Abstract?AIM: To compare the changes in epithelial thickness profile following TransPRK and Epi-LASIK for myopia.? METHODS: In this prospective non -randomized controlled study, 76 right eyes of 76 myopic patients with the spherical equivalent refraction -1.25 to -6.00D were included under the informed consent. The eyes were divided into TransPRK group for 43 eyes and Epi-LASIK group for 33 eyes. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones ( central, 2mm; paracentral, 2-5mm;and mid-peripheral, 5-6mm) preoperatively and at 1, 3, and 6mo postoperatively. The results were compared between the two groups.?RESULTS: The epithelium were thicker at 3 and 6mo after surgery compared to preoperative measurements in the two groups (all P<0.05).In TransPRK group, the epithelial thickness at 3 and 6mo demonstrated a negative meniscus-like lenticular pattern with lesser thickening centrally and progressively great thickening centrifugally (F3mo =-2.687,P=0.027;F6mo =-2.908,P=0.000).No statistically significant change was detected among the three zones in Epi-LASIK group (F=1.365, P=0.237). The epithelial thickness was thicker in the TransPRK group compared to the Epi-LASIK group mid-peripherally ( P<0.05) .? CONCLUSION: Significant epithelial thickening was observed after TransPRK and Epi-LASIK.It was showed a lenticular change with more thickening mid-peripherally after TransPRK than Epi -LASIK. Wound healing and inflammation may account for differences in the effect on epithelial thickness change by both surgeries.

Objective To investigate the biomechanical and pathological changes in vivo in the taut bands (TB) of biceps femoris in rats after repeated low-frequency electrical stimulation.Methods Twenty-eight Wistar rats were randomly divided into a control group,an electrical intensity-dependent fatigue group,which were subject to electric intensity-dependent fatigue test,and an electrical frequency-dependent fatigue group,which were subject to electrical frequency-dependent fatigue test.After fatigue tests,the taut band of the biceps femoris and the non-taut band of the contralateral biceps femoris were harvested for pathological observation.The maximum contraction force (MCF),electrical intensity-and frequency-dependent fatigue characteristics and any pathological changes in the TBs were assessed and compared to the non-taut band region of the other biceps femoris.Results The MCF at the 15th and 20th stimulation (1.42 ± 0.28 g and 0.93 ± 0.54 g respectively) were significantly lower than that at the 1 st and 5th stimulation of the TBs.High stimulation intensity (HSI) at the 15th and 20th stimulation (3.76 ± 0.71 V and 3.44 ± 0.97 V) were also significantly lower than at the 1st TB stimulation.At the 10th,15th and 20th stimulation of the TBs,MCF and HSI were both significantly lower than in the bands which were not tight.In the frequency-dependent fatigue stimulation tests,the frequency which generated the MCF of the TBs was significantly lower than in the bands which were not tight,while the MCF of the TBs was significantly higher than that of non-TBs.After either intensity or frequency fatigue testing,more severe edema,uneven cytoplasmic death and degeneration of muscle fibers were observed in sections from TBs than from the bands which were not tight.Conclusions Taut muscle bands are significantly less fatigue-resistant than normal muscle fibers.Taut bands may contribute to the fatigue of myofascial pain syndromes.

AIM:To investigate the effect of puerarin on acute high glucose-induced attenuation of ACh relaxation in isolated rat aortic rings, and to elucidate its underlying mechanism. METHODS: The thoracic aortic rings with endothelium of male Sprague-Dawley rats were mounted on a bath system. Isometric relaxation of aortic rings was measured. RESULTS: ① After incubation with high concentration of glucose (44 mmol/L), the vascular relaxation responses to ACh decreased. ② After coincubation with puerarin (10-10-10-8 mol/L) and high glucose, the high glucose-induced attenuation of ACh relaxation responses of artery was partly inhibited in a dose-dependent manner. ③ After incubation with puerarin for 2 h, the HO-1 activity of thoracic aorta increased. ZnPPIX (an inhibitor of heme oxygenase-1) abrogated the protective effect of puerarin. CONCLUSION: Puerarin prevents the acute high glucose-induced attenuation of endothelium-dependent relaxation in aortic rings. The mechanism might be involved in the activation of heme oxygenase-1.

Objective To study the effect of local mild hypothermia on the expression of matrix metallopro- teinases-2/9 (MMP-2/9) and brain edema in experimental intracerebral hemorrhage (ICH) in rat. Methods One hundred and forty-five Wistar rats were randomly divided into a normothermia sham-operation (NSO) group ( n = 15 ), a normothermia intracerebral hemorrhage (NICH) group (n = 75 ) and a mild hypotbermia intracerebral hemor- rhage (MHICH) group (n = 75). Autologous arterial blood was stereotaxically injected into the right caudate nucleus of the rats of the NICH and MHICH groups to make intracerebral hemorrhage model. The rats in the MHICH group were then subjected to 4 hours of local mild hypothermia, while those in the NICH group were under the room temper- ature. The brain water content, permeability of brain-blood barrier (BBB) and expressions of MMP-2/9 were meas- ured by immunohistochemistry method at 6 h, 24 h, 72 h, 5 d and 7 d after operation. Results In NICH group, the brain water content, permeability of BBB and expression of MMP-9 all began to increase at 6 h and peaked at 3 d after injection of blood and still higher than the NSO group at 7 d. The expression of MMP-2 only began to increase little at 24 h and peaked at 5 d after operation and remained highly expressed at 7 d. In the MHICH group, the chan- ges of brain water content, permeability of BBB and expression of MMP-9 were similar to those of the NICH group, but the extent of changes was significantly lower at the every time point. In NICH group and MHICH group, MMP-9 expression was positively correlated with both the brain water content and the permeability of BBB, but MMP-2 ex- pression was not correlated with them. Conclusion Mild hypothermia might protect BBB against injury caused by ICH and relieve brain edema and inflammation reaction through inhibiting the expression of MMP-2/9.

OBJECTIVETo study the alveolar bone surrounding situation and the length of the root of the maxillary labial inverted impacted incisor in mixed dentition after orthodontic treatment.

METHODSFourteen cases with maxillary labial inverted impacted incisor in mixed dentition were collected. Modified Nance arch and conventional appliance were used. Cone-bean CT (CBCT) was taken after the treatment. Simplant13.0 three-dimensional reconstruction and multi-planer reconstruction (MPR) method were used to observe the labial and lingual alveolar bone crest morphology, besides, the labial and lingual length from the alveolar bone crest to cemento-enamel junction (CEJ) of the impacted incisor and the homonym tooth after treatment, along with their root length and their labial and lingual length ratio of the root surrounded by the alveolar bone to the total root length were measured. The idependent samples t-test were used to analyze the variable differences.

RESULTSThe labial and lingual alveolar bone of fourteen cases crest of the diseased tooth after treatment presented general symmetry U shape from qualitative observation through the three-dimensional reconstruction. The labial and the lingual length of the diseased incisor from alveolar bone crest to CEJ [(2.47 ± 1.35) and (1.47 ± 0.84) mm] was significant increased than those of the homonym incisor [(1.03 ± 0.35) and (0.90 ± 0.37) mm] (P < 0.05); the length of the diseased incisor's post-treatment root [(9.82 ± 2.82) mm] was no statistically significant decreased than that of the homonym incisor root [(10.28 ± 1.38) mm, P = 0.59]; the labial and the lingual length ratio of the impacted tooth's root surrounded by the alveolar bone to the total root length [(72.83 ± 17.16)% and (85.32 ± 5.98)%] was statistically significant decrease than those of homonym teeth[(89.66 ± 3.98)% and (90.84 ± 4.61)%] (P < 0.05).

CONCLUSIONSThe diseased tooth's root had gotten enough length after the treatment. The labial and lingual alveolar bone of the maxillary labial inverted impacted incisor in mixed dentition can't offer sufficient adaptive hyperplasia after treatment, of which labial alveolar bone is more apparent, prompting careful protection when they were used.

Alveolar Process ; diagnostic imaging ; pathology ; Child ; Cone-Beam Computed Tomography ; Dentition, Mixed ; Female ; Follow-Up Studies ; Humans ; Incisor ; diagnostic imaging ; pathology ; surgery ; Male ; Maxilla ; diagnostic imaging ; pathology ; surgery ; Orthodontic Extrusion ; Tooth Root ; diagnostic imaging ; pathology ; Tooth, Impacted ; diagnostic imaging ; surgery

OBJECTIVETo investigate the effect of AMPK agonist 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR) on proliferation, differentiation and apoptosis of U937 cells and explore its possible mechanism.

METHODSU937 cells were cultured with different concentrations of AICAR for 24 h and 48 h. Cell proliferation was evaluated. Cell growth curve was analyzed by CCK-8; cell apoptosis was analyzed by cell morphology, Annexin V/7-AAD double labeling. The differentiation of U937 cells was evaluated by expression of CD11b. The Bcl-xL, Bax, Bim, caspase-3 mRNA expressions of U937 cells were determined by real time PCR.

RESULTSAICAR significantly inhibited the growth of U937 cells in a time-and dose-dependent manner, with a 24 h IC50 value of 1.1 mmol/L and 48 h of 0.9 mmol/L. 1.0 mmol/L AICAR didn't induce differentiation of U937 cells with the increase of CD11b expression for 24 h (P > 0.05). The U937 cells apoptosis was confirmed by cell morphology and Annexin V/7-AAD labeling. AICAR induced apoptosis of U937 cells and the apoptosis rate was (6.81 ± 1.16)% at 1 mmol/L AICAR higher than control group (2.74 ± 0.32)% without AICAR for 24 h treatment (P < 0.05). The real time PCR assay revealed that as compared with control group, the expression of Bim and caspase-3 mRNA were increased, while Bcl-xL and Bax were unchanged on the AICAR treatment.

CONCLUSIONAICAR can effectively inhibit proliferation and induce apoptosis of U937 cells. However, it has no significant effect on differentiation of U937 cells. The mechanism may be related with up-regulating Bim and Caspase-3.

Aminoimidazole Carboxamide ; analogs & derivatives ; pharmacology ; Apoptosis ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Humans ; Ribonucleotides ; pharmacology ; U937 Cells

Objective To observe the circadian rhythm of blood pressure and investigate the impact of Norvasc and Tanatril administrated at different time points based on the theory of time therapeutics in hypertensive patients. Methods The 24-hour ambulatory blood pressure was monitored in 130 inpatients and outpatients with grade 3 or 2 hypertension from May 2008 to November 2009. A total of 34 dipper hypertensive patients were grouped into dipper blood pressure group and 5 mg/d of Norvasc and Tanatril were taken by them at 6:00 AM. A total of 96 nondipper hypertensive patients were further divided into three subgroups after adjustment for age and gender: 5 mg/d of Norvasc and Tanatril were taken by group I (n = 30) at 6:00 AM; 5 mg/d of Tanatril at 6:00 AM and 5 mg/d of Norvasc at 18:00 PM by group Ⅱ (n = 32); 5 mg/d of Norvasc at 6:00 AM and 5 mg/d of Tanatrilat 18:00 PM by group Ⅲ(n=34).The 24-hour ambulatory blood pressure monitoring was performed again after four weeks treatment and 24-hour mean systolic blood pressure(24 hSBP),24-hour mean diastolic blood pressure(24 hDBP),daytime and nighttime mean systolic blood pressure(dSBP,nSBP)and daytime and nighttime mean diastolic blood pressure(dDBP,nDBP),were analyzed.Results The 24 hSBP,24 hDBP and dSBP,and dDBP were reduced from(154.3±5.6),(95.4±3.1),(158.7±6.5),(99.6±3.7)mmHg to(137.2±3.9),(82.5±2.7),(139.7±3.8),(85.2±3.5)mmHg,respectively,in dipper blood pressure group(t=2.124,2.356,2.278,2.449,all P<0.05).The 24 hSBP and 24 hDBP of the three groups in nondipper blood pressure were decreased from(154.4±6.1),(156.7±6.7),(156.6±5.2),(95.8±2.8),(94.9±3.8),(95.7±3.2)mmHg to (139.6±4.1),(134.5±4.6),(133.4±3.5),(83.5±4.2),(80.8±5.6),(81.6±4.7)mmHg,respectively(t=2.038,2.040,2.135,2.142,2.213,2.216,all P<0.05).dSBP and dDBP were decreased from(158.6±3.50),(158.4±5.6),(159.5±4.),(98.4±3.7),(99.6±3.7),(83.9±5.2)mmHg to(138.9±5.4),(136.7±4.1),(137.4±6.4),(85.8±5.3),(83.6±5.1),(83.9±5.2)mmHg,respectively(t=2.021,2.252,2.261,2.217,2.167,2.076,all P<0.05).nSBP and nDBP were decreased from(146.7±6.9),(149.8±3.9),(150.2±4.1),(93.7±4.2),(95.7±4.3),(93.4±3.3)mmHg to(133.7±4.6),(129.8±5.7),(127.6±2.8),(87.8±2.9),(78.5±6.4),(77.8±4.8)mmHg,respectively(t=1.798,2.032,2.014,1.864,2.157,2.166,all P<0.05).There were significant differences in nSBP and nDBP among all groups after treatment(F=2.32,2.17,all P<0.05),and the effect of the drugs was better in groug Ⅱ and Ⅲ than in group Ⅰ(q=3.17,4.03,3.32,4.19,all P<0.05),but there were no significant differences between group Ⅱ and Ⅲ(P>0.05).Conclusions Blood pressure can be controlled effectively by taking two antihypertensive medictions in the morning in hypertensive dipper patient but the blood pressure of nondipper hypertensive patients were able to be controlled more efficiently by taking the two antihypertensive medictions separately in the morning and at the evening compared with that taking the two drugs together in the morning.

BACKGROUNDBRAF(V600E) mutation is correlated with local aggressive clinicopathological features in papillary thyroid carcinoma; yet the relationship between this genetic variation and distant papillary thyroid carcinoma metastasis was unclear. This study aimed to investigate whether BRAF(V600E) is predictive for distant metastasis in the Chinese population.

METHODSOne hundred and seven patients with papillary thyroid carcinoma were enrolled in this study, including 43 patients with distant metastasis and 64 patients without. Quantitative real-time polymerase chain reaction was used to detect BRAF(V600E) mutation, while immunohistochemistry was performed to detect vascular endothelial growth factor (VEGF) expression. The associations between distant metastasis and BRAF(V600E) mutation, and VEGF expression as well as local clinicopathological factors were determined.

RESULTSA total of 28.6% of the patients in the distant metastasis group harbored BRAF(V600E) mutation, which was significantly lower than in the without distant metastasis group (68.8%, P < 0.001). BRAF(V600E) mutation was negatively correlated with positive VEGF expression (P = 0.001). Furthermore, 52.2% of the patients with distant metastasis exhibited VEGF expression, compared with 25.0% of those without. Higher levels of VEGF expression were also observed in the distant metastasis group. Tumor size, extra-thyroid invasion, and BRAF(V600E) mutation were independent predictors for distant metastasis according to multivariate analysis (odds ratios were 2.8, 12.4, and 0.3; 95% CI 1.483-5.334, and 2.950-52.407, 0.100-0.890; P = 0.002, 0.001, and 0.030, respectively). BRAF(V600E) mutation was negatively correlated with distant metastasis in adult subgroup analysis (P = 0.005) but was not an independent parameter.

CONCLUSIONSBRAF(V600E) mutation is predictive for distant metastasis in papillary thyroid carcinoma but not positively. VEGF may be involved in the pathogenesis of distant metastasis.

Adult ; Carcinoma ; chemistry ; genetics ; pathology ; Carcinoma, Papillary ; Female ; Humans ; Male ; Middle Aged ; Mutation ; Neoplasm Metastasis ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroid Neoplasms ; chemistry ; genetics ; pathology ; Vascular Endothelial Growth Factor A ; analysis

BACKGROUNDIn recent years, the prevalence of type 2 diabetes among Chinese population has been increasing by years, directly leading to an average annual growth rate of 19.90% of medical expenditure. Therefore, it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China. Therefore, in this study, we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services.

METHODSThis study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee's Basic Medical Insurance from 2010 to 2012. Based on the analysis of outpatient expenditure and its influential factors, we adopted decision tree approach to conduct a case-mix analysis. In the end, we built a case-mix model to calculate the standard expenditure and the upper limit of each combination.

RESULTSWe found that age, job status, and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes. Through the analysis of the decision tree, we used six variables (complication, age, diabetic foot, diabetic nephropathy, cardiac-cerebrovascular disease, and neuropathy) to group the cases, and obtained 11 case-mix groups.

CONCLUSIONSWe argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services. Bundled payment is effective to control the increase of outpatient expenditure. Further improvements are needed for the implementation of bundled payment reimbursement standards, together with relevant policies and measures.

Aged ; Diabetes Mellitus, Type 2 ; economics ; Female ; Health Expenditures ; standards ; Humans ; Insurance, Health, Reimbursement ; Male ; Middle Aged ; Outpatients

OBJECTIVETo describe the incidence and mortality rates of esophageal cancer from 1974-2002 in Cixian county of Hebei province. Basic information on comparative geographical, epidemiological, and clinical research was collected.

METHODSIn early 1970s, cancer registry system in Cixian was established, collecting information on all the esophageal cancer cases in Cixian. Data was checked manually, then computerized, coded and analyzed using the software--SPSS 11.5.

RESULTSFrom 1974 to 2002, there were 18 471 esophageal cancer cases in Cixian, with 11 068 males and 7403 females, respectively. The age standardized incidence rate (ASR) for males was 208.77 per 100,000, while 120.47 per 100,000 for females. The trend of incidence rate of esophageal cancer had decreased during the 29 years from 1974 to 2002 (trend chi(2) = 19.94, P < 0.001). From 25 years of age onward, the incidence rates of the lower age groups declined with the increase of age. As for geographic distribution, the incidence rate in mountainous areas and hilly areas showed a significant declining trend in mountainous areas, chi(2) = 195.00, P < 0.001; hilly areas, chi(2) = 46.08, P < 0.001. The esophageal cancer incidence in plain areas remained steady, but had a slight increase in recent years. From 1969 to 2002, there were 18,736 cases died of esophageal cancer with 11 598 males and 7138 females. The ASR for male was 127.17 per 100,000 and 101.57 per 100,000 for female. Compared with the year 1969, the mortality rate of esophageal cancer in 2002 had a 37.96% decline. The proportion of esophageal cancer among malignant tumors in different decades decreased significantly.

CONCLUSIONThe trend of the incidence rate of esophageal cancer had been decreasing for the last 29 years. The incidence rate in mountainous areas and hilly areas showed a declining trend while in the plain areas it remained steady but having slight increase in the recent years. The mortality rate of esophageal cancer had a significant decrease from 1969 to 2002.

Adult ; Age Factors ; China ; epidemiology ; Esophageal Neoplasms ; epidemiology ; mortality ; Female ; Humans ; Incidence ; Male ; Registries ; Software