AIM: To compare the efficiency and safety of torsional phacoemulsification with or without intelligent phacoemulsification ( IP ) software in hard nucleus cataract extraction.
METHODS: Ninety two eyes with Ⅳ - Ⅴ grades cataracts were enrolled in this randomized prospective study. Operated eyes were divided into two groups -those operated without IP software ( non- IP group, n =43) and those operated using IP software (IP group, n =49 ). The two groups were compared in terms of ultrasound time (UST) and cumulative dissipated energy (CDE). Post- operative outcome measures included the corneal edema and best-corrected visual acuity (BCVA) at 1,7d and 3mo postoperatively, corneal endothelial cell density and percentage of hexagonal cell at 7d and 3mo postoperatively.
RESULTS: UST was measured as 52. 51±9. 64s in non-IP Group and 48. 79±7. 13s in IP Group (P = 0. 030). CDE was 15. 78±3. 73% in non-IP Group and 14. 29±2. 77% in IP Group ( P = 0. 026). At the first postoperative day, the rate of BCVA>0. 1 in non-IP Group was 56%, and the rate in IP Group was 79% (P= 0. 066). Corneal edema in non-IP Group was 2. 98±0. 77 scores, and in IP Group it was 2. 61±0. 64 scores (P = 0. 021). At the postoperative 7 and 30d, the BCVA and corneal edema were no differences between two groups. At the postoperative 7d, corneal endothelial cell density in non- IP Group were 2497. 95 ±211. 48 / mm2 , less than 2586. 26±154. 71 / mm 2 in IP Group (P= 0. 029);percentage of hexagonal cell in IP group was 48. 33±8. 69%,higher than 44. 19±9. 48% of non-IP group(P= 0. 030).CONCLUSION: In hard nucleus cataract extraction, the IP software can combine the advantages of the two kinds of ultrasonic modes, which is more effective with lower ultrasound energy and less injury for the corneal endothclium, and is helpful for the recovery of vision at early stage after surgeries.

Objective To investigate the prevalence of sexual dysfunction in aged men and associated risk factors in Beijing. Methods A cross-sectional study was performed in communities of Beijing involved 1656 men aged over 50 years.The International Index of Erectile Function-5 (IIEF-5),Brief Male Sexual Function Inventory for Urology ( O'Leary 1995 ) and the International Prostate Symptom Score (IPSS)questionnaires was recorded.The body mass index (BMI),prostate size was measured.The survey was conducted to make sure if the patients had diabetes,high blood pressure,hyperlipidemia,cerebrovascular history,and smoking and drinking situation.Pearson's X2 test and unconditional logistic regression were used to investigate the factors associated with sexual dysfunction. Results 1644 subjects were enrolled.The incidence of ED,reduction of sexual desire and defective ejaculation was 90.45％,60.04％ and 38.81％ respectively,and significantly different according to age ( P ＜ O.05 ). Age was positively correlated with ED (3 =0.12,P＜0.05),reduction of sexual desire (β =0.10,P＜0.05) and defective ejaculation (β =0.10,P ＜ 0.05 ) ; ED was significantly associated with BMI (β =0.07,P ＜ 0.05 ).Hypertension and prostate size were risk factors for reduction of sexual desire and defective ejaculation; There was correlation between drinking and defective ejaculation ( β =- O.31,P ＜ 0.05 ). Conelusions Compared with high prevalence of ED and lower sexual desire,the incidence of defective ejaculation were lower; this may reflect the sexual activities of aged male were more active compared with the less success of really erection.The prevalence of ED,reduction of sexual desire or defective ejaculation increased with age.BMI was the risk factor for ED.Enlarged prostate and hypertension was associated with reduction of sexual desire,and drinking was the risk factor for defective ejaculation.

Objective To explore the differential diagnostic significance of clone analysis for multicentric occurrence (MO) and intrahepatic metastasis (IM) in hepatocellular carcinomas (HCCs).Methods Loss of heterozygosity (LOH) and microsatellite instability (MSI) were analyzed by microsatellite polymorphism test and the integration sites of HBV were assessed by Southern blot in each nodule of the HCCs. The clonalities were then compared between each nodule of the same patient and the diagnosis of MO or IM was concluded. Finally, the results based on clonality analysis were compared with those according to clinicopathological and imaging data. Results According to the results of LOH and MSI in 79 nodules and nontumorous tissue from 35 cases of mutiple HCCs, 5 (14.3%)and 29 cases (82.9 %) were divided into MO and IM, respectively. Both MO and IM presented simultaneously in 1 patient (2.9%). The integration sites of HBV could be analyzed in 77 nodules from 34 multiple HCCs. Among them, 6 (17. 6%) and 27 cases (79.4%) were divided into MO and IM, respectively. Both MO and IM presented simultaneously in 1 patient (2.9%). The classification results of microsatellite polymorphism test and HBV integration sites analysis demonstrated a significant positive correlation (rs = 0.909, P＜0.001). Nevertheless, neither the classification of microsatellite polymorphism test nor that of HBV integrate sites analysis was correlated with the discrimination according to clinicopathologic and imaging data (rs=0. 133, P=0. 468, rs =0. 262, P=0. 155, respectively). Recurrence in patients in the MO group occurred significantly later than that in IM cases who were diagnosed by clonality analyses (P=0. 001). Conclusion The clonality analysis based on the results of LOH and MSI or assessments of HBV integrate sites is useful for the differential diagnosis of MO and IM and their treatment and prognosis.

Objective To investigate the efficacy of the enhancement treatment on osteoporotic vertebral compression fracture and its complications in the elderly.Methods From September 2007 to February 2012,183 patients with osteoporotic vertebral compression fracture underwent percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) in our department.157 of them were completely followed up (PKP group,n=96; PVP group,n=61) and totally 182 vertebral bodies were fractured (PKP group,n=107; PVP group,n=75).Visual analogue scale (VAS) score and Oswestry disability index (ODI) score were evaluated before and 3 days and 3 months after the surgery.Plain film radiography was taken to evaluate the vertebral body height.ODI score was evaluated at the end of the follow-up.The leakage of polymethylmethacrylate (PMMA) during the operation and the refracture were recorded.Results The mean height of the vertebral body before operation had no difference between PVP and PKP group [(1.31±0.18) cm vs.(1.32±0.16) cm,t =0.72,P＞0.05].After the operation,the mean height of the vertebral body was lower in PVP group than in PKP group [(1.50±0.20) cm vs.(1.66±0.17) cm,t=2.28,P＜0.05].The mean amount of the PMMA injected into the vertebral bodies was less in PVP group than in PKP group [(2.93±0.34) ml vs.(3.34±0.49) ml,t=2.39,P＜0.05].In the PVP group,the VAS scores were (7.5±0.79),(3.0±0.6) and (1.9±0.9) before,3 days and 3 months after operation respectively,and there was a significant difference in VAS score before versus 3 days after operation (t =15.59,P＜0.05).In thePKPgroup,the VAS scores were (7.3±1.0),(3.0±0.8) and (2.2± 0.9)before,3 days and 3 months after operation respectively,and there was a significant difference in VAS score before versus 3 days after operation (t=10.69,P＜0.05).In the PVP group,the ODI scores were (78.9±7.3),(30.0±3.7) and (25.5±3.5) before and 3 months after operation and at the end of follow-up respectively,and there were significant differences in ODI score before operation versus 3 months after operation (t=20.83,P＜0.01) and 3 months after operation versus at the end of follow-up (t=4.03,P＜0.05).In the PKP group,the ODI scores were (78.8±6.8),(29.8±4.43) and (23.8 ± 2.7) before operation,3 months after operation and at the end of follow-up respectively,and there were significant differences in ODI score before operation versus 3 months after operation (t=21.52,P＜0.01) and 3 months after operation versus at the end of follow-up (t=3.14,P＜0.05).There were no significant differences in VAS and ODI scores between the two groups before versus after operation (t=0.34,P＞0.05).The incidence of refracture was 8.2％ in PVP group and 9.4％ in PKP group,which had no statistical difference between the two groups(x2 =0.06,P＞0.05).All the leakage was asymptomatic.The incidence of PMMA leakage was 20.0％ (15 cases) in PVP group and 9.3％ (10 cases) in PKP group,which had a statistical difference between the two groups (x2 =4.22,P ＜ 0.05).Conclusions Enhancement treatment for osteoporotic vertebral compression fracture can quickly relieve the pain and improve the quality of life.PKP and PVP show no differences in the effect of analgesia and the improvement of life quality,but PKP has the advantages in recovering vertebral height and reducing PMMA leakage.

Objective To explore the efficacy of postoperative transarterial chemoembolization (TACE) and portal vein chemotherapy (PVC) for hepatocellular carcinoma (HCC) patients complicated with portal vein tumor thrombus (PVTT). Methods One hundred and eleven HCC patients with PVTT were randomly divided into three groups receiving respectively tumor resection only ( group A) , resection plus TACE ( group B) , and resection plus TACE and PVC ( group C). Results (1) Group B had significantly lower recurrence rates at 0. 5- and 1-year, and higher survival rates at 0. 5-year compared with group A (P

Objective To explore the changes and clinical significance of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen time(FGB)and platelet(PLT)on Kawasaki disease(KD)in children with acute and convalescent 10 d,which aimed at early diagnosis,prediction and prognosis of coronary artery lesions.Methods Thirty-eight cases who were diagnosed KD were selected as KD group,30 cases age-matched acute respiratory infections in children with fever as fever group,moreover,30 cases of a class of elective surgery preoperative children admitted to surgical departments were put as control group.The plasma PT,APTT,TT,FGB,PLT of all cases and plasma APTT,FGB,PLT in recovery 10 d in children with KD disease were detected,and then the results were compared between the 3 groups;and the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d to coronary artery dilatation groups or not were compared.Results 1.APTT prolonged and FGB,PLT increased in KD children with acute stage,which had a significant difference compared with other groups(Pa0.05).2.When comparing the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d,the difference was significant(Pa

Objective To evaluate the feasibility and safety of embedding the totally implantable venous access port (TIVAP) via the access of right brachiocephalic vein (BCV).Methods The clinical data of 493 patients,who underwent the placement of TIVAP by using right BCV route during the period from March 2013 to December 2015,were retrospectively analyzed.The patients included 137 males and 356 females,with a mean age of (47.3±13.2) years old (ranging from 29 to 78 years old).The puncture success rate and TIVAP indwelling procedure-related complications were analyzed.Results The technical success rate was 100％,the success rate of initial puncturing was 99％ (488/493).The mean operation time was (22.5± 8.3) minutes (range of 18-35 minutes).Mis-puncturing of artery happened in 3 patients (0.61％,3/493);and no severe complications such as hemothorax or pneumothorax occurred.After implantation,the patients carried TIVAP for 124-986 days,with a mean of (271.1±53.8) days.The incidence of complications was 2.25％ (11/488),including hemorrhage at port site (n=2),catheter-related infection (n=l),partial thrombosis (n=2),and formation of fibrous protein sheath (n=6).No serious complications such as displacement or rupture of catheter,or catheter pinch-off syndrome (POS),etc.were observed.Conclusion The implantation of TIVAP by using right BCV route has high puncturing success rate,the technique is safe and reliable,and it can provide another option of catheter access for the clinical performance of TIVAP implantation.

Objective To explore the clinical value of guide-wire shaping in subclavian vein catheter-ization.Methods Totally 400 patients requiring right subclavian vein catheterization were equally divided into two groups according to the clinic date: intervention group ( with guide-wire shaping , n =200 ) and control group (without guide-wire shaping, n=200).The catheterization was carried out by the same doctor .The rates of ectopic wire were compared between the two groups .Results The overall success rate of catheteriza-tion was 98.25%(393/400) [98.5% (197/200) in intervention group and 98.0% (196/200) in control group, P=0.500].The incidence of catheter displacement was 1.02%(2/197) in intervention group, which was significantly lower than that [7.14% (14/196)] in control group (P=0.002).Conclusion As a sim-ple procedure , guide-wire shaping can effectively prevent catheter displacement during catheterization .

Objective To investigate the expression of FHIT gene in the 60Co gamma-ray irradiated human lymphocytoblast(AHH-1) cell and the bystander effect cell,and to explore the function of FHIT gene in the bystander effect of ionizing radiation.Method Preparation of bystander effect cell model:after irradiated with different dose of 60Co gamma-ray(0,2,5 Gy),the directly irradiated AHH-1 ceils were collected immediately by centfifugation and co-cultivated with non-irradiated cells in Transwell.forming the bystander effect group P1.In addition,some culture media supernatant of direcfly irradiated cells were transfefred to the non- irradiated cells culture medium,forming the group P2.Then cells were collected at 0,6,12,and 24 h after irradiation and the total RNA and protein were extracted.RT-PcR and Western blot were performed to determine the FHIT mRNA and protein level.respectively.Flow cytometry assay and cell counting were conducted to detect the alteration of cell cycle and cell proliferation,respectively at 0,24 h after irradiation.Results The mRNA level of FHIT gene among control cells,directly irradiated cells and bystander cells showed no obvious difference. while the FHIT protein level of the directly irradiated ceils and bystander cells was siguificandy down-regulated compared with the control cells(F=102.45,P<0.001).Moreover,the directly irradiated cells and bystander cells showed significant G2 phase arrest and obviously inhibited the proliferation ability.Conclusions 2 and 5 Gy of 60Co γ-ray irradiated AHH-1 cells can result in down regulation of the FHIT protein expression,which suggests that FHIT gene is involved in the process of bvstander effect induced by irradiation.

OBJECTIVETo evaluate the effects of Bisnaphthalimide (C8) on the proliferation and apoptosis of SMMC-7721 cells.

METHODSThe effects of C8 on the proliferation of SMMC-7721 cells were evaluated by MTT. Cell cycle and apoptotic cell percentage were studied by flow cytometry. The protein of Bcl-2 was detected by Western blot. The intra-cellular protein of Bcl-2 was detected by flow cytometry. The proteins of caspase9 and caspase3 were detected by ELISA.

RESULTSC8 inhibited the growth of SMMC-7721 cells. The IC50 of C8 on SMMC-7721 cells was 15 micromol/L. C8 initiated apoptosis of SMMC-7721 cells. After SMMC-7721 cells were exposed to C8 in concentrations of 10, 15, 20 micromol/L, the apoptosis rates were 16.8%, 29.4% and 35.8%, respectively, significantly higher than those of the controls (P less than 0.01). Flow cytometry and Western blot analysis showed that Bcl-2 protein level was inhibited after treatment with C8. The ELISA analysis showed that caspase9 and caspase3 were activated in the SMMC-7721 cells after the C8 treatment.

CONCLUSIONC8 could induce apoptosis of human liver cancer SMMC-7721 cells. C8 might be a potential efficient anticancer drug.