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.

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.

Objective To investigate the feasibility and efficacy of tunica vaginalis flap cover in treatment of recurrent urethrocutaneous fistula (UCF).Methods We reviewed the clinical datas of 25 cases of UCF after urethroplasty of hypospadias from January 2011 to January 2015.The mean age of the patients was 6.2 years(range 1.6-14.0 years).All patients had undergone previous hypospadias repair and at least one previous failed attempt to close the urethrocutaneous fistulae.There were 5 cases of fistula in the coronary sulcus,6 cases of fistula in the penile body and 14 cases of fistula at the junction of penis and scrotum.The diameter of urethrocutaneous fistulae were 3-10 mm.Single fistula was present in all patients.16 cases had undergone UCF repair for two times, 9 cases had undergone UCF repair for more than two times.After closing the fistula with inverting running stitch, a tunica vaginalis flap was mobilized to cover the repair site through a subcutaneous tunnel and the skin closed.Results The mean follow-up time was 2.1 years(range 0.5-4 years).The overall success rate was 96％ (24/25).Penile cosmesis was excellent.There was no evidence of recurrent fistulas or urethral strictures.All parents reported a straight penis when erected, and one patient in whom there was leak from the fistula site because of local wound infection.No postoperative complication was encountered in the testis.The testis was of normal size and position, and the ultrasound findings were normal.Conclusions Repairment of recurrent urethrocutaneous fistulas with a tunica vaginalis flap could be effective regardless of fistula location.The technique is simple to improve the success rate of the repair of UCF effectively and reduce the occurrence of postoperative complications.

Objective To prepared cleavable PEG modified paclitaxel loaded liposome (CLP-PTX) and to study its capability for tumor targeting.Methods Liposome was prepared by film-ultrasonic method.Cellular uptake by HepG2 cells was explored.The anti-proliferation efficiency of CLP-PTX was evaluated by MTF assay.HepG2 cells were xenografted in athymic nude mice to establish the animal models,which were used to evaluate the anti-cancer effect.Results The mean size of CLP-PTX was (95±9.5) nm with the Zeta potential of (-3±1.05) mV,and the entrapment efficiency of PTX was 85.6％.The cellular uptake of liposomes with addition of cysteine (Cys)was 2.8 times as high as that in the absence of Cys,and the difference was statistically significant (P＜0.01).Fluorescent microscopy qualitative observation demonstrated that the cells showed higher fluorescence intensity in the presence of Cys.The MTT assay showed the anti-proliferative activity against HepG2 cells of CLP-PTX depended on the paclitaxel concentration,and the inhibition ratio of CLP-PTX with addition of Cys was 1.6 times as high as that in the absence of Cys (P＜0.01),which was consistent with the cellular uptake results.Conclusions Comparing with paclitaxel,CLP-PTX inhibited the proliferation of HepG2 cells more persistently.Thus,CLP-PTX,as a new nanometer drug,has a special application value for tumor therapy.

Objective To establish a tree shrew model of Fusarium solani keractitis by injecting Fusarium solani conidia into the corneal stroma.Methods Fusarium solani was inoculated into Sabouraud culture medium and incubated at 26℃ for 7 days.Fungal suspension was collected and the number of spores was adjusted to 1 × 1010 CFU /mL on the blood cell count plate.Forty healthy tree shrews were randomly divided into experimental group (n=30) and control group (n=10).In the experimental group, 50 μL of fungal spore suspension was injected into the cornea center with a 29G needle, and 50 μL saline was injected in the control group.The models were evaluated by anterior segment photography, in vivo confocal microscopy, histopathology, and corneal tissue culture.Results The fungal infiltration, the degree of edema of corneal epithelial and endothelial cells, and the number of mycelium were positively correlated with time.The number of infiltrating inflammatory cells, mainly, neutrophils, reached a peak on the 7th day after modeling.The mycelial growth was parallel to the stromal fibers.After the successful establishment of the model, the corneal tissue culture showed the growth of Fusarium solani.The successful rate of modeling was 86%.Conclusions The tree shrew model of Fusarium solani keratitis is established by injecting spores of Fusarium solani into the cornea.

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.