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 identify the normal breast tissue and breast fibroadenoma tissue by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS),and to explore the biological characteristics of FD and the identification method by discussing its spectroscope characteristics.Methods The frozen section of 26 patients (all female,aged 19-59 years)were obtained by routine surgical resection.9 cases of normal tissue and 17 cases of breast fibroadenoma tissue were detected by Raman spectroscopy and then SHINERS technique was utilized.A total of 243 Raman and 273 SHINERS spectra were obtained.All the spectra were dealt with baseline corrected by fitting and subtracting a third-order polynomial and then smoothed with a 15-point Adjacent-Averaging.Results The characteristic peaks of normal breast tissue appeared in 1 090,1 157,1 262,1 300,1 442,1 658,1 745,and 1 874 cm-1 .After adding SHINs, some peaks shifted in 2 - 3 cm-1 , the relative strengths of 1 090 and 1 157 cm-1 were significantly increased,and the 1 496 cm-1 characteristic peak appeared.The main characteristic peaks of breast fibroadenoma appeared in 751,880,930,880,1 262,1 442,1 579,1 658,and 1 745 cm-1;one of the dominant characteristic peak should belong to lipids,but it can be seen that amideⅠ characteristic peak of protein became more significant.Conclusion Raman spectra can discover the differences of the characteristic peaks of amide Ⅰ between breast fibroadenoma and normal breast tissues. By virtue of different enhancement effects of SHINs to Raman specific peaks of the various tissues, breast fibroadenoma can be distinguished from normal tissue successfully.

Objective:To assess the efficacy of trastuzumab combined with neoadjuvant chemotherapy in the treatment of human epidermal growth factor receptor-2 (Her-2)positive breast cancer patients,and to explore its influencing factors of prognosis of breast cancer.Methods:The clinical materials of 112 Her-2 positive breast cancer patients were collected and they were divided into combined treatment group (trastuzumab + neoadj uvant chemotherapy)and single chemotherapy group (without trastuzumab ). SPSS 1 9.0 software was employed to calculate and analyze their clinical characteristics.The survival rate and prognosis were analyzed by Kaplan-Meier method,Log-rank test, and Cox regression. Results:Among the 112 Her-2 positive breast cancer patients, 23 cases were treated with trastuzumab,89 cases were treated without trastuzumab.The disease-free survival (DFS)in combined treatment group and single chemotherapy group had significant difference (P=0.012).And there was no significant difference of overall survival (OS)between two groups (P=0.064).The HR negative group had 18 (32.7%)patients with 5-level of Miller and Payne (MP)classification which was higher than HR positive group (5/46,10.9%)(P=0.009).In univariate analysis,the tumor size,node status at diagnosis and node status after operation were the influencing factors of DFS in the Her-2 positive breast cancer patients;the tumor size,node status at diagnosis,MP classification and node status after operation were the influencing factors of OS in the Her-2 positive breast cancer patients.The result of multivariate analysis indicated that the tumor size, node status at diagnosis,and with or without radiotherapy were the independent influencing factors of DFS and OS in the Her-2 positive breast cancer patients. Conclusion:The breast lesions in the Her-2 positive breast cancer patients with negative HR are relieved after treated with trastuzumab combined with neoadjuvant chemotherapy. The combination of trastuzumab and neoadj uvant chemotherapy can significantly improve the DFS and has a positive influence in the prognosis of Her-2 positive breast cancer patients.

Objective To investigate the effect of emulsified isoflurane anesthesia on the expression of hippocampal amyloid-beta protein (Aβ) and phosphorylation of Tau protein in rats.Methods Seventy-two healthy Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 3 groups:normal control group (group C,n =12),fat emulsion group (group E,n =12),and 8％ emulsified isoflurane group (group EI,n =48).30％ fat emulsion and 8％ emulsified isoflurane 0.15 ml/100 g were slowly injected via the tail vein in groups E and EI,respectively.Morris water maze test was performed 6 days before anesthesia.Twelve animals in each group were chosen at 2 h after administration (T1) in E group,at the corresponding time points in C group,or at T1 and 1,7 and 14 days after administration (T2-4) in EI group and underwent spatial probe tests,and the escape latency was measured.The rats were anesthetized with intraperitoneal 1％ pentobarbital sodium 4 g/100 g after the end of Morris water maze test.Blood samples were taken for determination of the plasma S100 protein concentration.The rats were then sacrificed and brains were removed for determination of the expression of hippocampal Aβ and phosphorylated Tau (p-Tau) protein by immunohistochemistry.Results The escape latency and swimming distance were significantly shorter on 3rd,4th and 5th days than those on 1st day of place navigation test before anethesia (P ＜ 0.01).Compared with group C,the escape latency and swimming distance were significantly prolonged and the time of staying at the original platform quadrant was shortened at T1,and the plasma S100 protein concentration was decreased at T4 in group EI (P ＜ 0.05),and no significant change was found in the each parameter of Morris water maze test,plasma S100 protein concentration,and expression of Aβ and p-Tau protein in group E (P ＞ 0.05).The escape latency and swimming distance were significantly shorter and the time of staying at the original platform quadrant was longer at T2-T4 than at T1 in group EI (P ＜ 0.05).Conclusion Emulsified isoflurane anesthesia exerts no effect on the expression of hippocampal Aβ and phosphorylation of Tau protein,indicating that hippocampal Aβ and Tau protein are not involved in emulsified isoflurane anesthesia-induced cognitive dysfunction in rats.

AngiotensinⅡ( AngⅡ) is the main functional bioac-tive peptide of the renin angiotensin system,and its basic function is to regulate salt-water homeostasis and blood pressure. Howev-er,recent studies have shown that AngⅡ plays a very important role in tumor formation and angiogenesis by acting on its type 1 receptor (AT1R) as a kind of potential growth factor. This arti-cle is a brief overview of the research on effects of AngⅡ-AT1R system in the process of tumor angiogenesis in recent years.

ObjectiveTo investigate the effect of isoflurane anesthesia on plasma cortisol,and brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in hippocampus in rots.MethodsThirty-six adult male SD rots,aged 10 weeks,weighing 250-280 g,were randomly assigned into 6 groups:control group (group C,n =6) and O2 group (group O,n =6),isoflurane group (group Ⅰ,n =24).The rats were exposed to 2％ isoflurane for 2 h (FGF 3 L/min) in group Ⅰ.While the rats were only exposed to the pure oxygen in group O.Six rats in each group were chosen to perform Morris water maze test after inhalation of pure oxygen was stopped in group O,and at 2 h,and at 1,7 and 14 days after the end of administration in group Ⅰ.The escape latency and swimming distance in place navigation test,and the number of crossing the platform and swimming distance in spatial probe test were recorded.After water maze test was terminated at each time point,blood samples were taken from the fossa orbitalis to determine the plasma cortisol concentration and the hippocampal tissue was obtained for measurement of the contents of BDNF and NGF.ResultsCompared with group C,the number of crossing the platform was significantly decreased,the swimming distance was significantly shortened,and the plasma cortisol concentration was significantly decreased in spatial probe test in group O,and the escape latency and swimming distance were significantly prolonged at 1 day after the end of administration in plaee navigation test,and the number of crossing the platform and the content of BDNF in the hippocampal tissue were significantly decreased,and the swimming distance was significantly shortened in spatial probe test in group Ⅰ (P ＜ 0.05 or 0.01 ).Conclusion lsoflurane anesthesia exerts a transient inhibitory effect on cognitive function in the short term,and promotion of the cortisol release and synthesis of BDNF is involved in the mechanism,but not the synthesis of NGF in hippocampus in rats.

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

Objective To compare intramedullary nail (IN) and dynamic hip screw (DHS) regarding their effects on hip abduction following fixation of intertrochanteric fractures.Methods From January 2008 to December 2015,310 patients with intertrochanteric firacture were treated at our department.They were divided into 2 groups depending on the manner of treatment.198 patients (71 males and 127 females) were subjected to intramedullary nailing,with an average age of 74.7 ± 5.6 years;there were 50 cases of 31-A 1,134 ones of 3 1-A2 and 14 ones of 3 1-A3 according to the AO classification.112 patients (35 males and 77 females) were subjected to dynamic hip screwing,with an average age of 74.1 ± 6.7 years;there were 24 cases of 31-A1,78 ones of 31-A2 and 10 ones of 31-A3.The 2 groups were compared in terms of time for weight-bearing ambulation and stand on one leg,gait,pelvic tilt,range of hip active abduction,muscle strength of the abductor and hip function at the final follow-up.Results Of this series,284 patients were followed up for 1.5 to 8.5 years (average,3.6 years) and 26 patients died.The IN group achieved significantly better outcomes in terms of time for weight-bearing ambulation (37.6 ±4.9 d),time for stand on one leg (60.1 ± 9.5 d),cases of normal gait and normal pelvic tilt (171 and 179),muscle strength of the abductor (62.3 ±4.4 N · m),and range of hip active abduction than the DHS group (53.0 ±8.4 d;71.0 ± 12.0 d;67 and 85;56.6 ± 3.3 N · m,respectively) (P ＜ 0.05).There was no significant difference between the 2 groups in the hip function at the final follow-up(91.4％ versus 84.5％ in the excellent and good rate)(P ＞ 0.05).Conclusion Compared with dynamic hip screwing,intramedullary nailing has a limited effect on hip abduction so that the patients may benefit from quicker functional recovery and faster improvement in quality of life.

BACKGROUND:In recent years,artificial cervical disc replacement surgery as a new method for the treatment of cervical disease has gradualy been accepted and understood,but relevant complications have gradualy attracted attention.OBJECTIVE:To investigate the clinical outcomes of artificial cervical disc replacement in the treatment of cervical disease and the range of motion of the replacement segment.METHODS: A total of 25 patients with artificial cervical disc replacement in the treatment of cervical spondylosis,who were treated in the Department of Orthopedics,Air Force General Hospital of Chinese PLA from August 2006 to April 2012,were enroled in this study,including 15 males and 10 females,aged 31-76 years,averagely 51.04 years.There were 6 cases of double segments and 19 cases of single segment.They were folowed up for 24 to 93 months.Clinical results were assessed using the Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores.Imaging was used to observe range of motion,cervical curvature,heterotopic ossification,and degeneration of adjacent segments.RESULTS AND CONCLUSION:Neurological function in al patients was improved to different degrees.One case suffered from mild heterotopic ossification,but no clinical symptoms were found.No significant difference in range of motion of surgical segment,and range of motion of upper and lower adjacent segments was detected between pre-replacement and final folow-up results (P＞0.05).No significant difference in range of motion of C2-C7 was found between pre-replacement and final folow-up results (P＞0.05).Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores were significantly improved during final folow-up compared with pre-replacement (P＜0.05).These results indicated that artificial cervical disc replacement in the treatment of cervical disease can achieve better clinical efficacy,can keep the range of motion of replacement segment and avoid the accelerated degeneration of adjacent segments.

A simple and quick method is described for the determination of ferulic acid, senkyunolide I, senkyunolide H, senkyunolide A and ligustilide in rhizomes of Ligusticum chuanxiong. The 5 active ingredients in the sample was extracted using 40% ethanol and analyzed by reversed-phase high performance liquid chromatography (HPLC). Chromatography separation was performed using Agilent 1100 series HPLC system with a Symmetry C18 column and gradient elution with a mixture of three solvents : solvent A, acetonitrile, solvent B, methanol and solvent C, 1% aqueous acetic acid, 0 min to 5 min A: B: C 20: 40: 40, 5 min to 30 min A: B: C 60 to 100 : 0 : 40 to 0. The effluent was monitored using a VWD detector set at 321 nm (0-4.3 min) and 275 nm (4.31-30 min). The flow rate was set at 1 mL x min(-1) and the injection volume was 10 microL. The column temperature was maintained at 35 degrees C. The calibration curve was linear (r > or = 0.99) over the tested ranges. The average recovery was 94.44%-103.1% (n = 6). The method has been successfully applied to the analysis in different harvest periods of L. chuanxiong samples. In this paper, single-factor randomized block design to study the 5 components content of L. chuanxiong on ten collecting stages. For the L. chuanxiong collected from April 15th to May 30rd, the content of 5 ingredients increased primarily, and then decreased. Determine the appropriate harvest time has important significance to the promotion of the quality of L. chuanxiong.
4-Butyrolactone ; analogs & derivatives ; analysis ; Acetic Acid ; chemistry ; Acetonitriles ; chemistry ; Benzofurans ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coumaric Acids ; analysis ; Ligusticum ; chemistry ; Methanol ; chemistry ; Solvents ; chemistry ; Time Factors