Background Free-flap Epi-LASIK surgery show a fast epithelial healing and mild trauma responses.Its mechanism is notable. Objective The aim of this study was to compare the corneal epithelial healing response following photorefractive keratectomy(PRK)and flap-free Epi-LASIK surgery. Methods Twelve experimental rabbits were randomly assigned to high cutting group(-10.00 D)and low cutting group(-3.00 D),and 2 normal matched rabbits were used as controls.PRK was performed in lateral eyes and flap-free epipolis laser in situkeratomileusis(Epi-LASIK)surgery was curried out in the fellow eyes.The corneal wound healing response in early stage of post-operation was examined under the slim lamp,and the inflammatory cells infiltration in cornea,basic fibroblast growth factor(bFGF)and nuclear transcription factor(NF-KB)expressions in corneal stroma were detected by hematine-eosin staining and immunohistochemstry in the seventh day after operation. Results The inflammatory reaction was milder in the eyes with Epi-LASIK than ones of PRK under the slim lamp.No significant difierences were found in numbers of inflammatory cells in cornea.expressions of bFGF and NF-κB in corneal stroma between two types of surgeries in low cutting group(P＞0.05).In high cutting group,the numbers of inflammatory cells were(12.25±1.22)/400 field in PRK eyes,and those of free-flap Epi-LASIK eyes were(6.67±0.31)/400 field,showing obvious difference between them(t=-8.87,P＜0.01).Expressions of NF-κB(A value)in cornea were 6.11±1.36 and 41.82±8.7 1 in PRK eyes of low cutting group and high cutting group.and those in free-flap Epi-LASIK were 3.01±0.81 and 11.59±4.55.indicating a drastically increase in PRK eyes(P＜0.05).The expressions of bFGF(A value)in corneal stroma were 33.59±6.98 and 123.68±18.81 in PRK eyes and those in free-flap Epi-LASIK eyes were 69.20±8.85 and 123.68±1 8.81 in low cutting group and high cutting group,presenting a considerably decrease in PRK eyes (P＜0.05).The corneal epithelial healing was faster in free-flap Epi-LASIK eyes than that in PRK eyes.and deeper cutting slowed the healing procedure. Conclusion In low cutting group,healing time of corneal epithelium is close between PRK and flap-free Epi-LASIK.But in high cutting group,epithelial healing is faster and inflammatory reaction is lighter in flap-free Epi-LASIK compared with PRK.

Objective To observe the pathological changes of hippocampus and myelin in rats with frontal cereberal ischemia and reperfusion after treated with methylcobalamine and to discuss the mechanism of the cerebral protective effect of methylcobalamine.Methods Cerebral ischemia and reperfusion models were made by clamping bilateral carotid arteries.Forty-five male Wistar rats were randomly allocated to sham-operation group,ischemia-reperfusion group and methylcobalamine group(n=15).1,2,4 weeks after reperfusion the rats in each group were divided into three groups(n=5).The pathological changes of hippocampus and myelin were observed by using light microscope,HE staining,LFB staining and electron microscope.Results The pyramidal neurons in hippocampus in ischemia and reperfusion groups expressed putrescence and myelin necrosis or demyelination at 1st week,and the histomorphological changes at 4th week were significant than that at 2nd week.The followings were observed in electron microscope: dimness,partly solubilization and collapsablity in myelin.The pyramidal neurons in hippocampus of therapy groups were similar to normal one and myelin expressed compaction and shipshape.The changes were more obvious at 4th week.Conclusion Methylcobalamine can obviously decrease the ischemia lesion of hippocampus and myelin and protect the brain function.

[Objective]To compare the effects of continuous femoral nerve block(CFNB) and epidural analgesia(CEA) on rehabilitation after total knee arthroplasty(TKA) surgery. [Methods]Fifty patients undergoing unilateral TKA surgery were randomly divided into group CFNB(n=25) and group CEA(n=25).All patients were received unilateral spinal anesthesia with 0.5% dicaine and given analgesia with 0.2 % ropivacaine with 1ug/ml sufentanil.VAS pain scores during rest and continuous passive movement(CPM) at each time point was recorded.Other parameter such as the angle of initiative flections,blood loss at 6 h post operation,the concentration of serum hemoglobin at 24 h,48 h and side effect were recorded.[Results]The VAS pain scores during test had no significant difference between two groups.The VAS scores of CPM at 24 h and 48 h in group CFNB were obvious lower(3.68?0.93 and 3.93?0.78) than those in group CEA.The initiative flections were similar at 12 and 24 hours after operation.The concentration of hemoglobin at 6 h after operation was lower than that before operation.After reinfusion it was increased but did not reach the level before operation.The incidence of side effects was not noted in both groups.[Conclusion]After TKA surgery,the continuous femoral nerve block can provide better pain relief.No adverse impact on rehabilitation movement of operated legs or blood loss and has less side effect.Therefore,it should be considered an alternative analgesia method after TKA.

Objective:To analyze the pulpal prognosis of replanted permanent teeth in children and to examine the associated factors .Methods:The samples consisted of 67 children with 81 avulsed perma-nent teeth treated in Peking University Hospital of Stomatology from 2000 to 2012 .Their clinical data of the replanted teeth were collected , and the follow-up period was no less than 12 months.The pulpal prognosis was classified as pulp necrosis and pulp non-necrosis .Results: The replantation within 30 minutes after avulsion led to the most significant increase in pulpal healing (P<0.05).The dental pulp of 80% ( 4/5 ) young permanent teeth replanted within 30 minutes remained vital , while all the teeth replanted after 30 minutes developed pulp necrosis within 60 days after replantation .Conclusion: The extra-alveolar period significantly affects the prognosis of pulp in immature permanent teeth after replanta-tion.When the extra-alveolar period is more than 30 minutes, the chance of pulp revascularization after replantation is very low , therefore pulp extirpation should be performed .

Objective:To analyze the prognosis about periodontal ligament healing of replanted perma-nent teeth in children and to examine the associated factors.Methods: The sample consisted of 49 children with 61 avulsed permanent teeth, whose injuries had been managed in the period from 2000 to 2012.The clinical data of replanted teeth were collected, and the follow-up period was no less than 12 months .The factors were analyzed in relation to postoperative outcomes, classified as functional periodon-tal healing ( FH ) , infection-related ( inflammatory ) resorption ( IRR ) and replacement resorption ( RR) .Results:The functional healing rate was 23.0%, while replacement resorption rate was 72.1%. The replacement resorption ( ankylosis ) was usually observed earlier by clinical examination than by radiographic examination.86.0% (40/47) resorptive processes were diagnosed within the first year. Physiological storages, such as milk, saline and saliva were significantly better to periodontal ligament healing than nonphysiological storages, such as tap water and sterilizing solutions ( chloramine and alco-hol) .Functional healing was found significantly more frequent in canines and premolars.Conclusion:The factor significantly affecting periodontal ligament healing is storage medium.Replacement resorption is the most common type of root resorption.The replacement resorption diagnosis must combine the radio-graphic examination with the clinical examination.It is better to follow up more than 1 year after tooth re-plantation.

Objective To study the relationship between serum leptin and thyroid function by investigating the change of serum leptin concentration in children with abnormal thyroid function (hyperthyroidism and hypothyroidism).Methods The levels of serum leptin was determined by radio-immunoassay(RIA) in 20 cases of hyperthyroidism, 17 cases of hypothyroidism, 25 cases of normal controls, respectively .Meanwhile, the serum levels of free triiodothyronine(FT 3), free thyroxine(FT 4) and thyroid-stimulating hormone(TSH) were measured by micro-particle-chemiluminescence immunoassay.Results The levels of serum leptin in hypothyroidism group before treatment was significantly lower than that of normal control groups (P0.05).Conclusions The levels of serum leptin in hypothyroidism markedly descend and no change in the hyperthyroidism. Thyroid hormone can promote the secretion of serum leptin eligibly.

Adult ; Connective Tissue Cells ; Female ; Humans ; Male ; Middle Aged ; Myofibroblasts ; cytology ; Nasal Polyps ; pathology ; Young Adult

Objective To investigate the temporal expression patterns of the related transcription factors and target genes in cardiomyocyte hypertrophy,and provide valuable clues for further researches on cardiomyocyte hypertrophy.Methods Isoproterenol (ISO) was used to induce ventricular myocytes hypertrophy in neonatal mice.The survival rate of cardiomyocyte was detected by CCK-8,and the average diameters and surface areas of cells were measured by computer photograph analysis system.The mRNA and protein expression levels of related genes were respectively measured by RT-PCR and Western blotting.Results The model of cardiomyocyte hypertrophy stimulated by ISO was constructed successfully.The expression levels of GATA4,MEF2C,GATA5,BNP and ANP increased 24 hours after ISO treatment,the expression levels of P300,α-MHC and TBX5 increased 12 hours after ISO treatment,and of SRF and β-MHC mRNA increased 6 hours after ISO treatment (P＜0.05).The expression levels of GATA4,α-MHC,β-MHC,SRF and P300 mRNA increased firstly,and then decreased in cardiomyocytes induced by ISO.The expression levels of GATA4,SRF,α-MHC,β-MHC and P300 mRNA were still higher than normal (P＜0.05),but of MEF2C decreased to normal (P＞0.0S) 72 hours after ISO treatment.The expression levels continuously elevated of GATA5,TBX5,ANP and BNP mRNA than that of controls (P＜0.05),while no fluctuation was found in NKX2.5 mRNA expression (P＞0.05).The expression of GATA4 protein increased,while of HEY2 protein decreased 48 hours after ISO treatment (P＜0.05).Conclusions In hypertrophic cardiomyocytes,the expression pattern of MEF2C is similar to,but the patterns of GATA5,GATA4,TBX5 and SRF are different with that in the development of heart,implying these genes are important during the process from compensatory stage to decompensation stage.The expression patterns of GATA4,MEF2C and SRF are similar to that of acetylase P300,implying the temporal expressions could be regulated by P300 in cardiomyocyte hypertrophy.

Objective To investigate the reason for hidden hemorrhage of hip fracture in elder.Methods All of 94 elder patients,who were diagnosed with intertrochanteric fracture or femoral neck fracture and received treatment in our department from October,2013 to September,2015,were included in this study.The time between injuries to admission was less than 4 hours of the two groups of patients.And the patients whose hemoglobin was less than 100 g/L were removed when admission,in order to avoid the interference of primary anemia.All information,including height,weight,and the value of hemoglobin (Hb) and hematocrit (Hct),were collected.Blood tests were performed immediately after admission,at daily morning preoperatively,and at the morning of the day of surgery.Preoperative blood loss (hidden hemorrhage) was recorded.With respect to blood loss of hidden hemorrhage,statistical analysis was performed at different times (immediate time after admission,and day 1,2,and 3 postoperatively)in the group of intertrochanteric fracture or in the group of femoral neck fracture,and subsequently performed between the two groups.Results The blood loss in the group of intertrochanteric fracture was 196.3 ml,310.1 ml and 418.3 ml in the 1st day,the 2nd day and the third day after admission.There was a significant difference among different time with respect to blood loss.The blood loss was 39.8 ml,65.7 ml and 82.9 ml in the 1st day,the 2nd day and the third day after admission in the group of femoral neck fracture.There was also a significant difference among different time with respect to blood loss.In experimental group,mean blood loss was 418.3 ml and mean Hb decreased by 23.7 g/L at day 3 postoperatively.In control group,mean blood loss was 82.9 ml and mean Hb decreased by 6.7 g/L at day 3 postoperatively.A significant difference was observed between the two groups.The blood loss in patients with intertrochanteric fracture was higher than that in patients with femoral neck fracture.Conclusion The blood loss was gradually increased in elder patients with intertrochanteric fracture over time.There was a significant difference in different time with respect to blood loss.Moreover,a significant difference was found in blood loss of hidden hemorrhage between intertrochanteric fracture and femoral neck fracture.

Objective To assess the reliability and validity of Chinese version National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Subjective Work Assessment Technique (SWAT) in evaluating mental workload of community physicians.Methods One hundred and ten community physicians selected by convenience sampling method from Shanghai were recruited.The split-half reliability,Cronbach's α coefficient and Item-total coefficients were adopted to assess the reliability and the validity of Chinese version NASA-TLX and SWAT scales in evaluating the metal workload of participants.Results For NASA-TLX,the Split-Half,Cronbach's α coefficient was 0.703 and 0.619 respectively,all Item-total coefficients (except for performance item) were greater than 0.4 (P ＜ 0.01).For SWAT,the Split-Half,Cronbach's α coefficient of was 0.647 and 0.669 respectively,Item-total coefficients were all greater than 0.4 (P ＜ 0.01).Factor analysis showed that two scales had good structure validity; item discrimination showed satisfactory item validity (except for performance item).The Spearman correlation coefficients between two scales ranged from 0.359 to 0.465 (P ＜ 0.01).Both of the modified versions of NASA-TLX had better reliability and validity than the original one,the one with removed both performance and frustrate item was better than one with removed performance item only.Conclusions The Chinese version NASA-TLX and SWAT can serve as reliable and valid instruments for assessing the community physicians' perception of mental workload in China; and the modified version of NASA-TLX especially the one with removed performance and frustrate item seems to work better than the original one.