AIM: To know the psychological conditions of various cataract patients in pre- and post-operative periods.METHODS: From June 2008 to June 2009, 278 cataract patients had been asked to complete a questionnaire anonymously of their self-evaluation of symptoms scale (SCL) before and after operation. In their pre-operative and post-operative surveys, the results were compared with the norms respectively. Patients were divided into two groups. Group A were age-related cataract patients; while Group B were cataract patients with glaucoma, trauma or metabolic disease.RESULTS: When cataract patients' masculine scores of somatization, depression, anxiety and fear factors before and after the operation rank higher than the norms, the differences had statistical significance(P＜0.05), especially the somatization factor(P＜0.01).While cataract patients with diseases such as glaucoma, trauma or diabetes got higher marks than age-related cataract patients in the aspects of anxiety, somatization, depression (P<0.05), and fear factors, the differences were of statistical significance(P<0.01).CONCLUSION: Cataract patients both in pre- and post- and operative periods have somatization behaviors and emotions of depression, anxiety and fear. Cataract patients with glaucoma, trauma or diabetes especially anxiety have more obvious symptoms than age-related cataract patients.

Objective To determine the characteristic features of solitary necrotic nodule(SNN)of the liver on precontrast and dynamic contrast enhanced magnetic resonance(MR)imaging.Methods We retrospectively reviewed 15 patients with histopathologically proved SNN.All of the images were evaluated for lesion features including the number,shape,size,location,border,signal intensity and pattern of enhancement.Results Sixteen lesions were found in 15 patients.Nonenhaneed T1-and T2 weighted images depicted 15 lesions in 14 patients and 14 lesions in 13 patients respectively.Maximum diameter of 14 lesions was less than 3 cm.On unenhanced T1-weighted images,5 lesions were hypointense,9 lesions were slishtly hypointense,and 1 was isointense with hypointense capsule and central punctate hypointense foci.Among14 lesions demonstrated on T2-weighted images,5 were hyperintense,4 were slightly hyperintense,3 were slightly hypointense,and 2 were hypointense.Punctate or linear high signal intensities were found in2 lesions.All lesions were not enhanced after contrast injection.On portal venous and delayed phase.all lesions appeared significantly hypointense with well-defined border.The shape was irregular in 12 lesions and was round or oval in 4 lesions.No enhancement was found in the lesion except thin delayed enhancement in capsules of 3 lesions after contrast agent administration.Conclusion Characteristic MRI features of SNN are helpful for distinguishing SNN from other hepatic lesions.

Objective:To investigate the predictive value of tumor regression rate after induction chemotherapy for survival of patients with locally advanced nasopharyngeal carcinoma.Methods:A total of 161 patients with stage Ⅲ-ⅣA nasopharyngeal carcinoma newly diagnosed at the Daping Hospital of Army Medical University from January 2009 to December 2012 were selected as the research subjects. The relationships between tumor size changes before and after induction chemotherapy and survival time were analyzed. Kaplan-Meier method was used to draw the survival curve accompanied with log-rank test. Cox regression analysis was used to analyze the risk factors affecting the prognosis of patients with nasopharyngeal carcinoma.Results:There were statistically significant differences in the tumor regression rate of primary lesions between N 1and N 2-3( Z=2.177, P=0.029), T 1-2and T 3-4( Z=-4.501, P<0.001)patients after induction chemotherapy. In N 1stage patients, the 5-year overall survival (OS) rates of patients with primary lesions achieving objective response ( n=18) and those without objective response ( n=19) after induction chemotherapy were 88.89% and 57.45%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=19) and those without objective response ( n=18) were 86.72% and 49.10% respectively, with statistically significant differences ( χ2=6.023, P=0.014; χ2=7.441, P=0.006). In N 2-3stage patients, the 5-year OS rates of patients with primary lesions achieving objective response ( n=81) and those without objective response ( n=43) after induction chemotherapy were 77.56% and 50.70%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=85) and those without objective response ( n=39) were 75.11% and 52.04% respectively, with significant differences ( χ2=8.037, P=0.005; χ2=7.268, P=0.007). Univariate Cox regression analysis showed that in patients with stage N 1, the tumor regression rate of primary lesions ( HR=0.048, 95% CI: 0.004-0.644, P=0.022), the efficacy of primary lesions ( HR=0.174, 95% CI: 0.037-0.830, P=0.028), the efficacy of cervical lymph node metastatic lesions ( HR=0.154, 95% CI: 0.033-0.725, P=0.017) after induction chemotherapy were significantly associated with OS; in N 2-3stage patients, the tumor regression rate of primary lesions ( HR=0.178, 95% CI: 0.056-0.564, P=0.003), the tumor regression rate of cervical lymph node metastatic lesions ( HR=0.081, 95% CI: 0.020-0.324, P<0.001), the efficacy of primary lesions ( HR=0.422, 95% CI: 0.228-0.781, P=0.006), the efficacy of cervical lymph node metastatic lesions ( HR=0.439, 95% CI: 0.238-0.813, P=0.009) after induction chemotherapy were significantly associated with OS. In multivariate Cox regression including N stage and tumor regression rate, N stage and efficacy, the interaction items were not statistically significant (all P>0.05). In T 1-2stage patients, the 5-year OS rates of patients with primary lesions achieving objective response ( n=45) and those without objective response ( n=13) after induction chemotherapy were 77.55% and 84.62%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=43) and those without objective response ( n=15) were 78.89% and 80.00% respectively, with no significant differences ( χ2=0.239, P=0.625; χ2=0.005, P=0.943); in T 3-4stage patients, the 5-year OS rates of patients with primary lesions achieving objective response ( n=54) and those without objective response ( n=49) after induction chemotherapy were 78.90% and 45.00%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=61) and those without objective response ( n=42) were 75.10% and 42.89% respectively, with significant differences ( χ2=13.615, P<0.001; χ2=12.752, P<0.001). Univariate Cox regression analysis showed that in patients with stage T 1-2, the tumor regression rate, the efficacy of primary lesions and cervical lymph node metastatic lesions after induction chemotherapy were not related to OS (all P>0.05); in T 3-4stage patients, the tumor regression rate of primary lesions ( HR=0.121, 95% CI: 0.033-0.444, P=0.001), the tumor regression rate of cervical lymph node metastatic lesions ( HR=0.126, 95% CI: 0.036-0.442, P=0.001), the efficacy of primary lesions ( HR=0.297, 95% CI: 0.150-0.588, P<0.001), the efficacy of cervical lymph node metastatic lesions ( HR=0.329, 95% CI: 0.173-0.625, P=0.001) after induction chemotherapy were significantly associated with OS. Multivariate Cox regression analysis showed that the interaction test of T stage and the efficacy of primary lesion trended to be statistically significant ( P=0.062). Conclusion:In patients with stage Ⅲ-ⅣA nasopharyngeal carcinoma, the responsiveness to induction chemotherapy in stage T 3-4patients has important value in predicting survival prognosis.

Objective To investigate the development of absorption atelectasis in healthy adult volunteers breathing 100% oxygen.Methods Six healthy volunteers aged 31-36 yrs weighing 60-80 kg were recruited into this study.Chest computed tomograph(CT)of the layer of interventricular septum was performed at the end of normal expiration(FRC)at 6 time points:(1)the baseline(T_1);(2)after 5 min maximal expiration(close to residual volume)(T_2);(3)immediately after 10 maximal inspiration and expiration(T_3);(4)after breathing 100% O_2 through face mask at tidal volume for 30 min(T_4);(5)after breathing 100% O_2 at maximal expiration for 5 min(T_5)and(6)breathing room air deeply 10 times(T_6).The area of atelectasis and poorly ventilated lung were expressed as percentage of the total lungs.Results There was no atelectasis or poorly ventilated lung at T_1. At T_2 the poorly ventilated lung accounted for 22.9%?5.0%,but there was no atelectasis.There was no atelectasis and poorly ventilated lung at T_3 and T_4.At T_5 atelectasis accounted for 4.5%?1.1% which was reduced to 0.9%?0.4% at T_6.Conclusion Breathing 100% oxygen at reduced lung volume can result in atelectasis.

OBJECTIVETo investigate the value of computer aided navigation system (CANS) in the treatment of post traumatic maxillofacial deformation.

METHODSFifty-four patients (M = 37, F = 17) were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48 - 72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices.

RESULTSAll the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was 0.2 - 3.5 mm, 0.8 - 2.0 mm and 0.2 - 2.2 mm respectively.

CONCLUSIONSComputer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.

Adult ; Computer Simulation ; Computer-Aided Design ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Orbital Fractures ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Tooth Ankylosis ; diagnostic imaging ; surgery ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery

AIMTo investigate the chemical constituents of tetraploidy Banlangen (Isatis indigotica Fort.).

METHODSCompounds were separated by chromatography on silica gel. Their structures were determined by spectral analysis and chemical evidence.

RESULTSThree compounds were isolated. Their structures were identified as (E)-2-[(3'-indole) cyanomethylene]-3-indolinone (I), 2-(4-hydroxy-3-methoxyphenyl)-4-[(4-hydroxy-3-methoxy-phenyl)-methyl]-3- hydroxymethyl-tetrahydro-furan (II) and 2-methoxy-4-[tetrahydro-4-[(4-hydroxy-3-methoxy-phenyl)-methyl]-3- hydroxymethyl-2-furanyl] phenyl-1-O-beta-D-glucopyranoside (III).

CONCLUSIONCompound I is a new compound.

Indoles ; chemistry ; Isatis ; chemistry ; genetics ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; genetics ; Polyploidy

Animals ; Brain Tissue Transplantation ; Cells, Cultured ; Immunohistochemistry ; Parkinson Disease ; therapy ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; transplantation ; Stem Cell Transplantation ; Tyrosine 3-Monooxygenase ; analysis

OBJECTIVETo study the influence of separation of distal tibiofibular syndesmosis on ankle joint and to compare various operative methods so as to find suitable stabilization for separated distal tibiofibular syndesmosis.

METHODSFrom July 1997 to July 2002, we treated 87 patients (64 males and 23 females, aged 18-54 years) with separation of distal tibiofibular syndesmosis, among whom, 79 were combined with fracture of malleolus. Manipulative reduction, internal fixation with cancellous screws and external fixation with plaster support were performed on 37 patients, fixation with plate and screws for fibular fracture and fixation with cancellous screws for distal tibiofibular syndesmosis on 34 patients, and repair of the distal tibiofibular ligaments with tendon of peroneus longus, reduction of the separated distal tibiofibular syndesmosis, and fixation with cancellous screws on 16 patients. The ankle joint had been dorsiflexed for 30 degrees when the distal tibiofibular syndesmosis was fixed with cancellous screws. And the cancellous screws were taken out at 8-10 weeks after operation.

RESULTSThese patients were followed up for at least two years. The curative effects were assessed according to the complaints of the patients and the contour, function and radiogram of the ankle joint: excellent in 55 patients (63%), good in 18 patients (21%), and fair in 14 patients (16%). Separation of distal tibiofibular syndesmosis recurred in 2 patients, who underwent a reoperation for repairing the distal tibiofibular ligaments with tendon of peroneus longus and recovered. One cancellous screw was broken off. No necrosis developed in the anterior skin of the ankle mortise.

CONCLUSIONSSeparation of distal tibiofibular syndesmosis can be treated with various reasonable operations. Repair with tendon of the peroneus longus can get excellent outcomes for complete separation of the distal tibiofibular syndesmosis.

Adolescent ; Adult ; Ankle Injuries ; diagnostic imaging ; physiopathology ; surgery ; Bone Screws ; Casts, Surgical ; Female ; Fibula ; injuries ; physiopathology ; Follow-Up Studies ; Humans ; Ligaments, Articular ; injuries ; physiopathology ; Male ; Middle Aged ; Radiography ; Tibia ; injuries ; physiopathology ; Treatment Outcome

Objective To discuss the molecular mechanism of 18F-fluorodeoxyglucose (FDG) uptake in tumor and to assess its value to identify pathologic type and cancer staging in patients with earlystage nasopharyngeal carcinoma.Methods Forty patients with nasopharyngeal carcinoma of early-stage,including 12 cases with T1 stage and 28 cases with T2 stage, underwent FDG PET imaging.The maximum standardized uptake value ( SUVmax ) and mean standardized uptake value ( SUVmean ) of FDG uptake of each patient were measured and compared between T1 and T2 stage by t-test.The expression of glucose transport protein 1 ( Glut1 ) and hexokinase- Ⅱ ( HK- Ⅱ ) of each case was measured in paraffin sections by streptavidin-perosidase (SP) immunohistochemistry.The positive expression rate of Glut1 and HK- Ⅱ was calculated and compared between T1 and T2 by x2 test.Meanwhile, the correlation between the expression of Glut1 or HK-Ⅱ and the SUVmax was tested by Pearson analysis.Results The SUVmax and SUVmean in 40 patients were 9.45 ± 1.87 and 6.04 ± 1.09, respectively.The SUVmax of patients with T1 stage (8.95 ± 1.91 ) was significantly lower (t =4.46, P＜0.001 ) than that of patients with T2 stage (11.55 ± 1.70), and the SUVmean of patients with T1 stage (5.61 ± 1.08) was significantly lower ( t = 6.76, P ＜ 0.001 ) than that of patients with T2 stage (7.98 ± 1.10) too.Among 40 patients, all patients showed positive expression of Glut1 and HK-Ⅱ , and the positive expression rate of Glut1 and HK-Ⅱ was ( 45.2 ± 10.9 )% and ( 68.3 ±9.5)%, respectively.The positive expression rate of Glut1 was (38.4 ±8.1)% in T1 stage and (49.7 ±12.6)% in T2 stage, which displayed no difference (x2 =40.58, P＞0.05), but the HK-Ⅱ positive expression rate showed significant difference (x2 =58.71, P＜0.05) between T1 stage (60.1 ±11.1)% and T2 stage (77.9 ± 14.7 )%.The correlation analysis indicated that there was low-degree positive correlation (r =0.369, P=0.019) between the SUVmax and Glut1 expression, and there was medium-degree positive correlation (r = 0.549, P = 0.001 ) between the SUVmax and HK-Ⅱ expression.Conclusion Expression of Glut1 and HK-Ⅱ was positively correlated with FDG uptake in patients with early-stage nasopharyngeal carcinoma.

The dhaD gene encoding glycerol dehydrogenase(GDH) from Klebsiella sp.was amplified,and was inserted into expression vector pET-28a(+),the plasmid pET-28a-dhaD was constructed and was transformed into Escherichia coli BL21(DE3).SDS-PAGE showed that the gene dhaD was expressed successfully in recombinant E.coli BL21.Then GDH was purified by Ni-NTA affinity chromatography,the results showed a single band about 39kDa on SDS-PAGE gel,and the specified activity was about 156U/mg.The special activity of GDH is 4.6-fold higher than that of unpurified and the activity recovery is 67.4%.The optimum reaction pH was 11.0,and the GDH activity have little changed when incubated in the buffer of pH7.0～11.0.The optimum reactive temperature was 30℃,and the GDH was more stable on the temperature of 25℃～45℃.The Km value was 0.54mmol/L and Vmax was 0.49 ?mol/ml?min in the glycerol.