Asthma ; immunology ; Congresses as Topic ; Humans ; Hypersensitivity ; immunology ; United States

Humans ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal

Allergy and Immunology ; Congresses as Topic ; Humans

Objective To compare the efficacy and predictability of sphere-cylinder-combined LASIK and two-zone cross-cylinder LASIK for the correction of moderate and high astigmatism.Design Prospective,comparative case series.Participants 40 eyes of 35 patients with mixed astigmatism undergoing LASIK.Methods All patients were treated with Visx Star IV LASIK system.20 eyes of 19 cases were used for sphere-cylinder combined LASIK mode and 20 eyes of 16 cases for two-zone-cross-cylinder LASIK mode.All sub- jects were followed more than 6 months.Main Outcome Measures Uncorrected visual acuity (UCVA),best spectacle-corrected visual acuity (BSCVA),spherical diopter,residual astigmatism and corneal thickness.Results For the patients who received two-zone-cross-cylinder LASIK mode,the UCVA at 6 months after surgery was 0.5 or above,and 13 eyes (65.0%) were 1.0 or above. For the patients who received sphere-cylinder-combined LASIK mode,the UCVA at 6 months after surgery was 0.5 or above,and 11 eyes (55.0%) was 1.0 or above (P=0.683).The residual astigmatism for the patients received sphere-cylinder-combined LASIK mode was (1.15?1.00)D,while for the patients received cross-cylinder LASIK mode was (1.13?0.62)D(P=0.045).The remotion depth of cornea for sphere-cylinder-combined LASIK mode and cross-cylinder LASIK mode was (36.73?13.12)?m and (15.60?6.85)?m,respectively (P= 0.031).Condusion The UCVA,residual astigmatism and corneal thickness after surgery in two-zone-cross-cylinder LASIK mode were better than that in sphere-cylinder-combined LASIK mode for the correction of moderate and high astigmatism.

Background Retinal neovascularization disease is a common cause of blinding.Retinal neovascularization is related to enhancing proliferation of vascular endothelial cells.So how to inhibit proliferation of vascular endothelial cells is a hot burning issue.p21 is known to be involved in the regulation of cell cycle and therefore inhibit the cell proliferation.However,the relationship of p21 and the proliferation of vascular endothelial cells in retinal neovascularization disease is for further study.Objective The aim of this experiment was to study the proliferation of rhesus retinal vascular endothelial cells(RF/6A) and expression of p21 in RF/6A cells under the hypoxia condition,and discuss their association.Methods The RF/6A cells were cultured and passaged in vitro,then they were randomly divided into normoxia culture group(5％ CO2 +95％ O2) and hypoxia for 1 hour,3,6,12 hours group(1％ 02+5％ CO2 +94％ N2).Flow cytometer(FCM) was used to check the distribution of RF/6A cell cycle in the normoxia culture group and hypoxia for 1 hour,3,6,12 hours groups.MTT assay was used to detect and compare the cell proliferation(A570)among the various groups.The expression of p21 in the cells was analyzed by Western blot.Results FCM showed that the cells proportion of G0/G1 stage was reduced initially and then increased afterward in hypoxia for 1 hour and 3,6,12 hours groups,showing a significant difference among 5 groups (F =20.083,P =0.000),and the cells proportion of S stage and G2/M stage were increased firstly and then declined in different hypoxia groups with statistical significances (F =7.861,P =0.001 ; F =10.305,P =0.003).Compared with normoxia culture group,cells proportion of G0/G1 stage was declined and that of S stage and G2/M stage were raised after hypoxia culture,showing statistically signifcant differences(P＜0.05).MTT showed that cell multiplication capacity(A570 value)strengthened firstly and then weakened in hypoxia groups with time prolongation,showing a significant difference among all the groups(F=7.768,P=0.001),and A570 value in hypoxia for 3 hours and 6 hours groups (0.315± 0.062,0.365 ± 0.064) was significantly higher than that of the normoxia group (0.205 ± 0.063),respectively(P＜0.05).Western blot showed that the expression of p21 in the cells down-regulated at the beginning and then up-regulated with the increase of hypoxia time,and there was statistical significance (F =16.738,P=0.000).The p21 relative levels in different hypoxia groups were reduced in comparison with the normoxia group,showing statistical signifcances(P＜0.05).Conclusions Short-term hypoxia could reduce the expression of the p21 in RF/6A and induce cell proliferation initially,then p21 increases and cell proliferation is inhibited with the prolongation of hypoxia time.

Background Recent studies have demonstrated that epicardial flow in nonculprit arteries,which has been assumed to be normal,was slowed in the setting of ST-elevation myocardial infarction (STEMI).However,the impact of primary percutaneous coronary intervention (PCI) on blood perfusion in nonculprit arteries in patients with STEMI has not been clarified.The purpose of this study was to investigate the impact of primary PCI on blood perfusion in nonculprit arteries in patients with STEMI and correlated clinical factors.Methods A total of 117 patients with anterior wall STEMI,the culprit artery being the left anterior descending artery (LAD),undergoing primary PCI (the study group) and 100 patients with normal coronary angiography (the control group) were enrolled.To observe the differences of corrected TIMI frame count (cTFC) and myocardial blush grade (MBG) before and after primary PCI in both culprit and nonculprit arteries,the left circumflex coronary artery (LCX),cTFC and MBG in the LAD and LCX were measured in the study group and control group.The study group was divided into three groups; reflow in the culprit artery group (the R group),no reflow in culprit artery group (the NR group),and no reflow in both the culprit artery and nonculprit artery group (the NRB group) according to MBG grade.The level of serum C-reactive protein (CRP),catecholamine,and fibroblast growth factor-21 (FGF21) were assayed.The clinical and angiographic characteristics were also analyzed.Results cTFC (28.1±24.3 vs.20.3±19.3,P ＜0.05) and MBG in the LCX were different in the study group compared to the control group before primary PCI.cTFC (25.2±22.3 vs.28.1±24.3,P ＜0.05) and the MBG level in the LCX were improved after successful primary PCI,but were not recovered to the normal level.Patients with no reflow in the culprit artery had a higher incidence of no-reflow in the nonculprit artery (78％ vs.19％,P ＜0.0001),and the levels of CRP ((3.29±1.31) mg/dl vs.(2.51±1.14) mg/dl vs.(2.93±1.07) mg/dl,P ＜0.05,respectively),catecholamine ((epinephrine (693.48±89.78) pg/ml vs.(398.12±93.28) pg/ml vs.(562.54±96.22) pg/ml,P ＜0.0001,respectively),and norepinephrine ((7012.43±932.47) pg/ml vs.(4012.34±814.16) pg/ml vs.(5549.03±912.65) pg/ml,P ＜0.0001,respectively)) in the NRB group were higher than those in the R group and NR group.The level of FGF21 ((0.299±0.093) ng/ml vs.(0.612±0.071)ng/ml vs.(0.428±0.074) ng/ml,P ＜0.0001 respectively) in the NRB group was lower than that in the R group and NR group.Conclusions The blood perfusion in the nonculprit artery may be impaired in patients with STEMI.Although nonculprit artery perfusion may be improved after successful primary PCI,it is still lower than that in the control group,and may be involved in inflammation and spasms.

The study intended to evaluate the effect of high-dese atorvastafin on serum high sensitive C-reactive protein (hs-CRP) and renal function in patients with acute myocardial infarction undergoing elective pereutancous coronary intervention ( PCI ). One hundred and sixty seven patients were randomly divided into two groups: in test group (n =84) patients received oral atorvastatin 80 mg/d and in control group (n = 83) patients received atorvastatin 20 mg/d, the medication in both groups was lasted for 7 days before PCL Compared to levels at 24 h before PCI, serum hs-CRP and creatinine levels at 48 h after PCI were increased in both groups ( both P < 0. 05), and glomerular filtration rate was decreased ( P < 0. 05 ). Compared to control group, serum hs-CRP and creatinine levels 24 h before PCI and 48 h after PCI in test group were significantly lower, and glomerular filtration rate was significantly higher (P <0. 05, respectively). The incidence of contrast-induced nephropathy was lower in test group than that in control group[7% (6/84) vs.18% (15/83), P <0.05]. The results indicate that high-dose atorvastatin might be effective in protecting patients with acute myocardial infarction undergoing elective PCI from contrast-induced nephropathy via inflammatory response inhibition.

OBJECTIVETo study on the reliability of the Akagi line as a reference axis to guide for rotational alignment of the proximal tibial component in total knee arthroplasty (TKA) the rotational alignment reference bony landmarks of the proximal tibial component on magnetic resonance image (MRI) were measured.

METHODSFrom January 2010 to December 2013, 80 normal knees of Chinese volunteers including 35 males and 45 females with an average age of (35.4±6.1) years were reviewed. The images of the knees were obtained by MRI. The surgical epicondylar axis (STEA) was identified in the femoral transverse sections and then was projected to the side of tibia, forming the SETA'. A line connecting the medial border of the patellar tendon and the middle of the posterior cruciate ligament insertion (Akagi line) and its vertical line (AK), as well as a line connecting the medial 1/3 of the patellar tendon and the middle of the posterior cruciate ligament insertion and its vertical line (AP), were identified in the tibial transverse sections. The angles were measured between the AK, AP and STEA'.

RESULTSThe angle between AK and STEA' was (0.59±2.07)°, and there was no significant difference between the two lines (t=-2.54, P=0.13). The mean angle between AP and STEA' was (3.21±2.04)°, and there was a significant difference between the two lines (t=14.05, P<0.05). There was a significant difference between the AK and AP (t=-11.68, P<0.05).

CONCLUSIONThe reliability of the Akagi line as a reference axis to guide for rotational alignment of the proximal tibial component in TKA is good.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Rotation ; Tibia ; surgery

In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years (14-83 years) and with a medium follow-up period of 18 months (12-24 months). Of all the cases of acute trauma, there were 10 cases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes (2 cases), advanced age (>65 years, 3 cases) and cigarette smoking (6 cases). The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.

AIM: To observe the efficacy of Conbercept for different types of macular edema after cataract surgery with diabetes.

METHODS: Totally 52 cases(52 eyes)of macular edema(ME)patients after cataract surgery with diabetes were selected between Jan 2017 and Dec 2018. According to the morphologies of ME through optical coherence tomography(OCT), patients were divided into 3 groups, diffuse retinal thickening(DRT group)with 18 cases(18 eyes), cystoid macular edema(CME group)with 20 cases(20 eyes)and serous retinal detachment(SRD group)with 14 cases(14 eyes). All the patients received intravitreal injection of Conbercept by using 1+PRN method and followed up for 12mo after treatment. The best corrected visual acuity(BCVA)and central macular thickness(CMT)and injection times were recorded and compared.

RESULTS: Before treatment, the differences of BCVA and CMT among 3 groups were not statistically significant, while the course of ME in DRT group was shorter than CME group and SRD group(P<0.05). 1mo after treatment, the BCVA and CMT in 3 groups were improved significant, and beginning at 3mo, the BCVA and CMT in 3 groups were continue to improve and stabilize, they were improved significant compared with before treatment(P<0.05). 1mo, 3mo, 6mo and 12mo after treatment, the BCVA and CMT in DRT group and CME group is better than SRD group(P<0.05), while the BCVA and CMT among DRT group and CME group were not statistically significant(P>0.05). The injection times in 3 groups was 3.2±0.9, 2.9±0.8 and 4.1±1.1, the injection times in SRD group was the most frequent in 3 groups(P<0.05).

CONCLUSION: ME after cataract surgery with diabetes should be treated early. Conbercept could improve BCVA and CMT in different types of ME after cataract surgery with diabetes effectively.