AIM: To investigate the clinical effect of small incision lenticule extraction (SMILE) for super high myopia.METHODS: Totally 64 cases (128 eyes) patients with super high myopia, were randomly divided into observation group and control group, 32 cases (64 eyes) in each group.The two groups were separately treated with SMILE or femtosecond laser LASIK (FS-LASIK).We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant (P>0.05).The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups (P>0.05).Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D.After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes (90.1%) in observation group and 49 eyes (76.6%) in the control group, within±1.0D were 64 eyes (100%) and 60 eyes(93.8%).CONCLUSION: SMILE is safe and effective in the treatment for super high myopia.The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.

Objective To investigate the changes of psychological state and family environment of the patients with neurosis (including depression and anxiety) in the process of treatment. Methods The Hamilton depression scale (HAMD), Hamilton anxiety scale(HAMA), self-rating depression scale(SDS), self-rating anxiety scale(SAS), family environment scale(FES), and family adaptability and cohesion scale(FACESⅡ-CV) were used to evaluate the changes of psychological state and family relationship in the process of treatment among patients with depression and anxiety hospitalized in general hospitals (n=45) and their family members (n=45). Results Before intervention, values of HAMD, HAMA, SDS and SAS in patients were higher than normal ones, and were in line with the corresponding diagnostic criteria. After psychological intervention and medication for 2 to 3 months, symptoms such as depression and anxiety were improved significantly, and values of the above scales were within normal ranges. Besides, there was also significant improvement in FES and FACESⅡ-CV after intervention among the patients. All the values of the family members were in the normal ranges before intervention, however, significantly positive changes were observed after intervention. Conclusion With the improvement in depression and anxiety after intervention among patients, the psychological pressure of family members is released, and family relationship is partially restored. The rehabilitation of patients plays an important role in the restoration of family function.

Objective In order to study the etiology and the hearing status of the deaf students in Hubei province, a survey was carried out from April 1999 to June 2000.Methods A total number of 813 deaf students in Hubei province were examined with audiometer and investigated through questionnaire. The pedigress analysis was conducted in deaf students with family history.Results The pedigrees of 227 familes with deafness were obtained, the inheritance pattern of 167 families could be ascertained. 232(28.5%) deaf students were diagnosed congenital deafness, 581 (71.5%) students were diagnosed acquired deafness. The degrees of deafness could be ascertained with 359(44.1%) students of profound deafness, 323(39.7%) students of severe deafness, 111(13.7%) students with moderate to severe deafness, 11(1.4%) students of moderate deafness, and 9(1.1%) students of mild deafness.Conclusion The hearing loss of deaf students is very serious, and genetic factor and ototoxic antibiotics were a principal causation in the occurrence of deafness.

OBJECTIVE To analyze the antimicrobial therapeutic schemes in appendectomy inpatients so as to(evaluate) the economic impact factors of each project.METHODS Totally 286 medical cases of appendectomy inpatients were chosen and analyzed from 2003 to 2005.The antimicrobial agent costs of each scheme were evaluated by(using) cost minimization analysis of pharmacoeconomic method.RESULTS There were 24 kinds of antimicrobial therapeutic schemes used by 286 cases.The commonest schemes were nitrodazoles + ?-lactams and nitrodazoles + ?-lactams + aminoglycosides(or clindamycin). The drug costs were 1671.46 and 1977.13 yuan(RMB)(individually) in combination of two or three kinds of antimicrobial agents.Choosing metronidazole instead of ornidazole could reduce drug fee significantly,which was also observed in choosing ceftazidime instead of other ?-lactams.CONCLUSIONS The antimicrobial drug utilization in our hospital is rational as a whole.Considering of economic factors,using metronidazole and ceftazidime(administering clindamycin if necessary) may be better than other schemes for prventing wound infection.

BACKGROUND: Abnormal hematopoietic microenvironment is an important factor causing dyshematopoiesis. However, no consensus has been reached on the sensitivity of hematopoietic stromal cells to irradiation.OBJECTIVE: To observe the changes of marrow stromal cells (MSCs) cycle and DNA content during the early stage of irradiation damage in mice, so as to further understand dyshematopoiesis due to radiation and provide scientific basis to avoid deleterious factors in hematopoietic environment.DESIGN: Completely randomized grouping and randomized controlled study based on the experimental animals.SETTING: Central laboratory of altitude military affairs medical department and altitude research institute of preventive medicine department, a military medical university of Chinese PLA.MATERIALS: This study was carried out at the Experimental Animal Center of Third Military Medical University between October 2002 and April 2003. A total of 60 healthy male Kunming mice were randomly divided into irradiation damage group and healthy control group, each having 30 mice.METHODS: The 30 mice in irradiation damage group were exposed to 60Co-γ of irradiation at a dose rate of 1.27 Gy/minutes within a distance of 4 m. Then the mice' marrow cells were harvested at day 3 and day 7 after irradiation, and were cultured in vitro for 14 days and 21 days for observation. Meanwhile the other 30 healthy mice unexposed to irradiation were considered as normal controls.MAIN OUTCOME MEASURES: Post-radiation number of MSCs colonies,cell cycle and DNA content.RESULTS: Although MSCs could grow and be adhered to walls after being exposed to irradiation of 5.0 Gy/s, the number of MSCs colonies was found significantly decreased compared to that of rnormal control group( P < 0.01 ).The colony number of the MSCs irradiated for 7 days obviously increased than that of MSCs irradiated for 3 days; however, MSCs recovered slowly and resulted in prolonged culture time, indicating the inhibited proliferation of MSCs due to irradiation damage. Results of flow cytometry showed that cells in G2+ M phase(2.60±0.41, 4.20±1.27) and DNA content (58.40±0.79,61.17 ± 1.35) in irradiation groups after 3-day and 7-day irradiation were obviously lower than those of normal control group(12.60 ±0. 75, 78.57±0. 83)(P <0.05-0.01).CONCLUSION: MSCs have relatively high sensitivity to irradiation damage and longer persisting period.

Adult ; Endocarditis, Bacterial ; microbiology ; Enterococcus faecium ; Humans ; Male

The relationship between C936T polymorphism at 3'-untranslated region of vascular endothelial growth factor (VEGF) gene and diabetic nephropathy (DN) was analysed in 194 type 2 diabetic patients. The frequencies of genotype CC and allele C were significantly higher in DN group than those in non-DN group and control group. Allele C and genotype CC of VEGF may be a genetic marker susceptible to DN.

Objectives To investigate the clinical significance of CYP2C19 genotype detection for antiplatelet therapy of elder cardiovascular and cerebrovascular diseases(CCVD).Methods We enrolled all elderly patients with either cardiovascular or cerebrovascular disorders who received clopidogrel as mono drug or in combination with another antiplatelet drug aspirin as secondary prevention for more than 12 months in our hospital from January to August 2015.Somatotypes of CYP2C19 genotypes of all participants were assessed to analyze the relapse of cardiac-cerebral vascular diseases in these patients.Results A total of 250 patients were enrolled,including 179 male and 71 female,with average age of (85.2 ± 7.9) years.Among these patients,there were 97 (38.8％) cases with EM CYP2C19 genotypes,110 cases(44.0 ％) with IM CYP2C19 genotypes,43 cases(17.2 ％) with PM CYP2C19 genotypes.When treated with clopidogrel for antiplatelet in secondary prevention process,the rate of the relapse in cardiovascular event was 34.9％ and higher in PM CYP2C19 genotype than in EM and IM CYP2C19 genotype (19.6 ％ and 15.5 ％,respectively) (x2 =7.251,P =0.027).This phenomenon was similar to patients who received stent implantation(x2=6.393,P =0.041).However,no statistically significant difference was observed in the recurrence rate of cerebral vascular disease between three different genotypes(EM 29.9 ％,IM 20.0 ％,PM 27.9％,x2 =2.880,P =0.237).Conclusions Our results highlight that CYP2C19 genotype might be a potential guidance for secondary prevention of cardiovascular and cercbrovascular disorders among elderly patients.Clopidogrel may be less effective in patients with SM CYP2C19 genotype than those with EM or PM CYP2C19 genotype for secondary prevention of cardiovascular disease.

Objective To evaluate the curative effects of intravenous methylprednisolone (IVMP) during the conservative management for patients with indirect optic nerve injury (ONI),and to analyze the benefits of visual evoked potential (VEP) monitoring in prognosis assessment.Methods Among the 253 patients with cranial-facial injury,108 sufferred from optic nerve injury including 89 cases without optic nerve decompression treatment.These 89 patients were randomly divided into:group A,in which patients were given methylprednisolone intravenously for 7 days; and group B,in which patients without methylprednisolone treatment.The extent of and time required for eyesight recovery were recorded.VEP measurement was carried out in all cases.Results No differences in gender,age and BMI (Body Mass Index,all P ＞ 0.05) were observed.The incidence of ONI was higher in patients with motorcycle accident than that in those with car accident (P ＜0.01).In the motorcycle accidents,casualties wearing a helmet had lower incidence of ONI (P ＜ 0.01).Patients treated with methylprednisolone had a shorter recovery time (P ＜ 0.01) from blindness,however there was no difference in long-term outcome between group A and B.In patients with visual improvement in the “ non-extinguished” group,the amplitude and latency of the P wave of VEP were markedly ameliorated after the treatments (P ＜ 0.01).Conclusions Most of the ONI casualties in our study were resulted from motorcycle accidents,and wearing a helmet is an effective protection measure.The intravenous methylprednisolone (IVMP) showed no effect on improving the prognosis in patients with conservative treatment.The IVMP shortened the recovery time at the expense of increase in risk of complications.VEP examination is beneficial in prognosis assessment for non-operative ONI patients.The improvement of the amplitude and latency of P wave has close correlations with patients'visual recovery.

Objective To evaluate the association of Smad2/3,Smad4 and P-Smad3 protein expressions in tissue with liver fibrosis in patients with chronic HBV infections.Methods Liver biopsy was performed to determine the liver fibrosis grades in 131 cases of chronic HBV infections.Immunohistochemistry and semiquantitative analysis were applied to detect the expression of Smad2/3,Smad4 and P-Smad3 proteins in liver tissues.Results Smad2/3,Smad4 and P-Smad3 were detected mainly in fibrous septum,portal areas,myofibroblasts,sinus and cytoplasm in the liver tissue.The expression of Smad2/3,Smad4 and P-Smad3 was increased with the development of fibrosis ( r =0.81,0.58and 0.68,P =0.000),and a strong positive correlation was observed among three proteins (r =0.75,0.87and 0.84,P =0.000).Conclusion The expression of Smad2/3,Smad4 and P-Smad3 is correlated with liver fibrosis in chronic HBV infection,which suggests that the up-regulation of Smad proteins may be involved in the progression of liver fibrosis.