Objective　 To evaluate the clinical effect of phacoemulsification and low powered posterior chamber intraocular lens implantation in high myopia. Methods　Phacoemulsification was performed on 128 eyes of 84 patients with cataract in high myopia through scleral tunnel incision. Average phaco time was 201s and ultrasonic energy was 33.8%. Results　The visual acuity 0.4 or better on the first day, in the first week and first month after the operations was in 71.1%,75.8%,79.7%respectively. Three months after surgery, 22.6% reached the vision of 1.0. The main cause of the poor result is due to the pathologic changes of the fundus in high myopia. The major complications were corneal edema (4.3%), fibrinous exudate in anterior chamber (1.6%) and rupture of posterior capsule (2.3%). Conclusion　Phacoemulsification and low powered posterior chamber intraocular lens implantation offers advantages of better rehabilitation of visual acuity, proper correction of ametropia, prevention of retinal detachment and is an unitable technique for highly myopia cataract patients.

Objective:To evaluate the stress distribution and displacement pattern in the restoration of Stern-ERA attachment mandible removable partial denture (RPD) with different designs through three-dimensional (3D) finite element (FE) analysis.Methods:3D-FE models were established based on human CT data and manufacturer's catalog.Vertical and 45° lingual oblique forces of 100 N were applied on the artificial teeth of the RPD.Three ERA attachment partial dentures with different bracing arms were designed,namely the basic design,rest bracing arm design and cross-arch bracing arm design.The von Mises stresses and displacements of abutment teeth and mucosa under denture base were analysed.The displacement of denture bases was examined.Results:Under the vertical and oblique loading,the maximum yon Mises stress was found at the distal shoulder on the distal abutment.The maximun displacement was observed at the buccal and distal occlusal surfaces of the distal abutment.The maximum displacement on the abutment was found to be the highest in rest bracing arm design group (14.91 μm and 63.09 μm),followed by the basic design group (9.38 μm and 50.56 μm) and the cross-arch bracing arm design group exhibited the smallest displacement (8.85 μm and 47.31 μm).Conclusion:The basic design Stern_ERA attachment for unilateral mandible distal extension defect appears to be more reasonable compared with rest arm and crossing-arch arm design from biomechanical point of view.

Objective To analyze the method of self-management education on the health status of patients with gastric carcinoma during chemotherapy. Methods Patients with gastric carcinoma (60 cases) were divided into the test group and the control group with 30 cases in each group. The two groups both received chemotherapy of complete cycle and general health education. The test group adopted self-management education based upon the above treatment, including collective education, group discussion and individual instruction. The treatment effect was appraised and compared by senior primary nurses. Results The recent total effective rate of chemotherapy in the test group was 76.7%, which was higher than that of the control group (50.0%). The level of life quality of the test group was also better than that of the control group (P<0.05). Conclusion Patients-centered self-management education could improve the health status of patients with gastric carcinoma during chemotherapy.

AIM: To investigate whether hypercapnia is protective against acute lung injury (ALI) in a rabbit model, and study it's potential mechanisms. METHODS: Twenty-two healthy New Zealand white rabbits were involved in this study, and randomly allocated to control group (group C), normocapnic group (group N) and hypercapnic group (group H). Oleic acid (0 1 mL/kg) was injected intravenously to establish ALI model. Lung mechanics, hemodynamics, blood-gas analysis, the content of malondialdehyde (MDA) and superoxide dismutase (SOD) activity in lung tissue were measured. Apoptosis was analyzed after 3h mechanical ventilation. RESULTS: (1) Peak airway pressure in group H was significantly lower than that in group N (P

Objective To investigate the protective effects of hypereapnia on acute lung injury(ALI)in an model of rabbits in vivo,and to observe its effect on oxygen free radicals in the lung tissue in order to uncover the potential mechanisms.Method In the laboratory of pharmacology,China Medical Univereity,twenty-two healthy New Zealand white rabbits were randomly assigned to control group(Group C,n=6)with the injection of normal saline(0.1 ml/kg),and sixteen rabbits were injected with oleic acid(0.1ml/kg)intravenously,and then were randomly dirided into normocapnia group(Group N,n=8)and hypercapnia group(Group H,n=8,FiCO2=8%).Then tracheostomy was performed,and the experimental animals were ventilated for 3 hours after oleic acid or sterile normal saline administration.Lung mechanics,hemodynamics,blood-gas analysis were monitored.The rabbits were exsangninated.and the lungs and heart were taken out from the thorax.The concentration of superoxide dismutase(SOD)and malondialdehyde(MDA)in the lung tissue were assayed.Lung tissue wet/dry ratio and pulmonary permeability index were measured and histologic damage was assessed after three hours'mechanical ventilation.Results Peak airway pressure in Group H was significantly lower than that in Group N and the dynamic lung comphance Was significantly higher than that in Group N(P＜0.05).PaO2 in Group H was significantly higher than that in Group N(P＜0.05).The concentration of MDA in the lung tissue in group H was significantly lower than that in Group N(P＜0.05),and SOD in group H was significantly higher than that in Group N(P＜O.05).Lung tissue wet/dry ratio and pulmonary permeability in group H were significantly lower than that in Group N(P＜0.05).Histological tissus damage in Group N wassignificantly severer than that in Group H.Conclusions Hypercapnia induced by inhalation of high concentration of carbon dioxide(8%)plays protective role in this in vivo model of ALI.The mechanisms may be associated with enhanced SOD activity and the attenuation of lipid peroxidation in the lung tissue.

Objective To investigate the effects of TLR7 on imiquimod induced apoptosis of THP-1 derived macrophages.Methods Three cell lines ( THP-1 derived macrophages, MDCK cell line and HUVEC cell line) with different capabilities of expressing TLR7 were selected.The survival rates of cells af-ter the treatment with different concentrations of imiquimod were detected by MTT assay.The levels of IL-6 in the supernatants of TLR7 inhibitor chloroquine or TLR7-siRNA treated cells were detected by enzyme-linked immunosorbent assay.The apoptosis of cells was detected by flow cytometry after inhibiting the ex-pression of TLR7.Results Imiquimod induced the apoptosis of THP-1 derived macrophages, MDCK cell lines and HUVEC cell lines.The levels of IL-6 were significantly decreased as the expression of TLR7 was inhibited by treating THP-1 derived macrophages with chloroquine or TLR7-siRNA.Treating THP-1 derived macrophages with chloroquine or TLR7-siRNA did not affect the cell apoptosis induced by imiquimod.Con-clusion Imiquimod could induce the apoptosis of THP-1 derived macrophages through TLR7 independent pathway.

Objective To study the effects of Toll-like receptor 4(TLR4) on oxidized low density lipoprotein ( ox-LDL) induced macrophage apoptosis and its possible mechanism .Methods THP-1 derived macrophages were divided into four groups including untreated control group , ox-LDL treated group , ox-LDL+LPS treated group and tunicamycin treated group .MTT assay and flow cytometry analysis were performed to measure cell vitality and cell apoptosis , respectively .Oil red O staining was used to observe the phagocytosis of lipids by macrophages .The persistent and intense endoplasmic reticulum ( ER) stress markers were de-tected by analyzing the expression of glucose-regulated protein 78 ( GRP78 ) and CCAAT/enhancer-binding protein homologous protein ( CHOP) at mRNA and protein levels by q-RT-PCR and Western blot .Small in-terfering RNA ( siRNA) was used to silence the expression of TLR 4 to further elucidate its possible mecha-nism.Results Flow cytomotry and MTT assay showed that the number of apoptotic cells in ox-LDL+LPS treated group were increased more significantly than that in ox-LDL treated group (P<0.01), and cell apop-tosis in both two groups were greater than that in control group (P<0.01).Compared with control group, the expression of GRP78 and CHOP at mRNA and protein levels were up-regulated in ox-LDL+LPS treated group and ox-LDL treated group (P<0.01), and the expression of GRP78 and CHOP in ox-LDL+LPS treated group was significantly higher than that in ox-LDL treated group (P<0.01).Silenced expression of TLR4 al-leviated the endoplasmic reticulum stress (P<0.05).Conclusion Increased expression of CHOP contribu-ted to cell apoptosis .TLR4 might promote ox-LDL induced macrophage apoptosis through accelerating endo-plasmic reticulum stress .

Objective To explore the outpatients′experience of caring and provide references for improving their experience of medical care.Methods The phenomenology research method was adopted in this study,and twenty-one outpatients were subject to an in-depth interview to learn their outpatient experiences.Results Ten themes of experience with caring were extracted as follows:passionate and patient,careful and considerate,respect for others,offers to help,encouraging and comforting,apologies and courteously,humor,truthful considerations,conscientious and responsible,and a caring environment setup.Five themes of experience without caring were extracted as follows:impatient communication, careless seeing of outpatients,delayed service,passive reminders,and facilities without enough details. Conclusions The outpatients may have abundant experiences of caring at the outpatient clinic,also lack of caring sometimes as well.Outpatient managers should keep an eye on outpatients′needs and satisfaction of caring from time to time,to improve the quality of outpatient service.

Objective To investigate the effectiveness and safety of applying compound lidocaine cream on tracheal mucosa as topical anesthesia to reduce the stress reaction during extubation of tracheal tube. Methods Sixty patients (aged 18-65yr,body weight 40-80kg,ASA Ⅰ-Ⅱ) scheduled for elective surgery under general anesthesia were selected,and they were randomly divided into compound lidocaine cream group (group L,n=30) and control group (group C,n=30). Orotracheal intubation was performed in all the patients. Compound lidocaine cream was uniformly smeared on the foremost third of endotracheal tubes before intubation in group L,and no drug was coated on endotracheal tubes in group C. The changes in blood pressure and heart rates during extubation,the use of hypotensive drugs,cough reflex,breath holding,sore throat and pharyngeal discomfort after extubation were compared between the two groups. Results The operation and intubation time of the two groups showed no significant difference. The blood pressure and heart rate during extubation,the rate of using hypotensive drugs,and the incidence of cough reflex and breath holding were lower in group L than in group C,while the foreign body sensation in pharynx were after extubation was more frequent in group L than in group C. The incidence of pharyngodynia was similar in the two groups,and the pharyngodynia and foreign body sensation in pharynx markedly improved one day after operation in both groups. Conclusion Topical anesthesia of tracheal mucosa using compound lidocaine cream may reduce the cough reflex and breath holding during extubation,and inhibit the stress reaction.

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