AIM: To investigate the clinical safety and effectiveness of the two kind of bandage contact lenses: Senofilcon A (Johnson & Johnson Acuvue Oasys) and Balafilcon A ( Bausch& Lomb pure vision ) after laser - assisted subepithelial keratectomy (LASEK).
METHODS: Thirty - eight patients (76 eyes) who had undergone the LASEK were divided into two groups. One group of patients wore Balafilcon A, the other group of patients fitted with Senofilcon A. The lenses were worn continuously for 7d. This was a seven - day experience and the patients scored for the symptom of the eyes (sore eyes, foreign body sensation and tearing) on the third day and the seventh day. Both of the two groups of patients taken off the soft contact lens on the seventh day and let their vision and corneal staining checked.
RESULTS: The symptoms of eye sore and tearing of the two groups patients were different. The patients who wore the Senofilcon A were better. The pain of eyes were also different at 3 and 7d after surgeries(Z = - 4. 146, P =0. 000; Z= - 2. 814, P = 0. 005). The difference on tearing between the two groups at 3 and 7d after surgeries were significant ( Z = -2. 309, P = 0. 021; Z= -3. 276, P= 0. 001). There was no difference on sensation of dryness between the two groups at 3 and 7d after surgeries (Z= -0. 447, P=0. 655; Z= -0. 966, P = 0. 334). After the lenses were taken off, the visual acuity of patients wearing Senofilcon A was better ( t = 3. 800, P = 0. 001 ); corneal staining showed limited spots in 1- 2 quadrants with significant difference (Z= -2. 384,P= 0. 017).
CONCLUSION: The Senofilcon A ( Johnson &Johnson Acuvue Oasys ) and Balafilcon A ( Bausch& Lomb pure vision) bandage contact lenses are safe and effective after LASEK, and the former is better than the latter in epithelial regeneration.

Natural killer (NK) cells, as an essential part of innate immunity, can directly identify and kill tumor cells after being activated by the synergistic action of surface inhibitory receptors and activated receptors. It can secrete cytokines to recruit dendritic cells (DCs), induce DCs maturation and enhance adaptive immune response. It can target cancer stem cells (CSCs) and circulating tumor cells (CTCs) to inhibit cancer metastasis. NK cells have a unique inflammatory tendency, which can respond to cytokines and chemokines released from tumor sites and migrate to tumor sites, making them occupy an important advantage in cancer targeted therapy. The research on cancer targeted therapy of NK cells as drug delivery carriers, NK cell membrane-coated biomimetic nanoparticles, and NK cell extracellular vesicles (NKEVs) has attracted more and more attention. The article will focus on the mechanism of NK cells inhibiting cancer, and summarize the research progress of cancer targeted therapy of NK cells.

Objective To analyze the clinical data, including clinical features, treatment, and prognosis,in patients with different kinds of pituitary adenomas. Methods In this retrospective study, 746 cases were included. The characteristics of general epidemiology, clinical symptoms, pathology, imaging, treatment, and prognosis were analyzed. Results Clinical features were different among various pituitary adenomas. Symptoms caused by mass effect and hormone abnormality were expresssed in varying degrees. Serum prolactin>121.28 μg/L can differentiate the prolactin adenoma from the other huge tumor causing hyperprolactinemia due to the mass effect. There is significant relationship between the size and the various types of pituitary adenomas ( P<0.01 ),also between the size and the invasive capability ( P<0.01 ). Conclusions The pituitary adenomas may have their specific epidemiological, clinical, pathological, and imaging features, due to the distinct biological behavior. It is necessary to do the diagnosis, treatment, and prognosis evaluation individually.

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.

G,the noval insertion mutation of c.2298_2299insC is identified in Chinese patients.

BACKGROUND:This systematic review aims to investigate the prediction value of diffusion tensor imaging for motor function recovery of ischemic stroke patients. METHODS:Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), PubMed, Embase, Clarivate Analytics, Scopus, CINAHL, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and Google Scholar were searched for either motor recovery or corticospinal tract integrity by diffusion tensor imaging in different stroke phase from January 1, 1970, to October 31, 2016. The study design and participants were subjected to metrological analysis. Correlation coefficient (r) was used for evaluating the relationship between fractional anisotropy (FA) and motor function outcome. Correlation coefficient values were extracted from each study, and 95％ confidence intervals (CIs) were calculated by Fisher's z transformation. Meta-analysis was conducted by STATA software. RESULTS:Fifteen studies with a total of 414 patients were included. Meta-analysis showed that FA in the subacute phase had the significant correlation with motor function outcome (ES=0.75, 95％CI 0.62-0.87), which showed moderate quality based on GRADE system. The weight correlation coefficient revealed that an effect size (ES) of FA in acute phase and chronic phase was 0.51 (95％CI 0.33-0.68) and 0.62 (95％CI 0.47-0.77) respectively. CONCLUSION:This meta-analysis reveals that FA in the subacute phase after ischemic stroke is a good predictor for functional motor recovery, which shows moderate quality based on the GRADE system.

Objective To analyze the relationship between the catheter to vein ratio and the formation of peripheral insertion of central venous catheter (PICC) related upper extremity deep venous thrombosis (PICC-UEDVT) in cases having undergone PICC in patients at intensive care unit (ICU) and further identify the best optimal ratio cut-off point to reduce the incidence of PICC-UEDVT.Methods A retrospective study was conducted, including 69 patients having undergone PICC with complete clinical data admitted to the Department of Critical Care Medicine of the First Affiliated Hospital of Nanchang University from August 2013 to December 2016; their ages were > 18 years old and catheter indwelling times were > 1 week; the patients' basic information, disease related laboratory parameters and catheter insertion situation were collected. According to the occurrence of PICC-UEDVT, they were divided into PICC-UEDVT group and non PICC-UEDVT group; the receiver operating characteristic (ROC) curve of the catheter to vein ratio versus the incidence ofPICC-UEDVT was plotted to assess the optimal ratio to reduce the incidence of PICC-UEDVT.Results In the 69 patients, there were 7 patients in the PICC-UEDVT group and 62 patients in the non PICC-UEDVT group, the incidence of PICC-UEDVT being 10.14%. Four, 5 and 6 French (Fr) catheters were indwelled in 43, 23 and 3 cases respectively, and the range of catheter to vein ratio was 20% - 67%. The comparisons between PICC-UEDVT group and non PICC-UEDVT group in various aspects were as follows: the incidence of DVT in the PICC-UEDVT group was significantly higher than that in non PICC-UEDVT group [42.9% (3/7) vs. 6.5% (4/62)], the rate of using vasopressor drugs [57.14% (4/7) vs. 17.74% (11/62)], D-dimer level [mg/L: 9.0 (3.0, 12.3) vs. 1.8 (1.0, 3.6)], patients of indwelling 5Fr catheter [71.4% (5/7) vs. 29.0% (18/62)] and the percentage of patientsapplying catheter to vein ratio 45%-67% [57.14% (4/7) vs. 17.74% (11/62)] in PICC-UEDVT group were all higher than those in the non PICC-UEDVT group, the differences being statistically significant (allP < 0.05). ROC analysis showed that the catheter to vein ratio 44% was the optimal cut off or critical point, the area under the ROC curve (AUC) at that point was 0.755, 95% confidence interval (95%CI) = 0.554-0.955, sensitivity = 71.4% and specificity = 79.0%; compared with the patients using 45%-67% catheter to vein ratio, the incidence of PICC-UEDVT was 6.182 times higher than those using the ratio 20%-44% [odds ratio (OR) = 6.182, 95%CI = 1.208-31.634,P = 0.036]; however, there was no significant difference in incidence of PICC-UEDVT between 20%-32% and 33%-44% (P = 1.000).Conclusion It is found that the 44% catheter to vein ratio was the optimal critical point to reduce the incidence of PICC-UEDVT, possessing relatively high sensitivity and specificity; applying <44% catheter to vein ratio can decrease the risk of PICC-UEDVT occurrence in patients at ICU.

Objective To evalute the efficacy of high-resolution CT(HRCT) in differential diagnosis and treatment of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows. Methods HRCT scanning was performed in 120 cases, 153 ears, with chronic otitis suppurative media and cholesteatoma otitis media, of which original data were processed with multi-planar reconstructtion (MPR) and maximum intensity projection ( MIP) , the characteristics of the soft-tissue shadows' growth, window width or window leveling and bony destruction were respectively observed, as well as compared with the surgery findings. Results In 120 patients (133 ears), 109 ears were diagnosed as cholesteatoma otitis media, and 44 ears were diagnosed as chronic suppurative otitis media, among which 33 ears had granulation tissue and 11 ears had secretion. One hundred and seven ears were postoperatively diagnosed as cholesteatoma otitis media, among which 25 ears had granulation tissue. Among 46 ears of chronic suppurative otitis media, 35 ears had granulation tissue, and only 11 ears had secretion. A 98. 6% diagnostic accuracy can be reached with HRCT in diagnosing cholesteatoma otitis media and chronic suppurative otitis media. The Youden's index was 0. 98, 0. 98 and 1. 00 respectively with HRCT in diagnosing cholesteatoma, granulation tissue and secretion. Conclusions Combination of the three different imaging methods, axial images, coronal MPR images and MIP images, can improve the efficacy of the HRCT diagnosis and definite chronic otitis media, which can be routinely used for surgery plan.

OBJECTIVETo elucidate the clinicopathologic features, immunophenotype and differential diagnosis of intracystic papillary carcinoma (IPC).

METHODSThe clinical and pathological characteristics of 14 cases of breast IPC were studied. Immunohistochemical study of SMA, MSA, ER, PR, p63, AE1/AE3, 34betaE12 and CK5/6 was performed using Envision method.

RESULTSThe age of IPC patients ranged from 42 to 79, with a mean age of 65.4 years. A palpable mass was the most common symptom. There were two morphological features: (1) Slender papillae lined by tall columnar epithelial cells which were present directly on the fibrovascular cores without an intervening myoepithelial cell layer (9 cases). (2) The proliferation may assume a cribriform architecture with rigid, punched-out regular spaces or a solid glandular pattern, studded with fibrovascular cores (5 cases). Low nuclear grade is typically seen. Among the 14 cases of IPC, 11 were of pure type. Ductal carcinoma in situ (DCIS) in adjacent ducts was found in one case, and invasive carcinoma was found in two cases. Immunohistochemical results showed that the tumor cells were homogenously strongly positive for ER and PR, but were negative or focally and weakly positive for CK5/6 and 34betaE12. Myoepithelial cell staining was negative within the tumor; and was diminished or scattered at the periphery of the tumor.

CONCLUSIONSIPC is a rare entity that usually arises in older women. It is specific enough in its clinical presentation and morphologic appearance to warrant distinction from other breast lesions.

Adult ; Aged ; Biomarkers, Tumor ; analysis ; Breast ; Breast Neoplasms ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; pathology ; secondary ; Carcinoma, Papillary ; pathology ; Female ; Humans ; Middle Aged

AIM: To investigate the protective effect of huoxuehuayu decoction on macula after phacoemulsification. Into A, B groups. The 80 eyes of A group were treated by conventional phacoemulsification; the patients (60 eyes) of B group were given huoxuehuayu decoction orally for two courses after phacoemulsification. Best-corrected visual acuity(BCVA), corneal and aqueous conditions ,thickness of macular central fovea and changes of macular retinal tissue in A, B groups were observed before surgery, 1 day; 1 week,2,4,6,8 weeks and 3 months after surgery. Was significantly higher than that of group A. One week after surgery the ratio of mild aqueous flare in group B was significantly lower than that of group A. The thickness of central fixation was significantly increased in both groups 1 week, 2, 4, 6, 8 weeks and 3 months after phacoemulsification; the difference between 2 to 8 weeks after surgery and pre-operation showed statistical significance in both groups. 11 eyes in A group had macular edema during 2 to 6 weeks after surgery, including 9 eyes with fovea thickened and 2 eyes with cystoid macular edema, and seven eyes' edema disappeared in 3 months. 2 eyes in B group had macular edema, including 1 eye fovea thickened and 1 eye cystoid macular edema, during 4 to 6 weeks after surgery, and the two eyes' edema disappeared 3 months after surgery. The fovea thickness in group B during 2 to 8 weeks after surgery was statistically lower than group A. Phacoemulsification.