Background The study on influences of gender,age and axial length (AL) on lens thickness (LT) and anterior chamber depth (ACD) in normal population is still lack in China.Objective This study was to measure LT and ACD in normal subjects and discuss their changes with age,gender and AL.Methods AL,ACD and LT were measured on 866 eyes of 433 normal population with Lenstar LS900 in Tianjin Eye Hospital from March through December in 2013,including 390 eyes in 195 males and 476 eyes of 238 females.ACD/AL,LT/AL and (ACD+LT)/AL were calculated after measurement.The subjects were grouped to the 10-20 years group,21-30 years group,31-40 years group,41-50 years group,51-60 years group and ≥61 years group based on age,or the 22 mm≤AL＜24 mm group,24 mm≤AL＜26 mm group and AL≥26 mm based on AL,and the measured parameters were compared and analyzed among the groups.Oral informed consent was obtained from each subject or child contutor prior to any medical examination.Results AL,ACD and LT values were (24.41±1.37),(2.89±0.42) and (4.05±0.52) mm in the males,and those in the females were (23.83±1.31),(2.72±0.40) and (4.20±0.44) mm,showing significant differences between them (t=6.278,6.102,-4.595,all at P=0.000).No significant differences were found in ACD,LT,ACD/AL,LT/AL and (ACD+LT)/AL values between the right eyes and the left eyes (t=-0.713,0.186,-0.754,0.296,-0.168,all at P＞0.05).As the increase of the AL,ACD was remarkable deepened but LT was declined,with the considerable difference among the 22 mm ≤ AL＜24 mm group,24 mm ≤ AL＜ 26 mm group and AL ≥ 26 mm group (F =176.640,94.569,both at P =0.000).ACD value was higher,but LT value was lower in the 24 mm≤AL＜26 mm group or AL≥26.00 mm group than that in the 22 mm≤AL＜24 mm group (all at P＜0.05).ACD value was gradually reduced,while LT value was elevated with aging,with significant differences among the different age groups (F =104.531,373.225,all at P =0.000).Significant correlations were found between age and ACD,LT or (ACD + LT)/AL,with the regression equations of ACD (mm) =-0.015 × age + 3.434 (F =-22.979,P =0.000);LT (mm) =0.024 × age + 3.122 (F =44.856,P =0.000),LT/AL =0.001 × age + 0.122 (F=37.982,P=0.000),(ACD+LT)/AL=0.001×age+0.259 (F=22.451,P=0.000).Conclusions Compared with normal females,males have thinner LT and deeper ACD.In the normal eyes,longer AL is,thinner LT is and the deeper ACD is.LT thickens and ACD deepens with aging.

Objective To investigate the expression of phospho-histone H3 (PHH3) protein in pancreatic neuroendocrine neoplasms (PNENs) and explore its potential value for pathological grading of PNENs.Methods Clinical and pathological data of 283 patients with PNENs treated in Changhai Hospital from December 2000 to May 2016 were retrospectively analyzed.PNENs tissue chip was prepared,and immunohistochemistry was used to examine the expression of PHH3 and Ki67.The receiver operating characteristic curve for PHH3 was drawn and the area under the curve(AUC) was calculated to determine the cutoff value for PNENs grading.Ki67 was used for PNENs grading according to domestic and intemational criteria for PNENs classification.The relationship of PHH3 and Ki67 classification with clinical pathological features and prognosis of PNENs as well as the correlation between the two classification methods were analyzed.Results Of 283 patients,132 were male and 151 were female,aged from 16 to 78 years old.The average age was (50 ± 1) years old.There were 44 cases with functional PNENs and 239 with non-functional PNENs.The diameter of tumors ranged from 1.1 cm to 17 cm and the average diameter was (4.1 ± 1.2)cm.According to the Ki67 standard,there were 127,116,33 and 7 cases of Grade G1,G2,pancreatic neuroendocrine tumor(PNET) G3 and pancreatic neuroendocrine cancer(PNEC) G3.According to the PHH3 standard,there were 118,119,3 8 and 8 cases of Grade G1,G2,PNET G3 and PNEC G3.There was a positive correlation between the two grading criteria (r =0.941,P ＜0.001).PHH3 expression and PNENs grading were not correlated with age,gender,tumor functional or not and tumor locations (all P ＞ 0.05),but were both positively correlated with tumor size,histological grade,lymph node metastasis,TNM stage and prognosis (all P ＜0.05).The average time of observing PHH3 and Ki67 staining per case in the immunohistochemistry of tissue chip was 9 min and 45 min,respectively.Conclusions Detection of PHH3 expression in PNENs can be used for the pathological diagnosis,grading and prognostic evaluation,which was more accurate and convenient than Ki67 criteria.

Thyroid cancer is one of the most common malignant tumors in the human endocrine system . It is one of the common diseases in head and neck ,thyroid and breast surgery .Its incidence rate is increasing year by year .With the development of ultrasonography and fine needle aspiration biopsy ,as well as the auxiliary exami-nation of gene detection technology ,the detective rate of early diagnosis of papillary thyroid microcarcinoma ( PT-MC) is getting higher and higher .Compared with conventional surgery , highlighting the advantages of minimally invasive surgery , endoscopic and ultrasound guided percutaneous ablation and other new surgical methods are gradually applied in clinical treatment .Combined with the new guideline ,the present paper reviews the progress in the diagnosis and treatment of papillary thyroid microcarcinoma .

Objective To investigate the clinical characteristics and therapy of acute perforation of gastric carcinoma(APGC) to improve the diagnosis,treatment and prognosis of APGC. Methods Forty cases of APGC admitted to Gong liao hospital of Zhenping county.Of the forty patients,ten underwent repair of perforation,twenty-one cases underwent palliative gastrectomy (six of them underwent lymphadenectomy three weeks after previous gastrectomy );five subjected to radical gastrectomy. two underwent gastrostomy or jejunostomy for nutrition.One underwent drainage and peritoneal lavage only;1 received non-operative therapy.Results Four patients died in this series.The 1-,2-,3-years survival rate was 83.3%(30/36),52.8%(19/36),27.8%(10/36)respectively. Conclusions Early diagnosis and adopting resection of gastric cancer plus comperhensive treatment can improve the prognosis of patients with APGC.

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcomas, this sarcoma occurs rarely in the larynx. Herein, we describe an unusual case of ASPS occurring in the larynx. The patient was a 46-year-old woman who presented with a more than 2-year history of right pyriform fossa mass and progressive hoarseness for three months. The endoscopic examination of the larynx revealed a mass in the right pyriform fossa with smooth surface and well-defined margin. Computed tomography demonstrated a heterogeneous tumor in the right pyriform fossa, and involving the paralaryngeal space, measuring approximately 2.1 cm x 1.7 cm x 2.6 cm, which was resected via lateral neck approach. Histopathology and immunohistochemistry revealed an ASPS. To ours knowledge, this is the first reported case of ASPS arising in pyriform fossa.
Female ; Hoarseness ; Humans ; Immunohistochemistry ; Larynx ; pathology ; Middle Aged ; Sarcoma, Alveolar Soft Part ; pathology ; Tomography, X-Ray Computed

Aged ; Diabetes Mellitus, Type 2 ; therapy ; Humans ; Walking

Polyethylene glycol (PEG) is extensively used to increasing the in vivo and in vitro stability of liposomes. However, PEGylated liposomes also produce some negative effects with further research, such as low cellular uptake, poor "endosomal escape" of pH sensitive liposome (PSL) and accelerated blood clearance (ABC) phenomenon, and this situation is referred as the "PEG dilemma". "PEG dilemma" posed severe challenges for the targeted delivery of PEGylated liposomes-loaded anticancer drugs, effective intracellular release of PEGylated PSL-encapsulated gene and protein drugs, and repeated administration of PEGylated liposomes. Therefore, it is urgent to solve the "PEG dilemma". This review focused on the definition, classification of "PEG dilemma", and discussed several possible approaches to overcome "PEG dilemma".
Antineoplastic Agents ; chemistry ; Drug Carriers ; chemistry ; Liposomes ; chemistry ; Polyethylene Glycols ; chemistry

Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor.Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery.All the lesions were scored according to the two different methods.Pathological results were made the golden criteria.The diagnosis accuracy of the two methods were compared.Results There were 145 benign and 115 malignant tumors.The diagnosis accuracy,specificity and sensibility of elastography were 85.0％,88.3％,80.1 ％ respectively.The critical value of contrastenhanced ultrasound was between 3 and 4.The diagnosis accuracy,specificity and sensibility of contrastenhanced ultrasound were 88.9％,87.6％,90.4％ respectively.Area under ROC curve of the two methods were 0.901 and 0.910,the difference was not statistically significant.Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis.The diagnosis accuracy was parallel to that of elastography.

Objective To explore the effects of TNF-α on the expression of IP33R1 mRNA and protein in human mesangial cells (HMCs) and elucidate the mechnism of TNF-α indnces the IP3R1 expression in the occurrence of hepatorenal syndrome (HRS).Methods HMCs was stimulated by tumor (TNF-α) with 100 ng/mL for different hours (2,4,8,24 hours).The expression change of IP3R1 mRNA and protein were detected by quantitative real-time polymerase chain reaction and immunoblot assay.Several inhibitors including D609,U73122,PP1,Safingol,Rottlerin and non-radioactive PKC assay to examine the mechanism of signal transduction of TNF-α-regulated IP3R1 in HMCs.Results The levels of IP3R1 mRNA at 2 h post-TNF-α exposure were significantly enhanced and reached peak at 8 h in HMCs (P ＜ 0.01),then descened at 24 h (P ＜ 0.01).The levels of IP3R1 protein at 4 h post-TNF-α exposure were obviously increased and reached peak at 24 h post-TNF-α exposure (P ＜ 0.01).Compared with the control group,safingol (PKC-α inhibitor) and D609 (PC-PLC inhibitor) each significantly suppressed TNF-α-induced expression of IP3R1 mRNA (3.30 ± 0.81) vs.(1.95 ± 0.130,P ＜ 0.05 ; (2.10 ± 0.49),P ＜ 0.01 andIP3R1 protein (3.09±0.13) vs.(1.86+0.39),P＜0.01; (1.98±0.02),P＜0.01.TNF-αpromoted autophosphorylation,and hence the activation,of PKC-α with maximal phosphorylation that occurred 8 h post-stimulation measured by non-radioactive PKC assay,and the effect was marked attenuated by pretreated with D609 or safingol.Conclusions TNF-α increased the expression of IP3R1 and this was mediated,at least in part,through the PC-PLC/PKC-α signaling pathways in HMCs.

Objective To investigate the efficacies of laparoscopic sleeve gastrectomy + duodenojejunal bypass (DJB) and laparoscopic gastric bypass in the treatment of patients with non-obese type 2 diabetes mellitus (T2DM).Methods The clinical data of 42 patients with type 2 diabetes mellitus and body mass index (BMI) ＜ 30 kg/m2 received surgical treatment at the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2013 were retrospectively analyzed.Fifteen patients received laparoscopic sleeve gastrectomy + DJB (Sleeve + DJB group),and 27 received Roux-en-Y gastric bypass (RYGB group).The follow-up time for all the patients was more than 6 months.The decrease of BMI,complete remission of T2DM,decrease of fasting glycemia and glycosylated hemoglobin (HbAlc),postoperative nutritional condition and the incidence of complications of the 2 groups were compared.The measurement data were analyzed using the t test and the repeated measurement chi-square test.Results The operation time of the Sleeve + DJB group and the RYGB group were (137 ± 61)minutes and (89 ± 43) minutes,with significant difference between the 2 groups (t =6.158,P ＜ 0.05).No mortality and hemorrhage,bowel obstruction and anastomotic stenosis were detected.One patient was complicated with bile leakage in the Sleeve + DJB group,and was cured by conservative treatment 5 days later.The levels of fasting glucose before operation and at postoperative month 1,3,6 were (8.9 ± 0.7) mmol/L,(5.8 ± 1.3) mmoL/L,(5.6 ±1.8) mmol/L and (5.7 ± 0.3) mmol/L in the Sleeve + DJB group,and (9.9 ± 1.2) mmol/L,(6.9 ± 0.8) mmol/L,(6.6 ± 2.2) mmol/L and (5.6 ± 0.8) mmol/L,with no significant difference between the 2 groups (F =1.670,2.932,0.444,0.158,P ＞ 0.05).The levels of HbAle before operation and at postoperative months 1,3,6 were 7.4％± 1.4％,6.5％ ±0.6％,5.7％±0.5％,5.9％ ±0.6％ in the Sleeve + DJB group,and 7.7％± 2.0％,6.8％ ± 1.3％,5.7％±0.8％,5.6％ ± 1.1％ in the RYGB group,with no significant difference between the 2 groups (F =0.055,0.125,0.005,0.286,P ＞ 0.05).The remission rates of T2DM of the Sleeve + DJB group and the RYGB group were 14/15 and 74.1％ (20/27) at postoperative month 6,with no significant difference between the 2 groups (x2 =2.320,P ＞ 0.05).The decrease rate of BMI of the Sleeve + DJB group and the RYGB group were 18.2％±9.5％ and 21.2％ ± 4.9％,with no significant difference between the 2 groups (t =0.982,P ＞0.05).The numbers of patients with postoperative anaemia,avitaminosis and diarrhea were 0,0,2 in the Sleeve + DJB group and 3,2,6 in the RYGB group,with no significant difference between the 2 groups (x2=1.795,1.167,0.908,P ＞0.05).The BMIs of all the patients were above 19 kg/m2.Conclusion The effects and incidence of postoperative complications of Sleeve + DJB for the treatment of T2DM are comparable to those of RYGB.Sleeve + DJB has less interference on the nutritional condition of patients compared with RYGB.