AlM:To investigate the factors and solutions of Tibetan Plateau excimer laser in situ keratomileusis ( LASlK ) for myopia overcorrection.METHODS: The relevant information, 32 cases ( 58 eyes) in 126 cases (252 eyes) had obvious overcorrection after LASlK were analyzed.RESULTS: Two months after surgery, 32 cases ( 58 eyes) overcorrection (23. 0%), uncorrected visual acuity of 0. 5 ~0. 8, overcorrection range of +1. 50 ~ +2. 25DS, subjective inserts were ≥ 1. 0; Five case ( 7 eyes ) overcorrection 6mo after surgery (2. 8%), uncorrected visual acuity 0. 8~1. 0-2 , overcorrection range is +0. 75 ~+1. 25DS, subjective inserts were≥1. 0. Corneal thickness of overcorrection was 500~563μm, preoperative refraction was -5. 00 ~ -7. 50D, astigmatism -1. 50 ~ -2. 75DC, preoperative best corrected visual acuity ≥1. 0.CONCLUSlON: Overcorrection and long recovery time after LASlK in Tibet, possibly with local factors altitude, temperature, humidity, surgical parameters and situation.

OBJECTIVETo reveal the effects of three days' repeated exhausted eccentric exercise on the skeletal muscle apoptosis and proliferation in rats.

METHODSFifty male SD rats aged at 8 week old were randomly divided into control group (C) and training groups (B1, B2, B3, B4) (n = 10), the training groups ran on a treadmill every day till exhausted. After they had been trained repeatedly for three days, their medial head of triceps brachii muscle cell apoptosis was detected in paraffin section by the TUNEL, expression of proliferating cell nuclear antigen (PCNA) protein was examined by immunohistochemistry.

RESULTS(1) The apoptosis appeared sequential change, and it was consistent with the exercise-induced skeletal muscle micro-injury (EIMmI). The apoptosis index in the training group after exercise was much greater than that in the control group (P < 0.05), and it reached the peak at 24 h after exercise, then it reduced at 48 h after exercise. (2) The express of PCNA exhibited a sequential change after exercise, the proliferation index in the training group after exercise was greater than that in the control group (P < 0.05), it increased after exercise immediately, but it reduced at 3 h after exercise, then was reached the peak at 24 h after exercise, the proliferation index was moderately correlated with the apoptosis index (P < 0.05).

CONCLUSION(1) Cell apoptosis can induce the delayed skeletal muscle damage. (2) Apoptosis may be a start factor of skeletal muscle regeneration.

Animals ; Apoptosis ; Cell Proliferation ; Male ; Muscle, Skeletal ; cytology ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley

italic>Alangium chinense is a commonly used medicinal plant of Alangiaceae Alangium, one of the characteristic Miao medicines in Guizhou. The genus is strongly differentiated and has complex morphological variation, with significant differences in active ingredients and potency among herbs. In this paper, we sequenced the chloroplast genomes of Alangium chinense subsp. Pauciflorum, Alangium chinense subsp. Strigosum and Alangium kurzii Craib using Illumina high-throughput sequencing technology. The genomes of Alangium chinense subsp. Pauciflorum, Alangium chinense subsp. Strigosum and Alangium kurzii Craib chloroplasts were sequenced, their assembly annotation and structural characterization were completed, and the genomes of the congeners Alangium chinense and Alangium alpinum were downloaded from NCBI for comparative analysis. Finally, the phylogenetic tree was constructed by selecting published species with close affinity to Alangium chinense family from NCBI. The results were as follows: Alangium chinense subsp. Pauciflorum, Alangium chinense subsp. Strigosum and Alangium kurzii Craib chloroplast genomes were 156 670, 156 672 and 156 871 bp in length, with a typical four-segment structure, all containing one long single copy region (LSC), one short single copy region (SSC) and two inverted repeat regions (IRa and IRb). All of them were annotated to 133 genes, including 88 protein-coding genes, 37 tRNA genes and 8 rRNA genes. Three types of long repeat sequences and SSR loci, forward repeats, palindrome repeats and reverse repeats, were found in all chloroplast genomes. Comparative genomic analysis showed that there was diversity in the boundary transition regions of the five species, no rearrangements or inversions were found in the chloroplast genome, and there were significant differences in the coding regions of ndhA, ycf1, rpl16, ycf2, and petD genes, which provided new loci for molecular identification of Patagonia. In the phylogenetic analysis, Alangium kurzii var. kurzii clustered as a single species, and Alangium chinense subsp. Pauciflorum and Alangium chinense subsp. Strigosum clustered as a single species, with a support rate of 93 and close affinity, indicating that the phylogenetic tree can be used for the species identification. This paper can provide a basis for the taxonomic identification of Alangium, ensure the safety of clinical use of anise herbs and regulate the market of Alangium chinense herbs.

Adolescent ; Adult ; Athletic Performance ; psychology ; Back ; physiology ; Electromyography ; Exercise ; physiology ; Humans ; Imagery (Psychotherapy) ; Male ; Young Adult

OBJECTIVETo evaluate the use of Delorme procedure for full-thickness rectal prolapse.

METHODSA series of 25 patients with full-thickness rectal prolapse were treated by Delorme procedure in four institutions between March 2005 and June 2010. The clinicopathological data were analyzed retrospectively.

RESULTSThere were 9 males and 16 females. The mean age was 52(46-72) years old. All the procedures were successfully performed. There were no perioperative deaths. The mean operative time was 65(45-150) min. The intraoperative bleeding was 58(20-200) ml. The mean length of hospital stay was 8.5(5-14) days. Anastomosis dehiscence occurred in 1 patient at post-operative day 7 who was managed under anesthesia. Minor complications occurred in 8(32%) patients, including urinary retention(n=3), intractable pain(n=1), and bowel obstruction(n=4). The follow up time ranged from 2 to 6 years with a median of 3.5 years. Prolapse recurrence was observed in 1(4%) patient during the follow up. The remission rates of fecal incontinence, constipation, bleeding were 37.5%(6/16), 45.5%(5/11), and 15.4%(2/11), respectively. The Wexner incontinence score significantly decreased (median, 5.0 vs. 9.0, P<0.01). The resting pressure and maximum squeeze pressure increased significantly after surgery, while the initial volume and maximal tolerance volume decreased significantly(All P<0.01).

CONCLUSIONSDelorme procedure is safe and easy to perform. The anorectal function is improved after surgery. Therefore it should be considered the procedure of choice for rectal prolapsed.

Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rectal Prolapse ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise.

METHODSThe statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries.

RESULTSAmong the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%), followed by suicide (49, 24.3%) and accident (44, 21.8%). The majority of suicide-induced death were by falling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants.

CONCLUSIONStudies on the morphology and its formative rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Forensic Medicine ; Head Injuries, Closed ; etiology ; mortality ; Humans ; Infant ; Male ; Middle Aged

OBJECTIVETo study the effect of anti-CD25 monoclonal antibody (mAb) combined with antithymocytic globulin (ATG) in the treatment of severe steroid-resistant acute graft-versus-host disease (aGVHD) after unrelated donor hematopoietic stem cell transplantation (UD-HSCT).

METHODSTen leukemic patients who developed severe steroid-resistant aGVHD during UD-HSCT received a standard dose of anti-CD25 mAb and a medium or low dose of ATG. The effect on aGVHD control, patients' survival, infection and relapse after the therapy were analyzed.

RESULTSEight of the 10 patients had complete remission and 2 had partial remission after the combined therapy. In the 8 patients with complete remission, 2 developed third degree aGVHD 3-3.5 months after the transplantation, and were managed with a second combined therapy to successfully achieve complete remission. In the total of 12 combined treatments, the median time of therapeutic effect was 5 days (3-10 days); the median complete relief time was 12 days (8-30 days) in the 10 cases. Among the 8 patients who survived for more than 3 months, 7 were diagnosed to have chronic GVHD including 4 with extensive chronic GVHD. No relapse of leukemia was found in these patients. Five patients survived the 2-year-long follow-up after the transplantation with survival time over 2 years; of the 5 patients who died within 2 years after the transplantation, 1 survived for more than one year, and 4 for less than 6 months. Two patients died from invasive fungal infection, two from aGVHD and one from cGVHD-induced multiple organ failure.

CONCLUSIONAnti-CD25 mAb combined with ATG has good therapeutic effect on steroid-resistant sever aGVHD and may help achieve high complete remission rate and long-term survival in leukemic patients after UD-HSCT.

Acute Disease ; Adult ; Antibodies, Monoclonal ; administration & dosage ; therapeutic use ; Antilymphocyte Serum ; administration & dosage ; therapeutic use ; Drug Resistance ; Drug Therapy, Combination ; Female ; Graft vs Host Disease ; drug therapy ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Prednisone ; therapeutic use ; Young Adult

BACKGROUNDDifferential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT). This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.

METHODSA retrospective case series of 35 ICMVT (M:F, 21:14; mean age (64.5 ± 10.6) years) and 23 gastrocnemius hematoma (M:F, 16:7; mean age (75.4 ± 11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012. Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein, great saphenous vein, calf muscles, skin, and soft tissue were examined.

RESULTSICMVT hypoechoic signals were characterized by long, tube-like masses on longitudinal sections and oval masses on transverse sections, with apparent muscle thrombosis boundaries, distal and proximal venous connections, and, often, lower limb DVT. Gastrocnemius hematoma hypoechoic signals were characterized by large volumes, enhanced posterior hematoma echo, hyperechoic muscle boundaries, no hematoma blood flow, and no DVT, and clear differences in trauma/exercise- and oral anticoagulant-induced hematomas were readily apparent. According to the measurement, the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0, whereas in gastrocnemius hematoma patients the ratio was more than 2.0. Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas. Partial muscle fibers in the hematoma due to muscle fractures were apparent.

CONCLUSIONHigh-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

Aged ; Diagnosis, Differential ; Female ; Humans ; Leg ; diagnostic imaging ; Male ; Middle Aged ; Muscle, Skeletal ; diagnostic imaging ; Retrospective Studies ; Ultrasonography ; Venous Thrombosis ; diagnostic imaging

OBJECTIVETo design transoralpharyngeal atlantoaxial reduction plate (TARP), evaluate its biomechanical performance and observe its preliminary clinical effect.

METHODSA brand-new TARP system was designed, including butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other operation instruments. Twelve fresh occipital bone-C(3) specimen were designed for biomechanical test including range of motion (ROM) (n = 6) and screw pull-out strength (n = 12). Preliminary clinical application of TARP was reported.

RESULTSThe reduction mechanism of the TARP system was designed cleverly. TARP had equal effect with Magerl + Brooks and it was more stable than the other three clinically widely used atlantoaxial fixators: Magerl, Brooks and anterior transarticular screw fixation through C(2) vertebral body. TARP's C(1) and C(2) screws were strong enough for atlantoaxial arthrodesis and their antipull-out performance was excellent. Clinical application on irreducible atlantoaxial dislocation proved that TARP had the function of instant reduction, the operation was feasible and the operation effect was significant.

CONCLUSIONTARP's design is novel and it has excellent biomechanical performance. The operation procedure is simple and reasonable. Furthermore, instant reduction could be completed during the operation and the fixation is strong. Above all, TARP is creative and will have excellent prospect.

Adolescent ; Adult ; Atlanto-Axial Joint ; surgery ; Equipment Design ; standards ; Equipment and Supplies ; adverse effects ; standards ; Female ; Humans ; Joint Dislocations ; etiology ; surgery ; Male ; Orthopedic Procedures ; methods ; Pharynx ; surgery ; Treatment Outcome

BACKGROUNDCurrent surgical practice for nephron sparing surgery allows at least 1 cm margin of normal tissue around the tumour. However, recent studies show that the width of the margin is not important, even simple enucleation is as effective as partial nephrectomy. We explored whether margin size has significant impacts on clinical outcomes in nephron sparing surgery for renal cell carcinoma of 4 cm or less.

METHODSBetween 1998 and 2006, 115 patients with sporadic, pathologically confirmed, renal cell carcinoma 4 cm or less (T1a) and normal contralateral kidney were treated by nephron sparing surgery using a margin less than 5 mm. The surgical margin status was evaluated from frozen and permanent paraffin sections.

RESULTSMean and median tumour diameter were 3.3 cm and 3.5 cm (range 1.0-4.0). The mean margin width was 2.2 mm (median 2.0, range 0-6). In addition, 114 cases had margins 5 mm or less (99.1%), 97 cases (84.3%) had margin 3 mm or less, and 26 cases had margin zero (22.6%). None of the patients had positive surgical margins. No patients died during follow-up (mean 65 months). There were no any major surgical complications and no distant metastasis was detected. Local recurrence was detected in one case (0.9%) at a different site of the kidney.

CONCLUSIONSFor early localized renal cell carcinoma of 4 cm or less, as long as tumour is completely excised, the size of margin in nephron sparing surgery is not important. Nephron sparing surgery with 5 mm margin is enough for tumour control. It provides excellent renal function preservation, favourable long term progression free survival and is not associated with an increased risk of local recurrence.

Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; surgery ; Female ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Nephrons ; surgery