Background Postoperative ametropia, especially large astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus often results in poor visual acuity.Though postoperative ametropia can be corrected by wearing glasses or performing corneal refractive surgery, the visual quality of patients is still poor, and the operations are difficult to implement because of insufficient corneal thickness.Toric intraocular collamer lens (TICL) implantation appears to have good corrective efficacy on severe astigmatism,but the research on the eyes after DALK is still less.Objective This study was to evaluate the efficacy and safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Methods This study protocol was approved by Ethic Commission of Nanjing Drum Tower Hospital,and written informed consent was obtained from each patient prior to any medical procedure.A self-controlled serial observational research was carried out.Eight ametropic eyes of 8 patients who received the DALK for keratoconus before 18 months were enrolled in Nanjing Drum Tower Hospital from August 201 1 to March 2012, with the spherical diopter range from 0 D to-7.5 D and cylindrical diopter range from-2.5 D to-6.0 D.TICL implantation was performed on the eyes.The eye examinations were carried out before surgery and 1 week,3 months,6 months, 1 year and 2 years after surgery,including uncorrected visual acuity (UCVA) ,best corrected visual acuity (BCVA) ,comprehensive optometry, corneal astigmatism degree, the central corneal thickness and anterior chamber depth (ACD), corneal endothelial cell counts (ECD) ,intraocular pressure.The examination outcomes were compared before and after surgery.The intraoperative and postoperative complications were observed to evaluate the safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Results The UCVA and BCVA were obviously improved at 6 months after TICL implantation in comparison with before surgery and maintained stable during the follow-up duration.The mean spherical diopter was from-0.5 D to-1.0 D and the mean cylindrical diopter was from-0.5 D to-2.0 D after surgery.The corneal endothelial cell counts were (2 520.2 ± 307.2) , (2 496.2 ± 306.2) , (2 469.6±304.5) , (2 432.0 ± 305.4), (2 383.4 ± 309.4)/mm2, and the intraoeular pressures were (14.57 ± 3.75), (16.62±4.21), (16.57±3.56), (15.66±3.37), (15.13±3.48) mmHg, showing insignificant differences among different time points (F =0.375,P =0.825;F =9.871, P =0.394).No significant differences were found in mean ACD and intraocular pressure between before and after surgery (t =1.56 ,P =0.16).The axial deviation of TICL was less than 10° in all the operated eyes 6 months after surgery.No intraoperative and postoperative complications were found during the follow-up duration.Conclusions TICL implantation is a safe and effective alternative and viable approach to myopic and astigmatism patients following DALK for keratoconus.

Objective:To study the influence of anesthesia with propofol or with ketamine on autonomic nerve function in children. Methods: 35 children aged 3-8 years old undergoing general anesthesia for palatoplasty with ASAⅠ-Ⅱ cleft palate were randomly divided into 2 groups, group Ⅰ(ketamine group,n=17)and group Ⅱ (propofol group, n=18).The low frequency (LF), high frequency (HF), ratio of low frequency and high frequency (LF/HF),total power (LF+HF), MAP, HR and SpO_2 were recorded before anesthesia (T0), after intubation (T1), incision of skin(T2), 1 h after the begining of operation(T3), after the completion of operation(T4) and extubation (T5). Results:In the 2 groups the values of LF, HF, LF/HF and LF+HF at T1-T4 were significantly lower than those at T0 (P0.05). In group Ⅱ,the indexes of HRV at T2-T5 were significantly lower than those in group Ⅰ(P

Inhibitors of epidermal growth factor have played an important role in the treatment of oncology.One of the most common adverse effects is aeneform eruption.This article reviews the incidence,clinical manifestation, mechanism and management for acneform eruption which related to inhibitors of epidermal growth factor.

Objective To observe effects of rhubarb extract on Ca dissolved quantity in demineralized enmnel. Methods Demineralization was performed after treating tooth facing with rhubarb extract of different concentrations and deionized water. The concentration of Ca was detected by ASCA biochemical analyzer after demineralization. Results Dissolved quantity of demineralized Ca in the rhubarb extract group (2 mg/ml, 4mg/ml) was significantly lower than that of the deionized water group (P<0.01) and the rhubarb extract group (1 mg/ml) (P<0.05), but higher than that of 2% sodium fluoride group (P>0.05). Dissolved quantity of demineralized Ca in the rhubarb extract (1 mg/ml) group was significantly higher thanthat of 2% sodium fluoride group (P<0.01), but lower than that of the deionized water group(P>0.05).Conclusion The rhubarb exwact (2mg/ml, 4mg/ml) can inhibit Ca dissolution in demineralized enamel.The inidal effective concentration of rhubarb extract is 2 mg/ml.

A questionnaire survey was conducted among 319 mental health workers from 319 grassroots health institutions of 21 districts (cities,counties) in Chengdu in March 2013.The items of survey included general information of participants,subjective perceptions and status of community mental health services.Total 252 effective questionnaires were received,the average age of participants was (33.12 ± 9.39) years (19-61);59.5％ had clinical medicine and 16.3％ had public health background;most of them had educational levels of three-year college or below (84.9％);the average duration of working experience was 18 months;86.5％ was part-time;most of participants (87.4％) thought that the mental health service was a hard job and only 25.3％ expressed satisfaction with the work.Only 16.3％ of community health service centers had rehabilitation facilities for mental illness patients.Public health education was carried out for average (2.21 ± 1.62) times/year,the education for mental patients and family members was (1.62 ± 1.83) times/year.Between areas with sufficient detection rate of mental illness and those with insufficient detection rate,there was significant difference in training frequency of mental workers (P =0.012),there were no significant differences in having formal employment of mental workers (P =0.064),professional guidance,co-working with police officers,co-working with Disabled Persons' Federation,and the duration of working experience (all P ＞ 0.05).The results suggest that the capacity of mental health service in community levels is relatively weak in Chengdu,and the personnel training,public education and rehabilitation work of mental health need to be strengthened.

OBJECTIVE: To provide reference for the management of central pharmacy in our hospital. METHODS: In daily work, performance score of a job was related with quality evaluation using grouping work model and management method of allocating a specific responsibility to a specific person. RESULT & CONCLUSION: The work process of central pharmacy is clear and plays a great role in economizing on resources relatively.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; Male ; Middle Aged ; Phytotherapy ; Tablets

Objective To investigate the impacts of γ-ray radiation on gene expressions of peripheral blood lymphocytes in SD rats,and to screen differential expression genes and biological pathways closely related to radiation injury.Methods The differential gene expression of peripheral blood lymphocytes in SD rats was selected by microarray at 6 h after 2 Gy 60Co γ-ray exposure in vitro and in vivo.Bioinformatics analysis of the differentially expressed genes was performed by using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases.Real-time quantitative PCR was applied to verify the screen results of the microarray.Results Fifty-five genes with three times over-expressed level were screened out from the radiation groups both in vitro and in vivo and they were involved in 6 signaling pathways.There were two differentially expressed genes of microarray assay were verified by PCR assay.Conclusions Differential expressed genes in the peripheral blood lymphocytes of SD rats could be induced by γ-ray radiation and they cooperatively contributed to a variety of biological processes.

Acute Disease ; Adult ; Emergency Nursing ; Emergency Treatment ; Humans ; Male ; Middle Aged ; Phosgene ; analogs & derivatives ; poisoning

ADAM Proteins ; blood ; immunology ; ADAMTS13 Protein ; Adult ; Female ; Humans ; Male ; Middle Aged ; Plasma Exchange ; Purpura, Thrombotic Thrombocytopenic ; blood ; pathology ; therapy