Objective To compare the safety,effectiveness and predictability of laser in situ keratomileusis (LASIK) with fem- tosecond laser (IntraLase) and mechanical microkeratome (Moria M2,head 90?m).Design Prospective clinical study.Participant 148 patients (274 eyes) with high myopia received operation of LASIK.Method The patients were assigned to receiving LASIK with corneal flap creation by Intralase femtosecond laser (134 eyes of 76 patients) or Moria 90 keratome (140 eyes of 72 patients),both groups receiving eximer laser ablation with VISX Star S4.Followed-up examinations such as visual acuity,refraction,wavefront aberra- tion,etc.were scheduled for 1 day,1 week,1 month and 3 months postoperatively.Main Outcome Measures Visual acuity,refrac- tion,wavefront aberration,Schirmer test and tear film breakup time(BUT).Results At 3 months after operation,108 eyes (80.6%) of IntraLase group had UCVA better than or equal to BSCVA preoperatively,showing no statistically significant difference to microker- atome group (116 eyes,82.9%,P=0.642).The mean residual spheroequivalent of refraction of IntraLase group was -0.49?0.70D,show- ing no statistically significant difference to microkeratome group (-0.56?0.83D,P=0.448).The mean Schirmer test of Intralase group was 9.5?4.0mm,showing no statistically significant difference to microkeratome group (9.5?7.2mm,P=0.950).The mean BUT of IntraLase group was 7.9?4.3s,showing no statistically significant difference to microkeratome group (8.08?5.48s,P=0.869).The postoperative higher-order aberrations of the IntraLase group was 0.480?0.133?m,lower than that of microkeratome group (0.578?0.169?m,P=0.034). Conclusions Thin-flap LASIK with femtosecond laser and mechanical keratome flap creation are both safe,effective for the correction of high myopia,showing good predictability and stability.Femtosecond laser has slightly better clinical outcomes than microkeratome.

Objective To improve the level of diagnosis and treatment of the traumatic and hemorrhagic shock.Methods 50 cases of patients with sever traumatic and hemorrhagic shock treated in our department between May 2004 and May 2007 were analyzed retrospectively,and their age,shock severity scale,time to hospital after in- jury,operation,fluid resuscitation volume etc were analyzed to show the relationship between the factors and the out- come.Results The rescue success rate was 76%(38 cases),and traumatic mortality was 24%(12 eases).Conclu- sion Shock severity scale and incorreet resuscitation manipulation are the main factors affecting the result of resusci- tation and treatment of traumatic shock,and early surgery can effectively improve the result of severe trauma thera- py.

Objective To investigate the influencing factors for eye cyclotorsion and pupil centroid shift during LASIK.Design Non-controlled retrospective case series.Participant 131 patients (262 eyes) with myopia received bilateral LASIK.Methods Eye cy- clotorsion and pupil centroid shift were measured with Custom Vue~(TM) software during operation and compared with age,gender,right or left eye,flap-making method,spherical equivalent (SE),pupil diameter before and during operation.Main Outcome Measures The de- gree of eye cyclotorsion and distance of pupil centroid shift during LASIK.Results The mean eye cyclotorsion during LASIK was 3.07??2.07?(0?-8.6?).The mean pupil centroid shift was 0.33?0.14 mm (0.04-0.51 mm).The eye cyclotorsion was relevant to preoperative pupil size,difference of pupil size before and during operation,and preoperative SE (r=0.188,0.156,0.130,all P7.0 mm was higher than that of with pupil diameter≤7.0mm (3.35??2.17?,2.71??1.89?,P=-0.014).Pupil centroid shift was higher in fight eyes than that in left eyes (0.39?0.12 mm,0.28?0.13 mm,P=0.000).Conclu- sion Eye cyclotorsion and pupil centroid shift during LASIK can be measured with Custom Vue~(TM) system.The eye cyclotorsion may be influenced by the preoperative pupil size.The pupil centroid during LASIK was more significant in the right eyes than in the left eyes.

OBJECTIVETo study the effect of Ti-TiO2 nanotubes with different diameters on the adhesion of fibroblast and osteoblast, and to find which diameter was more favorable for cells' respective adhesion.

METHODSPure titanium sheets were polished and then anodized at different potentials for 1 h with Ti as anode and Pt as cathode. TiO2 nanotubes formed at 1, 5, 10 and 20 V potentials served as experimental groups and polished pure titanium served as control group. Field emission scanning electron microscopy (Fe-SEM) was used to analyze the surface topography. Stained nucleus with Hoechst33342 were used to measure the cell adhesion. The cell shape on the sample surface were analyzed with Fe-SEM.

RESULTSTiO2 nanotube array of different inner diameters from 15 nm to 100 nm were grown on titanium sheets by anodization at potentials from 1 to 20 V. At 30, 60 and 120 min, fibroblast adhesion at nanotubes anodized at 5 V was (141 ± 9), (388 ± 14) and (489 ± 15) respectively, significantly less than any other nanotube surface at the same time (P < 0.01). Nanotubes anodized at 20 V had the least inhibitory effect for fibroblast adhesion with a number of (579 ± 14) at 120 min, and the cell shape was also inhibited. At 30, 60 and 120 min, osteoblast had a significant better adhesion on nanotubes formed at 5 V than it did on any other surface at the same time (P < 0.01), except the control group at 30 min, with the adhesion number of (198 ± 10), (431 ± 10) and (501 ± 10) respectively, and osteoblast had a abundant spread on nanotubes formed at 5 V; while osteoblast adhesion on nanotubes anodized at 20 V was (152 ± 11), (403 ± 9) and (465 ± 12) respectively, less than on any other nanotube surface within the same time (P < 0.05), and the cell shape on the surface changed to be more elongate.

CONCLUSIONSFibroblast adhesion is inhabited more or less on Ti-TiO2 nanotubes of different diameters. Nanotubes formed at 5 V have the most osteoblast adhesion, and inhibit fibroblast adhesion.

Animals ; Cell Adhesion ; Fibroblasts ; cytology ; ultrastructure ; Mice ; Microscopy, Electron, Scanning ; Nanotubes ; chemistry ; Osteoblasts ; cytology ; ultrastructure ; Surface Properties ; Titanium ; chemistry

Objective: To modify EBP(endotoxin binding peptide), clone and express the mutate of EBP gene and gain purified mEBP.Method: mEBPgene was cloned by PCR site-directed mutagenesis. PinpointXa-3/mEBP expression vector was designed to express human mEBP as a fusion protein in BL21 (DE3) pLysS. Digested engineering bacteria by lysozyme and collected inclusion bodies.Fusion protein was purified by Pinpoint TM Xa purification system and cleaved by factorXa,mEBP was purified by RP-HPLC. Results: Mutations at residues 5 and 18(Gln→Lys) was obtained by PCR site-directed mutagenesis, expressed and purified mEBP successfully.Conclusions: Obtaining of purified mEBP lay a foundation for its biological activity research.

Objective To compare the dose distribution of reserved planned tangential beam IMRT(2-field IMRT) with multifields beams IMRT(6-field IMRT) of the bulk-recurrent chest wall in postmastectomy breast cancer patients.Methods For 8 patients with chest wall in postmastectomy breast cancer bulk-recurrence,2-field IMRT and 6-field IMRT plans were generated on PTV in Pinnacle Planning System.The prescribed dose of PTV was 50 Gy in 25 fractions and GTV was 66-70 Gy which irradiated incrementally by subsequent plan in 8-10 fractions.The conformal index (CI) and homogeneity index (HI) of 95％ of prescribed dose over PTV were compared,while the dose distribution on ipsilateral lung and heart were evaluated.Results The CI of PTV by 6-field IMRT (0.66 ± 0.08) was higher than that of the2-field IMRT (0.53±0.10)(t=7.99,P＜0.05).The HI ofPTV by6-field IMRT (1.36±0.08)waslower than that of 2-field IMRT (2.19 ±0.78) (t =9.04,P ＜0.05).There was no statistical difference in V5,V10,V20 and V35 for ipsilateral lung and in D V35 and D for heart between two plans.Conclusions Compared with 2-field IMRT,6-field IMRT might have a better dose distribution on planning target volume(PTV) for chest wall in postmastectomy breast cancer bulk-recurrence patients,butthere is no significant difference in dose-volume of ipsilateral lung and heart between two plans.

BackgroundCorneal graft reject is a major cause of corneal transplantation failure.Although many immune-suppressing drugs have been utilized to reduce the reject response,their adverse effects on organ and tissue are still insoluble.The tolerance induction of natural killer T (NKT) cells is currently under investigation.However,the study on the application of NKT cells in high risk corneal transplantation is seldom.ObjectiveThe present study was to explore the effects of α-GalCer-activated NKT cella on allografts survival after high-risk corneal transplantation surgery via retro-bubar injection.Methods The lymphocytes were picked up from the spleen of SPF Lewis rats and cultured in RPMI 1640 medium with 100 mg/L α-GalCer.After one week,NKT cells were sorted by the FACSVantage system as CD161+ TCR-α+ cell from the lymphocytes with the cell densities 5×106/ml.Ten SPF Fisher344 rats were used to prepare the donor corneas,and 20 Lewis rats served as recipients.The high risk corneal transplantation models were created by corneal suturing in 20 recipient rats.Penetrating keratoplasty (PKP) was performed in the model rats.0.1 ml NKT cells or the same volume of normal saline solution were retro-bubarly injected at the end of surgery respectively.The corneal allografts were observed and scored based on Holland criteria at the three-day interval under the slit lamp for 30 days.Two weeks after surgery,three rats from each group were sacrificed by excessive anesthesia method and the eyeballs were obtained for histopathological examination.The inflammatory cell infiltration ( CD4+ and CD8+ ) in grafts was evaluated by immunochemistry and flow cytometry.The use of the animals complied with the Statement of ARVO.ResultsThe mean survival time of the allografts was (7.90± 1.37) days in normal saline solution group and (14.70± 1.49) days in NKT cell group,showing a statistically significant difference between the two groups ( t =10.61,P =0.00 ).Two weeks after surgery,all the allografts showed the severe opacity with lots of new blood vessels and edema in normal saline solution group.However,the corneal grafts were clear in NKT cell group.Abundant CD4+ and CD8+T lymphocytes were seen in the allografts in normal saline solution group,but the inflammatory cells were obviously less in NKT cell group.The percentage of NKT cells in the spleen was (5.67±0.25)％ in NKT cell group and ( 1.21±0.19)％ in normal saline solution group ( t =8.43,P =0.00 ).Conclusionsα-GalCer-activated NKT cells can prolong the survival time of allografts in high-risk corneal transplantation.Retro-bubar injection of α-GalCer-activated NKT cells probably is a new approach to the prevention of the rejection of corneal transplantation.

AlM: To study the therapeutic effect of external-route microsurgery forrhegmatogenous retinal detachment.
METHODS: ln 55 patients ( 55 eyes ) with rhegmatogenous retinal detachment, drainage of subretinal fluid, examination of locating the holes, sclera cryotherapy, scleral buckling, and vitreous cavity injection of filtrated air were performed under surgical microscope.
RESULTS:The retinal reattachment occurred in 50 cases after the primary surgery. The final rate of reattachment was 91% during 6 - 12mo follow - up. The retinal reattachment occurred in 1 case ( recurrent retinal detachment) after the secondary surgery and in 4 cases ( recurrent retinal detachment ) after vitrectomy. The eyesight was improved with different degrees in 55 cases.CONCLUSlON: The external- route microsurgery for rhegmatogenous retinal detachment is simple, safe and effective.

Hepatic artery stricture (HAS) after liver transplantation can lead directly to transplanted liver function exhaustion and complications of biliary system. The early diagnosis and treatment are crucial for better prognosis. Doppler ultrasound is the first method of choice, and angiography can give further clear dignosis. The balloon dilatation is still effective for hepatic arterial stenosis. With the more adaptable usage of oronary stent, if possible, would reveal more promising result especially for tortuous stenotic hepatic artery. The vascular reconstruction or repeated liver transplantation is still the effective therapeutic methods.