AIM: To study the visual quality, dry eye and biomechanical stability of patients with myopia and astigmatism after different corneal refractive surgeries. ·METHODS: A total of 986 patients with myopia and astigmatism were selected as the research object in our hospital from July 2015 to July 2016, according to the operation mode of the selection of the research object, the 986 patients were randomly divided into small incision lenticule extraction ( SMILE) group, femtosecond laser in situ keratomileusis ( FS-LASIK ) group, sub-bowman-keratomileusis ( SBK ) group and laser-assisted in situ keratomileusis ( LASIK ) group. The postoperative visual quality was determined by comparing the diopter, uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) and high-order image difference of 25d, 90d. The postoperative dry eye condition was determined by comparing the postoperative tear secretion test ( Schirmer Ⅰ test ) , tear film rupture time ( BUT ) and fluorescence staining ( FS) . The biomechanical stability of the patients was determined by comparing the corneal hysteresis ( CH ) and corneal resistance factor ( CRF ) values of the four groups. ·RESULTS: The diopter, UCVA, BCVA and high-order aberration comparison of FS-LASIK group, SBK group and LASIK group between before and after surgery, showed no significant difference ( P>0. 05 ); on diopter, BCVA, UCVA, there was no significant difference between before and after surgery in SMILE group (P>0. 05), but statistical significance difference on high order aberration (P<0. 05). The BUT and FS value of the four groups decreased obviously after operation, and the difference was statistically significant (P<0. 05). In LASIK group SIt after operation significantly decreased, with statistically significant compared with that before operation ( P <0. 05). After operation, CH and CRF of the four groups decreased with significant differences (P<0. 05). ·CONCLUSION: SMILE, FS-LASIK, SBK and LASIK are equally safe, effective and stable in the treatment of myopia and astigmatism.

Adolescent ; Adult ; Aged ; Animals ; Catfishes ; Ciguatera Poisoning ; Eggs ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Young Adult

?AIM:To investigate the correlation between dry eye and different degrees of diabetic retinopathy ( DR ) in type 2 diabetic patients.?METHODS: In the cross-sectional study, 340 patients (340 eyes) with type 2 diabetes were enrolled. Tear film function tests including tear meniscus height, tear film breakup time ( BUT ) , fluorescein staining, Schirmer Ⅰtest were performed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalmoscopy exam with dilated pupils to evaluate DR and whether companied by macular edema.?RESULTS:The prevalence of dry eye was 49. 41%. The mean duration of diabetes in patients with dry eye was 11.15±7.07a, while 6.92±5.45a without dry eye(P<0.01). Dry eye had the positive correlation to the development of DR. The incidence of dry eye in people with mild nonproliferative diabetic retinopathy ( NPDR ) , moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR) was 1. 097 times, 1. 724 times, 2. 86 times and 5. 43 times respectively, compared with people without DR. The occurrence of dry eye in people with macular edema increased by 3. 697 times compared with people without macular edema.?CONCLUSION: Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and development of diabetic retinopathy.

Objective To investigate the effects of hyperthyroidism on the electrophysiological characteristics of atrium and gap junction between atrium and pulmonary vein.Methods Twenty-four rabbits were randomly divided into control group and hyperthyroid group.Atrium and pulmonary vein were dissected after the atrial effective refractory period (AERP)was measured.Connexin 43(Cx43)and Counexin 40(Cx40)protein and mRNA were determined by Western blot and semi-quantitative reverse transcription-polymerase chain reaction,respectively.Results In comparison with control group,AERP and rate adaption of AERP in hyperthyroid group were significantly shorter than that of control group( P＜0.01).The concentration of Cx43 protein in hyperthyroid group was significantly higher than that of control group,but Cx40 protein was significantly lower than that of control group(P＜0.05).The expression of Cx43 mRNA in atrium and pulmonary vein was found to be up-regulated in hyperthyroid group as compared with that of control group(P＜0.01). With the level of Cx40 mRNA,there was no significant difference between two groups.Conclusion Thyroid hormone could lead to remodeling of both atrial electrophysiology and gap junction between atrium and pulmonary vein.

Objective： The current study was designed to evaluate the treatment results of nasopharyngeal carcinoma by conformal radiotherapy. Methods： From September 1997 to February 2000, a total of 41 cases of recurrent nasopharyngeal carcinoma were treated by conformal radiotherapy. Among them, 27 cases were treated by late-course hypofraction conformal radiotherapy with the dose of 20- 24 Gy at 80％ isodose, 4- 7 Gy per time, following routine radiotherapy of 39 Gy/30f/3weeks. Fourteen cases received total-course conformal radiotherapy with the dose of 59.8 Gy/46f/4.6weeks at 90％ isodose. Results： The reference isodose curves conform to the target in three dimensions in conformal radiotherapy. The acute radiation mucositis, cranial nerve paralysis and trismus incidence were similar in two groups, however, in the hypofractionation group 22％ developed necrosis of nasopharyngeal mucosa, 3.7％ developed reduced optic nerve lesion, whereas none of the hyperfractionation group had these complications. The tumor response rate were both 93％ for two groups. Conclusion： Hyperfraction conformal radiotherapy is effective in the treatment of recurrent nasopharyngeal carcinoma and has relatively lower incidence of radiation complication.

Objective:To investigate the effects of estradiol on ~(60)Co?-ray induced apoptosis of bone marrow hematopoietic cells of mice,and to discuss the related anti-irradiation mechanism.Methods:KM mice were randomly divided into 3 groups(15 mice/each group):control group(without radiation),pure radiation group and estradiol+radiation group(ER group).The pure radiation group was irradiated by 4.0 Gy?-ray at a dose rate of 1.15Gy/min;the ER group was administered with 0.1 mg estradiol(IM)at 10 days before 4.0 Gy?-ray radiation;and the control group received no special treatment.The apoptotic DNA segments of bone marrow hematopoietic cells were analyzed by DNA agarose gel electrophoresis;flow cytometry was used to examine the apoptosis rate of cells and expression of Fas and Bcl-2 at 4 h,8 h,and 12 h after irradiation.Results:Eight hours after radiation,the apoptotic DNA segments were obviously increased and apoptotic DNA ladder appeared,which was not seen in the other 2 groups.The apoptosis rate of bone marrow hematopoietic cells in ER group was significantly lower than that in the pure radiation group at 4,8,and 12 h after irradiation(P

BACKGROUND:Ischemia/reperfusion injury can cause the necrosis of cardiomyocyte,and it can also induce cell apoptosis.However,cell apoptosis may be the main death type of cardiomyocyte at the early stage of infarction,and it may be one of causes for expanding myocardial infarction area.OBJECTIVE:The goal of this study was to observe the anti-apoptotic effect of adenosine (ADO) preconditioning on cardiomyocytes during the ischemia/reperfusion,and to investigate the role of apoptosis-related gene protein Bcl-2 and Bax.DESIGN:A randomized controlled animal experiment.SETTING:First College of Clinical Medical Science,China Three Gorges University&Department of Cardiology,Yichang Central People's Hospital.MATERIALS:Thirty-six healthy male rabbits of clean grade,weighing 2.5 to 3.0 kg,were provided by Laboratory Animal Department,Tongji Medical College,Huazhong University of Science and Technology.The protocol was carried out in accordance with animal ethics guidelines for the use and care of animals.All rabbits were divided into 3 groups according to random number table.There were 12 animals in either control,ADO or ADO+DPCPX (an adenosine A1 receptor antagonist).METHODS:This experiment was carried out in the Central Laboratory,China Three Gorges University between October 2005 and October 2006.Ex vivo rabbit myocardial ischemia/reperfusion models were prepared.After being anesthetized,the rabbits were performed anticoagulation with heparin and carried out Langendorff retroperfusion.In the control group,the hearts of animals subjected to 40 minutes of ischemia and 60 minutes of reperfusion.Six of them were used for determining myocardial infarct size after reperfusion,another six for cardiomyocyte apoptosis,gene expression and ultrastructural analysis of myocardium.In the ADO group:The ADO hearts were continuously infused with 10 μmol/L of adenosine 30 minutes before ischemia,and operated according to the requirement of control group.In the DPCPX roup:the isolated hearts of animals were infused for 15 minutes with 10 mmol/L of DPCPX 45 minutes before ischemia.and operated in accordance with ADO group.MAIN OUTCOME MEASURES:①The heart rate and blood pressure of animals in 3 groups were measured during ischemia/reperfusion process.②The infarct size was determined by triphenyltetrazolium chloride(TTC) staining.③The apoptotic index of cardiomyocytes was detected by histological TUNEL staining and DNA ladder on agarose gel electrophoresis.④Apoptosis-related protein Bcl-2 and Bax expressions were detected by in situ immunohistochemical staining.RESULTS:Thirty-six rabbits were enrolled in the final analysis.①Comparison of heart rate and blood pressure:During the process of ischemia/reperfusion,both heart rate and blood pressure were persistently decreased significantly (P＜0.01).There were no significant differences in two indexes between any two groups (P＞0.05).②Comparison of myocardial infarct size:There were no significant differences in myocardial infarct size among the control group,ADO group and DPCPX group (P＞0.05).The myocardial infarct size of rabbits in the ADO group was significantly smaller than that in the control group.It suggested that ADO preconditioning could contract the myocardial infarct size of rabbits.The myocardial infarct size of rabbits in the ADO+DPCPX group was significantly larger than that in the ADO group,but significantly smaller than that in the control group (P＜0.01).It suggested that DPCPX could partially inhibit the protective effect of ADO.③Comparison of apoptosis of cardiomyocytes: Apoptotic cells were not found in the non-ischemic myocardial tissue,but found in the infarct tissue and infarct edge ischemic tissue.Apoptotic cells in the control group and ADO+DPCPX group were significantly more than those in the ADO group.Apoptotic index in the control group and ADO+DPCPX group was significantly higher than that in the control group,respectively (P＜0.01).④Comparison of apoptosis-related protein expression:The absorbance of Bax in the ADO group was significantly lower than that in the control group(P＜0.01).The absorbance of Bax in the ADO+DPCPX group was significantly lower than that in the control group,but significantly higher than that in the ADO group (P＜0.01).The value of Bcl-2/Bax in the control group was significantly lower than that in the ADO group (P＜0.01).The value of Bcl-2/Bax in the ADO+DPCPX group was significantly higher than that in the control group,but significantly higher than that in the ADO group(P＜0.01).CONCLUSION:Exogenous ADO inhiblts reperfusion-induced apoptosis of cardiomyocytes,which is partially mediated by DPCPX:Down-regulation of apoptosis-related Bax protein plays an important role in the anti-apoptotic effect of exogenous ADO.

Objective To explore the relationship between the degree of intraplaque neovascularization in carotid artery and the level of serum homocysteine.Methods Contrast-enhanced ultrasound were performed on 72 carotid atherosclerotic plaques of 48 patients.Contrast-enhancement within the plaque was categorizde as grade 1 to grade 3.The level of serum homocysteine were detected in the fasting state during the same period.Results According to the degree of contrast enhancement(grade 1 to 3),patients were divided into 3 groups.The more new vessels in plaque,the higher the level of homocysteine.The levels of homocysteine in three groups increased in turn.There were distinct differences among the three groups(F =18.49,P ＜0.05),and there was significant difference between every two groups (P ＜0.05).The linear correlation analysis showed that the level of homocysteine was positively correlated with the degree of carotid plaque enhancement (r =0.66,P ＜ 0.01).Conclusions Contrastenhanced ultrasonography could semi-quantitate new vessles in plaque.There was positive correlation between the degree of intraplaque neovascularization with the level of serum homocysteine.Combine with the level of serum homocysteine based on intraplaque neovascularization detected by contrast-enhanced ultrasound,the plaque stability could be more accurately evaluated.

Objective To explore the role of integrin αvβ6 in mediating the tolerance of gastric cancer AGS cells to 5-fluorouracil, and to determine whether direct β6-extracellular signal-regulated protein kinase(ERK) binding is involved. Methods Gastric cancer AGS cells in the logarithmic phase were incubated with either 5-fluorouracil for 24 hours ( control group), with 0.1 g/L of mouse anti-αvβ6 monoclonal antibody 10D5 for 6 hours and then with 5-fluorouracil for24 hours ( 10D5 group), with IgG2a and 5-fluorouracil ( IgG2a group), or with 5-fluorouracil and 20 μnol/L of ERK inhibitor PD98059 for 24 hours ( PD98059 group). Cell proliferation,apoptosis and the expression of Bcl-2 and caspase-3 protein were detected by MTT assay, flow cytometry and western blotting, respectively. All data were analysed by one-way analysis of variance and LSD test. Results The cell inhibition rates of the control group, 10D5 group, IgG2a group and PD98059 group were 28.1% ±2.7%,84.5% ± 1.6%, 31.4% ±5.2%, 86.7% ±5.2%, respectively, with a significant difference ( F = 342. 5, P ＜0.05). The apoptosis rates of the control group, 10D5 group, IgG2a group, and PD98059 group were 6.6% ±1.4%, 30.6% ± 2.4%, 8.1% ± 1.3%, 36.0% ±4.0%, respectively, with a significant difference among the four groups (F = 105.4, P ＜0.05 ). There was a significant difference in the expression of caspase-3 and Bcl-2 among the four groups (F=292.1, 181.6, P＜0.05). Conclusion Integrin αvβ6 can mediate the tolerance of gastric cancer AGS cells to 5-fluorouracil through direct β6-ERK binding.

This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and rehabilitation in the whole process are the keys to achieve successful integration of burn treatment and rehabilitation of this child.
Acellular Dermis ; Animals ; Anti-Bacterial Agents ; therapeutic use ; Burns ; rehabilitation ; therapy ; Cicatrix ; Debridement ; Humans ; Shock ; complications ; Skin ; Skin Transplantation ; Swine ; Trauma Severity Indices ; Treatment Outcome ; Wound Healing