989,8.773,P＜0.05).In addition,the gray scale of CNTF positive cells was significantly lower in Ⅱ-Ⅳ layers of visual cortex area 17 in the form deprivation amblyopia group than that the normal group (Ⅱ layer:106.98 ± 8.86 vs.138.65 ± 6.38 ; Ⅲ layer:109.56 ± 8.69 vs.149.59 ±8.55;Ⅳ layer:l16.65 ±9.52 vs.155.76±9.87) (t=7.105,8.043,6.986,P＜0.05).Both CNTF positive cell number and gray scale in Ⅰ,Ⅴ,Ⅵ layers of visual cortex area 17 had no significant differences between two groups (P＞0.05).Conclusions Form deprivation in critical period of a new born animal may lead to distributing abnormality of CNTF in visual cortex,which maybe play a role in the development of form deprived amblyopia.

Adamantinoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Adult ; Diagnosis, Differential ; Female ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Ilium ; Keratins ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Retrospective Studies ; Sarcoma, Ewing ; pathology ; Sarcoma, Synovial ; pathology ; Tibia ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo observe the clinical efficacy on pain in postmenopausal osteoporosis treated with the warm acupuncture therapy and discuss its effect mechanism.

METHODSNinety cases of postmenopausal osteoporosis were randomized into a warm acupuncture group, an electroacupuncture group and a medication group, 30 cases in each group. In the warm acupuncture group and the electroacupuncture group, Dazhu (BL 11), Shenshu (BL 23) and Xuanzhong (GB 39) were selected bilaterally and stimulated with the warm acupuncture and electroacupuncture therapies respectively, once a day for 30 days totally. In the medication group, caltrate-D tablets were prescribed, 600 mg, once a day for 30 days totally. The changes in the bone density T value, visual analogue scale (VAS) score, serum insulin like growth factor 1 (IGF-1), interleukin 6 (IL-6) and tumor necrosis factor (TNF-alpha) were observed before and after treatment in the three groups.

RESULTS(1) The bone density T value in the patients of postmenopausal osteoporosis did not change obviously after 30 days treatment with the three therapies; (2) VAS score was all reduced after treatment, in which, the result in the warm acupuncture group was the most obvious (6.73 +/- 0.24 before treatment vs 4.43 +/- 0.26 after treatment). The value after treatment in the warm acupuncture group was different significantly as compared with the electroacupuncture group (5.13 +/- 0.31) and the medication group (5.17 +/- 0.33, both P < 0.05). (3) The level of serum IGF-1 was improved after treatment in the warm acupuncture therapy [(119.5 +/- 20.1) ng/mL before treatment vs (156.5 +/- 23.9) ng/mL after treatment], which was more apparent as compared with the electroacupuncture group [(136.3 +/- 24.5) ng/mL] and the medication group [(127.7 +/- 22.1) ng/mL, all P < 0.05]. Concerning to reducing the levels of IL-6 and TNF-alpha in serum, the results in the warm acupuncture group were superior to the other two groups (all P < 0.05).

CONCLUSIONThe warm acupuncture therapy achieves the significant efficacy on pain in postmenopausal osteoporosis, which could be related to increasing the level of IGF-1, decreasing the levels of IL-6 and TNF-alpha, promoting bone formation and inhibting bone absorption.

Acupuncture Therapy ; methods ; Bone Density ; Female ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Interleukin-6 ; blood ; Middle Aged ; Osteoporosis, Postmenopausal ; blood ; physiopathology ; therapy ; Pain Management ; Tumor Necrosis Factor-alpha ; blood

Objective To observe the effect of splenectomy on mortality and brain water content of rats with brain injury so as to explore novel way for better clinical management of patients with severe traumatic brain injury. Methods Adult male SD rats were randomly divided into three groups, ie, sham operation on brain and spleen (Group A, n = 23), experimental brain trauma & sham operation on spleen (Group B, n =48) and experimental brain injury & splenectomy (Group C, n = 47). Modified Feeney' s method was used to create the animal model of experimental brain trauma, Longa' s scale was applied to evaluate the neurologic defect. Mortality within seven days following brain injury was calculat-ed. In the meantime, the brain water content was detected at days 1 (n = 8), 2 (n = 8), 3 (n = 8) and 7 (n = 7) after brain injury in each group, Results No statistical difference of Longs' s scale was found between Group B and Group C (P > 0.05). The mortalities within seven days after brain injury were 0%, 35.42 and 14.89% in Groups A, B and C respectively, with statistical difference between groups (P<0.05). The brain water content of Groups B and C at days 1, 2, 3 and 7 were (81.98±0.35)% & (81.78±0.41)%, (82.58±0.63)% & (81.81±0.48)% (P<0.05),(82.54±0.54)% & (81.52±0.84)% (P<0.05) and (81.50±0.41)% & (81.21±0.36)% (P>0.05) respectively. Conclusion Splenectomy can effectively reduce brain water content and significantly decrease mortality in rata with brain injury.

Background and purpose:Intensity-modulated radiotherapy(IMRT) can significantly improve the dosimetric distribution of both the target and organs at risk compared to tangential irradiation for whole breast. However,its optimized methods remain different and conflicting for many radiotherapy institutions.In order to achieve the optimized planning of IMRT for the irradiation of intact breast,we investigated different optimizing methods in three dimensional radiotherapy planning system.Methods:Ten patients with early-stage breast cancer after breast conserving surgery were eligible for the study.Two kinds of plans were performed on each patient in three-dimensional treatment planning system,inverse planning IMRT and forward planning IMRT which included 3 different optimizing methods as manual optimizing(MO),multiple points optimizing(PO) and automated inverse optimizing(AO).Various parameters were used to evaluate the efficacy of different IMRT plans.All plans were compared using dose volume histograms(DVH) for the planning target volume(PTV) and organs at risk(OARs).Results:For MO,PO,AO forward plans and inverse plans,median number of segments were 5,5.5,5 and 20 respectively,and mean total MU were 225.8, 228.4,226.4 and 345.8 MU,respectively.Comparing the different forward planning optimizations,the best target coverage and dose homogeneity of PTV was observed in AO plans(P(?)0.01),and PO and AO plans showed a better reduction of OARs exposure compared with MO plans(P(?)0.05).A further improvement of dose homogeneity in the PTV and better sparing of OARs was achieved using inverse planning(P(?)0.05).Conclusion:Forward planning IMRT with AO optimization for intact breast irradiation could provide both efficacy and dosimetric advantages better than others.The inverse IMRT plan showed more potential in improving the dosimetric outcomes.However,further studies are required for inverse optimizing plans.

Objective To investigate the incidence of nosocomial infection ( NI) in the hospital, analyze the related factors, and provide a scientific basis for reducing the incidence of NI.Methods A total of 37 744 inpatients from Jul 2008 to Jun 2009 were retrospectively analyzed, of which 862 inpatients suffering from NI.Results The rate of NI was 2.55% , the highest infected rate was in ICU(41.43% ).The susceptible ages were 60 above and 1 below, the infection rates were 4.11% and 3.36%.The infection rate of patients hospitalized for more than 20 d was 10.66%.Conclusions The rate of NI was 2.55% , the highest infected rate was in ICU(41.43% ).The susceptible ages were 60 above and 1 below, the infection rates were 4.11% and 3.36%.The infection rate of patients hospitalized for more than 20d was 10.66%.

BACKGROUNDThe coagulation function in patients with pancreatic carcinoma is abnormal and the reason is not very clear. In this study, we retrospectively analyzed the coagulation function in patients with pancreatic carcinoma.

METHODSFrom June 2004 to December 2007, 132 patients received diagnosis and treatment in our hospital. The coagulative parameters including the prothrombin time, activated partial thromboplastin time, and fibrinogen levels were collected and studied retrospectively.

RESULTSThe average fibrinogen levels in patients with pancreatic carcinoma, (476.21 +/- 142.05) mg/dl, were significantly higher than in patients with cholangiolithiasis, (403.28 +/- 126.41) mg/dl (P < 0.05). In patients with pancreatic carcinoma, the levels of fibrinogen in the group with jaundice were significantly higher than in patients without jaundice (P < 0.05). In patients who received Pancreaticoduodenectomy, Whipple's operation, the level of fibrinogen in the group with local invasiveness was significantly higher than in the group without invasiveness. The group with lymphatic metastasis had higher levels than the group without lymphatic metastasis (P < 0.05). There was no significant difference of intraoperative blood loss between patients with vitamin K, (748.27 +/- 448.51) ml, and those without vitamin K, (767.31 +/- 547.89) ml (P > 0.05).

CONCLUSIONSThe level of fibrinogen in patients with pancreatic carcinoma was elevated. The elevated fibrinogen level may be associated with invasiveness and lymphatic metastasis. Using vitamin K in perioperation management did not reduce intraoperative blood loss.

Adult ; Aged ; Aged, 80 and over ; Blood Coagulation ; physiology ; Cholelithiasis ; drug therapy ; metabolism ; surgery ; Female ; Fibrinogen ; metabolism ; Humans ; Jaundice ; metabolism ; physiopathology ; Lymphatic Metastasis ; physiopathology ; Male ; Middle Aged ; Pancreatic Neoplasms ; drug therapy ; metabolism ; physiopathology ; surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Vitamin K ; therapeutic use ; Young Adult

OBJECTIVETo investigate the efficacy and safety of fast-track surgery(FTS) in patients with colorectal cancer.

METHODSOne hundred and sixteen patients with colorectal cancer underwent colorectal operation between June 2006 and May 2008. FTS procedures were used in these patients during the study period. Data were retrospectively analyzed pertaining to post-operative hospital stay and operative complications.

RESULTSThe median postoperative hospital stay was (5.6+/-5.4)(range 1-54) d. Fourteen patients(12.1%) had postoperative complications, in which the rate of anastomotic leakage and wound infection was 1.7% and 2.6% respectively. 30-day readmission rate was 1.7%, and the 30-day mortality was 0.9%.

CONCLUSIONFast-track surgery is feasible in an unselected patient population undergoing elective colorectal cancer resection without compromising surgical outcomes.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; rehabilitation ; surgery ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Postoperative Care ; methods ; Retrospective Studies

OBJECTIVEHematologic relapse remains the greatest obstacle to the cure of acute lymphoblastic leukemia (ALL), especially T-lineage acute lymphoblastic leukemia (T-ALL) in children. Recent studies have shown that patients with increased risk of relapse can be identified by measuring residual leukemic cells, called minimal residual disease (MRD), during clinical remission. Current polymerase chain reaction (PCR) methods, however, for measuring MRD are cumbersome and time-consuming. To improve and simplify MRD assessment, the author developed a real-time quantitative PCR (RQ-PCR) assay for the detection of leukemic cells that harbor the tal-1 deletion. In addition, the author discussed the significance of MRD levels at different stages in treatment and prognosis of children with T-ALL.

METHODSA total of 50 consecutively enrolled patients with T-ALL were analysed for detection of leukemic cells harboring the most common tal-1 deletion. Serial dilutions of leukemic DNA were studied to find the sensitivity of detection with RQ-PCR assay. The MRD of 28 samples in clinical remission from 10 patients were quantified by RQ-PCR assay and limiting dilution assay. The results detected by both methods were compared statistically with correlation analysis.

RESULTS(1) A total of 10 patients presented tal-1 deletion involving the sildb1 breakpoint rearranged to tal1db1 in 50 cases with T-ALL. The breakpoints of relapsed samples are the same as those of the corresponding diagnostic samples; (2) The RQ-PCR assay had a sensitivity of detection of one leukemic cell among 100,000 normal cells. In 24 samples, MRD levels > 10(-5) could be detected with both methods. The percentages of leukemic cells measured by the two methods correlated well (r = 0.898, P < 0.001); (3) The MRD levels of 3 patients out of the 8 cases undergoing disciplinary regimen were over 10(-4) at the end of induction chemotherapy. They all relapsed in bone marrow during chemotherapy. The higher the MRD levels, the earlier the relapse. The other 5 patients with MRD levels < 10(-4) had been relapse-free survival (RFS) for 4-59 months, one of whom with increased MRD levels > 10(-4) for twice at the continuation stage had been RFS for 27 months till now.

CONCLUSIONSThe sildb1-taldb1 deletion presents in 20% of T-ALL, and is an ideal PCR marker for its specificity, uniform and stability; The tal-1 RQ-PCR can be used for the rapidly, sensitively and accurately quantitative assessment of MRD in T-ALL with the tal-1 deletion. MRD levels at different stages of chemotherapy have different significance in prognosis and treatment.

Adolescent ; Base Sequence ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Child ; Child, Preschool ; Female ; Gene Deletion ; Humans ; Male ; Molecular Sequence Data ; Neoplasm, Residual ; diagnosis ; Polymerase Chain Reaction ; methods ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; mortality ; Prognosis ; Proto-Oncogene Proteins ; genetics ; T-Cell Acute Lymphocytic Leukemia Protein 1