ObjectiveTo observe the retinal function and nerve fiber layer (RNFL) thickness after laser in situ keratomileusis (LASIK). MethodsLASIK was performed in 15 cases (30 eyes) with myopia after strict preoperative examination. All examinations such as vision, correction vision, diopter, intraocular pressure, corneal thickness, ocular axis, topography scan and fundus of eye examination were performed before and 1 day, 1 week, 1 month,3 months and 6 months after operation, as well as electroretinography (ERG), visual evoked potential (VEP), optical coherece tomography at same time. ResultsThere was not significant difference in the intraocular pressure, ERG and VEP 1 day after LASIK. The thickness of RNFL decreased 1 week after LASIK (P<0.05) and recovered 1～6 months later. ConclusionLASIK does not disturb the retinal function and RNFL thickness irreversiblely.

ObjectiveTo investigate the effect of filtering surgery on glaucoma.Methods50 glaucoma cases (60 eyes) were underwent trabeculectomy, including paracentesis in advance, suturing of sclera flap and conjunctiva flap, using mitomycin (MMC) and forming anterior chamber as soon as finished operation. All cases were followed up 1 year.ResultsPostoperative IOP was lower than 21 mmHg in 54 eyes, 6 eyes were <30 mmHg when treated with drugs. After operation, there were only 2 eyes had lower vision, the others had higher vision. Two eyes had conjunctiva filtering, two eyes had choroidal separation, but they recovered after non surgical therapy.ConclusionFiltering surgery can decrease common complications, increase vision of early stage, and make IOP recovered to normal.

Objective: To observe the effectiveness and safety of electroacupuncture (EA) plus Luohua Anshen oral liquid for patients with perimenopausal insomnia. Methods: A total of 66 participants who met the inclusion criteria were enrolled in the randomized controlled trial and allocated to a treatment group and a control group at a ratio of 1:1, with 33 cases in each group. Both groups were given Luohua Anshen oral liquid as a basic treatment. The treatment group was additionally given EA every other day, three times a week. Both groups were treated for four weeks and a four-week follow-up was conducted. The scores of Pittsburgh sleep quality index (PSQI), Kupperman index (KI) and traditional Chinese medicine sleep syndrome scale (TCMSSS) were recorded at pre- and post-treatment, and at the follow-up. Meanwhile, adverse effects were monitored and recorded. Results: After four-week treatment, the global scores of PSQI, KI and TCMSSS in both groups declined significantly (all P<0.05), and the decreases in the treatment group were more significant than those in the control group (allP<0.05). The global scores of PSQI, KI and TCMSSS in both groups at the follow-up visit were significantly different from the corresponding baseline (allP<0.05), while insignificantly different from those assessed at post-treatment (allP>0.05). The total effective rate was 93.9％ in the treatment group, significantly higher than 72.2％ in the control group (P<0.05). No significant adverse event was reported in this trial excepted one patient experienced slight dizziness in the first acupuncture treatment. Conclusion: EA plus Luohua Anshen oral liquid is safe for perimenopausal insomnia with satisfactory short- and long-term effectiveness, and it shows certain advantage compared with using Luohua Anshen oral liquid alone.

Objective To study the value of 64-slice spiral CT digital subtraction technique in the diagnosis of intracranial aneurysms.Methods 36 patients with subarachnoid hemorrhage underwent 64-slice spiral CT examination,including unenhanced CT scan and enhanced CT scan.The image data were used to reconstruct the conventional CTA and digital subtraction CTA(DSCTA).Then the differences of image quality and diagnostic efficiency between the CTA and DSCTA were compared based on the standard of DSA . Results There were 40 intracranial aneurysms in 36 patients . 40 aneurysms were detected completely by DSCTA,the sensitivity and specificity of the DSCTA were both 100% . 37 aneurysms were detected by CTA , and the sensitivity and specificity were 92.5% and 100%,respectively.There was significant difference in image quality between CTA and DSCTA(P＜0.01).Conclusion DSCTA with 64-slice spiral CT might be the first diagnostic tool in screening intracranial aneurysm.

Objective: To investigate the effect of electroacupuncture (EA) on cognitive function in D-galactose (D-gal)-induced aging rats, and the correlation between the effect and nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3)-ASC-Caspase-1 signaling pathway. Methods: Forty-six male Sprague-Dawley (SD) rats were randomly divided into a control group (n=10), a model group (n=12), an EA-7 d group (n=12) and an EA-21 d group (n=12). Except the control group, the other three groups received 42 consecutive days of intraperitoneal injection of D-gal to establish aging rat models with cognitive dysfunction. The control group received the same amount of normal saline via intraperitoneal injection. Two EA groups were given EA therapy for 21 consecutive days (began from the 22nd day of modeling) or 7 consecutive days (began from the 36th day of modeling) accordingly at Dazhui (GV 14), Baihui (GV 20), Shenshu (BL 23) and Zusanli (ST 36). After modeling/ intervention, all four groups received behavioral evaluations by Morris water maze (MWM) test, novel object recognition (NOR) test and step-down passive avoidance (SDPA) test followed by the Western blot (WB) detection of the expression levels of hippocampal NLRP3 inflammasome-associated proteins NLRP3, ASC and Caspase-1. Results: MWM (place navigation test, PNT) results showed that the escape latency in the model group was significantly longer than that in the other three groups (P<0.05), and there was no significant difference among the other three groups on the 1st day of the test (P>0.05). From the 2nd day to the 4th day of the test, there was no significant difference between the EA-21 d group and the control group (P>0.05) in the escape latency; the escape latency was significantly shorter in the EA-21 d group than in the model group and the EA-7 d group (P<0.05). MWM (spatial probe test, SPT) results showed that the time spent in the target quadrant was significantly shorter and platform crossover number was significantly lower in the model group than in the other three groups (P<0.05). The time spent in the target quadrant was longer in the EA-7 d group than in the model group (P<0.05), but was shorter than that in the control group and the EA-21 d group (P<0.05). There was no significant difference in the swimming speed among the four groups (P>0.05). NOR results showed that there was no significant difference in the recognition ratio between the EA-7 d group and the EA-21 d group (P>0.05), and the recognition ratio was significantly higher in the two EA groups than in the model group (P<0.05), but was lower than in the control group (P<0.05). SDPA results showed that the electric shock number was higher in the model group than in the other three groups (P<0.05), and the differences among the other three groups were statistically insignificant (P>0.05). The model group had the shortest step-down latency, followed by the EA-7 d group, the EA-21 d group and the control group in order (P<0.05). The WB results indicated that the expression level of NLRP3 was significantly lower in the control group and the EA-21 d group than in the model group and the EA-7 d group (P<0.05). The expression levels of ASC and Caspase-1 were significantly higher in the model group than in the other three groups (P<0.05), and there was no significant difference among these three groups (P>0.05). Conclusion: NLRP3 inflammasome may be involved in the development of cognitive decline in aging rats; 7 consecutive days of EA intervention can partially improve the cognitive impairment in aging rats though the effect is rather limited; 21 consecutive days of EA intervention may improve the learning and memory abilities in aging rats via downregulating the expression levels of NLRP3 inflammasome-associated proteins in hippocampus.

?AIM: To explore the relation of homocysteine ( Hcy ) and its metabolic related indicators with primary angle-closure glaucoma ( PACG) .?METHODS: In this study, a total of 150 PACG patients and 150 controls were enrolled. The patients with PACG were diagnosed by applanation tonometer, Humphrey perimetry ( HVF ) , optical coherence tomography ( OCT ) , gonioscope. The normal controls were recruited from physical examination center. Blood samples were collected and the plasma was used to determine homocysteine, vitamin B12 and folic acid. DNA was extracted to determine the methylenetetrahydrofolate reductase ( MTHFR ) C677TT genotype and gene polymorphism.?RESULTS:There was a statistically significant difference (t=2. 04,P=0. 04) in mean homocysteine levels between patients with PACG ( 16. 11 ± 1. 66μmol/L ) and controls (15. 74± 1. 52μmol/L). The level of vitamin B12 in PACG group was 248. 09 ± 119. 07pg/mL and the control group was 230. 21 ± 142. 93pg/mL. No statistically significant difference was found on the vitamin B12 level between the two groups ( t = 0. 84, P = 0. 40 ). The folic acid levels showed no statistically significant differences( t=1. 65,P=0.17) between the PACG group(12. 02±7. 81ng/mL) and the control group (13. 15 ± 6. 25ng/mL). The frequency distribution of the MTHFR C677T genotypes was found to be significantly associated (χ2 =6. 2,P<0. 05) with PCAG (CC 84. 7%, CT 4. 7%, TT 10. 7%) as compared to the controls (CC 94. 7%, CT 2. 0%, TT 3. 3%). The frequency distribution of TT genotypes of MTHFR C677T in the PACG group was significantly higher than that in the control group. Moreover, our findings showed significant difference (χ2=14. 2,P<0. 05) between the allele frequency of the C677T single nucleotide polymorphism within the MTHFR gene in POAG patients ( T 87. 0%, C 13. 0%) and the control group(T 95. 7%,C 4. 3%) .?CONCLUSION: These results show that the Hcy level and the TT genotypes of MTHFR C677T were higher in the PACG patients than in controls. Therefore, our data suggests that high Hcy level and the related indicators are associated with high PACG risk.

Objective:To investigate the effectiveness and safety of manual acupuncture for memory loss and sleep quality in chronic insomniacs.Methods:A total of 60 eligible participants were enrolled and randomized into either a treatment group or a control group,with 30 cases in each group.The treatment group was intervened by manual acupuncture whereas the control group was given sham acupuncture.In the two groups,the interventions were offered once every other day and three times a week,for 8 weeks in total.Before and after the treatment,Pittsburgh sleep quality index (PSQI) and eventrelated potentials (ERPs) were used to assess the patients' sleep quality and memory,respectively.Meanwhile,adverse events were monitored and recorded.Results:After 8-week treatment,both the treatment group and the control group showed a significant decrease in the PSQI global score (P＜0.001,P＜0.01),and the decrease in the treatment group was more significant than that in the control group (P＜0.001).The intra-group comparisons of ERPs indicated that,the latencies of N1 and P3 were shortened and the amplitudes of N1 and P3 were increased in the treatment group after the intervention,and the differences were statistically significant (P＜0.05,P＜0.001);in the control group,there were no significant changes in the latency and amplitude after the treatment (P＞0.05).The between-group comparisons of ERPs showed that the treatment group was more effective than the control group in shortening the latency of P3 (P＜0.01).Conclusion:Acupuncture can be a safe and effective treatment option for chronic insomnia coupled with memory impairment.

Objective:To observe the efficacy and safety of dexzopiclone plus auricular acupressure in intervening primary insomnia.Methods:A total of 72 participants who met the inclusion criteria were enrolled in a randomized controlled trial,with 36 cases allocated to a treatment group and 36 cases allocated to a control group.Both groups were given dexzopiclone as the routine treatment.Patients in the treatment group were given auricular acupressure with Wang Bu Liu Xing (Semen Vaccariae) seeds at the auricular acupoints related to sleep and emotion based on meridian theory,whereas for patients in the control group,the medical plasters with Wang Bu Liu Xing (Semen Vaccariae) seeds were only gently stuck to acupoints unrelated to sleep without stimulation.Patients in both groups were required to visit the hospital once a week for replacing the seeds and plasters.The course of intervention lasted for 8 weeks and the patients were followed up for another 4 weeks.Pittsburgh sleep quality index (PSQI) and Karolinska sleep diary (KSD) were used to evaluate the outcomes.Meanwhile,adverse effects were monitored and recorded.Results:In the enrolled 72 cases,4 patients (one in the treatment group and three in the control group) reported thirst and a bitter taste,and one case in the control group reported nausea and vomiting.At last,3 cases in the control group dropped out for adverse reactions,and 69 cases completed the clinical trial.After 8 weeks of treatment,the global scores of PSQI in both treatment and control groups decreased significantly compared with the baseline (both P＜0.001).Furthermore,the global score of PSQI in the treatment group was lower than that in the control group (P＜0.01).The global scores of PSQI in both groups at the follow-up were significantly different from the baseline (both P＜0.001),but insignificantly different compared with the post-treatment results (both P＞0.05).According to KSD,both treatment protocols could prolong the total sleep time,shorten sleep-onset latency,improve sleep efficacy and sleep quality significantly,and the changes in the treatment group were more significant.The total effective rate was 88.9％ in the treatment group,higher than 81.8％ in the control group,though the difference was statistically insignificant (P＞0.05).Conclusion:Dexzopiclone plus auricular acupressure is effective and safe for patients with primary insomnia both in short and long terms,and it is more effective than monotherapy of dexzopiclone.

OBJECTIVETo observe the protective effects of the Huanglian Jiedu decoction aqueous extract and its active fraction, which consists of total alkaloids, total flavonoids and total iridoid, on the thalamus of cerebral ischemia in rats.

METHODThe rat model of middle cerebral artery occlusion (MCAO) was chosen. Male SD rats were randomly divided into sham-operation group, model group, aqueous extract group (800 mg x kg(-1)), total alkaloids group(44 mg x kg(-1)), total flavonoids group (50 mg x kg(-1)) and the total iridoid group (80 mg x kg(-1)). The rats were administered the appropriate drugs intragastrically once a day, for 7 days after surgery. An equivalent volume of saline was given in the sham surgery and model groups. The HE staining was adopted to observe the pathological changes. Determination of Glu and gamma-GABA in thalamus were detected by HPLC with fluorescence detection. The expression of GAD65 was examined with immunohistochemistry and double staining with uorescent-conjugated antibodies against GFAP and Cx43 was chosen in this study.

RESULTThe neurons degenerated in MCAO rats after cerebral ischemia 7 d. The content of Glu, gamma-GABA decreased (P < 0.05), the expression of GAD65 reduced (P < 0.05) and the expression of GFAP and Cx43 increased (P < 0.01) in thalamus of rats compared with sham-operation group. Huanglian Jiedu decoction aqueous extract, total alkaloids, total flavonoids and total iridoid reduced the degeneration of neurons. Total flavonoids could promote the expression of GAD65 (P < 0.05) and decrease the expression of GFAP and Cx43 (P < 0.01) in thalamus compared with model group while it could also increased the content of Glu,gamma-GA BA to normal levels. Compared with model group, Huanglian Jiedu decoction aqueous extract, total alkaloids and total iridoid could raise the expression of Cx43, and Huanglian Jiedu decoction aqueous extract could also increase the expression of GAD65 (P < 0.05). The expression of GFAP in Huanglian Jiedu decoction aqueous extract group, total alkaloids group and total iridoid group were not different compared with model group while the content of gamma-GABA decreased (P < 0.05) compared with sham-operation group.

CONCLUSIONThe degeneration of nerve cells, the reduction of neurotransmitter amino acids content, the aberrant activation of astrocytes and the abnormal expression of GFAP and Cx43 will appear in thalamus of MCAO rats after ischemia. Huanglian Jiedu decoction total flavonoids could relieve the injury of nerve cell through inhibiting the abnormal activation of astrocytes and regulating the expression of GFAP and GAD65.

Animals ; Astrocytes ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Infarction, Middle Cerebral Artery ; drug therapy ; Male ; Protective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Thalamus ; drug effects

OBJECTIVETo evaluate the relationship between serosal invasion types and lymph node metastasis after total gastrectomy in gastric cancer patients, and explore its significance in planning practice rational dissection based on the serosa types of gastric cancer during surgery.

METHODSA total of 73 gastric cancer patients, who underwent total gastrectomy and lymph node dissection, were included in this study, and their clinicopathological data were analyzed. The serosa of gastric cancer was divided into five types: normal, reactive, nodular, tendonoid, and color-diffused, then they were combined into 3 groups: group 1: normal and reactive, group 2: nodular (including protruding nodular and flat nodular), and group 3: tendonoid and color-diffused. The lymph node metastasis ratios in the 3 groups were compared. The lymph nodes in each of the 3 groups were divided into 16 subgroups and the lymph node metastasis ratios of each subgroup in the 3 groups were compared and analyzed.

RESULTSThe lymph node metastasis ratio of the gastric cancer with normal and reactive type serosa was 5.3% (26/492), the nodular was 37.1% (250/673), the tendonoid and color-diffused was 50.0% (486/972). The lymph node metastasis ratio of normal and reactive type groups was the lowest, that of the tendonoid and color-diffused groups was the highest, and the nodular type in between, showing a statistically significant difference (P<0.01). The results of comparing the lymph node metastasis ratios from the 1st to 16th subgroup in the 3 groups showed the same trend (P<0.05).

CONCLUSIONAmong all serosa types of gastric cancer, the lymph node metastasis ratio of the tendonoid and color-diffused is the highest, the normal and reactive type is the lowest, and the nodular in between. The extent of rational dissection should be carried out on the basis of serosa types of gastric cancer during surgery. An extended dissection including D2 and D3 lymphadenectomy should be performed for the patients with tendonoid and color-diffused serosa, a rational decreased operation including D1-D1+ lymphadenectomy should be performed for those with a normal and reactive type serosa, and for the patients with nodular type serosa, we suggest performing standard D2 dissection.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Serous Membrane ; pathology ; surgery ; Stomach Neoplasms ; pathology ; surgery