AIM: To immediately observe the complication of corneal flap after LASIK surgery.
METHODS:A retrospective case series were studies. Totally 2 040 cases ( 4 080 eyes ) from January 2010 to October 2012 in our hospital were collected, the corneal flap was observed using lamp microscope after LASIK within 30min. Corneal flap dislocation, corneal flap strial and intraface debris were examined after operation, the effective treatment and controlled measure should be taken for these complications.
RESULTS: Postoperative complications were corneal flap dislocation 102 eyes (2. 5%), corneal flapstriae 95 eyes (2. 33%), interface debris 105 eyes (2.57%). No failure case was seen. There had no corneal flap-related complications, which seriously impact the visual quality after the surgery.
CONCLUSION: Carefully postoperative examination at the first - time is an effective way to manage some complications of post - LASIK. Thus promoting the diagnosis and treatment of post-LASIK complications.

Objective To evaluate the diagnostic value of tissue Doppler imaging (TDI) in classification of fetal arrhythmias, and conclude characters of each type of arrhythmias by analyzing wave forms of TDI. Methods Fifty-five fetuses suffered arrhythmia were included in study group. By comparing the results with control standard(M and PW), the sensitivity, specificity and reliability of TDI in diagnosis of fetal arrhythmias was calculated. At last, the character of waves by TDI of each type of arrhythmia was concluded. Fetal kinetocardiogram was made to identify the origin of arrhythmias. All cases were asked to perform electrocardiography and echocardiography examination after birth. Results The sensitivity, specificity and reliability of TDI was 98%, 100% and 100%, respectively. The character of atrioventricular waves and kinetocardiogram of 8 types fetal arrhythmias were conclude. Conclusions TDI has great value in classification of fetal arrhythmias.

Objective To investigate the effect of exogenous apelin-13 on oxidative stress, myocardial inflammatory cytokines and apoptosis in diabetic model rats.Methods A total of 40 male Wistar rats were randomly divided into 2 groups: normal control group (NC, n=8) and experimental group (EX, n=32).Diabetes was induced by feeding with high-sugary and high-fat diet for 8 weeks and a single intraperitoneal injection of streptozotocin (STZ) (30 mg/kg).The wellestablished 28 diabetic model rats were then randomly divided into 2 subgroups: model group (DM, n =14) and apelin-13 administration group (AP, n =14).The rats in AP group were given intraperitoneal administration of apelin-13 at a single dose of 0.1 μtmol · kg-1 · d-1 for 10 weeks, while NC group and DM group were given 0.9％ NaCl in the same way.All rats were sacrificed at the end of the week 10.Blood hydrogen peroxide (H2O2), nitric oxide (NO) and malonaldehyde (MDA) were measured by colorimetry, and superoxide dismutase (SOD) was measured by enzyme-linked immunosorbent assay (ELISA).The expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in rat myocardium were detected by immunohistochemistry.Masson staining was used to observe the myocardial fibrosis in rats of different groups.Cardiomyocyte apoptosis was determined by TUNEL.Results (1) Compared with NC groups, DM group showed that MDA, H2O2 and NO were significantly increased, while SOD was significantly decreased (F=22.400, 6.230, 4.267 and 8.901, all P＜0.0167).There was a statistically significant difference in the levels of MDA, H2O2,SOD between DM group and AP group.(2) The expression of TNF-α and IL-6 was significantly higher inDMgroup than inNCgroup (0.0599±0.0208 vs.0.0076±0.0031, F=35.139;0.0503±0.0243 vs.0.0071± 0.0024, F=15.946, both P＜0.0167).After 10 weeks of apelin-13 administration, the levels of inflammatory cytokines were significantly decreased in AP group than in DM group.(3) The myocardial apoptosis and fibrosis were significantly increased in DM group than in NCgroup [0.0293±0.0061 vs.0.0030-t-0.0013 and 0.0708±0.0420 vs.0.0013±0.0003, F=84.930 and 19.420, both P＜0.0167].The myocardial apoptosis and fibrosis were significantly decreased in AP group than in DM group (both P＜0.0167).Conclusions To some extent, apelin13 reduces the levels of oxidative stress and myocardial inflammation reaction in type 2 diabetes.Moreover, it may play a vital role in the improvement of myocardial apoptosis and fibrosis.

Abstract?AIM: To analyze the clinical effects of partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis.?METHODS:The conditions of 22 patients (25 eyes) who underwent partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis were retrospectively reviewed. The following data were analyzed:1 ) the angle of deviation of primary position; 2 ) the presence of diploma in the primary position;3) the presence of compensatory head posture;4) the motility of the affected eye.All of the patients attended 6mo postoperative follow-up examinations.?RESULTS: According to the results of examinations before and during operation, different operations were performed:2 eyes were treated with partial rectus muscle transportation, 20 eyes were treated with recession of antagonistic muscle of paralytic rectus muscle combined with partial rectus muscle transportation, 3 eyes were treated with recession of antagonistic muscle, partial rectus muscle transportation and recession of yoke muscle.Twenty patients were orthotropia in the primary position, the diploma and abnormal head posture were eliminated. Two patients with binocular lateral rectus muscles paralysis were in mild undercorrection which were resolved by wearing 8△and 10△prisms respectively. The procedure improved strabismus of 25 eyes from 100.23△ ± 42.61△ preoperatively to 0.82△ ± 2.67△postoperatively ( t=10.797,P<0.001).Ocular movement was improved from -4.52 ±0.51 preoperatively to -2.68 ± 0.63 postoperatively (t=-19.468, P<0.001).? CONCLUSION: Partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis can effectively correct the primary position in paralytic strabismus, eliminate the presence of diploma in primary position and abnormal head posture, and improve the ocular motility, which provides content clinical effects.

Objective To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). Methods A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade overⅢ - Ⅳ , acute cardiac insufficiency and the acute exacerbation of chronic cardiac insufficiency admitted to intensive care unit/cardiovascular care unit (ICU/CCU) of 58 Hospitals in China were enrolled. On the basis of the conventional treatment, all patients would be given rhBNP (neo adjuvant) with a loading dose of 1.5 μg/kg for 3-5 minutes, and followed by a maintenance dose of 0.010-0.015 μg·kg-1·min-1 for 3-7 days. Before the treatment and 1, 3, 7 days after treatment, researchers detected indexes of cardiac and renal function, the levels of N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), urea nitrogen (BUN), serum creatinine (SCr), and urine output; the renal function index was re-evaluated at 30 days after administration, and the time entering ICU again, re-admission, cardiovascular events were recorded. Results 408 patients were enrolled, with 241 males and 167 females. Age range was 28-95 years, the average age was (63.0±15.8) years, and 50-70 years old accounted for 46.8%. Compared with the data before treatment, NT-proBNP, PCWP and CVP significantly decreased at 6 hours after treatment [NT-proBNP (μg·kg-1·min-1): 4378.58±4082.29 vs. 6403.41±5759.48, PCWP (mmHg, 1 mmHg = 0.133 kPa):12.41±2.21 vs. 14.26±2.85 , CVP (mmHg): 10.63±2.62 vs. 11.45±3.45, all P < 0.05], and with the prolongation of injection, NT-proBNP, PCWP and CVP were gradually declined; CO 1 day after treatment (mL: 4.89±0.81 vs. 4.40±0.92) and LVEF 3 days after treatment (0.465±0.100 vs. 0.431±0.107) were significantly increased (both P < 0.05), and with the prolongation of injection, CO and LVEF were gradually increased. There were no obvious changes in BUN and SCr during the treatment, but 30 days after treatment, SCr was significantly lower than that pre-treatment (μmol/L: 110.98±47.40 vs. 132.62±75.60, P < 0.01). Compared with the data pre-treatment, urine output per hour was significantly increased at 3 hours after treatment (mL: 129.59±82.16 vs. 89.60±53.49, P =0.000); urine output every 24 hours was significantly increased at day 1 and day 2 after administration (mL: 2676.54± 1006.83, 2678.74±975.97 vs. 2150.36±283.76, both P < 0.01). In 7 days, the re-entry ICU rate was 2.7%, and the re-hospitalization rate was 2.88% within 30 days, re-cardiac failure rate was 1.43% in 30 days, and the overall fatality rate was 9.55% in 30 days. Conclusions The rhBNP can significantly improve heart function in patients with HF. And, it has a certain effect on renal function. The rhBNP is effective and safe for the treatment of cardiac insufficiency.

Objectives To investigate the effects of Apelin 13 on myocardial metabolism in diabetic rats.Methods A total of 40 male Wister rats were randomly divided into normal control group (NC,n=8) and experimental group (n =32).Diabetic rats model were induced by high-sugar and high-fat diet combined with low-dose intraperitoneal injection of streptozotocin (STZ).The wellestablished 28 diabetic model rats were randomly divided into diabetic model group (DM,n=14) and apelin-13 treated group (n=14).In the Apelin-13 group,diabetic rats were administered Apelin-13 [0.1 μmol/(kg · d)]by intraperitoneal injection for 10 weeks,while the control group and diabetic model group were given an equal volume of 0.9％ NaCl.At the end of the 10th week,all rats were sacrificed after fasting glucose measurement.Levels of serum free fatty acids (FFA) and myocardial FFA were measured by ELISA.Expression of myocardial glucose transporter member 4 (GLUT4) were detected by immunohistochemistry.The mRNA expressions of myocardial PPARα,CD36 and CPT-1 were detected by real-time fluorescence quantitative PCR.Results Fasting blood glucose,serum FFA and myocardial FFA were significantly higher in DM group than in NC group (all P＜ 0.05).The level of plasma glucose and myocardial FFA were significant lower(P＞0.05) in Apelin-13 treated group than in DM group;but serum FFA was not significantly lower(P＜0.05).The mRNA expressions of PPARα,CD36,CPT-1 in cardiac myocyte were higher in DM group and Apelin-13 treated group than in control(P＜0.05),and lower in Apelin-13 treated group than in DM group(P＜ 0.05).The expression of myocardial GLUT4 was significantly lower in DM group(1.138±0.316)and in Apelin-13-treated group (4.631 ± 1.832) than in NC group(9.132 ± 2.156),(F=65.507,P＜ 0.05),and higher in Apelin-13-treated group than in DM group(P＜0.05).Conclusions Apelin-13 increases myocardial expression of GLUT4,improves utilization of FFA,and it can effectively reduce the expression of PPARα,CD36 and CPT-1.Therefore,it may play a vital role in the improvement of myocardial metabolism in diabetic rats.

d malignancy, assessment of the lesion range and determining clinical staging of the prostatic lesions.

Objective To investigate the efficiency and safety of transfection green fluorescent protein plasmid to mouse cornea mediated by SonoVue and ultrasound.Methods Saline,plasmid+saline,plasmid+SonoVue and liposome+plasmid were injected respectively to mouse eye anterior chamber.Then the mouse eye of plasmid+saline and plasmid+SonoVue injection group were exposed to pulse wave ultrasound under 50 Hz pulse reDetition frequence,2 W/cm2 intensity and 10 minutes duration time.Fluorescence stereomicroscope was used to observe the expression of EGFP in the eye at the 1 st day,3rd day,7th day,14th and 21 st day after injection.Two mice were taken randomly from each group and were sacrificed at the 3rd day after injection.Their eyes were enucleated and made into frozen coronal sections.And fluorescence microscopy was performed to observe the type and distribution of EGFP positive cell.Tissue damage was observed in pathological section.Results EGFP was exDressed over the ocular surface in SonoVue and ultrasound group,and it obviously higher than only ultrasound exDosure group and liposome group.The expression of EGFP was not detect ed over the ocular surface in other groups.Pathological sections were not found any difference in each group.Conclusions SonoVue and ultrasound can successfully and safely transfer gene to ocular in vivo study.

Objective To explore the reasons for disharmony between medical staff and medical staff because of electronic clinical ordering,to specificate electronic medical order in ward in order to create a harmonious relationship between doctors and nurses. Methods The methods of qualitative research conducted in-depth interviews of 12 medical staff, field recordings and transcripts, and the method of content analysis were used. Results Two themes were sublimated:medical staff reasons:lack of communication between the medical staff;new doctors didn't have a good command of medical norms of specialist electronic orders; on the responsibility of checking the doctor's advice problems may lead to potential adverse events occurrence. System equipment reason: the electronic doctor's advice system set up the problem; the office computer quantity is insufficient. Conclusions Nonstandard electronic medical management leads to the disharmony of health care. It is suggested to standardize the management of electronic medical advice by implementation of the responsibility to avoid medical coupling errors. The health care workers need to strengthen communication, mutual understanding and forgiveness, in order to create a harmonious medical environment.

Objective To provide basis for routine fetal cardiac screening by comparing the ultrasound detection rate of fetal heart defects between the high-risk and low-risk population.Methods According to the questionnaire about maternal risk factors,all 7165 pregnant women were divided into two groups.The high-risk group included 2147 cases and the remained 5018 were considered as low-risk population.Routine fetal heart screening was performed by the four-chamber view,left and right outflow tract views.If some cardiac malformations were found,the detailed fetal echocardiography would be performed.Both the detection rate of fetal cardiac defects and distribution of the relevant risk factors were analyzed.Results Ninty-five(1.33%)cases of congenital heart disease were found in our study,32(1.49%)cases from highrisk group and 63(1.26%)cases from low-risk group.No significant was found between the two groups (X2=0.635,P＞0.05).Karyotyping were performed prenatally in 23 of 95 fetal congenital defects cases by cordocentesis and chorionbiopsy,and 11(47.83%)cases of concomitant chromosomal abnormality were found.Conclusions Routine fetal screening for congenital fetal diseases should be performed in non-selected population for the similar detection rate of fetal defect in high-risk and low-risk group.