?AlM: To observe the situations of different surgical methods on dry eyes in patients with pterygium excision combined transplantation.
?METHODS: Seventy-eight cases ofpterygium patients (81 eyes ) were randomly divided into three groups. Group A underwent pterygium excision combined large autologous conjunctival flap transplantation; group B underwent pterygium excision combined with small conjunctival flap;group C underwent pterygium excision combined with small conjunctival flap with autologous limbal stem cell. Repair of postoperative corneal epithelium, 1, 3mo preoperation and postoperation tear film break up time ( BUT ) and questionnaire of ocular surface disease index ( OSDl ) were observed among three groups, which caused the situation of dry eyes by pterygium and pterygium excision were evaluated.
?RESULTS: BUT: Group A was shorter than that in groups B and C at 15d postoperation (P<0. 05); at 1mo postoperation, group A was no statistical difference with groups B and C (P>0. 05). Postoperative dry eye ratio of group A was higher than that in groups B and C at 1mo postoperation ( P < 0. 05 ). There was no statistical difference between group B and group C ( P>0. 05 ) , but group C showed lower postoperative dry eye ratio. Corneal epithelium recover time of group A was longer than that in groups B and C (P<0. 05). There was no statistical difference between group B and group C ( P>0. 05), but group C showed a tendency to be shorter recover time.
? CONCLUSlON: Pterygium excision combined with small conjunctival flap and autologous limbal stem cell shows guickly corneal epithelium recover and low dry eye ratio and deserve to recommended.

AlM:To observe the clinical efficacy of two types of scleral-fixated posterior chamber intraocular lens ( lOL ) combined intra-capsule lens extraction to treat cataract dislocation.
METHODS: After intra - capsule lens extraction of dislocated cataract, two types of lOL were used as scleral-fixated posterior chamber lOL . First group was with four seal loops, the second group was with two open loops. All 21 patients (23 eyes) took the examination of the best corrected visual acuity, intraocular pressure, fundus, and lOL decentration using camera system attached to slit - lamp ophthalmoscope and lOL tilted using ultrasound biomicroscopy (UBM) at 6mo after surgery.RESULTS: After 6mo, all patients had improved eye sight. There was significant difference in the mean lOL decentration between the two groups ( 0. 57mm vs 0. 79mm, P<0. 05). There was significant difference in the mean lOL tilted degree between the two groups (6° vs 11°, P<0. 05) .
CONCLUSlON: lOL with four loops are more appropriate as scleral-fixated posterior chamber lOL with less tiltness and dicentration.

Objective To improve the diagnosis of tuberculosis ( TB) by analyzing Mycobacterium infection in fine-needle aspiration biopsy specimens from children with tuberculous lymphadenitis .Methods Fine-needle aspiration biopsy was performed on 269 children with tuberculous lymphadenitis diagnosed by Shanghai Public Health Clinical Center from January 2011 to September 2013 .The needle aspiration biopsy specimens were processed for acid-fast bacillus (AFB) smear test, mycobacterial culture and Mycobacterium identification ( p-nitrobenzoic acid inhibition test ) .Results Cytological diagnosis of tuberculous lymphade-nitis was made for 269 patients.The positive results by AFB smear test were detected in 63.19% of 269 specimens (n=170) and 40.15%(n=108) specimens were positive in mycobacterial culture .The differ-ence between the two tests were significant (P<0.01).The positive rate of Mycobacterium detected by using BACTEC MGIT 960 automated system and L?wenstein-Jensen culture method were 38 .66% ( n=104 ) and 28.99%(n=78), respectively, showing the significant difference between two tests (P<0.05).AFB smear test in combination with mycobacterial culture could precisely diagnose 70.63% of tuberculous lym-phadenitis in children.Of the 108 clinical isolates, 105 strains (97.2%) were Mycobacterium tuberculosis complex and the rest were non-tuberculous Mycobacterium strains (2.8%).Conclusion The positive rate by AFB smear test was significantly increased in fine needle aspiration biopsy specimens after a series of treatments including sample digestion , centrifugation and precipitation , but the positive rate of mycobacterial culture was reduced .Diagnostic accuracy could be significantly improved by using BACTEC MGIT 960 sys-tem.Mycobacterium tuberculosis complex was the predominant pathogenic bacterium in children with tubercu-lous lymphadenitis .

Objective To study the changes of serum procalcitonin (PCT) in the patients with simple brain trauma and its relationships with injury of severity, complications and outcome of injury.Methods A total of 120 patients with simple brain trauma were evaluated in a prospective observational study.The serum levels of procalcitonin and C-reactive protein were measured 1,2,3,5,7 and 10 days after the admission.During the following ten days after admission,the clinical data of patients with simple brain trauma were recorded,and also the patients with 28-day survival were followed up.Another 30 healthy subjects were enrolled in normal group for comparison. Results In different periods after trauma,the PCT levels in brain injury patients with different degree of injury severity were significantly different ( P ＜ 0.05 ).During the first two days after admission,there were no significant differences in serum PCT levels between non-infection group and infection group,but significant differences were found between two groups on the 3rd,5th,7th and 10th days ( P ＜ 0.05 ).Kaplan-Meier survival analysis showed the 28 days survival between the group with high PCT level and the group with lower PCT level was statistically significant ( P ＜0.05 ). Conclusions Poor outcomes and complications such as infection were often occurred in simple brain trauma patients with initially high PCT.The frequent determination of serum PCT levels is a useful approach to the judgment of injury severity and proguosis in patients with simple brain trauma.

Forty-two patients with type 2 diabetes (DM group),23 type 2 diabetic patients with unstable angina pectoris (DM + UAP group),and 36 healthy subjects (control group) were enrolled in this study.Serum samples were collected for determining serum concentrations of vascular endothelial growth factor (VEGF),Angiopoietin (Ang)-1,Ang-2,angiogenin,angiostatin,basic fibroblast growth factor,and platelet-derived growth factor-BB using protein array technology.The results showed that there were no significant differences in serum concentrations of all 7 angiogenic factors between control group and DM group.Whereas,serum concentrations of V EGF and Ang-2 were significantly increased in DM + UAP group compared with control group [(3 532.10 ± 1 813.72vs 2 444.50 ± 1 152.21) pg/ml,(286.90-± 217.01 vs 171.92 ± 106.63) pg/ml,both P＜0.01].Pearson's correlation analysis revealed that serum concentrations of all 7 angiogenic factors were not related to HbA1C,fasting and 2 h postprandial plasma glucose,triglycerides,high density lipoprotein cholesterol,as well as low density lipoprotein cholesterol.

Objective To investigate the serum of soluble CD40 ligand(sCD40L) in coronary heart disease and its relationship with serum lipid levels and the extent of coronary stenosis,whether upregulation of CD40L system is related to stability of atherosclerotic plaque in patients with acute coronary syndrome.Methods Enzyme-linked immunosorbent assay(ELISA) was used to measure the level of sCD40L in 64 patients with coronary heart disease(18 with acute myocardial infarction,19 with unstable angina pectoris and the other 27 with stable angina pectoris) and 20 matched healthy controls.Coronary stenosis of 29 patients were assessed by angiographic coronary stenosis morphology.Results sCD40L level was significantly higher in patients with acute coronary syndrome(ACS)((19.8?3.0)、(19.6?4.3)ng/mL in acute myocardial infarction and unstable angina pectoris group,respectively)than that of those with stable coronary heart disease and that of controls((8.3?3.2)ng/mL and(2.6?1.9)ng/mL,respectively P

Objective To investigate the effect of penehychdine hydrochloride (PHCD)on acute lung injury induced by acute severe acute pancreatitis and the expression of hypoxia inducible factor-1α(HIF-1α)in rats.Methods Forty healthy adult male SD rats were used and randomly divided into 3 groups, group S of sham operation,group ALI of pancreatitis-associated acute lung injury (PALI)and group P of PALI with PHCD.Rats of group ALI and group P were the model established of acute lung injury associated with SAP by retrograde injection of 4% sodium taurocholate into biliopancreatic duct.Rats of group P of acute lung injury with SAP were immediately given PHCD after SAP.Rats of group S and group ALI were injected the same amount of 0.9% sodium chloride solution.After modeling,the rats were sacri-ficed at 12 h.The wet/dry weight ratio (W/D)of lung tissue was calculated.Pathological changes of pan-creatic and lung tissues were scored.HIF-1α,IL-1β,IL-6 of lung tissues and serum amylase were detected by ELISA.The expression of TLR4,NF-κB p65 in lung tissue was detected by Western blot.Results Ex-tensive infiltration of neutrophils,alveolar hemorrhage and necrosis and fat necrosis with pancreatic tissue were observed in group PALI and group P.Pancreatic tissue injury score was significantly higher than that of group S (P <0.01).However,there was no statistically significant difference between the level of serum amylase in group P and group ALI.The W/D ratio of lung tissue in rats of group ALI and group P was sig-nificantly higher than those in group S (P <0.05).Compared with those of group ALI,the lung tissue pathological changes of group P were significantly improved,and the lung W/D value was significantly lower than that of group ALI (P <0.05).Compared with group S,the expression of TLR4,NF-κB p65,HIF-1αin lung tissue of group ALI and group P was significantly higher (P <0.01),and the expression of TLR4, NF-κB p65,HIF-1α,IL-1βand IL-6 in group P was significantly lower than that in group ALI (P <0.05).Conclusion PHCD could not alleviate the damage of pancreatic tissue of SAP.It suppressed the expression of HIF-1α,IL-1βand IL-6 and reduced the acute lung injury induced by SAP in rats,which might be depen-ded on suppressing the expression of inflammatory factors,such as HIF-1α.

Female ; Humans ; Hypertension, Pulmonary ; etiology ; Middle Aged ; Sjogren's Syndrome ; complications

Objective To investigate the sequences of the 3' end of genomes from enterovirus 71 isolated from pediatric patients with different symptoms in Beijing during 2008-2009.Methods Clinical specimens were collected from pediatric patients suffering from hand,foot and mouth disease(HFMD)and/or with neurological complications who visited the affiliated Children's Hospital during the epidemic seasons of 2008 and 2009 in Beijing.The samples were inoculated into the Vero cell line,and the virus isolates were further identified by nested reverse transcription-nested PCR(RT-nPCR)assay using universal enterovirus primers,type specific primers for EV71 and CA16.The 3' end of genomes(including 3D and 3' UTR regions)from 10 EV71 strains derived from various clinical presentations were amplified and sequenced.Results Analysis of the nucleotide sequences of the amplified fragments showed that the 3' end of genomes of 10 EV71 isolates include the 3D region of 1386 nucleotides(nt)encoding the 3D polymerase(3Dpol,462 amino acids),the terminator codon TGA and 3' UTR of 81 nt.Nucleotide sequence identities among 3D regions from these 10 EV71 isolates were in the range of 95.8%-99.6%,while the nucleotide sequence identities for 3' UTR were 96.3%-100%.The majority of nucleotide changes were located at the third codon positions which caused silent mutations,thus the amino acid sequence changes of 3Dpol among those 10 EV71isolates were scanty.The residues 140 and 263 which were R and 1 were substituted by K and V,respectively in 3 of 4 neurovirulent strains,whereas only 1 of 6 strains from mild cases had these 2 amino acid changes.The sequences of the 3D and 3' UTR regions of 10 EV71 isolates were compared to the representative strains of known genotypes from the GenBank.The nucleotide and amino acid sequences of 10 EV71 isolates in the 3D region exhibited highest homology to the subgenotype C4 of EV71(92.7%-94.2%and 96.8%-97.6%.respectively).However,3' UTR of 10 EV71 isolates shared the highest nucleotide identity with CA16/G10(88.9%-91.4%).The phylogenetic analysis based on the 3D regions demonstrated that 10 EV71 isolates had the closest genetic relationship with the representative isolate of CA sub-genotype of EV71 and shared more homology with CA16/G10 than other known genotypes of EV71.Conclusion Genetic analysis of the 3' end of genomes from 10 EV71 strains indicated that the 3' end of genome may play a role in the evolution of EV71.

OBJECTIVETo analyze the genotype, epidemic pattern and the characteristics of the disease of enteroviruses during the epidemic season of hand, foot and mouth disease (HMFD) in children from 2013 to 2014 in Beijing to provide the scientific evidence for prevention and treatment of HFMD.

METHODDuring April to September in 2013 and March to October in 2014, a total of 977 throat swabs were collected from children who visited the Children's Hospital Affiliated to Capital Institute of Pediatrics, including 147 from patients with HFMD in 2013, 343 with HFMD, 201 with atypical HFMD, 83 with herpangina, 25 with fever with convulsions, 64 fever with rash and 114 with rash in 2014. Enteroviruses universal type (EV), Enteroviruses type 71 (EV71) and Coxsackievirus group A 16 (CA16) were detected by real-time RT-PCR respectively. The nucleic acid of specimens which were identified with non-EV71, non-CA16 was tested by nested PCR and analyzed by VP1 sequencing. The detection rate and epidemic pattern of different genotypes of enterovirus were analyzed among different age groups and between 2013 and 2014.

RESULTOf 977 throat swabs, 80. 1% samples were detected positive for enteroviruses. The positive rates of CA16, EV71, CA6, CA10, CA4 and other EVs were 25. 6% (250/977), 18. 9% (185/977), 20. 0% (195/977), 5. 0% (49/977), 1.5% (15/977) and 9.1% (89/977), respectively. Twenty six of the 89 other EVs included CA2, CA5, CA8, CA9, CA12, CA14, CB2, CB5, E6, E9 and E25, each genotype of which was no more than 3. The nucleotide homologies shared among CA6, CA10 and CA4 strains between 2013 and 2014 were 94. 3% - 100%, 93. 8% - 99. 1% and 92.7% - 99. 8%, respectively. The positive rates of ≤1 year group were 71. 1% (106/149), which was lower than that of other age groups (all P <0. 05), but similar to that of >5 year group (χ2 =1. 181,P = 0. 277). In 2013, the positive rate of EV was 85. 7% (126/147) and the predominant genotype was CA6 54. 8% (69/126), followed by CA16 20. 6% (26/126) and EV71 11. 9% (15/126). In 2014, the positive rate of EV was 85. 4% (293/343) in the 343 children with HFMD, the predominant genotypes were CA16 with the positive rate of 42. 7% (125/293), EV71 with 38. 2% (112/293) and CA6 with only 11. 3% (33/293). In 2014, the positive rates of EV in 201 atypical HFMD, 83 herpangina, 25 fever with convulsions, 64 fever with rash and 114 rash were 83. 6% (168/201), 80. 7% (67/83), 76. 0% (19/25), 64. 1% (41/64) and 60. 5% (69/114), respectively. All genotypes of enteroviruses peaked mainly during May to August every year, but there were no obvious epidemiological pattern about each genotype.

CONCLUSIONCA6 became the main causative agent of HFMD in 2013, however, CA16 and EV71 predominated again in 2014 in Beijing. The clinical manifestations caused by CA6, CA10, CA4 and other genotype of enteroviruses differed from EV71 and CA16. Besides EV71 and CA16, more attention should be paid to CA6, CA10, CA4 and other type of enteroviruses.

Beijing ; epidemiology ; Child, Preschool ; Enterovirus A, Human ; classification ; Enterovirus Infections ; epidemiology ; virology ; Exanthema ; Fever ; Genotype ; Hand, Foot and Mouth Disease ; epidemiology ; virology ; Humans ; Infant ; Real-Time Polymerase Chain Reaction