Objective To evaluate the differences of the thinnest-point corneal thickness (TCT) decrease after three different corneal crosslinking (CXL) protocols for progressive keratoconus.Methyds Retrospective clinical case study.From August 2010 to November 2015,consecutive 85 patients (110 eyes) with progressive keratoconus were enrolled and treated with CXL in Department of Opthalmology,Navy General Hospital.21 patients of 25 eyes underwent standard epithelium-off corneal crosslinking (S-CXL),14 patients of 22 eyes underwent 1 g · L-1 riboflavin-sodium lactate Ringer's solution iontophoresis-assisted CXL (I-CXLa),and 50 patients of 63 eyes underwent 0.1％ riboflavin-distilled water solution I-CXLb.Preoperative and postoperative TCT were measured by ALLEGRO oculyzer.The differences of TCT decrease after treatment were compared among the three CXL protocols.Results The differences of TCT from baseline after 3 months,6 months and 12 months in the S-CXL group were (-14.93 ±27.16) μm,(-31.94 ±22.89) μm,(-27.71 ±26.01) μm,respectively,the I-CXLa group were (-20.14 ± 19.09) μm,(-10.10 ± 24.28) μm,(-7.11 ± 22.26)μm,respectively,the I-CXLb group were (-28.08 ± 26.14) μm,(-21.08 ± 25.62) μm,(-15.91 ± 19.19)μm,respectively.Three months after treatment,the differences of TCT decrease in the three groups was not statistically significant (P =0.188);Six and 12 months after treatment,the differences between S-CXL and I-CXLa were statistically significant (all P ＜0.05),but the differences between S-CXL and I-CXLb,between I-CXLb and I-CXLa showed no significant difference (all P ＞ 0.05).Conclusion Six and 12 months after treatment,TCT decrease is related to the CXL protocol.TCT decrease degree may reflect the intensity of crossinking.TCT decrease in I-CXLb is smaller than that in S-CXL,but there is no statistical difference.

Objective To compared the reliability and validity of the application of two consciousness assessment scales in neurosurgical patients by Full Outline of Unresponsiveness Score Coma Scale (FOUR) and the Glasgow Coma Scale (GCS), and provide the effective evaluation for the consciousness of the nerve severe patients. Methods A total of 100 neurological intensive patients from Nanfang Hospital, Southern Medical University were enrolled and the consciousness was evaluated by FOUR and GCS. The reliability and validity of these scales were evaluated and compared by the following method such as Cronbach αcoefficient, the inter-rater agreement,content validity index (CVI) and the receiver operating characteristic curve (ROC) which used to predict the discrimination of prognosis.The important experimental indexes of blood of the degree of brain injury were collected in the same period:S-100 B protein and neuron specific enolization enzymes (NSE). Results The Cronbach α coefficient was 0.811 (FOUR) and 0.923(GCS). The overall rater agreement was excellent with an intraclass correlation coefficients of 0.972 (FOUR) and 0.979(GCS). CVI was 0.965 (FOUR) and 0.973 (GCS). Both scales had better distinguish and predictive abilities for the poor prognosis.The area under the curve for mortality was 0.938 for the FOUR and 0.932 for the GCS. The best cut-off values for predicting poor prognosis were FOUR of 12 and GCS of 11. For the FOUR, the correlation coefficient was-0.324(P<0.05) with the level of NSE,-0.427(P<0.01) with the level of S-100B protein. For the GCS,the correlation coefficient was-0.316 (P<0.05) with the level of NSE,-0.395 (P<0.01) with the level of S-100B protein. Conclusions Both FOUR and GCS are a reliable scale for evaluating the level of consciousness in neurosurgical patients. The GCS is familiar with the medical staff while the FOUR is more adapted to assess the patients with tracheotomy or intubated and which more easy to remember and learn by medical staff of neurosurgery department.

On the basis of the origin comparison of known endothelial genesis inhibitors, a 417-bp cDNA fragment was amplified from umbilical cord by RT-PCR and cloned into the expression vector pPIC9, followed by transformation into Pichia pastoris GS115. The resulted yeast was induced with methanol to express recombinant protein. The resulted protein was purified from culture broth and designated as EDI-8t. The in vitro study showed that EDI-8t, originated from collagen VIII, could specifically inhibit the growth and migration of bovine aortic endothelial cells (BAEC) stimulated by basic fibroblast growth factor (bFGF). The protein also exhibited the activity to cause cell apoptosis. In vivo EDI-8t showed the identical activity comparing with endostatin to inhibit the growth of liver tumor transplanted into nude mice. Interestingly, EDI-8t showed higher activity than endostatin to inhibit tumor growth in metastatic model of melanoma mice.
Amino Acid Sequence ; Angiogenesis Inhibitors ; biosynthesis ; genetics ; isolation & purification ; Animals ; Antineoplastic Agents ; pharmacology ; Base Sequence ; Cattle ; Cells, Cultured ; Collagen Type VIII ; chemistry ; genetics ; Endothelium, Vascular ; metabolism ; Genetic Vectors ; genetics ; Human Umbilical Vein Endothelial Cells ; chemistry ; Humans ; Mice ; Mice, Nude ; Molecular Sequence Data ; Pichia ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; pharmacology

OBJECTIVETo explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result.

METHODSDefects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps.

RESULTSWounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control.

CONCLUSIONSSkin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.

Animals ; Debridement ; Dogs ; Hindlimb ; injuries ; Microsurgery ; Soft Tissue Injuries ; surgery ; Wound Healing ; Wounds, Gunshot ; surgery

Objective To explore the application disturbance coefficient (DC) value of noninvasive brain edema monitoring in patients after traumatic brain injury.Methods A total of 54 cerebral injury patients were performed by non-invasive brain edema monitoring from June to November 2016.The essential information,DC,intracranial pressure (ICP),and 6-month-later glasgow outcome score (GOS) were collected.Results DC was negatively correlated with ICP (r=-0.779 5,P＜0.01),and it was positively correlated with glasgow coma scale (GCS) and GOS (r=0.667 5,P＜0.01;r=0.630 6,P＜0.01).The mean of DC with good prognosis patients was 106.99±4.09,and that of the poor prognosis patients was85.26±4.45,the difference was statistically significant (P＜0.05).Conclusion DC has a good clinical application value.

Objective To investigate the relationship of age-related macular degeneration (AMD) with blood-lipid levels. Methods Individuals 40 years old or older who had undergone a physical-health examination in our hospital between January and December 2017 were enrolled in this study. Information regarding medical history and the results of essential ophthalmological and physical-health examinations were examined to exclude individuals with serious chronic diseases such as malignant tumors, stroke, myocardial infarction, pulmonary heart disease, hypertension, diabetes, and kidney disease. One thousand nine individuals with AMD (all at the early stage) were included in the AMD group, and 3489 individuals without AMD were included in the non-AMD group. Data of all participants, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels, were collected and analyzed. Results The average age in the AMD group was higher than that in the non-AMD group, and the male to female ratio was significantly higher in the AMD group (P<0.05). After adjusting for age, gender, and BMI confounders, multiple linear stepwise regression analysis revealed that HDL-C was associated with AMD (β=-0.026, 95% CI: 0.045-0.006, P=0.011); there was no correlation between TC, TG, LDL-C, and AMD (all P>0.05). Conclusion Early stage AMD was related to a decrease in HDL-C, which may be a protective factor against AMD. Further study is warranted to validate this finding.

Objective To determine the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for gastrointestinal lesions with inconclusive endoscopic biopsies. Methods A retrospective analysis was performed in 65 patients who were found to have gastrointestinal lesions with inconclusive endoscopic biopsies and underwent EUS-FNA in Drum Tower Hospital. Diagnostic value of EUS-FNA was determined by comparing with surgical histopathology and follow-up results. Results This study included 41 males ( 63％) and 24 females ( 37％) with median age of 60 years. The most common lesion was diffuse infiltrative lesions ( 37, 56. 9％) , followed by submucosal protrusion types ( 17, 26. 2％) . Fifty-four cases ( 83. 1％) were malignant lesions, and 11 cases ( 16. 9％) were benign. The overall sensitivity, specificity, and accuracy of EUS-FNA for gastrointestinal lesions with inconclusive biopsies were 76. 8％ ( 95％CI: 65. 7％-87. 8％) , 100. 0％ ( 95％CI: 66. 4％-100. 0％) , and 80. 0％( 95％CI: 70. 3％-89. 7％) , respectively. Sub-group analysis showed the sensitivity, specificity, and accuracy of EUS-FNA for diffuse infiltrative lesions were 70. 6％ ( 95％CI: 55. 3％-85. 9％, 100. 0％( 95％CI:29. 2％-100. 0％) , and 73. 0％ ( 95％CI: 58. 7％-87. 3％) , respectively. For submucosal protrusions, the sensitivity, specificity, and accuracy of EUS-FNA were 68. 8％ ( 95％CI: 46. 0％ -91. 5％) , 100. 0％ ( 95％CI: 2. 5％-100. 0％) , and 70. 6％ ( 95％CI: 44. 0％-89. 7％) , respectively. Conclusion EUS-FNA has moderate diagnostic value for endoscopic biopsy-inconclusive gastrointestinal lesions. It can be an alternative option when standard methods, such as endoscopic mucosal forceps biopsy, fail to provide a definitive diagnosis.