AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Background Congenital aniridia is a rare bilateral hereditary ophthalmopathy which impact panocular.Researches showed that congenital aniridia can be caused by different mutation locus of PAX6 genes,and the mutations are multifarious.Objective This study was to detect and anaiyze the mutations of a Chinese family with congenital aniridia by using targeted sequence capture sequencing and direct Sanger sequencing.Methods This study was approved by Ethic Committee of the First Affiliated Hospital of Zhengzhou University and followed Declaration of Helsinki.Written informed consent was obtained from subjects or their custodians before any related medical examination.A cross-sectional study was performed.A Chinese congenital aniridia family was included at the First Affiliated Hospital of Zhengzhou University in March,2016.All the family members received systemic medical examinations including nervous system and oral glucose tolerance test and then the ocular examinations were carried out.The periphery blood of 10 ml was collected from the members for genomic DNA extraction.Targeted sequence capture sequencing was performed on the DNA of proband to screen out the suspicious mutant locus.The mutation was verified by comparing the Sanger direct sequencing results from all family members.Results A total of 3 generations of 9 members were included in this congenital aniridia pedigree,and the Ⅰ 1 was dead without eye abnormality.Three patients (Ⅱ2 and her children Ⅲ1,Ⅲ2) and 5 normal family members were determined,showing an autosomal dominant inheritance pattern.No abnormal signs were found in nervous system and oral glucose tolerance test in the families.The reduce of visual acuity,ocular hypertension (21 mmHg),absence of biocular iris,opacification of corneal stroma,horizontal nystagmus,hapoplasia of fovea were found in all the sufferers.In addition,the ptosis of the left eye,congenital cataract of the right eye in Ⅱ 2 patient as well as biocular cataract and subluxation of lenses also were exhibited.The c.183C＞A mutation of the PAX6 gene was screened out to be a possible pathogenic mutation.The result of Sanger direct sequencing in the families verified a co-segregation of this mutation with mutant phenotypes.Conclusions PAX6 gene c.183C ＞A,a rare mutation in Chinese population,is a virulence mutation site in this aniridia family.

Objective To review the occurrence and relevant factors of adverse drug reactions (ADR) of Xueshuantong Injection. Methods Articles and documents in CNKI, VIP, and CBM were searched in June 2014 according to incorporation and exclusion standard. The dose, indication, medicating path and method, solvent, as well as the duration of treatment course and adverse reaction of Xueshuantong Injection were analyzed. The national information system for monitoring ADR was searched to collect adverse reaction cases of Xueshuantong Injection (2004.9-2014.9) reported in Lanzhou region. Cases were analyzed and under analogy with literature results. Results Totally 66 articles involving 4686 patients were included (except for patients of control group). Adverse reactions occurred in 767 patients, including skin damage (402 cases), systemic damage (221 cases), gastrointestinal system damage (75 cases). All of these were relieved after treatment. There were 11 adverse reaction cases of Xueshuantong Injection from Lanzhou region reported in the national information system for monitoring ADR. Conclusion There is a high incidence of adverse reactions in the clinical application of Xueshuantong Injection and ratio of serious adverse events report.

BACKGROUND: Conventional hemodialysis mainly for cleaning uremic micro molecule substance, such as urea nitrogen or creatinine; however, few hemodialyses can clean uremic middle molecule substances (MMS). With prolonged dialysis duration, MMS accumulates in vivo and induces a series of complications. OBJECTIVE: To compare the efficiency of adsorptive dialysis (hemoperfusion unites hemodialysis) and conventional hemodialysis in cleaning uremic MMS. METHODS: Totally 60 maintenance hemodialysis patients were averagely divided into the adsorptive dialysis group and conventional hemodialysis group. First of all, hemoperfusion apparatus and dialyser were connected in series to take the adsorptive dialysis in the adsorptive dialysis group (hemoperfusion apparatus were equipped before dialyser). 120 minutes later, the hemoperfusion apparatus was toke off and continues to hemodialysis for 120 minutes. Duration of conventional hemodialysis was 240 minutes. Changes in clinical symptoms and levels of liver function, kidney function, serum electrolytes, hemocytes and uremic MMS were observed prior to and after treatment. RESULTS AND CONCLUSION: Adsorptive dialysis could remove the MMS notably. Compared with the conventional hemodialysis group, a single 120 minutes treatment could decrease MMS significantly (P < 0.05). The platelet levels were obviously decreased in the adsorptive dialysis group after treatment (P < 0.05), which were significantly different from the conventional hemodialysis group (P < 0.05). There was no significant difference in liver function, kidney function or serum electrolytes concentration. But related symptoms, such as the skin itch, sleep disorders and myalgia, were relieved more or less.

OBJECTIVETo investigate the prognosis of adenoid cystic carcinoma (ACC) in minor salivary glands and its influencing factors.

METHODSClinical data of 52 patients with ACC in minor salivary glands were reviewed. The distribution of stage was as follows: stage I (6%), stage II (21%), stage III (27%) and stage IV (46%). Counting data was analyzed by χ(2) test or Fisher's exact. Survival rates were calculated by Kaplan-Merier method. Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.

RESULTSAll patients underwent primary tumor radical resection, 39 patients (75%) received postoperative radiation. The regional recurrence rate was 37% and distant metastasis rate was 21%. The 5-, 10-year cumulative local control rate were 68% and 63% respectively. The 5-, 10-year cumulative distant control rate were 86%, 68% respectively. The 5-, 10-year tumor specific survival rates were 70% and 54% respectively. Multivariate analysis showed that T stage, lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands.

CONCLUSIONSRecurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands. T stage, lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands. Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.

Adult ; Aged ; Carcinoma, Adenoid Cystic ; pathology ; radiotherapy ; secondary ; surgery ; Cobalt Radioisotopes ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Particle Accelerators ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Salivary Gland Neoplasms ; pathology ; radiotherapy ; surgery ; Salivary Glands, Minor ; Survival Rate ; Young Adult

The clinical tumor therapy was greatly challenged due to the complex characteristics of tumor microenvironment, however, which also provide arena for novel therapeutic strategies. In this study, poly(2-ethyl-2-oxazoline)-poly(lactic acid)-SS-poly(β-amino ester (PEOz-PLA-SS-PBAE) triblock copolymers with pH and GSH double response were synthesized, polymer micelles were prepared by thin film hydration method for loading of silybin to improve its antitumor activity. The critical micelle concentration was determined by pyrene fluorescence method as 1.8 μg·mL^-1. The particle size was 155.30 ± 1.80 nm as determined by dynamic light scattering, with polydispersity index of 0.168 ± 0.004. The drug loading and entrapment efficiency of the micelles were determined by HPLC as (5.48 ± 0.04)% and (68.52 ± 0.48)%, respectively. The in vitro drug release profiles showed that the micelles have low pH sensitivity and high GSH responsiveness, and exhibited sustained release profiles. The good biocompatibility of the material was proved by measuring the hemolysis rate and cytotoxicity of the blank micelle. The cytotoxicity and apoptosis rate of tumor cells showed that the drug loaded PEOz-PLA-SS-PBAE micelles had significant inhibitory effect and apoptosis-inducing effect on MDA-MB-231 cells. The results of wounding healing assay and Transwell invasion test showed that the drug loaded PEOz-PLA-SS-PBAE micelles could significantly inhibit the metastasis of MDA-MB-231 cells. The PEOz-PLA-SS-PBAE drug-loaded micelles prepared in this study have good inhibitory effect on tumor growth and anti-tumor metastasis in vitro, which lays the foundation for the further application of silybin.

BACKGROUNDHepatocellular carcinoma (HCC) is one of the deadliest cancers worldwide. In order to investigate the molecular biologic mechanism of HCC's development, we studied the expressions of SE-1, CD105 and CD31 in tumor endothelial cells (TECs) of HCC and in the serum of rats.

METHODSWe analyzed the expressions of SE-1, CD31 and CD105 in rat HCC tumor tissues using immunohistochemistry (IHC). Twenty HCC bearing rats and eighteen normal rats were examined for the expressions of SE-1, CD31 and CD105 antigens in serum by enzyme-linked immunosorbent assay (ELISA).

RESULTSSE-1, CD31 and CD105 antigens were detected both in HCC tissue and in normal liver tissue with higher expressions of CD31 and CD105 in HCC while the SE-1 antigen expression was higher in normal liver. Similarly, serum CD31 and CD105 in rats with HCC were significantly increased compared with normal rats (t = 2.8628, P = 0.0086; t = 4.4922, P < 0.0001, respectively). In contrast, SE-1 antigen in HCC rat serum was significantly decreased compared with normal rats (t = 3.4983, P = 0.0011).

CONCLUSIONSE-1, CD31 and CD105 are closely related with liver tumor angiogenesis, which is similar to their performances in terms of their expressions in the serum.

Animals ; Antigens, CD ; blood ; Carcinoma, Hepatocellular ; blood supply ; chemistry ; Endothelial Cells ; chemistry ; immunology ; Enzyme-Linked Immunosorbent Assay ; Immunohistochemistry ; Liver Neoplasms, Experimental ; blood supply ; chemistry ; Male ; Neovascularization, Pathologic ; blood ; Platelet Endothelial Cell Adhesion Molecule-1 ; blood ; Rats ; Rats, Inbred BUF

OBJECTIVEThe exercise rehabilitation in patient with chronic heart failure (CHF) is standard clinical practice, but it is rare using CardioPulmonary Exercise Testing (CPET) guide to prescribe exercise rehabilitation in China.

METHODSWe performed symptom limited maximal CPET in 10 patients with CHF, randomly divided into two groups: 5 patients as control without exercise and 5 exercise patients used Δ50%W intensity to exercise 30 min/d, 5 d/w, x12 w. Before and after 12 w rehabilitation, we evaluated functions.

RESULTSThere were no significant difference between two groups patients (P > 0.05). The exercise duration was increased from 8 min to 23 min after rehabilitation (P < 0.001); distance 6 minutes walking was increased from 394 m to 470 m (P < 0.05); score of Minnesota quality of life was decreased from 25 to 3 in exercise group (P < 0.01). However, there were nosignificant changes in control group (P>0.05) and their changes were smaller than those in exercise group (P < 0.01).

CONCLUSIONThe CPET guiding exercise rehabilitation is safe and effective for patients with CHF.

China ; Chronic Disease ; Exercise Test ; Exercise Therapy ; Heart Failure ; therapy ; Humans ; Quality of Life ; Walking

OBJECTIVETo identify patterns of hand, foot and mouth disease (HFMD) incidence in China during declining incidence periods of 2008, 2009, and 2010.

METHODSReported HFMD cases over a period of 25 months were extracted from the National Disease Reporting System (NDRS) and analyzed. An interrupted time series (ITS) technique was used to detect changes in HFMD incidence rates in terms of level and slope between declining incidence periods of the three years.

RESULTSOver 3.58 million HFMD cases younger than 5 years were reported to the NDRS between May 1, 2008, and May 31, 2011. Males comprised 63.4% of the cases. ITS analyses demonstrated a significant increase in incidence rate level (P<0.0001) when comparing the current period with the previous period. There were significant changes in declining slopes when comparing 2010 to 2009, and 2010 to 2008 (all P<0.005), but not 2009 to 2008.

CONCLUSIONIncremental changes in incidence rate level during the declining incidence periods of 2009 and 2010 can potentially be attributed to a few factors. The more steeply declining slope in 2010 compared with previous years could be ascribed to the implementation of more effective interventions and preventive strategies in 2010. Further investigation is required to examine this possibility.

China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Incidence ; Male ; Models, Statistical ; Population Surveillance ; Time Factors

Objective To investigate the effect of meteorological factors on the number of outpatients with pulmonary heart disease in Liangzhou district of Gansu province. Methods We collected the daily meteorological data (temperature, air pressure, precipitation, sunshine hours, etc.) of Liangzhou district of Gansu province and the number of daily outpatients with the pulmonary heart disease from 2014 to 2016, and used the distribution lag model to analyze the impact relationship and hysteresis effect of the meteorological factors on the number of outpatients to pulmonary heart disease clinics. Results The total number of outpatients with pulmonary heart disease was 20 462 in Liangzhou district from 2014 to 2016, and the average number of outpatients per day was 18.67. The number of outpatients with pulmonary heart disease per day was positively correlated with temperature and sunshine hours, and negatively correlated with air pressure, relative humidity and precipitation. Among them, the average daily temperature had the most significant effect on the number of outpatients with pulmonary heart disease (r=0.133, P<0.001). At the highest daily average temperature, lagging 16 days,the relative risk coefficient (RR value) was the highest (1.26, 95% CI:1.13-1.40). For every 1 ℃ increase in temperature, the number of outpatients with pulmonary heart disease increased by 1.26 (95% CI: 1.13-1.40). There was no risk of morbidity at an extreme low temperature (-18 ℃), and the relative risk of the number of the pulmonary heart disease outpatients was the greatest at lag 0-15 at an extreme high temperatures (29 ℃). Conclusion Meteorological factor is an important factor affecting the number of outpatients with pulmonary heart disease in Liangzhou district. The risk of pulmonary heart disease will increase due to temperature changes, and the impact will occur immediately on the same day. The high temperature effect is short-lived and the relative risk is high, while the relative risk of low temperature to the number of outpatients is relatively low and the lag time is long.