Objectives: To evaluate the efficacy of phacoemulsification and foldable IOL implantation with limbal tunnel incision.　Methods: A 3.2mm limbal tunnel incision was made on 72 eyes of 66 patients with senile, complicated and traumatic cataract. Phacoemulsification and foldable IOL implantation was performed. Visual acuity, corneal curvature and corneal topography were measured after the surgery.　 Results: One day, one week and one month after the surgery, visual acuity exceeded 0.5 in 69.4%, 80.6%,86.1% of the patients respectively. One week after the surgery, the mean astigmatism was (1.85±0.89)D(P<0.01), 0.30 D more than that before the surgery. Corneal topography showed that the incision was steep or flat. One month after the surgery, the mean astigmatism was (1.48±1.02)D，P>0.05,corneal topography had recovered.　 Conclusions: Phacoemulsification and foldable IOL implantation with limbal tunnel incision have comparatively simple, with less postoperative inflammation and faster recovery of visual acuity.

There is an independent-regulated renin-angiotensin system(RAS)in kidney.Most of patients with hypertension or kidney diseases present increased renal RAS activity,which maintains body water and sodium balance,but contributes to the occurrence of hypertension and renal damage progression.The article reviewes some recent basic and clinical researches,focusing on the renal RAS activation mechanisms,consequences and clinical significance of the intervention of RAS blockers,which may help us recognize local RAS function of kidney,explore the treatment strategies to control hypertension and slow chronic kidney disease progression.

Objective:To observe the changes in the anterior chamber before and after cataract surgery by ultrasound biomicroscopy (UBM) in eyes with primary angle closure glaucoma. Methods: Ultrasound biomicroscopy was used for anterior chamber imaging in 78 eyes of 50 patients with primary angle closure glaucoma before and 1 month after cataract phacoemulsification and intraocular lens implantation. And the intraocular pressures were recorded at the same time. Results: UBM allowed the imaging of the entire anterior eye segment. In the images, the differences between iris thickness (IT), iris zonule distance (IZD) and iris lens angle (?2) before and after the operation were statistically insignificant. After the operation, marked increases were observed in the anterior chamber depth (ACD), angle opening distance at 500 ?m from the scleral spur (AOD500), trabecular iris angle (?1) and trabecular ciliary process distance (TCPD), with statistically very significant differences from preoperation (P

BACKGROUND: The selective innervation of different sacral nerve roots on bladder in SD mice is still uncertain.OBJECTIVE: To study the selective innervation of sacral nerve roots to bladder in order to provide evidence for rebuilding bladder function after spinal cord injury and establishing experimental animal model of artificial bladder.DESIGN: Randomized and controlled study.SETTING: Department of orthopaedics in two universities and physiological department of a medical university.MATERIALS: The experiment was conducted in the Key Laboratory of Hand Function Reconstruction of Ministry of Public Health in Medical College of Fudan University from October 2000 to June 2002. Totally 10 male SD mice of clean class with body mass between 250 and 300 g were chosen.INTERVENTIONS: The mice were randomly divided into two groups of which one used left side as experimental side and the other used right side. Extradural electric stimulation was conducted to St -4 nerve roots of SD mice after spinal cord injury.MAIN OUTCOME MEASURES: To record the change of action potential of cystic nerve plexus and compound muscle action potential of bladder smooth muscle, and insert the pressure monitor into bladder to record internal pressure of bladder by pressure transducer.RESULTS: S1 -4 nerve all participate the innervation of bladder in SD mice,among them, the S2 nerve is the most important one, next with S1, S3 and S4is the minimum one.CONCLUSION: Different sacral nerve roots have different dominative effects to bladder smooth muscle. It is meaningful for patients of spinal cord injury to improve their urination function by performing artificially electric stimulation for emiction through the main nerve roots controlling of bladder or rebuilding artificial bladder reflex arc by neurorrhaphy

Objectives: To observe ultrastructural changes of the corneal endothelium and to assess the significance of the changes after irrigation and aspiration(I/A) of the anterior chamber in rabbits.　Methods: Corneal thickness and intraocular tension were measured and the ultrastructure of corneal endothelium was observed in scheduling times following I/A.　Results:Obvious injury of the membrane structure of corneal endothelium was viewed with scanning electron microscope 1 day after injury. Transmission electron microscope revealed marked swelling of the organelles, increasing vacuoles in the cytoplasm and swelling, denuding, dissolving of the cellular nuclei 3 days after injury. The lipoballs resulted from aggregation of lipid in the cellular membrane adhered to the defect region of endothelium 5 days after injury. Scanning electron microscope displayed marked sign of migration of the corneal endothelium 7 days following injury. The corneal endothelium was heteromorphic and the degeneration of the epithelium occurred. The corneal thickness gradually increased and directly related to the degree of the corneal muddiness. The corneal thickness increased and the injury of endothelium aggravated when intraocular tension increased. 　Conclusions:The results of ultrastructural examination indicated that destruction of the corneal endothelium following injury seems to be a consequential sequel. Dynamic corneal thickness measurement contributes to the judgement of degree of corneal endothelium injury. Control of intraocular tension is one of the important methods for preventing secondary injury of the corneal endothelium.

Harpagoside (HAR) is believed to be a main compound in Scrophularia ningpoensis which possess a broad of biological activities.Human serum albumin (HSA) has important physiological roles in transportation, distribution and metabolism of many endogenous and exogenous substances in body.It is great significance in pharmacology to investigate the interaction mechanism of HAR and HSA.In this work, the interaction between HAR and HSA was investigated by fluorescence and ultraviolet absorption spectroscopy at different pH (pH=4.0, 7.4, and 9.0) and temperatures (297, 310 and 323 K).The experimental results showed that the HAR could cause the fluorescence quenching of HSA through a static quenching procedure, showing that the HAR regularly quenched the intrinsic fluorescence of HSA, and a decrease in the quenching constant was observed with an increase in temperature.Under different conditions, all the magnitude of binding constants (KA) was larger than 105 L/mol and the number of binding sites (n) in the binary system were approximate to 1.Base on the magnitude of enthalpy and entropy changes, the negative values of ΔG, ΔH and ΔS revealed that the binding of HAR with HSA was spontaneous and exothermic process, and the main interaction forces of the HAR with HAR were van der Waals forces and/or hydrogen bonding interaction.The binding distance (r) between the HAR and HSA was calculated to be about 4.2 nm based on the theory of F(o)rster′s nonradiation energy transfer, which indicated that the energy transfer from HSA to HAR occurred with high possibility.What was more, the synchronous florescence spectroscopy confirmed the conformational changes of HSA during the binding reaction.

Objective:To analyze the clinical characteristics of intestinal tuberculosis improving the diagnosis rate of intestinal tuberculosis.Methods:From January 2014 to June 2018, at Wuhan Pulmonary Hospital, the data of clinical symptoms, laboratory examination, imaging, endoscopy, surgery and pathological examination of 205 patients with intestinal tuberculosis were retrospectively analyzed. Descriptive analysis was performed for statistical analysis.Results:Among 205 patients with intestinal tuberculosis, 145 cases were male and 60 cases were female, aged 14 to 85 years old. A total of 189 cases (92.2%) were complicated with lung tuberculosis, of which 151 cases (79.9%) were positive for sputum acid fast staining. A total of 126 cases were tested for feces acid fast staining, of which 83 cases (65.9%) were positive. A total of 60 cases (29.3%) were tested for GeneXpert Mycobacterium tuberculosis/rifampicintablet (GeneXpert MTB/RIP), of which 49 cases (81.7%) were positive. A total of 44 cases of intestinal tuberculosis were diagnosed by biopsy under electronic enteroscopy, and 21 cases were pathologically diagnosed with intestinal tuberculosis after surgical resection. The 21 patients were tested for GeneXpert MTB/RIP, of which 19 cases (90.5%) were positive and 10 cases (47.6%) were positive for tuberculin test. Six patients were clinically diagnosed with intestinal tuberculosis after effective treatment of antituberculosis drugs. Conclusions:Combination of clinical symptoms and laboratory, imaging, endoscopic and pathological examination, as well as the therapeutic effect of diagnostic antituberculosis treatment could make comprehensive diagnosis of intestinal tuberculosis. The GeneXpert MTB/RIP examination is of great value in the diagnosis of intestinal tuberculosis.

BACKGROUND:Mechanical stimulation has been confirmed to promote osteogenic differentiation of bone marrow stromal stem cells,but the mechanism is unknown.Primary cilia are important mechanoreceptors and regulate various signaling pathways such as TGF-β1/BMP-2/SMAD.They are likely to be important targets for mechanical regulation of bone marrow stromal stem cells. OBJECTIVE:To investigate the effect and mechanism of fluid shear stress on osteogenic differentiation of bone marrow stromal stem cells. METHODS:Rat bone marrow stromal stem cells were divided into control group,mechanical stimulation group(fluid shear mechanics intervention by shaking table),mechanical stimulation + IFT88 silencing group(mechanical stimulation + silencing IFT88 expression with siRNA).After 24 hours of intervention,qRT-PCR was utilized to determine the expression of transforming growth factor β1 and bone morphogenetic protein 2.Western blot assay was used to detect the expression of phosphorylated SMAD2/3 protein.Immunofluorescent staining of primary cilia was conducted and morphology was analyzed. RESULTS AND CONCLUSION:Shear stress stimulation could promote the transcriptional activity of transforming growth factor β1 and bone morphogenetic protein 2 genes,and increase the expression of phosphorylated SMAD2/3 protein.After siRNA interfered with primary cilia,this mechanical response effect was significantly reduced.There was a Spearman correlation between the change ratio of the primary cilium area of bone marrow stromal stem cells and the increased ratio of transforming growth factor β1 and bone morphogenetic protein 2 gene transcription.These findings indicate that primary cilia/intraflagellar transport mediates the activation of fluid shear stress-responsive transforming growth factor β1/bone morphogenetic protein 2/SMAD signaling pathway and promotes osteogenic differentiation of bone marrow stromal stem cells.

Objective:To establish UPLC specific chromatogram method and content determination method of Dryopteridis Crassirhizomatis Rhizoma; To comprehensively evaluate the Dryopteridis Crassirhizomatis Rhizoma from different producing areas.Methods:UPLC method was used to establish the specific chromatogram of 15 batches of Dryopteridis Crassirhizomatis Rhizoma from different producing areas. The quality was evaluated by cluster analysis and partial least square analysis. The content of total flavonoids was determined by ultraviolet spectrophotometry.Results:The established specific chromatogram identified a total of 21 common peaks, and identified 4 components through comparison with control samples. The clustering and partial least squares analysis showed that the samples from Anshan City in Liaoning Province, Yanbian Korean Autonomous Prefecture in Jilin Province, Jiamusi City in Heilongjiang Province, Jilin City in Jilin Province had a certain consistency. The results of total flavone content determination showed that the content of samples from different producing areas was different.Conclusion:The established UPLC characteristic chromatogram and content determination method of total flavone content of Dryopteridis Crassirhizomatis Rhizoma can reflect the quality of Dryopteridis Crassirhizomatis Rhizoma in different places. The quality of samples from different origins is similar, but the contents of the three producing areas fluctuated greatly.

Objective:To investigate the diagnostic value of serum Aspergillus fumigatus immunoglobulin G (IgG), bronchoalveolar lavage fluid (BALF) galactomannan antigen test (GM test) and combined detection of the two methods in chronic pulmonary aspergillosis (CPA). Methods:A total of 310 patients with suspected CPA who were hospitalized in Wuhan Pulmonary Hospital from January 2020 to December 2022 were screened. BALF-GM test and serum Aspergillus fumigatus IgG were detected. According to the inclusion and exclusion criteria, 151 confirmed or clinically diagnosed CPA patients were enrolled and 60 non-CPA cases were included as controls. The underlying diseases, clinical symptoms and imaging findings of the two groups were analyzed using case-control study. Statistical comparison was performed by chi-square test. The efficacies of BALF-GM test, serum Aspergillus fumigatus IgG test, and their combined detection for CPA were analyzed by receiver operating characteristic curve. Results:There were 130 confirmed cases and 21 clinically diagnosed cases among 151 patients with CPA, including 106 males (70.2%) with age of (54.6±15.5) years. The age of 60 non-CPA patients was (53.6±17.8) years, including 42 males (70.0%). The proportions of pulmonary tuberculosis, bronchiectasis and chronic obstructive pulmonary disease, and the incidence of hemoptysis in CPA group were 79.47%(120/151), 86.09%(130/151), 26.49%(40/151) and 43.71%(66/151), respectively, which were all higher than those in non-CPA group (10.00%(6/60), 25.00%(15/60), 8.33%(5/60) and 11.67%(7/60), respectively), and the differences were statistically significant ( χ2=86.14, 74.56, 8.44 and 19.48, respectively, all P<0.05). The proportion of interstitial lung disease in non-CPA group was 28.33%(17/60), which was higher than that in CPA group (2.65%, 4/151), and the difference was statistically significant ( χ2=31.61, P<0.001). The common imaging findings of CPA patients were pulmonary cavity (70.86%, 107/151), cavity inclusions (41.72%, 63/151) and lung damage (33.77%, 51/151). The specificity and sensitivity of serum Aspergillus fumigatus IgG for CPA diagnosis were 81.7% and 68.9%, respectively, and the area under the curve (AUC) was 0.753 (95% confidence interval (95% CI) 0.681 to 0.825, P< 0.001). The specificity and sensitivity of BALF-GM test were 76.7% and 67.5%, respectively, and the AUC was 0.724 (95% CI 0.649 to 0.800, P<0.001). The specificity and sensitivity of the two methods in series combined detection were 95.0% and 44.4%, respectively, and those of the two methods in parallel detection were 60.3% and 94.5%, respectively. The AUC of the combined diagnosis of CPA by the two methods was 0.843 (95% CI 0.783 to 0.903, P<0.001). Conclusions:Serum Aspergillus fumigatus IgG combined with BALF-GM test has a good diagnostic efficacy for CPA. The detection of serum Aspergillus fumigatus IgG is non-invasive and highly specific, which is beneficial to the early diagnosis and treatment of CPA.