AIM:To study the changes of tear film and ocular surface after the coaxial micro incision 2. 2mm and 2. 8mm in the phacoemulsification.
METHODS:Eighty-six patients ( One hundred and six eyes ) from 2014/06 to 2016/01 in our hospital were enrolled. The patients were randomly divided into two groups. Forty-four patients ( Fifty-three eyes) in group A: coaxial 2. 2mm micro- incision phacoemulsification cataract extraction and intraocular lens(IOL) implantation;Forty-two patients ( Fifty-three eyes ) in group B: the conventional coaxial 2. 8mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time ( BUT) , dry eye symptom ( DES) score, Schirmer's I test ( SⅠt ) and lid-wiper epitheliopathy ( LWE ) score were assessed preoperatively and postoperatively.
RESULTS:At 1wk, 1 and 2mo postoperatively, the BUT in two groups decreased after operations, and the BUT of group B was significantly lower than those of group A, the differences were statistically significant ( t = 3. 098, 4.512, 4.329; all P < 0. 05 ). The DES score in two groups increased, the DES score of group B was significantly higher than those of group A and the differences were statistically significant (t=-9. 449, -10. 029, -7. 141; all P<0. 05). The SⅠt in two groups increased after operations, the SⅠt of group B was significantly higher than those of group A and the differences were statistically significant (t=-6. 293, -4. 009, -3. 283; all P<0. 05). The LWE score in two groups increased after operations, the LWE score of group B was significantly higher than those of group A and the differences were statistically significant (t=-6. 542,-5. 125, -3. 632; all P<0. 05). At 6mo postoperatively, compared with the preoperative data, the BUT, DES score, S Ⅰ t and LWE score in group A showed no statistically significant differences (t=0. 659, 1. 276, 0. 548, 0.169; P>0. 05). The BUT, DES score, SⅠt and LWE score in group B showed statistically significant differences (t=-4. 063, 7. 306, 3. 621, 4. 208;all P<0. 05).CONCLUSION:Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.2mm microincision phacoemulsification, compared with the conventional coaxial 2. 8mm incision phacoemulsification surgery.

Objective To investigate the key procedures of the acute traumatic intracranial hematoma com-bined with herniation and the prognosis factors. Methods 45 cases of acute traumatic intraeranial hematoma com-bined with herniation from February 1997 to June 2008 were admitted in our hospital. Timely establishment of effec-tive ventilation and circulation and pre-operative examination were done to all the eases. Craniotomy hematoma clean was performed in 8 cases, hematoma clean and decompressive craniectomy was canducted in 33 cases and 4 cases were not operatively treated. Results 26 eases (58%) were cured,and 19 cases (42%) died. Conclusions The key procedures of the acute tranmatie intraeranial hematoma combined with herniation is timely establishment of ef-fective ventilation and circulation, and that is effective method to prevent secondary brain injury ; removing hematoma as soon as possible,and lifting the oppression of the brain stem are the keys to rescue patients. Prognosis is closely related to the degree of primary brain injury, eonseious level before operation and the time of herniation appearance.

BACKGROUNDThe Toll-like receptors (TLRs) represent a group of single-pass transmembrane receptors expressed on sentinel cells that are central to innate immune responses.The aim of this study was to investigate the presence of soluble TLRs in pleural effusions, and the diagnostic values of TLRs for pleural effusion with various etiologies.

METHODSPleural effusion and serum samples were collected from 102 patients (36 with malignant pleural effusion, 36 with tuberculous pleural effusion, 18 with bacterial pleural effusion, and 12 with transudative pleural effusion). The concentrations of TLR1 to TLR10 were determined in effusion and serum samples by enzyme linked immunosorbent assay. Four classical parameters (protein, lactate dehydrogenase, glucose and C-reactive protein (CRP)) in the pleural fluid were also assessed. Receiver-operating characteristic curves were used to assess the sensitivity and specificity of pleural fluid TLRs and biochemical parameters for differentiating bacterial pleural effusion.

RESULTSThe concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 in bacterial pleural effusion were significantly higher than those in malignant, tuberculous, and transudative groups, respectively. Analysis of receiver operating characteristic curves revealed that the area under the curves of TLR1, TLR3, TLR4, TLR7 and TLR9 were 0.831, 0.843, 0.842, 0.883 and 0.786, respectively, suggesting that these TLRs play a role in the diagnosis of bacterial pleural effusion. Also, the diagnostic value of TLRs for bacterial pleural effusions was much better than that of biochemical parameters (protein, lactate dehydrogenase, glucose and CRP).

CONCLUSIONSThe concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 appeared to be increased in bacterial pleural effusion compared to non-bacterial pleural effusions. Determination of these pleural TLRs may improve the ability of clinicians to differentiate pleural effusion patients of bacterial origin from those with other etiologies.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Middle Aged ; Pleural Effusion ; metabolism ; microbiology ; Prospective Studies ; Toll-Like Receptor 1 ; metabolism ; Toll-Like Receptor 3 ; metabolism ; Toll-Like Receptor 4 ; metabolism ; Toll-Like Receptor 7 ; metabolism ; Toll-Like Receptor 9 ; metabolism ; Toll-Like Receptors ; metabolism ; Young Adult

OBJECTIVEThe purpose of this study was to investigate the clinical significance of THY1 protein expression in epithelial ovarian cancer.

METHODSImmunohistochemistry (IHC) and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining were used to detect the protein expression of THY1, Ki67 and cell apoptosis in 76 epithelial ovarian cancers by tissue microarray. The correlation between THY1 expression and patients' clinical features was analyzed.

RESULTSOf the 76 epithelial ovarian cancer samples, 64 were informative for IHC and TUNEL assays and 42 (65.6%) among them showed down-regulated/loss expression of THY1 protein. A significant positive correlation of THY1 protein expression with clinical stage and distant metastasis was observed in this ovarian cancer cohort (P < 0.05). The more advanced the tumor stage, the more frequency of loss expression of THY1 protein. In addition, the mean positive rate of Ki67 staining in tumors with down-regulated/loss expression of THY1 was 33.7% +/- 3.5%, significantly higher than that in the tumors with normal expression of THY1 (17.3% +/- 6.1%, P = 0.0027). However, no significant correlation was observed between THY1 protein expression and tumor cell apoptosis as well as patients' survival in this series (P > 0.05).

CONCLUSIONDown-regulated/loss expression of THY1 protein in epithelial ovarian cancer is significantly correlated with cancer cell proliferation and metastasis in the epithelial ovarian cancer, and it may be used as one of the new molecular biomarkers to predict the disease progression in patients.

Adult ; Aged ; Apoptosis ; Cystadenocarcinoma, Mucinous ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Down-Regulation ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Humans ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Ovarian Neoplasms ; metabolism ; pathology ; Survival Rate ; Thy-1 Antigens ; metabolism

OBJECTIVETo detect the expression of stem cell transcription factor Oct-4 in squamous cell carcinoma (SCC) and seborrheic keratosis (SK) and its association with cancer stem cells.

METHODSImmunohistochemistry was used to detect Oct-4 expression in 35 SCC cases, 21 SK cases and 15 normal control skin tissues.

RESULTSOct-4 expression was negative in normal skin and showed a significant difference between SCC and SK tissues (P<0.05).

CONCLUSIONThe Oct-4-positive cells in SCC and SK are probably tumor stem cells. Oct-4 expression may provide an important evidence for isolation and identification of human SCC and SK stem cells.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Case-Control Studies ; Female ; Humans ; Keratosis, Seborrheic ; metabolism ; pathology ; Male ; Middle Aged ; Octamer Transcription Factor-3 ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; Young Adult

In the treatment process of proton radiation therapy,the patient needs to be positioned and immobilized before being moved into the treatment position.In this study,the patient was primarily positioned using the 6R robotic treatment couch as the patient support system(PSS).A simplified three-dimensional model of the treatment room was developed based on the relative motion within the treatment room.The forward and inverse kinematics of the 6R robotic treatment couch were analyzed using an improved Denavit-Hartenberg(D-H)representation.A collision interference model was created based on the actual treatment process.The motion path of the treatment couch was planned and simulated in MATLAB using an improved artificial potential field method for obstacle avoidance.The results indicate that the robotic treatment couch can smoothly navigate around obstacles to reach the target point,satisfying the positioning requirements for proton therapy.

Objective To explore the relationship between T lymphocyte subsets and both glioma malignancy and its prognosis, and determine a clinical immunologic index for evaluating preoperative glioma malignancy and its prognosis. Methods The data of 117 inpatients with primary intracranial tumors, including glioma (n=85) and meningioma (n=32), were retrospectively analyzed. Fluorescence-activated cell sorting (FACS) analysis was performed to detect the preoperative contents of T lymphocyte subsets on 32 patients with meningioma and patients with glioma, including 45 high-grade glioma (WHO, grade Ⅲ-Ⅳ) and 40 low-grade glioma (WHO, grade Ⅰ -Ⅱ); and then the differences of their immunologic indexes were analyzed. Based on the detection result of T lymphocyte subsets, patients with glioma were divided into two groups: CD4~+CD8~+<1 and CD4~+CD8~+>1. Follow-up for 3-5 years was performed and the survival difference of these two groups was analyzed. Results Patients with high-grade glioma showed a decreased ratio of CD4~+CD8~+ and an increased value of CD8~+ with significant difference as compared with patients with low-grade glioma (P<0.05); patients with high-grade glioma showed a decreased ratio of CD4~+CD8~+, and an increased value of CD8~+ with statistical significance compared with patients with meningioma (P <0.05); patients with low-grade glioma showed a decreased ratio of CD4~+CD8~+ with statistical significance compared with the patients with meningioma (P<0.05). Patients with glioma showed a decreased ratio of CD4~+CD8~+ and CD4~+, and an increased CD8~+ with statistical significance compared with patients with meningioma (P<0.05). After follow-up for 3-5 years, 48 patients with glioma was found in the CD4~+CD8~+>1 group with 21 death (43.8%) and 31 months as a median survival time; 37 patients with glioma was found in the CD4~+CD8~+<1 group with 23 death (62.2%) and 16 months as a median survival time. The Kaplan-Meier survival curves were analyzed with statistical significance (P<0.05). Conclusion The prognosis is poor in patients with low ratio of CD4~+CD8~+. The preoperative level of T lymphocyte subsets in peripheral blood, correlated to the glioma malignancy, can be considered as an index to evaluate the glioma malignancy and the prognosis in patients with glioma.

This study was aimed to investigate the expression of Hippo signaling pathway core element MST1 gene in acute leukemia (AL) patients, and explore its relation with AL pathogenesis and prognosis. 50 newly diagnosed patients with AL, 33 normal people, 23 patients with AL in complete remission, 12 refractory or relapsed patients were tested for the expression of MST1 gene by real-time quantitative PCR, Western blot was used to further validate the level of MST1 protein expression. And combined with clinical data, prognostic factors of the patients were analyzed. The results indicated that compared with the normal people, the expression level of MST1 in newly diagnosed patients with AL significantly decreased (P < 0.05), but significantly increased in AL patients with complete remission (CR), the difference of expression was statistically significant before CR and after CR (P < 0.05). Compared with refractory or relapsed patients, the expression level of MST1 gene in newly diagnosed patients was not significantly different (P > 0.05). Besides, the expression level of MST1 between the patients with CR and the normal people was not significantly different (P > 0.05). It is concluded that the low expression of MST1 may be related with the pathogenesis and prognosis of AL.
Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Gene Expression Regulation, Leukemic ; Humans ; Leukemia ; diagnosis ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Protein-Serine-Threonine Kinases ; metabolism ; Signal Transduction ; Young Adult

OBJECTIVETo study the clinical significance of tidal breathing lung function test in 1-4 years old children with wheezing diseases.

METHODSA total of 141 1-4 years old children with wheezing diseases were enrolled as the observed groups (41 cases of asthma, 54 cases of asthmatic bronchitis, and 46 cases of bronchopneumonia). Thirty children without respiratory diseases were enrolled as the control group. All the recruits underwent tidal breathing lung function test. The observed groups underwent bronchial dilation test, and tidal breathing flow volume (TBFV) parameters were evaluated before and after bronchial dilation test.

RESULTSThe observed groups showed obstructive ventilatory disorder (65%) according to the TBFV loop, and their ratio of time to peak tidal expiratory flow (TPTEF) to total expiratory time (TE) and ratio of volume to peak expiratory flow (VPEF) to total expiratory volume (VE) were significantly lower than in the control group (P<0.05). The asthma subgroup had significantly improved TPTEF/TE and VPEF/VE after bronchial dilation test (P<0.05). Taking an improvement rate of ≥ 15% either for TPTEF/TE or for VPEF/VE as an indicator of positive bronchial dilation test, the bronchial dilation test had a sensitivity of 47% and a specificity of 84% in diagnosing asthma in 1-4 years old children. The positive rate was 28% among the children in the asthma subgroup with an TPTEF/TE ratio of ≥ 23% before bronchial dilation test, versus 65% in those with an TPTEF/TE ratio of <23%.

CONCLUSIONSObstructive ventilatory disorder is the main impairment of tidal breathing lung function in 1-4 years old children with wheezing diseases. Tidal breathing bronchial dilation test can reflect a reversal of airway obstruction to a certain extent. The sensitivity of bronchial dilation test for the diagnosis of asthma is not satisfactory in 1-4 years old children with wheezing diseases, but this test has a relatively high diagnostic value in children with severe airway obstruction.

Asthma ; diagnosis ; physiopathology ; Bronchitis ; diagnosis ; physiopathology ; Bronchopneumonia ; diagnosis ; physiopathology ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Respiration ; Respiratory Function Tests ; methods ; Respiratory Sounds ; diagnosis ; drug effects ; physiopathology

Accurate prenatal diagnosis of complex congenital cardiovascular anomalies,vascular ones in particular,is still challenging.A fetal cardiovascular cast model can provide a copy of the cardiac chambers and great vessels with normal or pathological structures.This study was aimed to demonstrate three-dimensional anatomy of complex congenital cardiovascular anomalies in fetuses by means of corrosion casting.Twenty fetuses with prenatal-ultrasound-diagnosed complex cardiovascular anomalies were enrolled in this study (19 to 35 gestational weeks).Fetal cardiovascular cast models were made by a corrosion casting technique.The specimens were injected with casting material via the umbilical vein,and then immersed in strong acid after casting fluid was solidified,to disclose the geometries of cardiovascular cavities.Nineteen cast models were successfully made from 20 specimens.The casts distinctly showed the morphological malformations and spatial relationship between cardiac chambers and great vessels.One hundred and eleven abnormalities were revealed by casting in the 19 specimens,including 34 abnormalities located in the cardiac chambers (3,4 and 27 anomalies in the atria,atrioventricular valves and ventricles,respectively),and 77 in the great vessels (28,20,24 and 5 anomalies in the aorta and its branches,the pulmonary artery,the ductus arteriosus and the major veins,respectively).Corrosion casting can display three-dimensional anatomy of fetal complex cardiovascular anomalies.This improves our understanding of related pathomorphology and prenatal diagnosis.