ObjectiveTo investigate the effects of dexmedetomidine on postoperative cognitive dysfunction (POCD) in the elderly patients undergoing laparoscopic radical trachelectomy.MethodsSixty ASA Ⅰ or Ⅱ patients (aged 65-80 yr and weighing 55-74 kg) undergoing elective laparoscopic radical trachelectomy were randomly divided into two groups:30 patients received intravenous injection of dexmedetomidine 0.2 μg · kg - 1 ·h- 1 ( group D EX) and 30 received same volume of normal saline (control group,group NS) after induction of anesthesia.Cognitive function was assessed at 1 day before operation and on the 7th day after operation using a battery of nine cognitive dysfunction tests.ResultsCompared with group NS,on the 7th postoperative day,the incidence of POCD was decreased in group DEX ( P ＜ 0.05 ).ConclusionDexmedetomidine can improve POCD in the elderly patients undergoing laparoscopic radicaltrachelectomy.

Objective This study is to identify the presence of superoxide anion-generating system in human lens epithelial cells using arachidonic acid (AA) as the stimulator.Design Experimental study.Participants Human lens epithelial cells B3 (HLE B3). Methods Confluent human lens epithelial cells (HLE B3) were subjected to stimulation by AA and its derivatives.The generation of su- peroxide anion was quantified with a luminometer (LumiStar BMG) immediately upon AA and its derivatives addition.Cells preloaded with superoxide dismutase (SOD) or mannitol were used as negative controls and cells mixed with 3% ethanol (solvent for AA) were used as baseline.Cells were preloaded with inhibitors 30 minutes before luminometer measurement.A time-and concentration-depen- dent study on the AA-stimulated activation of mitogen-activated protein kinase (MAPK) was carried out using western blot analysis. Main Outcome Measures Superoxide generation,phosphorylation of MAPK.Results AA at dosage of 30-150 mM proportionally in- duced luminescence in HLE B3 cells,but was ineffective in cells preloaded with SOD or mannitol.DPI,a non-specific NADPH oxidase inhibitor eliminated AA-induced superoxide anion generation partially.Leinoleic acid,stearic acid,eicosa-11Z,14Z,17Z-trienoic acid (20:3) and eicosa-11Z,14Z-dienoic acid (20:2) were ineffective.The generation of superoxide anion was not contributed by cyclooxyge- nase or the cytochrome p450 pathway since indomethacin (inhibitor for cyclooxygenase) or ketoconazole (inhibitor for cytochrome p450) could not eradicate the stimulatory effect of AA.While CDC,a specific inhibitor for lipoxygenase could eliminate superoxide generation partially.The specific inhibitor for 5-lipoxygenase AA861 completely blocked the generation of superoxide anion.Western blot analysis of the cell lysate showed that AA at the concentrations of 30-150 mM progressively activated ERK and JNK.They were transiently ac- tivated between 2.5-30 minutes.The activations of ERK and JNK were dose-dependent and time-dependent.Conclusions Inhibition of superioxide anion generation may be a new approach to block lens epithelial cell proliferation and post-capsule opacification.

Objective:To improve the diagnostic accuracy of double contrast radiography of small and micro gastric carcinoma.Methods:The X-ray findings of small gastric carcinoma(9 cases)and micro-gastric carcinoma(3 cases) proved by surgical pathology were analyzed and compared with pathologic finding.1 misdiagnosed cases and 1 missed cases were analyzed.The double contrast films of acute gastric ulcer were reviewed and differentiated with SGC and MGC.Results:8 cases were examined by the double contrast procedure before gastroscopy,4 were diagnosed small gastric carcinoma,1 was diagnosed micro-gastric carcinoma,1 was misdiagnosed ulcer and 1 was missed,1 was suspected of being carcinoma.4 were examined by the double contrast procedure after gastroscopy,2 were small gastric carcinoma and 1 was micro-gastric carcinoma,which accorded with gastroscopy finding.One of micro-gastric carcinoma missed by gastroscopy was detected by DC.Conclusion:The imaging method of double contrast examination is the most effective one in detecting and diagnosing early gastric cancer.The detecting rate should be obviously increased by combining with gastroscopy closely. [

Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 93 cases of acute cholecystitis treated by LC from May 2003 to May 2005 was retrospectively reviewed, including 15 cases of preoperative endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) for common bile duct stones and 6 cases of intraoperative cholangiography. The LC was performed within 48 hours after admission. Results The LC was successfully completed in 91 cases (97.8%), whereas a conversion to open surgery was required in 2 cases (2.2%). The operation time was 35~160 min (mean, 65 min). Postoperatively, biliary leakage occurred in 3 cases (3.2%) and residual stones in the common bile duct were found in 3 cases (3.2%), which were all cured by open surgery combined with ERCP, EST, and endoscopic nasobiliary drainage (ENBD). No iatrogenic injuries happened. Conclusions With proper selection of ERCP and EST, LC for the treatment of acute cholecystitis is feasible and safe. But the incidence of conversions and complications may be high.

AIM:To observe the changes of tear film on the patients after laser in situ keratomileusis ( LASIK) with corneal flap created by femtosecond laser with Oculus corneal topography.
METHODS:Totally 120 myopic patients (240 eyes) were collected who underwent femtosecond laser surgery LASIK from August to September 2013, and these patients can be followed up for 3mo. Tear break-up time ( BUT) and tear meniscus height ( TMH ) with Oculus corneal topography were recorded preoperatively and postoperatively at 1wk;1, 2 and 3mo.
RESULTS: Oculus BUT: there existed obvious differences (P=0. 012, 0. 000, 0. 023<0. 05) in 1wk, 1 and 2mo compared with the preoperative level. While no such obvious difference ( P = 0. 236 > 0. 05 ) existed in 3mo compared with the preoperative level. TMH:there existed obvious differences (P=0. 025, 0. 019, 0. 026<0. 05) in 1wk, 1 and 2mo compared with the preoperative level. No such obvious difference ( P = 0. 375>0. 05 ) existed in 3mo compared with the preoperative level.
CONCLUSION: Femtosecond laser surgery affects the stability of the tear film at a certain time and a certain extent. The mechanism related to many factors. It is temporary and lighted.

AIM: To observe the changes of tear film on the patients after laser in situ keratomileusis ( LASIK ) with corneal flap created by femtosecond laser with the different gender.
METHODS: The 120 myopic patients ( 240 eyes ) who underwent femtosecond laser surgery LASIK from August to September 2013 were collected, and these patients were followed up for 3mo. The patients were divided into two groups according to the gender, group A was male (110 eyes of 55 patients); group B was female (130 eyes of 65 patients). Dry eye symptom score, tear break-up time ( BUT ) , Schirmer Ⅰ test, corneal fluorescein staining were recorded preoperatively and postoperatively in 1wk,1,2,3mo.
RESULTS: Dry eye symptom score: it was statistically significant between two groups after operation in the 1wk, 1, 2mo(P = 0. 000,0. 023, 0. 030). It had no statistical significance between the two groups in 3mo(P=0. 283). BUT: it was statistical significance between two groups after operation in the 1wk, 1, 2, 3mo ( P= 0. 000, 0. 017, 0.026, 0. 032 ). Schirmer Ⅰ test: it was statistically significant between two groups after operation in the 1wk, 1, 2mo(P = 0. 012,0. 024, 0. 018). It had no statistical significance between the two groups in 3mo ( P=0. 206 ) Corneal fluorescein staining:it was statistically significant between two groups after operation in the 1wk, 1, 2, 3mo (P=0. 022,0. 015, 0. 036, 0.041).
CONCLUSION: The influence of tear film after femtosecond laser surgery for men less than that for women.

To observe the changes of tear film on the patients after laser in situ keratomileusis(LASlK)with corneal flap created by femtosecond laser and microkeratome.
●METHODS: Totally 150 patients (300 eyes) with myopia received operation of LASlK. Patients were divided into two groups according to the methods of making corneal flap. The patients of group one were assigned to receiving LASlK with corneal flap creation by lntralase femtosecond laser (190 eyes of 95 patients), group two were assigned to receiving LASlK with corneal flap creation by microkeratome ( 110 eyes of 55 patients ). Dry eye symptom score, tear break-up time (BUT), Schirmer Ⅰtest(Slt), corneal fluorescein staining(FL)were recorded preoperatively and postoperatively at 1wk; 1, 3 and 6mo.
●RESULTS: Dry eye symptom score: there existed obvious differences at 1wk; 1, 3mo between two groups(P<0. 05). While no such obvious differences existed in the 6mo between two groups(P>0. 05). BUT: there existed obvious differences at 1wk, 1, 3mo between two groups(P<0. 05). While no such obvious differences existed at 6mo between two groups(P>0. 05). SchirmerⅠ test: there existed obvious differences in the 1wk, 1, 3mo between two groups(P<0. 05). Whileno such obvious differences existed in the 6mo between 2 groups(P>0. 05). FL: there existed obvious differences in the 1wk, 1, 3mo between two groups(P<0. 05). While no such obvious differences existed in the 6mo between two groups(P>0. 05).
●CONCLUSlON: The early stability of tear film decrease after operation in both of the two groups. The dry eye symptoms are lighter and recover faster.

To observe the effects of Feiyanning Decoction, a compound traditional Chinese herbal medicine, in inhibiting the growth of transplanted A549 tumors in nude mice and the expressions of p-Akt and HIF-1alpha in A549 tumors.

Objective: To analyze the prevalence of reduced visual acuity (VA) and to examine the association between reduced visual acuity and influencing factors among Chinese Han students, so as to provide bases for the prevention and treatment of reduced visual acuity.Methods: Subjects were from 2014 Chinese National Surveys on Students' Constitution and Health (CNSSCH).In this survey, 261 832 Han students aged 7-22 years participated.Unaided distance VA was measured using a retro-illuminated lgMAR chart with tumbling-E optotypes.Ametropia was determined by using serial bronchoscopy.Logistic regression was used to assess the association between reduced visual acuity and influencing factors.ArcMap 10 was used to map the regional distribution of reduced visual acuity.Results: Nationwide, the overall prevalence of reduced visual acuity was 66.6%, and was highest among the urban girls (73.5%).The prevalence of myopia was 60.8% and accounted for more than 90% among the students with reduced visual acuity.Compared with 2010 CNSSCH, the increments of reduced visual acuity were highest in the students aged 13-15 years (6.8 percentage points).The prevalence of reduced visual acuity ranged from 50.6% to 76.2% in each province (autonomous region, municipality) in 2014 CNSSCH.The top three of the prevalence of reduced visual acuity were Jiangsu (76.2%), Zhejiang (76.0%) and Shandong (75.9%), and the lowest three were Hainan (50.6%), Guizhou (53.9%) and Xinjiang (57.6%).Logistic regression showed that the girls, urban students, and students who spent ≥2 h per day in their after school homework were more likely to develop reduced visual acuity, but the students with physical activity time ≥2 h per day were less likely to develop reduced visual acuity.Conclusion: Although the situation was different in each province (autonomous region, municipality), reduced visual acuity has become a public concern affecting the health of students in China.Based on the intervention on the key populations, such as urban girls and pre adolescent students, we should also continue to strengthen the prevention and control for reduced visual acuity among all students.

Background Congenital cataract is a major cause for blindness of childhood.Genetic gene mutation accounts for almost 1/3 of congenital cataract patients.The most common inheritance type is autosomal dominant congenital cataract (ADCC).Over 100 mutations in 26 genes have been found to be associated with ADCC.Objective This study was to identify the disease-causing gene mutation in a family with ADCC.Methods This study was approved by Ethic Committee of Beijing Tongren Hospital and followed Declaration of Helsinki.A northern Chinese family with autosomal dominant congenital nuclear cataract was entrolled in Beijing Tongren Hospital in January 2011.Ocular examinations were performed and periphery blood specimens were collected from each family member under the informed consent.Genomic DNA was extracted.Twenty-one microsatellite markers around 17 ADCC genes were selected for linkage analysis,and two-point LOD score was calculated.CRYGC gene and CRYGD gene were amplified and screened for mutations using direct sequencing.ProtScale software was used to analyze the changes of hydrophobicity of the mutated protein.Co-segregation of the observed change with the disease phenotype was further detected by restriction fragment length polymorphism (RFLP).Results This family included 20 members of 4 generations,and 9 patients were examined in serial 4 passages,which conformed to autosomal dominant inheritance pattern.Clinical examination revealed binocular congenital nuclear cataract in the 9 patients.Maximum two-point LOD score was 4.68 at marker D2S325 (θ=0).A known T→C change at position 127 of cDNA sequence was found by mutations screening of CRYGD gene.ProtScale programs showed an obvious increase of the local hydrophobicity in the mutant protein.RFLP results indicated that this missense mutation co-segregated with affected members of the family,but was absent in unaffected members and 100 unrelated controls.Conclusions c.T127C mutation of CRYGD gene appears to be the molecular pathogenesis of this ADCC family.Aberrant structure of mutant CRYGD protein caused by hydrophobicity change may lead to opacification of lens.