AIM:To observe the application efficiency of 5g/L indocyanine green ( ICG ) staining technique for continuous circular capsulorhexis ( CCC ) during phacoemulsification in white cataract.
METHODS:Ninety-eight patients (98 eyes) with white cataract were randomly divided into staining group ( 50 cases, 50 eyes) and control group (48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps.
RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant (P<0. 05). During follow-up, no dye particle and the complications of iritis or high intraocular pressure were found in the eyes of staining group. Anterior chamber inflammation, corneal opacity compared with control group, the difference was not statistically significant.
CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.

BACKGROUNDHelical tomotherapy (HT) is a new image-guided intensity-modulated radiation therapy (IMRT) technique. It is reported that HT plan for non-small-cell lung cancer (NSCLC) can give better dose uniformity, dose gradients, and protection for the lung than IMRT plan. We compared the dosimetric characteristics of HT for NSCLC with those of conventional IMRT to observe the superiority of HT.

METHODSThere was a comparative case series comprising 10 patients with NSCLC. Computed tomographic (CT) images of delineated targets were transferred to the PrecisePlan planning system (IMRT) and Tomo planning system (HT). The prescription doses were 70 Gy/33F for the gross tumor volume (GTV) and the visible lymph nodes (GTVnd), and 60 Gy/33F for the clinical target volume (CTV) and the clinical target volume of the visible lymph nodes (CTVnd). The dose restrictions for organs at risk were as follows: the maximum dose to spinal cord ≤ 45 Gy, V20 to the total lungs < 30%, V50 to the heart < 50%, and V55 to the esophagus < 50%. Both plans were evaluated by means of the dose coverage of the targets, dose-volume histograms (DVHs), and other dosimetric indices.

RESULTSThe dose coverage, conformity, and homogeneity of the targets' volumes were found to be satisfactory in both plans, but the homogeneity of the HT plan was better than that of IMRT. The high-dose radiation volume (V20-V30) to the lung and the mean lung dose (MLD) decreased (P < 0.05), but the low-dose radiation volume (V5-V10) increased slightly in the HT plan (P > 0.05). The maximum doses to the spinal cord, heart, esophagus and trachea in the HT plan were lower than those in the IMRT plan, but the differences were not statistically significant.

CONCLUSIONSThe HT plan provids better dose uniformity, dose gradients, and protection for the organs at risk. It can reduce the high-dose radiation volume for lung and the MLD, but may deliver a larger lung volume of low-dose radiation.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; radiotherapy ; Humans ; Male ; Middle Aged ; Radiography ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Treatment Outcome

Background Prevention and treatment of posterior capsular opacification (PCO) is a hot issue.To establish a PCO animal model is the basis of relevant studies.The most common methods of creating a PCO model are phacoemulsification surgery with or without intraocular lens (IOL) implantation.But the suitability of different methods is unclear.Objective This experiment was to compare the outcome between the two methods of establishing a PCO model in rabbit eyes.Methods Twenty New Zealand white rabbits were collected and randomized into 2 groups.Phacoemulsification of cataract with IOL or without IOL implantation was performed on the right eyes of rabbits in these two groups.The operative eyes were examined under the slit lamp from day 1 through 3 months after surgery.The inflammatory response was evaluated and compared between the two groups,and the extent of PCO was graded based on Odrich's criteria.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The inflammatory response,including conjunctival congestion,corneal edema and aqueous flare were less severe in the model eyes with IOL implantation than the eyes without IOL implantation 1-3 days after operation.Inflammatory response gradually disappeared and showed the same degree in the PCO grade from 2 weeks through 3 months in both groups.The numbers of eyes with 1-3 grade of PCO were 8 and 9,and those with 0 grade of PCO were 2 and 1 in the with IOL implantation group and without IOL implantation group,respectively,showing a significant difference (P=0.39).PCO appeared at 1 month,extended at 2 months and formed dense fibrosis following operation.Conclusions The model outcome of phacoemulsification combined with IOL implantation is better than without IOL implantation one.It is the ideal animal model for the study of after cataract.

?AlM: To compare the clinical effect between small-incision cataract surgery and phacoemulsification.
?METHODS: Totally 93 patients ( 124 eyes ) with age-related cataract who received treatment in Mar 2010 and Feb 2013 were dicided into 2 groups randomly. Forty-two patients ( 59 eyes ) in group small - incision cataract surgery ( SlCS ) were treated by SlCS, while other 51 patients ( 65 eyes ) in group Phaco were treated by phacoemulsification. And then, postoperative visual acuity, corneal astigmatism, surgically induced astigmatism ( SlA ) and intraoperative and postoperative complications were contrasted between groups.
?RESULTS: After 1d and 1wk of postoperation, there were 38 eyes ( 64. 4%) and 41 eyes ( 69. 5%) having a better visual acuity of 0. 5 in the SlCS group, while there were 29 eyes (44. 6%) and 32 eyes (49. 2%) in the Phaco group. The vision of SlCS group was better than that of Phcao group (χ2 = 4. 877, 5. 242, P < 0. 05 ). On postoperative 1 and 3mo, with acuity of 0. 5 or better, eye numbers showed no statistically significant differences between two groups (χ2 = 0. 005, 0. 085, P>0. 05). The average corneal astigmatism used analysis of repeatedly measuring designing variance: Comparing the corneal astigmatism in intra - groups at different times, it was statistically significant (F=25. 624, P<0. 05), and had a tendency to decrease with time. However, there was no statistical significance for corneal astigmatism between groups (F=0. 986, P>0. 05). The coneal astigmatism of each group was higher at 1wk after the surgery than that of preoperation, and the contrast had statistical sigenficence (t=2. 906, 2. 427, P<0. 05). The Phaco group with SlA was lower than the SlCS group at 1wk and 1mo after the surgery (t=-4. 628, 2. 770, P<005). lt had no statistical significance in SlA by comparing with the two groups at 3mo after the surgery (t=0. 754, P>0. 05). There were statistical differences in SlA at different time both by intra-group comparison and group comparison ( F=26. 37, P<0. 05, F = 14. 29, P<0. 05). The comparison of posterior capsule rupture, the postoperative corneal edema and anterior chamber pigment membrane reaction in two groups showed no statistical significance.
?CONCLUSlON: Our research shows that small-incision cataract surgery and phacoemulsification had similar effect in the treatment of cataract. Phacoemulsification is not the only surgery option for the best treatment effect. Small- incision cataract surgery can be popularized in basic- level hospitals, achieving the effect similar to phacoemulsification.

Objective To observe the presence of bacterial biofilms in mueosal specimens in patients operated for chronic rhinosinusitis.Methods A total of 12 subjects undergoing endoscopic sinus surgery were included.The control group was 6 patients with obstructive sleep apnea-hypopnea syndrome. Six patients with chronic rhinosinusitis were enrolled in the study group.Mucosa of uncinate process, ethmoid bulla or maxillary sinus was obtained during endoscopic sinus surgery.All the samples were prepared using standard methods for scanning electron microscopy.Patients' information such as age, gender, symptoms, sinus CT, endoscopic examination, skin prick test were recorded in detail.Results Standard-preparation scanning electron microscopy displaed denuded epithelium and disarrayed cilia in chronic rhinosinusitis patient's mucosa.In the study group, bacterial biofilms of different morphology were seen in five samples; One sample showed filamentous structure like fungi.Using strict scanning electron microscopy morphologic criteria, 83.3% samples in the study group were found to have micrographic evidence of biofilms.No bacterial biofilms were detected in the control group.Conclusions In the patients undergoing surgery for chronic rhinosinusitis, different degree of mucosal injury could be found.Bacteria biofilms of different life stages were demonstrated to be present No bacterial biofilms were detected in the control group.

OBJECTIVEA reversed superficial temporal artery auricular flap was presented to explore a new method for reconstructing the defects of the distal nose by microsurgical techniques.

METHODSA reversed superficial temporal artery auricular flap had been used on fifteen patients with nasal defects, including thirteen patients with alar defects and two patients with nasal tip defects. The reversed superficial temporal vessels of the flap were anastomosed with the recipient facial vessels. The size of the flap was 2.5 cm x 2. 0 cm - 4.0 cm x 2.5 cm, the length of the vascular pedicle was 5 - 8 cm, average 6.5 cm

RESULTSThe flap survived uneventfully in all fifteen patients.

RESULTSdemonstrated satisfactory symmetry between the reconstructed ala and the contralateral side as well as an excellent tip projection. The donor-site defect was minimal.

CONCLUSIONSThe reversed superficial temporal artery auricular flap offers an adequate length of vascular pedicle of the flap, it delivers a good solution to the problem of the vascular pedicle shortage of the proximal superficial artery auricular flap. This technique may become the top choice in the microvascular auricular transfer.

Adult ; Ear, External ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods ; Surgical Flaps ; blood supply ; Temporal Arteries ; surgery ; Tissue Transplantation ; Young Adult

OBJECTIVETo investigate the inhibitory effects of genistein on tyrosine protein kinase (TPK)-mitogen activated protein kinase (MAPK) signal transduction pathway in hypertrophic scar fibroblasts (HSFb), in order to explore the molecular mechanism of inhibition of scar hyperplasia by genistein.

METHODSHSFbs were isolated from human hypertrophic scar tissues and cultured in vitro. The cells were treated by genistein in different concentrations (25, 50, 100 micromol/L, respectively), followed by basic fibroblast growth factor (bFGF) stimulation. The activity of TPK was assessed with [gamma-32P] ATP substrate incorporation. The phosphorylation protein expression levels of main signal molecules in TPK-Ras-MAPK pathway including c-Raf, MEKl/2, extracellular signal regulated kinase (ERK), p38MAPK, c-Jun N-terminal kinase (JNK) were determined by Western blot. HSFbs treated with dimethylsulfoxide (DMSO) were used as control group.

RESULTSAfter being treated with genistein in concentration of 25, 50, 100 micromol/L, the activity of TPK in HSFbs was depressed significantly [(7.15 +/- 0.35) x 10(5), (5.62 +/- 0.88) x 10(5), (5.62 +/-0.88) x 10(5) 10(5) pmol x min(-1) x mg(-1), respectively] when compared with that in control group [(8.92 +/- 0.28) x 10(5) pmol x min(-1) x mg(-1), P < 0.05]. Compared with those in control group,the phosphorylation protein expression levels of c-Raf, MEK1/2, ERK1/2 and p38 MAPK were lowered in different degree (P < 0.05 or P < 0.01) after genistein treatment. The phospho-JNK levels after treatment with genistein were similar to that of control group. Under the condition of pretreatment with genistein, the activities of TPK and signal pathway protein expressions in HSFb showed a downward trend after stimulation with bFGF.

CONCLUSIONGenistein can effect the proliferation and activation of HSFb by inhibiting the phosphorylation of receptor of TPK signal transduction pathway (TPK --> Raf --> MEK --> ERK/p38).

Adolescent ; Adult ; Cell Proliferation ; Cells, Cultured ; Child ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Female ; Fibroblasts ; drug effects ; metabolism ; Genistein ; pharmacology ; Humans ; Male ; Mitogen-Activated Protein Kinases ; metabolism ; Phosphorylation ; Protein-Tyrosine Kinases ; metabolism ; Signal Transduction ; drug effects ; Young Adult

Metabonomics, as a newly developed technique, is expected to be a powerful technique in clinical diagnosis. Metabonomics-based diagnosis involves the global metabolic analysis of body-fluids, determination of biomarkers by multivariate statistic analysis, and establishemen of mathematic models for clinical diagnosis with the aid of pattern recognition. This article reviews the adoption of various analytical and computational strategies, application of metabonomics in clinical diagnosis, and potential challenges and development trends.
Biomarkers ; metabolism ; Body Fluids ; metabolism ; Diagnostic Techniques and Procedures ; Humans ; Metabolome ; Metabolomics ; methods ; Models, Theoretical ; Multivariate Analysis

BACKGROUNDToll like receptor (TLR) 9 has been shown to play a crucial role in the pathogenesis of systemic lupus erythematosus (SLE) in animal models. Its pathogenic role in human SLE, however, was poorly elucidated. This study was performed to investigate the role of TLR9 involved in the aberrant signaling pathway and its correlation with disease activity in SLE.

METHODSmRNA level of TLR9 and interferon (IFN) regulatory factor 5 (IRF5) in peripheral blood mononuclear cells (PBMCs) were determined by real-time polymerase chain reaction (PCR). IFN-a expression was measured in the serum of the SLE patients by enzyme-linked immunosorbent assay (ELISA).

RESULTSTLR9 expression was significantly higher in SLE patients than that in health controls (P = 0.011). SLE patients with positive anti-dsDNA antibody had significantly higher expression of TLR9 than that with negative anti-dsDNA antibody (P = 0.001). TLR9 expression was positively correlated with fever (P = 0.017), alopecia (P = 0.046), safety of estrogens in lupus erythematosus national assessment SLE disease activity index (SELENA-SLEDAI) score (r(s) = 0.385, P = 0.003), and the level of IRF5 (r(s) = 0.35, P = 0.027) and IFN-a (r(s) = 0.627, P = 0.001) in SLE patients.

CONCLUSIONTLR9 is associated with SLE disease activity and might be involved in the IFN-a pathway of SLE.

Adolescent ; Adult ; Antibodies, Antinuclear ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interferon Regulatory Factors ; metabolism ; Interferon-alpha ; blood ; Leukocytes, Mononuclear ; metabolism ; Lupus Erythematosus, Systemic ; blood ; genetics ; metabolism ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Toll-Like Receptor 9 ; genetics ; metabolism ; Young Adult

Objective To find out about the sanitary conditions of drinking water along the border line of Inner Mongolia via safety evaluation of drinking water along the border line of Inner Mongolia.Methods 108 samples of drinking water along the border line of Inner Mongolia(70 samples of self-supply source water,21 ones of self-supply tap water and 17 ones of municipal tap water)were collected.Hygienic evaluation of sensory indexes, normal chemical indexes, toxicological indexes and microbiology indexes of water quality was performed according to hygienic standards for drinking water(GB 5749—2006).Results 58 samples were qualified with a total qualified rate of 53.7%.The unqualified rate of the total number of coliforms was the highest(20.4%),followed by fluoride(19.4%).As for deep wells, shallow wells and surface water,there was no statistically significant difference.Compared with municipal tap water,the unqualified rate of self-supply water(28.6%)was higher(17.7%).Conclusion The qualified rate along the border line of Inner Mongolia of drinking water is low.Treatment and disinfection facilities for drinking water,detection devices of water quality are needed.The cleaning and disinfection of storage tanks should be performed periodically in oder to prevent waterborne infectious diseases.